To enhance information sharing, GNYHA has arranged with the New York State Department of Health (DOH) to make visible key data elements from the Critical Asset Survey (CAS) in GNYHA’s Sit Stat platform. All New York State hospitals are expected to update the CAS at least semiannually and upon changes to assets noted in the survey. Incorporation of key CAS data elements into Sit Stat will improve data alignment and enhance the completeness of facility data in Sit Stat without additional data entry burdens on facilities.

Hospitals and health systems that participate in Sit Stat are required to complete this form to permit GNYHA to access and display the identified CAS data elements for their respective facility. GNYHA has shared the list of CAS data elements to be included in the Sit Stat platform. Hospitals and health systems are encouraged to review said list before submitting this form. We ask that participating hospitals and health systems submit this form by July 30.

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* 1. Permission Statement: 
By checking the box below, my organization consents to NYS DOH providing responses from the HERDS Critical Asset Survey (CAS) to GNYHA for the purpose of GNYHA displaying certain of the responses within its Sit Stat system. I acknowledge that selection of the particular data to display will be at the discretion of GNYHA and in collaboration with its Sit Stat Advisory Council, which consists of members participating in the Sit Stat program.

I understand my organization's responses will be visible in the Sit Stat system to all participating organizations, including other hospitals and key response agencies, but no patient-level data is shared. I also understand that updates to data elements sourced via the CAS can NOT be updated in Sit Stat. Any updates for my facility to CAS data elements must be provided directly within the NYS DOH HERDS CAS survey, in the Health Commerce System. GNYHA will request periodic data reports from NYS DOH in order to ensure data in Sit Stat is up to date.

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* 2. Facility Signatory Information

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