Annual IHCA Excellence Awards Program. Staff & Specialty Award Program Details. Before you submit your nominations:

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1 Annual IHCA Excellence Awards Program NOMINATIONS The Annual IHCA Excellence Awards Program (formerly the Annual IHCA Awards) recognizes the outstanding work going on in long term care centers around Illinois every day. Recognizing your staff members and volunteers who have proven to be an invaluable resource to your center s team is an excellent way to show your appreciation. The IHCA Staff & Specialty Awards gives members the chance to do that. Additionally, you can submit nominations for your center s innovative programs, communications and community outreach projects. *Note: If you have nurses you would like to nominate for an award, please do so by nominating them for an LTCNA Nursing Award. More details about that program available later in the year. The information in this nomination packet pertains only to the IHCA Staff & Specialty Awards. Staff & Specialty Award Program Details Each member center office that submits a nomination(s) must designate ONE contact for all of their nominations. Winners of the IHCA Staff & Specialty Awards will be announced during National Skilled Nursing Care Week (formerly National Nursing Home Week), May 13-19, 2018, and each award will be presented to the winner at their facility by a member of the IHCA staff and/or Board of Directors. All nominees will receive a certificate recognizing their achievement. Facilities are welcomed (and encouraged!!) to submit multiple nominations. A list of nominees, as well as information about the chosen winners, will be featured in IHCA publications, on our website and/or social media pages. Press releases will be sent to local media outlets announcing the winners. Before you submit your nominations: Visit for more information. Did you know that you can submit your nominations online? Click here to access the online form. Some of the Rules & Procedures have changed, so please read them carefully. Please note specifically: o A photo of each nominee is nominee is no longer required for IHCA Staff & Specialty Award Nominees. o A letter of recommendation is no longer required for most categories. For those categories that do not require it, you may still submit one if you choose, but no more than two (2) will be accepted. Please read the instructions on the nomination form carefully. Have you included all of the required materials (i.e. Nomination form, the Award Category form, answers to the category questions, supporting materials if applicable, etc.)? If submitting a Photo of the Year nomination, did you include a signed release form for any/all residents in the photo(s)? If you have any questions, please contact Ashley Caldwell at acaldwell@ihca.com or

2 Award Categories The criteria for the following nominations are based on excellence and outstanding service in long term care. Staff Awards Administration: Administrator Assisted/Supportive Living Director Employees: Social Service Professional Activity Professional Specialty Awards Associate Member Community Partnership Innovative Program Media Event Communication Photograph Volunteer Award Housekeeping Professional Food Service/Dietary Professional Environmental Services Professional Business Office Professional Administrator s Choice Award (for nominees who do not fit into other categories) Award Nomination Rules & Procedures 1. Designated Contact: Each member center must choose one person to serve as the designated contact. All follow-up correspondence, award information, nomination questions, etc. will be sent to the Designated Contact. 2. The Designated Contact must be included on each nomination. 3. The nominee must be an employee (volunteer for volunteer award) of an IHCA member center. Associate member nominees must be a current member of IHCA and provide goods/services to IHCA member centers. 4. Member centers are encouraged to submit multiple nominations. 5. You may submit multiple nominations for each category. 6. Each entry should include: a. A completed Nomination Form; b. A completed Award Category Form (Administration, Employee, Volunteer, etc.) with answers to that category s set of questions; and, c. Any required supporting materials. 7. You may submit your nominations online. If submitting hard copies, please make sure that all forms are printed legibly or typed. 8. Letters of recommendation for employee, volunteer and associate member nominations (optional for most categories, no more than two will be accepted) or supporting news clippings and/or documentation for specialty award nominations should be attached accordingly and will not be returned. 9. Please try to avoid using the Nominee s name or the name of the facility as much as possible in the answers to the category questions and in the letter(s) of recommendation. It will make it easier to prepare the forms for the judges. 10. Winners will be chosen by a panel of judges selected by IHCA. IHCA reserves the right not to present any award. 11. Award winners will be announced during National Skilled Nursing Care Week (formerly National Nursing Home Week). All nominees will receive a certificate of recognition. Submission Deadline Nominations must be received no later than close of business on Friday, March 23, 2018 to be considered. Send to: Attn: Ashley Caldwell Fax to: (217) Illinois Health Care Association to: acaldwell@ihca.com 1029 South 4 th Street Springfield, IL 62703

