Att G - Respondent Contact Materials

Attachment G-Base Resp Contact Materials 5-8.pdf

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

Att G - Respondent Contact Materials

OMB: 0920-0943

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0943 can be found here:

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Attachment G: Base Protocol Respondent Contact Materials
G1
G2

G3
G4
G5

RCC NCHS Advance Letter
RCC Questionnaire mailings
o NCHS Cover Letter with FAQs (Initial, Follow-up 1 and 2)
o NCHS Data Brief
o NCHS Confidentiality Brochure
o Letter of Support
RCC Reminder/Thank You Letter
ADSC NCHS Advance Letter
ADSC Questionnaire mailings
o NCHS Cover Letter with FAQs (Initial, Follow-up 1 and 2)
o ADSC Brochure
o NCHS Confidentiality Brochure
o Letter of Support
ADSC Reminder/Thank You Letter

Attachment G1--RCC-NCHS Advance Letter
[NCHS Letterhead]
Date
Name of Director
Name of Community
Community Address
Community City, State, Zip
Dear ,
We are pleased to inform you that a national study of residential care communities will be conducted by the Centers for
Disease Control and Prevention’s National Center for Health Statistics (NCHS). This study, the National Study of LongTerm Care Providers (NSLTCP), is a new national survey to be conducted every two years on a representative sample of
about 11,000 residential care providers. Our purpose is to collect information about the characteristics of residential care
providers, the services they offer, as well as general information on staffing, demographics and the health of the residents
they serve, and payment sources for these services. The NSLTCP data will be used to help policymakers and health care
planners more fully understand and plan for the long-term care needs of the U.S. population.
The NSLTCP sample is scientifically selected, and you have been chosen at random to participate. Each response from
the over 11,000 residential care providers in our sample is vital to capturing an accurate picture of residential care in the
U.S.. In the next few weeks, a packet will be sent to you containing study literature and information to complete the
survey by mail or via the web over a safe and secure network. When your survey arrives, please complete it at your
earliest convenience. Answering the questions will take 30 minutes on average.
Your participation in this study is voluntary, but will assist greatly in helping to further our nation’s understanding and
planning for the long-term care needs of the elderly and disabled populations.
Data collected by NSLTCP is authorized by Section 306 of the Public Health Services Act (Title 42, U.S. code 242K). As
required by federal law (section 308(d) of the Public Health Services Act in 42, U.S. Code, 242m(d) and the Confidential
Information Protection and Statistical Efficiency Act Title 5 of PL 107-347), all information collected will be used only
for statistical purposes and held in the strictest confidence. No data on individual residents will be collected.
The following national organizations are in support of NSLTCP: American Seniors Housing Association (ASHA),
Assisted Living Federation of America (ALFA), LeadingAge, and the National Center for Assisted Living/American
Health Care Association (NCAL/AHCA).
If you would like to learn more about this study, please visit http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP
representative toll free at (800) XXX-XXXX.
Thank you in advance for your help in this important endeavor.
Sincerely,
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

Attachment G2--RCC Questionnaire mailings-RCC-NCHS Cover Letter with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Community
Community Address
Community city, state, zip code
Dear ,
A couple of weeks ago, we contacted you about a new initiative conducted by the Centers for Disease Control and
Prevention’s National Center for Health Statistics, the National Study of Long-Term Care Providers (NSLTCP). We now
invite you to participate in this important national study of long-term care providers in the United States. The purpose of
NSLTCP is to collect information every two years about the characteristics of places providing long-term care, the
services they offer, general information on staffing, demographics and health of the residents they serve, and payment for
these services. NSLTCP data will inform long-term care providers, planners, researchers, and policymakers about
residential care communities which are increasingly becoming an important part of the long-term care continuum in this
country.
Enclosed is your NSLTCP survey questionnaire. Please complete the mail survey in the next week and return it to RTI,
our survey contractor, in the pre-addressed, postage-paid envelope provided. You also have the option to access and
complete the survey via the web if that is more convenient for you. To access your web survey over a safe and secure
network, go to the following URL address and type the password provided below. This password is unique to you. Please
keep it safe in case you need to access your survey again later.
URL:
Password:
If you need technical support with the web survey, you may call 1-800-XXX-XXXX
Completing the survey will take 30 minutes on average. Before beginning the survey, please have your community
records readily available to help you answer the questions about number of residents, demographics of residents, number
of staff, and hours worked by staff.
Your participation in this national study is voluntary, but will assist greatly in helping to further our nation’s
understanding of long-term care needs of the elderly and disabled population. The information you provide will be used
for statistical purposes and held in the strictest confidence.
Thank you for your help in this important research.
Sincerely,

Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics
________________________________________
To learn more, please visit http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP representative at (800) XXX-XXXX

