Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Dialysis Component Modified 509600 169867 0 Form and Instruction 0920-20LW Dialysis Component
Form and Instruction 0920-1317 COVID-19 Module Dialysis Outpatient Facility
NHSN and Secure Access Management Services (SAMS) enrollment Unchanged 11500 11500 0 Form and Instruction 0920-20LW NHSN Registration Form
Resident Impact and Facility Capacity - Business and Financial Operations Occupations Unchanged 97240 72930 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Form and Instruction 0920-1317 CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - Business and Financial Operations Occupations retrospective Unchanged 935 623 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - LTCF Personnel Unchanged 604292 453219 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Form and Instruction 0920-1317 CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - LTCF Personnel retrospective Unchanged 5811 3874 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations Unchanged 97240 72930 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Form and Instruction 0920-1317 CDC 57.144 Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations retrospective Unchanged 935 623 0 Form and Instruction CDC 57.144 Resident Impact and Facility Capacity
Resident Therapeutics - Business and Financial Operations Occupations Unchanged 97240 16207 0 Form and Instruction 0920-1317 CDC 57.XXX Long Term Care Facility: Resident Therapeutics
Resident Therapeutics - LTCF Personnel Unchanged 604292 100715 0 Form and Instruction 0920-1317 CDC 57.XXX Long-Term Care Facility: Resident Therapeutics
Resident Therapeutics - State and Local Health Dept. Occupations Unchanged 97240 16207 0 Form and Instruction 0920-1317 CDC 57.XXX Long Term Care Facility: Resident Therapeutics
Staff and Personnel Impact - Business and Financial Operations Occupations Unchanged 97240 24310 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - Business and Financial Operations Occupations retrospective Unchanged 935 234 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel Unchanged 604292 151073 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel retrospective Unchanged 5811 1453 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations Unchanged 97240 24310 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations retrospective Unchanged 935 234 0 Form and Instruction CDC 57.145 Staff and Personnel Impact
Supplies & Personal Protective Equipment - Business and Financial Operations Occupations Modified 97240 40517 0 Form and Instruction CDC 57.146 Supplies & Personal Protective Equipment
Form and Instruction CDC 57.146 COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - LTCF Personnel Modified 604292 251788 0 Form and Instruction CDC 57.146 Supplies & Personal Protective Equipment
Form and Instruction CDC 57.146 COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - State and Local Health Dept Occupations Modified 97240 40517 0 Form and Instruction CDC 57.146 Supplies & Personal Protective Equipment
Form and Instruction CDC 57.146 COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Ventilator Capacity & Supplies - Business and Financial Operations Occupations Unchanged 97240 8103 0 Form and Instruction CDC 57.147 Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - LCTF Personnel Unchanged 604292 50358 0 Form and Instruction CDC 57.147 Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - State and Local Health Dept Occupations Unchanged 97240 8103 0 Form and Instruction CDC 57.147 Ventilator Capacity & Supplies
Total burden requested under this ICR: 4530322 1519695 0  
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