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[NCEZID] Survey of Nursing Homes to Support a Pilot Test of a National Healthcare Safety Network (NHSN) Electronic Health Record (EHR) Implementation Guide (IG)

IC 263139 under ICR 202402-0920-010 · OMB 0920-1071.

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Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
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[NCEZID] Survey of Nursing Homes to Support a Pilot Test of a National Healthcare Safety Network (NHSN) Electronic Health Record (EHR) Implementation Guide (IG) 0920-1071-24AT
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a NH Survey NHSurvey_CDC NH EHR_dev07_Clean_final_2023Oct13.docx Yes Yes Fillable Fileable

Health Public Health Monitoring

 

250 0
   
Private Sector Businesses or other for-profits
 
   70 %

  Requested 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 250 0 0 0 0 250
Annual IC Time Burden (Hours) 83 0 0 0 0 83
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
GenIC Request Template Service Delivery Fast Track Template_CDC-NHproject_final_2023Oct13.docx 10/31/2023
Survey Instructions Invite SurveyInstructions_dev04_Clean.docx 10/31/2023
Research Determination Human Subjects Determination.pdf 10/31/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.