Federal Register / Vol. 86, No. 166 / Tuesday, August 31, 2021 / Notices 48703 

(202) 418–2040 or email: kurian.jacob@

fcc.gov. 

SUPPLEMENTARY INFORMATION: The 

meeting on September 22, 2021, at 1:00 

p.m. EDT, will be held electronically 

only and may be viewed live, by the 

public, at http://www.fcc.gov/live. Any 

questions that arise during the meeting 

should be sent to CSRIC@fcc.gov and 

will be answered at a later date. The 

meeting is being held in a wholly 

electronic format in light of travel and 

gathering restrictions related to COVID– 

19 in place in Washington, DC, and the 

larger U.S., which affect members of 

CSRIC and the Commission. 

The CSRIC is a Federal Advisory 

Committee that will provide 

recommendations to the Commission to 

improve the security, reliability, and 

interoperability of communications 

systems. On June 30, 2021, the 

Commission, pursuant to the Federal 

Advisory Committee Act, renewed the 

charter for CSRIC VII for a period of two 

years through June 29, 2023. The 

meeting on September 22, 2021, will be 

the first meeting of CSRIC VIII under the 

current charter. The Commission will 

provide audio and/or video coverage of 

the meeting over the internet from the 

FCC’s web page at http://www.fcc.gov/ 

live. The public may submit written 

comments before the meeting to Suzon 

Cameron, CSRIC VIII Designated Federal 

Officer, by email to CSRIC@fcc.gov. 

Open captioning will be provided for 

this event. Other reasonable 

accommodations for people with 

disabilities are available upon request. 

Requests for such accommodations 

should be submitted via email to 

fcc504@fcc.gov or by calling the 

Consumer & Governmental Affairs 

Bureau at (202) 418–0530 (voice), (202) 

418–0432 (tty). Such requests should 

include a detailed description of the 

accommodation needed. In addition, 

please include a way the Commission 

can contact you if it needs more 

information. Please allow at least five 

days’ advance notice; last-minute 

requests will be accepted but may be 

impossible to fill. 

Federal Communications Commission. 

Katura Jackson, 

Federal Register Liaison, Office of the 

Secretary. 

[FR Doc. 2021–18690 Filed 8–30–21; 8:45 am] 

BILLING CODE 6712–01–P 

FEDERAL RESERVE SYSTEM 

Formations of, Acquisitions by, and 

Mergers of Bank Holding Companies 

The companies listed in this notice 

have applied to the Board for approval, 

pursuant to the Bank Holding Company 

Act of 1956 (12 U.S.C. 1841 et seq.) 

(BHC Act), Regulation Y (12 CFR part 

225), and all other applicable statutes 

and regulations to become a bank 

holding company and/or to acquire the 

assets or the ownership of, control of, or 

the power to vote shares of a bank or 

bank holding company and all of the 

banks and nonbanking companies 

owned by the bank holding company, 

including the companies listed below. 

The public portions of the 

applications listed below, as well as 

other related filings required by the 

Board, if any, are available for 

immediate inspection at the Federal 

Reserve Bank(s) indicated below and at 

the offices of the Board of Governors. 

This information may also be obtained 

on an expedited basis, upon request, by 

contacting the appropriate Federal 

Reserve Bank and from the Board’s 

Freedom of Information Office at 

https://www.federalreserve.gov/foia/ 

request.htm. Interested persons may 

express their views in writing on the 

standards enumerated in the BHC Act 

(12 U.S.C. 1842(c)). 

Comments regarding each of these 

applications must be received at the 

Reserve Bank indicated or the offices of 

the Board of Governors, Ann E. 

Misback, Secretary of the Board, 20th 

Street and Constitution Avenue NW, 

Washington DC 20551–0001, not later 

than September 30, 2021. 

A. Federal Reserve Bank of St. Louis 

(Holly A. Rieser, Manager) P.O. Box 442, 

St. Louis, Missouri 63166–2034. 

