56590 Federal Register / Vol. 73, No. 189 / Monday, September 29, 2008 / Notices 

standardized, regulatory approach to 

healthcare is necessary. 

Response: The Medicare CoPs are the 

minimum health and safety 

requirements that all hospitals must 

meet to participate in the Medicare 

program and serves as a single, 

standardized federal regulatory 

approach. Accreditation by an 

accreditation organization is voluntary 

and is not required for Medicare 

participation. A hospital may opt for 

routine surveys by a State survey agency 

to determine whether it meets the 

Medicare requirements. 

Comment: One commenter stated that 

it is CMS’ responsibility to review 

DNVHC’s application thoroughly to 

ensure DNVHC will meet the intent of 

the regulations. This commenter also 

expressed concerns related to a 

potential conflict of interest issue as 

DNVHC currently provides Joint 

Commission readiness consulting 

services to prepare hospitals for a Joint 

Commission accreditation survey. 

Response: All deeming applications 

are reviewed in accordance with the 

requirements at § 488.4 and § 488.8 to 

ensure that the applicant’s accreditation 

program meets or exceeds Medicare’s 

requirements. In terms of the conflict of 

interest issue raised by the commenter, 

DNVHC has provided a written 

statement as part of its application that 

this consultative service will be 

discontinued when DNVHC is approved 

as a nationally recognized accreditation 

organization for hospitals. 

IV. Provisions of the Final Notice 

A. Differences Between DNVHC’s 

Standards and Requirements for 

Accreditation and Medicare’s 

Conditions and Survey Requirements 

We compared DNVHC’s hospital 

accreditation requirements and survey 

process with the Medicare hospital CoPs 

and survey process as outlined in the 

State Operations Manual (SOM). Our 

review and evaluation of DNVHC’s 

deeming application, which were 

conducted as described in section III of 

this final notice, yielded the following: 

• DNVHC modified its policies 

related to the effective date of 

participation in Medicare for new 

providers in accordance with 

requirements at § 489.13; 

• DNVHC modified its policies 

regarding time frames for sending and 

receiving a required plan of correction, 

and the required elements of an 

approved plan of correction in 

accordance with section 2728 of the 

SOM; 

• DNVHC developed and conducted 

training for its surveyors to ensure that 

all deficiencies cited contain a 

regulatory reference, a clear and 

detailed description of the deficient 

practice and relevant finding; 

• In accordance with § 488.3(a) and 

Appendix A of the SOM, DNVHC 

modified its policies to ensure that all 

off-campus provider based locations, 

satellite locations and services provided 

at remote locations that are under the 

hospital’s CCN number will be surveyed 

at least once every three years; 

• To meet the Medicare requirements 

at § 488.20(a) and § 488.28(a), DNVHC 

developed a policy regarding our 

requirements for submission of a plan of 

correction by the hospital and the 

completion of an onsite follow-up 

survey to determine compliance with 

Medicare CoPs after citing condition 

level noncompliance during a 

recertification survey; 

• DNVHC developed a policy 

regarding condition level 

noncompliance identified during an 

initial certification survey for 

participation in Medicare in accordance 

with section 2005A2 of the SOM; 

• DNVHC modified its policies 

regarding complaint investigation 

activities with appropriate licensing 

bodies and ombudsmen programs in 

accordance with the requirements at 

§ 488.4(a)(6); 

• DNVHC amended its interpretive 

guidance and surveyor tool to include 

the survey methods its surveyors would 

use to determine compliance with the 

requirements at § 482.12(f)(2), 

§ 482.23(a), and § 482.23(c)(1); 

• DNVHC amended its interpretive 

guidance and surveyor tools to meet the 

requirements at § 482.13(c)(3), 

§ 488.22(c)(3), § 482.23(c)(3), 

§ 482.24(c)(1)(iii), § 482.25(b)(2)(i), 

§ 482.25(b)(6), § 482.25(b)(7), 

§ 482.30(b)(3)(i), § 482.43(e), 

§ 482.45(a)(1), § 482.51(a), § 482.52, 

§ 482.53(b), § 482.54, § 482.54(a), and 

§ 482.56; 

• DNVHC added language to its 

standards, and interpretive guidance to 

address the requirements at 

§ 482.13(e)(9), § 482.30, and 

§ 482.30(b)(1)(ii)(A)–(B); 

• DNVHC amended its policies by 

eliminating recommendations referred 

to as ‘‘opportunities for improvement’’ 

from the written survey findings to meet 

the requirements at § 488.28(a) and 

Section 2726 of the SOM. 

B. Term of Approval 

Based on the review and observations 

described in section III of this final 

notice, we have determined that 

DNVHC’s requirements for hospitals 

meet or exceed our requirements. 