National Study of Long-Term Care Providers (NSLTCP)
Frequently Asked Questions
Why should I participate in this survey?
CDC’s National Center for Health Statistics (NCHS) recognizes that residential care communities are an important part of the
long-term care spectrum in the United States. NCHS recently completed the first ever nationwide study of residential care
communities (see enclosed Data Brief). NCHS’ new survey, the National Study of Long-Term Care Providers (NSLTCP), will
track trends in the supply and use of residential care, the characteristics and practices of residential care communities, and the
characteristics of residential care residents. NSLTCP is similar to surveys NCHS has done for other types of long-term care
providers, such as nursing homes, hospice care agencies, and home health care agencies. When you participate you help ensure
that the survey data for residential care communities are up-to-date and reflect an unbiased national sample that health care
planners and policymakers can use to inform long-term care policy.
What other residential care communities are being contacted to participate in this survey?
The survey includes approximately 11,000 residential care communities operating in the United States. This is a random
national sample, and we do not release the names of these communities that participate to anyone. This is to protect the privacy
of individual places and the residents they serve.
Will the results be made public and, if so, when and where?
A summary report is anticipated for December 2013. A public use dataset is planned to be released December 2013. These
materials will be made available online at http://www.cdc.gov/nchs/nsltcp.htm.If you would like to be informed when they are
available you may want to join the Long-Term Care ListServ at http://www.cdc.gov/nchs/dhcs/longterm_listserv.htm. Note
also that identifying information about participants will not be contained in the public use dataset.
Why can’t some other community take our place?
If you do not participate, the unique qualities of your community will be lost. The survey will be used by Congress and decision
makers who will formulate policy for the next decades. You represent other communities like yours. If you don’t participate,
there is no guarantee that residential care communities like yours will be adequately represented. We don’t want decisions based
on this survey data to be made without all types of communities, including those like yours, represented in the data. Also,
NCHS aims to produce state estimates where possible; if you do not participate, we may not be able to produce estimates for
your state.
Where did you get my name?
Individual state licensing agencies provided the names of all licensed, certified or otherwise regulated residential care
communities in their respective states.
Will my name and information be held confidential?
Yes. NSLTCP is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). All information
collected in this survey will be held in the strictest confidence according to law [Section 308 (d) of the Public Health Service
Act (42 United States Code 242m (d) and the Confidential Information Protection and Statistical Efficiency Act (PL 107-347)].
Information collected in this survey may be used only for statistical purposes. Any government staff, contractor, or agent who
willfully discloses confidential information may be subject to a jail term or a $250,000 fine.
Who supports this study?
This survey is supported by American Seniors Housing Association (ASHA), Assisted Living Federation of America (ALFA),
LeadingAge, and the National Center for Assisted Living/American Health Care Association (NCAL/AHCA).
The enclosed letter of support provides this specific information.
Where should I mail my completed questionnaire?
Please return your completed questionnaire in the enclosed pre-addressed, postage-paid envelope. The address is:
NSLTCP, RTI International, Suite 100 Imperial Court Business Park, 1000 Parliament Court, Durham, NC 27703
If I choose to take the survey on the web, can I stop partway through and start again where I left off at a later time?
Yes. If you are unable to complete the survey in one sitting, the answers you entered will be saved, and you can pick up where
you left off at a later time. You will not need to start the survey again from the beginning.

Attachment G2--RCC Questionnaire mailings-RCC-Base Follow-up Letter #1 with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Community
Community Address
Community city, state, zip code
Dear ,
Recently, we sent you an invitation to participate in the National Study of Long-Term Care Providers (NSLTCP).
The packet we sent you included a hardcopy survey questionnaire or the option to complete the NSLTCP survey via
the web. To date, we have not received your completed survey and ask that you please consider taking part in this
important research.
We understand that you are very busy. Please know that your responses are very important in helping to further our
nation’s understanding of the long-term care needs of the elderly and disabled populations in the United States.
For your convenience, enclosed is another copy of the NSLTCP mail survey questionnaire for you to fill out. Please
complete the mail survey and return it to RTI, our survey contractor, in the pre-addressed, postage-paid envelope
provided. Or, if it is more convenient for you to fill out the survey via the web over a safe and secure network, you
can access your survey by going to the following URL address and typing the unique password provide below.
URL:
Password:
If you need technical support with the web survey, you may call 1-800-XXX-XXXX
Completing the survey takes 30 minutes on average. Please have your community records available so you can
easily answer the questions about number of residents, demographics of residents, number of staff, and hours worked
by staff.
Many organizations and leaders in the long-term care community, including American Seniors Housing Association
(ASHA), Assisted Living Federation of America (ALFA), LeadingAge, and the National Center for Assisted
Living/American Health Care Association (NCAL/AHCA), join me in urging you to participate in this important
research.
If you have questions or would like to learn more about this study, please call a NSLTCP representative at (800)
XXX-XXXX.
Thank you for your help.
Sincerely,
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics
To learn more, please visit http://www.cdc.gov/nchs/nsltcp.htm

