OMB control number

[NCEZID] The National Healthcare Safety Network (NHSN)

OMB 0920-0666 · HHS/CDC.

OMB 0920-0666

The National Healthcare Safety Network (NHSN) is a system designed to accumulate, exchange, and integrate relevant information and resources among private and public stakeholders to support local and national efforts to protect patients and promote healthcare safety. Specifically, the data is used to determine the magnitude of various healthcare-associated adverse events and trends in the rates of these events among patients and healthcare workers with similar risks. The data will be used to detect changes in the epidemiology of adverse events resulting from new and current medical therapies and changing risks. This Revision contains minor changes to a few forms and minor burden changes.

The latest form for [NCEZID] The National Healthcare Safety Network (NHSN) expires 2029-03-31 and is listed under ICR 202506-0920-018.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form 57.106 Patient Safety Monthly Reporting Plan	Form and Instruction
Form 57.902 NHSNCoLab Pilot Site Technical Assessment	Form and Instruction
Form 57.901 NHSNCoLab Pilot Site Demographics	Form and Instruction
Form 57.900 NHSN FHIR digital Quality Measures (dQMs)	Form and Instruction
Form 57.803 All Hazards	Form and Instruction
Form 57.802 Bed Capacity-IT Initial Set Up	Form and Instruction
Form 57.801 External Validation Summary Report	Form and Instruction
Form 57.215 Seasonal Survey on Influenza Vaccination Programs for Healthcare Personnel	Form and Instruction
Form 57.214 CSV Submission	Form
Form 57.211 CSV Submission	Form
Form 57.133 Patient Safety Attestation	Form and Instruction
Form 57.130 Pathogens of High Consequence (document unavailable)	Form and Instruction
Form 57.124 Yearly Maintenance (form not used)	Form
Form 57.124 Initial Set-up (form not used)	Form
Form 57.123 Yearly Maintenance (form not used)	Form
Form 57.123 Initial Set-up (form not used)	Form
Form 57.102 NHSN Help Desk Customer Satisfaction Survey	Form and Instruction
Form CDC 57.302 Hemovigilance Module Monthly Incident Summary (document unavailable)	Form and Instruction
Form 57.800 Billing Code Data	Form
Form 57.701 Glycemic Control Module-HYPO Annual Survey	Form and Instruction
Form 57.700 Reporting Plan Glycemic Control Module Hypoglycemia	Form and Instruction
Form 57.700 Medication Safety-Digital Measure Reporting Plan (HYPO, HAKI, ORAE) -IT Yearly Maintenance	Form and Instruction
Form 57.700 Medication Safety-Digital Measure Reporting Plan (HYPO, HAKI, ORAE) -IT Initial Set up	Form and Instruction
Form 57.600 Reporting Plan LOSMEN	Form and Instruction
Form 57.600 Reporting Plan LOSMEN	Form and Instruction
Form 57.600 Reporting Plan LOSMEN Yearly Maintenance	Form and Instruction
Form 57.600 Reporting Plan LOSMEN Initial Set-up	Form and Instruction
Form 57.145 LTC-AU Module	Form and Instruction
Form 57.132 Reporting Plan HOB and HTCDI	Form and Instruction
Form 57.132 Patient Safety Digital Reporting Plan (RPS CSV)	Form and Instruction
Form 57.408 Monthly Survey Patient Days & Nurse Staffing	Form and Instruction
Form CDC 57.214 Annual Healthcare Personnel Influenza Vaccination Summary	Form and Instruction
Form CDC 57.211 Weekly HCP Influenza Vaccination Cumulative Summary Non-Long-Term Care Facilities	Form and Instruction
Form 57.601 Late Onset Sepsis/ Meningitis Denominator Form: Data Table for monthly electronic upload	Form and Instruction
Form 57.602 LOS / MEF: Data Table for Monthly Electronic Upload	Form and Instruction
Facility Administrator Change Request	Form and Instruction
Form CDC 55.122 State Health Department HAI Mandate and Validatyion Survey	Form
Form CDC 57.405 Outpatient Procedure Component - SSI Denominators	Form
Form 57.404 Outpatient Procedure Component - SSI Denominators	Form
Form 57.507 Home Dialysis Center Practices Survey	Form
Form 57.320 Hemovigilance Adverse Reaction - Other Transfusion Reaction	Form
