Federal Register / Vol. 83, No. 171 / Tuesday, September 4, 2018 / Notices 44877 

MATTERS TO BE CONSIDERED: 

Compliance matters pursuant to 52 

U.S.C. 30109 

Matters concerning participation in civil 

actions or proceedings or arbitration 

* * * * * 

CONTACT PERSON FOR MORE INFORMATION: 

Judith Ingram, Press Officer, Telephone: 

(202) 694–1220. 

Laura E. Sinram, 

Deputy Secretary of the Commission. 

[FR Doc. 2018–19230 Filed 8–30–18; 4:15 pm] 

BILLING CODE 6715–01–P 

FEDERAL ELECTION COMMISSION 

Sunshine Act Meeting 

TIME AND DATE: Thursday, September 6, 

2018 at 3:00 p.m. 

PLACE: 1050 First Street NE, 

Washington, DC (12th Floor). 

STATUS: This meeting will be open to 

the public. 

MATTERS TO BE CONSIDERED: 

Correction and Approval of Minutes for 

August 2, 2018 

Draft Advisory Opinion 2018–11: 

Microsoft Corporation 

Notice of Availability for REG 2018–02 

(Leadership PACs’ Personal Use) 

Implementation of OMB Circular A– 

123: Internal Control Program 

Management and Administrative 

Matters 

CONTACT PERSON FOR MORE INFORMATION: 

Judith Ingram, Press Officer, Telephone: 

(202) 694–1220. 

Individuals who plan to attend and 

require special assistance, such as sign 

language interpretation or other 

reasonable accommodations, should 

contact Dayna C. Brown, Secretary and 

Clerk, at (202) 694–1040, at least 72 

hours prior to the meeting date. 

Dayna C. Brown, 

Secretary and Clerk of the Commission. 

[FR Doc. 2018–19229 Filed 8–30–18; 4:15 pm] 

BILLING CODE 6715–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project ‘‘Medical 

Expenditure Panel Survey (MEPS) 

Household Component and the MEPS 

Medical Provider Component.’’ 

This proposed information collection 

was previously published in the Federal 

Register on June 4, 2018 and allowed 60 

days for public comment. AHRQ did not 

receive substantive comments from 

members of the public. The purpose of 

this notice is to allow an additional 30 

days for public comment. 

DATES: Comments on this notice must be 

received by October 4, 2018. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at OIRA_submission@

omb.eop.gov (attention: AHRQ’s desk 

officer). 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Medical Expenditure Panel Survey 

(MEPS) Household Component (HC) 

In accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3521, 

AHRQ invites the public the comment 

on this proposed information collection. 

For over thirty years, results from the 

MEPS and its predecessor surveys (the 

1977 National Medical Care 

Expenditure Survey, the 1980 National 

Medical Care Utilization and 

Expenditure Survey and the 1987 

National Medical Expenditure Survey) 

have been used by OMB, DHHS, 

Congress and a wide number of health 

services researchers to analyze health 

care use, expenses and health policy. 

Major changes continue to take place 

in the health care delivery system. The 

MEPS is needed to provide information 

about the current state of the health care 

system as well as to track changes over 

time. The MEPS permits annual 

estimates of use of health care and 

expenditures and sources of payment 

for that health care. It also permits 

tracking individual change in 

employment, income, health insurance 

and health status over two years. The 

use of the NHIS as a sampling frame 

expands the MEPS analytic capacity by 

providing another data point for 

comparisons over time. 

Households selected for participation 

in the MEPS–HC are interviewed five 

times in person. These rounds of 

interviewing are spaced about 5 months 

apart. The interview will take place 

with a family respondent who will 

report for him/herself and for other 

family members. 

