Recognition Awards 2017 Nomination Package

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VIRGINIA HEALTH CARE ASSOCIATION VIRGINIA CENTER FOR ASSISTED LIVING Recognition Awards 2017 Nomination Package Supporting Those Who Make a Difference In Long Term Care

RECOGNITION AWARDS James G. Dunton Distinguished Service Award for Lifetime Achievement VHCA-VCAL s highest honor, the James G. Dunton Distinguished Service Award for Lifetime Achievement, is named for Jim Dunton, former VHCA Executive Director and a truly great gentleman who led a life of distinction. This award is presented to a candidate who has been active with the association at least ten years, risen to the top of the profession by pursuing excellence, expanding into new areas, and contributing to long term care in Virginia. VHCA Nursing Facility Administrator of the Year Award This award recognizes a nursing center administrator for outstanding statewide leadership who has been active in the association at least four years, has current direct supervisory responsibility, has demonstrated outstanding leadership ability, and has contributed significantly to the profession of long term care administration. VCAL Assisted Living Administrator of the Year Award This award recognizes an assisted living administrator for outstanding statewide leadership who has been active in the association at least two years, has current direct supervisory responsibility, has demonstrated outstanding leadership ability, and has contributed significantly to the profession of long term care administration.

VHCA-VCAL Director of Nursing of the Year Award This award recognizes an individual who possesses and demonstrates clinical and managerial expertise, leadership skills in quality care with positive outcomes, respect for residents, co-workers and policy, integrity and a high standard of ethical behavior, the ability to maintain an efficient, professional environment, and availability to staff and family members. VHCA-VCAL Certified Nursing Assistant (CNA) of the Year Award This award recognizes the dedication and compassion among our center s CNAs. The CNA of the year should demonstrate respect for residents, co-workers and the workplace, as well as, set and adhere to a high standard of personal ethics. The individual should exhibit leadership skills, mentor new staff, present a positive professional image, and maintain a positive and friendly relationship with family members and visitors, and exhibit a solid attendance record along with flexibility in work scheduling and duties. Nominate a deserving individual today! Applications must be received by June 1.

PAST AWARD RECIPIENTS James G. Dunton Distinguished Service Award Recipients 2016 Doug Suddreth 2015 Jake Mast 2014 Patsy A. Hobson 2013 J. S. Parker Jones, IV 2012 Donna Duss Nursing Facility Administrators of the Year 2016 Ashley Jackson 2015 Mandy Gannon 2014 William J. Belmonte 2013 Derrick Kendall 2012 Vernon Baker Assisted Living Administrators of the Year 2016 Pam Doshier 2015 Joan Thomas 2014 Elizabeth Dammeyer 2013 Pam Guthrie 2012 Susan O Malley Directors of Nursing of the Year 2016 Tomeka Scott, Brandermill Woods Retirement Community, Midlothian 2015 Pamela Whorley, Envoy of Staunton 2014 Ann Jenkins, Lynn Care Center at Warren Memorial Hospital, Front Royal 2013 Susan Parks, Heritage Hall - Nassawadox 2012 Nancy Chila, Mount Vernon Nursing & Rehabilitation Center, Alexandria Certified Nursing Assistants of the Year 2016 Patricia Hendricks, Heritage Hall - Blackstone 2015 Sabrina Collins, Heritage Hall Nassawadox 2014 Nancy Crickenberger, Dogwood Village of Orange County 2013 Janet Harris, The Healthcare Center at Brandermill Woods, Midlothian 2012 Sheila Plowden, The Sylvestery, McLean

James G. Dunton Distinguished Service Award for Lifetime Achievement Nomination Form VHCA-VCAL s highest honor is presented in recognition of a lifetime of outstanding contributions to long term care in Virginia. This award recognizes an individual who has been active in the association for at least 10 years. The information requested on this form must be completed in full. I. NOMINEE INFORMATION Nominee Nominee s Center/Company City, State & Zip Code II. NOMINATOR INFORMATION Name Position Nominator s Center/Company E-mail III. ABOUT THE NOMINEE Length of Time at Present Center/Company LTC Employment History (CV or resume may be attached) VHCA-VCAL Involvement (with dates) Community or Civic Involvement (over)