Form CDC 57.319 Hemovigilance Adverse Reaction - Unknown Transfusion Reaction	Form
Form CDC 57.318 Hemovigilance Adverse Reaction - Transfusion Associated Circulatory Overload (document unavailable)	Form
Form 57.317 Hemovigilance Adverse Reaction - Transfusion Related Acute Lung Injury	Form
Form CDC 57.316 Hemovigilance Adverse Reaction - Transfusin Associated Graft vs. Host Disease (document unavailable)	Form
Form CDC 57.315 Hemovigilance Adverse Reaction - Transfusion Associated Dyspnea	Form
Form 57.314 Hwemovilgilance Adverse Reaction - Post Transfusion Purpura	Form
Form 57.313 Hemovigilance Adverse Reaction - Infection	Form
Form 57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction	Form
Form CDC 57.311 Hemovigilance Adverse Reaction - Febrile Non-hemolytic Transfusion Reaction	Form
Form 57.310 Hemovigilance Adverse Reaction - Delayed Serologic Transfusion Reaction	Form
Form CDC 57.309 Hemovigilance Adverse Reaction - Delayed Hemolytic Transfusion Reaction	Form
Form 57.308 Hemovigilance Adverse Reaction - Allergic Transfusion Reaction	Form
Form 57.307 Hemovigilance Adverse Reaction - Acute Hemolytic Transfusion Reaction	Form
Form 57.306 Hemovigilance Module Annual Survey - Non-acute Care Facility	Form
Form 57.129 Adult Sepsis_	Form
Form CDC 57.115 Custom Event	Form
Form 57.113 Pediatric Ventilator-Associated Event (PedVAE)	Form and Instruction
Form CDC 57.504 Prevention Process Measures Monthly Monitoring for Dialysis	Form
Form CDC 57.501 NHSN Registration Form	Form
Form CDC 57.403 Outpatient Procedure - Monthly Denominators and Summary	Form
Form CDC 57.402 Outpatient Procedure - Component Event (document unavailable)	Form
Form CDC 57.401 Outpatient Procedure Component - Monthly Reporting Plan	Form
Form CDC 57.400 Outpatient Procedure Component - Annual Facility Survey	Form
Form 57.151 Patient Safety Component—Annual Facility Survey for IRF	Form and Instruction
Form 57.150 Urinary Tract Infection (UTI) for LTCF	Form and Instruction
Form CDC 57.143 Prevention Process Measures Monthly Monitoring	Form
Form CDC 57.142 Denominators for LTCF	Form
Form CDC 57.141 Monthly Reporting Plan for LTCF	Form
Form 57.112 Ventilator Associated Event (VAE)	Form and Instruction
Form CDC 57.139 MDRO and CDI LabID Event Reporting Monthly Summary Data for LTCF	Form
Form CDC 57.138 Laboratory-identified MDRO or CDI Event for LTCF	Form
Form CDC 57.137 Long-Term Care Facility Component -- Annual Facility Survey	Form
Form CDC 57.305 Hemovigilance Module Incident	Form
Form CDC 57.303 Hemovigilance Module Monthly Reporting Denominators	Form and Instruction
Form 57.301 Hemovigilance Module Monthly Reporting Plan	Form and Instruction
Form CDC 57.300 Hemovigilance Module - Annual Survey	Form
Form CDC 57.105 Group Contact Information	Form
Form 57.140 Urinary Tract Infection (UTI) for LTCF	Form and Instruction
Form 57.103 Patient Safety Component-Annual Hospital Survey	Form and Instruction
Form CDC 57.101 Facility Contact Information	Form
Form 57.124 Antimicrobial Use and Resistance (AUR): Pharmacy Data Monthly Electronic Upload Specification Tables (document unavailable)	Form and Instruction
Form 57.123 Antimicrobial Use and Resistance (AUR): Microbiology Laboratory Data Monthly Electronic Upload Specification Tables	Form and Instruction
Form CDC 57.100 NHSN Registration Form	Form
Form 57.121 Denominator for Procedure	Form and Instruction
Form 57.128 Laboratory-identified MDRO or CDI Event	Form
Form CDC 57.120 Surgical Site Infection	Form
Form CDC 57.126 MDRO or CDI Infection Event	Form
Form CDC 57.503 Demominators for Dialysis Event Surveillance	Form
Form CDC 57.127 MDRO and CDI Prevention Process and Outcome Measures Monthly Reporting	Form
Form CDC 57.118 Denominators for Intensive Care Unit (ICU)/Other locations (not NICU or SCA)	Form
Form CDC 57.117 Denominators for Specialty Care Area (SCA)/Oncology (ONC)	Form
Form CDC 57.125 Central Line Insertion Practices Adherence Monitoring (document unavailable)	Form
Form CDC 57.116 PedVAE Optional Denominators Neonatal Intensive Care Unit (NICU)	Form
Form 57.114 Urinary Tract infection (UTI) (document unavailable)	Form and Instruction
Form 57.111 Pneumonia (PNEU)	Form and Instruction
Form CDC 57.502 Dialysis Event	Form and Instruction
Form 57.108 Primary Bloodstream Infection (BSI)	Form and Instruction
Form 57.500 Home Dialysis Center Practices Survey	Form and Instruction
B3. Comment #3_Response.pdf	Public Comments
B3. Comment #3.pdf	Public Comments
B2. Comment #2_Response.pdf	Public Comments
B2. Comment #2.pdf	Public Comments
B1. Comment and Response #1.pdf	Public Comments
2025 OMB package FHIR Measures Data Dictionary_Updates.xlsx	Supplementary Document
2025 OMB package FHIR Daily Data Dictionary Updates.xlsx	Supplementary Document
G. Privacy Impact Assessment.pdf	Supplementary Document
Memo.NC.Director NHSN (002) sign.pdf	Supplementary Document
F2. NHSN 308d Request for Extension and Ammendment.docx	Supplementary Document
F1. NHSN 308d Approval 2015.pdf	Supplementary Document
E4. Human Subjects Determination.pdf	Supplementary Document
E3. Human Subjects Determination.pdf	Supplementary Document
E2. Report of End of Human Research Review 0.1253.docx	Supplementary Document
E1. Closure CDC Protocol # 4062.docx	Supplementary Document
D2. Explanation for Program Changes or Adjustments 2025-0920-0666.docx	Supplementary Document
D1. Explanation for Program Changes or Adjustments 2025-0920-0666.docx	Supplementary Document
B. Published 60-Day FRN.pdf	Supplementary Document
A3. 42 USC 242m.pdf	Supplementary Document
A2. 42 USC 242k.pdf	Supplementary Document
A1. 42 USC 242b.pdf	Supplementary Document
SSB 0920-0666 2025.docx (document unavailable)	Supporting Statement B
SSA 0920-0666_9.26.25_final.docx	Supporting Statement A
57.106 Patient Safety Monthly Reporting Plan	Form and Instruction
57.106 Patient Safety Monthly Reporting Plan	Form and Instruction
Claims Data - Initial IT Set-Up	Other-data file
Patient Safety Component Digistal Measure Reporting Plan (RPS ONLY Daily FHIR Submission) - Yearly Maintenance	Other-data file
Patient Safety Component Digistal Measure Reporting Plan (RPS ONLY Daily FHIR Submission) -IT Intial Set Up	Other-data file
NHSNCoLab Pilot Site Technical Assessment	Form and Instruction
NHSNCoLab Pilot Site Technical Assessment	Form and Instruction
NHSNCoLab Pilot Site Demographics	Form and Instruction
NHSNCoLab Pilot Site Demographics	Form and Instruction
NHSN FHIR Digital Quality Measures (dQMs)	Form and Instruction
NHSN FHIR Digital Quality Measures (dQMs)	Form and Instruction
All Hazards	Form and Instruction
All Hazards	Form and Instruction
Bed Capacity-IT Initial Set Up	Form and Instruction
Bed Capacity-IT Initial Set Up	Form and Instruction
External Validation Summary Report	Form and Instruction
External Validation Summary Report	Form and Instruction
Seasonal Survey on Influenza Vaccination Programs for Healthcare Personnel	Form and Instruction
Seasonal Survey on Influenza Vaccination Programs for Healthcare Personnel	Form and Instruction
Annual Healthcare Personnel Influenza Vaccination Summary (CSV)	Form
Annual Healthcare Personnel Influenza Vaccination Summary (CSV)	Form
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities (CSV)	Form
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities (CSV)	Form
Patient Safety Attestation	Form and Instruction
Patient Safety Attestation	Form and Instruction
57.130 Pathogens of High Consequence	Form and Instruction
57.130 Pathogens of High Consequence	Form and Instruction
AUR Pharmacy Data Electronic Upload Specification Tables (Yearly Maintenance)	Form
AUR Pharmacy Data Electronic Upload Specification Tables (Yearly Maintenance)	Form
AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up)	Form
AUR Pharmacy Data Electronic Upload Specification Tables (Initial Set-up)	Form
AUR Microbiolgy Data Electronic Upload Specification Tables (Yearly Maintenance)	Form
AUR Microbiolgy Data Electronic Upload Specification Tables (Yearly Maintenance)	Form
