Information Collection Request

Developmental Studies to Improve the National Health Care Surveys

ICR 202212-0920-005 · OMB 0920-1030 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Electronic Files Development Form and Instruction New Repair queued
Telephone Protocol Form and Instruction New Repair queued
Contact Info Verification Form and Instruction New Repair queued
DCW Questionnaire Form and Instruction New Repair queued
Form 0920-1030 Advance Package Call Protocol Form and Instruction New Repair queued
Form 0920-1030 Semi Structured Telephone Protocol Form and Instruction New Repair queued
DCW Draft Question List Form and Instruction New Available
Director DCS Sampling Call Form and Instruction New Available
Director Sampling Appointment Setting Call Form and Instruction New Available
DHCS Generic 0920-1030 SS B 12012022.docx Supporting Statement B Uploaded 2022-12-07 Repair queued
DHCS Generic 0920-1030 SS A 12012022_final.docx Supporting Statement A Uploaded 2022-12-07 Repair queued
Att B 60-Day Published FRN 9_30_2022.pdf Supplementary Document Uploaded 2022-12-07 Repair queued
Att A Authorizing Legislation.docx Supplementary Document Uploaded 2022-12-07 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
277471 [NCHS] Frame Development for the Residential Care Component of the National Post-acute and Long-term Care Study Form and Instruction NewElectronic Files Development
277471 [NCHS] Frame Development for the Residential Care Component of the National Post-acute and Long-term Care Study Form and Instruction NewTelephone Protocol
277471 [NCHS] Frame Development for the Residential Care Component of the National Post-acute and Long-term Care Study Form and Instruction NewContact Info Verification
266335 [NCHS] Adding Incentives Experiments to the Direct Care Worker Pilot Study Form and Instruction NewDCW Questionnaire
266335 [NCHS] Adding Incentives Experiments to the Direct Care Worker Pilot Study Instruction New
261147 [NCHS] Sampling Frame Form and Instruction NewAdvance Package Call Protocol
261147 [NCHS] Sampling Frame Form and Instruction NewSemi Structured Telephone Protocol
261147 [NCHS] Sampling Frame Instruction New
260303 [NCHS] Direct Care Worker Pilot Study Form and Instruction NewDCW Draft Question List
260303 [NCHS] Direct Care Worker Pilot Study Form and Instruction NewDirector DCS Sampling Call
260303 [NCHS] Direct Care Worker Pilot Study Form and Instruction NewDirector Sampling Appointment Setting Call

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
02/28/2026 36 Months From Approved 06/30/2023
8,247 0 8,247
9,000 0 9,000
0 0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
[NCHS] Adding Incentives Experiments to the Direct Care Worker Pilot Study n/a
[NCHS] Direct Care Worker Pilot Study n/a, n/a, n/a ,   ,  
[NCHS] Frame Development for the Residential Care Component of the National Post-acute and Long-term Care Study n/a, n/a, n/a ,   ,  
[NCHS] Sampling Frame 0920-1030, 0920-1030 ,  

table that charts list 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 8,247 8,247 0 0 0 0
Annual Time Burden (Hours) 9,000 9,000 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No