Per Diem to States for Care of Eligible Veterans in State Homes

ICR 202005-2900-011

OMB: 2900-0883

Federal Form Document

ICR Details
2900-0883 202005-2900-011
Active
VA 2900-NEW
Per Diem to States for Care of Eligible Veterans in State Homes
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/02/2020
Retrieve Notice of Action (NOA) 07/22/2020
In its next revision, extension, or reinstatement request, VA shall ensure all forms in this collection display the information required by 5 CFR 1320.8(b)(3)(v).
  Inventory as of this Action Requested Previously Approved
11/30/2023 36 Months From Approved
11,780 0 0
5,630 0 0
0 0 0

The circumstances making this collection of forms necessary for providing information to the VA are from Title 38 CFR Part 51 State Veterans Homes (SVH) regulations published in the Federal Register as final rule on November 28, 2018 (RIN 2900-A088). This collection of forms was part of a previously approved collection under OMB Control Number 2900-0160. However, it has been determined that these six forms will be separated from the other three forms in 2900-0160, and this ICR seeks renewal under a new OMB Control Number. These six forms are presented to and completed by SVH management and then assessed and utilized by VA SVH Representatives designated by the Medical Center Director of VA of jurisdiction during the annual VA survey process at each SVH across the U.S. as a regulatory action. This collection of forms falls under the auspices of Geriatrics and Extended Care in VA Central Office (10NC4). As per VHA Directive 1145.01, this collection of forms is part of the annual VA survey process. The legal requirements that necessitate this collection of information are found specifically at 38 CFR Parts 51.31, 51.43, and 51.210 for all three levels of care; nursing home, domiciliary, and adult day health care.

PL: Pub.L. 109 - 461 211(a)(5) Name of Law: Veterans Benefits, Health Care, and Information Technology - Modification to State Home Authorities
  
None

Not associated with rulemaking

  84 FR 35453 07/23/2019
84 FR 53243 10/04/2019
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 11,780 0 0 11,780 0 0
Annual Time Burden (Hours) 5,630 0 0 5,630 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This collection of forms was part of a previously approved collection under OMB Control Number 2900-0160. However, it has been determined that these six forms will be separated from the other three forms in 2900-0160, and this ICR seeks renewal under a new OMB Control Number. Therefore, this is presented as a 'new' collection and all burden numbers constitute an increase.

$97,760
No
    Yes
    Yes
No
No
No
No
Frances O'Donnell 703 405-2449 fran.odonnell@cathexiscorp.com

  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.
07/22/2020


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