Author Contributions: Dr Schaefer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Schaefer, Jhung, Dahl, Patel, Bolyard, Sehulster, Perz.
Acquisition of data: Jhung, Dahl, Schillie, Simpson, Llata.
Analysis and interpretation of data: Schaefer, Simpson, Link-Gelles, Sinkowitz-Cochran, Srinivasan, Perz.
Drafting of the manuscript: Schaefer, Jhung, Perz.
Critical revision of the manuscript for important intellectual content: Schaefer, Jhung, Dahl, Schillie, Simpson, Llata, Link-Gelles, Sinkowitz-Cochran, Patel, Bolyard, Sehulster, Srinivasan, Perz.
Statistical analysis: Schaefer, Link-Gelles.
Administrative, technical, or material support: Dahl, Schillie, Simpson, Llata, Sinkowitz-Cochran, Sehulster, Perz.
Study supervision: Jhung, Dahl, Perz.
Financial Disclosures: Dr Schillie reported owning stock in Pfizer, Eli Lilly, Monsanto, General Electric, and Walgreens. No other disclosures were reported.
Funding/Support: Funding for the pilot ASC inspections was provided by the Centers for Medicare & Medicaid Services.
Role of the Sponsor: The Centers for Medicare & Medicaid Services reviewed and approved the use of its data for this work and approved submission of the manuscript. Representatives from CMS are listed as coauthors and their individual contributions are previously noted.
Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention or the Centers for Medicare & Medicaid Services.
Previous Presentation: This study was presented in part at the Fifth Decennial International Conference on Healthcare-Associated Infections; March 21, 2010; Atlanta, Georgia.
Additional Contributions: We thank state surveyors from Maryland, North Carolina, and Oklahoma who conducted the pilot inspections and without whom this study would not have been possible. Pilot inspections were conducted as part of the state surveyors' usual job duties. They did not receive additional compensation for their contributions. Angela Mason-Elbert, MS, JD (Centers for Medicare & Medicaid Services), assisted with design of the pilot, and Karen Hoffman, RN, MS, CIC (North Carolina Statewide Program for Infection Control and Epidemiology); Laura Polakowski, MD, MSPH (Centers for Disease Control and Prevention); and Emily Piercefield, MD, DVM (Centers for Disease Control and Prevention), provided infection control assistance in the ASC inspections. None of these individuals received compensation for their contributions.