80 FR 50382 - Agency Information Collection: (Per Diem for Nursing Home Care of Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care of Veterans in State Homes)

DEPARTMENT OF VETERANS AFFAIRS

Federal Register Volume 80, Issue 160 (August 19, 2015)

Page Range		50382-50383
FR Document		2015-20458

The Veterans Health Administration (VHA), Department of Veterans Affairs (VA), is announcing an opportunity for public comment on the proposed collection of certain information by the agency. Under the Paperwork Reduction Act (PRA) of 1995, Federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information and allow 60 days for public comment in response to the notice. This notice solicits comments on the information needed to provide payment of per diem to State homes that provide nursing home care to eligible veterans and payment of per diem to State homes that provide adult day health care to eligible veterans. The intended effect of these provisions was to ensure that veterans receive high quality care in State Homes.

Federal Register, Volume 80 Issue 160 (Wednesday, August 19, 2015)

[Federal Register Volume 80, Number 160 (Wednesday, August 19, 2015)]
[Notices]
[Pages 50382-50383]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-20458]


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DEPARTMENT OF VETERANS AFFAIRS

[OMB Control No. 2900-0160]


Agency Information Collection: (Per Diem for Nursing Home Care of 
Veterans in State Homes; Per Diem for Domiciliary Adult Day Health Care 
of Veterans in State Homes)

AGENCY: Veterans Health Administration, Department of Veterans Affairs.

ACTION: Notice.

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SUMMARY: The Veterans Health Administration (VHA), Department of 
Veterans Affairs (VA), is announcing an opportunity for public comment 
on the proposed collection of certain information by the agency. Under 
the Paperwork Reduction Act (PRA) of 1995, Federal agencies are 
required to publish notice in the Federal Register concerning each 
proposed collection of information and allow 60 days for public comment 
in response to the notice. This notice solicits comments on the 
information needed to provide payment of per diem to State homes that 
provide nursing home care to eligible

[[Page 50383]]

veterans and payment of per diem to State homes that provide adult day 
health care to eligible veterans. The intended effect of these 
provisions was to ensure that veterans receive high quality care in 
State Homes.

DATES: Written comments and recommendations on the proposed collection 
of information should be received on or before October 19, 2015.

ADDRESSES: Submit written comments on the collection of information 
through Federal Docket Management System (FDMS) at www.Regulations.gov; 
or Colette Alvarez, Chief Business Office, Purchased Care, Veterans 
Health Administration (10N21R), Department of Veterans Affairs, 810 
Vermont Avenue NW., Washington, DC 20420 or email: 
[email protected]. Please refer to ``Per Diem for Nursing Home 
Care of Veterans in State Homes; Per Diem for Domiciliary and Adult Day 
Health Care of Veterans in State Homes, OMB Control No. 2900-0160'' in 
any correspondence. During the comment period, comments may be viewed 
online through the FDMS.

FOR FURTHER INFORMATION CONTACT: Colette Alvarez at (775) 842-5755.

