2026 SCHCHA Leadership Award Survey

IMPORTANT NOTE:
Deadline to Submit Nominations - October 26, 2026

Nomination Instructions
Please complete the nomination form below to nominate an individual you believe is deserving of this special recognition.

Please provide all requested information about the nominee.

Be specific when describing the nominee’s accomplishments, contributions, and impact. Do not include the nominee’s name or agency name in narrative responses. Nominations will be evaluated through a blind judging process.
Review all responses before submitting. Incomplete nominations will not be considered.
This survey cannot be saved and completed later. Please gather all necessary information before beginning.

Criteria for the Award
The nominee must be an administrator, director, clinical manager, or other senior leader in an upper-level management or administrative position who has worked in home care, home health, and/or hospice for a minimum of five years.

The nominee must demonstrate:

Excellence and commitment to job performance
A commitment to the industry through developing and leading internal agency committees, serving on SCHCHA committees, or participating in other industry-related committees
An interest in professional growth through continuing education
A commitment to the community through participation in community activities

Thank you for taking the time to recognize a deserving member of the SCHCHA community!

1.Nominator's Full Name(Required.)

2.Nominator's Agency(Required.)

3.Nominator's Email(Required.)

4.Nominator's Phone Number(Required.)

5.Nominee's Full Name(Required.)

6.Nominee's Agency Name(Required.)

7.Nominee's Title and Credentials(Required.)

8.Nominee's Email(Required.)

9.Nominee's Phone Number(Required.)

10.Number of Years Worked in Home Care, Home Health, and/or Hospice(Required.)

11.List the committees, subcommittees, task forces and/or commissions this individual has lead and/or developed either at their agency, SCHCHA, or other industry related organizations. (250 words or less)
Reminder: Do not use the nominee’s name or agency in your response.(Required.)

12.List the community activities, organizations, committees, boards, volunteer efforts, or other community initiatives in which this individual participates. Include a brief description of their involvement and contributions, where applicable. (250 words or less)
Reminder: Do not use the nominee’s name or agency in your response.(Required.)

13.Describe the efforts this individual has undertaken to enhance their professional growth and development. Include formal education, certifications, workshops, conferences, seminars, continuing education, and other professional development activities. (250 words or less)
Reminder: Do not use the nominee’s name or agency in your response.(Required.)

14.Describe how this individual has impacted and inspired his/her team. (250 words or less)
Reminder: Do not use the nominee’s name or agency in your response.(Required.)

15.Please provide a narrative illustrating how this individual demonstrates excellence, accountability, compassion, integrity, and commitment to job performance and/or patient care. Include specific examples of the nominee’s innovation, leadership, and contributions. You may also describe the nominee’s impact in areas such as agency financial performance, new ideas or programs, cost savings, client/patient satisfaction, employee satisfaction, mentoring, or other meaningful accomplishments.(250 words or less)
Reminder: Do not use the nominee’s name or agency in your response.(Required.)