[Federal Register Volume 81, Number 1 (Monday, January 4, 2016)]
[Notices]
[Pages 92-93]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-32965]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier: CMS-359/360]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services.

ACTION: Notice.

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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

[[Page 93]]

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 minimize the information collection 
burden.

DATES: Comments must be received by March 4, 2016.

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-359/360 Comprehensive Outpatient Rehabilitation Facility (CORF) 
Eligibility and Survey Forms 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.
    1. Type of Information Collection Request: Extension of a currently 
approved information collection; Title of Information Collection: 
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and 
Survey Forms and Supporting Regulations; Use: The form CMS-359 is used 
as the application for health care providers seeking to participate in 
the Medicare program as a Comprehensive Outpatient Rehabilitation 
Facility (CORF). This form initiates the process for facilities to 
become certified as a CORF and it provides the CMS Regional Office 
State Survey Agency staff identifying information regarding the 
applicant that is stored in the Automated Survey Processing Environment 
(ASPEN) system.
    The form CMS-360 is a survey tool used by the State Survey Agencies 
to record information in order to determine a provider's compliance 
with the CORF Conditions of Participation (CoPs) and to report this 
information to the Federal government. The form includes basic 
information on the CoP requirements, check boxes to indicate the level 
of compliance, and a section for recording notes. We have the 
responsibility and authority for certification decisions which are 
based on provider compliance with the CoPs and this form supports this 
process. Form Number: CMS-359/360 (OMB Control Number: 0938-0267); 
Frequency: Occasionally; Affected Public: Private Sector (Business or 
other for-profits); Number of Respondents: 50; Number of Responses: 50; 
Total Annual Hours: 123.

(For questions regarding this collection contact James Cowher (410) 
786-1948.)


    Dated: December 28, 2015.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office of Strategic Operations and 
Regulatory Affairs.
[FR Doc. 2015-32965 Filed 12-31-15; 8:45 am]
 BILLING CODE 4120-01-P