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FY 2027 MRSA Validation Template
ICR 202405-0938-006 · OMB 0938-1352 · Object 142449101.
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| File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
|---|---|
| File Title | FY 2027 MRSA Validation Template |
| Subject | Methicillin-Resistant Staphylococcus Aureus (MRSA) Validation Template |
| Keywords | FY, 2027, Methicillin-Resistant, Staphylococcus, Aureus, MRSA, Validation, Template |
| Author | CMS |
| Last Modified By | Calc |
| File Modified | 2024-05-09 |
| File Created | 2026-08-26 |
| Conversion State | complete |
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Methicillin-Resistant Staphylococcus Aureus (MRSA) Validation Template In support of the Centers for Medicare & Medicaid Services (CMS) Hospital-Acquired Condition (HAC) Reduction Program inpatient data validation efforts for the Fiscal Year (FY) 2027 program year: • Each hospital selected for MRSA validation is to produce a list of all final results for blood cultures that are positive for MRSA during an inpatient episode of care The list may include cultures collected in the ED and/or 24-hour observation locations collected prior to an inpatient admission; however, if the patient was only seen in the ED and/or 24-hour observation and never admitted as an inpatient status, do not include these on the Validation Template. These are scenarios where CMS and the National Healthcare Safety Network (NHSN) reporting differ. FY 2027 - MRSA Validation Template (Use this template for 1Q 2024 through 4Q 2024 blood cultures positive for MRSA - all quarters must be submitted on separate templates) FIELD (* indicates required field) DESCRIPTION SECTION The National Healthcare Safety Network (NHSN)-assigned facility ID under which your hospital NHSN Facility ID* submits NHSN data. Hospital's 6-digit CMS Certification Number (CCN). Do not include any hyphens. Provider ID/CCN* Hospital Information Section Hospital Name associated with CCN. Hospital Name* Complete the first row in the Enter the 2 character abbreviation for the state in which the hospital is located. State* spreadsheet. The information Select from the drop-down list the calendar quarter to which the MRSA Validation Template provided in the first row will Calendar Quarter* pertains. be applied to all positive blood Hospital contact name for CMS to contact with questions. Hospital Contact Name* cultures listed on the template. Phone number for hospital contact listed. Contact Phone* Email address for hospital contact listed. Contact Email* Blood cultures positive for MRSA Select Yes or No from the drop-down list. Does the hospital have any final results for blood cultures positive for MRSA for patients in the calendar quarter referenced? (Y/N)* The patient identifier assigned by the hospital. Use the same patient identifier that would be submitted to NHSN if the episode of care (EOC) would be reported as a laboratory-identified MRSA Patient Identifier* bacteremia event. The patient date of birth using MM/DD/YYYY format. Birthdate* Select Female, Male or unknown from the drop-down list to indicate the sex of the patient. Sex* Enter date of patient’s inpatient admission to hospital in MM/DD/YYYY format. Date of admission = date that the patient is physically admitted to an inpatient location. Time spent in the Emergency Admit Date* Department or other outpatient locations before admission are NOT used to set the Date of Admission. See table below for additional information. Enter date patient was discharged from the hospital in MM/DD/YYYY format. If a patient has not Patient & Blood Culture Section been discharged from the hospital enter "Not Discharged" for the Discharge Date field. Discharge Discharge Date* Complete for every final positive blood dates that fall within the reporting quarter will be eligible for validation. culture. First name of patient. First Name Last name of patient. Last Name Select from the drop-down list, the NHSN location to which the patient was assigned when the blood culture positive for MRSA was collected. NHSN Location* Only locations from the drop-down will be accepted; do not use a