The Goals of Culture Change are:
- restore control over daily living to residents of long-term care facilities, respecting the right of residents to make their own decisions;
- involve all levels of staff in the care process, honoring those who work most closely with residents;
- include families and friends in a comprehensive team building approach to care;
- provide a familiar and hospitable environment, a supportive workplace and responsive, individualized care practices that focus on the needs and preferences of people, rather than those of the facility.
In 2000, these reform leaders from around the United States established the Pioneer Network (http://www.pioneernetwork.net/ as the umbrella organization for the Culture Change movement. In recent years, this movement has expanded to include home and community-based services.
The Centers for Medicare and Medicaid Services (“CMS”) and the MA Department of Public Health (“DPH”) are committed to working with facilities to find innovative ways to allow the implementation of Culture Change.
The essence of Culture Change fulfills the mandate of the Nursing Home Reform Law (OBRA’87) by allowing nursing homes to be responsive to individual resident’s needs and creating an environment in which residents thrive.
- The following CMS Video Link discusses how Culture Change is consistent with existing federal regulations: http://www.pioneernetwork.net/research/cmsmov.wmv (media player is required to view this file).
- The MA Culture Change Coalition was initiated in mid-2005 to foster Culture Change in MA facilities. Participants in the Coalition include a wide-range of long-term care related organizations. The Massachusetts Advocates for Nursing Home Reform represents residents, their families/friends, Family-Run Councils, and other advocates in the Coalition.
Furthermore, results from a study conducted by Marilyn Rantz, University of Missouri, reported that good-quality care in nursing homes actually costs less than poor quality care (March/April, 2003 Nursing Outlook). Rantz says the important point practitioners can take from this study is that well-run, quality health care can be achieved without high costs.
Examples of successful Culture Change in two diverse nursing home settings:
- The Maine General Rehabilitation and Nursing Center in Glenridge, portrayed in the American Health Quality Association Culture Change documentary, is in a rural, close-knit community. The documentary, “Culture Change in Long-Term Care: A Case Study", can be obtained through the production company: ImageWorks 619-239-6161.
- Providence Mount St. Vincent, located Seattle, WA, has 215 skilled nursing beds and is one of the original Culture Change facilities in the country. (http://www.providence.org/Long_Term_Care/Mount_St_Vincent.)