Form CDC Form 57.141 CDC Form 57.141 Monthly Reporting Plan for LTCF
[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
57.141_ReportPlan_LTCF_July2021
Monthly Reporting Plan form for Long-term Care Facilities
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⚠️ Notice: This form may be outdated.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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