Justification for Change

Request for Approval of a Non-Substantive Change:

Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-Term Care Providers

OMB No. 0920-0943 Exp. Date: 07/31/2015

January 23, 2013

Lauren Harris-Kojetin

Chief, Long-Term Care Statistics Branch

Division of Health Care Statistics

National Center for Health Statistics

Phone: 301.458.4369

Fax: 301.458.4693

Email: [email protected]

Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-Term Care Providers

A1. Justification Circumstances Making the Collection of Information Necessary

This request is for a nonsubstantive change to an approved project (OMB No. 0920-0943 Exp. Date: 07/31/2015), data collection for the residential care community (RCC) and adult day services center (ADSC) components for the National Study of Long-Term Care Providers (NSLTCP), including the estimated sample size and estimated annual burden. As we did in 2012, the data to be collected from RCCs and ADSCs will include basic characteristics, services offered, staffing, and practices of providers, as well as distributions of the demographics, physical functioning, and cognitive functioning of users (RCC residents and ADSC participants) aggregated to the RCC/ADSC level. The 2014 NSLTCP will be administered by mail, web, and telephone. As we did in 2012, data will be collected from a sample of 11,690 RCCs and a census of 5,000 ADSCs in the 50 states and the District of Columbia.

Changes

• Drop and revise select questionnaire items on RCCs and ADSCs that were fielded in 2012.

• Add questionnaire items on number of hours worked by staff, resident diagnoses, and falls

• Revise NCHS cover letters that will be sent to survey respondents

• Drop three methods experiments

• Add follow-up calls to 1,000 respondents after mailings to provide technical assistance and answer questions.

A comparison of the proposed 2014 questions and the 2012 questions that were fielded is in Attachment A, and the 2014 NSLTCP questionnaire items are in Attachment B. The revised NCHS letters are presented in Attachment C. The questionnaire emailing follow-up is in Attachment D.

A2: Purpose and use of information collection

As with 2012, the data to be collected in 2014 from RCCs and ADSCs will include basic characteristics, services offered, staffing, and a profile of the demographics, physical functioning, and health status of residents/participants aggregated to the RCC/ADSC level.

Our data contractor for the 2012 NSLTCP, RTI International, and NCHS’ QDRL (OMB No. 0920-0222) each conducted rounds of cognitive interviewing using the 2012 NSLTCP questions, and identified problematic questions within each of the questionnaire sections. Based on their recommendations, we are proposing to drop, revise and add items for 2014. We plan to rotate back in some of the dropped items in the 2016 wave. We propose the following changes for 2014, by questionnaire section (unless specified, changes refer to both ADSC and RCC):

Background Information

• Drop items on continuing care communities, number of respite care residents/participants, other sources of funding (ADSC question), organization affiliation, and other type of provider license (ADSC question).

Services Offered

• Drop items on dementia care staffing (RCC questions), case management services, and person-centered care.

• Revise items on depression screening and services.

Staff Profile

• Drop number of full-time equivalents (FTEs) for all staffing categories.

• Add items on number of hours worked by full- and part-time staff.

Resident/Participant Profile

• Drop items on living arrangements (ADSC question), cognitive impairment screening, needing assistance with bed transferring (ADSC only), use of a wheelchair or scooter, hospital readmissions, movement in/out of RCCs and ADSCs, and deaths.

• Add cardiovascular disease and diabetes to diagnoses and an item on falls.

Record Keeping

• Drop capabilities for tracking resident/participant information.

• Add hospital to electronic health information exchange item.

We think these question changes will help increase response rates, minimize missing data, and increase the reliability and validity of NSLTCP. A comparison of the fielded 2012 questions and proposed 2014 questions are in Attachment A. The 2014 questionnaire items are in Attachment B.

A12. Estimates of Annualized Burden Hours and Costs

A. Burden Hours

Table 1 includes the average annual burden for data collection over the three year clearance with our 2014 changes. We learned from the 2012 NSLTCP that on average it took more time to gather records than we thought. However, for 2014 we estimate the burden for each response to the questionnaire will be the same as 2012 (30 minutes), because we shortened the questionnaire and revised problematic questions. In 2014 1,000 ADSC and RCC Directors will receive a follow-up call after the first questionnaire mailing. We expect this call to take on average 10 minutes with a total burden of 167 hours. The new total estimate of annualized burden is 8,936 hours.

Table 1: Estimated Annualized Burden Hours

Type of Respondent	Form Name	Number of Respondents	Number of Responses	Average Burden/ Response (in minutes)	Response Burden (in hours)
RCC Director	RCC Questionnaire	11,701	1	30/60	5,851
ADSC Director	ADSC Questionnaire	5,000	1	30/60	2,500
RCC and ADSC Directors	Data Retrieval	1,670	1	15/60	418
RCC and ADSC Directors	Follow-Up Call	1,000	1	10/60	167
Total	8,936

A15. Explanations for Program Changes or Adjustments

This package was originally approved for 8,769 annualized burden hours for three years, of which 8,769 was indeed utilized for year one. In 2014 1,000 ADSC and RCC Directors will receive a follow-up call after the first questionnaire mailing. We expect this call to take on average 10 minutes with a total burden of 167 hours. The new total estimate of annualized burden is 8,936 hours. Over the remaining two years of burden (representing a balance of 17,538 hours), only one additional wave of data collection is planned, for which 8,936 hours of anticipated burden will be utilized.

B2. Procedures for the Collection of Information

As with the 2012 wave, the 2014 wave includes NCHS letters that will be included in a series of survey mailings. For 2014, we would like to make minor revisions to the letters so that they are shorter, updated, and include a deadline for respondents. We would like to minimize redundant text between the letters, and revise them so they emphasize the 2014 wave of data collection. The proposed letters are in Attachment C.

B3. Methods to Maximize Response Rates and Deal with Nonresponse

In the 2012 wave of NSLTCP, we conducted three methods experiments to maximize response rates; we would like to delete these for the 2014 wave.

In the 2014 wave, we would like to add follow-up calls to 1000 ADSC and RCC cases after the first questionnaire mailing to confirm receipt of the questionnaire, provide technical assistance, and answer any questions. We hypothesize that these calls will maximize our response rates. Attachments

Attachment A-1: Comparison of 2012 and 2014 ADSC Questionnaire Items

Attachment A-2: Comparison of 2012 and 2014 RCC Questionnaire Items

Attachment B-1:  2014 NSLTCP ADSC Questionnaire Items

Attachment B-2:  2014 NSLTCP RCC Questionnaire Items

Attachment C-1:  2014 NSLTCP NCHS Advance Notification Letters

Attachment C-2:  2014 NSLTCP NCHS First Mailing Letters

Attachment C-3:  2014 NSLTCP NCHS Follow-up #1 Letters

Attachment C-4:  2014 NSLTCP NCHS Follow-up #2 Letters

Attachment C-5:  2014 NSLTCP NCHS Thank You Reminder Letters

Attachment C-6:  2014 NSLTCP NCHS Trouble Reaching You Letters

Attachment C-7:  2014 NSLTCP NCHS Chain Packet Letters

Attachment D: Questionnaire Mailing Follow-Up Call

Attachment I: Data Retrieval Call

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