The MEPS–HC has the following goal: 

D To provide nationally 

representative estimates for the U.S. 

civilian noninstitutionalized population 

for: 

Æ Health care use, expenditures, 

sources of payment 

Æ health insurance coverage 

Medical Expenditure Panel Survey 

(MEPS) Medical Provider Component 

(MPC) 

The MEPS–MPC will contact medical 

providers (hospitals, physicians, home 

health agencies and institutions) 

identified by household respondents in 

the MEPS–HC as sources of medical 

care for the time period covered by the 

interview, and all pharmacies providing 

prescription drugs to household 

members during the covered time 

period. The MEPS–MPC is not designed 

to yield national estimates as a standalone survey. The sample is designed to 

target the types of individuals and 

providers for whom household reported 

expenditure data was expected to be 

insufficient. For example, Medicaid 

enrollees are targeted for inclusion in 

the MEPS–MPC because this group is 

expected to have limited information 

about payments for their medical care. 

The MEPS–MPC collects event level 

data about medical care received by 

sampled persons during the relevant 

time period. The data collected from 

medical providers include: 

• Dates on which medical encounters 

during the reference period occurred 

• Data on the medical content of each 

encounter, including ICD–10 codes 

• Data on the charges associated with 

each encounter, the sources paying for 

the medical care-including the 

patient/family, public sources, and 

private insurance, and amounts paid 

by each source 

Data collected from pharmacies 

include: 

• Date of prescription fill 

• National drug code (NDC) or 

prescription name, strength and form 

• Quantity 

• Payments, by source 

The MEPS–MPC has the following 

goal: 

• To serve as an imputation source 

for and to supplement/replace 

household reported expenditure and 

source of payment information. This 

data will supplement, replace and verify 

information provided by household 

respondents about the charges, 


sradovich on DSK3GMQ082PROD with NOTICES
44878 Federal Register / Vol. 83, No. 171 / Tuesday, September 4, 2018 / Notices 

payments, and sources of payment 

associated with specific health care 

encounters. 

This study is being conducted by 

AHRQ through its contractors, Westat 

and RTI International, pursuant to 

AHRQ’s statutory authority to conduct 

and support research on health care and 

on systems for the delivery of such care, 

including activities with respect to the 

cost and use of health care services and 

with respect to health statistics and 

surveys. 42 U.S.C. 299a(a)(3) and (8); 42 

U.S.C. 299b-2. 

Method of Collection 

To achieve the goals of the MEPS–HC 

the following data collections are 

implemented: 

1. Household Component Core 

Instrument. The core instrument 

collects data about persons in sample 

households. Topical areas asked in each 

round of interviewing include priority 

condition enumeration, health status, 

health care utilization including 

prescribed medicines, expenses and 

payments, employment, and health 

insurance. Other topical areas that are 

asked only once a year include access to 

care, income, assets, satisfaction with 

providers, and children’s health. While 

many of the questions are asked about 

the entire reporting unit (RU), which is 

typically a family, only one person 

normally provides this information. All 

sections of the current core instrument 

are available on the AHRQ website at 

http://meps.ahrq.gov/mepsweb/survey_

comp/survey_questionnaires.jsp. 

2. Adult Self-Administered 

Questionnaire. A brief self-administered 

questionnaire (SAQ) will be used to 

collect self-reported (rather than 

through household proxy) on health 

opinions and satisfaction with health 

care, and information on health status, 

preventive care and health care quality 

measures for adults 18 and. The 

satisfaction with health care items are a 

subset of items from the Consumer 

Assessment of Healthcare Providers and 

Systems (CAHPS®). The health status 

items are from the Veterans Rand 12 

item health survey (VR–12), a generic 

instrument developed with the support 

of the Department of Veterans Affairs 

and the Centers for Medicare and 

Medicaid Services. Additionally, there 

are questions addressing adult 

preventive care for both males and 

females. This questionnaire is revised 

from the previous OMB clearance. 

