Focus Group-Residents and Family

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

Documents and Forms

Document Name Document Type
Focus Group-Residents and Family Form
0985-New Draft Focus Group Guide_Residents and Family Members (6).pdf Other-Focus Group Guide
Focus Group Residents and Family Members 0985-New Draft Focus Group Participant Info_Residents and Family Members (1).pdf Form

Information Collection (IC) Details

IC Title:	Focus Group-Residents and Family	Agency IC Tracking Number:

Is this a Common Form? No		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
Form	NA	Focus Group Residents and Family Members	0985-New Draft Focus Group Participant Info_Residents and Family Members (1).pdf		Yes	Yes	Fillable Fileable
Other-Focus Group Guide			0985-New Draft Focus Group Guide_Residents and Family Members (6).pdf		Yes	No	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	24	24
Annual IC Time Burden (Hours)	24	24
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

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