Source: https://www.federalregister.gov/documents/2003/08/20/03-21234/agency-information-collection-activities-under-omb-review
Timestamp: 2018-08-14 16:22:54
Document Index: 615700990

Matched Legal Cases: ['art 52', 'arts 17', 'art 52', 'arts 17', 'art 52', 'arts 17', 'art 52', 'arts 17']

https://www.federalregister.gov/d/03-21234 https://www.federalregister.gov/d/03-21234
Denise McLamb, Information Management Service (045A4), Department of Veterans Affairs, 810 Vermont Avenue NW., Washington, DC 20420, (202) 273-8030, Fax (202) 273-5981 or e-mail to: denise.mclamb@mail.va.gov. Please refer to “OMB Control No. 2900-0160.”
a. State Home Inspection—Staffing Profile, VA Form 10-3567.
g. Statement of Assurance of Compliance with Equal Opportunity Law, VA Form 10-0144A.
h. Per Diem for Adult Day Health Care of Veterans in State Homes, 38 CFR part 52, and Per Diem for Nursing Home Care of Veterans in State Homes, 38 CFR parts 17, 51, and 48.
Abstract: VA pays per diem to State homes providing adult day health care to eligible veterans. To ensure high quality care is furnished to the veterans, VA requires those facilities providing adult day health care to furnish 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; documents pertaining to the management of the facilities; food menu planning; pharmaceutical records; and life safety documentation. This information is necessary to ensure that VA per diem payments are limited to facilities providing high quality care to eligible veterans.
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. The Federal Register notice with a 60-day comment period soliciting comments on this collection of information was published on May 6, 2003, at pages 24048-24050.
Affected Public: State, Local or Tribal Government, Individuals or Households, and Not-For-Profit Institutions.
a. State Home Inspection—Staffing Profile, VA Form 10-3567—86 hours.
b. State Home Report and Statement of Federal Aid Claimed, VA Form 10-5588—1,026 hours.
e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10-0143A—21 hours.
g. Statement of Assurance of Compliance with Equal Opportunity Law, VA Form 10-0144A—21 hours.
h. Per Diem for Adult Day Health Care of Veterans in State Homes, 38 CFR Part 52, and Per Diem for Nursing Home Care of Veterans in State Homes, 38 CFR Parts 17, 51, and 48—4,125 hours.
a. State Home Inspection—Staffing Profile, VA Form 10-3567—30 minutes.
e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10-0143A—7 minutes.
f. Certification Regarding Lobbying, VA Form 10-0144—7 minutes. Start Printed Page 50220
g. Statement of Assurance of Compliance with Equal Opportunity Law, VA Form 10-0144A—7 minutes.
h. Per Diem for Adult Day Health Care of Veterans in State Homes, 38 CFR Part 52, and Per Diem for Nursing Home Care of Veterans in State Homes, 38 CFR Parts 17, 51, and 48—7 minutes.
a. State Home Inspection—Staffing Profile, VA Form 10-3567—171.
b. State Home Report and Statement of Federal Aid Claimed, VA Form 10-5588—171.
e. Statement of Assurance of Compliance with Section 504 of the Rehabilitation Act of 1973, VA Form 10-0143A—171.
g. Statement of Assurance of Compliance with Equal Opportunity Law, VA Form 10-0144A—171.
h. Per Diem for Adult Day Health Care of Veterans in State Homes, 38 CFR Part 52, and Per Diem for Nursing Home Care of Veterans in State Homes, 38 CFR Parts 17, 51, and 48—21,002.
[FR Doc. 03-21234 Filed 8-19-03; 8:45 am]