hospital-assigned location. Lab ID, accession number or specimen number corresponding to positive blood culture. Lab ID* Provide the date the blood culture was collected in MM/DD/YYYY format. Blood Culture Date* Provide the time the blood was collected if easily available. Blood Culture Time For additional information, view the appropriate MRSA Abstraction Manual posted on the Inpatient Data Validation Resources https://qualitynet.cms.gov/inpatient/data-management/data-validation/resources page of QualityNet (direct link): For the purposes of CMS inpatient data validation, please note the differences between NHSN data submission and validation template/medical record submission, as described below: Record Type NHSN Data Submission Inpatient Submit data per NHSN instruction. ED and/or Observation only – did not convert to inpatient status; includes patients with Observation status in an inpatient location. Submit data per NHSN instruction, regardless of whether the patient changed to inpatient status, and mark the inpatient status accordingly. CMS Inpatient Rehabilitation Facilities (IRF) and CMS Inpatient Psychiatric Facilities (IPF) Submit data per NHSN instruction. Validation Template Submission Enter all positive cultures on Validation Templates, including those performed in ED and/or Observation locations if and only if there was a corresponding inpatient status. Do NOT enter positive cultures for patients that did not convert to inpatient status. The patient must change to an inpatient status to be valid for the CMS data validation. Cultures submitted on the Validation Template that are not inpatient admissions may result in mismatch. Do NOT enter positive cultures for patients that had only a rehabilitation or psychiatric stay. These are not valid for CMS data validation. Cultures submitted on the template that are not inpatient admissions may result in mismatch. Medical Record Submission to CDAC Submit inpatient records, including corresponding ED and/or Observation documentation. There must be documentation in the record to indicate inpatient status. The patient must change to an inpatient status to be valid for CMS data validation. Records submitted for validation that are not inpatient admissions will be considered invalid. Rehab and psych stays are not valid for CMS data validation. Records submitted for validation that are not acute inpatient admissions will be considered invalid. PRA Disclosure Statement According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0938-1352 (Expires 01/31/2026). The time required to complete this information collection is estimated to average 10 hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to CMS, 7500 Security Boulevard, Attn: PRA Reports Clearance Officer, Mail Stop C4-26-05, Baltimore, Maryland 21244-1850. ****CMS Disclosure**** Please do not send applications, claims, payments, medical records or any documents containing sensitive information to the PRA Reports Clearance Office. Please note that any correspondence not pertaining to the information collection burden approved under the associated OMB control number listed on this form will not be reviewed, forwarded, or retained. If you have questions or concerns regarding where to submit your documents, please contact the Validation Support Contractor at [email protected]. NHSN Provider ID/CCN* Facility ID* Hospital Name* State* Calendar Quarter* Hospital Contact Name* Contact Phone* Contact Email* Blood cultures positive for MRSA (Y/N) * Patient Identifier* Birthdate* Sex* Admit Date* Discharge Date* First Name Last Name NHSN Location* Lab ID* Blood Culture Date* Blood Culture Time Below is a list of NHSN Locations applicable for CMS inpatient data validation MRSA reporting. CDC LOCATION LABEL CDC LOCATION CODE Inpatient Adult Critical Care Units Burn Critical Care IN:ACUTE:CC:B Medical Cardiac Critical Care IN:ACUTE:CC:C Medical Critical Care IN:ACUTE:CC:M Medical-Surgical Critical Care IN:ACUTE:CC:MS Neurologic Critical Care IN:ACUTE:CC:N Neurosurgical Critical Care IN:ACUTE:CC:NS Oncology Medical Critical Care Oncology Surgical Critical Care Oncology Medical-Surgical Critical Care Onsite Overflow Critical Care IN:ACUTE:CC:ONC_M