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Agenda
Reg Review
ICR
ICR Documents
Supporting Statement A
Document
Date Uploaded
CMS-P-0015A (0935-0568) Supporting Statement A - Passback2 responses Cle....docx
12/03/2019
Supporting Statement B
Document
Date Uploaded
CMS-P-0015A (0935-0568) Supporting Statement B - Passback2 responses Cle....docx
08/06/2019
Supplementary Documents
Title
Document
Document Type
Date Uploaded
Winter Respondent Newslette
2019_Winter Respondent Newsletter- Eng.pdf
Supplementary Document
04/16/2019
MCBS Calendar ENG
2019-2020 MCBS Calendar ENG.pdf
Supplementary Document
04/16/2019
AtTheDoorEnglish
AtTheDoorEnglish.pdf
Supplementary Document
04/16/2019
Community Advance Letter
AttachmentBControlLetter508c.pdf
Supplementary Document
02/11/2020
Community Authority Letter
Community Authority Letter.doc.docx
Supplementary Document
02/11/2020
MCBS Community Brochure
MCBS Community Brochure_Eng.pdf
Supplementary Document
04/16/2019
MCBS IAQ Brochure
MCBS IAQ Brochure_Eng.pdf
Supplementary Document
04/16/2019
Refusal Letter
Refusal Letter_Com_Continuing Rs_Eng_FM800.doc
Supplementary Document
04/16/2019
Thank You Letter
Thank You Letter_Comm_Eng.doc
Supplementary Document
04/16/2019
Facility Advance Letter
Facility Advance Letter.doc
Supplementary Document
04/16/2019
HIPAA Letter
HIPAA Letter.doc
Supplementary Document
04/16/2019
MCBS Facility Brochure
MCBS Facility Brochure_Eng.pdf
Supplementary Document
04/16/2019
Resident Consent Form
Resident Consent Form.pdf
Supplementary Document
04/16/2019
Next of Kin Consent Form
Next of Kin Consent Form.pdf
Supplementary Document
04/16/2019
Supporting Statment A
CMS-P-0015A (0935-0568) Supporting Statement A - Passback2 responses Cle....docx
Supplementary Document
08/06/2019
Supporting Statment B
CMS-P-0015A (0935-0568) Supporting Statement B - Passback2 responses Cle....docx
Supplementary Document
08/06/2019
Crosswalk
Summary of Questionnaire Changes_OMB Passback.pdf
Supplementary Document
08/06/2019
Advance Letter Experiment Report
AttachmentCAdvLtrReportFinal.docx
Supplementary Document
02/11/2020
Community Advance Letter
AttachmentARevisedLetter508c.pdf
Supplementary Document
02/11/2020
Crosswalk (Advance Letter)
Advance Letter Revisions Crosswalk for OMB.docx
Supplementary Document
02/18/2020
Justification of non-substantive change
CMS P 0015A MCBS nonsubstantive change request Adv Letter.docx
Justification for No Material/Nonsubstantive Change
02/11/2020
Public Comments
Author Name
Comment Document
Author Affiliation
Sponsoring Org.
Type
Category
Date of Comment
Date Comment Received
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.