State Annual Long-Term Care OMBudsman Report

OMB 0985-0005

The State Annual Long Term Care Ombudsman Report is needed to: comply with state and Administration on Aging reporting requirements in the Older Americans Act; carry out recommendations made by the General Accounting Office, the Department of Health and Human Services' Office of the Inspector General, and the Institute of Medicine; advocate at the state and federal levels for changes needed to improve the quality of life and care in long-term care facilities; and effectively manage the Long-Term Care Ombudsman Program at the local, state and federal levels. The report form and instructions have been in continuous use, with minor modifications, since they were first approved by OMB for the FY 1995 reporting period.

The latest form for State Annual Long-Term Care OMBudsman Report expires 2021-04-30 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
State Annual Long-Term Care Ombudsman Report Form and Instruction
0005 Supporting Statement LTCOP.docx Supporting Statement A
State Annual Long-Term Care Ombudsman Report Form and Instruction

All Historical Document Collections

202404-0985-004	Extension without change of a currently approved collection	2024-10-31
202108-0985-001 Approved with change	Reinstatement without change of a previously approved collection	2021-08-10
201802-0985-003 Approved with change	Revision of a currently approved collection	2018-02-27
201612-0985-001 Approved with change	Revision of a currently approved collection	2016-12-22
201507-0985-002 Approved with change	Extension without change of a currently approved collection	2015-07-13
201205-0985-001 Approved without change	Extension without change of a currently approved collection	2012-05-04
200906-0985-001 Approved without change	Extension without change of a currently approved collection	2009-06-24
200604-0985-001 Approved without change	Revision of a currently approved collection	2006-04-04
200509-0985-001 Approved without change	Extension without change of a currently approved collection	2005-09-19
200411-0985-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2004-11-10
200210-0985-001 Approved without change	Reinstatement with change of a previously approved collection	2002-10-23
200106-0985-002 Approved without change	Revision of a currently approved collection	2001-06-20
199807-0985-001 Approved without change	Extension without change of a currently approved collection	1998-07-16
199708-0985-001 Approved without change	Reinstatement with change of a previously approved collection	1997-08-18
199506-0985-001 Approved without change	New collection (Request for a new OMB Control Number)	1995-06-29