Information Collection

57.138 Laboratory-Identified MDRO or CDI Event for LTCF

IC 197542 under ICR 201407-0920-007 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form CDC 57.138 57.138 Laboratory-Identified MDRO or CDI Event for LTCF	Form
CDC 57.138 Laboratory-identified MDRO or CDI Event for LTCF 57.138_LabIDEvent_LTCF_BLANK.docx	Form
Att G.11_ LTCF MDRO CDI.pdf Att G.11_Laboratory-identified Multidrug-Resistant Organism (MDRO) & Clostridium difficile Infection (CDI) Events for Long-term	IC Document

IC Title:

57.138 Laboratory-Identified MDRO or CDI Event for LTCF

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	CDC 57.138	Laboratory-identified MDRO or CDI Event for LTCF	57.138_LabIDEvent_LTCF_BLANK.docx		Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 250

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	2,000	2,000
Annual IC Time Burden (Hours)	500	500
Annual IC Cost Burden (Dollars)	18,920	18,920

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att G.11_Laboratory-identified Multidrug-Resistant Organism (MDRO) & Clostridium difficile Infection (CDI) Events for Long-term Care Facility	Att G.11_ LTCF MDRO CDI.pdf	08/28/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.