SUPPLEMENTARY INFORMATION: Under the PRA of 1995 (Pub. L. 104-13; 44 
U.S.C. 3501-3521), Federal agencies must obtain approval from the 
Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. This request for comment is being 
made pursuant to section 3506(c)(2)(A) of the PRA.
    With respect to the following collection of information, VHA 
invites comments on: (1) Whether the proposed collection of information 
is necessary for the proper performance of VHA's functions, including 
whether the information will have practical utility; (2) the accuracy 
of VHA's estimate of the burden of the proposed collection of 
information; (3) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (4) ways to minimize the burden of 
the collection of information on respondents, including through the use 
of automated collection techniques or the use of other forms of 
information technology.
    Titles: (Per Diem for Nursing Home Care of Veterans in State Homes; 
Per Diem for Domiciliary Adult Day Health Care of Veterans in State 
Homes).
    a. Title 38, CFR parts 51 and 52, State Home Programs.
    b. State Home Inspection--Staffing Profile, VA Form 10-3567.
    c. State Home Report and Statement of Federal Aid Claimed, VA Form 
10-5588.
    d. Claim for Payment for Nursing Home Care Provided to Veterans 
Awarded Retroactive Service Connection, VA Form 10-5588A.
    e. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH.
    f. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143.
    g. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-0143a.
    h. Certification Regarding Lobbying, VA Form 10-0144.
    i. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0144a.
    j. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0460.
    OMB Control Number: 2900-0160.
    Type of Review: Revision of a currently approved collection.
    Abstract: VA pays per diem to State Veterans Homes (SVHs) providing 
nursing home, domiciliary and adult day health services care to 
eligible Veterans. VA pays per diem to SVHs for the care of Veterans 
irrespective of whether the Veteran has wartime or peacetime service.
    VA processes two different types of state nursing home per diem 
payments. Each is determined by a Veteran's eligibility. One is a 
higher per diem or prevailing rate for certain Veterans who have 
service-connected disabilities. The other is a basic rate that is paid 
to Veterans who are not eligible for the higher rate. VA also ensures 
that SVHs meet VA standards through surveys, audits, and reconciliation 
of records. VA requires facilities providing nursing home, domiciliary 
and 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 pertain to the management of the 
facilities; food menu planning; pharmaceutical records; and life safety 
documentation. Without access to such information, VA would not be able 
to determine whether high quality care is being provided to Veterans.
    For an eligible Veteran to be considered for per diem payments for 
nursing home, domiciliary or ADHC, two forms are required to be 
submitted to the VA medical center of jurisdiction for each Veteran, at 
the time of the Veteran's admission to a SVH (VA Form 10-10EZ, 
Application for Health Benefits or 10-10EZR, Health Benefits Renewal 
Form) and VA Form 10-10SH, State Home Program Application for Veteran 
Care Medical Certification).
    Affected Public: State, Local or Private Government.
    Estimated Annual Burden: 6,818 hours.
    Home Programs:
    a. State Home Inspection Staffing Profile, VA Form 10-3567--69.5 
hrs.
    b. State Home Report and State of Federal Aid Claimed, VA Form 10-
5588--834 hrs.
    c. Claim for Payment for Nursing Home Care Provided to Veterans 
Awarded Retroactive Service Connection, VA Form 10-5588A--180 hrs.
    d. State Home Program Application for Veteran Care--Medical 
Certification, VA Form 10-10SH--3,802 hrs.
    e. Department of Veterans Affairs Certification Regarding Drug-Free 
Workplace Requirements for Grantees Other Than Individuals, VA Form 10-
0143--12 hrs.
    f. Statement of Assurance of Compliance with Section 504 of the 
Rehabilitation Act of 1973, VA Form 10-1043a--12 hrs.
    g. Certification Regarding Lobbying, VA Form 10-0144--12 hrs.
    h. Statement of Assurance of Compliance with Equal Opportunity 
Laws, VA Form 10-0460--12 hrs.
    i. Request for Prescription Drugs from an Eligible Veteran in a 
State Home, VA Form 10-0144a--12 hrs.
    j. Application for Recognition (Letter to Under Secretary for 
Health)--2 hrs.
    k. Recognition & Certification (Sections 51.30 and 52.30)--120 hrs.
    l. Quality of Life (Sections 51.100 and 52.100)--350 hrs.
    m. Section, Administration and (Section 51.210 and 52.210)--1,400.
    Estimated Average Burden per Respondent:
    Frequency of Response: On Occasion.
    Estimated Number of Respondents: 12,884.

    By direction of the Secretary.
Kathleen M. Manwell,
Program Analyst, VA Privacy Service, Office of Privacy and Records 
Management, Department of Veterans Affairs.
[FR Doc. 2015-20458 Filed 8-18-15; 8:45 am]
 BILLING CODE 8320-01-P

50382 Federal Register / Vol. 80, No. 160 / Wednesday, August 19, 2015 / Notices

over the Line either is pending with the Surface Transportation Board, Clearance Officer, 1750 Pennsylvania
Surface Transportation Board (Board) or Washington, DC 20423–0001) or by Ave. NW., Suite 8140, Washington, DC
with any U.S. District Court or has been calling OEA at (202) 245–0305. 20220, or email at PRA@treasury.gov.
decided in favor of a complainant Assistance for the hearing impaired is FOR FURTHER INFORMATION CONTACT:
within the two-year period; and (4) the available through the Federal Copies of the submission(s) may be
requirements at 49 CFR 1105.7(c) Information Relay Service at (800) 877– obtained by emailing PRA@treasury.gov
(environmental report), 49 CFR 1105.11 8339. Comments on environmental and or viewing the entire information
(transmittal letter), 49 CFR 1105.12 historic preservation matters must be collection request at www.reginfo.gov.
(newspaper publication), and 49 CFR filed within 15 days after the EA SUPPLEMENTARY INFORMATION:
1152.50(d)(1) (notice to governmental becomes available to the public.
agencies) have been met. Environmental, historic preservation, Departmental Offices, Office of the
As a condition to this exemption, any public use, or trail use/rail banking Procurement Executive
employee adversely affected by the conditions will be imposed, where OMB Number: 1505–0081.
abandonment shall be protected under appropriate, in a subsequent decision. Type of Review: Revision of a
Oregon Short Line Railroad— Pursuant to the provisions of 49 CFR currently approved collection.
Abandonment Portion Goshen Branch 1152.29(e)(2), BNSF shall file a notice of Title: Solicitation of Proposal
Between Firth & Ammon, in Bingham & consummation with the Board to signify Information for Award of Public
Bonneville Counties, Idaho, 360 I.C.C. that it has exercised the authority Contracts.
91 (1979). To address whether this granted and fully abandoned the line. If Abstract: Information requested of
condition adequately protects affected consummation has not been effected by offerors is specific to each procurement
employees, a petition for partial filing of a notice of consummation by solicitation, and is required for Treasury
revocation under 49 U.S.C. 10502(d) August 19, 2016, and there are no legal to properly evaluate the capabilities and
must be filed. or regulatory barriers to consummation, experience of potential contractors who
Provided no formal expression of the authority to abandon will desire to provide the supplies or
intent to file an offer of financial automatically expire. services to be acquired. Evaluation will
assistance (OFA) has been received, this Board decisions and notices are be used to determine which proposal
exemption will be effective on available on our Web site at most benefits the Government.
September 18, 2015, unless stayed ‘‘WWW.STB.DOT.GOV.’’ Affected Public: Private Sector:
pending reconsideration. Petitions to Decided: August 14, 2015. Businesses or other for-profits.
stay that do not involve environmental Estimated Burden Hours: 203,193.
By the Board, Rachel D. Campbell,
issues,1 formal expressions of intent to Director, Office of Proceedings. Dated: August 13, 2015.
file an OFA under 49 CFR Dawn D. Wolfgang,
Jeffrey Herzig,
1152.27(c)(2),2 and interim trail use/rail
Clearance Clerk. Treasury PRA Clearance Officer.
banking requests under 49 CFR 1152.29
[FR Doc. 2015–20519 Filed 8–18–15; 8:45 am] [FR Doc. 2015–20375 Filed 8–18–15; 8:45 am]
must be filed by August 31, 2015.
Petitions to reopen or requests for BILLING CODE 4915–01–P BILLING CODE 4810–25–P

