View Information Collection (IC)
View Information Collection (IC)

View Information Collection (IC)

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Other-Facility Screening Interview Script for Meeting with Facility Administrators Yes Yes Printable Only
Other-MCBS Facility Round 55 Instrument Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Sepcifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-English Specifications Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-Questionnaire Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Roster Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-English Rosters Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Questionnaire Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-Spanish Version Yes Yes Printable Only
Other-English Show Cards Yes Yes Printable Only
Other-Spanish Show Cards Yes Yes Printable Only

Health Health Care Services

 

16,217 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 48,650 0 2,450 0 0 46,200
Annual IC Time Burden (Hours) 57,062 0 10,092 0 0 46,970
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
attachment 01 08/25/2010
attachment 02 08/25/2010
attachment 03 08/25/2010
Attachments TOC 08/25/2010
attachment 07 08/25/2010
attachment 08 08/25/2010
attachment 09 08/25/2010
attachment 10 08/25/2010
attachment 11 08/25/2010
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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