Enroll in the Superior Health Quality Alliance Nursing Home COVID-19 ECHO

Superior Health Quality Alliance (Superior Health) is offering a virtual TeleECHO series to support Nursing Homes across Michigan and Wisconsin in the adoption of evidence-based quality improvement processes to achieve positive outcomes related to management of Coronavirus Disease 2019 (COVID-19). Throughout the TeleECHO series, Superior Health will train and support nursing home staff on best practices for protecting patients, staff and visitors from deadly coronavirus infection and spread.

1. In which states do you provide services? *This question is required.

2. Please indicate your organization's name: *This question is required.

3. Please indicate your CMS Certification Number (CCN) *This question is required. This question requires a valid number format.

4. Have you previously participated with the Superior Health Quality Alliance ECHO Program?
*This question is required.(Cohort 1 and 2 began November 2020, Cohort 3 began February 2021)

5. Please identify a primary contact who we should follow up with regarding any questions or next steps. *This question is required.

First Name

Last Name

Phone Number

Email Address

6. If different than the primary contact, please indicate contact information for the facility administrator.

First Name

Last Name

Phone Number

Email Address