Attachment G2--RCC Questionnaire mailings-RCC-Base Follow-up Letter #2 with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Community
Community Address
Community city, state, zip code
Dear ,
We contacted you recently about participating in the National Study of Long-Term Care Providers (NSLTCP), being
conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. This national study
collects information every two years about characteristics of residential care communities and the types of services they
provide. Your participation will ensure that the unique qualities of your community are represented in this important
nationwide data collection effort.
All responses are confidential and protected by federal laws. For your convenience, we have provided another copy of the
mail questionnaire. Or, you can go to the following URL address and enter your unique password provided below to
access the survey via the web over a safe and secure network.
URL:
Password:
If you need technical support with the web survey, you may call 1-800-XXX-XXXX
Completing the survey takes 30 minutes on average. Please have your community records available so you can easily
answer the questions about number of residents, demographics of residents, number of staff, and hours worked by staff.
Providers and policymakers need to better understand the services that older people and younger persons with disabilities
require. Your answers to the survey will help inform policymakers about this type of care.
Please consider completing the enclosed NSLTCP mail survey this week and returning it in the pre-addressed, postagepaid return envelope provided. If you have questions or would like to learn more about this study, please call a NSLTCP
representative at (800) XXX-XXXX or visit the survey website at http://www.cdc.gov/nchs/nsltcp.htm.
Sincerely,

Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics
________________________________________

National Study of Long-Term Care Providers (NSLTCP)
Frequently Asked Questions
Why should I participate in this survey?
CDC recognizes that residential care communities are an important part of the long-term care spectrum in the United States.
CDC recently completed the first ever nationwide study of residential care communities (see enclosed Data Brief). CDC’s new
survey, the National Study of Long-Term Care Providers (NSLTCP), will track trends in the supply and use of residential care,
the characteristics and practices of residential care communities, and the characteristics of residential care residents. NSLTCP
is similar to surveys CDC has done for other types of long-term care providers, such as nursing homes, hospice, and home
health care agencies. When you participate you help ensure that the survey data for residential care communities are up-to-date
and reflect an unbiased national sample that health care planners and policymakers can use to inform long-term care policy.
What other residential care communities are being contacted to participate in this survey?
The survey includes approximately 11,000 residential care communities operating in the United States. This is a random
national sample, and we do not release the names of these communities that participate to anyone. This is to protect the privacy
of individual places and the residents they serve.
Will the results be made public and, if so, when and where?
A summary report is anticipated for December 2013. A public use dataset is planned to be released December 2013. These
materials will be made available online at http://www.cdc.gov/nchs/nsltcp.htm.If you would like to be informed when they are
available you may want to join the Long-Term Care ListServ at http://www.cdc.gov/nchs/dhcs/longterm_listserv.htm. Note
also that identifying information about participants will not be contained in the public use dataset.
Why can’t some other community take our place?
If you do not participate, the unique qualities of your community will be lost. The survey will be used by Congress and decision
makers who will formulate policy for the next decades. You represent other communities like yours. If you don’t participate,
there is no guarantee that residential care communities like yours will be adequately represented. We don’t want decisions based
on this survey data to be made without all types of communities, including those like yours, represented in the data. Also,
NCHS aims to produce state estimates where possible; if you do not participate, we may not be able to produce estimates for
your state.
Where did you get my name?
Individual state licensing agencies provided the names of all licensed, certified or otherwise regulated residential care
communities in their respective states.
Will my name and information be held confidential?
Yes. NSLTCP is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). All information
collected in this survey will be held in the strictest confidence according to law [Section 308 (d) of the Public Health Service
Act (42 United States Code 242m (d) and the Confidential Information Protection and Statistical Efficiency Act (PL 107-347)].
Information collected in this survey may be used only for statistical purposes. Any government staff, contractor, or agent who
willfully discloses confidential information may be subject to a jail term or a $250,000 fine.
Who supports this study?
This survey is supported by American Seniors Housing Association (ASHA), Assisted Living Federation of America (ALFA),
LeadingAge, and the National Center for Assisted Living/American Health Care Association (NCAL/AHCA).
The enclosed letter of support provides this specific information.
Where should I mail my completed questionnaire?
Please return your completed questionnaire in the enclosed pre-addressed, postage-paid envelope. The address is:
NSLTCP, RTI International, Suite 100 Imperial Court Business Park, 1000 Parliament Court, Durham, NC 27703
If I choose to take the survey on the web, can I stop partway through and start again where I left off at a later time?
Yes. If you are unable to complete the survey in one sitting, the answers you entered will be saved, and you can pick up where
you left off at a later time. You will not need to start the survey again from the beginning.

