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NHSN weekly resident vaccination reporting for nursing homes

Short answer: every Medicare or Medicaid nursing home reports to CDC's National Healthcare Safety Network (NHSN) each week. The report covers the residents in the building, how many are vaccinated against COVID-19, flu and RSV, and how many tested positive or went to the hospital. It is one form, the Weekly Respiratory Pathogens and Vaccination Summary for residents (CDC 57.218). The week runs Monday to Sunday. You can type the numbers in or upload a CSV file. The report is counts only, never names.

Updated October 22, 2026 · Checked against the official sources listed at the end

Who has to report, and what

The rule is 42 CFR 483.80(g). Since January 1, 2025, long-term care facilities must report COVID-19, influenza and RSV information to NHSN, in the format and as often as the Secretary sets. CMS's memo QSO-25-11-NH lists the data: facility census, resident vaccination status for COVID-19, flu and RSV, confirmed resident cases (overall and by vaccination status), and hospitalized residents with confirmed cases.

CDC's 2026 protocol asks for the data each week. As of October 2026 that weekly duty is still in place. Check CMS's memos if you hear it has changed, since the rule has been revised more than once since 2020.

This is separate from the resident chart. Under 483.80(d), the chart still has to show the education, the offer and the result for each resident. NHSN only gets the totals.

Keeping resident vaccine records in a spreadsheet? Pact tracks every resident's flu, pneumococcal, COVID-19 and RSV education, offer and outcome, shows who's due, and makes your NHSN upload files. $2 per certified bed a month, added to staff tracking. Pact signs a BAA before the first resident is added. Resident immunization tracking · Staff files · Get my price

The reporting week and the count

A reporting week is Monday through Sunday. You pick the week in NHSN and enter that week's numbers. You can go back and edit a week later. New data for a week you already entered replaces what was there.

The denominator is every resident who occupied a bed for at least one day (at least 24 hours) during the week. Count each resident once, even if they left and came back. If no residents fall in a category, enter 0. NHSN won't save the form with a required field blank.

Question 1: residents in the building that week (the denominator).
Questions 2a to 2c: how many of them are up to date on COVID-19, have this season's flu vaccine, and have had an RSV vaccine.
Questions 3 and 4: new positive tests and hospitalizations for COVID-19, flu and RSV, each with the number who were vaccinated.
Question 5: treatments (therapeutics). Optional, added in March 2026.

What counts as proof of a shot given elsewhere

A resident who got a shot before admission or at a pharmacy can count as vaccinated, but only with written proof. CDC says the record should show the date, the place and the vaccine type. A verbal statement isn't enough to count a shot given outside the facility.

For NHSN's counts, a resident can state a medical reason or a refusal of the COVID-19 vaccine verbally. Your own chart rules are stricter: F883 and your policy still expect the refusal or contraindication documented in the medical record. Many homes keep a signed declination.

Three ways to get the numbers into NHSN

Type them in: open the week on the RPV residents form and enter each count.
Upload a CSV file: one row per facility per week, in CDC's template. This is the fastest way if your numbers come out of a spreadsheet or a tracking tool.
Use NHSN's optional person-level vaccination form: enter each resident, and NHSN adds up the weekly totals for you. It means typing resident names and dates into NHSN, and the case and hospital questions still go in the weekly summary.

How the RPV CSV upload works

CDC posts the resident template on its long-term care pages. The current one is release 14.1 (March 2026), with 35 columns in a set order, starting with orgid, survweekstart and survweekend. CDC's file layout document gives the rules for each column.

Upload steps, from CDC's instructions: in NHSN, go to Respiratory Pathogens and Vaccination, then RPV Residents (CDC's newer guide calls the page RPV Summary, RPV: Residents). Use Upload CSV at the bottom of the page, choose the file and upload. Read the message NHSN shows. It tells you which row or column it rejected and why.

Dates are the Monday start and the Sunday end of the week.
orgid is only needed when a group uploads for several facilities. A single home can leave it out.
The required counts must be there, even when they are 0.
A vaccinated count can't be more than its parent count. Example: residents with a positive flu test who had the flu vaccine can't be more than residents with a positive flu test.
No resident names go in the file. It is totals only.

Mistakes that cost time

Counting a resident twice after a hospital stay. The denominator counts each person once per week.
Counting a shot given elsewhere with no written record. Without proof, NHSN counts that resident as not vaccinated.
Using last season's flu shot. The flu count is the current season's vaccine.
Missing weeks. Put a weekly reminder on one person's calendar and name a backup.
A spreadsheet that drifts from the chart. AHCA's advice is to check any separate log against the resident's medical record regularly.

How Pact helps

Pact's resident immunization tracking keeps each resident's flu, pneumococcal, COVID-19 and RSV education, offer and outcome. From those records it fills in the week's counts for questions 1 and 2a to 2c. You type the week's positive tests and hospitalizations, which Pact doesn't keep. Pact checks NHSN's rules (required counts, sub-counts no bigger than their parent) and makes the CSV in CDC's template, with no names in it.

You download the file and upload it in NHSN yourself. Pact doesn't submit to NHSN for you and doesn't work for CDC or CMS. Resident tracking is $2 per certified bed a month, added to staff tracking, and Pact signs a business associate agreement (BAA) with your home before the first resident is added.

Common questions

Is weekly NHSN reporting still required for nursing homes?

Yes, as of October 2026. 42 CFR 483.80(g) requires long-term care facilities to report COVID-19, flu and RSV data to NHSN, and CDC's 2026 protocol asks for it weekly. CMS has changed these rules before, so watch CMS's memos to states.

What days does an NHSN reporting week cover?

Monday through Sunday. Count every resident who occupied a bed for at least one day (24 hours) that week, once each.

Can a single nursing home upload a CSV file?

Yes. The weekly resident summary can be entered by hand or uploaded as a CSV file in CDC's template. The orgid column is only needed when a group uploads for several facilities.

Do resident names go to NHSN?

Not in the weekly summary. It is counts only. NHSN's optional person-level form does take each resident's details, and NHSN adds up the totals from them.

Does a verbal report of an outside flu shot count?

Not for NHSN. A shot given outside the facility needs a written record with the date, the place and the vaccine type. Without it, the resident isn't counted as vaccinated.

Does Pact send our report to NHSN?

No. Pact makes the weekly file from your resident records and the numbers you type in. You upload it in NHSN yourself, with your own NHSN login.

Sources

Related guides

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