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Resident Impact and Facility Capacity - State and Local Health Dept Occupations

IC 243701 under ICR 202211-0920-014 · OMB 0920-1317.

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
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Resident Impact and Facility Capacity - State and Local Health Dept Occupations 0920-20LW
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CDC 57.144 Resident Impact and Facility Capacity CDC 57.144_COVID-19 form_Resident Impact and Facility Capacity_v2 updated 6.2020 Final.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1317 CDC 57.144 Resident Impact and Facility Capacity 57.144-LTCF_RIFC_V6.docx NA Yes Yes Fillable Fileable
Form and Instruction 0920-1317 / CDC 57.144 Resident Impact and Facility Capacity Form 23MAY2022 57.144 RICF form 10.1.3 OMB.docx NA Yes Yes Fillable Fileable

Health Public Health Monitoring

 

1,870 0
   
State, Local, and Tribal Governments
 
   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 0 0 0 -97,240 0 97,240
Annual IC Time Burden (Hours) 0 0 0 -72,930 0 72,930
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
RIFC - Instructions 57.144-RIFC toi_V13_10.1.3 OMB.docx 05/23/2022
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.