RCC Provider Questionnaire

[NCHS] Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Post-acute and Long-term Care Study

Documents and Forms

Document Name Document Type
RCC Provider Questionnaire Form and Instruction
2024 Residential Care Community Questionnaire Att C-1 RCC questionnaire 0524.docx Form and Instruction
0920-25-0097 0920-0943 NPALS_RCC_Final_Updated 0920-0943 NPALS_RCC_Final_Updated.pdf Form

Information Collection (IC) Details

IC Title:	RCC Provider Questionnaire	Agency IC Tracking Number:	0920-25-0097

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 and Instruction	None	2024 Residential Care Community Questionnaire	Att C-1 RCC questionnaire 0524.docx		Yes	Yes	Fillable Fileable
Form	0920-25-0097	0920-0943 NPALS_RCC_Final_Updated	0920-0943 NPALS_RCC_Final_Updated.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: Health Resources Utilization Statistics	FR Citation: 49 FR 37697

Number of Respondents: 5,800	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 50 %

	Requested	Previously Approved
Annual Number of Responses for this IC	5,800	5,800
Annual IC Time Burden (Hours)	2,900	2,900
Annual IC Cost Burden (Dollars)	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.