IN:ACUTE:CC:ONC_S IN:ACUTE:CC:ONC_MS IN:ACUTE:CC:OF_ONSITE Prenatal Critical Care IN:ACUTE:CC:PNATL Respiratory Critical Care Surgical Cardiothoracic Critical Care Surgical Critical Care IN:ACUTE:CC:R IN:ACUTE:CC:CT IN:ACUTE:CC:S Trauma Critical Care IN:ACUTE:CC:T Inpatient Pediatric Critical Care Units ONC Pediatric Critical Care IN:ACUTE:CC:ONC_PED Pediatric Burn Critical Care Pediatric Surgical Cardiothoracic Critical Care Pediatric Medical Critical Care Pediatric Medical-Surgical Critical Care IN:ACUTE:CC:B_PED Pediatric Neurosurgical Critical Care IN:ACUTE:CC:NS_PED Pediatric Respiratory Critical Care Pediatric Surgical Critical Care IN:ACUTE:CC:R_PED IN:ACUTE:CC:S_PED Pediatric Trauma Critical Care IN:ACUTE:CC:T_PED IN:ACUTE:CC:CT_PED IN:ACUTE:CC:M_PED IN:ACUTE:CC:MS_PED Inpatient Neonatal Units Well Newborn-- Nursery (Level I) IN:ACUTE:WARD:NURS Special Care Nursery (Level II) IN:ACUTE:STEP:NURS Neonatal Critical Care (Level II/III) IN:ACUTE:CC_STEP:NURS Neonatal Critical Care (Level III) IN:ACUTE:CC:NURS Neonatal Critical Care (Level IV) IN:ACUTE:CC:NURS_IV Inpatient Specialty Care Areas (SCA) Dialysis Specialty Care Area IN:ACUTE:SCA:DIAL Pediatric Dialysis Specialty Care Area IN:ACUTE:SCA:DIAL_PED Pediatric Solid Organ Transplant Specialty IN:ACUTE:SCA:SOTP_PED Care Area Solid Organ Transplant Specialty Care IN:ACUTE:SCA:SOTP Area Inpatient Adult Wards Antenatal Care Ward IN:ACUTE:WARD:ANTENAT Behavioral Health/Psych Ward IN:ACUTE:WARD:BHV Burn Ward IN:ACUTE:WARD:B Ear, Nose, Throat Ward IN:ACUTE:WARD:ENT Gastrointestinal Ward IN:ACUTE:WARD:GI Genitourinary Ward IN:ACUTE:WARD:GU Gerontology Ward IN:ACUTE:WARD:GNT Gynecology Ward IN:ACUTE:WARD:GYN Jail Unit IN:ACUTE:WARD:JAL Labor and Delivery Ward Labor, Delivery, Recovery, Postpartum Suite Medical Ward Medical-Surgical Ward Neurology Ward IN:ACUTE:WARD:LD Neurosurgical Ward IN:ACUTE:WARD:NS Oncology Leukemia Ward Oncology Lymphoma Ward Oncology Leukemia/Lymphoma Ward IN:ACUTE:WARD:ONC_LEUK IN:ACUTE:WARD:ONC_LYMPH IN:ACUTE:WARD:ONC_LL IN:ACUTE:WARD:LD_PP IN:ACUTE:WARD:M IN:ACUTE:WARD:MS IN:ACUTE:WARD:N Oncology Solid Tumor Ward IN:ACUTE:WARD:ONC_ST Oncology Hematopoietic Stem Cell IN:ACUTE:WARD:ONC_HSCT Transplant Ward Oncology General Hematology-Oncology IN:ACUTE:WARD:ONC_HONC Ward Ophthalmology Ward IN:ACUTE:WARD:OPH Orthopedic Ward Orthopedic Trauma Ward Onsite Overflow Ward Plastic Surgery Ward Postpartum Ward Pulmonary Ward IN:ACUTE:WARD:ORT IN:ACUTE:WARD:T_ORT IN:ACUTE:WARD:OF_ONSITE IN:ACUTE:WARD:PLS IN:ACUTE:WARD:PP IN:ACUTE:WARD:PULM Rehabilitation Ward (within Hospital) IN:ACUTE:WARD:REHAB School Infirmary Stroke (Acute) Ward Surgical Ward Telemetry Ward Vascular Surgery Ward Chemical Dependency Ward IN:ACUTE:WARD:IFM IN:ACUTE:WARD:STRK IN:ACUTE:WARD:S IN:ACUTE:WARD:TEL IN:ACUTE:WARD:VS IN:ACUTE:WARD:CD Inpatient Pediatric Wards IN:ACUTE:WARD:BHV_ADOL Adolescent Behavioral Health Ward Oncology Pediatric Hematopoietic Stem Cell Transplant Ward Oncology Pediatric General Hematology/Oncology Ward Pediatric Behavioral Health Ward Pediatric Burn Ward Pediatric Ear, Nose, Throat Ward Pediatric Genitourinary Ward Pediatric Medical Ward Pediatric Medical-Surgical Ward Pediatric Neurology Ward IN:ACUTE:WARD:ONC_HSCT_PED IN:ACUTE:WARD:ONC_HONC_PED IN:ACUTE:WARD:BHV_PED IN:ACUTE:WARD:B_PED IN:ACUTE:WARD:ENT_PED IN:ACUTE:WARD:GU_PED IN:ACUTE:WARD:M_PED IN:ACUTE:WARD:MS_PED IN:ACUTE:WARD:N_PED Pediatric Neurosurgical Ward IN:ACUTE:WARD:NS_PED Pediatric Orthopedic Ward IN:ACUTE:WARD:ORT_PED Pediatric Rehabilitation Ward (within HospiIN:ACUTE:WARD:REHAB_PED Pediatric Surgical Ward IN:ACUTE:WARD:S_PED Inpatient Step Down Units Adult Step Down Unit IN:ACUTE:STEP Oncology Step Down Unit IN:ACUTE:STEP:ONC Pediatric Step-Down Unit IN:ACUTE:STEP:PED Inpatient Mixed Acuity Units Adult Mixed Acuity Unit IN:ACUTE:MIXED:ALL_ADULT Pediatric Mixed Acuity Unit IN:ACUTE:MIXED:ALL_PEDS Mixed Age Mixed Acuity Unit IN:ACUTE:MIXED:ALL Oncology Mixed Acuity Unit (all ages) IN:ACUTE:MIXED:ONC Inpatient Operating Rooms Cardiac Catheterization Room/Suite IN:ACUTE:OR:CATH Cesarean Section Room/Suite IN:ACUTE:OR:LD Interventional Radiology IN:ACUTE:OR:RAD Operating Room/Suite IN:ACUTE:OR Post Anesthesia