 NHSN Registration Form | Form |
| Dialysis COVID-19 Outpatient Form | Form |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form and Instruction |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form |
| Form 57.145 Staff and Personnel Impact form (57.145) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.144 Resident Impact and Facility Capacity form (57.144) | Form |
| Form 57.155 NHSN - Point of Care Testing Results - LTCF personnel (reporting resident test results) | Form and Instruction |
| Form 57.155 NHSN - Point of Care Testing Results -LTCF personnel (reporting staff test results) | Form and Instruction |
| 0920-1306 Change Memo - NHSN COVID-19 LTCF_11.10.20.docx | Justification for No Material/Nonsubstantive Change |
| 0920-1290 Change Memo - NHSN COVID-19 LTCF_10 15 20.docx | Justification for No Material/Nonsubstantive Change |
| Revised SSB 15OCT2020.docx | Supporting Statement B |
| Revised SSA 15OCT2020.docx | Supporting Statement A |
| Revised Emergency Request Memo 15OCT2020.docx | Supplementary Document |
 Dialysis Facility Infection Preventionists - NHSN New Facility Enrollment |
Form |
| Dialysis Facility Infection Preventionists - Dialysis COVID-19 Outpatient Form |
Form |
| State and Local Health Department occupations - Staff and Personnel Impact form (57.145) - Retrospective Data Entry |
Form |
| Business and Financial Operations occupations - Staff and Personnel Impact form (57.145) - Retrospective Data Entry |
Form and Instruction |
| LTCF - Staff and Personnel Impact form (57.145) - Retrospective Data Entry |
Form |
| State and Local Health Department occupations -Staff and Personnel Impact form (57.145) |
Form |
| Business and Financial Operations occupations - Staff and Personnel Impact form (57.145) |
Form |
| LTCF - Staff and Personnel Impact form (57.145) |
Form |
| State and Local Health Department occupations - Resident Impact and Facility Capacity form (57.144) - Retrospective Datat Entry |
Form |
| Business and Financial Operations occupations - Resident Impact and Facility Capacity form (57.144) - Retrospective Data Entry |
Form |
| LTCF Resident Impact and Facility Capacity form (57.144) - Retrospective Data Entry |
Form |
| State and Local Health Department occupations - Resident Impact and Facility Capacity form (57.144) |
Form |
| Business and Financial Operations Occupations - Resident Impact and Facility Capacity form (57.144) |
Form |
| LTCF Personnel - Resident Impact and Facility Capacity form (57.144) |
Form |
| NHSN COVID-19 Long Term Care Facility (LTCF) Module - LTCF Personnel |
Form and Instruction |
| NHSN COVID-19 Long Term Care Facility (LTCF) Module - LTCF Personnel |
Form and Instruction |