Previous terms continue: CDC will commit to evaluating responses and updating associated burdens when this emergency is transitioned into the larger NHSN COVID package.
Inventory as of this Action
Requested
Previously Approved
11/30/2020
11/30/2020
11/30/2020
3,229,106
0
1,098,200
1,139,032
0
137,275
0
0
0
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 jurisdictions. This Non-Substantive Change Request is submitted for LTCF forms that have been modified to account for current practices in testing and identifying cases among staff and residents.
CDC seeks a one-month extension of the expired 0920-1290 - National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities package, so that it can incorporate a new data collection form to the NHSN COVID-19 Long Term Care Facility (LTCF) Module: Point of Care Testing Results form (CDC 57.1) The data collected via this form will inform state and local health departments as well as federal public health entities about testing results for patients and staff in nursing homes. This data will be used to identify COVID-19 outbreaks in nursing homes, add to the situational awareness of COVID-19 in jurisdictions, as well as to enable public health agencies to assist in infection prevention and control activities. NHSN has requested OMB approval of this form by 10/15/2020. In order for this nonmaterial/non-substantive change request to be approved, an emergency request to extend the National Healthcare Safety Network (NHSN) Patient Impact Module for Coronavirus (COVID-19) Surveillance in Healthcare Facilities package (0920-1290), is hereby submitted. The changes made as the result of this nonmaterial/non-substantive change request will be incorporated into the standard package upon approval by OMB.
Change Request results in an Increase in burden due to modifications to LTCF forms
No
Yes
No
No
No
No
Yes
Jeffrey Zirger 404 639-7118 wtj5@cdc.gov
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:
(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;
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.
Form 57.145 Business and Financial Operations occupations - Staff and Personnel Impact form (57.145)
0920-1306 Change Memo - NHSN COVID-19 LTCF_11.10.20.docx
Dialysis Facility Infection Preventionists - NHSN New Facility Enrollment