Care Unit/Recovery Room IN:ACUTE:OR_STEP 24-Hour Observation Area OUT:ACUTE:WARD Emergency Department OUT:ACUTE:ED Facility-Wide Locations FACWIDEIN FACWIDEOUT Facility-wide Inpatient (FacWideIN) Facility-wide Outpatient (FacWideOUT) Acute Care Facilities General RSA reporting. LOCATION DESCRIPTION Critical care area for the care of patients with significant/major burns. Critical care area for the care of patients with serious heart problems that DO NOT require heart surgery. Critical care area for the care of patients who are being treated for nonsurgical conditions. Critical care area for the care of patients with medical and/or surgical conditions. Critical care area for the care of patients with life- threatening neurologic diseases. Critical care area for the surgical management of patients with severe neurologic diseases or those at risk for neurologic injury as a result of surgery. Critical care area for the care of oncology patients who are being treated for nonsurgical conditions related to their malignancy. Critical care area for the evaluation and management of oncology patients with serious illness before and/or after cancer-related surgery. Critical care area for the care of oncology patients with medical and/or surgical conditions related to their malignancy. Area previously used for non-patient care which has been repurposed to care for critically ill or injured patients. Critical care area for the care of pregnant patients with complex medical or obstetric problems requiring a high level of care to prevent the loss of the fetus and to protect the life of the mother. Critical care area for the evaluation and treatment of patients with severe respiratory conditions. Critical care area for the care of patients following cardiac and/or thoracic surgery. Critical care area for the evaluation and management of patients with serious illness before and/or after surgery. Critical care area for the care of patients who require a high level of monitoring and/or intervention following trauma or during critical illness related to trauma. Critical care area for the care of oncology patients ≤18 years old who are being treated for surgical or nonsurgical conditions related to their malignancy. Critical care area for the care of patients ≤18 years old with significant/major burns. Critical care area for the care of patients ≤18 years old following cardiac and thoracic surgery. Critical care area for the care of patients ≤18 years old who are being treated for nonsurgical conditions. Critical care area for the care of patients ≤18 years old with medical and/or surgical conditions. Critical care area for the surgical management of patients ≤18 years old with severe neurologic diseases or those at risk for neurologic injury as a result of surgery. Critical care area for the evaluation and treatment of patients ≤18 years old with severe respiratory conditions. Critical care area for the evaluation and management of patients ≤18 years old with serious illness before and/or after surgery. Critical care area for the care of patients ≤18 years old who require a high level of monitoring and/or intervention following trauma or during critical illness related to trauma. Hospital area for evaluation and postnatal care of healthy newborns. May include neonatal resuscitation and stabilization of ill newborns until transfer to a facility at which specialty neonatal care is provided. The capabilities of Level II, listed below, are from the American Academy of Pediatrics definitions of levels of neonatal care.1 Level II special care nursery Level I capabilities plus: -Provide care for infants born ≥32 wks. gestation and weighing ≥1500 g who have physiologic immaturity or who are moderately ill with problems that are expected to resolve rapidly and are not anticipated to need subspecialty services on an urgent basis -Provide care for infants convalescing after intensive care -Provide mechanical ventilation for brief duration (<24 h) or continuous positive airway pressure or both -Stabilize infants born before 32 wks. gestation and weighing less than 1500 g until transfer to a neonatal intensive care facility Combined nursery housing both Level II and