3. Veteran SAQ. MEPS includes a new 

self-administered questionnaire for 

spring of 2019 data collection targeting 

the veteran population. The 

questionnaire asks questions in the 

following domains of interest: If a 

veteran is eligible for VA health care; if 

a Veteran is enrolled in VA health care; 

coordination of care in and out of the 

VA health care system, services 

provided to Veterans in and out of the 

VA health care system, and VA 

eligibility priority groups, for Veterans 

enrolled in VA health care and for 

Veterans eligible for VA health care. To 

assist in the correct identification of 

priority groups, the questionnaire may 

also include items assessing the 

following: Presence of serviceconnected disability; service-connected 

disability rating; presence of 

presumptive-conditions; timing and era 

of active duty; and VA receipt of 

disability compensation benefits. AHRQ 

worked with the Veteran Health 

Administration to develop the 

questionnaire content. 

4. Diabetes Care SAQ. A brief selfadministered paper-and-pencil 

questionnaire on the quality of diabetes 

care is administered once a year (during 

rounds 3 and 5) to persons identified as 

having diabetes. Included are questions 

about the number of times the 

respondent reported having a 

hemoglobin A1c blood test, whether the 

respondent reported having his or her 

feet checked for sores or irritations, 

whether the respondent reported having 

an eye exam in which the pupils were 

dilated, the last time the respondent had 

his or her blood cholesterol checked and 

whether the diabetes has caused kidney 

or eye problems. Respondents are also 

asked if their diabetes is being treated 

with diet, oral medications or insulin. 

This questionnaire is unchanged from 

the previous OMB clearance. 

5. Authorization forms for the MEPS– 

MPC Provider and Pharmacy Survey. As 

in previous panels of the MEPS, we will 

ask respondents for authorization to 

obtain supplemental information from 

their medical providers (hospitals, 

physicians, home health agencies and 

institutions) and pharmacies. 

6. MEPS Validation Interview. Each 

interviewer is required to have at least 

15 percent of his/her caseload validated 

to insure that the computer assisted 

personal interview (CAPI) questionnaire 

content was asked appropriately and 

procedures followed, for example the 

use of show cards. Validation flags are 

set programmatically for cases preselected by data processing staff before 

each round of interviewing. Home office 

and field management may also request 

that other cases be validated throughout 

the field period. When an interviewer 

fails a validation their work is subject to 

100 percent validation. Additionally, 

any case completed in less than 30 

minutes is validated. A validation 

abstract form containing selected data 

collected in the CAPI interview is 

generated and used by the validator to 

guide the validation interview. 

To achieve the goal of the MEPS–MPC 

the following data collections are 

implemented: 

1. MPC Contact Guide/Screening Call. 

An initial screening call is placed to 

determine the type of facility, whether 

the practice or facility is in scope for the 

MEPS–MPC, the appropriate MEPS– 

MPC respondent and some details about 

the organization and availability of 

medical records and billing at the 

practice/facility. All hospitals, 

physician offices, home health agencies, 

institutions and pharmacies are 

screened by telephone. A unique 

screening instrument is used for each of 

these seven provider types in the 

MEPS–MPC, except for the two home 

care provider types which use the same 

screening form. 

2. Home Care Provider Questionnaire 

for Health Care Providers. This 

questionnaire is used to collect data 

from home health care agencies which 

provide medical care services to 

household respondents. Information 

collected includes type of personnel 

providing care, hours or visits provided 

per month, and the charges and 

payments for services received. Some 

HMOs may be included in this provider 

type. 

3. Home Care Provider Questionnaire 

for Non-Health Care Providers. This 

questionnaire is used to collect 

information about services provided in 

the home by non-health care workers to 

household respondents because of a 

medical condition; for example, 

cleaning or yard work, transportation, 

shopping, or child care. 

4. Medical Event Questionnaire for 

Office-Based Providers. This 

questionnaire is for office-based 

physicians, including doctors of 

medicine (MDs) and osteopathy (DOs), 

as well as providers practicing under 

the direction or supervision of an MD or 

DO (e.g., physician assistants and nurse 

practitioners working in clinics). 

Providers of care in private offices as 

well as staff model HMOs are included. 

5. Medical Event Questionnaire for 

Separately Billing Doctors. This 

questionnaire collects information from 

physicians identified by hospitals 

(during the Hospital Event data 

collection) as providing care to sampled 

persons during the course of inpatient, 

outpatient department or emergency 

room care, but who bill separately from 

the hospital. 

