Agency Information Collection Activities: Submission for OMB Review; Public Comment Request; for the State Annual Long-Term Care Ombudsman Report (OMB Control Number 0985-0005), 86807-86809 [2024-25358]
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Federal Register / Vol. 89, No. 211 / Thursday, October 31, 2024 / Notices
extension or reinstatement of an existing
collection of information, and to allow
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the burden estimate or any
other aspect of this collection of
information, including the necessity and
utility of the proposed information
collection for the proper performance of
the agency’s functions, the accuracy of
the estimated burden, ways to enhance
the quality, utility, and clarity of the
information to be collected, and the use
of automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
Comments on the collection(s) of
information must be received by the
OMB desk officer by December 2, 2024.
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.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, please access the CMS PRA
website by copying and pasting the
following web address into your web
browser: https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.
DATES:
lotter on DSK11XQN23PROD with NOTICES1
FOR FURTHER INFORMATION CONTACT:
William Parham at (410) 786–4669.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
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18:18 Oct 30, 2024
Jkt 265001
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Financial
Statement of Debtor; Use: When a
Medicare Administrative Contractor
(MAC) overpays a physician or supplier,
the overpayment is associated with a
single claim, and the amount of the
overpayment is moderate. In these
cases, the physician/supplier usually
refunds the overpaid amount in a lump
sum. Alternatively, the MAC may
recoup the overpaid amount against
future payments. A recoupment is the
recovery by Medicare of any
outstanding Medicare debt by reducing
present or future Medicare payments
and applying the amount withheld to
the indebtedness. The recoupment can
be made only if the physician/supplier
accepts assignment since the MAC
makes payment to the physician/
supplier only on assigned claims.
The physician/supplier may be
unable to refund a large overpaid
amount in a single payment. The MAC
cannot recover the overpayment by
recoupment if the physician/supplier
does not accept assignment of future
claims or is not expected to file future
claims because of going out of business,
illness or death. In these unusual
circumstances, the MAC has authority
to approve or deny extended repayment
schedules up to 12-months or may
recommend to the Centers for Medicare
and Medicaid Services (CMS) to
approve up to 60 months. Before the
MAC takes these actions, the MAC will
require full documentation of the
physician’s/supplier’s financial
situation. Thus, the physician/supplier
must complete the CMS–379, Financial
Statement of Debtor.
Section 1893(f)(1)) of the Social
Security Act and 42 CFR 401.607
provides the authority for collection of
this information. Section 42 CFR
405.607 requires that, CMS recover
amounts of claims due from debtors
including interest where appropriate by
direct collections in lump sums or in
installments. Form Number: CMS–379
(OMB control number: 0938–0270);
Frequency: Yearly; Affected Public:
State, Local, or Tribal Governments;
Number of Respondents: 500; Total
Annual Responses: 500; Total Annual
Hours: 1,000 hours. (For policy
questions regarding this collection
PO 00000
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86807
contact Monica Thomas, at 410–786–
4292.)
William N. Parham, III,
Director, Division of Information Collections
and Regulatory Impacts, Office of Strategic
Operations and Regulatory Affairs.
[FR Doc. 2024–25331 Filed 10–30–24; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Community Living
Agency Information Collection
Activities: Submission for OMB
Review; Public Comment Request; for
the State Annual Long-Term Care
Ombudsman Report (OMB Control
Number 0985–0005)
Administration for Community
Living, HHS.
ACTION: Notice.
AGENCY:
The Administration for
Community Living (ACL) is announcing
that the proposed collection of
information listed above has been
submitted to the Office of Management
and Budget (OMB) for review and
clearance as required under section
506(c)(2)(A) of the Paperwork Reduction
Act of 1995. This 30-day notice collects
comments on the information collection
requirements related to the proposed
new information collection
requirements relating to the State
Annual Long-Term Care Ombudsman
Report (OMB Control Number 0985–
0005).
SUMMARY:
Comments on the collection of
information must be submitted
electronically by 11:59 p.m. (ET) or
postmarked. December 2, 2024.
