Compensation Opt-Out

Please fill out this form if you are not interested in receiving the $6,000 dollar compensation. This is available to eligible nursing homes participating in the National Nursing Home Covid-19 Action Network (NNHCAN) 16-week sessions. If you do NOT want to opt-out and would like to receive the 6,000 compensation, please visit the following form https://app.smartsheet.com/b/form/90193d6102de445fa5a7c29279da544d to start your request. Please refer to the compensation checklist found here https://iecho.unm.edu/sites/nh_unm1/download.hns?i=218. If you have any questions please feel reach out to ECHONursingHome@salud.unm.edu

Please type in your Facility name in this drop-down. If your facility is the same name as another the city has been added.

Select or enter value
Caret IconCaret symbol

By clicking this checkbox you are confirming that you do NOT want to receive the $6,000 compensation.

Can you please provide a brief reason you have decided to opt-out of receiving compensation for your participation in the National Nursing Home Covid-19 Action Network?

Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse