Long Term Care- Electronic Focus Group

ASPE Generic Clearance for the Collection of Qualitative Research and Assessment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0421 can be found here:

Documents and Forms

Document Name Document Type
0990-0421Attachment A_Discussion Guide_Betty White.doc Other-survey
0990-0421 OMB Generic Clearance_LTC focus groups 060515 (3).doc memo IC Document
0990-0421SupportingStatementA_LTC.docx suppt. st A IC Document
0990-0421SupportingStatementB_LTC.docx suppt st B IC Document

Information Collection (IC) Details

IC Title:	Long Term Care- Electronic Focus Group	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-survey			0990-0421Attachment A_Discussion Guide_Betty White.doc		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	40	40
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
memo	0990-0421 OMB Generic Clearance_LTC focus groups 060515 (3).doc	06/16/2015
suppt. st A	0990-0421SupportingStatementA_LTC.docx	06/16/2015
suppt st B	0990-0421SupportingStatementB_LTC.docx	06/16/2015

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.