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:
202404-0920-010
Status:
Historical Active
Previous ICR Reference No:
202403-0920-007
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1317-24FJ
Title:
[NCEZID] 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 without change
Conclusion Date:
05/15/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/26/2024
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2026
03/31/2026
03/31/2026
Responses
8,864,813
0
6,989,713
Time Burden (Hours)
6,460,072
0
5,693,130
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 Change Request is submitted to make changes to two data collection instruments. • 57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities • 57.219 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary There is a net increase in burden hours associated with this Change Request.
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:
87 FR 55815
09/12/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 73309
11/29/2022
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
21
IC Title
Form No.
Form Name
COVID-19 Hospital Data Form (Psychiatric and Rehabilitation Facilities)
0920-1317
COVID-19 Hospital Data Form
Dialysis Component
n/a
COVID–19 Module - Dialysis Outpatient Facility
Healthcare Personnel Safety Monthly Reporting Plan - completed by Dialysis Facilities
CDC Form 57.203
Healthcare Personnel Safety Monthly Reporting Plan
Healthcare Personnel Safety Monthly Reporting Plan - completed by Inpatient Psychiatric Facilities
CDC Form 57.203
Healthcare Personnel Safety Monthly Reporting Plan
Long Term Care Facility Resident Impact and Facility Capacity Pathway
57.144, CDC 57.144
Resident Impact and Facility Capacity
,
COVID-19 and Respiratory Infections Module Long Term Care Facility Resident Impact and Facility Capacity Pathway Form (57.144) 07SEP2023
Monthly Reporting Plan form for Long-term Care Facilities
CDC Form 57.141
Monthly Reporting Plan for LTCF
NHSN COVID-19 Hospital Module (Infusion Centers and Outpatient Clinics reporting Inventory & use of therapeutics (MABs)
n/a
NHSN COVID-19 Hospital Module Infusion Centers and Outpatient Clinics
NHSN COVID-19 Hospital Module - Hospitals (excluding Psychiatric and Rehabilitation Facilities)
n/a, 0920-1317
NHSN COVID-19 Hospital Module
,
COVID-19 Hospital Data Form
NHSN and Secure Access Management Services (SAMS) enrollment
0920-1317
NHSN Registration Form
Point of Care Testing Results
57.155
Point of Care Testing Results
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
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
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary
0920-1317, CDC Form 57.219
Healthcare Personnel COVID-19 Vaccination Cumulative Summary_26APR2024
,
Healthcare Personnel COVID-19 Vaccination Cumulative Summary_CDC 57.219 26APR2024
Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities
0920-1317 / CDC Form 57.509
Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities
0920-1317, 57.218, 0920-1317 / CDC Form 57.218
Weekly COVID-19 Vaccination Cumulative Summary for Residents of Long-Term Care Facilities
,
Weekly Vaccination Cumulative Summary for Residents of Long-Term Care Facilities (57.218)
,
Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF-CDC 57.218_26APR2024
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
8,864,813
6,989,713
0
1,875,100
0
0
Annual Time Burden (Hours)
6,460,072
5,693,130
0
766,942
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:
Yes
Burden Reduction Due to:
Changing Forms
Short Statement:
Non-Substantive Change Request is submitted to modify • 57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities • 57.219 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary There is a net increase in burden hours associated with this Change Request.
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:
04/26/2024
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