AUR Microbiology Data Electronic Upload Specification Tables (Initial Set-up)	Form
AUR Microbiology Data Electronic Upload Specification Tables (Initial Set-up)	Form
NHSN Help Desk Customer Satisfaction Survey	Form and Instruction
NHSN Help Desk Customer Satisfaction Survey	Form and Instruction
Hemovigilance Module Monthly Incident Summary	Form and Instruction
Hemovigilance Module Monthly Incident Summary	Form and Instruction
Billing Code Data: 837I Upload	Form
Billing Code Data: 837I Upload	Form
57.701 - Glycemic Control Module-HYPO Annual Survey	Form and Instruction
57.701 - Glycemic Control Module-HYPO Annual Survey	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-Infection Preventionist	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-Infection Preventionist	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Yearly Maintenance	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Yearly Maintenance	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Initial Set up	Form and Instruction
57.700 - Medication Safety Component FHIR Measure-Glycemic Control Module Hypoglycemia-IT Initial Set up	Form and Instruction
57.600 - Neonatal Component Late Onset Sepsis Meningitis (LOSMEN) Module CDA Data Collection-Infection Preventionist	Form and Instruction
57.600 - Neonatal Component Late Onset Sepsis Meningitis (LOSMEN) Module CDA Data Collection-Infection Preventionist	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-Infection Preventionist	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-Infection Preventionist	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Yearly Maintenance	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Yearly Maintenance	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Initial Set up	Form and Instruction
57.600 - Neonatal Component FHIR Measure-Late Onset Sepsis Meningitis (LOSMEN) Module-IT Initial Set up	Form and Instruction
57.145 - Long Term Care Antimicrobial Use (LTC-AU) Module CDA	Form and Instruction
57.145 - Long Term Care Antimicrobial Use (LTC-AU) Module CDA	Form and Instruction
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-Infection Preventionist	Form and Instruction
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-Infection Preventionist	Form and Instruction
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-IT Yearly Maintenance	Other-OMB Header and Burden Statement
57.132 - Patient Safety Component FHIR Measures-HOB, HT-CDI Modules-IT Initial Set up	Other-OMB Header and Burden Statement
57.132 - Patient Safety Digital Reporting Plan (RPS CSV)	Form and Instruction
57.132 - Patient Safety Digital Reporting Plan (RPS CSV)	Form and Instruction
Monthly Survey Patient Days & Nurse Staffing	Form and Instruction
Monthly Survey Patient Days & Nurse Staffing	Form and Instruction
Annual Healthcare Personnel Influenza Vaccination Summary (manual)	Form and Instruction
Annual Healthcare Personnel Influenza Vaccination Summary (manual)	Form and Instruction
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities	Form and Instruction
Weekly Healthcare Personnel Influenza Vaccination Cumulative Summary for Non-Long-Term Care Facilities	Form and Instruction
Late Onset Sepsis/Meningitis Denominator Form: Data Table (Monthly)	Form and Instruction
Late Onset Sepsis/Meningitis Denominator Form: Data Table (Monthly)	Form and Instruction
Late Onset Sepsis / Meningitis Event Form: Data Table for Monthly Electronic Upload	Form and Instruction
Late Onset Sepsis / Meningitis Event Form: Data Table for Monthly Electronic Upload	Form and Instruction
57.104 NHSN Administrator Change Request Form	Form and Instruction
57.104 NHSN Administrator Change Request Form	Form and Instruction
57.122 HAI Progress Report State Health Department Survey	Form
57.122 HAI Progress Report State Health Department Survey	Form
57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) Event	Form
57.405 Outpatient Procedure Component - Surgical Site Infection (SSI) Event	Form
57.404 Outpatient Procedure Component - SSI Denominators	Form
