BACKGROUND: The Centers for Medicare and Medicaid (CMS) require infection reporting for long-term care facilities (LTCF). The National Healthcare Safety Network (NHSN) offers option for submission of these data. While NHSN provides instructions, many facilities do not have the expertise to complete the process without assistance. The state health department (SHD) and the CMS contracted Quality Improvement Organization (QIO) combined efforts to facilitate enrollment.
METHODS: Staff members from QIO and SHD became official notaries to expedite enrollment. A total of 56 facilities were approached for enrollment and began the process independently. Live/recorded webinars were offered as well as instructional documents, facility visits, follow-up emails, and weekly phone calls. SAS 9.4 was used to determine time from start of efforts until each specific step in the enrollment process and time in between steps. Each average represents values for facilities completing that particular step.
RESULTS: Average days until facilities received SAMS cards ranged from 19.0-88.0, median=56.0 (n=20) (Fig.1). For those facilities completing the process and have conferred rights (n=17), this process took an average of 63 days, ranging from 29.0-110.0. Days between the notarization of ID documents and receipt of SAMS card was an average of 30.6 days ranging from 23.0 to 38.0. Time limiters included staff turnover, incorrect/insufficient identity documentation, and delays in receipt of automated emails. As of December 2016, 7 facilities were required to restart the SAMS process for various reasons.
CONCLUSIONS: LTCF facilities face challenges, but the partnership between agencies helps LTCFs to successfully enroll and begin reporting. Factors contributing to the success of enrollment include technical knowledge and capabilities, staff retention, and resources. As NHSN enrollment is not mandatory, other priorities often take precedent. Ongoing activities include assistance for unenrolled facilities, surveillance/monitoring education, intervention opportunities, and emphasis on data quality. This may have been due to the large volume of enrollment requests.