NHSN COVID-19 Hospital Module - Hospitals (excluding Psychiatric and Rehabilitation Facilities)

[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities

OMB: 0920-1317

IC ID: 257193

Documents and Forms
Document Name
Document Type
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

NHSN COVID-19 Hospital Module - Hospitals (excluding Psychiatric and Rehabilitation Facilities) 0920-1317
 
No Removed
 
Mandatory
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction n/a NHSN COVID-19 Hospital Module Hospital COVID Data Form - webform_FINAL.docx Yes Yes Fillable Fileable
Form and Instruction 0920-1317 COVID-19 Hospital Data Form Form-COVID-19 Hospital Data Form-Clean Version.docx N/A Yes Yes Fillable Fileable

Health Public Health Monitoring

 

5,200 0
   
Private Sector Not-for-profit institutions, Businesses or other for-profits
 
   100 %

  Approved 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 0 0 -1,898,000 0 0 1,898,000
Annual IC Time Burden (Hours) 0 0 -2,847,000 0 0 2,847,000
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
TOI COVID-19 Hospital Module Form TOI-for Completion of the COVID-19 Hospital Data Reporting Form.docx 09/07/2023
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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