ADDRESSES: Submit written comments
and recommendations for the proposed
information collection within 30 days of
publication of this notice to
www.reginfo.gov/public/do/PRAMain.
Find the information collection by
selecting ‘‘Currently under 30-day
Review—Open for Public Comments’’ or
by using the search function. By mail to
the Office of Information and Regulatory
Affairs, OMB, New Executive Office
Bldg., 725 17th St. NW, Rm. 10235,
Washington, DC 20503, Attention: OMB
Desk Officer for ACL.
FOR FURTHER INFORMATION CONTACT:
Beverly Laubert, Beverly.Laubert@
acl.hhs.gov, (202) 795–7364.
SUPPLEMENTARY INFORMATION: In
compliance with 44 U.S.C. 3507, ACL
has submitted the following proposed
collection of information to OMB for
review and clearance. The State Annual
DATES:
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31OCN1
86808
Federal Register / Vol. 89, No. 211 / Thursday, October 31, 2024 / Notices
lotter on DSK11XQN23PROD with NOTICES1
Long-Term Care Ombudsman Report is
needed to comply with Administration
for Community Living/Administration
on Aging reporting requirements in the
Older Americans Act (OAA); and 45
CFR 1324.21(b) (1) and (b)(2)(v). The
Long-Term Care Ombudsman Report is
used to measure the services and
strategies that are provided to assist
residents in the protection of their
health, safety, welfare, or rights;
advocate at the state and federal levels
for changes needed to improve the
quality of life and care in long-term care
facilities; and effectively manage the
Long-Term Care Ombudsman Program
at the state and federal level. The
National Ombudsman Reporting System
(NORS) was developed in response to
these needs and directives. Section
712(c) of the OAA requires the state
agency to establish a statewide uniform
reporting system to:
(1) Collect and analyze data relating to
resident complaints and conditions in
long-term care facilities for the purpose
of identifying and resolving significant
problems.
and
(2) Submit the data on a regular basis
to the state licensing/certifying agency,
other state and federal entities that the
Ombudsman determines to be
appropriate, the Assistant Secretary for
Aging, and the National Long-Term Care
Ombudsman Resource Center.
Comments in Response to the 60-Day
Federal Register Notice
In accordance with 5 CFR 1320.8(d),
ACL published a 60-day Notice in the
Federal Register on August 6, 2024, at
89 FR 63955–63956.
Please see public comments received
during the 60-day notice and ACLs
response to comments listed below.
ACL received comments from
individuals and groups including the
National Association of State
Ombudsman Programs (NASOP); the
National Association of Local LongTerm Care Ombudsmen (NALLTCO),
the California Long-Term Care
Ombudsman Association (CLTCOA),
National Ombudsman Resource Center
(NORC), and a gerontologist/researcher.
Commenters who addressed the
utility of the data and burden estimates
supported the continuation of the NORS
collection. NALLTCO recommended
that ACL conduct a future study of the
documentation burden on local longterm care Ombudsmen.
NASOP recommended that changes in
data elements be undertaken with ample
time to adjust state systems and receive
training before implementation, with a
request for ACL grant funding for
implementation costs. Both
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18:18 Oct 30, 2024
Jkt 265001
recommendations were deferred for
future consideration if funding is
available. Regarding recommendations
specific to adding or removing data
elements, ACL opts to hold those
suggestions for future revision after
further consideration and analysis of
impact of the changes; including the
impact on State Ombudsman programs
that would need to change their data
collection systems. Comments that ACL
accepted were changes to instructions
and examples and reporting tips for
clarity.
Most of the comments were requests
to modify instructional examples and
reporting tips. Some of the
recommendations indicated
misunderstandings that can be resolved
with technical assistance, the below
nine comments/recommendations were
accepted.
Comment 1: One respondent
requested clarification on how to code
complaint disposition when a resident
dies before an outcome of the complaint
has been obtained.
Response 1: Reporting tips were
changed to instruct the Ombudsman to
report such instances as withdrawn
when there is not a resident
representative to determine resolution.
Comment 2: One respondent
requested revision to complaint type
F01—Accidents and falls to update
language from describing a resident who
self-propels to a resident who uses a
wheelchair independently.