Attachment G2--RCC Questionnaire mailings-Place holder for NSRCF Resident Data Brief
[screenshot]
Entire report found at:
http://www.cdc.gov/nchs/data/databriefs/db91.pdf

Attachment G2--RCC Questionnaire mailings-NCHS Confidentiality Brochure

Attachment G2--RCC Questionnaire mailings-RCC Base Provider Associations’ Letter of Support

In 2012, CDC’s National Center for Health Statistics (NCHS) will be
launching the National Study of Long-Term Care Providers (NSLTCP),
a first ever national study of the major providers of long-term care. This
data collection effort will include a representative sample of residential
care and assisted living communities across the country.

National data collection will start in September 2012 and end in January
2013. The following organizations encourage your participation:
•
•
•
•

American Seniors Housing Association (ASHA)
Assisted Living Federation of America (ALFA)
LeadingAge
National Center for Assisted Living/American
Association (NCAL/AHCA)

Health

Care

Residential care directors will be asked to provide information about
their communities through a mail, Web or telephone survey and will
take about an hour to complete. The survey includes questions about
residential care services, staffing, and practices, and resident
demographics, physical and cognitive functioning, and payment
sources. This information will help policy makers, health care planners,
and residential care/assisted living providers better understand, plan
for, and serve the future long-term care needs of the aging population.

While data from this survey will be made publicly available, all data will
be kept confidential and will be aggregated, so that the names of the
communities, staff, residents and respondents will not be identifiable

Attachment G3-RCC-Reminder/Thank You Letter
Dear Director,
Recently, we sent you a survey packet for the National Study of Long-Term Care Providers (NSLTCP). If you have
completed the questionnaire, thank you for your participation.
If you have not completed your survey yet, we hope you will consider participating. Completing the questionnaire takes
30 minutes on average. Your responses are very important to provide accurate information on long-term care in the United
States. Please complete the mail questionnaire and return it in the pre-addressed, postage-paid envelope provided earlier.
To access your web survey over a safe and secure network, go to the following URL address and type the unique
password provided below.
URL:
Password:
If you need technical support with the web survey, you may call 1-800-XXX-XXXX
If you have any questions about NSLTCP or need an additional questionnaire, please visit
http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP representative at (800) XXX-XXXX.
Thank you once again,

Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

Attachment G4-ADSC NCHS Advance Letter
[NCHS Letterhead]
Date
Name of Director
Name of Center
Center Address
Center City, State, Zip
Dear ,
We are pleased to inform you that a national study of adult day services centers will be conducted by the Centers for
Disease Control and Prevention’s National Center for Health Statistics (NCHS). This study, the National Study of LongTerm Care Providers (NSLTCP), is a new survey to be conducted every two years on about 5,000 adult day services
centers. Our purpose is to collect information about the characteristics of adult day service providers, the services they
offer, as well as general information on staffing, demographics and the health of the participants they serve, and payment
sources for these services. The NSLTCP data will be used to help policymakers and health care planners more fully
understand and plan for the long-term care needs of the U.S. population.
Each response from the 5,000 adult day services centers that have been selected to participate in NSLTCP is vital to
capturing an accurate picture of adult day services in the U.S.. In the next few weeks, a packet will be sent to you
containing study literature and information to complete the survey by mail or via the web over a safe and secure network.
When your survey arrives, please complete it at your earliest convenience. Answering the questions will take 30 minutes
on average.
Your participation in this study is voluntary, but will assist greatly in helping to further our nation’s understanding and
planning for the long-term care needs of the elderly and disabled populations.
Data collected by the NSLTCP is authorized by Section 306 of the Public Health Services Act (Title 42, U.S.
code 242K). As required by federal law (section 308(d) of the Public Health Services Act in 42, U.S. Code,
242m(d) and the Confidential Information Protection and Statistical Efficiency Act Title 5 of PL 107-347),
information collected will be used only for statistical purposes and held in the strictest confidence. No data on
individual participants will be collected.

The National Adult Day Services Association (NADSA) is in support of NSLTCP.
If you would like to learn more about this study, please visit http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP
representative toll free at (800) XXX-XXXX.
Thank you in advance for your help in this important endeavor.
Sincerely,
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

Attachment G5-ADSC Questionnaire Mailings-ADSC Base-Cover Letter with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Center
Center Address
Center city, state, zip code
Dear ,
A couple of weeks ago, we contacted you about a new initiative conducted by the Centers for Disease Control and
Prevention’s National Center for Health Statistics, the National Study of Long-Term Care Providers (NSLTCP).
We now invite you to participate in this important national study of long-term care providers in the United States.
The purpose of NSLTCP is to collect information every two years about the characteristics of places providing longterm care, the services they offer, general information on staffing, demographics and health of the participants they
serve, and payment for these services. The NSLTCP data will inform long-term care providers, planners,
researchers, and policymakers about adult day services centers which are increasingly becoming an important part of
the long-term care continuum in this country.
Enclosed is your NSLTCP survey questionnaire. Please complete the mail survey in the next week and return it to
RTI, our survey contractor, in the pre-addressed, postage-paid envelope provided. You also have the option to access
and complete the survey via the web if that is more convenient for you. To access your web survey over a safe and
secure network, go to the following URL address and type the password provided below. This password is unique to
you. Please keep it safe in case you need to access your survey again later.
URL:
Password:

If you need technical support with the web survey, you may call 1-800-XXX-XXXX
Completing the survey will take 30 minutes on average. Before beginning the survey, please have your center
records readily available to help you answer the questions about number of participants, demographics of
participants, number of staff, and hours worked by staff.
Your participation in this national study is voluntary, but will assist greatly in helping to further our nation’s
understanding of long-term care needs of the elderly and disabled population. The information you provide will be
used for statistical purposes and held in the strictest confidence.
Thank you for your help in this important research.
Sincerely,

Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics
To learn more, please visit http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP representative at (800) XXX-XXXX

National Study of Long-Term Care Providers (NSLTCP)
Frequently Asked Questions
Why should I participate in this survey?
CDC’s National Center for Health Statistics (NCHS) recognizes that adult day services programs are an important
component of long-term care in the United States. NCHS’ new survey, the National Study of Long-Term Care Providers
(NSLTCP), will track trends in the U.S. adult day services programs, including center supply and use, characteristics and
practices of centers, and characteristics of center participants. This is similar to surveys NCHS has done for other types of
long-term care providers, such as assisted living communities, nursing homes, and home health care agencies. When you
participate you help ensure that the survey data for adult day services centers are up-to-date and reflect an unbiased
national sample that health care planners and policymakers can use to inform long-term care policy.
What other adult day services centers are being contacted to participate in this survey?
The survey includes approximately 5,000 adult day services centers operating in the United States. We do not release the
names of these centers that participate to anyone. This is to protect the privacy of individual places and the participants
they serve.
Will the results be made public and, if so, when and where?
A summary report is anticipated for December 2013. A public use dataset is planned to be released December 2013. These
materials will be made available online at http://www.cdc.gov/nchs/nsltcp.htm.If you would like to be informed when they are
available you may want to join the Long-Term Care ListServ at http://www.cdc.gov/nchs/dhcs/longterm_listserv.htm. Note
also that identifying information about participants will not be contained in the public use dataset.
Why can’t some other center take our place?
If you do not participate, the unique qualities of your center will be lost. The survey will be used by Congress and decision
makers who will formulate policy for the next decades. You represent other centers like yours. If you don’t participate,
there is no guarantee that adult day services centers like yours will be adequately represented. We don’t want decisions
based on this survey data to be made without all types of centers, including those like yours, represented in the data. Also,
NCHS aims to produce state estimates where possible; if you do not participate, we may not be able to produce estimates
for your state.
Where did you get my name?
A nonprofit association of adult day services centers compiled a list of all adult day services centers in the U.S. under
contract to NCHS.
Will my name and information be held confidential?
Yes. NSLTCP is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). All information
collected in this survey will be held in the strictest confidence according to law [Section 308 (d) of the Public Health
Service Act (42 United States Code 242m (d) and the Confidential Information Protection and Statistical Efficiency Act
(PL 107-347)]. Information collected in this survey may be used only for statistical purposes. Any government staff,
contractor, or agent who willfully discloses confidential information may be subject to a jail term or a $250,000 fine.
Who supports this study?
This survey is supported by the National Adult Day Services Association (NADSA). The enclosed letter of support
provides this specific information.
Where should I mail my completed questionnaire?
Please return your completed questionnaire in the enclosed pre-addressed, postage-paid envelope. The address is:
NSLTCP, RTI International, Suite 100 Imperial Court Business Park, 1000 Parliament Court, Durham, NC 27703
If I choose to take the survey on the web, can I stop partway through and start again where I left off at a later time?
Yes. If you are unable to complete the survey in one sitting, the answers you entered will be saved, and you can pick up
where you left off at a later time. You will not need to start the survey again from the beginning.

Attachment G5-ADSC Questionnaire Mailings-ADSC Base Follow-up Letter #1 with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Center
Center Address
Center city, state, zip code
Dear ,
Recently, we sent you an invitation to participate in the National Study of Long-Term Care Providers (NSLTCP).
The packet we sent you included a hardcopy survey questionnaire or the option to complete the NSLTCP survey via
the web. To date, we have not received your completed survey and ask that you please consider taking part in this
important research.
We understand that you are very busy. Please know that your responses are very important in helping to further our
nation’s understanding of the long-term care needs of the elderly and disabled populations in the United States.
For your convenience, enclosed is another copy of the NSLTCP mail survey questionnaire for you to fill out. Please
complete the mail survey questionnaire and return it to RTI, our survey contractor, in the pre-addressed, postage-paid
envelope provided. Or, if it is more convenient for you to fill out the survey via the web over a safe and secure
network, you can access your survey by going to the following URL address and typing the unique password
provided below.
URL:
Password:

National Study of Long-Term Care Providers (NSLTCP)
Frequently Asked Questions
Why should I participate in this survey?
CDC’s National Center for Health Statistics (NCHS) recognizes that adult day services programs are an important
component of long-term care in the United States. NCHS’ new survey, the National Study of Long-Term Care Providers
(NSLTCP), will track trends in the U.S. adult day services programs, including center supply and use, characteristics and
practices of centers, and characteristics of center participants. This is similar to surveys NCHS has done for other types of
long-term care providers, such as assisted living communities, nursing homes, and home health care agencies. When you
participate you help ensure that the survey data for adult day services centers are up-to-date and reflect an unbiased
national sample that health care planners and policymakers can use to inform long-term care policy.
What other adult day services centers are being contacted to participate in this survey?
The survey includes approximately 5,000 adult day services centers operating in the United States. We do not release the
names of these centers that participate to anyone. This is to protect the privacy of individual places and the participants
they serve.
Will the results be made public and, if so, when and where?
A summary report is anticipated for December 2013. A public use dataset is planned to be released December 2013. These
materials will be made available online at http://www.cdc.gov/nchs/nsltcp.htm.If you would like to be informed when they are
available you may want to join the Long-Term Care ListServ at http://www.cdc.gov/nchs/dhcs/longterm_listserv.htm. Note
also that identifying information about participants will not be contained in the public use dataset.
Why can’t some other center take our place?
If you do not participate, the unique qualities of your center will be lost. The survey will be used by Congress and decision
makers who will formulate policy for the next decades. You represent other centers like yours. If you don’t participate,
there is no guarantee that adult day services centers like yours will be adequately represented. We don’t want decisions
based on this survey data to be made without all types of centers, including those like yours, represented in the data. Also,
NCHS aims to produce state estimates where possible; if you do not participate, we may not be able to produce estimates
for your state.
Where did you get my name?
A nonprofit association of adult day services centers compiled a list of all adult day services centers in the U.S. under
contract to NCHS.
Will my name and information be held confidential?
Yes. NSLTCP is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). All information
collected in this survey will be held in the strictest confidence according to law [Section 308 (d) of the Public Health
Service Act (42 United States Code 242m (d) and the Confidential Information Protection and Statistical Efficiency Act
(PL 107-347)]. Information collected in this survey may be used only for statistical purposes. Any government staff,
contractor, or agent who willfully discloses confidential information may be subject to a jail term or a $250,000 fine.
Who supports this study?
This survey is supported by the National Adult Day Services Association (NADSA). The enclosed letter of support
provides this specific information.
Where should I mail my completed questionnaire?
Please return your completed questionnaire in the enclosed pre-addressed, postage-paid envelope. The address is:
NSLTCP, RTI International, Suite 100 Imperial Court Business Park, 1000 Parliament Court, Durham, NC 27703
If I choose to take the survey on the web, can I stop partway through and start again where I left off at a later time?
Yes. If you are unable to complete the survey in one sitting, the answers you entered will be saved, and you can pick up
where you left off at a later time. You will not need to start the survey again from the beginning.

Attachment G5-ADSC Questionnaire Mailings-ADSC Base Follow-up Letter #2 with FAQs
[NCHS Letterhead]
Date
Name of Director
Name of Center
Center Address
Center city, state, zip code
Dear ,
We contacted you recently about participating in the National Study of Long-Term Care Providers (NSLTCP),
being conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics. This
national study collects information every two years about characteristics of adult day services centers and the
types of services they provide. Your participation will ensure that the unique qualities of your center are
represented in this important nationwide data collection effort.
All responses are confidential and protected by federal laws. For your convenience, we have provided another
copy of the mail questionnaire. Or, you can go to the following URL address and enter your unique password
provided below to access the survey via the web over a safe and secure network.
URL:
Password:

If you need technical support with the web survey, you may call 1-800-XXX-XXXX
Completing the survey takes 30 minutes on average. Please have your center records available so you can easily
answer the questions about number of participants, demographics of participants, number of staff, and hours
worked by staff.
Providers and policymakers need to better understand the services that older people and younger persons with
disabilities require. Although information on nursing homes, home health agencies, inpatient rehabilitation
facilities, short-term and post-acute care hospitals is routinely collected, there is very little national information on
adult day services centers. Your answers to the survey will help inform policymakers about this type of care.
Please consider completing the web survey this week or filling out the enclosed NSLTCP mail survey
questionnaire and returning it in the pre-addressed, postage-paid return envelope provided. If you have questions
or would like to learn more about this study, please call a NSLTCP representative at (800) XXX-XXXX or visit
the survey website at http://www.cdc.gov/nchs/nsltcp.htm.
Sincerely,
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