III newborns and infants, as per the NHSN level definitions above and below. This is analogous to a mixed acuity unit specifically for Neonatal Critical Care patients. A hospital neonatal intensive care unit (NICU) organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high- risk newborn infants and those with complex and critical illness. The capabilities of Level III, listed below, are from the American Academy of Pediatrics definitions of levels of neonatal care.1 Level III NICU Level II capabilities plus: -Provide sustained life support -Provide comprehensive care for infants born < 32 wks. gestation and weighing <1500 g and infants born at all gestational ages and birth weights with critical illness -Provide prompt and readily available access to a full range of pediatric medical subspecialists, pediatric surgical specialists, pediatric anesthesiologists, and pediatric ophthalmologists -Provide a full range of respiratory support that may include conventional and/or high-frequency ventilation and inhaled nitric oxide -Perform advanced interpretation on an with urgent basis,illness including computed and echocardiography Critical care area forimaging, the carewith of newborns and infants serious requiring Leveltomography, IV care; area MRI, is supervised by a neonatologist Level IV Level III capabilities plus: -Located within an institution with the capability to provide surgical repair of complex congenital or acquired conditions -Maintain a full range of pediatric medical subspecialists, pediatric surgical subspecialists, and pediatric subspecialists at the site -Facilitate transport and provide outreach education Specialty care area for the care of patients who require acute dialysis as a temporary measure. Specialty care area for the care of patients ≤18 years old who require acute dialysis as a temporary measure. Specialty care area for the postoperative care of patients ≤18 years old who have had a solid organ transplant (for example, heart/lung, kidney, liver, pancreas). Specialty care area for the postoperative care of patients >18 years old who have had a solid organ transplant (for example, heart/lung, kidney, liver, pancreas). Hospital area for observation, evaluation, treatment or surgery of high-risk pregnancy patients. Area for the evaluation and treatment of patients with acute psychiatric or behavioral disorders. Area for the evaluation and treatment of patients who have burns. Area for the evaluation, treatment, or surgery of patients with ear, nose, or throat disorders. Area for the evaluation, treatment, or surgery of patients with disorders of the gastrointestinal tract. Area for the evaluation, treatment, or surgery of patients with disorders of the genitourinary system. Area for the evaluation, treatment, or surgery of patients with age-related diseases. Area for the evaluation, treatment, or surgery of female patients with reproductive tract disorders. Overnight stay patient care area of a hospital or correctional facility used only for those who are in custody of law enforcement during their treatment. Area where women labor and give birth. Suite used for labor, delivery, recovery and postpartum care -- all within the same suite. Area for the evaluation and treatment of patients with medical conditions or disorders. Area for the evaluation of patients with medical and/or surgical conditions. Area for the evaluation and treatment of patients with neurologic disorders. Area for the care of patients whose primary reason for admission is to have neurosurgery or to be cared for by a neurosurgeon after head or spinal trauma. Area for the evaluation and treatment of patients with leukemia. Area for the evaluation and treatment of patients with lymphoma. Area for the evaluation and treatment of patients with leukemia and/or lymphoma. Area for the evaluation and treatment of oncology patients with solid tumors. Area for the care of patients who undergo stem cell transplant for the treatment of cancers, immune effector cell therapy, and/or blood or immune system disorders. Area for the evaluation and treatment of patients with cancer and/or blood disorders. Area for the care of patients whose primary reason for