OMB control number
Process Evaluation and Special Studies Related to the Long-Term Care OMBudsman Program
OMB 0985-0055 · HHS/ACL.
OMB 0985-0055
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form 1 Volunteers Survey | Form |
| Form 2 Local Representatives Survey | Form |
| Form 1 Local Director Survey | Form |
| Form 2 State Ombudsmen Survey | Form |
| Form 1 State Ombudsman Interview | Form |
| Form 1 National Stakeholders Interview | Form |
| Form 1 Federal Staff Interview Protocol | Form |
 Nonsubstantive Changes for Phase 2 of LTCOP Data Collection (0985-0055) (11-27-17).docx | Justification for No Material/Nonsubstantive Change |
| OMB Package Section B_FINAL.docx | Supporting Statement B |
| OMB Package Section A-FINAL-REVISED.docx | Supporting Statement A |
 Volunteers Survey |
Form |
| Local Directors/Regional Representaitves and Local Representatives |
Form |
| Local Directors/Regional Representaitves and Local Representatives |
Form |
| State Ombudsman Interview Protocol and Survey |
Form |
| State Ombudsman Interview Protocol and Survey |
Form |
| National Stakeholders Interview Protocol |
Form |
| Federal Staff National Stakeholders |
Form |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201712-0985-001 | No material or nonsubstantive change to a currently approved collection | 2017-12-01 | Approved without change | |
| 201612-0985-003 | New collection (Request for a new OMB Control Number) | 2016-12-23 | Approved without change |