Therefore, we approve DNVHC as a 

national accreditation organization for 

hospitals that request participation in 

the Medicare program, effective 

September 26, 2008 through September 

26, 2012. 

V. Collection of Information 

Requirements 

This document does not impose 

information collection and record 

keeping requirements. Consequently, it 

need not be reviewed by the Office of 

Management and Budget under the 

authority of the Paperwork Reduction 

Act of 1995 (44 U.S.C. 35). 

Authority: Section 1865 of the Social 

Security Act (42 U.S.C. 1395bb). 

(Catalog of Federal Domestic Assistance 

Program No. 93.778, Medical Assistance 

Program; No. 93.773, Medicare—Hospital 

Insurance Program; and No. 93.774, 

Medicare—Supplemental Medical Insurance 

Program) 

Dated: August 21, 2008. 

Kerry Weems, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. E8–22585 Filed 9–25–08; 11:15 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: Child Care and Development 

Fund Plan for States/Territories for FFY 

2010–2011 (ACF–118). 

OMB No.: 0970–0114. 

Description: The Child Care and 

Development Fund (CCDF) Plan (the 

Plan) for States and Territories is 

required from each CCDF Lead agency 

in accordance with Section 658E of the 

Child Care and Development Block 

Grant Act of 1990, as amended (Pub. L. 

101–508, Pub. L. 104–193, and 42 U.S.C. 

9858). The implementing regulations for 

the statutorily required Plan are set forth 

at 45 CFR 98.10 through 98.18. The 

Plan, submitted on the ACF–118, is 

required biennially, and remains in 

effect for two years. The Plan provides 

ACF and the public with a description 

of, and assurance about, the States or 

the Territories child care program. The 

ACF–118 is currently approved through 

June 30, 2009, making it available to 

States and Territories needing to submit 

Plan Amendments through the end of 

the FY 2009 Plan Period. However, in 

July 2009, States and Territories will be 

required to submit their FY 2010–2011 

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Federal Register / Vol. 73, No. 189 / Monday, September 29, 2008 / Notices 56591 

Plans. Consistent with the statute and 

regulations, ACF requests extension of 

the ACF–118 with minor corrections 

and modifications. The Tribal Plan 

(ACF–118a) is not affected by this 

notice. 

Respondents: State and Territorial 

CCDF Lead Agencies. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

ACF–118 .......................................................................................................... 56 0.50 162.57 4,551.96 

Estimated Total Annual Burden 

Hours: 4,551.96 

In compliance with the requirements 

of Section 506(c)(2)(A) of the Paperwork 

Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information collection described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Administration, 

Office of Information Services, 370 

L’Enfant Promenade, SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer. E-mail address: 

infocollection@acf.hhs.gov. All requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments on: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

the quality, utility, and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

Consideration will be given to 

comments and suggestions submitted 

within 60 days of this publication. 

Dated: September 23, 2008. 

Janean Chambers, 

Reports Clearance Officer. 

[FR Doc. E8–22722 Filed 9–26–08; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: Methodology for Determining 

Whether an Increase in a State’s Child 

Poverty Rate Is the Result of the TANF 

Program—NPRM. 

OMB No.: 0970–0186. 

Description: In accordance with 

Section 413(i) of the Social Security Act 

and 45 CFR part 284, the Department of 

Health and Human Services (HHS) 

intends to reinstate the following 

information collection requirements. 

For instances when Census Bureau data 

show that a States child poverty rate 

increased by 5 percent or more from one 

year to the next, a State may submit 

independent estimates of its child 

poverty rate. If HHS determines that the 

States independent estimates are not 

more reliable than the Census Bureau 

estimates, HHS will require the State to 

submit an assessment of the impact of 

the TANF program(s) in the State on the 

child poverty rate. If HHS determines 

from the assessment and other 

information that the child poverty rate 

in the State increased as a result of the 

TANF program(s) in the State, HHS will 

then require the State to submit a 

corrective action plan. 

Respondents: The respondents are the 

50 States and District of Columbia; 

when reliable Census Bureau data 

become available for the Territories, 

additional respondents might include 

Guam, Puerto Rico and the Virgin 

Islands. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden 

hours per 

response 

Total 

burden hours 

Optional Submission of Data on Child Poverty from an Independent Source 54 1 8 432 

Assessment of the Impact of TANF on the Increase in Child Poverty ........... 54 1 120 6,480 

Corrective Action Plan ..................................................................................... 54 1 160 8,640 

Estimated Total Annual Burden 

Hours: 15,552. 

In compliance with the requirements 

of Section 506(c)(2)(A) of the Paperwork 

Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information collection described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Administration, 

Office of Information Services, 370 

L’Enfant Promenade, SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer. E-mail address: 

infocollection@acf.hhs.gov. All requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments on: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

the quality, utility, and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

Consideration will be given to 

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