[Federal Register Volume 76, Number 91 (Wednesday, May 11, 2011)]
[Pages 27323-27325]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-11302]



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: ``Pre-test of an Assisted Living Consensus Instrument.'' In 
accordance with the Paperwork Reduction Act, 44 U.S.C. 3501-3521, AHRQ 
invites the public to comment on this proposed information collection.

DATES: Comments on this notice must be received by July 11, 2011.

ADDRESSES: Written comments should be submitted to: Doris Lefkowitz, 
Reports Clearance Officer, AHRQ, by e-mail at 
    Copies of the proposed collection plans, data collection 
instruments, and specific details on the estimated burden can be 
obtained from the AHRQ Reports Clearance Officer.

Clearance Officer, (301) 427-1477, or by e-mail at 


Proposed Project

Pre-Test of an Assisted Living Consensus Instrument

    Using a consensus-based process and in partnership with the Center 
for Excellence in Assisted Living (CEAL), AHRQ has developed a data 
collection tool that will collect uniform information about individual 
assisted living facilities (ALFs) in the United States to increase the 
value of healthcare for consumers by helping them make informed choices 
when selecting an ALF. Included in the development process were a 
voluntary committee of national representatives of Assisted Living 
Facilities, consumers, and researchers.
    Assisted living (AL) is a relatively new long-term care option that 
currently serves approximately one million older and dependent 
Americans. Unlike skilled nursing facilities which are Federally 
regulated and relatively uniform from state to state, ALFs vary from 
state to state, as well as within each state, reflecting various core 
values that embrace consumer choice and provider diversity.
    Most states mandate a set of basic services that an ALF must offer, 
such as meals and housekeeping. The upper limits of allowable services 
are also often prescribed. However, within the range of services 
required and allowed, ALFs in most states are given some

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latitude as to who they choose to serve and what services they choose 
to provide. Further, the choice of services is not always confined by 
geography; that is, given the widespread dispersion of families, 
potential AL residents may be looking to choose among assisted living 
properties in different states, thereby widening the choices available.
    While some ALFs are equipped to serve a wide range of resident 
needs, it is more common that an assisted living property will address 
a particular ``market niche.'' There are many ways in which ALFs offer 
diversity--in the religious or cultural affiliations of its target 
market; in the house rules that influence expectations about dress and 
behavior in the dining room; in the admission and discharge criteria in 
place; as well as in the range of services provided. Major variation is 
found in the extent to which a particular ALF is able and willing to 
serve those with dementia. While most ALFs admit and retain residents 
with mild cognitive impairment, those without a specialized dementia 
program may have difficulty serving residents with common symptoms such 
as a lack of safety awareness, wandering, sleep disturbances and 
    To some extent, admission and discharge criteria are dictated by 
the laws and regulations of the state in which a particular ALF 
operates. Beyond this, ALFs have considerable latitude in assessing 
individuals whom they will admit and retain in their facilities.
    In addition to the assessment of needed services in relation to the 
services that are available, the ability to pay for AL services is a 
critical factor for both the consumer and ALF decision-making about 
whether and when an individual moves into and out of a particular ALF. 
Approximately ten percent of AL residents receive subsidies through 
State Medicaid Waiver or State Plan programs, and fewer than three 
percent are covered by long-term care insurance. Thus, a substantial 
percentage of AL consumers use savings and other assets, including 
proceeds from the sale of their homes, to pay for their stay in an ALF. 
In choosing an ALF, consumers need to consider whether a particular 
facility is able to accept Medicaid or other third party payments, both 
now and in the future, should their assets become depleted.
    This research has the following goals:
    (1) Refine the data collection tool through pre-testing with a 
sample of ALFs; and
    (2) Make the data collection tool publically available through the 
AHRQ Web site.
    This study is being conducted by AHRQ through its contractor, Abt 
Associates Inc., pursuant to AHRQ's statutory authority to conduct and 
support research on healthcare and on systems for the delivery of such 
care, including activities with respect to the quality, effectiveness, 
efficiency, appropriateness and value of healthcare services. 42 U.S.C. 

Method of Collection

    To achieve the goals of this project the following data collection 
will be undertaken:
    (1) Telephone verification. The purpose of the telephone 
verification is to ensure that the most current mailing address of each 
ALF is utilized for the survey pre-test, and to obtain the name of the 
Administrator or Executive Director of the ALF so the mailed pre-test 
survey can be addressed directly to that person; and
    (2) Pre-test of the Assisted Living Provider Information Tool for 
Consumer Education. The data collection will include information on 
several topics of interest to consumers including services available in 
ALFs and costs of those services, criteria for moving into and out of 
an ALF, resident's rights, house rules, life safety features, staffing 
within the ALF, and the availability of dementia care services within 
the ALF. The purpose of the pre-test is to assess the utility of the 
data collection tool as well as the feasibility for its implementation.
    The data that will be collected through this effort will be used to 
make final refinements to the Assisted Living Provider Information Tool 
for Consumer Education and to make adjustments to the recommended 
processes for implementing a similar data collection effort on a 
broader basis.

Estimated Annual Respondent Burden

    Exhibit 1 shows the estimated annualized burden for the 
respondents' time to participate in this project. The telephone 
verification will be completed by 285 AL providers and will take 
approximately one minute to complete. The pre-test of the Assisted 
Living Provider Information Tool for Consumer Education will be 
completed by 191 ALFs and will require approximately 25 minutes to 
complete. The total annual burden is estimated to be 85 hours.
    Exhibit 2 shows the estimated annualized cost burden associated 
with the respondents' time to participate in this project. The total 
annualized cost burden is estimated to be $3,576.

                                  Exhibit 1--Estimated Annualized Burden Hours
                                                             Number of
              Form name                   Number of        responses per        Hours per         Total burden
                                         respondents         respondent          response            hours
Telephone verification..............                285                  1               1/60                  5
Pre-test............................                191                  1              25/60                 80
    Total...........................                476                 na                 na                 85

                                   Exhibit 2--Estimated Annualized Cost Burden
                                          Number of         Total burden      Average hourly
              Form name                  respondents           hours            wage rate*     Total cost burden
Telephone verification..............                285                  5             $15.37                $77
Pre-Test............................                191                 80              43.74              3,499
    Total...........................                476                 85                 na              3,576
* Based upon the mean of the average wages reflected in the National Compensation Survey (May 2009) U.S.
  Department of Labor, Bureau of Labor Statistics. Wage categories used: phone verification--office and
  administrative support workers; pre-test--medical and health services managers in the United States.

[[Page 27325]]

Estimated Annual Costs to the Federal Government

    The total cost of this contract to the government is $424,000. The 
project extends over four years, but this request is for a one year OMB 
clearance. Exhibit 3 shows a breakdown of the total cost as well as the 
annualized cost.

             Exhibit 3--Estimated Total and Annualized Cost
             Cost component                 Total cost      Annualized
Project Development.....................        $125,000         $31,250
Data Collection Activities..............          90,000          22,500
Data Processing and Analysis............          30,000           7,500
Reporting of results....................          30,000           7,500
Project Management......................         164,552          41,138
    Total Costs.........................         439,552         109,888

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 healthcare research and 
healthcare 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: April 22, 2011.
Carolyn M. Clancy,
[FR Doc. 2011-11302 Filed 5-10-11; 8:45 am]