Capella STAR Award
Annual Outstanding Employee Recognition Program
Nomination Form
During its 10th year of service, Capella Healthcare is launching a new annual award, designed to recognize individuals who are
shining examples of the organization’s values. One employee at each hospital will be recognized, with one of those selected
for company-wide recognition. Hospitals will determine their award recipients during July, sending the nomination packet to
the Capella’s Corporate Awards Committee by Friday, August 1. The national award recipient will receive $1,000, with
another $1,000 being presented in their honor to a non-profit community service organization of their choice.
Qualifications
Eligibility: Any employee of a Capella-affiliated organization with at least 12 months of service, in good standing. This
employee is someone who demonstrates our values in all they do. They:
• Make the safety, comfort and well-being of patients their top priority
• Are committed to working together with their colleagues, collaborating to provide the best possible health care
• Are honest and truthful, acting with integrity at all times
• Are courteous to all, respecting the feelings and viewpoints of others
• Value all resources and use them wisely
They are role models in the following pillars:
• Quality – This person is passionate about providing the highest possible quality of care with an uncompromising focus
on safety.
• Service –This individual is dedicated to exceeding the expectations of all they serve, earning consistent praise.
• People – This employee is a great team member and works well with others; they are committed to making their
community a better place in which to live – for everyone.
HOSPITAL NAME:
NAME OF NOMINEE:
DEPARTMENT & TITLE:
VALUES. How does this employee
demonstrate the values above in
all they do? Please share specific
examples.
Use additional pages as needed.
PILLARS. How has this person’s
commitment to QUALITY, SERVICE
& PEOPLE positively impacted
others. Please share specific
examples?
Use additional pages as needed.
YOUR NAME / NOMINATOR’S
NAME:
NOMINATOR’S DEPARTMENT &
TITLE:
NOMINATOR’S EMAIL & PHONE: