Information Collection Request

[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities

ICR 202501-0920-003 · OMB 0920-1317 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 57.510 57.510 COVID–19 Module Dialysis Outpatient Facility-CSV Form and Instruction Unchanged Available
Form 57.509 57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities-.CSV Form and Instruction Unchanged Available
Form 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_CSV Form and Instruction Unchanged Available
Form 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_Manual Form and Instruction Unchanged Available
Form 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component_CSV Form and Instruction Unchanged Available
Form 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component _Manual Form and Instruction Unchanged Available
Form 57.220 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_CSV Form and Instruction Unchanged Available
Form 57.220 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_Manual Form and Instruction Unchanged Available
Form 57.155 57.155 Point of Care Testing Results - CSV Form and Instruction Unchanged Available
Form 57.219 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (.csv) Form and Instruction Unchanged Available
Form 57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (.csv) Form and Instruction Modified Available
Form 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) Form and Instruction Unchanged Repair queued
Form 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (manual) Form and Instruction Unchanged Available
Form 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) Form and Instruction Unchanged Repair queued
Form 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (manual) Form and Instruction Unchanged Available
Form 57.102 57.102 - Hospital Respiratory Data Fomr (Daily - API) Form and Instruction Unchanged Available
Form 57.102 57.102 Hospital Respiratory Data Form (Daily - .csv import) Form and Instruction Unchanged Available
Form 57.102 57.102 - Hospital Respiratory Data Form (Daily - user entry) Form and Instruction Unchanged Repair queued
Form 0920-1317 57.101 Hospital Respiratory Data Form (Weekly - API) Form and Instruction Unchanged Repair queued
Form 0920-1317 57.101 Hospital Respiratory Data Form (Weekly - .csv import) Form and Instruction Unchanged Available
Form 0920-1317 57.101 Hospital Respiratory Data Form (Weekly - User Entry) Form and Instruction Unchanged Available
Form 57.155 57.155 Point of Care Testing Results - Manual Form and Instruction Unchanged Repair queued
Form 57.509 57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities_Manual Form and Instruction Unchanged Available
Form Form 57.218 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (manual) Form and Instruction Modified Available
Form 57.219 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (manual) Form and Instruction Unchanged Repair queued
Form 57.510 57.510 COVID–19 Module Dialysis Outpatient Facility_Manual Form and Instruction Unchanged Available
Form 0920-1317 57.140 NHSN and Secure Access Management Services (SAMS) enrollment Form and Instruction Unchanged Available
Change Memo 0920-1317 December 2024.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-01-09 Available
D. Explanation for Program Changes or Adjustments.docx Supplementary Document Uploaded 2024-10-29 Available
G2. Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-10-29 Available
G1. Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-10-29 Available
G. Privacy Impact Assessment.pdf Supplementary Document Uploaded 2024-10-29 Available
E3. Human Subjects Determination.pdf Supplementary Document Uploaded 2024-10-29 Available
B. FRN-60 day.pdf Supplementary Document Uploaded 2024-10-29 Available
SSB 0920-1317 NHSN COVID-19_FINAL.docx Supporting Statement B Uploaded 2024-10-29 Available
SSA 0920-1317 NHSN COVID 08JAN2025.docx Supporting Statement A Uploaded 2025-01-08 Available
Change Memo 0920-1317 August 2024_FINAL_v2.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-08-22 Available
Change Memo 0920-1317.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-08-06 Available
Change Request Memo NHSN COVID-19 0920-1317_26APR2024 v2.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-04-26 Available
Change Memo for CDC NHSN COVID-19 OMB Package 0920-1317.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-03-14 Repair queued
Resident Impact and Facility Capacity- csv temp..csv Supplementary Document Uploaded 2023-09-07 Available
TOI-Facility Importing COVID-19 and Respiratory Infections using a .csv file_RIFC.docx Supplementary Document Uploaded 2023-09-07 Repair queued
Change Memo for NHSN September 2023_0920_1317.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-09-07 Available
Crosswalk_57.218.docx Supplementary Document Uploaded 2023-09-07 Available
Crosswalk_57.144.docx Supplementary Document Uploaded 2023-09-07 Repair queued
Crosswalk-COVID-19 Hospital Data.docx Supplementary Document Uploaded 2023-09-07 Available
Crosswalk 11.4 updated COVID JUNE_final.docx Supplementary Document Uploaded 2023-05-18 Available
Change Memo for NHSN May 2023_0920_1317_final.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-05-18 Available
CDC Response to APIC Dec29 letter sk lw.docx Supplementary Document Uploaded 2023-03-06 Repair queued
5. NHSN - Report of End of Human Research Review 0.1253.docx Supplementary Document Uploaded 2022-11-28 Available
6. IRB Protocol Closure.pdf Supplementary Document Uploaded 2022-11-28 Available
3. Privacy Act Checklist 2022.docx Supplementary Document Uploaded 2022-11-28 Repair queued
1c. 42 USC 242m.PDF Supplementary Document Uploaded 2022-11-28 Available
1b. 42 USC 242k.PDF Supplementary Document Uploaded 2022-11-28 Available
1a. 42 USC 242b.PDF Supplementary Document Uploaded 2022-11-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
271955 57.510 COVID–19 Module Dialysis Outpatient Facility-CSV Form and Instruction Unchanged
271950 57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities-.CSV Form and Instruction Unchanged
271948 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_CSV Form and Instruction Unchanged
271947 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_Manual Form and Instruction Unchanged
271946 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component_CSV Form and Instruction Unchanged
271945 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component _Manual Form and Instruction Unchanged
271943 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_CSV Form and Instruction Unchanged
271941 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_Manual Form and Instruction Unchanged
271935 57.155 Point of Care Testing Results - CSV Form and Instruction Unchanged
270333 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (.csv) Form and Instruction Unchanged
270316 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (.csv) Form and Instruction Modified
270313 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) Form and Instruction Unchanged
270312 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (manual) Form and Instruction Unchanged
270310 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) Form and Instruction Unchanged
270309 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (manual) Form and Instruction Unchanged
269868 57.102 - Hospital Respiratory Data Fomr (Daily - API) Form and Instruction Unchanged
269867 57.102 Hospital Respiratory Data Form (Daily - .csv import) Form and Instruction Unchanged
269866 57.102 - Hospital Respiratory Data Form (Daily - user entry) Form and Instruction Unchanged
269865 57.101 Hospital Respiratory Data Form (Weekly - API) Form and Instruction Unchanged
269864 57.101 Hospital Respiratory Data Form (Weekly - .csv import) Form and Instruction Unchanged
269863 57.101 Hospital Respiratory Data Form (Weekly - User Entry) Form and Instruction Unchanged
266012 57.155 Point of Care Testing Results - Manual Form and Instruction Unchanged
249436 57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities_Manual Form and Instruction Unchanged
249435 Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (manual) Form and Instruction Modified
249434 Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (manual) Form and Instruction Unchanged
243719 57.510 COVID–19 Module Dialysis Outpatient Facility_Manual Form and Instruction Unchanged
243698 57.140 NHSN and Secure Access Management Services (SAMS) enrollment Form and Instruction Unchanged
ICR Details
0920-1317 202501-0920-003
Active 202410-0920-012
HHS/CDC 0920-1317
[NCEZID] National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/10/2025
Retrieve Notice of Action (NOA) 01/10/2025
Previous Terms of Clearance/Comments continue: Approved consistent with the understanding that in the next revision/extension of the package, the agency will update this information collect to use detailed race/ethnicity question (SPD 15, Figure 1, March 28, 2024) or the agency will justify in Supporting Statement A why it cannot use the detailed question.
  Inventory as of this Action Requested Previously Approved
01/31/2028 01/31/2028 01/31/2028
3,557,181 0 3,653,433
1,731,823 0 1,752,540
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 healthcare facilities within their jurisdiction. This Change Request is submitted for 0920-01317 to modify two currently approved data collection instruments. Burden for manual submission increased from 227,500 to 284,332 and for .csv submission decreased from 104,000 to 26,451. There is an overall net decrease in burden.