3 Nomination Form This form must be submitted with each nomination. These forms are only for the IHCA Staff & Specialty Awards. Choose one of the following categories to submit your nomination. A category must be checked for the nomination to be considered. An award category form with the responses to each category s questions should be included with this form. There is no limit to the number of nominees accepted from each facility. Administrator Assisted Living Director Food Service/Dietary Professional Housekeeping Professional Environmental Services Professional Social Service Professional Business Office Professional Activity Professional Administrator s Choice Award Associate Member Community Partnership Innovative Program Media Event Volunteer Publication Photograph Designated Contact Contact Name & Title Contact Address IHCA Member Center/Program Center Address City/State/Zip Telephone ( ) Fax ( ) Nominee Information Nominee s Name: **If different from above please fill in the following: IHCA Member Center/Program Center Address City/State/Zip Telephone ( ) Fax ( ) Local Media Information Please list 2 media outlets (newspaper, radio, television) you would like to have notified if your nominee is a winner: Media Name Fax ( ) Media Name Fax ( ) - 3 -

4 ADMINISTRATION AWARDS Administrator (Check One Category per Form) Assisted Living Director Each entry must include the following items in order to be considered: 2. Typed answers to the questions below. 3. Two letters from department heads or staff members outlining why the individual should be selected (500-word limit per letter). No more than two (2) letters will be accepted. 1. How long has the nominee worked in the long term care profession? 2. How long has the nominee worked at this facility? 3. How many beds does the nominee s facility have? 4. What has the nominee done to enhance the relationship between the facility and the community? 5. Please give specific examples of programs the nominee has implemented to enhance resident care and administration at the facility. 6. Please describe any specific challenges this individual has overcome or accomplishments they have reached that have benefited the residents and/or staff at the facility. 7. How does the nominee promote teamwork in the facility? (specific examples) 8. How does the nominee interact with residents and their families? 9. List the nominee s community activities, including local, state and national organizations. 10. Describe the extent of the nominee s involvement in IHCA

5 EMPLOYEE AWARDS (Check One Category per Form) **Please note: the Administrator s Choice Category is for those individuals who do not fit with any other categories. Please be sure to check the appropriate category for each of your nominees. Environmental Services Professional Food Service/Dietary Professional Housekeeping Professional Business Office Professional Activity Professional Social Service Professional Administrator s Choice Award Each entry must include the following items in order to be considered: 2. Typed answers to the following questions in the space below. One additional piece of paper may be submitted. **Optional You may also submit a typed recommendation letter (500-word limit) from the employing administrator or department head explaining why the employee deserves the award. No more than two (2) letters will be accepted. 1. How long has the nominee worked in the long term care profession? 2. How long has the nominee worked at this facility? 3. What is the nominee s position at the facility? 4. How long has the nominee worked in his/her current position? 5. What is unique about this nominee s job performance that makes him/her deserving of recognition? 6. Please give a description of the nominee s contributions to improving the quality of care and resident quality of life in his/her facility (specific examples). 7. Please describe the way this employee interacts with and provides support for his/her department. 8. Please list any additional training his employee has received to improve or further his/her job skills. 9. Please list any organization in which this employee is involved

