Computerized Automated Personal Interviewing (CAPI) Conversion of the Medicare Current Beneficiary Survey (MCBS) Facility Questionnaire (CAPI Conversion of MCBS Facility Questionnaire)
ICR 199702-0938-006
OMB: 0938-0568
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0938-0568 can be found here:
Computerized Automated
Personal Interviewing (CAPI) Conversion of the Medicare Current
Beneficiary Survey (MCBS) Facility Questionnaire (CAPI Conversion
of MCBS Facility Questionnaire)
The MCBS
Facility quesionnaire and CAPI conversion are approved for use
through 9/98 under the following conditions: 1) HCFA understands
that this clearance action does not apply to other MCBS components,
including the MCBS supplement recently approved through 8/97 on an
emergency basis; 2) the next submission for review under this OMB
number 0938-0568 contains all components of the MCBS currently
fielded; 3) HCFA immediately incorporates the new dislosure
statements mandated by the Paperwork Reduction Act of 1995. For the
public record, HCFA submits to OMB the revised forms/instructions;
4) prior to the next submission, HCFA, NCHS, and AHCPR brief OMB on
continuing departmental efforts to inte- grate nursing home
surveys; and 5) prior to fielding this CAPI instrument, HCFA
clarifies which issues referenced in the WESTAT memos dated 6/19/96
and 6/6/96 are resolved or remain unresolved pending future
negotiations and refinements. In response to these clarifications,
OMB may request additional amendments to this instrument.
Inventory as of this Action
Requested
Previously Approved
09/30/1998
09/30/1998
08/31/1997
1,900
0
16,000
16,000
0
16,000
0
0
0
Adaptation of the MCBS can be broken
down into two separate parts: (A) conversion of the facility
interview from a hard-copy questionnaire to a CAPI format beginning
in May, 1997. CAPI, which the MCBS currently employs in the
community interview, increases the accuracy of the interview
process by automating skip patterns, customizing questions,
creating computed variables such as a time line of residence
history, and automatically checking completeness and consistency of
responses. (B) Modification to some of the questions that are
currently used in the facility interview to make them more
comparable.....
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.
Computerized Automated Personal Interviewing (CAPI) Conversion of the Medicare Current Beneficiary Survey (MCBS) Facility Questionnaire (CAPI Conversion of MCBS Facility Questionnaire)