public use conditions under 49 CFR
1152.28 must be filed by September 8,
2015, with the Surface Transportation DEPARTMENT OF THE TREASURY DEPARTMENT OF VETERANS
Board, 395 E Street SW., Washington, AFFAIRS
DC 20423–0001. Submission for OMB Review;
[OMB Control No. 2900–0160]
A copy of any petition filed with the Comment Request
Board should be sent to applicant’s AGENCY: Department of the Treasury Agency Information Collection: (Per
representative: Karl Morell, Karl Morell Diem for Nursing Home Care of
ACTION: Notice.
& Associates, 655 Fifteenth Street NW., Veterans in State Homes; Per Diem for
Suite 225, Washington, DC 20005. SUMMARY: The Department of the Domiciliary Adult Day Health Care of
If the verified notice contains false or Treasury will submit the following Veterans in State Homes)
misleading information, the exemption information collection request to the
is void ab initio. AGENCY: Veterans Health
Office of Management and Budget
BNSF has filed environmental and Administration, Department of Veterans
(OMB) for review and clearance in
historic reports that address the effects, Affairs.
accordance with the Paperwork
if any, of the abandonment on the Reduction Act of 1995, Public Law 104– ACTION: Notice.
environment and historic resources. 13, on or after the date of publication of
OEA will issue an environmental SUMMARY: The Veterans Health
this notice. Administration (VHA), Department of
assessment (EA) by August 24, 2015.
DATES: Comments should be received on Veterans Affairs (VA), is announcing an
Interested persons may obtain a copy of
or before September 18, 2015 to be opportunity for public comment on the
the EA by writing to OEA (Room 1100,
assured of consideration. proposed collection of certain
1 The Board will grant a stay if an informed ADDRESSES: Send comments regarding information by the agency. Under the
decision on environmental issues (whether raised the burden estimate, or any other aspect Paperwork Reduction Act (PRA) of
by a party or by the Board’s Office of Environmental of the information collection, including 1995, Federal agencies are required to
Analysis (OEA) in its independent investigation) suggestions for reducing the burden, to publish notice in the Federal Register
cannot be made before the exemption’s effective
tkelley on DSK3SPTVN1PROD with NOTICES

date. See Exemption of Out-of-Serv. Rail Lines, 5 (1) Office of Information and Regulatory concerning each proposed collection of
I.C.C. 2d 377 (1989). Any request for a stay should Affairs, Office of Management and information and allow 60 days for
be filed as soon as possible so that the Board may Budget, Attention: Desk Officer for public comment in response to the
take appropriate action before the exemption’s Treasury, New Executive Office notice. This notice solicits comments on
effective date.
2 Each OFA must be accompanied by the filing Building, Room 10235, Washington, DC the information needed to provide
fee, which is currently set at $1,600. See 49 CFR 20503, or email at OIRA_Submission@ payment of per diem to State homes that
1002.2(f)(25). OMB.EOP.gov and (2) Treasury PRA provide nursing home care to eligible

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Document Created: 2015-12-15 11:58:57
Document Modified: 2015-12-15 11:58:57

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Action		Notice.
Dates		Written comments and recommendations on the proposed collection of information should be received on or before October 19, 2015.
Contact		Colette Alvarez at (775) 842-5755.
FR Citation		80 FR 50382