Reporting antimicrobial use (AU) and antimicrobial resistance (AR) data to the National Healthcare Safety Network (NHSN) enables the Centers for Disease Control and Prevention (CDC) to better understand and benchmark antimicrobial use in the nation’s hospitals, track and identify potential antimicrobial resistance emergence, and drive national progress on minimizing antimicrobial resistance.
Why is AUR reporting critical?
This data helps institutions benchmark their use of antimicrobials against peer hospitals, uncovering areas where they overuse or underuse these important medications. Beyond internal improvements, AUR reporting data also helps track resistance patterns across the U.S. This nationwide data pool equips the CDC and other public health bodies to spot emerging threats and develop strategies to combat AR, preserving the effectiveness of life-saving antibiotics for future generations.
Another major benefit of AUR reporting data from your hospital is the provision of a standardized antimicrobial administration ratio (SAAR). At a high level, SAAR benchmarks your antimicrobial use against other hospitals submitting AU data to NHSN, using advanced statistical methodology to account for the hospital’s unique characteristics, such as location, hospital size, types of patients served, the proportion of beds dedicated to intensive care, etc. Pharmacists can leverage SAARs to better understand how their observed antimicrobial use differs from the predicted usage, and identify areas of strength and improvements.
What are CMS reporting requirements?
For U.S. healthcare organizations, AUR reporting is increasingly tied to compliance and financial performance. The Centers for Medicare & Medicaid Services (CMS) has incorporated AUR reporting into its Promoting Interoperability Program. This initiative is designed to encourage hospitals to share data that improves patient safety and public health monitoring.
Hospitals participating in CMS reimbursement programs are strongly incentivized to submit AUR data. Those that fail to comply with reporting requirements risk substantial financial penalties, including significant reductions in reimbursement rates. On the other hand, meeting these reporting benchmarks can earn hospitals additional points toward program compliance, directly affecting reimbursements and operational budgets.
Is NHSN AUR reporting required?
AUR reporting was originally voluntary through the NHSN for several years, Centers for CMS programs like Promoting Interoperability are beginning to require AUR reporting. Joint Commission has been auditing components of antimicrobial stewardship (AMS) for several years and require AMS programs to track antimicrobial use using Days of Therapy (DOT) or AU reporting in surveys as a required element of performance beginning in January 2023.
In 2025, the Promoting Interoperability program separated the AUR measures into AU and AR, respectively. Hospitals that were previously exempted from AUR submissions due to lacking electronic lab system will be required to submit AU data.
By meeting these NHSN and Joint Commission requirements, hospitals not only strengthen their clinical practices but also build a strong case for ongoing accreditation and prepare for greater regulatory expectations in the future.
Based on historical data, financial adjustments have been:
- Hospitals that do not meet mandatory reporting risk a 75% reduction in the annual rate increase approved under the inpatient prospective payment system rules
- Critical Access Hospitals risk a 1% reduction in their Medicare payment reimbursements for non-compliance.
Beyond compliance: A global imperative
The importance of AUR reporting extends far beyond meeting regulatory standards. Antimicrobial resistance is a global crisis, with resistant infections causing thousands of deaths each year. Every hospital submitting AUR data contributes to a clearer understanding of how resistance develops and spreads. These insights drive innovations in treatment, identify high-risk trends, and enable more effective interventions to curb AMR’s impact.
For individual hospitals, actively engaging in AUR reporting leads to meaningful change. Frontline healthcare providers, such as pharmacists, can use this data to design AMS interventions that prevent resistance while ensuring patients receive optimal care. The ability to monitor, adjust, and improve local practices has far-reaching consequences—not just for the hospital but for the larger community.
How to prepare for AUR reporting updates
Updates happen quickly in this space. Pharmacy teams recently took steps to prepare for AUR reporting updates with NHSN (Jan 2023) and CMS (Jan 2024). If you don’t have a pharmacy surveillance solution that allows for seamless reporting to NHSN, we strongly urge you to consider one. Many pharmacy teams will attempt to gather and submit this data themselves, but the complex reporting and submission process makes this difficult. Consider a solution that automatically gathers and calculates the data and allows for one-click submission to the NHSN.
Simplifying AUR reporting with trusted tools
Solutions like Sentri7 AUR Reporting enable hospitals to seamlessly report AUR data to support Antimicrobial Stewardship requirements for the Joint Commission, CMS reimbursement opportunities, and NHSN reporting.
An ONC-certified solution like Sentri7 automates the gathering, calculation, and submission of AUR data, significantly reducing the administrative burden on pharmacy and IT teams. With built-in analytics, these tools also provide hospitals with visual dashboards that make it easier to spot trends and evaluate SAARs, allowing teams to act quickly and effectively to improve antimicrobial use.