Awards - Distinguished Service - West Virginia Health Care Association

Please use the following guidelines.

Eligibility and Criteria:

This award category is available to both nursing facility and assisted living members. This special award is designed to recognize an individual, facility, business, volunteer, organization, or group that has worked in the long-term care field for over 10 years and has made an outstanding positive impact or contribution to long-term care in West Virginia. Nominees may be an owner or employed by a member facility, retired from or associated with a member facility, or an associate member at the time of nomination. The nominee need not be an employee of the nominating facility.

Refer to the Rules of Entry for additional requirements and guidelines to explain why this nominee should be the recipient of the award based on the criteria below.

Awards - Distinguished Service

Nominee Name*
First Last
Nominee Title*

Professional License(s)
List all professional license(s) held by the nominee (if applicable)
Facility*

Facility Address*
Street Address City State ZIP Code

Facility Phone*

Your Name*
First Last
Your Title*

Your Email Address*
(A notification email will be sent to this address)

Administrator's Name
If different than above
First Last
Administrator's Email Address
(A notification email will be sent to the facility administrator)

1. Describe what contributions this nominee has made to long-term care in West Virginia.*
(The nominee must remain anonymous for the judges. Please do not use this person's name in your answer.)
2. What separates this person from his or her peers in terms of skills, attributes, and performance?*
(The nominee must remain anonymous for the judges. Please do not use this person's name in your answer.)

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Awards – Distinguished Service

Awards - Distinguished Service

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