Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration

Forms and Documents

Document Name	Status
CMS-10240 nhvbp-pra.doc Supporting Statement B	2007-10-11
Response to Comments.doc Supplementary Document	2007-10-11
CMS-10240 Summary of Changes to Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration).doc Supplementary Document	2007-10-11
CMS-10240 nhvbp-paperburden.xls Supplementary Document	2007-10-11
CMS-10240 nhvbp-pra.doc Supporting Statement A	2007-10-11

IC Document Collections

IC ID	Document Title	Status
182817	Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: ONGOING DATA (CMS-10240) Other-Application, Survey, Data collection Form, Statistical Met	New
182816	Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: BASELINE DATA Other-Application, Survey, Data Collection Form and Statistical	New

ICR Details

OMB Control No: 0938-1039	ICR Reference No: 200711-0938-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration
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: 03/25/2008
	Date Received in OIRA: 11/20/2007
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2011	36 Months From Approved
Responses	2,000	0	0
Time Burden (Hours)	49,170	0	0
Cost Burden (Dollars)	400,000	0	0

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Abstract: The NHVBP Demonstration is a CMS "pay-for-performance" initiative to improve the quality of care furnished to Medicare beneficiaries residing in nursing homes. Under this three-year demonstration project, CMS will assess the performance of nursing homes based on selected quality measures, and then make additional payments to those nursing homes that achieve a higher performance based on those measures. In the first year of the demonstration, quality will be assessed based on the following four domains: staffing, appropriate hospitalizations, outcome measures from the minimum data set (MDS), and survey deficiencies. Additional quality measures may be added in the second and third years of the demonstration as deemed appropriate. The main purpose of the NHVBP data collection effort is to gather information that will enable CMS to determine which nursing homes will be eligible to receive incentive payments under the NHVBP Demonstration. All measures included in the MDS outcomes, survey deficiency, and appropriate hospitalization domains can be calculated from existing secondary data sources, such as the MDS, annual nursing home certification surveys, and Medicare claims data. However, for the staffing domain, no satisfactory alternative source for these data has been identified. Therefore, CMS will collect payroll-based staffing and resident census information to help assess the quality of care in participating nursing homes. CMS will additionally collect data on two measures, staff immunization status and use of resident care experience surveys, which may be included in the payment determination during the second and third years of the demonstration.

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Authorizing Statute(s): US Code: 42 USC 1395b-1(a)(1)(A) Name of Law: null
   US Code: 42 USC 1395b-1(b) Name of Law: null
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 39812	07/20/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 58096	10/12/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: BASELINE DATA
Data Collection for the Nursing Home Value-Based Purchasing (NHVBP) Demonstration: ONGOING DATA (CMS-10240)

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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	2,000	0	0	2,000	0	0
Annual Time Burden (Hours)	49,170	0	0	49,170	0	0
Annual Cost Burden (Dollars)	400,000	0	0	400,000	0	0

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

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This change results in an increase in burden. The objective of the demonstration is to assess the quality of care furnished to Medicare beneficiaries by participating nursing homes, then reward the nursing homes that achieve higher quality of care. To the extent possible, CMS has identified existing secondary data sources for computing quality performance. However, there are no existing secondary sources available which meet the data needs of the NHVBP demonstration with respect to staffing measures, staff influenza immunization rates, or use of resident experience of care surveys. Therefore, these data must be collected from the participating nursing homes.

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Annual Cost to Federal Government: $80,000

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: 11/20/2007

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