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Federal forms, ICRs, and supporting documents

Information Collection Request

FEASIBILITY OF SURVEYING HOSPICES AND HOME HEALTH AGENCIES (CONCEPT CLEARANCE)

ICR 198807-0920-001 · OMB 0920-0236 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
110936 FEASIBILITY OF SURVEYING HOSPICES AND HOME HEALTH AGENCIES (CONCEPT CLEARANCE) Migrated
ICR Details
0920-0236 198807-0920-001
Historical Active
HHS/CDC
FEASIBILITY OF SURVEYING HOSPICES AND HOME HEALTH AGENCIES (CONCEPT CLEARANCE)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 09/27/1988
Retrieve Notice of Action (NOA) 07/21/1988
  Inventory as of this Action Requested Previously Approved
01/31/1990 01/31/1990
1 0 0
1 0 0
0 0 0
THE PURPOSE OF THIS PROJECT IS TO DEVELOP AND FIELD TEST DATA SETS, DATA COLLECTION PROCEDURES AND INSTRUMENTS FOR OBTAINING INFORMATION ABOUT HOME HEALTH AGENCIES AND HOSPICES AND ABOUT THEIR CLIENTS. THE DATA ARE NEEDED BY THE LONG-TERM CARE COMMUNITY TO ASSIST IN SETTING STANDARDS, PLANNING AND ASSESSING THE NEED FOR LONG-TERM CARE SERVICES
None
None
No
1
IC Title Form No. Form Name
FEASIBILITY OF SURVEYING HOSPICES AND HOME HEALTH AGENCIES (CONCEPT CLEARANCE)
  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 1 0 0 1 0 0
Annual Time Burden (Hours) 1 0 0 1 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
07/21/1988