admission is to have eye surgery or to be cared for by an ophthalmologist after eye trauma. Area for the evaluation, treatment, or surgery on bones, joints, and associated structures by an orthopedist. Area for the evaluation and treatment of patients with orthopedic injuries or disorders. Area previously used for non-patient care which has been repurposed to care for non-critically ill or injured patients Area for the care of patients who have reconstructive surgery performed by a plastic surgeon. Area for the care of patients recovering from childbirth. Area for the evaluation and treatment of patients with respiratory system conditions or disorders. Area for the evaluation and restoration of function to patients who have lost function due to acute or chronic pain, musculoskeletal problems, stroke, or catastrophic events resulting in complete or partial paralysis. Overnight stay patient care area of a school infirmary or health center (for example, private residential school or college campus). Area for the evaluation, stabilization, and treatment of patients who have experienced an acute stroke. Area for the evaluation and treatment of patients who have undergone a surgical procedure. Hospital area dedicated to providing evaluation and treatment of patients requiring continuous cardiac monitoring Area for the evaluation and treatment of patients who have undergone vascular surgery. Area for the evaluation and treatment of patients with chemical dependency. Area for the evaluation and treatment of patients 13-18 years old with acute psychiatric or behavioral disorders. Area for the care of patients ≤18 years old who undergo stem cell transplant for the treatment of cancers and/or blood or immune system disorders. Area for the evaluation and treatment of patients ≤18 years old with cancer and/or blood disorders. Area for the evaluation and treatment of patients ≤18 years old with acute psychiatric or behavioral disorders. Area for the evaluation and treatment of patients ≤18 years old who have tissue injury caused by burns. Area for the evaluation and treatment of patients ≤18 years old with disorders of the ear, nose, and/or throat. Area for the evaluation and treatment of patients ≤18 years old with disorders of the genitourinary system. Area for the evaluation and treatment of patients ≤18 years old with medical conditions or disorders. Area for the evaluation and treatment of patients ≤18 years old with medical and/or surgical conditions. Area for the evaluation and treatment of patients ≤18 years old with neurologic disorders. Area for care of patients ≤18 years old whose primary reason for admission is to have neurosurgery or to be cared for by a neurosurgeon after head or spinal trauma. Area for the evaluation and treatment of patients ≤18 years old with orthopedic injuries or disorders. Area for the evaluation and restoration of function to patients ≤18 years old who have lost function due to acute or chronic pain, musculoskeletal problems, stroke, or catastrophic events resulting in complete or partial paralysis. Area for the evaluation and treatment of patients ≤18 years old who have undergone a surgical procedure. Area for adult patients who are hemodynamically stable and can benefit from close supervision and monitoring, such as frequent pulmonary toilet, vital signs, and/or neurologic and neurovascular checks. Area for oncology patients who are hemodynamically stable and can benefit from close supervision and monitoring, such as frequent pulmonary toilet, vital signs, and/or neurologic and neurovascular checks. Area for patients ≤18 years old who are hemodynamically stable and can benefit from close supervision and monitoring, such as frequent pulmonary toilet, vital signs, and/or neurologic and neurovascular checks. Hospital area for the evaluation and treatment of adult patients whose conditions are of varying levels of acuity (for example, critical care, ward-level care, step-down type care, etc.). Such a care area may be comprised of patients followed by different hospital services (for example, coronary, medical, surgical, etc.). This care area may or may not include ''acuity adaptable'' or ''universal'' beds (specifically, this