ICR Documents

Document Date Uploaded
CMS-P-0015A 0938-0568_SSA-EOP Passback2_clean.docx 02/02/2021

Document Date Uploaded
CMS-P-0015A_0935-0568_SSB_clean.docx 02/02/2021

Title Document Document Type Date Uploaded
Respondent Newsletter MCBS Newsletter English.pdf Supplementary Document 11/23/2020
MCBS Calendar ENG MCBS Calendar English.pdf Supplementary Document 11/23/2020
AtTheDoorEnglish At the Door Sheet English.pdf Supplementary Document 11/23/2020
Refusal Letter Refusal Letter_Com_Continuing Rs_Eng_FM800.doc Supplementary Document 04/16/2019
HIPAA Letter HIPAA Letter.docx Supplementary Document 11/23/2020
Resident Consent Form Resident Consent Form.pdf Supplementary Document 11/23/2020
Next of Kin Consent Form Next of Kin Consent Form.pdf Supplementary Document 11/23/2020
CAPI Screenshots of Introductory Screen and Thank You Screen Attachment7CAPIscreenshots.pdf Supplementary Document 08/19/2020
Facility Advance Letter_InPerson Facility Advance Letter_InPerson.docx Supplementary Document 11/23/2020
Facility Advance Letter_Phone Facility Advance Letter_Phone.docx Supplementary Document 11/23/2020
Community Advance Letter_COVID-19 Community Advance Letter_COVID-19.docx Supplementary Document 11/23/2020
Community Advance Letter_InPerson_English Community Advance Letter_InPerson_English.pdf Supplementary Document 11/23/2020
Community Advance Letter_NGACO Community Advance Letter_NGACO.docx Supplementary Document 11/23/2020
Community Advance Letter_Phone_English Community Advance Letter_Phone_English.docx Supplementary Document 11/23/2020
Community Authority Letter Community Authority Letter.docx Supplementary Document 11/23/2020
Community Authority Letter_NGACO Community Authority Letter_NGACO.docx Supplementary Document 11/23/2020
Community Brochure_InPerson_English Community Brochure_InPerson_English.pdf Supplementary Document 11/23/2020
Community Brochure_Phone_English Community Brochure_Phone_English.pdf Supplementary Document 11/23/2020
IAQ Brochure English IAQ Brochure English.pdf Supplementary Document 11/23/2020
Non-response Letter_Continuing_English Non-response Letter_Continuing_English.docx Supplementary Document 11/23/2020
Reminder Advance Letter_Phone_English Reminder Advance Letter_Phone_English.docx Supplementary Document 11/23/2020
Reminder Letter_In Person_English Reminder Letter_In Person_English.docx Supplementary Document 11/23/2020
Reminder Letter_NGACO Reminder Letter_NGACO.docx Supplementary Document 11/23/2020
Reminder Letter_Phone_English Reminder Letter_Phone_English.docx Supplementary Document 11/23/2020
Reminder Postcard_InPerson Reminder Postcard_InPerson.docx Supplementary Document 11/23/2020
Reminder Postcard_Phone Reminder Postcard_Phone.docx Supplementary Document 11/23/2020
Thank You Letter English Thank You Letter English.docx Supplementary Document 11/23/2020
COVID-19 Summer 2020 Supplement Test Report Attachment 8. COVID-19 Summer 2020 Supplement Test Report.docx Supplementary Document 02/02/2021
Crosswalk of Changes in Fall COVID-19 Supplement Attachment 9. Crosswalk of Changes in Fall COVID-19 Supplement.docx Supplementary Document 02/02/2021
Crosswalk (New Items) Summary of New Items_Crosswalk.pdf Supplementary Document 02/02/2021

Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received