National Study of Long-Term Care Providers (NSLTCP)
Frequently Asked Questions
Why should I participate in this survey?
CDC’s National Center for Health Statistics (NCHS) recognizes that adult day services programs are an important
component of long-term care in the United States. NCHS’ new survey, the National Study of Long-Term Care Providers
(NSLTCP), will track trends in the U.S. adult day services programs, including center supply and use, characteristics and
practices of centers, and characteristics of center participants. This is similar to surveys NCHS has done for other types of
long-term care providers, such as assisted living communities, nursing homes, and home health care agencies. When you
participate you help ensure that the survey data for adult day services centers are up-to-date and reflect an unbiased
national sample that health care planners and policymakers can use to inform long-term care policy.
What other adult day services centers are being contacted to participate in this survey?
The survey includes approximately 5,000 adult day services centers operating in the United States. We do not release the
names of these centers that participate to anyone. This is to protect the privacy of individual places and the participants
they serve.
Will the results be made public and, if so, when and where?
A summary report is anticipated for December 2013. A public use dataset is planned to be released December 2013. These
materials will be made available online at http://www.cdc.gov/nchs/nsltcp.htm.If you would like to be informed when they are
available you may want to join the Long-Term Care ListServ at http://www.cdc.gov/nchs/dhcs/longterm_listserv.htm. Note
also that identifying information about participants will not be contained in the public use dataset.
Why can’t some other center take our place?
If you do not participate, the unique qualities of your center will be lost. The survey will be used by Congress and decision
makers who will formulate policy for the next decades. You represent other centers like yours. If you don’t participate,
there is no guarantee that adult day services centers like yours will be adequately represented. We don’t want decisions
based on this survey data to be made without all types of centers, including those like yours, represented in the data. Also,
NCHS aims to produce state estimates where possible; if you do not participate, we may not be able to produce estimates
for your state.
Where did you get my name?
A nonprofit association of adult day services centers compiled a list of all adult day services centers in the U.S. under
contract to NCHS.
Will my name and information be held confidential?
Yes. NSLTCP is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). All information
collected in this survey will be held in the strictest confidence according to law [Section 308 (d) of the Public Health
Service Act (42 United States Code 242m (d) and the Confidential Information Protection and Statistical Efficiency Act
(PL 107-347)]. Information collected in this survey may be used only for statistical purposes. Any government staff,
contractor, or agent who willfully discloses confidential information may be subject to a jail term or a $250,000 fine.
Who supports this study?
This survey is supported by the National Adult Day Services Association (NADSA). The enclosed letter of support
provides this specific information.
Where should I mail my completed questionnaire?
Please return your completed questionnaire in the enclosed pre-addressed, postage-paid envelope. The address is:
NSLTCP, RTI International, Suite 100 Imperial Court Business Park, 1000 Parliament Court, Durham, NC 27703
If I choose to take the survey on the web, can I stop partway through and start again where I left off at a later time?
Yes. If you are unable to complete the survey in one sitting, the answers you entered will be saved, and you can pick up
where you left off at a later time. You will not need to start the survey again from the beginning.

Attachment G5-ADSC Questionnaire Mailings-ADSC Brochure

ADULT DAY SERVICES (ADS) CENTERS BROCHURE (4-page foldout)

National Study of Long-Term Care Providers
National Health Care Surveys

Cover page NSLTCP artwork to be developed

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention
National Center for Health Statistics

Introduction
The National Study of Long-Term Care Providers (NSLTCP) is a new national data collection effort to gather
ongoing information about the characteristics of adult day services centers and other long-term care providers.
Also included are residential care/assisted living communities, nursing homes, home health agencies and
hospice agencies. The Centers for Disease Control and Prevention’s National Center for Health Statistics
sponsors NSLTCP. This brochure describes the adult day services component of this ground-breaking study.

Importance
In 2010, there were an estimated 4,600 adult day services centers in the United States that served about
260,000 older persons and younger adults with disabilities on any given day.1 Adult day services centers are an
important and growing segment of the long-term care provider industry, serving community-based individuals,
and their family caregivers, who need supportive services to enable them to continue to reside at home. This
study, to be conducted every two years, will provide an up- to-date snapshot of the characteristics of these
centers and the participants who rely on their services. The information collected will provide reliable national
and state-level estimates of key policy-relevant characteristics and practices of adult day services centers. These
data will help characterize how these centers meet the needs of elders and adults with disabilities and help
shape future long-term care policies.

