ICR Documents

Supporting Statement A Document Date Uploaded CMS-P-0015A 0938-0568_SSA.docx 07/24/2026 Supporting Statement B Document Date Uploaded CMS-P-0015A_0938-0568_SSB.docx 07/24/2026 Supplementary Documents Title Document Document Type Date Uploaded Respondent Newsletter MCBSRespondentNewsletter.pdf Supplementary Document 07/23/2026 MCBS Calendar MCBSCalendar.pdf Supplementary Document 07/23/2026 HIPAA Letter HIPAALetter.pdf Supplementary Document 07/23/2026 Resident Consent Form ResConsentForm.pdf Supplementary Document 07/23/2026 Next of Kin Consent Form NextofKinForm.pdf Supplementary Document 07/23/2026 CAPI Screenshots of Introductory Screen and Thank You Screen Attachment 6. CAPI screenshots.pdf Supplementary Document 07/23/2026 Facility Advance Letter_InPerson FacAdvanceLetter.pdf Supplementary Document 07/23/2026 MCBS Facility Broc MCBSFacilityBrochure.pdf Supplementary Document 07/23/2026 Community Advance Letter_Phone_English ComAdvLetterContactYou.pdf Supplementary Document 07/23/2026 Community Authority Letter ComAuthLetter.pdf Supplementary Document 07/23/2026 Video Interviewing Letter VideoInterviewingLetter.pdf Supplementary Document 07/23/2026 Community Brochure_English RedesignedComBrochure.pdf Supplementary Document 07/23/2026 Non-response Letter_Continuing_English NonResponseLetter.pdf Supplementary Document 07/23/2026 Reminder Letter_In Person_English ReminderLetter.pdf Supplementary Document 07/23/2026 Reminder Postcard_InPerson ReminderPostcard.pdf Supplementary Document 07/23/2026 Thank You Letter English CMSThankYouLetter.pdf Supplementary Document 07/23/2026 Community Reminder Advance Letter Multimode ComAdvLetterCallUs.pdf Supplementary Document 07/23/2026 MCBS FAQ MCBSFAQ.pdf Supplementary Document 07/23/2026 Based FAQ BaseFAQEnclosure.pdf Supplementary Document 07/23/2026 Base Thank you Letter BaseThankYouLetter.pdf Supplementary Document 07/23/2026 Community Language Insert ComLanguageInsert.pdf Supplementary Document 07/23/2026 Facility Advance Letter Billing Offices FacAdvLetterBillOffices.pdf Supplementary Document 07/23/2026 Facility Prepare Interview Letter FacPrepInterviewLetter.pdf Supplementary Document 07/23/2026 Facility Thank You Letter FacThankYouLetter.pdf Supplementary Document 07/23/2026 Health Care Statement Gaining Cooperation Letter HCStatementGPLetter.pdf Supplementary Document 07/23/2026 Non Response Letter Fraud NonResponseLetterFraud.pdf Supplementary Document 07/23/2026 Available by Web Continuing Facility Letter Available by Web Continuing Facility Letter.pdf Supplementary Document 07/23/2026 Facility Web Reminder Letter Facility Web Reminder Letter.pdf Supplementary Document 07/23/2026 Facility Web Screener Letters Facility Web Screener Letters.pdf Supplementary Document 07/23/2026 Facility Web Survey Invitation Emails Facility Web Survey Invitation Emails.pdf Supplementary Document 07/23/2026 Crosswalk 2027 Full Clearance 30-Day Crosswalk.docx Supplementary Document 07/23/2026 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received