IV. SELECTION CRITERIA In a typed narrative (no more than 2 pages) please explain why your nominee should be selected as a recipient of the James G. Dunton Distinguished Service Award for Lifetime Achievement and how he/she has fulfilled the selection criteria. 1. Has been active in VHCA-VCAL for a minimum of 10 years. 2. Continued effective performance in one or more positions over an extended time period. 3. Personal expertise that sustains and improves quality in long term care. 4. Leadership qualities that might include the ability to identify, assess and resolve problems. 5. Provides leadership, constructive guidance, inspiration and respect. 6. Has demonstrated a lifetime commitment to improving long term care services. V. CHECKLIST FOR NOMINATOR This section is intended to help you make sure you are returning the required information with your nomination. All documents must be mailed/emailed to the VHCA-VCAL office by June 1 to be considered. Completed nomination form. Written narrative explaining why your nominee should be selected for this award. At least three (3) letters of recommendation that support your nomination. Criteria for letters: 1) Letters may not exceed one page. 2) Letters must be printed on official letterhead and signed. High-resolution digital headshot of the nominee (e.g., tiff or jpeg). Additional photographs of the nominee (at least 5 recommended). Any additional materials to support your nomination (e.g., news articles, letters from residents and family members) (optional). VI. HOW TO SUBMIT YOUR NOMINATION 1. Mail this nomination form and supporting materials to: Doran Hutchinson, Vice President of Member Services and Education VHCA-VCAL 2112 West Laburnum Avenue, Suite 206 Richmond, Virginia 23227 If mailing your submission, please include high-resolution digital headshot of the nominee (e.g., tiff or jpeg) on a CD or thumb drive. You may also email the headshot to Doran Hutchinson at doran.hutchinson@vhca.org. OR 2. Scan and email the nomination form and supporting materials to Doran Hutchinson at doran.hutchinson@vhca.org. Please include a high-resolution digital headshot of the nominee (e.g., tiff or jpeg). Applications must be received by June 1.

VHCA Nursing Facility Administrator of the Year Award Nomination Form The Nursing Facility Administrator of the Year Award recognizes outstanding statewide leadership among administrators in VHCA member facilities. The information requested on this form must be completed in full. I. NOMINEE INFORMATION Nominee Nominee s Center/Company City, State & Zip Code Administrator License # Date of Issuance II. NOMINATOR INFORMATION Nominated by Nominator s Center/Company E-Mail III. ABOUT THE NOMINEE Length of time at present center LTC Employment History (CV or resume may be attached) VHCA-VCAL Involvement with dates Community or Civic Involvement IV. SELECTION CRITERIA The nominee must be a licensed administrator of record in a VHCA member nursing center who: 1. Has been active in VHCA-VCAL for a minimum of 4 years. 2. Has current, direct supervisory responsibility. 3. Has demonstrated outstanding leadership ability. 4. Has contributed significantly to the profession of long term care (LTC) administration. (over)

In a typed narrative, please explain why your nominee should be selected for this honor. Please include specific evidence of the following: 1. Personal leadership and dedication to residents and staff. 2. Exceptional efforts to increase the quality of life in their center. 3. Cooperative and collaborative relationships with others to support the profession as a whole. 4. Ability to identify needs and develop creative solutions to routine as well as unique problems. 5. Competence in maximizing funds, people, goods and services. 6. Efficiency in planning and organization. 7. Initiating behavior that acquaints legislators and other state officials with the important issues facing LTC. 8. Commitment to earn and extend respect to residents and colleagues. V. CHECKLIST FOR NOMINATOR This section is intended to help you make sure you are returning the required information with your nomination. All documents must be mailed/emailed to the VHCA-VCAL office by June 1 to be considered. Completed nomination form. Written narrative explaining why your nominee should be selected for this award. At least three (3) letters of recommendation that support your nomination. Criteria for letters: 1) Letters may not exceed one page. 2) Letters must be printed on official letterhead and signed. High-resolution digital headshot of the nominee (e.g., tiff or jpeg). Additional photographs of the nominee (at least 5 recommended). Any additional materials to support your nomination (e.g., news articles, letters from residents and family members) (optional). VI. HOW TO SUBMIT YOUR NOMINATION 1. Mail this nomination form and supporting materials to: Doran Hutchinson, Vice President of Member Services and Education VHCA-VCAL 2112 West Laburnum Avenue, Suite 206 Richmond, Virginia 23227 If mailing your submission, please include high-resolution digital headshot of the nominee (e.g., tiff or jpeg) on a CD or thumb drive. You may also email the headshot to Doran Hutchinson at doran.hutchinson@vhca.org. OR 2. Scan and email the nomination form and supporting materials to Doran Hutchinson at doran.hutchinson@vhca.org. Please include a high-resolution digital headshot of the nominee (e.g., tiff or jpeg). Applications must be received by June 1.