57.404 Outpatient Procedure Component - SSI Denominators	Form
57.507 Home Dialysis Center Practices Survey	Form
57.507 Home Dialysis Center Practices Survey	Form
57.320 Hemovigilance Adverse Reaction - Other Transfusion Reaction	Form
57.320 Hemovigilance Adverse Reaction - Other Transfusion Reaction	Form
57.319 Hemovigilance Adverse Reaction - Unknown Transfusion Reaction	Form
57.319 Hemovigilance Adverse Reaction - Unknown Transfusion Reaction	Form
57.318 Hemovigilance Adverse Reaction - Transfusion Associated Circulatory Overload	Form
57.318 Hemovigilance Adverse Reaction - Transfusion Associated Circulatory Overload	Form
57.317 Hemovigilance Adverse Reaction - Transfusion Associated Acute Lung Injury	Form
57.317 Hemovigilance Adverse Reaction - Transfusion Associated Acute Lung Injury	Form
57.316 Hemovigilance Adverse Reaction - Transfusion Associated Graft vs. Host Disease	Form
57.316 Hemovigilance Adverse Reaction - Transfusion Associated Graft vs. Host Disease	Form
57.315 Hemovigilance Adverse Reaction - Transfusion Associated Dyspnea	Form
57.315 Hemovigilance Adverse Reaction - Transfusion Associated Dyspnea	Form
57.314 Hemovigilance Adverse Reaction - Post Transfusion Purpura	Form
57.314 Hemovigilance Adverse Reaction - Post Transfusion Purpura	Form
57.313 Hemovigilance Adverse Reaction - Infection	Form
57.313 Hemovigilance Adverse Reaction - Infection	Form
57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction	Form
57.312 Hemovigilance Adverse Reaction - Hypotensive Transfusion Reaction	Form
57.311 Hemovigilance Adverse Reaction - Febrile Non-hemolytic Transfusion Reaction	Form
57.311 Hemovigilance Adverse Reaction - Febrile Non-hemolytic Transfusion Reaction	Form
57.310 Hemovigilance Adverse Reaction - Delayed Serologic Transfusion Reaction	Form
57.310 Hemovigilance Adverse Reaction - Delayed Serologic Transfusion Reaction	Form
57.309 Hemovigilance Adverse Reaction - Delayed Hemolytic Transfusion Reaction	Form
57.309 Hemovigilance Adverse Reaction - Delayed Hemolytic Transfusion Reaction	Form
57.308 Hemovigilance Adverse Reaction - Allergic Transfusion Reaction	Form
57.308 Hemovigilance Adverse Reaction - Allergic Transfusion Reaction	Form
57.307 Hemovigilance Adverse Reaction - Acute Hemolytic Transfusion Reaction	Form
57.307 Hemovigilance Adverse Reaction - Acute Hemolytic Transfusion Reaction	Form
57.306 Hemovigilance Module Annual Facility Survey - Non-acute Care Facility	Form
57.306 Hemovigilance Module Annual Facility Survey - Non-acute Care Facility	Form
57.129_Adult Sepsis	Form
57.129_Adult Sepsis	Form
57.115 Custom Event	Form
57.115 Custom Event	Form
57.113 Pediatric Ventilator-Associated Event (PedVAE)	Form and Instruction
57.113 Pediatric Ventilator-Associated Event (PedVAE)	Form and Instruction
57.504 Prevention Process Measures Monthly Monitoring for Dialysis	Form
57.504 Prevention Process Measures Monthly Monitoring for Dialysis	Form
57.501 Dialysis Monthly Reporting Plan	Form
57.501 Dialysis Monthly Reporting Plan	Form
57.403 Outpatient Procedure Component - Monthly Denominators and Summary	Form
57.403 Outpatient Procedure Component - Monthly Denominators and Summary	Form
57.402 Outpatient Procedure Component Event	Form
57.402 Outpatient Procedure Component Event	Form
57.401 Outpatient Procedure - Monthly Reporting Plan	Form
57.401 Outpatient Procedure - Monthly Reporting Plan	Form
57.400 Outpatient Procedure - Annual Facility Survey	Form
57.400 Outpatient Procedure - Annual Facility Survey	Form
57.151 Patient Safety Component -- Annual Facility Survey for IRF	Form and Instruction
57.151 Patient Safety Component -- Annual Facility Survey for IRF	Form and Instruction
57.150 Patient Safety Component -- Annual Facility Survey for LTAC	Form and Instruction
57.150 Patient Safety Component -- Annual Facility Survey for LTAC	Form and Instruction
57.143 Prevention Process Measures Monthly Monitoring for LTCF	Form
57.143 Prevention Process Measures Monthly Monitoring for LTCF	Form
