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
Print and follow detailed checklist [PDF - 227 KB] October 2014 to ensure successful and efficient enrollment.
Complete the Healthcare Personnel Safety Component [PDF - 3 MB] training.
Be sure to check trusted websites and spam blockers.
Time to complete step 1: 30 minutes
Step 2: Register
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
After registration, you will receive two emails: ‘Welcome to NHSN!’
arrives from NHSN immediately and ‘Invitation to Register’
arrives from SAMS-no-reply within 1-3 days.
Step 3a: Register with SAMS
From the ‘Invitation to Register’ email, log in to SAMS with your username (i.e., email address) and temporary password provided. Accept the SAMS Rules of Behavior and complete the online SAMS registration form.
Time to complete step 3a: 16 minutes
Within 1-3 days of successful online registration,
receive SAMS ‘Identity Verification Request’ email.
Step 3b: Complete and Submit Identify Proofing Verification
From the ‘Identify Verification Request’ email, print the Identity Verification Form, complete it, and take it to a notary public for endorsement. Fax the form and supporting documentation to CDC. You will receive ‘SAMS Account Activation’ and ‘SAMS Activity Authorization’ emails when your access is approved.
To access SAMS, you must receive your SAMS grid card, which will be delivered to your home address via U.S. mail within 30 days of your SAMS approval email.
Time to complete step 3b: 35 minutes
Step 4: Submit NHSN Facility Contact Form Electronically
Log in to SAMS using your password and SAMS grid card and select ‘NHSN Enrollment.’ Submit required NSHN forms, including facility contact information.
Time to complete step 4: 32 minutes
Immediately after submitting forms, receive NHSN email,
subject "NHSN facility enrollment submitted."
Step 5: Sign and Send Consent
Using the above NHSN email, open, print, and sign the consent form. Ensure two 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 grid card and password, and then copy and paste the link into that browser window.
Time to complete step 5: 10 minutes
Within 3 business days, receive NHSN email, subject ‘NHSN enrollment approved.’
Congratulations, enrollment is complete!
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Centers for Disease Control and Prevention
National Healthcare Safety Network
1600 Clifton Rd
Atlanta, GA 30333
- Contact NHSN@cdc.gov