IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program (CMS-10036)

ICR 202505-0938-002

OMB: 0938-0842

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Supporting Statement A
2025-05-07
Supplementary Document
2025-05-07
IC Document Collections
ICR Details
0938-0842 202505-0938-002
Received in OIRA 202408-0938-015
HHS/CMS CCSQ
IRF-PAI for the collection of data pertaining to the Inpatient Rehabilitation Facility Prospective Payment System and Quality Reporting Program (CMS-10036)
Revision of a currently approved collection   No
Regular 05/07/2025
  Requested Previously Approved
36 Months From Approved 10/31/2027
622,300 571,151
1,179,256 1,194,814
0 0

The Centers for Medicare & Medicaid Services (CMS) is requesting approval of revisions to the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI) Version 4.1 that will be effective on October 1, 2024. On April 7, 2023 the Centers for Medicare & Medicaid Services (CMS) issued a notice of proposed rulemaking (NPRM) (88 FR 20950) which proposes modifications to the collection of quality reporting data in the Inpatient Rehabilitation Facility Quality Reporting Program (IRF QRP). Specifically, CMS proposes to adopt two new measures and remove three measures from the IRF QRP. Per the NPRM, CMS proposes to require IRFs to start collecting assessment data using the IRF-PAI Version 4.2 for IRF patients beginning October 1, 2024.

US Code: 42 USC 1395ww(jX2)(d) Name of Law: Prospective Payment for Inpatient Rehab Services
   PL: Pub.L. 105 - 1 4421 Name of Law: Prospective Payment for Inpatient Rehab Hospital Services
   PL: Pub.L. 111 - 148 3004 Name of Law: Quality Reporting for Long-Term Care Hospitals, etc.
  
None

0938-AV48 Proposed rulemaking 90 FR 18534 04/30/2025

No

1
IC Title Form No. Form Name
Inpatient Rehabilitation Facility - Patient Assessment Instrument CMS-10036, CMS-10036 IRF- PAI version 4.2 ,   IRF- PAI version 4.4

  Total Request 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 622,300 571,151 0 51,149 0 0
Annual Time Burden (Hours) 1,179,256 1,194,814 0 -15,558 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Burden has decreased due to the removal of five items from the IRF-PAI version 4.4 which include, O0350. Patient’s COVID-19 vaccination is up to date, R0310. Living Situation, R0320A. and R0320B. Food, and • R0330. Utilities. CMS We estimates a decrease in the amount of time it will take to complete a single IRF PAI Version 4.4 as compared to the previously approved package.

$3,319,952
No
    Yes
    Yes
Yes
No
No
No
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov

  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.
05/07/2025


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