Business and Financial Operations Occupations - Resident Impact/Facility Capacity Form - Retrospective Data Entry

National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities

OMB: 0920-1290

IC ID: 241809

Information Collection (IC) Details

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Business and Financial Operations Occupations - Resident Impact/Facility Capacity Form - Retrospective Data Entry
 
No Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 0920-1290 COVID-19 Module - LTCF Resident Impact and Facility Capacity Form (Retrospective Datat Entry) CDC 57.144_TOI_Resident Impact and Facility Capacity (OMB) (002) lw CLEAN.docx NA Yes Yes Fillable Fileable

Health Health Care Services

 

1,223 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 1,223 0 0 0 0 1,223
Annual IC Time Burden (Hours) 306 0 0 0 0 306
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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