Risk Factors for Invasive Methicillin-Resistant Staphylococcus aureus (MRSA) among Patients Recently Discharged from Acute Care Hospitals

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement Part B HACO Final.docx	Supporting Statement B	Uploaded 2012-09-26	Repair queued
Attachment J HACO IRB approval.doc	Supplementary Document	Uploaded 2012-09-26	Repair queued
Attachment I_non research determination.pdf	Supplementary Document	Uploaded 2012-09-26	Repair queued
Attachment H_ Nursing Home Medical Record review Form.pdf	Supplementary Document	Uploaded 2012-09-26	Repair queued
Attachment E - Verbal Consent.docx	Supplementary Document	Uploaded 2012-09-26	Repair queued
Attachment D MR review form for Case and Control.pdf	Supplementary Document	Uploaded 2012-09-26	Available
Attachment C ABCs MRSA CRF.pdf	Supplementary Document	Uploaded 2012-09-26	Repair queued
Attachment A Sec 301 42 USC 2411.pdf	Supplementary Document	Uploaded 2012-09-26	Available
Supporting Statement Part A HACO_FINAL.docx	Supporting Statement A	Uploaded 2012-09-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
204338	Post-Discharge Hospital Patients- Telephone Interview	Instruction	New
204337	Post-discharge Hospital Patients - Telephone Screening Form	Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 201209-0920-010
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Risk Factors for Invasive Methicillin-Resistant Staphylococcus aureus (MRSA) among Patients Recently Discharged from Acute Care Hospitals
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 02/12/2013
	Date Received in OIRA: 09/28/2012
Terms of Clearance: Withdrawn at the request of CDC.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: MRSA infections are associated with increased medical costs, morbidity and mortality. MRSA is resistan to first line antimicrobial therapies. Little is known about MRSA risk factors post-discharge.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: 42USC241
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 24209	04/23/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 40363	07/09/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Post-discharge Hospital Patients - Telephone Screening Form
Post-Discharge Hospital Patients- Telephone Interview

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $270,033

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/28/2012

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