№ files_lp_3_process_7_011265
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Administrative public health surveillance reporting form documenting monthly HAI events, prevention process measures, and COVID-19 vaccination data for long-term care facilities under CDC oversight.
Year:
Not specified
Month/Year:
To be completed by facility
Facility ID:
To be completed by facility
Document Type:
Monthly reporting form
Subject:
Healthcare Associated Infection (HAI) surveillance and prevention measures
Infection Types:
UTI; Laboratory-identified Event (LabID Event)
Organism Data:
Specific Organism Type; All Specimens
Prevention Measures:
Hand Hygiene; Gown and Gloves Use
COVID-19 Module:
Healthcare Personnel COVID-19 Vaccination Summary; Resident COVID-19 Vaccination Summary
Scope:
Facility-wide Inpatient (FacWideIN)
Confidentiality Basis:
Public Health Service Act Sections 304, 306 and 308(d) (42 USC 242b, 242k, 242m(d))
Responsible Authority:
Centers for Disease Control and Prevention (CDC)
OMB Control Number:
0920-0666
Form Number:
CDC 57.141 (Front), v7.0
Estimated Reporting Burden:
5 minutes per response
Submission Contact:
CDC Project Clearance Officer, 1600 Clifton Rd., MS D-74, Atlanta, GA 30333
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
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The product description is provided for reference. Actual content and formatting may differ slightly.
Note:
Facility ID
Year:
Not specified
Country:
United States
Document Type:
Surveillance reporting form
Subject:
Laboratory-identified MDRO or Clostridioides difficile infection events
Applicable Setting:
Long-term care facility (LTCF)
Issuing Authority:
Centers for Disease Control and Prevention (CDC)
Legal Framework:
Public Health Service Act Sections 304, 306 and 308(d) (42 USC 242b, 242k, 242m(d))
OMB Control Number:
0920-0666
Form Number:
CDC 57.138
Revision:
rev 4, v9.4
Estimated Reporting Burden:
15 minutes per response
Data Collected:
Resident identifiers, admission dates, organism type, specimen details, care location, transfer status, antibiotic therapy, demographic information
Confidentiality Statement:
Information collected under guarantee of strict confidence for public health surveillance purposes
Note:
Facility ID
Event Type:
UTI
Year:
2021
Region / City:
United States
Topic:
Healthcare, COVID-19, Long-term Care Facilities
Document Type:
Instructional Guide
Organization:
Centers for Disease Control and Prevention (CDC)
Author:
Centers for Disease Control and Prevention (CDC)
Target Audience:
Healthcare Providers, Long-term Care Facilities
Effective Period:
January 2021
Approval Date:
January 2021
Modification Date:
None
Year:
2026
Region / City:
United States
Theme:
Healthcare / Infection Control
Document Type:
Medical Record
Organization / Institution:
CDC
Author:
CDC
Target Audience:
Healthcare Providers
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Last Modification:
Not specified
Year:
2025
Region / City:
New York City
Subject:
Public hearings and meetings schedule
Document type:
Index
Organization / Institution:
Various New York City government agencies
Target audience:
General public
Effective period:
November 2025
Approval date:
November 2025
Amendment date:
Not specified
Context:
An index of upcoming public hearings, meetings, notices, and hearings related to different agencies and services within New York City for November 2025.
Year:
2025
Region / City:
Martinsville, Virginia
Topic:
Financial Report
Document Type:
Report
Agency / Institution:
City of Martinsville
Author:
Robert A. Floyd, Director of Budget & Procurement
Target Audience:
City Manager, Budgeting and Procurement Officials
Period of Validity:
July 1, 2024 – January 28, 2025
Approval Date:
January 28, 2025
Date of Changes:
N/A
Contextual Description:
Financial report summarizing the unaudited revenues and expenditures for the City of Martinsville, Virginia, covering the first half of the fiscal year.