6. Hospital Event Questionnaire. This 

questionnaire is used to collect 

information about hospital events, 

including inpatient stays, outpatient 


sradovich on DSK3GMQ082PROD with NOTICES
Federal Register / Vol. 83, No. 171 / Tuesday, September 4, 2018 / Notices 44879 

department, and emergency room visits. 

Hospital data are collected not only 

from the billing department, but from 

medical records and administrative 

records departments as well. Medical 

records departments are contacted to 

determine the names of all the doctors 

who treated the patient during a stay or 

visit. In many cases, the hospital 

administrative office also has to be 

contacted to determine whether the 

doctors identified by medical records 

billed separately from the hospital; 

doctors that do bill separately from the 

hospital will be contacted as part of the 

Medical Event Questionnaire for 

Separately Billing Doctors. HMOs are 

included in this provider type. 

7. Institutions Event Questionnaire. 

This questionnaire is used to collect 

information about institution events, 

including nursing homes, rehabilitation 

facilities and skilled nursing facilities. 

Institution data are collected not only 

from the billing department, but from 

medical records and administrative 

records departments as well. Medical 

records departments are contacted to 

determine the names of all the doctors 

who treated the patient during a stay. In 

many cases, the institution’s 

administrative office also has to be 

contacted to determine whether the 

doctors identified by medical records 

billed separately from the institution 

itself. Some HMOs may be included in 

this provider type. 

8. Pharmacy Data Collection 

Questionnaire. This questionnaire 

requests the NDC and when that is not 

available the prescription name, 

strength and form as well as the date 

prescription was filled, payments by 

source, the quantity, and person for 

whom the prescription was filled. When 

the NDC is available, we do not ask for 

prescription name, strength or form 

because that information is embedded 

in the NDC; this reduces burden on the 

respondent. Most pharmacies have the 

requested information available in 

electronic format and respond by 

providing a computer generated 

printout of the patient’s prescription 

information. If the computerized form is 

unavailable, the pharmacy can report 

their data to a telephone interviewer. 

Pharmacies are also able to provide a 

CD–ROM with the requested 

information if that is preferred. HMOs 

are included in this provider type. 

Dentists, optometrists, psychologists, 

podiatrists, chiropractors, and others 

not providing care under the 

supervision of a MD or DO are 

considered out of scope for the MEPS– 

MPC. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondents’ time to participate in the 

MEPS–HC and the MEPS–MPC. 

The MEPS–HC Core Interview will be 

completed by 13,338* (see note below 

Exhibit 1) ‘‘family level’’ respondents, 

also referred to as RU respondents. 

Since the MEPS–HC consists of 5 

rounds of interviewing covering a full 

two years of data, the annual average 

number of responses per respondent is 

2.5 responses per year. The MEPS–HC 

core requires an average response time 

of 92 minutes to administer. The Adult 

Female SAQ will be completed once a 

year by each female person in the RU 

that is 18 years old and older, an 

estimated 12,984 persons. The Adult 

Male SAQ will be completed once a 

year by each male person in the RU that 

is 18 years old and older, an estimated 

11,985 persons. The Adult SAQs each 

require an average of 7 minutes to 

complete. The Diabetes care SAQ will 

be completed once a year by each 

person in the RU identified as having 

diabetes, an estimated 2,072 persons, 

and takes about 3 minutes to complete. 

The Veteran SAQ will be completed 

once by each in-scope person who is a 

veteran of the U.S. military identified in 

the Round 1, Panel 23 interview, an 

estimated 1,350 persons. The Veteran 

SAQ requires an average of 15 minutes 

to complete. The authorization form for 

the MEPS–MPC Provider Survey will be 

completed once for each medical 

provider seen by any RU member. The 

12,804 RUs in the MEPS–HC will 

complete an average of 5.4 forms, which 

require about 3 minutes each to 

complete. The authorization form for 

the MEPS–MPC Pharmacy Survey will 

be completed once for each pharmacy 

for any RU member who has obtained a 

prescription medication. RUs will 

complete an average of 3.1 forms, which 

take about 3 minutes to complete. About 

one third of all interviewed RUs will 

complete a validation interview as part 

of the MEPS–HC quality control, which 

takes an average of 5 minutes to 

complete. The total annual burden 

hours for the MEPS–HC are estimated to 

be 60,278 hours. 

All medical providers and pharmacies 

included in the MEPS–MPC will receive 

a screening call and the MEPS–MPC 

uses 7 different questionnaires; 6 for 

medical providers and 1 for pharmacies. 

Each questionnaire is relatively short 

and requires 2 to 19 minutes to 

complete. The total annual burden 

hours for the MEPS–MPC are estimated 

to be 17,388 hours. The total annual 

burden for the MEPS–HC and MPC is 

estimated to be 77,666 hours. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours 

per response 

Total burden 

hours 

MEPS–HC 

MEPS–HC Core Interview ............................................................................... * 13,338 2.5 92/60 51,129 

Adult Female SAQ ........................................................................................... 12,984 1 7/60 1,515 

Adult Male SAQ ............................................................................................... 11,985 1 7/60 1,398 

Diabetes care SAQ .......................................................................................... 2,072 1 3/60 104 

Veteran SAQ .................................................................................................... 1,350 1 15/60 338 

Authorization form for the MEPS–MPC Provider Survey ................................ 12,804 5.4 3/60 3,457 

Authorization form for the MEPS–MPC Pharmacy Survey ............................. 12,804 3.1 3/60 1,985 

MEPS–HC Validation Interview ....................................................................... 4,225 1 5/60 352 

Subtotal for the MEPS–HC .............................................................................. 71,562 na na 60,278 

MEPS–MPC 

MPC Contact Guide/Screening Call ** ............................................................. 36,598 1 2/60 1,220 

Home care for health care providers questionnaire ........................................ 635 1.53 9/60 146 

Home care for non-health care providers questionnaire ................................. 11 1 11/60 2 

Office-based providers questionnaire .............................................................. 11,210 1.65 10/60 3,083 


sradovich on DSK3GMQ082PROD with NOTICES
44880 Federal Register / Vol. 83, No. 171 / Tuesday, September 4, 2018 / Notices 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Hours 

per response 

Total burden 

hours 

Separately billing doctors questionnaire .......................................................... 12,397 3.46 13/60 9,294 

Hospitals questionnaire ................................................................................... 5,310 3.26 9/60 2,597

Institutions (non-hospital) questionnaire .......................................................... 116 2.05 9/60 36 

Pharmacies questionnaire ............................................................................... 6,919 2.92 3/60 1,010 

Subtotal for the MEPS–MPC .................................................................... 73,196 na na 17,388 

Grand Total ....................................................................................... 144,758 na na 77,666 

* While the expected number of responding units for the annual estimates is 12,804, it is necessary to adjust for survey attrition of initial respondents by a factor of 0.96 (13,338 = 12,804/0.96). 

** There are 6 different contact guides; one for office based, separately billing doctor, hospital, institution, and pharmacy provider types, and 

the two home care provider types use the same contact guide. 

Exhibit 2 shows the estimated annual 

cost burden associated with the 

respondents’ time to participate in this 

information collection. The annual cost 

burden for the MEPS–HC is estimated to 

be $1,467,167; the annual cost burden 

for the MEPS–MPC is estimated to be 

$298,580. The total annual cost burden 

for the MEPS–HC and MPC is estimated 

to be $1,765,746. 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly 

wage rate 

Total cost 

burden 

MEPS–HC 

MEPS–HC Core Interview ............................................................................... 13,338 51,129 * $24.34 $1,244,480 

Adult Female SAQ ........................................................................................... 12,984 1,515 * 24.34 36,875 

Adult Male SAQ ............................................................................................... 11,985 1,398 * 24.34 34,027 

Diabetes care SAQ .......................................................................................... 2,072 104 * 24.34 2,531 

Veteran SAQ .................................................................................................... 1,350 338 * 24.34 8,227 

