Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A) Modified 49650 58450 0 Form and Instruction CMS-P-0015A Attachment 5 - Facility Screener
Form and Instruction CMS-P0015A Attachment 6 - MCBS Faclility Round 64 Instruments
Form and Instruction CMS-P0015A Attachment 8 - Verification Re-interview
Form and Instruction CMS-P0015A MCBS Household Round 67 Instruments
Form and Instruction CMS-P0015A General Specifications Screen Types_19.01.0001
Form and Instruction CMS-P0015A General Specifications Spanish Text_19.01.001
Form and Instruction CMS-P0015A Spanish Folder General Specifications Spanish Text_19.01.001
Form and Instruction CMS-P0015A English Showcards HI-Eng
Form and Instruction CMS-P0015A Spanish Showcars KN-Sp
Form and Instruction CMS-P0015A English Section by Section CPS_16.01.0002
Form and Instruction CMS-P0015A English Section by Section ENS_10.01.0001
Form and Instruction CMS-P0015A English Section by Section HF_10.01.0002
Form and Instruction CMS-P0015A English Section by Section HI_17.01.0002
Form and Instruction CMS-P0015A English Section by Section HIS_13.01.0001
Form and Instruction CMS-P0015A English Section by Section IA_08.01.0000
Form and Instruction CMS-P0015A English Section by Section IN_12.01.0000
Form and Instruction CMS-P0015A English Section by Section KN_05.01.0002
Form and Instruction CMS-P0015A English Section by Section
Form and Instruction CMS-P0015A English Section by Section
Form and Instruction CMS-P0015A English Section by Section
Form and Instruction CMS-P0015A English Section by Section
Form and Instruction CMS-P0015A English Section by Section
Form and Instruction CMS-P0015A English Section by Section
Total burden requested under this ICR: 49650 58450 0  
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