Year:
2025
Region / City:
Waukesha County
Theme:
Social Services, Community Outreach
Document Type:
Newsletter
Organization:
St. Vincent de Paul Waukesha County
Author:
Bob Glowacki, Ivan Mejias, Megan Clementi, Rob Shelledy, Robin Hernandez, Bonnie Pranger
Target Audience:
Volunteers, Community Members
Period of Validity:
March 2025
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Topic:
Industrial Stormwater Management
Document Type:
Self-Audit
Authority/Organization:
Minnesota Pollution Control Agency (MPCA)
Year:
2023
Region / City:
N/A
Subject:
Key Performance Indicators, Payment Mechanism, Supplier Payments
Document Type:
Guidance
Organization / Institution:
Crown Commercial Service
Author:
N/A
Target Audience:
Suppliers, Contract Managers
Period of Validity:
September 2023
Approval Date:
N/A
Date of Changes:
N/A
Year:
2023
Note:
Region / City
Theme:
Residential and Mental Health Services for Youth
Document Type:
Meeting Notes
Organization:
Cornerstone Support Services
Target Audience:
Mental health and residential care providers, youth services, DCS, and related professionals
Description:
Meeting notes outlining updates on residential care programs, assessments, licensing, and compliance requirements for service providers in mental health and youth care.
Year:
2021
Region / City:
N/A
Subject:
Hockey Operations
Document Type:
Report
Organization / Institution:
SYHA
Author:
JD Anderson
Target Audience:
SYHA Board, Coaches, Parents
Action Period:
September 2021
Approval Date:
N/A
Modification Date:
N/A
Date:
May 14, 2020
Organization:
Brainerd Basketball Association (BBA)
Meeting Type:
Monthly Board Meeting
Location:
Zoom Meeting
Board Members Present:
Steve Gilbert, Jennifer Rushin, Ellen Thomes, Derek Hendrickson, Troy Nelson, Micah Benson, Charlie Schoeck, Darren Mayers, Tim Baumann, Jason Hennessey, Wade Haapajoki
Board Members Absent:
Jim Russell, Jennifer Miller
Agenda Items:
Old Business, New Business, June Planning Meeting Topics
Next Meeting:
June 10, 2020 @ Cragun’s Legacy Grille, 5-9 PM
Topics Discussed:
Gym use, tournament planning, season schedule, volunteer coordination, referee fees, registrations, board policies, playing time, scoreboard advertisements, coach screening
Company:
Westbrook-Parker
Address:
6313 Lake Ivanhoe Way
Document type:
Monthly report
Reporting period:
January 2016
Fiscal context:
Fourth quarter review and first quarter results
Industry:
Database software and web applications
Key topics:
Financial performance, sales growth, staffing changes, client acquisition, product revenue
Revenue categories:
Client services, database web applications
Geographic scope:
Not specified
Notable events:
Executive promotion, conference invitations, industry award
Awards:
PCNews.com Editor’s Choice Award (January 2016)
Clients added:
13 new clients
Client segments:
Schools, nonprofits, small to medium-sized businesses
Effective date of organizational changes:
January 2016
Year:
2016
Region / City:
Not specified
Theme:
Business Growth, Database Software, Client Acquisition
Document Type:
Monthly Report
Organization / Institution:
Westbrook-Parker
Author:
Not specified
Target Audience:
Business stakeholders, company employees
Period of Action:
January 2016
Approval Date:
January 2016
Date of Changes:
Not specified
Year:
1995
Region / City:
Not specified
Subject:
Pension Scheme
Document Type:
Application Form
Author:
Not specified
Target Audience:
Pension scheme applicants
Validity Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Note:
Date
Contextual Description:
Report on the ongoing status of outpatient treatment, documenting client compliance and service details.
Year:
2024
Note:
Region / City
Topic:
Employee Assistance Program, Benefits
Document Type:
Form
Period of validity:
2024-2028
Year:
2020
Region / City:
Wisconsin
Topic:
Tank Inspection
Document Type:
Checklist
Agency:
Wisconsin Department of Agriculture, Trade and Consumer Protection
Author:
Unknown
Target Audience:
Tank owners, inspectors
Period of Validity:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Contextual description of the document:
A form for reporting and managing data related to Candida testing and alerts within the AR Lab Network.