Authorization forms for the MEPS–MPC Provider Survey .............................. 12,804 3,457 * 24.34 84,143 

Authorization form for the MEPS–MPC Pharmacy Survey ............................. 12,804 1,985 * 24.34 48,315 

MEPS–HC Validation Interview ....................................................................... 4,225 352 * 24.34 8,568 

Subtotal for the MEPS–HC ....................................................................... 71,562 60,278 na 1,467,167 

MEPS–MPC 

MPC Contact Guide/Screening Call ................................................................ 36,598 1,220 ** 17.25 21,045 

Home care for health care providers questionnaire ........................................ 635 146 ** 17.25 2,519 

Home care for non-health care providers questionnaire ................................. 11 2 ** 17.25 35 

Office-based providers questionnaire .............................................................. 11,210 3,083 ** 17.25 53,182 

Separately billing doctors questionnaire .......................................................... 12,397 9,294 ** 17.25 160,322 

Hospitals questionnaire ................................................................................... 5,310 2,597 ** 17.25 44,798 

Institutions (non-hospital) questionnaire .......................................................... 116 36 ** 17.25 621 

Pharmacies questionnaire ............................................................................... 6,919 1,010 *** 15.90 16,059 

Subtotal for the MEPS–MPC .................................................................... 73,196 17,388 na 298,580 

Grand Total ....................................................................................... 144,758 77,666 na 1,765,746 

* Mean hourly wage for All Occupations (00–0000). 

** Mean hourly wage for Medical Secretaries (43–6013). 

*** Mean hourly wage for Pharmacy Technicians (29–2052). 

Occupational Employment Statistics, May 2017 National Occupational Employment and Wage Estimates United States, U.S. Department of 

Labor, Bureau of Labor Statistics. https://www.bls.gov/oes/current/oes_nat.htm#b29-0000. 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, comments on AHRQ’s 

information collection are requested 

with regard to any of the following: (a) 

Whether the proposed collection of 

information is necessary for the proper 

performance of AHRQ’s health care 

research and health care information 

dissemination functions, including 

whether the information will have 

practical utility; (b) the accuracy of 

AHRQ’s estimate of burden (including 

hours and costs) of the proposed 

collection(s) of information; (c) ways to 

enhance the quality, utility and clarity 

of the information to be collected; and 

(d) ways to minimize the burden of the 

collection of information upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 


sradovich on DSK3GMQ082PROD with NOTICES
Federal Register / Vol. 83, No. 171 / Tuesday, September 4, 2018 / Notices 44881 

comments will become a matter of 

public record. 

Francis D. Chesley, Jr., 

Acting Deputy Director. 

[FR Doc. 2018–19027 Filed 8–31–18; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project ‘‘Nursing 

Home Survey on Patient Safety Culture 

Database.’’ 

This proposed information collection 

was previously published in the Federal 

Register on May 31, 2018, and allowed 

60 days for public comment. AHRQ 

received no substantive comments 

during this period. The purpose of this 

notice is to allow an additional 30 days 

for public comment. 

DATES: Comments on this notice must be 

received by October 4, 2018. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at OIRA_submission@

omb.eop.gov (attention: AHRQ’s desk 

officer). 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Nursing Home Survey on Patient Safety 

Culture Database 

In accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3521, 

AHRQ invites the public the comment 

on this proposed information collection. 

In 1999, the Institute of Medicine called 

for health care organizations to develop 

a ‘‘culture of safety’’ such that their 

workforce and processes focus on 

improving the reliability and safety of 

care for patients (IOM, 1999; To Err is 

Human: Building a Safer Health 

System). To respond to the need for 

tools to assess patient safety culture in 

health care, AHRQ developed and pilot 

tested the Nursing Home Survey on 

Patient Safety Culture with OMB 

approval (OMB NO. 0935–0132; 

Approved July 5, 2007). 

