Information Collection

57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)

IC 183558 under ICR 202102-0920-011 · 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⚠️ Notice: This information collection may be referencing outdated material.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 57.118 57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)	Form
CDC 57.118 Denominators for Intensive Care Unit (ICU)/Other locatio 57.118_DenominatorICU_BLANK.DOCX	Form
G8. Denominators for Patient Safety Component.pdf Att G8_Denominators for Patient Safety Component	IC Document

IC Title:

57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)

Agency IC Tracking Number:

0920-0666

Is this a Common Form? No

IC Status: Unchanged

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 57.118	Denominators for Intensive Care Unit (ICU)/Other locations (not NICU or SCA)	57.118_DenominatorICU_BLANK.DOCX		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,500

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	330,000	330,000
Annual IC Time Burden (Hours)	27,500	27,500
Annual IC Cost Burden (Dollars)	53,757,000	53,757,000

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Att G8_Denominators for Patient Safety Component	G8. Denominators for Patient Safety Component.pdf	07/25/2016

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