Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the Collection of Data Related to the Patient Driven Payment Model and the Skilled Nursing Facility QRP (CMS-10387)
Minimum Data Set 3.0 Nursing
Home and Swing Bed Prospective Payment System (PPS) for the
Collection of Data Related to the Patient Driven Payment Model and
the Skilled Nursing Facility QRP (CMS-10387)
Revision of a currently approved collection
No
Regular
07/17/2025
Requested
Previously Approved
36 Months From Approved
11/30/2025
2,784,397
3,469,183
2,682,974
2,861,351
0
0
The Minimum Data Set (MDS) is a
uniform instrument used in every Medicare/Medicaid certified
nursing home in the United States to assess resident condition. It
was developed in response to the Landmark Institute of Medicine
(IOM) Report on Nursing Home Quality in 1987 where the MDS was seen
as a critical component in efforts to improve the quality of care
in nursing homes. The Omnibus Reconciliation Act of 1987 (OBRA
1987) also set forth new provisions for Medicare and Medicaid
related to new standards for care in the nursing home setting. From
its inception, the MDS was intended to serve several purposes: (1)
Collect data to inform care plans (2) To generate quality
indicators to evaluate nursing homes and guide improvement
interventions (3) To serve as a data source for nursing home
payment systems. Pursuant to sections 4204(b) and 4214(d) of OBRA
1987, the current requirements related to the submission and
retention of resident assessment data are not subject to the
Paperwork Reduction Act (PRA), but it has been determined that
requirements for SNF staff performing, encoding and patient
assessment data necessary administer the payment rate methodology
described in 413.337, are subject to the PRA. The SNF QRP was
established in CMS-1622-F (August 4, 2015; 80 FR 46390) and began
collecting data from SNFs in fiscal year (FY) 2016 using the MDS.
As described in section 1899B (b)(1)(B) of the Social Security Act
(the Act), SNFs are required to submit standardized patient
assessment data with respect to the following categories: •
Functional Status • Cognitive Function • Special Services,
Treatments, and Interventions • Medical Conditions and
Comorbidities • Impairments • Other categories deemed necessary and
appropriate by the Secretary Both the Patient Driven Payment Model
(PDPM) in the SNF PPS and the SNF QRP collect data through the MDS
3.0. The PDPM was described and adopted for SNFs and Swing Beds in
CMS-1696-F (August 8, 2018; 83 FR 39162). This package is a request
for a revision to the current Minimum Data Set (MDS) assessment
instrument for the Skilled Nursing Facility (SNF). This package
represents a request from the Centers for Medicare & Medicaid
Services (CMS) to implement the MDS 3.0 v1.18.11 beginning October
1, 2023 to October 1, 2026 in order to meet the requirements of
policies finalized in the Federal Fiscal Year (FY) 2020 Skilled
Nursing Facility (SNF) Prospective Payment System (PPS) final rule
(CMS-1718-F, RIN 0938-AT75). A PRA package was submitted at the
time of the finalized policies and approved on 11/22/2019, but the
compliance date for the finalized policies (10/01/2020) was delayed
due to the COVID-19 public health emergency (PHE). Please note,
however, the burden was never retracted, and the implementation of
the instrument was simply delayed. While there has been no change
in assessment-level burden since the approval of the MDS 3.0
v1.17.2, there has been a change in total burden since 2019 when
the package was originally approved due to a decrease in the number
of MDS assessments completed and a change in the hourly rate for
clinicians completing the assessment.
PL:
Pub.L. 105 - 33 4432(a) Name of Law: Prospective Payment for
Skilled Nursing Facilities
US Code:
42 USC 1395yy(e) Name of Law: Payment to Skilled Nursing
Facilities for Routine Costs
Since the MDS 3.0 v1.19.1 was
approved, CMS has removed one standardized patient assessment data
element from the discharge assessment for the SNF QRP and removed
MDS items that are not needed for case-mix adjusting the SNF per
diem payment for PDPM but were not accounted for in the FY 2019 SNF
PPS final rule (83 FR 39165 through 39265). We also continue to
monitor the number of SNFs and the number of beneficiaries seeking
SNF services. After an increase in SNF admissions in the years
following the COVID-19 public health emergency, the total number of
SNFs and the number of individuals admitted to SNFs for skilled
services has decreased as represented by the 19.7% decrease in the
total number of assessments reported in this ICR from the previous
ICR. Finally, we also updated the data submission system to the
iQIES for the SNF QRP. This was a replacement of the legacy QIES
ASAP data submission system and imposes no additional requirements
or burden on the part of SNFs. These updates resulted in the
following changes to the current burden estimate: •A decrease of
218 SNFs, with the current number at 15,253. •This ICR estimates
1,589,560 SNF PPS 5-day assessments, a decrease of 158,252
assessments over the last approved package. •This ICR estimates
1,112,822 SNF PPS Discharge assessments, a decrease of 525,119
assessments over the last approved package. •This ICR estimates
82,015 SNF PPS IPA assessments, a decrease of 1,415 assessments
over the last approved package. As a result of these changes (see
Table 6), the total annual hour burden across facilities has
decreased by 178,377 hours (2,861,351 minus 2,682,974), and the
annual cost burden across facilities has decreased by
$12,504,227.70 ($209,755,274.80 minus $197,251,047.10).
$3,319,952
No
No
No
No
No
No
Yes
Denise King 410 786-1013
Denise.King@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.
Form CMS-10387 Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)
CMS-10387 - SupportingStatement.docx
Skilled Nursing Facility (SNF) Minimum Data Set (MDS) 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) Item Sets (NP, NO/SO, NS, NOD, NSD)