57.142 Denominators for LTCF Locations	Form
57.142 Denominators for LTCF Locations	Form
57.141 Monthly Reporting Plan for LTCF	Form
57.141 Monthly Reporting Plan for LTCF	Form
57.112 Ventilator-Associated Event (VAE)	Form and Instruction
57.112 Ventilator-Associated Event (VAE)	Form and Instruction
57.139 MDRO and CDI Prevention Process Measures Monthly for LTCF	Form
57.139 MDRO and CDI Prevention Process Measures Monthly for LTCF	Form
57.138 Laboratory-Identified MDRO or CDI Event for LTCF	Form
57.138 Laboratory-Identified MDRO or CDI Event for LTCF	Form
57.137 Long Term care Facility Component--Annual Facility Survey	Form
57.137 Long Term care Facility Component--Annual Facility Survey	Form
57.305 Hemovigilance Incident	Form
57.305 Hemovigilance Incident	Form
57.303 Hemovigilance Module Monthly Reporting Denominators	Form and Instruction
57.303 Hemovigilance Module Monthly Reporting Denominators	Form and Instruction
57.301 Hemovigilance Module Monthly Reporting Plan	Form and Instruction
57.301 Hemovigilance Module Monthly Reporting Plan	Form and Instruction
57.300 Hemovigilance Module Annual Survey -- Acute Care Facility	Form
57.300 Hemovigilance Module Annual Survey -- Acute Care Facility	Form
57.105 Group Contact Information	Form
57.105 Group Contact Information	Form
57.140 Urinary Tract Infection (UTI) for LTCF	Form and Instruction
57.140 Urinary Tract Infection (UTI) for LTCF	Form and Instruction
57.103 Patient Safety Component - Annual Hospital Survey	Form and Instruction
57.103 Patient Safety Component - Annual Hospital Survey	Form and Instruction
57.101 Facility Contact Information	Form
57.101 Facility Contact Information	Form
57.124 Antimicrobial Use and Resistence (AUR) - Pharmacy Data	Form and Instruction
57.124 Antimicrobial Use and Resistence (AUR) - Pharmacy Data	Form and Instruction
57.123 Antimicrobial Use and Resistance (AUR) - Microbiology Data Upload Tables	Form and Instruction
57.123 Antimicrobial Use and Resistance (AUR) - Microbiology Data Upload Tables	Form and Instruction
57.100 NHSN Registration Form	Form
57.100 NHSN Registration Form	Form
57.121 Denominators for Procedure	Form and Instruction
57.121 Denominators for Procedure	Form and Instruction
57.128 Laboratory Identified or CDI MDRO Event	Form
57.128 Laboratory Identified or CDI MDRO Event	Form
57.120 Surgical Site Infection (SSI)	Form
57.120 Surgical Site Infection (SSI)	Form
57.126 MDRO or CDI Infection Event	Form
57.126 MDRO or CDI Infection Event	Form
57.503 Denominators for Outpatient Dialysis	Form
57.503 Denominators for Outpatient Dialysis	Form
57.127 MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring	Form
57.127 MDRO and CDI Prevention Process and Outcome Measures Monthly Monitoring	Form
57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)	Form
57.118 Denominators for Intensive Care Unit (ICU) Other Locations (Not NICU or SCA)	Form
57.117 Denominators for Specialty Care Area (SCA)/Onocology (ONC)	Form
57.117 Denominators for Specialty Care Area (SCA)/Onocology (ONC)	Form
57.125 Central Line Insertion Practices Adherence Monitoring Form	Form
57.125 Central Line Insertion Practices Adherence Monitoring Form	Form
57.116 Denominators for Neonatal Intensive Care Unit (NICU)	Form
57.116 Denominators for Neonatal Intensive Care Unit (NICU)	Form
57.114 Urinary Tract Infection (UTI)	Form and Instruction
57.114 Urinary Tract Infection (UTI)	Form and Instruction
57.111 Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)	Form and Instruction
57.111 Pneumonia (includes Any Patient Pneumonia flow Diagram and Infant and Children Pneumonia Flow Diagram)	Form and Instruction
57.502 Dialysis Event	Form and Instruction
57.502 Dialysis Event	Form and Instruction
57.108 Primary Bloodstream Infection (BSI)	Form and Instruction
57.108 Primary Bloodstream Infection (BSI)	Form and Instruction
57.500 Outpatient Dialysis Center Practices Survey	Form and Instruction
57.500 Outpatient Dialysis Center Practices Survey	Form and Instruction