model of patient care allows a patient to stay in same bed during all phases of his care, from critical care through lower levels of care). Hospital area for the evaluation and treatment of pediatric patients whose conditions are varying levels of acuity (for example, critical care, ward-level care, step down type care, etc.). Such a care area may be comprised of patients followed by different hospital services (for example, coronary, medical, surgical, etc.). This care area may or may not include “acuity adaptable” or “universal” beds (specifically, this model of patient care allows a patient to stay in the same bed during all phases of his care, from critical care through lower levels of care). Hospital area for the evaluation and treatment of a mixture of adult and pediatric patients whose conditions are of varying levels of acuity (for example, critical care, ward-level care, step-down type care, etc.). Such a care area may be comprised of patients followed by different hospital services (for example, coronary, medical, surgical, etc.). This care area may or may not include ''acuity adaptable'' or ''universal'' beds (specifically, this model of patient care allows a patient to stay in same bed during all phases of his care, from critical care through lower levels of care). Area for the evaluation and treatment of a mixture of adult and pediatric oncology patients whose conditions are of varying levels of acuity (for example, critical care, ward-level care, step-down type care, etc.). This care area may or may not include "acuity adaptable" or “universal” beds (specifically, this model of patient care allows a patient to stay in the same bed during all phases of care, from critical care through lower levels of care). A room or rooms in a hospital equipped for the performance of heart catheterizations for diagnostic or therapeutic purposes. Operating Room requirements for air changes, temperature, humidity and surfaces must be met. A room or suite in a hospital equipped for the performance of obstetric and gynecologic surgeries and for the care of the neonate immediately after birth. Operating Room requirements for air changes, temperature, humidity and surfaces must be met. A room where diagnostic or therapeutic radiology procedures are done on outpatients or inpatients. Operating room requirements for air changes, temperature, humidity, and surfaces must be met. A room or suite in a hospital equipped for the performance of surgical operations. Requirements for air changes, temperature, humidity, and surfaces must be met. Area designated for monitoring patients for immediate effects of anesthesia before either going home or on to an in-patient care area. Area where patients are monitored for suspected or non-life-threatening conditions for 24 hours or less. More than 50% of patients in this location must be outpatients who are not expected to be admitted to an inpatient unit. Area that provides emergency medical services; top priority is given to those with life-threatening illness or injury. Facility-wide Inpatient (FacWIDEIn) Facility-wide Outpatient (FacWIDEOut) USER GUIDE AND SUBMISSION INSTRUCTIONS ---> The FY 2027 Validation Template User Guide and Submission Instructions , along with supporting documentation, can be found on the CMS QualityNet website. To access, select [Hospitals–Inpatient], and then [Data Management], followed by [Data Validation], and lastly [Resources]: https://qualitynet.cms.gov/inpatient/data-management/data-validation/resources The only acceptable method of sending HAI Validation Templates is through the CMS Managed File Transfer (MFT) application: https://qnetmft.cms.gov HAI Validation Templates contain Protected Health Information (PHI) and cannot be sent via email -- even if a template were sent encrypted from a secure workplace email, it would still be considered a security violation. We suggest hospitals ask their IT department add [email protected] to your ‘Safe Senders List’ to ensure validation-related email notifications are not blocked. It is recommended to submit HAI Validation Templates at least a week prior to the submission deadline in case there are difficulties with transmitting