GenIC#5 - Justification of Non-substantive Change (10-21-16)

0938-1185 (GenIC #5) Change Justification_ESRD Grievant Satisfaction Survey_revised -10-21-16.docx

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (CMS-10415)

GenIC#5 - Justification of Non-substantive Change (10-21-16)

OMB: 0938-1185

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3000 Bayport Drive, Suite 300 - Tampa, FL 33607
Phone: 813-865-3535
Fax: 813-854-1514 [email protected]
www.esrdncc.org
www.kcercoalition.com




October 21, 2016

Non-Substantive Change Request to OMB CN 0938-1185

ESRD Grievant Satisfaction Survey

This is a non-substantive change request to the survey materials for the OMB-approved ESRD Grievant Satisfaction Survey. Changes made to the pre-notification letter are as follows:

Pre-Notification Letter and Survey Questionnaire

  • Change letterhead from ESRD NCC to CMS

  • Change letter content to adhere to reading and literacy levels required for beneficiary communication. Literacy levels were adjusted from a much grade higher level to 6.2 grade level.

These changes have no impact on the burden associated with this collection. We are currently receiving survey respondent contact information; thus, approval for these corrections is needed quickly to ensure that our survey administrator can use the updated versions of the pre-notification letter.

ESRD National Coordinating Center (NCC)

Non-Substantive Change to OMB CN 0938-1185

Version 2.0 Revision Date: 03/25/2016

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