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Form 57.136 Long-Term Care Facility Component – Respiratory Tract In
[NCEZID] The National Healthcare Safety Network (NHSN)
57.136_RTI_LTCF_BLANK
57.136 Long Term Care Facility Component - Respiratory Tract Infection
OMB: 0920-0666
OMB.report
HHS/CDC
OMB 0920-0666
ICR 202402-0920-011
IC 238093
Form 57.136 Long-Term Care Facility Component – Respiratory Tract In
( )
⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0920-0666 can be found here:
2025-06-30 - Reinstatement with change of a previously approved collection
2025-05-20 - No material or nonsubstantive change to a currently approved collection
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