Submitted by CDC_DSMH_WG on
CDC's comment for inclusion in USCDI v7
a. National Ambulatory Medical Care Survey (NAMCS) Health Center Component samples all care delivery sites under the sampled health center. To increase NAMCS quality control it would be helpful to receive Facility Managing Organization Identifier. As NAMCS grows, a Facility Managing Organization Identifier would help ensure that data is correctly linked to the specific facility and decrease risk for data loss and duplication. National Hospital Care Survey relies on hospitals to submit data and hospitals can contain non-sampled facilities (e.g., Federally Qualified Health Centers, primary care practices, etc.). In this context, having detailed facility information is essential for the unique identification of each facility. Additionally, an important goal of the National Health Care Surveys data modernization effort is to reduce redundancy and reporting burden. To that end, DHCS is collaborating with CDC other programs to repurpose data that is already being collected from ambulatory and hospital-based settings. This requires linking to other existing data sets using unique IDs such as Facility Managing Organization ID. The unique facility identifiers increases accurate and reliability in the matching process, resulting in improved data quality available for decision making. Having these unique IDs will also be critical as the National Health Care Surveys explore leveraging the TEFCA framework to facilitate interoperability with QHINS which require patient and organizational matching across the complex health care ecosystem. In summary, having critical IDs results in overall cost savings in the health care and public health ecosystem while potentially improving patient outcomes.
b. Location of data element in the current HCS CDA IG V1.2: x-path /ClinicalDocument/documentationOf/serviceEvent/performer/assignedEntity/id
c. This data element is in C-CDA 4.0. Link in the C-CDA IG- https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html
d. Description of what DHCS currently receives in production: Nothing is available currently.
Submitted by CDC_DSMH_WG on
CDC comments for draft USCDI v8
CDC recommends the inclusion of facility managing organization identifier in draft USCDI v8.
Justification: While Facility Identifier is in USCDI V7.0 it is profiled in the US Core Location Profile and not the organization profile. The US Core Location Profile specifies the facility or physical service location itself and not necessarily the organization that manages/owns a facility. US Core describes it as the “Unique business identifier for facility or location.” Having Facility Identifier in USCDI v7 does not, by itself, imply that you will receive the facility’s managing organization or its identifier.
National Ambulatory Medical Care Survey (NAMCS) Health Center Component samples all care delivery sites under the sampled health center. To increase NAMCS quality control it would be helpful to receive Facility Managing Organization Identifier which may be different than the facility identifier, due to the varying physical locations of delivery sites under the sampled health center. In 2025, NAMCS received data from 85 health centers (for the NAMCS-Health Center Component) and over 110,000 clinical care providers (for the NAMCS- Provider Visit Component).[M(1] [CN2] [CN3] As NAMCS grows, a Facility Managing Organization Identifier would help ensure that data is correctly linked to the specific facility and decrease risk for data loss and duplication. For example, one sampled health center can have over 100 different delivery sites, in locations that can cross state lines. Therefore, it is important to have an overarching managing organization identifier that represents the higher-level organization and can be associated with all of its individual facilities.
National Hospital Care Survey relies on hospitals to submit data and hospitals can contain non-sampled facilities (e.g., Federally Qualified Health Centers, primary care practices, etc.). In this context, having detailed facility information to include facility ID and Facility Managing Organization IDis essential for the unique identification of each facility and its managing organization. For example, an individual hospital may be part of a larger health system or hospital network. For example, MedStar Health operates multiple hospitals, including MedStar Montgomery Medical Center, MedStar Southern Maryland Hospital Center, and MedStar Union Memorial Hospital. While each hospital is a distinct facility, they are part of the broader MedStar Health system. Capturing the Facility Management Organization ID is therefore important because it enables the survey to identify and associate individual hospitals with the overarching organization responsible for managing them. This organizational relationship can support more accurate reporting and analysis when data are collected or aggregated at the health-system level rather than solely at the individual facility level. Currently the National Hospital Care Survey receives data from 27 hospitals, and these numbers may continue to grow in the future.
Linkage to other CDC Program Data: Additionally, an important goal of the NHCS data modernization effort is to reduce redundancy and reporting burden. To that end, the Division of Health Care Statistics (DHCS) is collaborating with other CDC programs including the National Hospital Safety Network (NHSN) to repurpose data that is already being collected from hospital-based settings. This requires linking to other existing data sets using unique IDs such as Facility Managing Organization ID. The unique facility identifiers increase accurate and reliability in the matching process, resulting in improved data quality available for decision making while reducing burden on health care providers and EHR vendors.
TEFCA: Having these unique IDs will also be critical as the NHCS explore leveraging the TEFCA framework to facilitate interoperability with QHINS which require patient and organizational matching across the complex health care ecosystem. In summary, having critical IDs results in overall cost savings in the health care and public health ecosystem while potentially improving patient outcomes.
Location of data element in the current HCS CDA IG V1.2: x-path /ClinicalDocument/documentationOf/serviceEvent/performer/assignedEntity/id
This data element is in C-CDA 4.0. Link in the C-CDA IG- https://hl7.org/cda/us/ccda/StructureDefinition-USRealmHeader.html
Description of what CDC currently receives in production: Nothing is available currently.