As legislative mandates for disclosure of data on health care–associated infections (HAIs) to the public escalate, with both economic and reputational implications for hospitals, the development of a valid national surveillance system has become imperative. Recent studies have identified interinstitutional variability of surveillance techniques. These inconsistencies affect the validity of publicly reported HAI data, which has as a primary goal the advancement of patient safety through the reduction of HAIs. The continued funding of state validation studies, the expansion of qualitative research to further assess interrater bias, the endorsement of educational materials to assist infection preventionists with application of National Healthcare Safety Network criteria, and the development of automated surveillance methods are all necessary to ensure a national HAI surveillance system that can be used for public reporting.