Address:
10500 Little Patuxent Parkway
Suite 210
Columbia, MD 21044
Email:
programs@paltcfoundation.org
Phone: 410-992-3134
  • 1 Current: Applicant's Information
  • 2 Project Information
  • 3 Complete
*Required
You may nominate a facility for the 2020 QIHO Award by completing the information requested below. Nominations for the 2020 QIHO Award are due November 11, 2019
Please list credentials separated by commas.
Please upload a current copy of the State/Federal Survey results for the institution/facility in one of the following file formats: doc, .docxpdftxt.
One file only.
128 MB limit.
Allowed types: txt rtf pdf doc docx odt ppt pptx odp xls xlsx ods.
Address
Attendance
I understand that a facility representative must be in attendance at an upcoming AMDA-Society for Post-Acute and Long-Term Care Medicine annual convention to receive the award and present their program at a session.