6 VOLUNTEER AWARD Volunteer of the Year nominees can be individuals or groups who have volunteered their time and attention for the benefit of your residents. Each entry must include the following items in order to be considered: 2. Typed answers to the following questions in the space below. One additional piece of paper may be submitted. **Optional You may also submit a typed recommendation letter (500-word limit) explaining why the volunteer deserves the award. No more than two (2) letters will be accepted. 1. How long has the nominee volunteered in the long term care profession? 2. How long has the nominee volunteered at this facility? 3. What is unique about this nominee s performance that makes him/her deserving of recognition? 4. Please give a description of the nominee s contributions to improving the quality of care and resident quality of life in his/her facility (specific examples). 5. Please describe the way this volunteer interacts with and provides support for facility staff. 6. Please list any additional training this volunteer has received to improve or further his/her skills. 7. Please list any organization in which this volunteer is involved

7 ASSOCIATE MEMBER AWARD Nominees for IHCA Associate Member of the year must be an IHCA Associate Member in good standing and provide goods/services to the nominating facility/corporation. Each nomination must include the following items in order to be considered: 2. Typed answers to the following questions in the space below. One additional piece of paper may be submitted. **Optional You may also submit a typed recommendation letter (500-word limit) explaining why the individual/company deserves the award. No more than two (2) letters will be accepted. 1. How long has the nominee provided goods/services to your facility? 2. How long have you known the nominee? 3. Has the nominee been willing/able to work with the facility in financially difficult times? 4. What has the nominee done to enhance the public perception of long term care in Illinois? 5. Please give specific examples of how the nominee s expertise/caring attitude has helped improve resident care at the facility. 6. How has the nominee assisted the facility in promoting community relations? 7. How has the nominee supported IHCA in promoting long term care in Illinois? 8. Describe the extent of the nominee s involvement in the IHCA

8 COMMUNITY PARTNERSHIP AWARD This award has been established to recognize the efforts of long term care facilities/programs who are involved in significant service to the community. This award has been named the Community Partnership Award as the winners must exemplify the essence of what it means to live and work in a community as we serve long term care residents in Illinois. Each completed nomination packet must include the following items in order to be considered: 2. Typed answers to the following questions in the space below. One additional piece of paper may be submitted. 3. One TYPED essay (500 words maximum) that describes the impact this program has had in the facility/program and the community. No more than two letters will be accepted. Brief Project Description: Community Partner Contact & Title Address City Daytime Phone Zip Code Fax

9 INNOVATIVE PROGRAM AWARD This award recognizes a unique program at a member facility/program that sets a leadership example for others programs that are not typical of every long term care facility/program programs that are creative, inventive, original and unprecedented. Innovative programs in any facility/program department or discipline will be eligible for this award. All nominated programs must have been active at least one year prior to February 1, In judging, attention will be given to whether the program has received special recognition by the profession or the community. The level of demonstrated success and unique commitment by the facility/program will also be considered. Each completed nomination packet must include the following items in order to be considered: 2. TYPED answers to the following general questions in the space provided; and 3. One TYPED essay (500 words maximum) that describes the impact this program has had in the facility/program and the community. Rules of Entry 1. The written entry must include a completed Nomination Form in addition to the completed answers to the following questions. 2. Entries should include any newspaper clippings or supporting documentation of the program s effectiveness. Attachments will not be returned. 3. The center/program submitting the nomination must be an IHCA member center/program at time of application and at time the award is presented. Name of the program being nominated Name and title of the person who has primary responsibility for conducting this program at your facility/program: Brief description of the program Who is the audience for this program (i.e. general public, families of Alzheimer s disease, residents, community members, etc.)? - 9 -

10 Innovative Program Award Part 2 When did the program begin? How do you publicize this program? How has the program received recognition in the community? (Please attach any appropriate press clippings, letters of praise from participants, or other information/materials; please do not include more than two (2) pieces of supporting documentation) What were your goal(s) for this program? Have you achieved your goal(s)? How can you demonstrate your success? What are your future plans for this program? (proposed expansion, changes, etc.) Why do you feel this program is unique and sets an example for other Illinois long term care facilities/ programs? Other comments Please use additional paper if you need more space

