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State Annual Long-Term Care OMBudsman Report
State Annual Long-Term Care Ombudsman Report
OMB: 0985-0005
IC ID: 10248
OMB.report
HHS/ACL
OMB 0985-0005
ICR 200509-0985-001
IC 10248
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0985-0005 can be found here:
2024-10-31 - Extension without change of a currently approved collection
2021-08-10 - Reinstatement without change of a previously approved collection
Documents and Forms
Document Name
Document Type
no available documents/forms check other ICs listed under this ICR
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
State Annual Long-Term Care Ombudsman Report
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Migrated
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Federal Enterprise Architecture Business Reference Module
Line of Business:
Subfunction:
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
52
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
52
0
0
0
0
52
Annual IC Time Burden (Hours)
10,258
0
0
2,638
0
7,620
Annual IC Cost Burden (Dollars)
0
0
0
-58,068,000
0
58,068,000
Documents for IC
Title
Document
Date Uploaded
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.