Information Collection Request

Hospice Conditions of Participation (CMS-10277)

ICR 201406-0938-002 · OMB 0938-1067 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Hospice PRA 2013 CMS-10277 Supporting_Statement_Part_A 5-7-14 Final - 508 Compliant 06.04.14.pdf Supporting Statement A Uploaded 2014-06-04 Available
IC Document Collections
IC IDCollectionTypeStatusForm
211892 Hospice Conditions of Participation 418.58 Phase 3 New
211891 Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis New
211890 Hospice Condition of Participation 418.58 Phase 2 data entry New
211889 Hospice Conditions of Participation 418.58 Phase 1 New
211888 Hospice Conditions of Participation 418.108(c)(1) New
211887 Hospice Conditions of Participation 418.110(m) New
211886 Hospice Conditions of Participation 418.100(e) New
211885 Hospice Conditions of Participation 418.52(b) New
211884 Hospice Condtions of Participation 418.52(a) New
211883 Hospice Conditions of Participation 418.28 develop revocation form New
211882 Hospice Conditions of Participation 418.24 explain election form New
211881 Hospice Conditions of Participation 418.28 explain revocation form New
211880 Hospice Conditons of Participation 418.24 develop election form New
195470 Hospice Conditions of Participation 418.22(b)(4) Modified
195469 Hospice Condition of Participation (418.22(b)(4) and (b)(5) Modified
195468 Hospice Conditions of Participation 418.22(b)(3) Modified
189585 Hospice Conditions of Participation 418.114 (b) Modified
189584 Hospice Conditions of Participation 418.114 (d) Modified
189583 Hospice Conditions of Participation 418.112(e)(3) Modified
189582 Hospice Conditions of Participation (418.110 (n) new hospice program Modified
189581 Hospice Conditions of Participation 418.110(n) training Modified
189580 Hospice Conditions of Participation 418.106(a) and (e) Modified
189579 Hospice Conditions of Participation 418.78(a)(c)(d) and (e) Modified
189578 Hospice Conditions of Participation 418.76(b)(c) and (d) Modified
189577 Hospice Conditions of Participation 418.56(b) and (c) Modified
189576 Hospice Conditions of Participation (418.52(a)(3) Modified
ICR Details
0938-1067 201406-0938-002
Historical Active 201011-0938-017
HHS/CMS
Hospice Conditions of Participation (CMS-10277)
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 11/24/2014
Retrieve Notice of Action (NOA) 06/23/2014
  Inventory as of this Action Requested Previously Approved
11/30/2017 36 Months From Approved
19,284,489 0 0
3,242,280 0 0
0 0 0

The CoPs and accompanying requirements specified in the regulations are used by Federal or State surveyors as a basis for determining whether a hospice qualifies for approval or re-approval under Medicare. CMS and the healthcare industry believe that the availability to the hospice of the type of records and general content of records, which this regulation specifies, is standard medical practice, and is necessary in order to ensure the well-being and safety of patients and professional treatment accountability.

US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program
   PL: Pub.L. 97 - 248 122 Name of Law: Tax Equity & Fiscal Responsibility Act
   PL: Pub.L. 101 - 239 6005(b) Name of Law: Omnibus Reconciliation Act of 1989
   PL: Pub.L. 105 - 33 Title IV, Chapter 4 Name of Law: BBA of 1997
   PL: Pub.L. 108 - 173 946 Name of Law: Medicare Prescription Drug, Improvement, & Modernization Act of 2003
  
US Code: 42 USC 1395x Name of Law: Hospice Care; Hospice Program

Not associated with rulemaking

  78 FR 71617 11/29/2013
79 FR 31335 06/02/2014
No

26
IC Title Form No. Form Name
Hospice Conditions of Participation 418.100(e)
Hospice Conditions of Participation 418.110(m)
Hospice Conditions of Participation 418.58 Phase 1
Hospice Condition of Participation 418.58 Phase 2 data entry
Hospice Conditions of Participation (418.52(a)(3)
Hospice Conditions of Participation 418.56(b) and (c)
Hospice Conditions of Participation 418.76(b)(c) and (d)
Hospice Conditions of Participation 418.78(a)(c)(d) and (e)
Hospice Conditions of Participation 418.106(a) and (e)
Hospice Conditions of Participation 418.110(n) training
Hospice Conditions of Participation (418.110 (n) new hospice program
Hospice Conditions of Participation 418.112(e)(3)
Hospice Conditions of Participation 418.114 (d)
Hospice Conditions of Participation 418.114 (b)
Hospice Conditions of Participation 418.22(b)(3)
Hospice Condition of Participation (418.22(b)(4) and (b)(5)
Hospice Conditions of Participation 418.22(b)(4)
Hospice Condtions of Participation 418.52(a)
Hospice Conditons of Participation 418.24 develop election form
Hospice Conditions of Participation 418.108(c)(1)
Hospice Conditions of Participation 418.58 Phase 2 aggregate/data analysis
Hospice Conditions of Participation 418.58 Phase 3
Hospice Conditions of Participation 418.28 explain revocation form
Hospice Conditions of Participation 418.24 explain election form
Hospice Conditions of Participation 418.28 develop revocation form
Hospice Conditions of Participation 418.52(b)

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 19,284,489 0 0 17,061,295 0 2,223,194
Annual Time Burden (Hours) 3,242,280 0 0 1,882,066 0 1,360,214
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The 1,907,624 hour increase is due to three main factors. First, the number of Medicare-certified hospices has increased by 36 percent, from 2,872 to 3,897. Second, the number of patients receiving hospice services has increased by 77 percent, from 869,201 to 1,535,919. Third, the burden hours previously accounted for in OMB control number 0938-0302 have been updated and moved into this package in order to consolidate all hospice PRA burdens into a single package.

$0
No
No
Yes
No
No
Uncollected
Denise King 410 786-1013 [email protected]

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
06/23/2014