Response 2: The example was
updated accordingly.
Comment 3, 4: Two respondents
recommended changing how volunteer
representatives are counted to include
all volunteers who were representatives
during the reporting year. Current
instructions are to count volunteers as
the number on September 30 of the
fiscal year.
Response 3,4: The description was
updated to ensure that all volunteer
representatives are counted.
Comment 5: One respondent
requested that ACL allow newsletters
and other forms of media to be counted
as community education.
Response 5: As use of social media
and other electronic means of imparting
information has increased, community
education activities are under-reported
within current instructions. A revision
to the instructions was made to
accommodate the request.
Comment 6, 7: Two respondents
recommended a change to the
description of complaint type I03—
Supplies, storage, and furnishings to
include facility failure to properly store
hazardous chemicals and other hazards.
PO 00000
Frm 00025
Fmt 4703
Sfmt 4703
Response 6, 7: I03 is a complaint type
about shortage of supplies. Instead, the
examples and reporting tips for I01—
Environment were revised to
accommodate the comments.
Comment 8: One respondent
suggested modifying the description of
program activity elements S64 and
S65—Resident council participation to
include instances of training to resident
groups that might not be formal resident
councils.
Response 8: The modification was
made to accommodate the suggestion. A
corresponding change was made to S66
and S67—Family council participation.
Comment 9: One respondent
requested that ACL remove the
requirement to report expenditures in
NORS or, in the alternative, specify that
expenditures be reported as obligated.
Response 9: ACL has worked to
reconcile multiple means of financial
reporting. The NORS requirement will
not be removed because NORS is the
source of publicly reported information
about Ombudsman program resources.
However, the examples and reporting
tips were modified to instruct states to
report using consistent accounting
methods.
ACL received the following comments
and did not accept them for inclusion in
NORS.
Comment: One respondent
recommended including ‘‘fear’’ of
retaliation in the complaint type where
retaliation is reported and adding a
complaint code for theft of medications.
Response: Because such problems can
be captured within existing complaint
codes, it is not necessary to add to the
collection.
Comment: One respondent suggested
adding to the definition of complainant
to capture referrals from legislators.
Response: ACL will provide technical
assistance about reporting entities that
make referrals, which is different from
complainants.
Comment: Two respondents suggested
removing the verification data element
because Ombudsman programs work to
resolve all problems expressed by
residents.
Response: Verification is key to the
purpose of investigation and ACL will
provide technical assistance if needed to
supplement training provided by the
NORC.
Comment: One respondent suggested
changing language from ‘‘perpetrator’’ to
‘‘aggressor’’ when a complaint involves
a resident living with dementia.
Response: In the example described in
the comment, the use of the abuse
complaint type could be incorrect; ACL
and NORC will provide technical
assistance on how to code complaints to
E:\FR\FM\31OCN1.SGM
31OCN1
lotter on DSK11XQN23PROD with NOTICES1
Federal Register / Vol. 89, No. 211 / Thursday, October 31, 2024 / Notices
reflect resident experience rather than
changing a term that is commonly used
in abuse investigations by other entities.
Comment: Three respondents
recommended modification to the
psychological abuse complaint code to
include social media posts and posting
of photographs.
Response: The current reporting tips
include oral, written, or gestured
language and are sufficient to include
social media posts. Photos are also
included in the reporting tips.
Comment: Three respondents
recommended adding language to
complaint types in the category of
autonomy, choice, and rights to address
emergence of artificial intelligence to
monitor residents.
Response: This issue requires further
review and will be considered for future
revisions.
Comment: One respondent suggested
adding a reporting tip to complaint type
F10- Rehabilitation services to instruct
Ombudsmen how to report contractures
as gross neglect.
Response: Further review is needed,
and this suggestion will be considered
for future revisions.
Comment: One respondent
recommended that instruction be added
to select staffing as a secondary
complaint and to broaden the definition
of staffing.
Response: The use of secondary
complaint codes when a resident or
complainant has not expressed staffing
as a complaint would be a significant
change in practice with potential
unintended consequences. This requires
further review and may be considered in
future revisions. The existing definition
of J03—Staffing is sufficiently inclusive
of staffing vacancies.
