Form CDC 57.144 CDC 57.144 Resident Impact and Facility Capacity
[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
57.144 RIFC form v13 final 5.3.23_CLEAN
Long Term Care Facility Resident Impact and Facility Capacity Pathway
OMB: 0920-1317
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-1317 can be found here:
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