files, and to allow time for revisions/corrections when necessary. If you are unable to log in to the CMS MFT application, the first person to contact is your hospital's Security Official (SO). If your SO is unable to establish your access, you will need to contact the Center for Clinical Standards & Quality (CCSQ) Service Center by phone at 866-288-8912. It is recommended hospitals have two SOs at all times to ensure the ability to upload Validation Templates by the established submission deadlines. We suggest hospitals ask their IT department to add [email protected] to their ‘Safe Senders List’ to ensure validation-related email notifications are received. HAI VALIDATION TEMPLATE COMPLETION & SUBMISSION TIPS Prior to submitting Validation Templates to CMS, it is recommended that quality assurance is performed on the data within the template. Review the [Definitions] tab to ensure correct information is entered in each field. ü ü ü ü ü ü ü ü ü ü ü ü ü ü Do not add, delete, rename, or change the order of the tabs. Do not add, delete, or rename column headings. Do not leave the first row blank or skip rows between patient data. Make sure the Provider ID/CCN field is exactly 6 numeric characters (do not add a hyphen). Make sure the State field contains the 2 character abbreviation for your state, not the full state name. Verify the Calendar Quarter listed on each Validation Template is correct. Review all dates for accuracy and correct format as specified on the [Definitions] tab. If a patient has not been discharged from the hospital, enter ‘Not Discharged’ for the Discharge Date field. The 'Blood cultures positive for MRSA' column cannot include rows listing both "Yes" and "No"; entering "No" indicates no positive cultures for the quarter. Ensure all NHSN locations are within the approved NHSN drop down on the template. Hospital-assigned locations will not be accepted. Be sure to populate all required fields on each consecutive row if there were multiple final positive cultures collected for the same patient. Perform quality check of data entered into this template against what was entered into NHSN; stay mindful of differing CMS and NHSN deadlines. Check to ensure any cases with a separate Inpatient Rehabilitation Facility (IRF) or Inpatient Psychiatric Facility (IPF) CCN are not included on the template. Append the file name with the 6-digit CCN/Provider ID, followed by an underscore and the quarter. For example: 012345_1QYY_FYXX_MRSA_ValTemp.xlsx • When submitting templates via the [Compose] button within the Mail area of the CMS MFT dashboard, input the subject of the message with the 6-digit CCN/Provider ID, Submission Quarter, and Template type(s) attached. For example: 012345 1QYY FYXX MRSA & CDI Validation Templates • When choosing a recipient, select the ellipsis button to the right of the To field and then select the [Groups] tab to locate the "Validation Support Contractor" group. Do NOT select any individual person(s) from the recipient list; only select the "Validation Support Contract" Group. Some individual accounts are not regularly monitored—sending to any one individual risks delay in processing. • Leave the 'Require Registered Users' box checked under Options. Un-checking this box puts the message at risk of not being processed. • We strongly encourage hospitals to add a check on the 'Read Receipt' box under Options. After a file has been downloaded by someone on the Validation Support Contractor team, it will be in the queue for processing. • It is suggested that users verify a message has been sent by clicking on the [Sent Items] button from the left-side navigation panel of the MFT dashboard. NOTE: It can take a couple minutes for messages to appear in the Sent Items folder. Please, do NOT re-send messages multiple times, as this significantly delays processing and requires version confirmation. • You will receive email confirmation (usually within 2 business days of being downloaded) from the Validation Support Contractor letting you know the Validation Templates were processed. If you do not receive a processing confirmation, please include your hospital's 6-digit CCN/Provider ID in an email to [email protected]