VCAL Assisted Living Administrator of the Year Award Nomination Form The Assisted Living Administrator of the Year Award recognizes outstanding statewide leadership among assisted living administrators in Virginia. The information requested on this form must be completed in full. I. NOMINEE INFORMATION Nominee Nominee s Center/Company City, State & Zip Code Administrator License # Date of Issuance II. NOMINATOR INFORMATION Nominated by Nominator s Center/Company E-Mail III. ABOUT THE NOMINEE Length of time at present center LTC Employment History (CV or resume may be attached) VHCA-VCAL Involvement with dates Community or Civic Involvement IV. SELECTION CRITERIA The nominee must be a licensed administrator of record in a VCAL member nursing center who: 1. Has been active in the Association for a minimum of two years. 2. Has current, direct supervisory responsibility. 3. Has demonstrated outstanding leadership ability. 4. Has contributed significantly to the profession of long term care (LTC) administration. (over)

In a typed narrative, please explain why your nominee should be selected for this honor. Please include specific evidence of the following: 1. Personal leadership and dedication to residents and staff. 2. Exceptional efforts to increase the quality of life in their center. 3. Cooperative and collaborative relationships with others to support the profession as a whole. 4. Ability to identify needs and develop creative solutions to routine as well as unique problems. 5. Competence in maximizing funds, people, goods and services. 6. Efficiency in planning and organization. 7. Initiating behavior that acquaints legislators and other state officials with the important issues facing LTC. 8. Commitment to earn and extend respect to residents and colleagues. V. CHECKLIST FOR NOMINATOR This section is intended to help you make sure you are returning the required information with your nomination. All documents must be mailed/emailed to the VHCA-VCAL office by June 1 to be considered. Completed nomination form. Written narrative explaining why your nominee should be selected for this award. At least three (3) letters of recommendation that support your nomination. Criteria for letters: 1) Letters may not exceed one page. 2) Letters must be printed on official letterhead and signed. High-resolution digital headshot of the nominee (e.g., tiff or jpeg). Additional photographs of the nominee (at least 5 recommended). Any additional materials to support your nomination (e.g., news articles, letters from residents and family members) (optional). VI. HOW TO SUBMIT YOUR NOMINATION 1. Mail this nomination form and supporting materials to: Doran Hutchinson, Vice President of Member Services and Education VHCA-VCAL 2112 West Laburnum Avenue, Suite 206 Richmond, Virginia 23227 If mailing your submission, please include high-resolution digital headshot of the nominee (e.g., tiff or jpeg) on a CD or thumb drive. You may also email the headshot to Doran Hutchinson at doran.hutchinson@vhca.org. OR 2. Scan and email the nomination form and supporting materials to Doran Hutchinson at doran.hutchinson@vhca.org. Please include a high-resolution digital headshot of the nominee (e.g., tiff or jpeg). Applications must be received by June 1.

VHCA-VCAL Director of Nursing of the Year Nomination Form The VHCA-VCAL Director of Nursing (DON) of the Year Award recognizes the best among current Virginia s licensed nurses actively employed for a minimum of two years by a current member center. I. NOMINEE INFORMATION Nominee Nominee s Center/Company City, State & Zip Code II. NOMINATOR INFORMATION Nominated by Nominator s Center/Company E-Mail III. ABOUT THE NOMINEE Length of time at present center LTC Employment History (CV or resume may be attached) VHCA-VCAL Involvement with dates Community or Civic Involvement IV. SELECTION CRITERIA In a typed narrative, describe why the nominee should be recognized by VHCA-VCAL as DON of the Year. Please share any unique leadership skills, responsibilities and talents of the nominee. You may include examples of actual situations exemplifying the DON s professionalism and outline significant events and contributions above and beyond the normal daily routine that you believe puts the DON in a special category worthy of recognition. The nominee should possess and demonstrate the following qualities: 1. Clinical and managerial expertise. 2. Leadership skills in quality care with positive outcomes. 3. Respect for residents, co-workers and policy. 4. Integrity and a high standard of ethical behavior. 5. Ability to maintain an efficient, professional environment. 6. Availability to staff and family members. (over)

V. CHECKLIST FOR NOMINATOR This section is intended to help you make sure you are returning the required information with your nomination. All documents must be mailed/emailed to the VHCA-VCAL office by June 1 to be considered. Completed nomination form. Written narrative explaining why your nominee should be selected for this award. At least three (3) letters of recommendation that support your nomination. Criteria for letters: 1) Letters may not exceed one page. 2) Letters must be printed on official letterhead and signed. High-resolution digital headshot of the nominee (e.g., tiff or jpeg). Additional photographs of the nominee (at least 5 recommended). Any additional materials to support your nomination (e.g., news articles, letters from residents and family members) (optional). VI. HOW TO SUBMIT YOUR NOMINATION 1. Mail this nomination form and supporting materials to: Doran Hutchinson, Vice President of Member Services and Education VHCA-VCAL 2112 West Laburnum Avenue, Suite 206 Richmond, Virginia 23227 If mailing your submission, please include high-resolution digital headshot of the nominee (e.g., tiff or jpeg) on a CD or thumb drive. You may also email the headshot to Doran Hutchinson at doran.hutchinson@vhca.org. Additional materials and letters of recommendation should be attached. OR 2. Scan and email the nomination form and supporting materials to Doran Hutchinson at doran.hutchinson@vhca.org. Please include a high-resolution digital headshot of the nominee (e.g., tiff or jpeg). Applications must be received by June 1.

VHCA-VCAL Certified Nursing Assistant of the Year Nomination Form The VHCA-VCAL Certified Nursing Assistant (CNA) of the Year award recognizes excellence among CNAs actively employed for a minimum of two years by a current VHCA-VCAL member center. This nomination form must be completed by the Director of Nursing and/or the Administrator, and signed by both. I. NOMINEE INFORMATION Nominee Nominee s Center/Company City, State & Zip Code Administrator License # Date of Issuance II. NOMINATOR INFORMATION Nominated by Nominator s Center/Company E-Mail III. ABOUT THE NOMINEE Length of time at present center LTC Employment History (CV or resume may be attached) VHCA-VCAL Involvement with dates Community or Civic Involvement (over)

IV. SELECTION CRITERIA In a typed narrative please describe why the nominee should be recognized by VHCA-VCAL as the CNA of the Year. Please share any unique responsibilities and talents of the CNA. Also include examples of actual situations exemplifying the CNA s professionalism, and outline significant events and contributions above and beyond the normal daily routine that you believe puts the CNA in a special category worthy of recognition. The nominee should demonstrate the following qualities: 1. Respect for residents, co-workers and rules. 2. Practices good personal ethics. 3. Leadership skills (e.g., assists in care plan process). 4. Mentors new employees. 5. Presents a professional image. 6. Practices safety procedures. 7. Behaves in a friendly manner to family members and visitors. 8. Maintains a solid attendance record and exhibits flexibility in work schedule and duties. V. CHECKLIST FOR NOMINATOR This section is intended to help you make sure you are returning the required information with your nomination. All documents must be mailed/emailed to the VHCA-VCAL office by June 1 to be considered. Completed nomination form. Written narrative explaining why your nominee should be selected for this award. At least three (3) letters of recommendation that support your nomination. Criteria for letters: 1) Letters may not exceed one page. 2) Letters must be printed on official letterhead and signed. High-resolution digital headshot of the nominee (e.g., tiff or jpeg). Additional photographs of the nominee (at least 5 recommended). Any additional materials to support your nomination (e.g., news articles, letters from residents and family members.) (optional). VI. HOW TO SUBMIT YOUR NOMINATION 1. Mail this nomination form and supporting materials to: OR Doran Hutchinson, Vice President of Member Services and Education VHCA-VCAL 2112 West Laburnum Avenue, Suite 206 Richmond, Virginia 23227 If mailing your submission, please include high-resolution digital headshot of the nominee (e.g., tiff or jpeg) on a CD or thumb drive. You may also email the headshot to Doran Hutchinson at doran.hutchinson@vhca.org. 2. Scan and email the nomination form and supporting materials to Doran Hutchinson at doran.hutchinson@vhca.org. Please include a high-resolution digital headshot of the nominee (e.g., tiff or jpeg). Applications must be received by June 1.