Superior Health Quality Alliance Program Assessment

Superior Health Quality Alliance requests your answers to the following questions so we can tailor our activities and assistance to best meet your organization’s needs. On average, this questionnaire takes approximately 20-25 minutes and should be completed in one sitting.

Please answer the questions completely to the best of your ability.

• If a question does not apply to your organization, choose "not applicable".
• If you are unsure of an answer but can confirm it with other staff at your organization or make an educated guess, please answer to the best of your ability. If you are unable to answer a question, you may skip it.
• Because responses cannot be saved if you close your browser window, we recommend reviewing the questions before you begin. Please refer to the Question Preview File linked in the email to preview the questions.

Questions may be completed as a team or an individual can respond on behalf of the organization. If you complete the questionnaire as a team, please provide contact information for the most appropriate individual. A copy of your responses will be emailed to you after you submit the form. Superior Health Quality Alliance may reach out to your organization to learn more or offer specific resources or support based on your responses. However, we will NOT share identifying information about you or your organization with CMS or other participants.

Some questions refer to “patients” and “residents.” Please answer based on the population you serve, even if you do not refer to them as “patients” or “residents.” 

Again, if you have any questions or concerns before you begin, please contact info@superiorhealthqa.org.