Comments can also be sent 

electronically to 

Comments.applications@stls.frb.org: 

1. Friendship Bancshares, Inc., Linn, 

Missouri; to acquire 40 percent of the 

voting shares of Grey Mountain 

Holdings, Inc., Columbia, Missouri, and 

thereby indirectly acquire voting shares 

of Investors Community Bank, 

Chillicothe, Missouri. 

B. Federal Reserve Bank of Kansas 

City (Jeffrey Imgarten, Assistant Vice 

President) 1 Memorial Drive, Kansas 

City, Missouri 64198–0001: 

1. Employee Stock Ownership Plan 

Accounts Trust of the Security Bank 

KSOP & Trust, Laurel, Nebraska; to 

become a bank holding company by 

acquiring 31.3 percent of the voting 

shares of First Laurel Security Co., and 

thereby indirectly acquiring voting 

shares of Security Bank, both of Laurel, 

Nebraska. 

Board of Governors of the Federal Reserve 

System, August 26, 2021. 

Michele Taylor Fennell, 

Deputy Associate Secretary of the Board. 

[FR Doc. 2021–18760 Filed 8–30–21; 8:45 am] 

BILLING CODE 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 (AHRQ), 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 

‘‘Ambulatory Surgery Center Survey on 

Patient Safety Culture Database.’’ This 

proposed information collection was 

previously published in the Federal 

Register on May 25, 2021 and allowed 

60 days for public comment. AHRQ did 

not receive substantive comments. The 

purpose of this notice is to allow an 

additional 30 days for public comment. 

DATES: Comments on this notice must be 

received by September 30, 2021. 

ADDRESSES: Written comments and 

recommendations for the proposed 

information collection should be sent 

within 30 days of publication of this 

notice to www.reginfo.gov/public/do/ 

PRAMain. Find this particular 

information collection by selecting 

‘‘Currently under 30-day Review—Open 

for Public Comments’’ or by using the 

search function. 

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 

Ambulatory Surgery Center Survey on 

Patient Safety Culture Database 

Ambulatory surgery centers (ASCs) 

are a fast-growing healthcare setting, 

demonstrating tremendous growth both 

in the volume and complexity of 

procedures being performed. ASCs 

provide surgical services to patients 

who are not expected to need an 

inpatient stay following surgery. The 


khammond on DSKJM1Z7X2PROD with NOTICES
48704 Federal Register / Vol. 86, No. 166 / Tuesday, August 31, 2021 / Notices 

Centers for Medicare and Medicaid 

Services (CMS) defines ASCs as distinct 

entities that operate exclusively to 

provide surgical services to patients 

who do not require hospitalization and 

are not expected to need to stay in a 

surgical facility longer than 24 hours. 

AHRQ’s mission. As described in its 

1999 reauthorizing legislation, Congress 

directed the Agency for Healthcare 

Research and Quality (AHRQ) to 

enhance the quality, appropriateness, 

and effectiveness of health services, as 

well as access to such services, by 

establishing a broad base of scientific 

research and promoting clinical and 

health systems practice improvements. 

The legislation also directed AHRQ to 

‘‘conduct and support research, 

evaluations, and training, support 

demonstration projects, research 

networks, and multidisciplinary centers, 

provide technical assistance, and 

disseminate information on health care 

and on systems for the delivery of such 

care, including activities with respect to 

health statistics, surveys, database 

development, and epidemiology.’’ 

Furthermore, AHRQ shall conduct 

and support research ‘‘to provide 

objective clinical information to health 

care practitioners and other providers of 

health care goods or services; identify 

the causes of preventable health care 

errors and patient injury in health care 

delivery; develop, demonstrate, and 

evaluate strategies for reducing errors 

and improving patient safety; and 

disseminate such effective strategies 

throughout the health care industry’’. 

Background on the Ambulatory 

Surgery Center Survey on Patient Safety 

Culture (ASC SOPS). 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 ASC Survey on 

Patient Safety Culture with OMB 

approval (OMB NO. 0935–0216; 

approved October 31, 2013). 

