States will be requested to complete and submit the survey which is intended to identify methods and promising practices for identifying, reporting, tracking, and resolving incidents of abuse, neglect, and exploitation. The results of the survey will also be used to review the strengths and weaknesses of each state’s incident management system and will inform guidance to help ensure states comply with sections 1902(a)(30)(A) and 1915(c)(2)(A) of the Social Security Act.
The latest form for Home and Community Based Services (HCBS) Incident Management Survey (CMS-10692) expires 2022-06-30 and can be found here.
Document Name |
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Supplementary Document |
Supporting Statement B |
Supporting Statement A |
Approved without change |
Extension without change of a currently approved collection | 2022-06-29 | |
Approved with change |
New collection (Request for a new OMB Control Number) | 2019-03-15 |