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 R88BrochurePhone.pdf Supplementary Document 06/12/2020 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 R88FacilityPhoneAdvance Letter.docx Supplementary Document 06/12/2020 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 R88AdvanceLetterPhone.docx Supplementary Document 06/12/2020 Crosswalk (Advance Materials) R88 Adv Materials Crosswalk.docx Supplementary Document 06/12/2020 Postcard Reminder R88ReminderPostcard.docx Supplementary Document 06/12/2020 Advance Letter No Phone R88AdvanceLetterNoPhone.docx Supplementary Document 06/12/2020 Justification of non-substantive change CMS P 0015A MCBS nonsubstantive change request Adv Mailings.docx Justification for No Material/Nonsubstantive Change 06/12/2020 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received