Information Collection List

IC Title	Status	Responses	Hours	Dollars	Document Type	Form No.	Form Name
Medicare Current Beneficiary Survey (MCBS): Rounds 48-56 (CMS Number CMS-P-0015A)	Removed	0	0	0	Form and Instruction	CMS-P-0015A	Background Questionnaire
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Expenditure Questionnaire
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Health Ins Questionnaire
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Health Status Base Line
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Resident History
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Prescription Medicines
					Form and Instruction	CMS-P-0015A	MCBS Facility Round 46 Use of Services Module
					Form and Instruction	CMS-P-0015A	Facility Screening Interview Script
					Form and Instruction	CMS-P-0015A	MCBS Household Round 46 Questionnaire English
					Form and Instruction	CMS-P-0015A	MCBS Household Round 46 Questionnaire Spanish
					Form and Instruction	CMS-P-0015A	MCBS Household Round 46 Show Cards
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)	Modified	48650	57062	0	Other-Facility Screening Interview Script for Meeting with Facility Administrators
					Other-MCBS Facility Round 55 Instrument
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Sepcifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-English Specifications
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-Questionnaire
					Other-English Rosters
Other-English Roster
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-English Rosters
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Questionnaire
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-Spanish Version
Other-English Show Cards
Other-Spanish Show Cards
Total burden requested under this ICR:		48650	57062	0
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