Survey and content
Data collection is estimated to begin Fall 2012. All 5,000 adult day services centers throughout the United States
are included in NSLTCP. RTI International is collecting the data for the National Center for Health Statistics.
Directors are contacted by mail to complete the survey. No information about individual adult day services
center participants will be collected. Information will be collected on these and other topics:
About adult day services centers• Basic characteristics- ownership, average daily attendance, years in operation
• Services provided- social work, case management, therapeutic, transportation
• Staffing- types and numbers of employees and staff under contractual arrangement
• Practices-Depression screening, use of Electronic Health Records, chronic disease management, personcentered care

2010 MetLife, Inc., Ohio State University College of Social Work, National Adult Day Services Association (NADSA) National
Study of Adult Day Services.
22

About participants- aggregate level distributions
• Demographics
• Physical functioning
• Cognitive functioning
• Alzheimer’s disease and other dementias
• Participant transitions

Goals and intended uses of the data
The National Study of Long-Term Care Providers is designed to provide national data and state-level data where
feasible, about the characteristics of adult day services centers and other long-term care providers, the services
they offer, general information on staffing, demographics and health of the clientele they serve, and payment
for these services. These data can then be used by providers, consumers, policymakers, and researchers to:
•
•
•
•
•
•

estimate the U.S. national supply of adult day services centers and other types of paid regulated longterm care providers;
estimate key policy-relevant characteristics and practices of these long-term care providers;
estimate the national use of these providers;
estimate key policy-relevant characteristics of these providers nationally; and
within the above goals, produce state-level estimates for as many states as feasible with the National
Center for Health Statistics’ confidentiality and reliability standards;
enable comparisons within and between different types of long-term care providers at a similar point in
time as well as monitoring trends over time.

Confidentiality
The Centers for Disease Control and Prevention’s National Center for Health Statistics is required by law to
maintain the confidentiality of data it collects. All data that directors provide will be kept in strict confidence and
will be used only for statistical purposes. All information, publications, and data files will be released in such a
way that no individual provider, staff, or participant can be identified. Participants receive assurance of this
confidentiality under the Public Health Services Act. Any National Center for Health Statistics staff, contractor, or
agent who willfully discloses confidential information may be subject to a jail term or a $250,000 fine.

Data dissemination
The adult day services centers and assisted living/residential care survey data will be available in public- use files
from the NSLTCP website: http://www.cdc.gov/nchs/nsltcp.htm by late 2013. A long-term care overview
report is also planned for release in late 2013 and will be on the NSLTCP website.

NSLTCP supporters

National Adult Day Services Association (NADSA)

American Heath Care Association

American Seniors Housing Association

Assisted Living Federation of America

Center for Excellence in Assisted Living (CEAL)

LeadingAge

National Association of Home Care and Hospice

National Center for Assisted Living

National Home and Palliative Care Organization

To learn more about NSLTCP call
301–458–4747, or visit the NSLTCP website:

http://www.cdc.gov/nchs/nsltcp.htm

Attachment G5-ADSC Questionnaire Mailings-NCHS Confidentiality Brochure

Attachment G5-ADSC Questionnaire Mailings-Base Professional Association letter of support

The National Study of Long-Term Care Providers (NSLTCP) is the first ever federal study of
adult day services (ADS) centers. For the first time, the NSLTCP will allow us to compare our
services, participants, and funding to other providers such as home health care and assisted living
communities. The information is critical as we continue to develop adult day services in this
current economic environment. The National Adult Day Services Association encourages and
appreciates your participation in this important, national research effort.
NSLTCP is designed to provide national informationand where possible state
informationabout ADS centers and their participants. ADS center directors will be asked to
provide information about their centers through a mail, Web, or telephone survey. The survey
includes questions about services, staffing, and practices; participants’ physical and cognitive
functioning; and sources of payment for participants’ care. This information will help
policymakers, health care planners, and ADS providers better understand, plan for, and serve the
future long-term care needs of older persons and younger adults with disabilities. All individual
data will be kept confidential and the data will be aggregated, so that the names of ADS
centers, staff, participants and respondents will not be identifiable.
The study is being conducted by the National Center for Health Statistics (NCHS), an agency of
the Centers for Disease Control and Prevention (CDC). National data collection will start in
September 2012. All ADS centers will be invited to participate in the national survey. If you
have any questions or concerns, please feel free to contact me at (877) 745-1440.

Teresa Johnson

Managing Director

Attachment G6-ADSC Base Reminder/Thank You Letter
Dear Director,
Recently, we sent you a survey packet for the National Study of Long-Term Care Providers (NSLTCP). If you have
completed the questionnaire, thank you for your participation.
If you have not completed your survey yet, we hope you will consider participating. Completing the questionnaire takes
30 minutes on average. Your responses are very important to provide accurate information on long-term care in the United
States. Please complete the mail questionnaire and return it in the pre-addressed, postage-paid envelope provided earlier.
To access your web survey over a safe and secure network, go to the following URL address and type the unique
password provided below.
URL:
Password:
If you need technical support with the web survey, you may call 1-800-XXX-XXXX
If you have any questions about NSLTCP or need an additional questionnaire, please visit
http://www.cdc.gov/nchs/nsltcp.htm or call a NSLTCP representative at (800) XXX-XXXX.
Thank you once again,
Edward J. Sondik, Ph.D.
Director, National Center for Health Statistics

File Type	application/pdf
File Title	Microsoft Word - Attachment G-Base Resp Contact Materials 5-8.doc
Author	gwo9
File Modified	2012-06-13
File Created	2012-06-13