Thank you for watching this 5-minute informational video. Please complete the following attestation and polling questions to ensure credit for completing this mandatory task. Please refer to the Project Notification Letter instructions emailed to your facility on Friday January 20, 2017 for additional tasks to be completed.

* 1. Please enter your facility name.

* 2. Please enter your 6-digit CMS certification facility provider number  (begins with 45 or 67).

* 3. Please enter your first name.

* 4. Please enter your last name.

* 5. Please enter your email address.

* 6. This 5-Minute Video met the stated objectives.

* 7. This 5-Minute Video gave me a quick overview on the functionality of the Monthly Report

* 8. This 5-Minute Video will be helpful finding the project resources posted on the website under the Quality Improvement Activities section

* 9. By completing this survey I attest that I watched the 5-Minute Video (enter date of completion)


* 10. I understand the implementation of the CMS Watchlist

* 11. Please share any additional questions, concerns or comments here. Also, feel free to contact the Network directly for further assistance.