National Nursing Home Expenditure Survey: National Medical Expenditure Survey, Pretest, Rounds 2 and 3

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
112164	National Nursing Home Expenditure Survey: National Medical Expenditure Survey, Pretest, Rounds 2 and 3	Migrated

ICR Details

OMB Control No: 0935-0095	ICR Reference No: 199505-0935-001
Status: Historical Active	Previous ICR Reference No: 199412-0935-001
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: National Nursing Home Expenditure Survey: National Medical Expenditure Survey, Pretest, Rounds 2 and 3
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/18/1995
	Date Received in OIRA: 05/10/1995
Terms of Clearance: Approved for use through 12/95 under the following conditions: 1) NCHS and AHCPR meet with OMB on August 7th to discuss the integration of the 1996 NMES nursing home survey with the 1997 provider-based survey. In preparation for this meeting, PHS staff should prepare a chart that compares question by question the data collected on each of these surveys. Subsequent to this meeting, OMB may request that Round 3 of the NMES nursing home pretest and its CAPI version be amended; and 2) the description of PHS' data consolidation effort included as an amendment to the Pretest Rounds 1-3 and Main Rounds 1-3 of the 1996 Household Survey (FAMES) includes a detailed description of integration plans for nursing home data collections. This description should be available for public comment as part of the FAMES submission pending OMB review and PHS' conference outreach efforts as soon as possible (but no later than July 24, 1995) to allow for preliminary consideration of such comments in the August 7th meeting.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/1995	12/31/1995	11/30/1995
Responses	1	0	0
Time Burden (Hours)	866	0	252
Cost Burden (Dollars)	0	0	0

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Abstract: Nursing home staffs and community respondents will provide data on a sample of facilities and a sample of residents of those facilities. Data will be collected on use of nursing homes, expenditures for care, resident characteristics, and services provided. This survey is a pretest of instruments and procedures for the nursing home component of the 1996 National Medical Expenditure Survey (NMES-3).

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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 Expenditure Survey: National Medical Expenditure Survey, Pretest, Rounds 2 and 3

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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	0	0	1	0	0
Annual Time Burden (Hours)	866	252	0	614	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? Yes Part B of Supporting Statement

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: 05/10/1995

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