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5-Step Enrollment for Ambulatory Surgery Center Facilities

Note: The following instructions are for ambulatory surgical centers (ASCs) that must enroll in NHSN for the purpose of fulfilling CMS’s Ambulatory Surgical Center Quality Reporting (ASCQR) Program requirements.  Participating CMS-licensed ASCs will be required to report healthcare personnel vaccination summary data via NHSN beginning with the 2014-2015 influenza season.  Detailed operational guidance, training, and other information for this reporting are available at NHSN ASC Surveillance for Healthcare Personnel Vaccination.

If your facility is already enrolled in NHSN, e.g. because your state requires your facility to report surgical site infections, it does not have to be re-enrolled.  Your NHSN Facility Administrator may simply activate the Healthcare Personnel Safety Component in NHSN.

Step 1: Training and Preparation

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Be sure to check trusted websites and spam blockers.

Time to complete step 1: 30 minutes

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Step 2: Register

Rules of behavior screen

Agree to the NHSN Rules of Behavior and register your facility with NHSN using your CMS Certification Number (CCN). ASCs will have a 10 character alphanumeric CCN with a “C” in the third position.

Time to complete step 2: 10 minutes

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After registration, you will receive two e-mails, one immediately from NHSN with subject “NHSN Facility Registration Submitted” and another within 24 hours from Sams-No-reply (CDC) inviting you to register with SAMS.

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Step 3a: Review and Accept SAMS Rules of Behavior and Register with SAMS

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Log into the SAMS application using the assigned username (i.e., your current e-mail address) and temporary password from the invitation e-mail.  Accept the SAMS Rules of Behavior and complete the SAMS registration form.

 

Time to complete step 3a: 12 minutes

blue barYou will receive an e-mail from sams-no-reply@cdc.gov with the subject " Identity Verification Request."down arrow

Step 3b: Complete and Submit Identity Proofing Documentation

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Print the Identify Verification Form you received from SAMS and take it to a notary public for endorsement.  Fax the form and supporting documentation to CDC.  You will receive an email from SAMS when your SAMS access has been approved. 

You must receive your SAMS grid card, which will be delivered to your home address via U.S. mail within 7-10 days of receiving your SAMS approval e-mail.  If you do not receive your SAMS grid card within 10 days please contact nhsn@cdc.gov for assistance.

Time to complete step 3b: Varies

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Step 4: NHSN Enrollment

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Log in to SAMS using your password and SAMS grid card and select NHSN Enrollment. Submit required enrollment information. 

ASCs enrolling only to report HCP influenza vaccination summary data to CMS are not required to complete a facility survey.  On the Facility Enrollment screen the NHSN Facility Administrator should select “AMB-SURG – Outpatient Surgery Facility” as the Facility Type and they should select the Healthcare Personnel Safety (HPS) Component checkbox. 

Time to complete step 4: 15 minutes

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After submitting the facility’s enrollment, receive an e-mail from NHSN with the
subject "NHSN facility enrollment submitted."

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Step 5: Sign and Send Consent

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Using the above NHSN email, open, print, and sign the consent form. Ensure 2 signatures are on the form and fax to CDC.

Tip: To open the consent form, you may need to log in to SAMS using your password and SAMS grid card and then copy and paste the link into that browser window.

Time to complete step 5: 10 minutes

blue barWithin 3 business days, receive NHSN email, subject "NHSN enrollment approved." down arrow

Congratulations, enrollment is complete!

Continue to NHSN SET-UP (required before beginning reporting)

 

 

CMS requirements click here for more information

CDA
Contact NHSN:
  • Centers for Disease Control and Prevention
    National Healthcare Safety Network
    MS-A24
    1600 Clifton Rd
    Atlanta, GA 30333
  • Contact NHSN@cdc.gov
     
Contact Us:
  • Centers for Disease Control and Prevention
    1600 Clifton Rd
    Atlanta, GA 30333
  • 800-CDC-INFO
    (800-232-4636)
    TTY: (888) 232-6348
  • New Hours of Operation
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    Closed Holidays
  • Contact CDC–INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
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