OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

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

OMB 0920-0943 ยท HHS/CDC.

OMB 0920-0943

This request is for a Reinstatement with change of OMB Control Number 0920-0943 - Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-term Care Providers. The goal of this study is to collect data for the residential care community (RCC) and adult day services center (ADSC) survey components of the 4th National Study of Long-Term Care Providers (NSLTCP). The data to be collected will include the basic characteristics, services, staffing, and practices of RCCs and ADSCs, and the demographics, selected health conditions and health care utilization, physical functioning, and cognitive functioning of RCC residents and ADSC participants. This reinstatement involves minor changes to the instruments including addition of COVID-19 questions. The number of respondents and the burden have increased as well.

The latest form for [NCHS] Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Post-acute and Long-term Care Study expires 2023-09-30 and is listed under ICR 202007-0920-018.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-25-0097 0920-0943 NPALS_ADSC_Final_UpdatedForm
2024 Adult Day Services Center QuestionnaireForm and Instruction
ADSC Provider QuestionnaireForm and Instruction
Form 0920-25-0097 0920-0943 NPALS_RCC_Final_UpdatedForm
2024 Residential Care Community QuestionnaireForm and Instruction
RCC Provider QuestionnaireForm and Instruction
Change Request Memo - EO14168 - 0920-0943 (NPALS).docxJustification for No Material/Nonsubstantive Change
Change Request Memo - EO14168 - 0920-0943 (NPALS).docx Justification for No Material/Nonsubstantive Change
Att H Human Subjects ERB Letter.docxSupplementary Document
Att H Human Subjects ERB Letter.docx Supplementary Document
Att G Prompting letters and emails.docxSupplementary Document
Att G Prompting letters and emails.docx Supplementary Document
Att F-4 Questionnaire packet NCHS Strictly Confidential Brochure.docxSupplementary Document
Att F-3 Questionnaire packet Letters of Support.docxSupplementary Document
Att F-3 Questionnaire packet Letters of Support.docx Supplementary Document
Att F-2 Questionnaire packet NCHS Data Briefs.docxSupplementary Document
Att F-1 Questionnaire packet NCHS Cover Letter with FAQs 0524_final.docxSupplementary Document
Att E Advance Notification Letter.docxSupplementary Document
Att E Advance Notification Letter.docx Supplementary Document
2024 NPALS SS B 070824_final.docxSupporting Statement B
Att D-2 ADSC Question Changes 0524.xlsxSupplementary Document
Att D-2 ADSC Question Changes 0524.xlsx Supplementary Document
Att D-1 RCC Question Changes 0524.xlsxSupplementary Document
Att D-1 RCC Question Changes 0524.xlsx Supplementary Document
Att B Federal Register Notice.pdfSupplementary Document
Att A Public Health Service Act (306ab and 308d).docxSupplementary Document
Att A Public Health Service Act (306ab and 308d).docx Supplementary Document
2024 NPALS SS A 070824_final.docxSupporting Statement A
2024 NPALS SS A 070824_final.docxSupporting Statement A
Data Retrieval Call Other-Info Sheet
ADSC Provider Questionnaire Form
ADSC Provider Questionnaire Form and Instruction
ADSC Provider Questionnaire Form and Instruction
RCC Provider Questionnaire Form
RCC Provider Questionnaire Form and Instruction
RCC Provider Questionnaire Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202504-0920-018 No material or nonsubstantive change to a currently approved collection 2025-05-01
202407-0920-006 Revision of a currently approved collection 2024-07-31
202205-0920-006 Revision of a currently approved collection 2022-06-08 Approved without change
202007-0920-018 Reinstatement with change of a previously approved collection 2020-07-28 Approved without change
201803-0920-001 Revision of a currently approved collection 2018-04-11 Approved without change
201604-0920-007 Reinstatement without change of a previously approved collection 2016-04-27 Approved without change
201402-0920-003 No material or nonsubstantive change to a currently approved collection 2014-02-04 Approved without change
201206-0920-004 New collection (Request for a new OMB Control Number) 2012-06-20 Approved with change

OMB Details

RCC/ADSC Contact Confirmation Call Script

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-0943RCC/ADSC Contact Confirmation Call ScriptNAForm

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.