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
Revised_ Supporting Statement Part B HACO_revised_02.05.2013.docx	Supporting Statement B	Uploaded 2013-02-13	Available
Attachment J-HACO IRB approval letter.docx	Supplementary Document	Uploaded 2013-02-13	Available
Attachment I_non research determination.pdf	Supplementary Document	Uploaded 2013-02-13	Available
Attachment A Sec. 301 42 USC 241[1].pdf	Supplementary Document	Uploaded 2013-02-13	Available
Attachment H_ Nursing Home Medical Record review Form.pdf	Supplementary Document	Uploaded 2013-02-15	Available
Attachment D. MR review form for Case and Control.pdf	Supplementary Document	Uploaded 2013-02-15	Available
Attachment C. ABCs MRSA. CRF.pdf	Supplementary Document	Uploaded 2013-02-15	Available
Attachment E - Verbal Consent.revised docx.docx	Supplementary Document	Uploaded 2013-02-14	Available
Revised_ Supporting Statement Part A HACO_02.05.2013.docx	Supporting Statement A	Uploaded 2013-02-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205891	Post-Discharge Hospital Patients without MRSA infection (Control Patients) Telephone Interview	Instruction	New
205890	Post-discharge Hospital Patients without MRSA Infection (Control-Patients) Screening and Consent	Instruction	New
205889	Post-Discharge Hospital Patients (Case Patients)- Telephone Interview	Instruction	New
205888	Post-discharge Hospital Patients with MRSA (Case Patients) - Screening and Consent Process	Instruction	New

ICR Details

OMB Control No: 0920-0958	ICR Reference No: 201302-0920-016
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 18811
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: Approved with change	Conclusion Date: 03/20/2013
	Date Received in OIRA: 02/21/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2015	24 Months From Approved
Responses	735	0	0
Time Burden (Hours)	133	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: USC 241
  

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: 4

table that charts list of burden

IC Title	Form No.	Form Name
Post-discharge Hospital Patients with MRSA (Case Patients) - Screening and Consent Process
Post-Discharge Hospital Patients (Case Patients)- Telephone Interview
Post-discharge Hospital Patients without MRSA Infection (Control-Patients) Screening and Consent
Post-Discharge Hospital Patients without MRSA infection (Control Patients) Telephone Interview

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	735	0	0	735	0	0
Annual Time Burden (Hours)	133	0	0	133	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new ICR request

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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? No

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: 02/21/2013

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