[Federal Register Volume 80, Number 172 (Friday, September 4, 2015)]
[Notices]
[Pages 53516-53517]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-22033]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifiers: CMS-1728-94 and CMS-2567]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Centers for Medicare & Medicaid Services (CMS) is 
announcing an opportunity for the public to comment on CMS' intention 
to collect information from the public. Under the Paperwork Reduction 
Act of 1995 (the PRA), federal agencies are required to publish notice 
in the Federal Register concerning each proposed collection of 
information (including each proposed extension or reinstatement of an 
existing collection of information) and to allow 60 days for public 
comment on the proposed action. Interested persons are invited to send 
comments regarding our burden estimates or any other aspect of this 
collection of information, including any of the following subjects: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of the agency's functions; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (4) the use of 
automated collection techniques or other forms of information 
technology to

[[Page 53517]]

minimize the information collection burden.

DATES: Comments must be received by November 3, 2015.

ADDRESSES: When commenting, please reference the document identifier or 
OMB control number. To be assured consideration, comments and 
recommendations must be submitted in any one of the following ways:
    1. Electronically. You may send your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) that are accepting comments.
    2. By regular mail. You may mail written comments to the following 
address: CMS, Office of Strategic Operations and Regulatory Affairs, 
Division of Regulations Development, Attention: Document Identifier/OMB 
Control Number ____, Room C4-26-05, 7500 Security Boulevard, Baltimore, 
Maryland 21244-1850.
    To obtain copies of a supporting statement and any related forms 
for the proposed collection(s) summarized in this notice, you may make 
your request using one of following:
    1. Access CMS' Web site address at http://www.cms.hhs.gov/PaperworkReductionActof1995.
    2. Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to [email protected].
    3. Call the Reports Clearance Office at (410) 786-1326.

FOR FURTHER INFORMATION CONTACT: Reports Clearance Office at (410) 786-
1326.

SUPPLEMENTARY INFORMATION: 

Contents

    This notice sets out a summary of the use and burden associated 
with the following information collections. More detailed information 
can be found in each collection's supporting statement and associated 
materials (see ADDRESSES).

CMS-10387 Skilled Nursing Facility (SNF) Prospective Payment System and 
Consolidated Billing
CMS-2567 Statement of Deficiencies and Plan of Correction and 
Supporting Regulations

    Under the PRA (44 U.S.C. 3501-3520), federal agencies must obtain 
approval from the Office of Management and Budget (OMB) for each 
collection of information they conduct or sponsor. The term 
``collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 
1320.3(c) and includes agency requests or requirements that members of 
the public submit reports, keep records, or provide information to a 
third party. Section 3506(c)(2)(A) of the PRA requires federal agencies 
to publish a 60-day notice in the Federal Register concerning each 
proposed collection of information, including each proposed extension 
or reinstatement of an existing collection of information, before 
submitting the collection to OMB for approval. To comply with this 
requirement, CMS is publishing this notice.

Information Collection

    1. Type of Information Collection Request: Revision of a currently 
approved collection; Title of Information Collection: Home Health 
Agency Cost Report; Use: Providers of Services participating in the 
Medicare program are required under sections 1815(a), 1833(e) and 
1861(v)(1)(A) of the Social Security Act (42 U.S.C. 1395g) to submit 
annual information to achieve settlement of costs for health care 
services rendered to Medicare beneficiaries. In addition, regulations 
at 42 CFR 413.20 and 413.24 require adequate cost data and cost reports 
from providers on an annual basis. The Form CMS-1728-94 cost report is 
needed to determine a provider's reasonable cost incurred in furnishing 
medical services to Medicare beneficiaries and reimbursement due to or 
from a provider. Form Number: CMS-1728-94 (OMB control number: 0938-
0022); Frequency: Annually; Affected Public: Private sector (Business 
or other for-profits and Not-for-profit institutions); Number of 
Respondents: 11,352; Total Annual Responses: 11,352; Total Annual 
Hours: 2,576,904. (For policy questions regarding this collection 
contact Angela DiGorgio at 410-786-4516.)
    2. Type of Information Collection Request: Extension without change 
of a currently approved collection; Title of Information Collection: 
Statement of Deficiencies and Plan of Correction Supporting 
Regulations; Use: Section 1864(a) of the Social Security Act requires 
that the Secretary use state survey agencies to conduct surveys to 
determine whether health care facilities meet Medicare and Clinical 
Laboratory Improvement Amendments participation requirements. The Form 
CMS-2567 is the means by which the survey findings are documented. This 
section of the law further requires that compliance findings resulting 
from these surveys be made available to the public within 90 days of 
such surveys. The Form CMS-2567 is the vehicle for this disclosure. The 
form is also used by health care facilities to document their plan of 
correction and by CMS, the states, facilities, purchasers, consumers, 
advocacy groups, and the public as a source of information about 
quality of care and facility compliance. The regulations at 42 CFR 
488.18 require that state survey agencies document all deficiency 
findings on a statement of deficiencies and plan of correction, which 
is the CMS-2567. Sections 488.26 and 488.28 further delineate how 
compliance findings must be recorded and that CMS prescribed forms must 
be used. Form Number: CMS-2567 (OMB Control Number: 0938-0391); 
Frequency: Yearly and occasionally; Affected Public: Private Sector 
(Business or other for-profit and Not-for-profit institutions); Number 
of Respondents: 64,500; Total Annual Responses: 64,500; Total Annual 
Hours: 128,083. (For policy questions regarding this collection contact 
Sharon Lash at 410-786-9457.)

    Dated: September 1, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-22033 Filed 9-3-15; 8:45 am]
BILLING CODE 4120-01-P