SCREENER ROUND, NATIONAL NURSING HOME EXPENDITURE SURVEY, NATIONAL MEDICAL EXPENDITURE SURVEY-PRETEST

ICR 199409-0935-001

OMB: 0935-0094

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0935-0094 199409-0935-001
Historical Active
HHS/AHRQ
SCREENER ROUND, NATIONAL NURSING HOME EXPENDITURE SURVEY, NATIONAL MEDICAL EXPENDITURE SURVEY-PRETEST
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/14/1994
Retrieve Notice of Action (NOA) 09/14/1994
  Inventory as of this Action Requested Previously Approved
07/31/1995 07/31/1995
143 0 0
12 0 0
0 0 0

THIS IS A PRETEST OF THE SCREENER ROUND OF THE NATIONAL NURSING HOME EXPENDITURE SURVEY (NNHES) OF THE NATIONAL MEDICAL EXPENDITURE SURVEY (NMES 3). IT WILL TEST PROCEDURES FOR SCREENING AND RECRUITING FACILITIES ELIGIBLE AS NURSING HOMES.

None
None


No

1
IC Title Form No. Form Name
SCREENER ROUND, NATIONAL NURSING HOME EXPENDITURE SURVEY, NATIONAL MEDICAL EXPENDITURE SURVEY-PRETEST

  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 143 0 0 143 0 0
Annual Time Burden (Hours) 12 0 0 12 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
09/14/1994


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