US Code: 42 USC 242b, k, m Name of Law: U.S. Public Health Service Act (PHSA)
  
None

Not associated with rulemaking

  89 FR 47962 06/04/2024
89 FR 84146 10/21/2024
Yes

27
IC Title Form No. Form Name
57.101 Hospital Respiratory Data Form (Weekly - .csv import) 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.101 Hospital Respiratory Data Form (Weekly - API) 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.101 Hospital Respiratory Data Form (Weekly - User Entry) 0920-1317 Hospital Respiratory Data Weekly Reporting Form
57.102 - Hospital Respiratory Data Fomr (Daily - API) 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.102 - Hospital Respiratory Data Form (Daily - user entry) 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.102 Hospital Respiratory Data Form (Daily - .csv import) 57.102 Hospital Respiratory Data Daily Reporting Form 14AUG2024
57.140 NHSN and Secure Access Management Services (SAMS) enrollment 0920-1317 NHSN Registration Form
57.155 Point of Care Testing Results - CSV 57.155 Point of Care Testing Results
57.155 Point of Care Testing Results - Manual 57.155 Point of Care Testing Results
57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_CSV 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_CSV
57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_Manual 57.220 Weekly Person Level Respiratory Pathogen and Vaccination for Residents-LTCF Component_Manual
57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_CSV 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_CSV
57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_Manual 57.221 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-Healthcare Personnel Safety Component_Manual
57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component _Manual 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component_Manual
57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component_CSV 57.221 Healthcare Personnel COVID-19 Person Level Vaccination-LTC Component_CSV
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities-.CSV 57.509 57.509 Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients_CSV
57.509 Weekly Patient COVID-19 Vaccination Cumulative Summary for Dialysis Facilities_Manual 57.509 Weekly COVID-19 Vaccination Cumulative Summary for Dialysis Patients_Manual
57.510 COVID–19 Module Dialysis Outpatient Facility-CSV 57.510 57.510 COVID–19 Module Dialysis Outpatient Facility-.csv
57.510 COVID–19 Module Dialysis Outpatient Facility_Manual 57.510 COVID–19 Module - Dialysis Outpatient Facility
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (.csv) 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel (manual) 57.217 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Healthcare Personnel
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (.csv) 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents
Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents (manual) 57.216 Optional Person Level Reporting of Weekly COVID-19 Vaccination for Long-Term Care Residents
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (.csv) 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary (manual) 57.219 Healthcare Personnel COVID-19 Vaccination Cumulative Summary
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (.csv) 57.218, 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of Long-Term Care Facilities ,   Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF (.csv)
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities (manual) 57.218, Form 57.218 Weekly Respiratory Pathogen and Vaccination Summary for Residents of Long-Term Care Facilities (manual) ,   Weekly Respiratory Pathogen and Vaccination Summary for Residents of LTCF (manual)

  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 3,557,181 3,653,433 0 -96,252 0 0
Annual Time Burden (Hours) 1,731,823 1,752,540 0 -20,717 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
Change Request is submitted for 0920-01317 to modify two currently approved data collection instruments. Burden for manual submission increased from 227,500 to 284,332 and for .csv submission decreased from 104,000 to 26,451. There is an overall net decrease in burden.

$49,992,135
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Yes
Jeffrey Zirger 404 639-7118 [email protected]

  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.
01/10/2025