AHRQ's National Nursing Home COVID-19 Coordinating Center

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 3 Attachment E: Nursing Home Key Informant Interview	Form and Instruction	New	Missing upstream
Form 2 Attachment B: Survey instrument - nonparticipant	Form and Instruction	New	Repair queued
Form 1 Attachment B: Survey instrument - participant	Form and Instruction	New	Missing upstream
AHRQ_NHCCC_SSA_02_10_2022.docx	Supporting Statement A	Uploaded 2022-02-28	Repair queued
Attachment_D_Key_Informant_Interview_Information_Sheet_10-15-2021.docx	Supplementary Document	Uploaded 2022-02-23	Repair queued
Attachment_C_Key_Informant_Interview_Recruitment_Materials_10-15-2021.docx	Supplementary Document	Uploaded 2022-02-23	Repair queued
Attachment_A_Invitation Letter_NonParticipant_10-15-2021.docx	Supplementary Document	Uploaded 2022-02-23	Repair queued
AHRQ_NHCCC_SSB_02_10_2022.docx	Supporting Statement B	Uploaded 2022-02-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
251741	Attachment E: Nursing Home Key Informant Interview	Form and Instruction	New
251740	Attachment B: Survey instrument - nonparticipant	Form and Instruction	New
251739	Attachment B: Survey instrument - participant	Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202202-0935-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/AHRQ	Agency Tracking No:
Title: AHRQ's National Nursing Home COVID-19 Coordinating Center
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/01/2022

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	2,314	0
Time Burden (Hours)	688	0
Cost Burden (Dollars)	0	0

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Abstract: As of February 3, 2022, nursing homes have reported 902,964 confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease since 2019 (COVID-19), resulting in over 147,000 COVID-19-related deaths The U.S. Department of Health and Human Services (HHS) has distributed funds to nursing homes and launched several initiatives to improve nursing home safety and infection control. AHRQ’s National Nursing Home COVID-19 Action Network (https://www.ahrq.gov/nursing-home/about/index.html) (the Network) is a cornerstone of HHS’s response, intended to provide training and assistance to nursing homes on best practices to minimize transmission of SARS-CoV-2. The Network expands AHRQ’s programmatic efforts to address quality and safety in long-term care, and aligns with other agency efforts to provide COVID-19 guidance to nursing homes. As the pandemic continues, nursing homes require easy access and implementation support for up-to-date best practices on SARS-CoV-2 infection control, COVID-19 care and management, and safety measures to protect residents and staff. AHRQ’s National Nursing Home COVID-19 Coordinating Center plays a complementary role to the Network, serving as a bridge between AHRQ’s Network initiatives and the nursing home quality improvement (QI) community. The Coordinating Center is tasked with 1) coordinating engagement with scientific and policy stakeholders to identify safety needs and best practices, 2) ensuring coordinated development and dissemination of QI tools and other resources, and 3) assessing the effectiveness of the Network in providing training and mentorship to support nursing homes in responding to the COVID-19 pandemic. As part of the Coordinating Center activities, AHRQ seeks to conduct an assessment of whether and how the Network activities aided the nursing homes’ efforts to mitigate the challenges posed by the COVID-19 pandemic. The goals of the performance assessment are to: 1. assess the reach, retention, and engagement of the Network; 2. study the implementation approach, gaps and barriers; 3. study the long-term impact, sustainability, and replicability of the training program and Network activities.

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Authorizing Statute(s): US Code: 42 USC 299 Name of Law: Agency for Healthcare Research and Quality Act of 1999.
  

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:
	86 FR 69649	12/08/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 11074	02/28/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Attachment B: Survey instrument - nonparticipant	2	Attachment B: Survey instrument - nonparticipant
Attachment B: Survey instrument - participant	1	1,662
Attachment E: Nursing Home Key Informant Interview	3	Attachment E: Nursing Home Key Informant Interview

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	2,314	0	0	2,314	0	0
Annual Time Burden (Hours)	688	0	0	688	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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 is a new information collection request.

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Annual Cost to Federal Government: $810,101

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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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: 03/01/2022

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