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1984 National Nursing Home Survey Pretest (admission Component Revision)
1984 NATIONAL NURSING HOME SURVEY PRETEST (ADMISSION COMPONENT REVISION)
OMB: 0937-0115
IC ID: 112339
OMB.report
HHS/OASH
OMB 0937-0115
ICR 198311-0937-002
IC 112339
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0937-0115 can be found here:
1985-05-22 - No material or nonsubstantive change to a currently approved collection
1984-12-18 - Revision of a currently approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
1984 NATIONAL NURSING HOME SURVEY PRETEST (ADMISSION COMPONENT REVISION)
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
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
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
4,250
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
4,500
0
0
0
0
4,500
Annual IC Time Burden (Hours)
2,139
0
0
0
0
2,139
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.