Comment: Two respondents
recommended adding language to the
definition and examples for complaint
type L01—Resident representative or
family conflict to include other visitors
with different types of relationships.
Response: The complaint type as
currently defined is specific to the
nature of the relationships of family
members and individuals that residents
choose to be their representative; adding
others could dilute the meaning of the
data element.
Comment: Two respondents requested
the addition of a new complaint type for
reporting resident-to-resident
altercations that are not willful abuse.
Response: ACL is not adding or
removing data elements with this
renewal but will consider this
recommendation in the future after
analysis of impact and alternatives
within the existing collection.
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18:18 Oct 30, 2024
Jkt 265001
Comment: Three respondents
recommended adding a new category of
complaints and individual complaint
types about discrimination.
Response: ACL is not adding or
removing elements but will seek
additional input and consider this
change in the future after analysis of
impact.
Comment: Two respondents suggested
adding a new complaint category to
allow for short-term collection of data
for a special purpose.
Response: ACL is not adding or
removing elements with this renewal
but will consider the recommendation
after analysis of impact and alternatives.
Comment: One respondent asserted
that complaint/case terminology in data
elements S01–S06 is confusing.
Response: The data elements are text
fields and provide flexibility for the
State Ombudsman to describe
complaints as they determine best.
Technical assistance will be provided.
Comment: One respondent requested
clarification about reporting hours
donated by volunteers when the
volunteer receives travel
reimbursement.
Response: The Older Americans Act
allows for reimbursement and travel is
included in the current examples and
reporting tips.
Comment: One respondent requested
clarification about removal or
remediation of conflicts of interest.
Response: How conflicts of interest
are addressed is a matter of rule (45 CFR
1324.21(b)) implementation and
technical assistance will be provided as
part of broader regulatory guidance.
Comment: One respondent suggested
the addition of a code for a specific type
of expenditure.
Response: ACL is not adding or
removing data elements with this
revision of NORS but will consider this
change in the future.
Comment: One respondent suggested
clarification of local funds expended.
Response: The instruction is written
as intended and technical assistance
will be provided.
Comment: Four respondents
recommended changes to routine access
visitation reporting.
Response: Routine access visits as
defined are an important measure of
resident access to their advocate
separate from visits to handle
complaints, as well as a measure of the
impact of program funding. ACL will
explore this request further and
consider a change in the future; data
elements are not being changed in this
revision.
Comment: Three respondents
commented that instructions are vague
PO 00000
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86809
about how to report the number of
facilities and that closures have an
impact on how routine access visits are
measured on a quarterly basis.
Response: The examples and tips are
specific that the count of facilities is as
of the last day of the federal fiscal year.
Routine access is based upon the count
of facilities as of the last day of the fiscal
year. The data element is defined as
intended, routine access does not
include facilities that open after the first
quarter or close before the fourth quarter
of the fiscal year. Technical assistance
will be provided.
Comment: One respondent requested
a new data element for reporting facility
closures.
Response: At this time ACL is not
adding or removing elements but will
consider this change in the future after
analysis of impact and alternatives.
Comment: Two respondents requested
new Ombudsman program staffing data
elements—statewide turnover rates,
years of experience of Ombudsman
representatives, and the staff-to-bed
ratio of staff.
Response: At this time ACL is not
adding or removing elements but will
consider this change in the future after
analysis of potential methods of
collection.
Estimated Program Burden
ACL estimates the burden of this
collection of information as follows:
Fifty-two grantees report to ACL using
NORS.
a. Number of respondents—52
b. Frequency of response—1
c. Total annual responses—52
d. Hours per response—214
e. Total burden hours—11,153
Dated: October 28, 2024.
Maura Calsyn,
Principal Deputy Administrator for the
Administration for Community Living,
performing the delegable duties of the
Administrator and the Assistant Secretary for
Aging.
[FR Doc. 2024–25358 Filed 10–30–24; 8:45 am]
BILLING CODE 4154–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2023–D–0093]
M13A Bioequivalence for ImmediateRelease Solid Oral Dosage Forms;
International Council for
Harmonisation; Guidance for Industry;
Availability
AGENCY:
Food and Drug Administration,
HHS.
