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2016 Residential Care Community Questions-Version B
Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-term Care Providers
OMB: 0920-0943
IC ID: 202804
OMB.report
HHS/CDC
OMB 0920-0943
ICR 201604-0920-007
IC 202804
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0943 can be found here:
2024-07-31 - Revision of a currently approved collection
2022-06-08 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
2016 Residential Care Community Questions-Version B
Form
National Study of Long Term Care Provider --2016 Residen
Att D-2 _2016 RCC Questions-Version B_031816.docx
Form
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
2016 Residential Care Community Questions-Version B
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form
NONE
National Study of Long Term Care Provider --2016 Residential Care Community Questions-Version B
Att D-2 _2016 RCC Questions-Version B_031816.docx
Yes
Yes
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
Health Resources Utilization Statistics
FR Citation:
49 FR 37697
Number of Respondents:
2,923
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
15 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
2,923
0
2,923
0
0
0
Annual IC Time Burden (Hours)
1,462
0
1,462
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.