Data Retrieval Telephone Call

Attachment H: Data Retrieval Telephone Call

Form Approved

OMB No. 0920-0943

Exp. Date xx/xx/20xx

NOTICE – Public reporting burden of this collection of information is estimated to average 5 minutes per response. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0943).

Assurance of Confidentiality – All information which would permit identification of an individual, a practice, or an establishment will be held confidential, will be used for statistical purposes only by NCHS staff, contractors, and agents only when required and with necessary controls, and will not be disclosed or released to other persons without the consent of the individual or establishment in accordance with section 308(d) of the Public Health Service Act (42 USC 242m) and the Confidential Information Protection and Statistical Efficiency Act (PL-107-347).

There will be data retrieval calls to RCC and ADSC directors when after receiving the submitted hardcopy mail questionnaires there is missing information for critical items, such as average daily attendance (ADSC only), number of licensed beds (RCC only), and current enrollment/residents.

In terms of respondent burden, we have assumed that the respondent will spend on average 5 minutes on the phone during the retrieval call, and that no more than 5% of cases will require retrieval.