11 MEDIA EVENT AWARD Many of our facilities and programs excel in community outreach programs that result in media coverage or positive publicity. The purpose of this award is to recognize the entity that best demonstrates the ability to promote the work being done for the residents of the entity. Each completed nomination packet must include the following items in order to be considered: 2. TYPED answers to the following general questions in the space provided; and 3. Evidence (newspaper article, radio spots, news clips, etc.) that meets one of the following criteria: Creativity of coverage turning a single non-event into a story Difficulty of coverage turning a single potentially negative event into a positive Education coverage of a single event staged solely for community education Consistency a media campaign on a single subject Note: Media coverage/publicity must have occurred between February 1, 2017 and February 1, 2018 to be eligible for the 2018 award. Name of Project/Program Project Contact & Title Brief Project Description _ What were your goals for this project? _ How did you measure the success of this project? _ What did you learn from this project that can be applied to other media activities for your facility/program? Please use additional paper if you need more space and don t forget to attach evidence to demonstrate your media efforts

12 COMMUNICATIONS AWARD Demonstrate your center s ability to educate residents, families and the general public by submitting your publications or other communications pieces. These communications can include, but are not limited to, facility brochures, newsletters, calendars and event fliers, promotional videos and more. The primary focus of the judges will be content and its effectiveness in educating readers about the facility/program and long term care. Criteria includes content, writing style, originality and design. Each completed nomination packet must include the following items in order to be considered: 2. TYPED answers to the following general questions in the space provided; and 3. A sample of the publication or communications/marketing piece being submitted. 1. Briefly describe the facility. 2. Is/was the piece created, designed and produced in-house or by a professional outside of the facility? 3. Who is responsible for coordinating the communication? 4. How often is the piece produced? 5. What is the mission statement of the publication/communications piece? _ 6. Describe the communications piece/tell us about the publication. What type of information is usually included? 7. Who receives the piece? Don t forget to submit a sample of your communications piece!

13 PHOTOGRAPH AWARD A picture is worth a thousand words and many are worthy of an award! Tell your story by submitting a photograph for this year s award. Each completed nomination packet must include the following items in order to be considered: 2. TYPED answers to the following general questions in the space provided. 3. A copy of the photo being submitted; and 4. A signed release form for any residents in the photo. The photograph may be taken by anyone associated with the facility, such as an employee, family member, volunteer, visitor, resident; or it can be taken by anyone outside the facility, such as a newspaper or professional photographer. A maximum of five (5) photographs will be accepted from each facility. Please read the following rules carefully as only entries that have met all criteria will be considered. 1. All entries must be 8 x10 or smaller. (Montages/collages and negatives will not be accepted.) 2. Photo attachments should be no larger than 4 MB. 3. This form must be filled out for each photograph submitted, but you may submit only one Nomination Form if you would like. 4. Photographs may be used for IHCA promotional materials and will not be returned. 5. Photographs must have been taken between February 1, 2017 and February 1, 2018 and must include at least one resident of an IHCA member center/program. 6. Photographs must be submitted by an IHCA member center/program. 7. A dated and signed release form from the resident, family and/or guardian of the resident pictured must be on file at the facility for each entry. The release should allow for the photograph to be used by the facility and/or IHCA in this program and subsequent promotions. Please submit a copy of release with each entry form. 1. Briefly describe the facility. 2. Give the name and title of the photographer. 3. Name the resident(s) in the photograph. 4. Describe what event is taking place in the picture or an interesting story associated with the photograph. (If there is a newspaper story in which the photograph appeared, please include it, with date of publication.)

14 PHOTO AND INTERVIEW RELEASE FORM Date I hereby grant the Illinois Health Care Association (the IHCA) permission to interview me and/or to use my likeness in photograph(s)/video in any and all of its publications and in any and all other media, whether now known or hereafter existing, in perpetuity, and for other uses by the IHCA. I will make no monetary or other claim against the IHCA for the use of the interview and/or the photograph(s)/video. Name (print full name) Signature Relation to subject (if subject is a minor) Address City, State, ZIP Telephone Please return completed form to Ashley Caldwell at: Illinois Health Care Association OR Fax to: S. Fourth St. Springfield, IL to: acaldwell@ihca.com

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