Reform of Requirements for Long-Term Care Facilities (CMS-10573)

OMB 0938-1363

Long term care facilities are required to maintain certain documentation within their own agency records that demonstrates compliance with specific requirements for participation in the Medicare and Medicaid programs. This documentation is maintained on-site for use in the long term care facility survey process.

The latest form for Reform of Requirements for Long-Term Care Facilities (CMS-10573) expires 2022-06-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
CMS-10573 response to comments 06.26.2024.docx Supplementary Document
CMS-10573 Supporting Statement (Updates for CMS-3442-F) 07.22.2024 clean.docx Supporting Statement A
483.71(b)
483.35(b)
483.80(h)
483.80(g)
483.80(d)(3)(vi) & (vii)
483.80(d)(3)(iv)
483.80(d)(3)(ii) & (iii)
483.80(d)(3).
483.85(e)
483.80(a)
483.71
483.60(c)(4)
483.25(n)(2)
483.21(c)
483.21(b)(2)(ii)
483.21(a)
483.15(c)(4)
485.10(g)(17)
483.10(c)(2)
483.75(a)

All Historical Document Collections

202407-0938-017 Approved without change	Revision of a currently approved collection	2024-07-25
202407-0938-014 Withdrawn and continue	Revision of a currently approved collection	2024-07-25
202206-0938-011 Approved with change	Revision of a currently approved collection	2022-06-09
201901-0938-005 Approved without change	Existing collection in use without an OMB Control Number	2019-06-14

OMB Details

483.75(a)

Federal Enterprise Architecture: Health - Health Care Services