Kristy Schmidt Looks like we are all thinking along the same lines. Our CHC did the same 2 years ago. One year after becoming an FQHC and growing, we definitely saw the need to have middle managers more engaged. We developed what we call a Joint Leadership Team. Once per month for 90 min this group meets with Senior Leadership. We have a standing agenda then add agenda items as needed. We engage them by teaching them more about the clinic. Agenda items include: deep dive into monthly financials; updates on strategic plan / goals; Quality updates; other training on policy development. We spent several months reviewing a few chapters of the OSV & Compliance Guide to help them be better prepared for the OSV site visit. Some of the challenges we encountered early on what how they disseminate information to their depts/associates as it was not being done. We had to set clear expectations and this seemed to help.