[Federal Register Volume 80, Number 237 (Thursday, December 10, 2015)]
[Notices]
[Pages 76744-76745]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-31107]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


Agency Information Collection (Title 38, Parts 51 and 52, State 
Home Programs) Activities Under OMB Review

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act (PRA) of 1995 
(44 U.S.C. 3501-3521), this notice announces that the Veterans Health 
Administration (VHA), Department of Veterans Affairs, will submit the 
collection of information abstracted below to the Office of Management 
and Budget (OMB) for review and comment. The PRA submission describes 
the nature of the information collection and its expected cost and 
burden and includes the actual data collection instrument.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before January 11, 2016.

ADDRESSES: Submit written comments on the collection of information 
through www.Regulations.gov, or to Office of Information and Regulatory 
Affairs, Office of Management and Budget, Attn: VA Desk Officer; 725 
17th St. NW., Washington, DC 20503 or sent through electronic mail to 
[email protected]. Please refer to ``OMB Control No. 2900-
0160 (Title 38, Parts 51 and 52, State Home Programs)'' in any 
correspondence. During the comment period, comments may be viewed 
online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Crystal Rennie, Enterprise Records 
Service (005R1B), Department of Veterans Affairs, 810 Vermont Avenue 
NW., Washington, DC 20420, (202) 632-7492 or email 
[email protected]. Please refer to ``OMB Control No. 2900-0160 
(Title 38, Parts 51 and 52, State Home Programs)'' in any 
correspondence.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (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.

SUPPLEMENTARY INFORMATION: Titles: Title 38, Parts 51 and 52, State 
Home Programs.
    OMB Control Number: 2900-0160, (Title 38, Parts 51 and 52, State 
Home Programs).
    Type of Review: Revision.
    Abstract: Title 38, CFR part 51, provides for the payment of per 
diem to State homes that provide nursing home care to eligible 
veterans. Title 38, CFR part 52, provides for the payment of per diem 
to State homes that provide adult

[[Page 76745]]

day health care to eligible veterans. The intended effect of these 
provisions was to ensure that veterans receive high quality care in 
State Homes. To ensure that high quality care is furnished veterans, VA 
requires those facilities providing nursing home care and adult day 
health care programs to veterans to supply various kinds of 
information. The information required includes an application for 
recognition based on certification; appeal information, application and 
justification for payment; records and reports which facility 
management must maintain regarding activities of residents or 
participants; information relating to whether the facility meets 
standards concerning residents' rights and responsibilities prior to 
admission or enrollment, during admission or enrollment, and upon 
discharge; the records and reports which facilities management and 
health care professionals must maintain regarding residents or 
participants and employees; various types of documents pertaining to 
the management of the facility; food menu planning; pharmaceutical 
records; and life safety documentation. VA Form 10-10EZ (OMB approval 
2900-0091) is used in conjunction with the VA Form 10-10SH.
    Affected Public: State, Local or Private Government.
    Estimated Annual Burden: 6,858 Burden hours.
    a. State Home Inspection Staffing Profile, VA Form 10-3567--69.5 
hrs.
    b. State Home Report and State of Federal Aid Claimed, VA Form 10-
5588--834 hrs.
    c. Claim for Payment for Nursing Home Care Provided to Veterans 
Awarded Retroactive Service Connection, VA Form 10-5588A--180 hrs.
    d. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--3,802 hrs.
    e. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10- 
0143--12 hrs.
    f. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--12 hrs.
    g. Certification Regarding Lobbying, VA Form 10-0144--12 hrs.
    h. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0460--12 hrs.
    i. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0144a--12 hrs.
    j. Application for Recognition (Letter to Under Secretary for 
Health)--2 hrs.
    k. Recognition & Certification (Sections 51.30 and 52.30)--120 hrs.
    l. Quality of Life (Sections 51.100 and 52.100)--350 hrs.
    m. Section, Administration and (Section 51.210 and 52.210)--1,400 
hrs.
    Estimated Average Burden per Respondent:
    Frequency of Response: On Occasion.
    Estimated Number of Respondents: 12,884.

    By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records 
Management, Department of Veterans Affairs.
[FR Doc. 2015-31107 Filed 12-9-15; 8:45 am]
 BILLING CODE 8320-01-P