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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 8.18.2020_clean.docx
08/19/2020
Supporting Statement B
Document
Date Uploaded
CMS-P-0015A (0935-0568) Supporting Statement B_clean.docx
08/19/2020
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 English.docx
Supplementary Document
06/15/2020
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
Advance Letter Experiment Report
AttachmentCAdvLtrReportFinal.docx
Supplementary Document
02/11/2020
Community Advance Letter
R88AdvanceLetterPhone.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
Crosswalk
2021 Full Clearance 30-Day Crosswalk.docx
Supplementary Document
06/15/2020
CAPI Screenshots of Introductory Screen and Thank You Screen
Attachment7CAPIscreenshots.pdf
Supplementary Document
08/19/2020
Summary of New Items
Summary of New Items_OMB 2nd Passback_8.19.2020.pdf
Supplementary Document
08/19/2020
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.