E:\FR\FM\31OCN1.SGM
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]]>Agencies
[Federal Register Volume 89, Number 211 (Thursday, October 31, 2024)]
[Notices]
[Pages 86807-86809]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-25358]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Community Living
Agency Information Collection Activities: Submission for OMB
Review; Public Comment Request; for the State Annual Long-Term Care
Ombudsman Report (OMB Control Number 0985-0005)
AGENCY: Administration for Community Living, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Administration for Community Living (ACL) is announcing
that the proposed collection of information listed above has been
submitted to the Office of Management and Budget (OMB) for review and
clearance as required under section 506(c)(2)(A) of the Paperwork
Reduction Act of 1995. This 30-day notice collects comments on the
information collection requirements related to the proposed new
information collection requirements relating to the State Annual Long-
Term Care Ombudsman Report (OMB Control Number 0985-0005).
DATES: Comments on the collection of information must be submitted
electronically by 11:59 p.m. (ET) or postmarked. December 2, 2024.
ADDRESSES: Submit written comments and recommendations for the proposed
information collection within 30 days of publication of this notice to
www.reginfo.gov/public/do/PRAMain.
Find the information collection by selecting ``Currently under 30-
day Review--Open for Public Comments'' or by using the search function.
By mail to the Office of Information and Regulatory Affairs, OMB, New
Executive Office Bldg., 725 17th St. NW, Rm. 10235, Washington, DC
20503, Attention: OMB Desk Officer for ACL.
FOR FURTHER INFORMATION CONTACT: Beverly Laubert,
[email protected], (202) 795-7364.
SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has
submitted the following proposed collection of information to OMB for
review and clearance. The State Annual
[[Page 86808]]
Long-Term Care Ombudsman Report is needed to comply with Administration
for Community Living/Administration on Aging reporting requirements in
the Older Americans Act (OAA); and 45 CFR 1324.21(b) (1) and (b)(2)(v).
The Long-Term Care Ombudsman Report is used to measure the services and
strategies that are provided to assist residents in the protection of
their health, safety, welfare, or rights; advocate at the state and
federal levels for changes needed to improve the quality of life and
care in long-term care facilities; and effectively manage the Long-Term
Care Ombudsman Program at the state and federal level. The National
Ombudsman Reporting System (NORS) was developed in response to these
needs and directives. Section 712(c) of the OAA requires the state
agency to establish a statewide uniform reporting system to:
(1) Collect and analyze data relating to resident complaints and
conditions in long-term care facilities for the purpose of identifying
and resolving significant problems.
and
(2) Submit the data on a regular basis to the state licensing/
certifying agency, other state and federal entities that the Ombudsman
determines to be appropriate, the Assistant Secretary for Aging, and
the National Long-Term Care Ombudsman Resource Center.
Comments in Response to the 60-Day Federal Register Notice
In accordance with 5 CFR 1320.8(d), ACL published a 60-day Notice
in the Federal Register on August 6, 2024, at 89 FR 63955-63956.
Please see public comments received during the 60-day notice and
ACLs response to comments listed below.
ACL received comments from individuals and groups including the
National Association of State Ombudsman Programs (NASOP); the National
Association of Local Long-Term Care Ombudsmen (NALLTCO), the California
Long-Term Care Ombudsman Association (CLTCOA), National Ombudsman
Resource Center (NORC), and a gerontologist/researcher.
Commenters who addressed the utility of the data and burden
estimates supported the continuation of the NORS collection. NALLTCO
recommended that ACL conduct a future study of the documentation burden
on local long-term care Ombudsmen.
NASOP recommended that changes in data elements be undertaken with
ample time to adjust state systems and receive training before
implementation, with a request for ACL grant funding for implementation
costs. Both recommendations were deferred for future consideration if
funding is available. Regarding recommendations specific to adding or
removing data elements, ACL opts to hold those suggestions for future
revision after further consideration and analysis of impact of the
changes; including the impact on State Ombudsman programs that would
need to change their data collection systems. Comments that ACL
accepted were changes to instructions and examples and reporting tips
for clarity.
