First Name
Last Name
Company Name
Functional Role
ADNS/ADON
Clinical Consultant
Corporate Clinical Director
Dietitian
DNS/DON
Executive Director/Administrator
Health Information Specialist
Infection Preventionist
LTC Service Provider/Vendor
Nurse Assessment Coordinator/MDS Coordinator
Nurse Consultant
Occupational Therapist
Other
Other MDS/RAI Professional
Other Nurse Executive
Physical Therapist
Quality Improvement Professional
Rehabilitation Nurse
Reimbursement Specialist/Corporate Consultant
Social Worker
Speech Therapist
Staff Development Educator
Staff Nurse
Email
*
Work Phone
Number of Members for Organizational Membership
1
2-9
10+
Number of Facilities per Organizational Member
One Facility
Multiple Facilities