• Facilities are eligible to submit an upgrade application within one year of their original designation. For example, if a facility applied at the March 1, 2023 deadline and received their designation in May 2023, they may apply for an upgrade at the September 1, 2023 deadline or the March 1, 2024 deadline.  
• Because documentation requirements changed for the September 1, 2023 deadline, application documentation requirements for upgrade will be different based on when the initial application was completed. 
• Please reference the checklists below to ensure you upload the correct documents.  
• Please also refer to the Application Upgrade and​ Renewa​l Timeline​​. 
  

Required Documentation Based on Original Application Submission Period

• Upgrade from Bronze to Silver/Gold Requirements 
• ​​Within Online Application:  
• Leadership 2: Attest to facility leadership support for time and personnel 
• Leadership 3: Attest to facility leadership support for resources 
• Upload Documentation:  
• Action 2: Prospective audit and feedback for specific antibiotic agents 
• Action 3: One additional guideline 
• Tracking 2: Antibiotic use (e.g. Days of therapy (DOT)/1000 patient days) 
• Tracking 3: Prospective audit and feedback interventions by types AND acceptance 
• Tracking 4:  Adherence to facility-specific evidence-based treatment guidelines  
• Education 1: Competency based training 
• Education 2: Education to prescribers as part of the prospective audit and feedback process 
• Part III: Demonstration of Outcomes 
• Part IV: Community Engagement (only if upgrading to Gold) 
• Upgrade from Silver to Gold Requirements 
  
• Part IV: Community Engagement

Original Application September 2023 and Later