2017 Assisted Living Hero Award Nomination Form

2017 ASSISTED LIVING HERO AWARD NOMINATION FORM

Honor those who help make the lives of your residents more rewarding. Nominate the hard-working staff within your community for the annual NCALA Assisted Living Hero Award! Nominations are open to current NCALA Provider Members.

Nominees should be exemplary in protecting each resident’s right to privacy, fostering independence, nurturing the spirit of, and promoting the individuality of each resident. Executive Directors are not eligible for this award. One nominee per NCALA member community, please.

The top 3 Hero Award winners will each receive $1,000.00, one night hotel accommodation during this year’s conference, and a free 2018 conference registration (with CEUs). NCALA will recognize all nominees and finalists in The NCALA Advisor and on NCALA social media pages. Name of Community:

Nominator First Name: Nominator Last Name:

Nominator’s E-mail:

Nominator’s Title: Nominator’s Phone:

Nominee First Name: Nominee Last Name:

Nominee’s Title:

The nominators of the top three winners will be notified directly. At that time, NCALA requests that you notify your nominee—after informing NCALA of when you plan to do so, in order that we can arrange to makes videos to be used at NCALA’s Fall Conference.

NCALA asks you ensure your nominee attends the 2017 NCALA Fall Conference & Trade Show on Wednesday, October 11, 2017, where all three finalists will be honored. If your nominee is not able to attend, please let NCALA know so that we can move to the next finalist on the list.

All those nominated are NCALA Champions. Though these individuals are not selected as Hero Award winners, they are honored for championing quality of life for the residents they serve and their embrace of the resident-centered philosophy of senior living. Champions are rewarded for their dedication with a special certificate from the NCALA Board Chair & President and by having their names published in The NCALA Advisor and posted on NCALA social media pages. Nominations are due no later than July 21, 2017. Late submissions cannot be accepted. Accepted via e-mail at: [email protected].

Nominator Questions: 1. What three values does the nominee embrace and how are they exemplified?

2. Give examples how the nominee champions quality of life for the residents. How does the nominee offer choice, dignity and independence to residents?

3. Share why the nominee could be identified as a role model to staff in senior living communities. Give specific examples how this individual has impacted, improved and inspired the work place and keeps positive relationships with other staff.

4. Give a short story about the relationship the nominee has with a resident or family.

5. Describe volunteer or outside the community activities the nominee may participate in to advocate for seniors and fight against ageism.

6. Does the nominee have a background or story that is so central to their identity that you believe their application would be incomplete without it? Please share.

7. Discuss an accomplishment or event that you believe marked a key transition point in the nominee’s personal or professional life.

Nominations are due no later than July 21, 2017. Late submissions cannot be accepted. Accepted via e-mail at: [email protected].