Facility Advance Letter_InPerson

DEPARTMENT OF HEALTH & HUMAN SERVICES
Centers for Medicare & Medicaid Services

Dear [Administrator]:

[Month], [Year]

I am writing to request your assistance in helping us conduct an important study called the Medicare Current
Beneficiary Survey (MCBS). A resident in your facility, [R First] [R Last], has been selected to participate in this
study.
Since 1991, the Centers for Medicare and Medicaid Services (CMS), part of the U.S. Department of Health and
Human Services, have conducted the MCBS in order to better understand the needs of Americans enrolled in
Medicare. It is the nation’s primary source of information about how Medicare affects the people it serves, and we
intend to use the information collected to improve the Medicare program. Because we cannot interview everyone
on Medicare, a sample of 16,000 Medicare beneficiaries was selected to represent all of those on Medicare.
A portion of the selected Medicare beneficiaries reside in long-term care facilities. Including these
beneficiaries in the study is extremely important because long-term care issues are at the forefront of the
national health policy agenda. We need your help to collect information about a resident in your facility.
The interview focuses on the utilization and costs of the health care being received by [R First] [R Last],
along with a small section describing the characteristics of your facility. Much of the information can be
abstracted directly from the resident’s chart and will only require about an hour of your staff’s time. For
the most recent public version of the questions you may be asked, you may visit: cms.gov/ResearchStatistics-Data-and-Systems/Research/MCBS/Questionnaires
No residents of your facility will be contacted directly. All of the information your organization provides will be
kept private to the extent permitted by law, as prescribed by The Federal Privacy Act of 1974. Your participation
is voluntary, and your relationship with programs administered by CMS will not be affected in any way by
whether or not you participate.
NORC at the University of Chicago, a respected social science research organization, has been contracted to
conduct the MCBS. A professional interviewer will contact you within the next few weeks to schedule an
interview time. Let me emphasize again that your residents’ Medicare benefits cannot be affected in any way by
the answers that you provide, or by whether or not you choose to participate.
If you have any questions about the study or would like to schedule an appointment, please call NORC toll-free at
1-844-777-2151, or email NORC at [email protected]. Enclosed is a brochure that provides you with more
information about the survey. You can also visit the MCBS respondent website at mcbs.norc.org to learn more.
The Medicare Current Beneficiary Survey is important. Please help us in this national effort to improve the
Medicare program.
Sincerely,

Marina Vornovitsky
Director, Medicare Current Beneficiary Survey
Centers for Medicare and Medicaid Services

Enclosure
OMB No. 0938-0568 | Expires 8/31/2025