The survey is designed to enable 

nursing homes to assess provider and 

staff perspectives about patient safety 

issues, medical error, and error 

reporting and includes 42 items that 

measure 12 composites of patient safety 

culture. AHRQ made the survey 

publicly available along with a Survey 

User’s Guide and other toolkit materials 

in November 2008 on the AHRQ 

website. 

The AHRQ Nursing Home SOPS 

Database consists of data from the 

AHRQ Nursing Home Survey on Patient 

Safety Culture. Nursing homes in the 

U.S. can voluntarily submit data from 

the survey to AHRQ through its 

contractor, Westat. The Nursing Home 

SOPS Database (OMB NO. 0935–0195, 

last approved on September 30, 2015) 

was developed by AHRQ in 2011 in 

response to requests from nursing 

homes interested in viewing their 

organizations’ patient safety culture 

survey results. Those organizations 

submitting data receive a feedback 

report, as well as a report on the 

aggregated de-identified findings of the 

other nursing homes submitting data. 

These reports are used to assist nursing 

home staff in their efforts to improve 

patient safety culture in their 

organizations. 

Rationale for the information 

collection. The Nursing Home SOPS 

and Nursing Home SOPS Database 

support AHRQ’s goals of promoting 

improvements in the quality and safety 

of health care in nursing home settings. 

The survey, toolkit materials, and 

database results are all made publicly 

available on AHRQ’s website. Technical 

assistance is provided by AHRQ through 

its contractor at no charge to nursing 

homes, to facilitate the use of these 

materials for nursing home patient 

safety and quality improvement. 

This database will: 

(1) Present results from nursing 

homes that voluntarily submit their 

data, 

(2) Provide data to nursing homes to 

facilitate internal assessment and 

learning in the patient safety 

improvement process, and 

(3) Provide supplemental information 

to help nursing homes identify their 

strengths and areas with potential for 

improvement in patient safety culture. 

This study is being conducted by 

AHRQ through its contractor, Westat, 

pursuant to AHRQ’s statutory authority 

to conduct and support research on 

health care and on systems for the 

delivery of such care, including 

activities with respect to the quality, 

effectiveness, efficiency, 

appropriateness and value of health care 

services and with respect to quality 

measurement and improvement. 42 

U.S.C 299a(a)(1) and (2) 

Method of Collection 

To achieve the goal of this project the 

following activities and data collections 

will be implemented: 

(1) Eligibility and Registration Form— 

The nursing home (or parent 

organization) point-of-contact (POC) 

completes a number of data submission 

steps and forms, beginning with the 

completion of an online Eligibility and 

Registration Form. The purpose of this 

form is to collect basic demographic 

information about the nursing home and 

initiate the registration process. 

(2) Data Use Agreement—The purpose 

of the data use agreement, completed by 

the nursing home POC, is to state how 

data submitted by nursing homes will 

be used and provides privacy 

assurances. 

(3) Nursing Home Site Information 

Form—The purpose of the site 

information form, completed by the 

nursing home POC, is to collect 

background characteristics of the 

nursing home. This information will be 

used to analyze data collected with the 

Nursing Home SOPS survey. 

(4) Data File(s) Submission—POCs 

upload their data file(s) using the data 

file specifications, to ensure that users 

submit standardized and consistent data 

in the way variables are named, coded 

and formatted. The number of 

submissions to the database is likely to 

vary each year because nursing homes 

do not administer the survey and submit 

data every year. Data submission is 

typically handled by one POC who is 

either a corporate level health care 

manager for a Quality Improvement 

Organization (QIO), a survey vendor 

who contracts with a nursing home to 

collect their data, or a nursing home 

Director of Nursing or nurse manager. 

POCs submit data on behalf of 5 nursing 

homes, on average, because many 

nursing homes are part of a QIO or 

larger nursing home or health system 

that includes many nursing home sites, 

or the POC is a vendor that is submitting 

data for multiple nursing homes. 

Survey data from the AHRQ Nursing 

Home Survey on Patient Safety Culture 

are used to produce three types of 

products: 

(1) A Nursing Home SOPS User 

Database Report that is made publicly 

available on the AHRQ website; 


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