Change NHSN Facility Administrator

Re-Assignment of Facility Administrators

NHSN users should complete this form ONLY to request reassignment of facility administrators when the currently-listed facility administrator is unavailable. Any other inquiries (e.g., change of email, adding users) will not be addressed via this form and instead should be handled through the facility administrator or sent to NHSN@cdc.gov. All requests will be processed in the order received.

NHSN Facility Administrator Reassignment

When the NHSN Facility Administrator role needs to be reassigned, the current Facility Administrator should follow the steps below to ensure that the role is properly reassigned to an additional facility user. Furthermore, facility users that no longer require access to NHSN can be deactivated by following the steps below. This process can be completed by any user with administrative rights.

Reassigning the NHSN Facility Administrator Role

From the left navigation bar, you will select Facility > Facility Info.
From the Edit Facility Information screen, go to the Contact Information sections.
Find “Facility Administrator” on the list and click the “reassign” button on the far right of the screen. You will be asked to find and select an existing user who will be reassigned this role. NOTE: The existing user must be assigned as a user with administrative rights. Once selected, remember to save the updated information on the Edit Facility Information page.

Reassigning the NHSN Facility Administrator Role [YouTube – 5 min]

Deactivating Users

Note: Users cannot be deleted once added to NHSN.
Select USERS on the left navigation bar, select FIND, and FIND again on the bottom of the screen. Select the user’s profile, go to EDIT, at the USER ACTIVE drop down, toggle to YES/NO>SAVE.

If the current NHSN Facility Administrator is no longer available, the incoming NHSN Facility Administrator should complete the form below to request the change in the absence of the current NHSN Facility Administrator.

How to Deactivate and Activate a User in the Facility [YouTube – 5 min]

Please contact NHSN@cdc.gov for additional support.

NHSN Facility Administrator Change Request Form

Form Approved
OMB No. 0920-0666
Exp. Date 12/31/22

Important Reminders for NHSN Facility Administrator

The NHSN Primary Facility Contact information must be updated in the NHSN application if the listed contact is no longer active at the facility.
NHSN users who are no longer active at the facility must be deactivated in the NHSN application to avoid unauthorized access to the facility data.

Please allow up to 5 business days for the change request to be verified and completed.
NHSN Email: NHSN@cdc.gov

All fields are required, unless marked optional.

Facility Name*

Facility Street Address*

City, State and Zip*

Date of Request*

(MM/DD/YYYY)

Facility OrgID(optional)

Facility CCN(optional)

(if applicable)

Current NHSN Facility Admin Name*

(FirstName, LastName)

Current NHSN Facility Admin Email*

Current NHSN Facility Admin Phone*

(xxx-xxx-xxxx)

New NHSN Facility Admin Name*

(FirstName, LastName)

New NHSN Facility Admin Email*

New NHSN Facility Admin Phone*

(xxx-xxx-xxxx)

Does New NHSN Facility Admins currently have SAMS access?(optional)

Is the currently listed NHSN Facility Administrator still active at the facility?*

Select one

If yes, please explain why the currently listed NHSN Facility Administrator is unable to make the reassignment(optional)

By checking the box below, you are certifying that you are an executive, director, or in a leadership role for the aforementioned facility. You also certify that all of the information provided above is true and correct to the best of your knowledge and that the NHSN Facility Administrator for the aforementioned NHSN facility should be reassigned by CDC as indicated above.*

I agree

Name*

(FirstName, LastName)

Job Title/Role*

Email*

Date*

(MM/DD/YYYY)

* Required field

Assurance of Confidentiality: The voluntarily provided information obtained in this surveillance system that would permit identification of any individual or institution is collected with a guarantee that it will be held in strict confidence, will be used only for the purposes stated, and will not otherwise be disclosed or released without the consent of the individual, or the institution in accordance with Sections 304, 306 and 308(d) of the Public Health Service Act (42 USC 242b, 242k, and 242m(d)).Public reporting burden of this collection of information is estimated to average less than 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC, Reports Clearance Officer, 1600 Clifton Rd., MS D-74, Atlanta, GA 30333, ATTN: PRA (0920-0666).

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