Information Collection

57.128 Laboratory Identified or CDI MDRO Event

IC 183563 under ICR 202301-0920-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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 57.128 Rev 7, 57.128 Laboratory Identified or CDI MDRO Event	Form and Instruction
CDC 57.128 Rev 7, Lab ID Event 57.128_LabIDEvent_BLANK.docx	Form and Instruction
CDC 57.128 Rev 7, Lab ID Event 57.128_LabIDEvent_BLANK.docx	Form and Instruction
57.128 Laboratory-identified MDRO or CDI Event (with revised GI 57.128_LabIDEvent_November_2022.docx	Form
57.128 Laboratory-identified MDRO or CDI Event (with revised GI 57.128_LabIDEvent_November_2022.docx	Form
57.128_LabIDEvent_November_2022.docx 57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes)	IC Document
57.128_LabIDEvent_November_2022.docx 57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes)	IC Document

IC Title:

57.128 Laboratory Identified or CDI MDRO Event

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

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 and Instruction	CDC 57.128 Rev 7, v8.5	Lab ID Event	57.128_LabIDEvent_BLANK.docx		Yes	Yes	Fillable Fileable
Form	57.128	Laboratory-identified MDRO or CDI Event (with revised GISAB questions)	57.128_LabIDEvent_November_2022.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 4,800

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	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	379,200	0	379,200
Annual IC Time Burden (Hours)	132,720	6,320	126,400
Annual IC Cost Burden (Dollars)	0	-5,013,024	5,013,024

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
57.128 Laboratory-identified MDRO or CDI Event (with GISAB edits in tracked changes)	57.128_LabIDEvent_November_2022.docx	04/25/2023

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