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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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 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.
Step 3a: Review and Accept SAMS Rules of Behavior and Register with SAMS
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
You will receive an e-mail from email@example.com with the subject " Identity Verification Request."
Step 3b: Complete and Submit Identity Proofing Documentation
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 firstname.lastname@example.org for assistance.
Time to complete step 3b: Varies
Step 4: NHSN Enrollment
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
After submitting the facility’s enrollment, receive an e-mail from NHSN with the
subject "NHSN facility enrollment submitted."
Step 5: Sign and Send Consent
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
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