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Form 0920-1317 VA COVID-19 Resident Event Form
[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
Clean 10.1.4 COVID 19 event reporting_resident form revised_7.22
VA - Resident COVID-19 Event Form - LTCF
OMB: 0920-1317
OMB.report
HHS/CDC
OMB 0920-1317
ICR 202305-0920-005
IC 247668
Form 0920-1317 VA COVID-19 Resident Event Form
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1317 can be found here:
2024-03-14 - No material or nonsubstantive change to a currently approved collection
2023-09-07 - No material or nonsubstantive change to a currently approved collection
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