Information Collection Request

Outcome Evaluation of the Long-Term Care Ombudsman Program (LTCOP)

ICR 202008-0985-001 · OMB 0985-0069 · Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Stakeholders/ State Unit on Aging (SUA) Directors/Former Ombudsmen Form and Instruction New Available
Focus Group-Residents and Family Form New Repair queued
Focus Group-Facility Administrators and Staff Form and Instruction New Available
LTCOP ACL Response to OMB comment 091720.docx Supplementary Document Uploaded 2020-09-17 Available
0985-New LTCOP OMB Package Section A_07-13-2020.docx Supporting Statement A Uploaded 2020-08-04 Available
0985-New LTCOP Part B_022120_rev 7-27-2020.docx Supporting Statement B Uploaded 2020-08-03 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
242981 Stakeholders/ State Unit on Aging (SUA) Directors/Former Ombudsmen Form and Instruction New
242980 Focus Group-Residents and Family Form New
242979 Focus Group-Facility Administrators and Staff Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2023 36 Months From Approved
1,985 0 0
715 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 1,985 0 0 1,985 0 0
Annual Time Burden (Hours) 715 0 0 715 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No