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LTCF Resident Impact and Facility Capacity - LTCF personnel

IC 241490 under ICR 202008-0920-012 · OMB 0920-1290.

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Form
Form and Instruction
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LTCF Resident Impact and Facility Capacity - LTCF personnel
 
No Modified
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form none Resident impact and facility capacity CDC 57.144_COVID-19 form_Resident Impact and Facility Capacity_v3_Ready for DEV 7.23.20.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1290 LTCF Resident Impact and Facitlity Capacity POC - 26AUG2020 CDC 57.144_COVID-19_Resident Impact and Facility Capacity POC 20AUG2020.docx NA Yes Yes Fillable Fileable

Health Health Care Services

 

9,782 0
   
Individuals or Households
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 254,332 0 0 0 0 254,332
Annual IC Time Burden (Hours) 169,555 0 21,195 0 0 148,360
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Instructions - LTCF Resident Impact and Facitlity Capacity CDC 57.144_TOI_Resident Impact and Facility Capacity POC 20AUG2020.docx 08/26/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.