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202603-0920-006	Revision of a currently approved collection	2026-03-13
202506-0920-018	Reinstatement with change of a previously approved collection	2025-06-30
202505-0920-007	No material or nonsubstantive change to a currently approved collection	2025-05-20
202502-0920-016	No material or nonsubstantive change to a currently approved collection	2025-03-28
202412-0920-019	Revision of a currently approved collection	2024-12-23	Approved with change
202412-0920-018	Revision of a currently approved collection	2024-12-20	Withdrawn and continue
202412-0920-016	Revision of a currently approved collection	2024-12-23	Withdrawn and continue
202410-0920-013	Revision of a currently approved collection	2024-11-15
202408-0920-016	No material or nonsubstantive change to a currently approved collection	2024-08-26
202402-0920-011	No material or nonsubstantive change to a currently approved collection	2024-02-28	Approved without change
202310-0920-013	Revision of a currently approved collection	2023-11-17	Approved without change
202301-0920-005	Revision of a currently approved collection	2023-04-26	Approved with change
202212-0920-013	Revision of a currently approved collection	2022-12-21	Approved without change
202112-0920-014	Revision of a currently approved collection	2022-01-03	Approved with change
202104-0920-002	No material or nonsubstantive change to a currently approved collection	2021-04-09	Approved with change
202102-0920-011	No material or nonsubstantive change to a currently approved collection	2021-02-23	Approved without change
202010-0920-016	Revision of a currently approved collection	2020-11-25	Approved with change
202006-0920-003	No material or nonsubstantive change to a currently approved collection	2020-06-04	Approved with change
201908-0920-004	Revision of a currently approved collection	2019-10-11	Approved with change
201808-0920-011	Revision of a currently approved collection	2018-10-11	Approved with change
201807-0920-002	No material or nonsubstantive change to a currently approved collection	2018-07-09	Approved without change
201801-0920-008	No material or nonsubstantive change to a currently approved collection	2018-01-31	Approved without change
201708-0920-029	Revision of a currently approved collection	2017-10-30	Approved with change
201607-0920-013	Revision of a currently approved collection	2016-08-17	Approved with change
201603-0920-007	No material or nonsubstantive change to a currently approved collection	2016-03-16	Approved without change
201508-0920-001	Revision of a currently approved collection	2015-09-11	Approved with change
201407-0920-007	Revision of a currently approved collection	2014-09-23	Approved without change
201308-0920-010	Revision of a currently approved collection	2013-08-28	Approved without change
201211-0920-005	Revision of a currently approved collection	2012-11-01	Approved without change
201112-0920-004	Revision of a currently approved collection	2011-12-08	Approved without change
201105-0920-001	Revision of a currently approved collection	2011-05-02	Approved without change
201104-0920-012	Revision of a currently approved collection	2011-04-14	Improperly submitted and continue
200908-0920-002	Revision of a currently approved collection	2009-08-19	Approved without change
200906-0920-001	No material or nonsubstantive change to a currently approved collection	2009-06-08	Improperly submitted and continue
200901-0920-009	No material or nonsubstantive change to a currently approved collection	2009-01-30	Approved without change
200801-0920-009	Revision of a currently approved collection	2008-01-30	Approved without change
200712-0920-003	No material or nonsubstantive change to a currently approved collection	2007-12-14	Approved without change
200701-0920-002	No material or nonsubstantive change to a currently approved collection	2007-01-12	Withdrawn and continue
200409-0920-012	New collection (Request for a new OMB Control Number)	2004-09-30	Approved with change