2022 Staff Recognition Program Nomination

Winners will be honored at our Annual Convention and Trade Show on Friday, September 30, 2022.

The 2022 Staff Recognition Program is here again and this is a way for you to honor your staff and volunteers. Our yearly awards ceremony is just a small way of honoring some of the great men and women who care for the elders of our great state! The time taken from your busy schedules to fill out this nomination is very much appreciated.

2022 RULES:

- You MUST be a member facility and current on your dues.
- At least one person from your facility MUST register for the convention and trade show.
- Facilities may only nominate one person per category.
- Each nominee must have been employed at the member home for at least one year at the time of nomination.
- Previous award winners are not eligible for re-nomination.
- KHCA/KCAL Committees will review all nominations and make a selection.
- Category winners will be recognized during the Staff Recognition Award Luncheon at the Annual Convention and Trade Show on Friday, September 30, 2022, in Mulvane, KS. (Details on the ceremony, seating arrangement and cost of extra lunch tickets will be provided closer to the event.)
- Due to time constraints during the recognition luncheon, we will be unable to individually recognize the list of Honorable Mention nominees. However, they will be mailed a Certificate of Recognition in the days following the conference.

NOMINATION DEADLINE: Friday, August 26, 2022

NOMINATING CRITERIA: The goal is to select individuals who are compassionate and caring when dealing with residents, their families, and staff.

These nominees should show dedication and enthusiasm, as well as innovation in the delivery of services in the long term care setting. There is no right or wrong way to do this – just tell their story. Include contributions to the overall facility, anecdotes on how they improve the quality of life of the residents, and examples of how they elevate the profession of long term care.

Question Title

* 1. Mark the type of Home or Community the nominee is with.

Assisted Living

Home Plus

Skilled Nursing

Residential Healthcare

Name of the Home or Community

Question Title

* 2. Choose the category you wish to nominate. Facilities may only nominate ONE person PER CATEGORY. Each nominee must have been employed at the member home for at least one year at the time of the nomination.

Activity Professional

Volunteer

Nurse Aide - CNA or CMA

Support Staff

Social Worker/SSD

Food Service Employee

Environmental Service Worker

DON/ADON of the Year

Administrator

Charge Nurse/MDS Nurse

Assisted Living Operator

Assisted Living Worker

Assisted Living Nurse/RCC

Question Title

* 3. Important Note: Homes will receive a confirmation when nominations are received, as well as if their nominee is an honorable mention. Also, homes will receive a phone call if their nominee has been selected as one of the category winners. Please be sure to list a valid e-mail address and a valid phone number for the nominator when filling out the forms.

Name of Nominee

Home or Community Name

Address, City and Zip

Telephone

Administrator

Administrator's Email Address

Facility Contact

Facility Contact Email Address

Nominator (if different from above)

Nominator's Email Address

Question Title

* 4. In 250 words or less, please tell us about your nominee!

Question Title

* 5. Please attach a picture of the nominee, if you have one available, but if you don't we will contact them at a later date. Thank you!

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