National Healthcare Safety Network (NHSN) Frequently Asked Questions

The National Healthcare Safety Network (NHSN) is the nation’s most widely used healthcare-associated infection tracking system. As part of the COVID-19 response, providers, including long-term care facilities, are eligible to report infection data through NHSN. Nursing homes are required by the Centers for Medicare & Medicaid Services to report. This page serves as a guide for the latest updates and How-To for reporting COVID-19 data. To report your data to CMS, click here.

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Enrolling in NHSN

Can more than one user have access and enter data for the facilit?

Yes. We recommend having multiple users at the facility who can login and enter data. However, only one user can be assigned the role of NHSN Facility Administrator.

How do I add an additional user(s) to NHSN for my facility?

The facility administrator for NHSN will need to log in and add the additional user(s). When logged in, click on User>add from the left blue menu. You will then need to enter the person’s first and last name, email address in which they’d like to use for their NHSN login (we recommend a personal email address) and assign a username. For the username, just enter first initial and last name (for example: jsmith) Once that is complete and the user is added, if the user already has access to NHSN they will immediately have access to the new facility. If they do not already have access to NHSN they will receive an invitation email to register with SAMS and follow the enrollment instructions.

How do I enroll my facility in NHSN to report COVID 19 data?

  • If you already have access to NHSN, you can go ahead and report COVID, no action required.
  • If you do not currently have access to NHSN, follow instructions here

Do I need to submit any forms to report COVID data into NHSN?

If you only want to gain access for COVID reporting there is no requirement to submit any paper forms or surveys. The enrollment steps are provided here.

What if I have duplicate facilities enrolled in NHSN?

You will need to withdraw duplicate facilities from NHSN by doing the following:

  1.  Log into the duplicate enrolled facility in NHSN.
  2. On the left navigation pane, select facility->facility info.
  3. Scroll down to the component itemization and deselect the component that is a duplicate.
  4. Accept the alert indicating that you’ve deselected the facility.
  5. Select update to reflect changes.

If you do not have access to both facilities, you will need to fill out the Facility Administrator Change form here.

How do I change the Facility Administrator?

  • Complete this online form
  • The NHSN Primary Facility Contact information must be updated in the NHSN application if the listed contact is no longer active at the facility.
  • NHSN users who are no longer active at the facility must be deactivated in the NHSN application to avoid unauthorized access to the facility data.

How to Enter COVID-19 Data in NHSN

When I log-in, I don't see my facility or the COVID reporting option. What do I do?

To troubleshoot, close out your web browser completely. Open Internet Explorer (Do NOT use Google Chrome or Microsoft Edge), type in the entire web address (Do NOT use a saved link, or a remembered link) https://sams.cdc.gov and click Enter. This should solve the issue. If not, please contact techassist@qsource.org for assistance.

Do I report my COVID data into NHSN weekly or daily?

Facilities must submit the data through the NHSN at least once every seven days. Facilities may choose to submit multiple times a week. CMS is not prescribing which day of the week the data must be submitted, although reporting should remain consistent with data being submitted on the same day(s) each week. The collection period should also remain consistent (e.g., Monday through Sunday). Each Monday, CMS will review the data submitted to assess if each facility submitted data at least once in the previous seven days. The data pulled each Monday will also be used to update the data that is publicly reported.

Download: CMS COVID-1 NHSN Reporting Requirements for Nursing Homes

How can I tell if my data was submitted?

After completing and saving each COVID-19 pathway in NHSN a pop-up message will appear to confirm the record was saved. Additionally, a complete record, meaning a response was given for every question in this pathway, will be highlighted green on the calendar page. An incomplete record will be highlighted tan. After you have completed all four COVD-19 pathways, you will see four green bars on the calendar for the day you entered data.

Download LONG-TERM CARE FACILITY (LTCF) Facility Guide to Using the COVID-19 Module

I've been reporting, but it's not showing up on the CMS publicly reported data. Why?

CMS uses the CMS Certification Number (CCN) for your facility to track the data being reported. To ensure your CNN is linked to your NHSN account, follow these instructions from the CDC.

Download: LTC How to ADD and EDIT Facility CCN with NHSN

When will fines be assessed if data is not entered?

