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OMB Control No: 0920-1290	ICR Reference No: 202003-0920-015
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20LW
Title: National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR: No
Type of Review Request: Emergency	Approval Requested By: 03/24/2020
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/26/2020
	Date Received in OIRA: 03/24/2020
Terms of Clearance: Approved consistent with CDC’s commitment to clearly caveat the interpretation of the national representativeness of the data and the ability of this collection to document longitudinal trends due to changes in the number and characteristics of participating hospitals throughout the epidemic as well as differences in how each hospital implements this data collection, including variation in which staff collect the data on any given day.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	6 Months From Approved
Responses	702,000	0	0
Time Burden (Hours)	234,000	0	0
Cost Burden (Dollars)	0	0	0

Abstract: The goal of this information collection is to 1) capture the daily, aggregate impact of COVID-19 on healthcare facilities, and 2) monitor medical capacity to respond at local, state, and national levels. This information will be used to inform the overall real-time COVID-19 response efforts and possible resource allocation, and enable state and local health departments to gain immediate access to the COVID-19 data for hospitals within their jurisdiction.

Emergency Justfication: I have determined that the information must be collected prior to the expiration of time period established under Part 1320, and that this information is essential to CDC’s ability, as well as that of state and local health departments, to effectively address the national public health crisis caused by the Novel Coronavirus (COVID-19). As rates of infection and resulting deaths continue to rise across the nation, healthcare facilities and public health departments are facing significant strain on patient care and infection prevention efforts. NHSN plans to introduce a new surveillance module that will enable hospitals to report daily COVID-19 patient counts to NHSN, and NHSN in turn will enable state and local health departments to gain immediate access to the COVID-19 data for hospitals in their jurisdiction. COVID-19 data submitted to NHSN also will be used immediately by CDC’s emergency COVID-19 response. NHSN’s role as a shared platform for healthcare-associated infection surveillance provides a valuable foundation for COVID-19 surveillance. The COVID-19 modules can additionally be adapted for future outbreaks of COVID or other infectious diseases. A large majority of the nation’s hospitals already participate in NHSN, and infection preventionists (IPs) in those hospitals use NHSN for surveillance and reporting of healthcare-associated infection and antimicrobial resistance. CDC cannot reasonably comply with the normal clearance procedures due to the public harm that could escalate if routine processing of this request is required. CDC requests authorization to use information collection instruments in the existing NHSN web-based application for 180 days to enable immediate CDC and public health departments with immediate access to COVID-19 patient impact data.

Authorizing Statute(s): US Code: 42 USC 242b, 242k, 242m Name of Law: Public Health Service Act

Citations for New Statutory Requirements: None

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

Federal Register Notices & Comments
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
COVID-19 Patient Impact Module Form	0920-20LW

ICR Summary of Burden

	Total Approved	Change Due to Agency Discretion
Annual Number of Responses	702,000	702,000
Annual Time Burden (Hours)	234,000	234,000
Annual Cost Burden (Dollars)	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a New Emergency Collection.

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination. Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination. No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Yes

Agency Contact: Kevin Joyce 404 639-1944 kdj7@cdc.gov

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