National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities

ICR 202109-0920-006

OMB: 0920-1317

Federal Form Document

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Justification for No Material/Nonsubstantive Change
2021-09-22
Justification for No Material/Nonsubstantive Change
2021-05-28
Justification for No Material/Nonsubstantive Change
2021-02-25
Justification for No Material/Nonsubstantive Change
2021-01-28
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supplementary Document
2020-09-21
Supporting Statement B
2020-09-21
Supporting Statement A
2021-01-15
IC Document Collections
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249439 New
249438 New
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ICR Details
0920-1317 202109-0920-006
Received in OIRA 202105-0920-014
HHS/CDC 0920-1317-21IH
National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
No material or nonsubstantive change to a currently approved collection   No
Regular 09/22/2021
  Requested Previously Approved
01/31/2024 01/31/2024
7,502,054 5,052,366
4,736,898 1,732,245
0 0

The goal of this information collection is to 1) capture the daily, aggregate impact of COVID-19 on healthcare facilities, and 2) monitor medical capacity to respond at local, state, and national levels. This information will be used to inform the overall real-time COVID-19 response efforts and possible resource allocation, and enable state and local health departments to gain immediate access to the COVID-19 data for healthcare facilities within their jurisdiction. This Non-Substantive Change Request is submitted to improve the usefulness and quality of data that is gathered regarding residents with newly positive SARS-CoV-2 viral test results and their vaccination status. This will also likely aid in improving the quality of data which can be used regarding break-through cases.

US Code: 42 USC 242b, k, m Name of Law: The Public Health Service Act
  
None

Not associated with rulemaking

  85 FR 21443 04/17/2020
85 FR 59313 09/21/2020
Yes

31
IC Title Form No. Form Name
Dialysis Component 0920-20LW, 0920-1317, 0920-1317, 0920-1317 / Form 57.510 Dialysis Component ,   COVID-19 Module Dialysis Outpatient Facility ,   COVID-19 Module Dialysis Outpatient Facility Form 27MAY2021 ,   COVID–19 Module - Dialysis Outpatient Facility
Healthcare Personnel Safety Monthly Reporting Plan - completed by Dialysis Facilities 0920-1317 / CDC Form 57.203 Healthcare Personnel Safety Monthly Reporting Plan
Healthcare Personnel Safety Monthly Reporting Plan - completed by Inpatient Psychiatric Facilities 0920-1317 / CDC Form 57.203 Healthcare Personnel Safety Monthly Reporting Plan
Monthly Reporting Plan form for Long-term Care Facilities 0920-1317 / CDC Form 57.141 Monthly Reporting Plan for LTCF
NHSN and Secure Access Management Services (SAMS) enrollment 0920-20LW NHSN Registration Form
Resident Impact and Facility Capacity - Business and Financial Operations Occupations CDC 57.144, 0920-1317 CDC 57.144 Resident Impact and Facility Capacity ,   Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - Business and Financial Operations Occupations retrospective CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - LTCF Personnel 0920-1317 Form 57.144, 0920-1317 CDC 57.144, CDC 57.144 Resident Impact and Facility Capacity ,   Resident Impact and Facility Capacity ,   Resident Impact and Facility Capacity Form 21SEP2021
Resident Impact and Facility Capacity - LTCF Personnel retrospective CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations CDC 57.144, 0920-1317 CDC 57.144 Resident Impact and Facility Capacity ,   Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations retrospective CDC 57.144 Resident Impact and Facility Capacity
Resident Therapeutics - Business and Financial Operations Occupations 0920-1317 CDC 57.XXX Long Term Care Facility: Resident Therapeutics
Resident Therapeutics - LTCF Personnel 0920-1317 CDC 57.XXX Long-Term Care Facility: Resident Therapeutics
Resident Therapeutics - State and Local Health Dept. Occupations 0920-1317 CDC 57.XXX Long Term Care Facility: Resident Therapeutics
Staff and Personnel Impact - Business and Financial Operations Occupations CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - Business and Financial Operations Occupations retrospective CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel retrospective CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations retrospective CDC 57.145 Staff and Personnel Impact
Supplies & Personal Protective Equipment - Business and Financial Operations Occupations CDC 57.146, CDC 57.146 Supplies & Personal Protective Equipment ,   COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - LTCF Personnel CDC 57.146, CDC 57.146 Supplies & Personal Protective Equipment ,   COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - State and Local Health Dept Occupations CDC 57.146, CDC 57.146 Supplies & Personal Protective Equipment ,   COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
VA - Resident COVID-19 Event Form - LTCF 0920-1317, 0920-1317 VA COVID-19 Resident Event Form ,   Resident COVID-19 Event Form 22SEP2021
VA - Staff and Personnel COVID-19 Event Form - LTCF 0920-1317, 0920-1317 VA - Staff and Personnel COVID-19 Event Form ,   Staff and Personnel COVID-19 Event Form 22SEP2021
Ventilator Capacity & Supplies - Business and Financial Operations Occupations CDC 57.147 Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - LCTF Personnel CDC 57.147 Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - State and Local Health Dept Occupations CDC 57.147 Ventilator Capacity & Supplies
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary 0920-1317 / CDC Form 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities 0920-1317 / CDC Form 57.509 Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities 0920-1317 / CDC Form 57.218 Weekly COVID-19 Vaccination Cumulative Summary for Residents of Long-Term Care Facilities

  Total Request 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 7,502,054 5,052,366 0 2,449,688 0 0
Annual Time Burden (Hours) 4,736,898 1,732,245 0 3,004,653 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
Burden change due to modifications made to the following 0920-1317 Forms: 1. Dialysis COVID-19 form (57.510) 2. LTCF Veterans Affairs Staff and Personnel COVID-19 Event form (57.160) 3. LTCF Veterans Affairs Resident COVID-19 Event form (57.159) 4. LTCF Point of Care Testing Results Tool (57.155) 5. LTCF Resident Impact and Facility Capacity form (57.144) 6. LTCF healthcare associated infections event form (57.142) 7. Weekly COVID-19 Vaccination Data Collection Forms & Monthly Reporting Plans: 57.203, 57.141, 57.509, 57.219, 57.218

$0
No
    Yes
    No
No
No
No
Yes
Jeffrey Zirger 404 639-7118 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/22/2021


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