Deadlines: May 17, 2020: facilities must submit first set of data.  CMS will provide facilities with an initial two-week grace period to begin reporting cases in the NHSN system (which ends at 11:59 p.m. on May 24, 2020). Facilities that fail to begin reporting after the third week (by 11:59 p.m. on May 31, 2020) will receive a warning letter reminding them to begin reporting the required information to CDC.

For facilities that have not started reporting in the NHSN system by 11:59 p.m. on June 7, 2020, ending the fourth week of reporting, CMS will impose a per day (PD) CMP of $1,000 for one day for the failure to report that week. For each subsequent week that the facility fails to submit the required report, the noncompliance will result in an additional one day PD CMP imposed at an amount increased by $500.

CMS Reporting Requirements for Long Term Care Facilities

Can I enter data for more than one facility at one time?

Yes. A currently active user can enter data in bulk for multiple facilities. You will need to create a group and enter data via a CSV file upload. Here are the instructions to do that.

COVID19 Group Guide

How do I join a group so others can review my data?

Often, facilities may want to join a group and confer rights to another entity. For example, a vendor assisting with data entry, state health department or corporate leadership. Here are the instructions for doing so. You will need to obtain the Group ID and password from that entity in order to join their group.

Making Sure Your COVID-19 Data is Accurate

How far back to you have to report aggregate cases when reporting for the first time?

Please report numbers beginning May 1, 2020 to current day when entering data for the first time. It is optional to report numbers from January 1, 2020 through April 30, 2020.

Instructions for Completion of the COVID-19 Long-term Care Facility (LTCF): Resident Impact and Facility Capacity Form

If this is NOT the first time our facility has entered COVID-19 data, do we enter cumulative numbers or only new data?

Only new data is required after the facility’s first submission. Unless otherwise stated in the table of instructions for a pathway, responses to the COVID-19 questions requiring counts must only include the total number of new counts since the last time data were entered in the module. Answers to the yes or no questions must be based on responses on the date of data entry.

Download LONG-TERM CARE FACILITY (LTCF) Facility Guide to Using the COVID-19 Module

Do I have to report data if there are no Covid-19 cases?

Yes, all data forms must be completed. Here are instructions for completing data entry.

How do I count admissions?

Enter the number of residents newly admitted or readmitted to the LTCF from a hospital where they were treated for suspected or laboratory positive COVID-19 since the last date Admission counts were entered.

Download: Instructions for Completion of the COVID-19 LTC Facility: Resident Impact and Facility Capacity Form (CDC 57.144)

Do I report a resident death that occurred at the hospital?

If a resident transferred out of your facility to the hospital as suspected or confirmed COVID-19 then later died at the hospital, you would report that resident death in your COVID-19 deaths. If they were transported for other reasons and died at the hospital you would report that in your total deaths.

Note: hospitals are not required to report COVID deaths at this time, so it will not be duplicate numbers.

Download: Instructions for Completition of the COVID-19 LTC Facility: Resident Impact and Facility Capacity Form (CDC 57.144)

How do I report suspected resident cases?

Enter the number of residents who have been or are newly managed as though they have COVID-19, but do not have a laboratory positive COVID-19 test result, this week. We clarified with the CDC that this does not include residents who are being isolated merely as a precaution. This is for residents who are actually suspected to possibly have COVID-19.

We isolate all new admits. Do we count as suspected?

No. Not unless they are showing signs and symptoms. (Confirmed on June 16, 2020 CDC training webinar)

We are testing residents and staff because of state requirements. Do they count as suspected?

We already have entered a resident as suspected. Now the resident has tested positive for COVID-19. How do we enter this?

In this situation, the resident would be entered as suspected the first time and as confirmed the second. Do not remove the resident’s previous data.

Download: Instructions for Completion of the COVID-19 LTC Facility: Resident Impact and Facility Capacity Form (CDC 57.144)(Confirmed on June 16, 2020 CDC training webinar)

When I select the save button, does it automatically report or do I need to export my data?

You just need to click “save” to report data. There is an option available to export saved data for additional analysis outside of NHSN, but this is not required in order to submit data.

Download: Long-term Care Facility Guide to Using the COVID-19 Module

Can data be corrected after it has been submitted?

Yes. Click on the calendar date, update the data and click save. The CDC database will be updated and the updated data will be sent to CMS on the following Monday in the next NHSN data submission. They only time you would edit data is if you accidentally entered the wrong number or had a data entry error. (Confirmed on June 16, 2020 CDC training webinar.)