View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-1317
ICR Reference No:
202105-0920-014
Status:
Historical Active
Previous ICR Reference No:
202102-0920-015
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1317-
Title:
National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/04/2021
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/28/2021
Terms of Clearance:
Previous terms continue: CDC will work with its OIRA desk officer should changes due to the changing nature of the public health emergency be necessary. CDC will detail in all publications and use of the data any limitations based upon changes in respondent characteristics.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2024
01/31/2024
01/31/2024
Responses
5,052,366
0
4,530,322
Time Burden (Hours)
1,732,245
0
1,519,695
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 healthcare facilities within their jurisdiction. This Non-Substantive Change Request is submitted to add a section called Vaccine Status to the Dialysis COVID-19 Outpatient Facility form, and two new forms to the Long-Term Care Facility COVID-19 Module: (1) Veterans Affairs Staff and Personnel COVID-19 Event form and (2) Veterans Affairs Resident COVID-19 Event form.
Authorizing Statute(s):
US Code:
42 USC 242b, k, m
Name of Law: The 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
60-day Notice:
Federal Register Citation:
Citation Date:
85 FR 21443
04/17/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 59313
09/21/2020
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
25
IC Title
Form No.
Form Name
Dialysis Component
0920-20LW, 0920-1317, 0920-1317
Dialysis Component
,
COVID-19 Module Dialysis Outpatient Facility
,
COVID-19 Module Dialysis Outpatient Facility Form 27MAY2021
NHSN and Secure Access Management Services (SAMS) enrollment
0920-20LW
NHSN Registration Form
Resident Impact and Facility Capacity - Business and Financial Operations Occupations
0920-1317 CDC 57.144, CDC 57.144
Resident Impact and Facility Capacity
,
Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - Business and Financial Operations Occupations retrospective
CDC 57.144
Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - LTCF Personnel
0920-1317 CDC 57.144, CDC 57.144
Resident Impact and Facility Capacity
,
Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - LTCF Personnel retrospective
CDC 57.144
Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations
0920-1317 CDC 57.144, CDC 57.144
Resident Impact and Facility Capacity
,
Resident Impact and Facility Capacity
Resident Impact and Facility Capacity - State and Local Health Dept Occupations retrospective
CDC 57.144
Resident Impact and Facility Capacity
Resident Therapeutics - Business and Financial Operations Occupations
0920-1317 CDC 57.XXX
Long Term Care Facility: Resident Therapeutics
Resident Therapeutics - LTCF Personnel
0920-1317 CDC 57.XXX
Long-Term Care Facility: Resident Therapeutics
Resident Therapeutics - State and Local Health Dept. Occupations
0920-1317 CDC 57.XXX
Long Term Care Facility: Resident Therapeutics
Staff and Personnel Impact - Business and Financial Operations Occupations
CDC 57.145
Staff and Personnel Impact
Staff and Personnel Impact - Business and Financial Operations Occupations retrospective
CDC 57.145
Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel
CDC 57.145
Staff and Personnel Impact
Staff and Personnel Impact - LTCF Personnel retrospective
CDC 57.145
Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations
CDC 57.145
Staff and Personnel Impact
Staff and Personnel Impact - State and Local Health Dept Occupations retrospective
CDC 57.145
Staff and Personnel Impact
Supplies & Personal Protective Equipment - Business and Financial Operations Occupations
CDC 57.146, CDC 57.146
Supplies & Personal Protective Equipment
,
COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - LTCF Personnel
CDC 57.146, CDC 57.146
Supplies & Personal Protective Equipment
,
COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
Supplies & Personal Protective Equipment - State and Local Health Dept Occupations
CDC 57.146, CDC 57.146
Supplies & Personal Protective Equipment
,
COVID-19 Module - LTCF: Supplies and Personal Protective Equipment
VA - Resident COVID-19 Event Form - LTCF
0920-1317
VA COVID-19 Resident Event Form
VA - Staff and Personnel COVID-19 Event Form - LTCF
0920-1317
VA - Staff and Personnel COVID-19 Event Form
Ventilator Capacity & Supplies - Business and Financial Operations Occupations
CDC 57.147
Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - LCTF Personnel
CDC 57.147
Ventilator Capacity & Supplies
Ventilator Capacity & Supplies - State and Local Health Dept Occupations
CDC 57.147
Ventilator Capacity & Supplies
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
5,052,366
4,530,322
0
522,044
0
0
Annual Time Burden (Hours)
1,732,245
1,519,695
0
212,550
0
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
Burden increase due to modifications made to to add a section called Vaccine Status to the Dialysis COVID-19 Outpatient Facility form, and two new forms to the Long-Term Care Facility COVID-19 Module: (1) Veterans Affairs Staff and Personnel COVID-19 Event form and (2) Veterans Affairs Resident COVID-19 Event form.
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:
Jeffrey Zirger 404 639-7118 wtj5@cdc.gov
Common Form ICR:
No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date:
05/28/2021
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