Most of the comments were requests to modify instructional examples
and reporting tips. Some of the recommendations indicated
misunderstandings that can be resolved with technical assistance, the
below nine comments/recommendations were accepted.
Comment 1: One respondent requested clarification on how to code
complaint disposition when a resident dies before an outcome of the
complaint has been obtained.
Response 1: Reporting tips were changed to instruct the Ombudsman
to report such instances as withdrawn when there is not a resident
representative to determine resolution.
Comment 2: One respondent requested revision to complaint type
F01--Accidents and falls to update language from describing a resident
who self-propels to a resident who uses a wheelchair independently.
Response 2: The example was updated accordingly.
Comment 3, 4: Two respondents recommended changing how volunteer
representatives are counted to include all volunteers who were
representatives during the reporting year. Current instructions are to
count volunteers as the number on September 30 of the fiscal year.
Response 3,4: The description was updated to ensure that all
volunteer representatives are counted.
Comment 5: One respondent requested that ACL allow newsletters and
other forms of media to be counted as community education.
Response 5: As use of social media and other electronic means of
imparting information has increased, community education activities are
under-reported within current instructions. A revision to the
instructions was made to accommodate the request.
Comment 6, 7: Two respondents recommended a change to the
description of complaint type I03--Supplies, storage, and furnishings
to include facility failure to properly store hazardous chemicals and
other hazards.
Response 6, 7: I03 is a complaint type about shortage of supplies.
Instead, the examples and reporting tips for I01--Environment were
revised to accommodate the comments.
Comment 8: One respondent suggested modifying the description of
program activity elements S64 and S65--Resident council participation
to include instances of training to resident groups that might not be
formal resident councils.
Response 8: The modification was made to accommodate the
suggestion. A corresponding change was made to S66 and S67--Family
council participation.
Comment 9: One respondent requested that ACL remove the requirement
to report expenditures in NORS or, in the alternative, specify that
expenditures be reported as obligated.
Response 9: ACL has worked to reconcile multiple means of financial
reporting. The NORS requirement will not be removed because NORS is the
source of publicly reported information about Ombudsman program
resources. However, the examples and reporting tips were modified to
instruct states to report using consistent accounting methods.
ACL received the following comments and did not accept them for
inclusion in NORS.
Comment: One respondent recommended including ``fear'' of
retaliation in the complaint type where retaliation is reported and
adding a complaint code for theft of medications.
Response: Because such problems can be captured within existing
complaint codes, it is not necessary to add to the collection.
Comment: One respondent suggested adding to the definition of
complainant to capture referrals from legislators.
Response: ACL will provide technical assistance about reporting
entities that make referrals, which is different from complainants.
Comment: Two respondents suggested removing the verification data
element because Ombudsman programs work to resolve all problems
expressed by residents.
Response: Verification is key to the purpose of investigation and
ACL will provide technical assistance if needed to supplement training
provided by the NORC.
Comment: One respondent suggested changing language from
``perpetrator'' to ``aggressor'' when a complaint involves a resident
living with dementia.
Response: In the example described in the comment, the use of the
abuse complaint type could be incorrect; ACL and NORC will provide
technical assistance on how to code complaints to
[[Page 86809]]
reflect resident experience rather than changing a term that is
commonly used in abuse investigations by other entities.
Comment: Three respondents recommended modification to the
psychological abuse complaint code to include social media posts and
posting of photographs.
Response: The current reporting tips include oral, written, or
gestured language and are sufficient to include social media posts.
Photos are also included in the reporting tips.
Comment: Three respondents recommended adding language to complaint
types in the category of autonomy, choice, and rights to address
emergence of artificial intelligence to monitor residents.
Response: This issue requires further review and will be considered
for future revisions.
Comment: One respondent suggested adding a reporting tip to
complaint type F10- Rehabilitation services to instruct Ombudsmen how
to report contractures as gross neglect.
Response: Further review is needed, and this suggestion will be
considered for future revisions.
