(CMS-359/360) Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms
Reinstatement with change of a previously approved collection
No
Regular
09/11/2020
Requested
Previously Approved
36 Months From Approved
18
0
76
0
0
0
In order to participate in the Medicare program as a CORF, providers must meet federal conditions of participation. The certification form is needed to determine if providers meet at least preliminary requirements. The survey form is used to record provider compliance with the individual conditions and report findings to CMS.
US Code:
42 USC 485.50
Name of Law: Conditions of Participation: CORF
In this PRA package we have recalculated the burden based on the existing number of new CORFs per year and the estimated number of CORFs that are surveyed per year. This has result in an increase in the cost burden of $2,057.14 and a decrease in burden hours of 46.5 hours.
These changes in the burden is attributable to several factors. First, we determined that there are currently 49 CORFs. The CORFs are surveyed every 6 years, so on average, 8 CORFs are surveyed each year. Also, according to our statistics, there are 10 new CORFs each year.
In the previous PRA package submission, it was stated that there were 40 annual responses for the form CMS-360. We believe that this estimate was too high because it would be the total number of CORFs existing at the time.
The form CMS-360 is completed by a surveyor during the survey of a CORF that occurs only every 6 years. As these surveys occurs only every 6 years, the accrediting organizations (AOs) or the state survey agencies (SAs) cannot possibly survey all of the existing CORFs in the same year. Due to the limitation on their resources, they would divide the CORFs up and only do a certain number of surveys per year. We believe and assume for the sake of the burden calculations that the AO or SA would survey 1/6th of all CORFs each year. Therefore, if there are currently 49 CORFs, only 8 CORFs would be surveyed per year (49 divided by 6 = 8.18).
Second, we increased the estimated time burden for the CMS-359 form from 15 minutes to 30 minutes because we did not believe that 15 minutes is an adequate amount of time to read the instructions and gather the information required to complete the form. We also added a 30 minute time burden for the time required for an administrative staff person to copy and mail this form to the SA. This burden was not accounted for in the prior burden estimate.
We also increased the estimated time required to complete the CMS-360 report from 3 hours to 8 hours, because we believe that this burden was significantly underestimated in the prior burden estimate. The CMS-360 report is a survey report, and is based on the
12
survey activities performed by the surveyor. The survey for a CORF takes approximately one day to complete. It would not be possible for a surveyor to complete the CMS-360 report in only 3 hours, if it takes the surveyor 8 hours to complete the survey. We also added a 15 minute time burden for an administrative staff person to copy, or scan and email the completed CMS-360 survey report to the appropriate CMS Location. This burden was not accounted for in the prior burden estimate, yet is a burden that is associated with the completion of the CMS-360 survey report.
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.
Form CMS-360 Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...
Supporting Statement A for CMS 359 CMS 360. 6.04.20.docx
Comprehensive Outpatient Rehabilitation Facility (CORF) Eligibility and Survey Forms and Information Collection Requirements in 42 CFR 485.56, 485.58, 485.60, 485.64...