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Form Approved
OMB No. 09200666
Exp. Date: 01/31/2021
www.cdc.gov/nhsnLong Term Care Facility ComponentAnnual Facility Survey
Page 1 of 6Tracking #:
*Survey Year:
State Provider #:*required for savingFacility
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How to fill out nhsn denominator form

How to fill out nhsn denominator form
01
To fill out the NHSN denominator form, follow these steps:
02
Start by downloading the form from the NHSN website.
03
Open the downloaded form in a suitable software like Adobe Acrobat Reader.
04
Read the instructions carefully to understand the information required.
05
Begin by filling out the basic details like facility name, address, and contact information.
06
Move on to provide information about the reporting period and patient population.
07
Input the number of inpatient days, outpatient days, and observation days during the reporting period.
08
Fill in the details regarding the total number of beds available, bed occupancy rate, and patient days for each ward or unit.
09
Specify any exclusions or adjustments to the data if applicable.
10
Review the form to ensure all necessary fields are completed accurately.
11
Save the completed form and submit it according to the NHSN guidelines.
Who needs nhsn denominator form?
01
The NHSN denominator form is needed by healthcare facilities that are enrolled in the National Healthcare Safety Network (NHSN) program.
02
This includes hospitals, long-term care facilities, dialysis centers, and other healthcare settings.
03
These facilities are required to report data on various measures, including patient and healthcare personnel safety, to the Centers for Disease Control and Prevention (CDC) through the NHSN system.
04
The denominator form specifically captures data related to the facility's patient population, such as inpatient, outpatient, and observation days, bed occupancy rates, and more.
05
By submitting the NHSN denominator form, healthcare facilities contribute to national surveillance efforts and help identify and prevent healthcare-associated infections and other safety hazards.
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What is nhsn denominator form?
The NHSN denominator form is a document used to report data related to patient encounters and healthcare-associated infections to the National Healthcare Safety Network (NHSN).
Who is required to file nhsn denominator form?
Healthcare facilities participating in the National Healthcare Safety Network (NHSN) are required to file the NHSN denominator form.
How to fill out nhsn denominator form?
To fill out the NHSN denominator form, facilities must collect relevant data on patient encounters, including admission rates and patient days, and input this data into the designated sections of the form according to NHSN guidelines.
What is the purpose of nhsn denominator form?
The purpose of the NHSN denominator form is to provide a standardized way for healthcare facilities to report data on patient encounters, which helps in monitoring infection rates and improving patient safety.
What information must be reported on nhsn denominator form?
The NHSN denominator form must report information such as the number of patient admissions, total patient days, and specific risk factors relevant to the healthcare setting.
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