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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

training

 
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

down arrow

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

blue barAfter 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.down arrow

Step 3a: Register with SAMS

person sitting at computer

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

blue barWithin 1-3 days of successful online registration,
receive SAMS ‘Identity Verification Request’ email. down arrow

Step 3b: Complete and Submit Identify Proofing Verification

training

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

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Step 4: Submit NHSN Facility Contact Form Electronically

person sitting at computer

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

blue barImmediately after submitting forms, receive NHSN email,
subject "NHSN facility enrollment submitted."down arrow

Step 5: Sign and Send Consent

monitor and envelop

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

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:
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    Atlanta, GA 30333
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  • Contact CDC–INFO
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