Information Collection Request

Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-term Care Providers

ICR 201206-0920-004 · OMB 0920-0943 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Data Retrieval Telephone Call Questionnaire Form New Repair queued
Adult Day Services Center Questionnaire Form New Repair queued
Residential Care Community Questionnaire Form New Available
NSLTCP DC Supp State Part B 5-8.doc Supporting Statement B Uploaded 2012-06-11 Available
Attachment H-Chain outreach package 5-8.pdf Supplementary Document Uploaded 2012-06-13 Available
Attachment G-Base Resp Contact Materials 5-8.pdf Supplementary Document Uploaded 2012-06-13 Available
Attachment M -Exp 3 Resp Contact Materials 5-8.doc Supplementary Document Uploaded 2012-06-11 Available
Attachment L -Exp 2 Resp Contact Materials 5-8.doc Supplementary Document Uploaded 2012-06-11 Available
Attachment K -Exp 1 Resp Contact Materials 5-8.doc Supplementary Document Uploaded 2012-06-11 Available
Attachment J CATI FAQs 5-24 comments.docx Supplementary Document Uploaded 2012-06-11 Available
Attachment F -Human Subjects Determination 5-8.doc Supplementary Document Uploaded 2012-06-11 Available
Attachment E Workgroup Participants 5-7.docx Supplementary Document Uploaded 2012-06-11 Available
Attachment D-Federal Register Notice 5-8.doc Supplementary Document Uploaded 2012-06-11 Repair queued
Attachment A -NCHS Legislation 5-8.doc Supplementary Document Uploaded 2012-06-11 Available
NSLTCP DC Supp State Part A 7-25.doc Supporting Statement A Uploaded 2012-07-30 Available
IC Document Collections
ICR Details
0920-0943 201206-0920-004
Historical Active
HHS/CDC
Data Collection for the Residential Care Community and Adult Day Services Center Components of the National Study of Long-term Care Providers
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 07/30/2012
Retrieve Notice of Action (NOA) 06/20/2012
  Inventory as of this Action Requested Previously Approved
07/31/2015 12 Months From Approved
18,371 0 0
8,769 0 0
0 0 0

NCHS seeks approval to collect data for the residential care community (RCC) and adult day services center (ADSC) components of a new study, the National Study of Long-Term Care Providers (NSLTCP). Data from RCCs and ADSCs include basic characteristics, services offered, staffing, and practices of providers, and distributions of the demographics, physical functioning, and cognitive functioning of users (RCC residents and ADSC participants) aggregated to the RCC/ADSC level. The study will be administered by mail, web, and telephone to a sample of 11,701 RCCs and a census of 5,000 ADSCs in the 50 states and the District of Columbia.

US Code: 42 USC 242k Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  76 FR 78261 12/16/2011
77 FR 33745 06/07/2012
No

  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 18,371 0 0 18,371 0 0
Annual Time Burden (Hours) 8,769 0 0 8,769 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.

$1,903,248
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]

  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.
06/20/2012