[Federal Register Volume 78, Number 56 (Friday, March 22, 2013)]
[Notices]
[Pages 17777-17778]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-06642]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0616]


Proposed Information Collection (Application for Furnishing Long-
Term Care Service to Beneficiaries of Veterans Affairs, and Residential 
Care Home Program) Activity: Comment Request

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA), Department of 
Veterans Affairs (VA), is announcing an opportunity for public comment 
on the proposed collection of certain information by the agency. Under 
the Paperwork Reduction Act (PRA) of 1995, Federal agencies are 
required to publish notice in the Federal Register concerning each 
proposed collection of information, including each proposed extension 
of a currently approved collection, and allow 60 days for public 
comment in response to the notice. This notice solicits comments for 
information needed to determine non-Federal nursing home qualification 
to provide care to Veteran patients.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before May 21, 2013.

ADDRESSES: Submit written comments on the collection of information 
through the Federal Docket Management System (FDMS) at 
www.Regulations.gov; or to Cynthia Harvey-Pryor, Veterans Health 
Administration (10B4), Department of Veterans Affairs, 810 Vermont 
Avenue NW., Washington, DC 20420 or email: [email protected]. 
Please refer to ``2900-0616'' in any correspondence. During the comment 
period, comments may be viewed online through FDMS.

FOR FURTHER INFORMATION CONTACT: Cynthia Harvey-Pryor (202) 461-5870 or 
Fax (202) 273-9387.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from OMB for 
each collection of information they conduct or sponsor. This request 
for comment is being made pursuant to Section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Titles:
    a. Application for Furnishing Long-Term Care Services to 
Beneficiaries of Veterans Affairs, VA Form 10-1170.
    b. Residential Care Home Program--Sponsor Application, VA Form 
2407.
    OMB Control Number: 2900-0616.
    Type of Review: Revision of a currently approved collection.
    Abstract:
    a. VA Form 10-1170 is completed by community agencies wishing to 
provide long term care to Veterans receiving VA benefits.
    b. VA Form 10-2407 is an application used by a residential care 
facility or home that wished to provide residential home care to 
Veterans. It serves as the agreement between VA and the residential 
care home that the home will

[[Page 17778]]

submit to an initial inspection and comply with requirements for 
residential care. An agency may not conduct or sponsor, and a person is 
not required to respond to a collection of information unless it 
displays a currently valid OMB control number.
    Affected Public: Business or other for-profit.
    Estimated Annual Burden:
    a. VA Form 10-1170--83 hours.
    b. VA Form 2407--42 hours.
    Estimated Average Burden per Respondent:
    a. VA Form 10-1170--10 minutes.
    b. VA Form 2407--5 minutes.
    Frequency of Response: One time.
    Estimated Number of Respondents:
    a. VA Form 10-1170--500.
    b. VA Form 2407--500.

    Dated: March 19, 2013.

    By direction of the Secretary.
William F. Russo,
Deputy Director, Office of Regulations Policy and Management, Office of 
General Counsel, Department of Veterans Affairs.
[FR Doc. 2013-06642 Filed 3-21-13; 8:45 am]
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