Change Memo for
National Healthcare Safety Network (NHSN)
Coronavirus (COVID-19)
Surveillance in Healthcare Facilities
(OMB Control No. 0920-1317)
Expiration Date: 01/31/2024
Program Contact
Lauren Wattenmaker
Surveillance Branch
Division of Healthcare Quality Promotion
National Center for Emerging and Zoonotic Infectious Diseases
Centers for Disease Control and Prevention
Atlanta, Georgia 30333
Phone: 404-718-5842
Email: nlh3@cdc.gov
Submission Date: May 26, 2021
The Centers for Disease Control and Prevention (CDC), Division of Healthcare Quality Promotion (DHQP) requests a non-substantive of an approved Information Collection Request:
National Healthcare Safety Network (NHSN) Coronavirus (COVID-19) Surveillance in Healthcare Facilities (OMB Control No. 0920-1317)
Dialysis
CDC is adding a section called Vaccine Status to the Dialysis COVID-19 Outpatient Facility form. This section will add approximately 5 minutes to the completion of the form. This section is necessary for CDC to determine and understand the vaccine efficacy for the dialysis patient community. As a means for minimizing reporting burden on individual dialysis facilities, NHSN has enabled large dialysis organizations (LDOs) to report on behalf of facilities in their organizations via CSV upload. A majority of dialysis reporting is accomplished in this manner.
Veteran State Homes
CDC is adding 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. These forms are designed specifically for state veterans homes which include skilled nursing facilities (LTC-SNF-SVH) and assisted living facilities (LTC-ALF-SVH) that are required to report person-level COVID-19 data to the Veterans Health Administration (VHA) via NHSN. The requirement is part of H.R.7105, the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020. NHSN will supply data from the Veteran Home COVID-19 Module to the VHA.
Both event forms collect information about each resident or staff person with a positive COVID-19 test. This includes name, age, sex, race, ethnicity, and veteran status. Additional information collected includes re-infections, vaccination status, therapeutics received, hospitalization and death. An event form must be entered each time a resident or staff person newly tests positive for COVID-19, including re-infections and re-admissions.
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities. Burden estimate of 1 hour for each week the form is completed.
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities. Burden estimate of 1 hour for each week the form is completed.
Burden Updates
The Centers for Medicare and Medicaid Services (CMS) Interim Final Rule 42 CFR 483.80(g)(1)(viii)-(ix) released May 11, 2021 now requires all CMS-certified skilled nursing facilities to report COVID-19 vaccination data for residents and staff as well as therapeutics data for residents. Reporting these data elements to NHSN was previously optional, thus the burden estimates have been increased to account for the required reporting by all CMS-certified skilled nursing facilities.
Burden Estimates
Type of Respondent |
Form Name |
No. of Respondents |
No. Responses per Respondent |
Avg. Burden per response (in hrs.) |
Total Burden (in hrs.) |
Microbiologist |
Dialysis COVID-19 Outpatient Facility |
7,900 |
104 |
25/60 |
342,333 |
Microbiologist |
Resident COVID-19 Event Form |
188 |
36 |
40/60 |
4,512 |
Microbiologist |
Staff and Personnel COVID-19 Event Form |
188 |
36 |
25/60 |
2,820 |
Microbiologist |
Weekly Healthcare Personnel COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities |
15,400 |
52 |
1 |
800,800 |
Microbiologist |
Weekly Resident COVID-19 Vaccination Cumulative Summary for Long-Term Care Facilities |
15,400 |
52 |
1 |
800,800 |
Microbiologist |
COVID-19 Long Term Care Facility: Resident Therapeutics |
15,400 |
52 |
10/60 |
133,467 |
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Wattenmaker, Lauren (CDC/DDID/NCEZID/DHQP) |
File Modified | 0000-00-00 |
File Created | 2022-07-19 |