The survey is designed to enable 

ASCs to assess provider and staff 

perspectives about patient safety issues, 

medical error, and error reporting. The 

survey includes 27 items that measure 

8 composites of patient safety culture. In 

addition to the composite items, the 

survey includes one item measuring 

how often ASCs document near-misses; 

one item asking whether the respondent 

is in the room during surgeries, 

procedures, or treatments; and three 

items about communication before and 

after surgeries, procedures, or 

treatments. The survey also includes an 

overall rating item on patient safety, two 

items about respondent characteristics, 

and a section for open-ended comments. 

AHRQ made the survey publicly 

available along with a Survey User’s 

Guide and other toolkit materials in 

May 2015 on the AHRQ website. 

The AHRQ ASC SOPS Database 

consists of data from the AHRQ ASC 

Survey on Patient Safety Culture. 

Ambulatory surgery centers in the U.S. 

can voluntarily submit data from the 

survey to AHRQ, through its contractor, 

Westat. The ASC SOPS Database (OMB 

NO. 0935–0242; Approved September 

10, 2018) was developed by AHRQ in 

2019 in response to requests from ASCs 

interested in tracking their own survey 

results. Organizations submitting data 

receive a feedback report, as well as a 

report of the aggregated, de-identified 

findings of the other ASCs submitting 

data. These reports are used to assist 

ASC staff in their efforts to improve 

patient safety culture in their 

organizations. 

Rationale for the information 

collection. The ASC SOPS and the ASC 

SOPS Database support AHRQ’s goals of 

promoting improvements in the quality 

and safety of health care in ASCs. 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 ASCs, to 

facilitate the use of these materials for 

ASC patient safety and quality 

improvement. 

Rationale for information collection 

approval. The Agency for Healthcare 

Research and Quality (AHRQ) requests 

that the Office of Management and 

Budget (OMB) reapprove, under the 

Paperwork Reduction Act of 1995, 

AHRQ’s collection of information for 

the AHRQ ASC SOPS Database; OMB 

NO. 0935–0242; Approved September 

10, 2018. 

This database will: 

1. Present results from ASCs that 

voluntarily submit their data; 

2. Provide data to ASCs to facilitate 

internal assessment and learning in the 

patient safety improvement process; and 

3. Provide supplemental information 

to help ASCs 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 healthcare 

services and with respect to health 

statistics, surveys, and database 

development. 42 U.S.C 299a(a)(1) and 

(8). 

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 point-of-contact (POC), often the 

manager of the ASC, completes a 

number of data submission steps and 

forms, beginning with completion of an 

online Eligibility and Registration Form. 

The purpose of this form is to collect 

basic demographic information about 

the ASC and initiate the registration 

process. 

2. Data Use Agreement—The purpose 

of the data use agreement, completed by 

the ASC manager, is to state how data 

submitted by ASCs will be used and 

provides privacy assurances. 

3. ASC Site Information—The 

purpose of the site level specifications, 

completed by the ASC POC, is to collect 

background characteristics of the ASC. 

This information will be used to analyze 

data collected with the ASC SOPS 

survey. 

4. Data Files Submission—POCs 

upload their data file(s), using ASC 

survey 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 ASCs 

do not administer the survey and submit 

data every year. Data submission is 

typically handled by one POC who is 

either an ASC administrative manager 

or a survey vendor who contracts with 

an ASC to collect and submit its data. 

Survey data from the AHRQ 

Ambulatory Surgery Center Survey on 

Patient Safety Culture are used to 

produce three types of products: 

(1) An ASC SOPS Database Report 

that will be made publicly available on 

the AHRQ website (see ASC Database 

Report); 

(2) Individual ASC Survey Feedback 

Reports that are customized for each 

ASC that submits data to the database; 

and 

(3) Research data sets of individuallevel and ASC-level de-identified data 

to enable researchers to conduct 

analyses. All data released in a data set 

are de-identified at the individual-level 

and the ASC-level. 

ASCs will be invited to voluntarily 

submit their ASC SOPS survey data into 

the database. AHRQ’s contractor, 

Westat, then cleans and aggregates the 

data to produce a PDF-formatted 


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Federal Register / Vol. 86, No. 166 / Tuesday, August 31, 2021 / Notices 48705 

Database Report displaying averages, 

standard deviations, and percentile 

scores on the survey’s items and patient 

safety culture composite measures. The 

report also displays these results by 

ASC characteristics (e.g., number of 

operating/procedure rooms and 

geographic region) and respondent 

characteristics (e.g., staff position and 

hours worked per week). 

The Database Report includes a 

section on data limitations, emphasizing 

that the report does not reflect a 

representative sampling of the U.S. ASC 

population. Because participating ASCs 

will choose to voluntarily submit their 

data into the database and therefore are 

not a random or national sample of 

ASCs, estimates based on this selfselected group might be biased 

estimates. We recommend that users 

review the database results with these 

caveats in mind. 

Each ASC that submits its data 

receives a customized survey feedback 

report that presents their results 

alongside the aggregated results from 

other participating ASCs. 

ASCs use the ASC SOPS Survey, 

Database Reports, and Individual ASC 

Survey Feedback Reports for a number 

of purposes, to: 

• Raise staff awareness about patient 

safety; 

• Elucidate and assess the current 

status of patient safety culture in their 

ASC; 

• Identify strengths and areas for 

patient safety culture improvement; 

• Examine trends in patient safety 

culture change over time; and 

• Evaluate the cultural impact of 

patient safety initiatives and 

interventions. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondents’ time to participate in the 

database. An estimated 100 ASC 

managers (i.e., POCs from ASCs) will 

complete the database submission steps 

and forms. Each POC will submit the 

following: 

• Eligibility and registration form 

(completion is estimated to take about 5 

minutes). 

• Data use agreement (completion is 

estimated to take about 3 minutes). 

• ASC Site Information Form 

(completion is estimated to take about 5 

minutes). 

• Survey data submission will take an 

average of one hour. 

The total burden is estimated to be 

121 hours. 

Exhibit 2 shows the estimated 

annualized cost burden based on the 

respondents’ time to submit their data. 

The cost burden is estimated to be 

$5,804.37. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name 

Number of 

respondents/ 

POCs 

Number of 

responses 

per POC 

Hours per 

response 

Total burden 

hours 

Eligibility and Registration Form ...................................................................... 100 1 5/60 8 

Data Use Agreement ....................................................................................... 100 1 3/60 5 

ASC Site Information Form ............................................................................. 100 1 5/60 8 

Data Files Submission ..................................................................................... 100 1 1 100 

Total .......................................................................................................... NA NA NA 121 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name 

Number of 

respondents/ 

POCs 

Total burden 

hours 

Average 

hourly wage 

rate * 

Total cost 

burden 

Eligibility and Registration Form ...................................................................... 100 8 $47.97 $383.76 

Data Use Agreement ....................................................................................... 100 5 47.97 239.85 

ASC Site Information ....................................................................................... 100 8 47.97 383.76 

Data Files Submission ..................................................................................... 100 100 47.97 4,797.00 

Total .......................................................................................................... NA 121 NA 5,804.37 

* Based on the mean hourly wage for 100 ASC Administrative Services Managers (11–3010; $47.97) obtained from the May 2019 National Industry-Specific Occupational Employment and Wage Estimates: NAICS 621400—Outpatient Care Centers (located at https://www.bls.gov/oes/ 

current/naics4_621400.htm#11-00000). 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3520, 

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 

comments will become a matter of 

public record. 

Dated: August 25, 2021. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2021–18694 Filed 8–30–21; 8:45 am] 

BILLING CODE 4160–90–P 


khammond on DSKJM1Z7X2PROD with NOTICES