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ECHO (Extension for Community Healthcare Outcomes) is a collaborative model of medical education and care management that uses telemedicine to empower clinicians. Inter-disciplinary specialists mentor and share their expertise across a virtual network via case-based learning, enabling primary care clinicians to treat patients with complex conditions in their own communities. University of Rochester has developed and implemented an innovated an ECHO program for nursing homes. The mission of ECHO is to educate nursing home staff by presenting challenging patient cases along with educational sessions. Clinics occur two times a week and participants are given a baseline survey of their knowledge followed by a 6 month follow-up survey. 55 patient cases and 4 follow up cases have been presented. The ECHO project covers 13 rural and urban counties and enrolled 52 nursing homes. Over the past year 1,888 staff participated and 614 CME credits awarded within the past year. Since this is a new program, evaluation data is critical to fine-tuning the curriculum to ensure it meets the needs of the nursing homes. Preliminary evaluations indicate high staff satisfaction with ECHO. Post surveys found gaps in knowledge and use of non-pharmacological approaches (e.g., sensory rooms, music therapy, doll therapy) to treat difficult behaviors and lack of appropriate staff training on how to handle behavior problems. The initial evaluation data provide strong evidence for the feasibility of applying the ECHO model to nursing homes. Next steps include the development and dissemination of a novel curriculum on behavioral problems tailored to nursing homes.