Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
57.101 Hospital Respiratory Data Form (Weekly - .csv import) Unchanged 179088 86559 0 Form and Instruction 0920-1317
57.101 Hospital Respiratory Data Form (Weekly - API) Unchanged 92872 23218 0 Form and Instruction 0920-1317
57.101 Hospital Respiratory Data Form (Weekly - User Entry) Unchanged 59696 200977 0 Form and Instruction 0920-1317
57.102 - Hospital Respiratory Data Fomr (Daily - API) Unchanged 279225 69806 0 Form and Instruction 57.102
57.102 - Hospital Respiratory Data Form (Daily - user entry) Unchanged 179580 173594 0 Form and Instruction 57.102
57.102 Hospital Respiratory Data Form (Daily - .csv import) Unchanged 538740 260391 0 Form and Instruction 57.102
57.140 NHSN and Secure Access Management Services (SAMS) enrollment Modified 11500 958 0 Form and Instruction 57.140
57.155 Point of Care Testing Results - CSV Modified 470250 86213 0 Form and Instruction 57.155
Form and Instruction 0920-1317
57.155 Point of Care Testing Results - Manual Modified 470250 86213 0 Form and Instruction 57.155
Form and Instruction 57.155
57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) Modified 6188 6497 0 Form and Instruction 57.216
Form and Instruction 57.216
Form and Instruction 57.216
57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (manual) Modified 55692 56620 0 Form and Instruction 57.216
Form and Instruction 57.216
Form and Instruction 57.216
57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) Modified 1548 1625 0 Form and Instruction 57.217
Form and Instruction 57.217
Form and Instruction 57.217
57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (manual) Modified 13908 14140 0 Form and Instruction 57.217
Form and Instruction 57.217
Form and Instruction 57.217
57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (.csv) Modified 84864 56576 0 Form and Instruction 57.218
Form and Instruction 57.218
Form and Instruction 57.218
Form 57.218
57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (manual) Modified 582764 388509 0 Form and Instruction Form 57.218
Form and Instruction 57.218
Form and Instruction 57.218
Form and Instruction 57.218
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities-.CSV Modified 33624 22416 0 Form and Instruction 57.509
Form and Instruction 57.509
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities_Manual Modified 1284 963 0 Form and Instruction 57.509
Form and Instruction 57.509
57.510 COVID–19 Module Dialysis Outpatient Facility-CSV Unchanged 6000 1000 0 Form and Instruction 57.510
57.510 COVID–19 Module Dialysis Outpatient Facility_Manual Unchanged 6000 2000 0 Form and Instruction 57.510
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (.csv) Unchanged 90012 60008 0 Form and Instruction 57.219
Form and Instruction 57.219
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (manual) Unchanged 159936 119952 0 Form and Instruction 57.219
Form and Instruction 57.219
Total burden requested under this ICR: 3323021 1718235 0  
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