NATIONAL NURSING HOME SURVEY

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
111092	NATIONAL NURSING HOME SURVEY	Migrated

ICR Details

OMB Control No: 0920-0353	ICR Reference No: 199407-0920-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: NATIONAL NURSING HOME SURVEY
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/25/1994
	Date Received in OIRA: 07/26/1994
Terms of Clearance: The survey instrument is approved for use through 9/97. OMB postpones action on NCHS' request for $75 remuneration for the Expense Question- naire until NCHS provides more information regarding how its survey plan will allow for determination of the cost effectiveness of such remuneration. OMB believes that the cost effectiveness of such payment should be ascertained earlier in the survey process so that remuneration is not wasted for the entire survey effort. Also, NCHS has not explained the basis for its anticipated 80% response rate with remuneration. The remuneration analysis should be provided to OMB prior to fielding the instrument, in that the survey plan and samp for this effort may have to be adjusted to accommodate the remuneratio test. Finally, OMB is not compelled by NCHS' arguments that other projects, such as the Medicare Beneficiary Survey, cannot provide sufficient,timely data for nursing home services. Any future submissi for OMB review further should describe: 1) why resident-specific information from the Medicare Beneficiary Survey is inadequate for research purposes for this particular population; and 2) how NCHS coul "benchmark" data from this effort against the Medicare Beneficiary Survey over time.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1997	09/30/1997
Responses	1,500	0	0
Time Burden (Hours)	4,250	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: THE NNHS SYSTEM PROVIDES NATIONAL BASELINE AND TREND DATA ON NURSING HOMES, THE COST INCURRED BY THE FACILITY IN PROVIDING CARE, AND THEIR RESIDENTS. THE NNHS IS DESIGNED TO SATISFY THE DATA NEEDS OF THOSE WH ESTABLISH STANDARDS FOR PLANNING, PROVIDING, AND ASSESSING LONG-TERM CARE SERVICES.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
NATIONAL NURSING HOME SURVEY

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ICR Summary of Burden

	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	1,500	0	0	1,500	0	0
Annual Time Burden (Hours)	4,250	0	0	4,250	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/26/1994

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