Comment: One respondent recommended that instruction be added to
select staffing as a secondary complaint and to broaden the definition
of staffing.
Response: The use of secondary complaint codes when a resident or
complainant has not expressed staffing as a complaint would be a
significant change in practice with potential unintended consequences.
This requires further review and may be considered in future revisions.
The existing definition of J03--Staffing is sufficiently inclusive of
staffing vacancies.
Comment: Two respondents recommended adding language to the
definition and examples for complaint type L01--Resident representative
or family conflict to include other visitors with different types of
relationships.
Response: The complaint type as currently defined is specific to
the nature of the relationships of family members and individuals that
residents choose to be their representative; adding others could dilute
the meaning of the data element.
Comment: Two respondents requested the addition of a new complaint
type for reporting resident-to-resident altercations that are not
willful abuse.
Response: ACL is not adding or removing data elements with this
renewal but will consider this recommendation in the future after
analysis of impact and alternatives within the existing collection.
Comment: Three respondents recommended adding a new category of
complaints and individual complaint types about discrimination.
Response: ACL is not adding or removing elements but will seek
additional input and consider this change in the future after analysis
of impact.
Comment: Two respondents suggested adding a new complaint category
to allow for short-term collection of data for a special purpose.
Response: ACL is not adding or removing elements with this renewal
but will consider the recommendation after analysis of impact and
alternatives.
Comment: One respondent asserted that complaint/case terminology in
data elements S01-S06 is confusing.
Response: The data elements are text fields and provide flexibility
for the State Ombudsman to describe complaints as they determine best.
Technical assistance will be provided.
Comment: One respondent requested clarification about reporting
hours donated by volunteers when the volunteer receives travel
reimbursement.
Response: The Older Americans Act allows for reimbursement and
travel is included in the current examples and reporting tips.
Comment: One respondent requested clarification about removal or
remediation of conflicts of interest.
Response: How conflicts of interest are addressed is a matter of
rule (45 CFR 1324.21(b)) implementation and technical assistance will
be provided as part of broader regulatory guidance.
Comment: One respondent suggested the addition of a code for a
specific type of expenditure.
Response: ACL is not adding or removing data elements with this
revision of NORS but will consider this change in the future.
Comment: One respondent suggested clarification of local funds
expended.
Response: The instruction is written as intended and technical
assistance will be provided.
Comment: Four respondents recommended changes to routine access
visitation reporting.
Response: Routine access visits as defined are an important measure
of resident access to their advocate separate from visits to handle
complaints, as well as a measure of the impact of program funding. ACL
will explore this request further and consider a change in the future;
data elements are not being changed in this revision.
Comment: Three respondents commented that instructions are vague
about how to report the number of facilities and that closures have an
impact on how routine access visits are measured on a quarterly basis.
Response: The examples and tips are specific that the count of
facilities is as of the last day of the federal fiscal year. Routine
access is based upon the count of facilities as of the last day of the
fiscal year. The data element is defined as intended, routine access
does not include facilities that open after the first quarter or close
before the fourth quarter of the fiscal year. Technical assistance will
be provided.
Comment: One respondent requested a new data element for reporting
facility closures.
Response: At this time ACL is not adding or removing elements but
will consider this change in the future after analysis of impact and
alternatives.
Comment: Two respondents requested new Ombudsman program staffing
data elements--statewide turnover rates, years of experience of
Ombudsman representatives, and the staff-to-bed ratio of staff.
Response: At this time ACL is not adding or removing elements but
will consider this change in the future after analysis of potential
methods of collection.
Estimated Program Burden
ACL estimates the burden of this collection of information as
follows:
Fifty-two grantees report to ACL using NORS.
a. Number of respondents--52
b. Frequency of response--1
c. Total annual responses--52
d. Hours per response--214
e. Total burden hours--11,153
Dated: October 28, 2024.
Maura Calsyn,
Principal Deputy Administrator for the Administration for Community
Living, performing the delegable duties of the Administrator and the
Assistant Secretary for Aging.
[FR Doc. 2024-25358 Filed 10-30-24; 8:45 am]
BILLING CODE 4154-01-P
