5-Step Enrollment for Outpatient Dialysis Facilities - CMS QIP

For complete detailed enrollment instructions please download the NHSN Facility Administrator Enrollment Guide March 2018. pdf icon[PDF – 797K] . Please see FAQs about NHSN and the CMS ESRD QIP Rule.

Once a facility is enrolled in NHSN, additional users can be added. At least two users with administrator rights per facility are recommended to provide coverage for staff absences and turnover. New users, start here: New Outpatient Dialysis Center User Checklist pdf icon[PDF – 200 KB]


Step 1: Training and Preparation
2 healthcare personnel working on a laptop

Print and follow the Outpatient Dialysis Facility Enrollment Checklist pdf icon[PDF – 200 KB] to ensure successful and efficient enrollment.

Complete required training and Outpatient Dialysis Center Practices Surveypdf icon [PDF – 152 KB]. Be sure to check trusted websites and spam blockers.

Time to complete step 1: 2 hours, 45 minutes

down arrow
Step 2: Register
Rules of Behavior

Agree to Rules of Behavior and register facility with NHSN using CMS Certification Number (CCN) or CDC assigned enrollment ID.

Time to complete step 2: 10 minutes

down arrow

After registration, you will receive two emails: ‘Welcome to NHSN!’
arrives from NHSN immediately and ‘Invitation to Register’
arrives from SAMS-no-reply within 24 hours.

down arrow
Step 3a: Register with SAMS
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

down arrow

Within 24 hours of successful online registration,
receive SAMS ‘Identity Verification Request’ email.

down arrow
Step 3b: Complete and Submit Identity Proofing Verification
Identity Verification Request

From the ‘Identity 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 14-21 days of your SAMS approval email. If you do not receive your grid card within 21 days, please contact samshelp@cdc.gov for assistance.

Time to complete step 3b: 35 minutes

down arrow
Step 4: Submit NHSN Forms Electronically
Login to SAMS

Log in to SAMS using your password and SAMS grid card and select ‘NHSN Enrollment.’ Submit required NHSN forms online, including facility contact information.

Time to complete step 4: 32 minutes

down arrow

Shortly after successfully submitting the forms, the Facility Administrator
and Primary Contact will receive a “NHSN Facility Enrollment Submitted” email.

down arrow
Step 5: Submit Consent
Login to NHSN

Login to NHSN, select the appropriate component, and review the “Agreement to Participate and Consent”.  Check the box to ‘Accept’ next to the appropriate contact name and then ‘Submit’ the form in each component.

Time to complete step 5: 5 minutes

down arrow

Congratulations, enrollment is complete!

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