August 30, 2022 – Nursing homes that embraced culture change principles prior to COVID-19 largely maintained or expanded their efforts to focus on resident quality of life and person-centered care principles, a new study from a group of leading culture-change organizations has found.
Nearly three-quarters, or 71%, of key culture-change metrics were maintained or expanded within at least 60% of surveyed nursing homes, the non-profit Altarum found in a recently fielded survey. Other key findings from the group of 62 nursing homes in 30 states include:
- 77% maintained or expanded efforts to learn and support residents’ interests
- 87% had no restrictions on visitation as of March 2022, and 81% reconfigured or updated indoor space to better facilitate COVID-safe gatherings
- 61% expanded support for virtual communication, such as assistance with video calls and e-mail
The surveyed homes consisted of communities affiliated with The Green House Project, Pioneer Network, the Eden Alternative, and the Live Oak Project – organizations dedicated to overhauling the institutional nursing home culture that far too often prioritizes operator convenience, efficiency, and profit over resident quality of life.
Despite the positive trends, culture change sites still faced challenges during the pandemic, with many reporting having to scale back group outings, intergenerational programming, resident input into mealtimes and menu selection, and other vital principles of nursing home culture change.
These results emphasize the real need to incorporate culture-change principles both more widely within nursing homes and more broadly in long-term care policy and regulations, particularly during current and future public health emergencies.
Altarum’s report and recommendations also build on other recent work that calls for both physical transformation of nursing homes – including conversions to all private rooms and bathrooms – and comprehensive culture change that puts residents, not finances or efficiency, at the center of all decisions.
“There is no one-size-fits all solution to the challenges facing long-term care in America, but we cannot go wrong when we put elders’ needs and wants ahead of all other considerations,” Green House Project senior director Susan Ryan said. “We must work together to ensure that these vital culture-change principles are incorporated into any and all post-COVID nursing home reforms.”
“Altarum is very pleased to learn that the creativity and flexibility inherent in person-centered care enabled these nursing home leaders to continue, and even expand, practices like resident choice in daily routines and supporting visits from people important to residents, during the pandemic,” Sarah Slocum, program director for delivery system transformation at Altarum, said. “We believe that person-centered care is key to resident quality of life and to nursing home quality improvement overall.”
“Enough already! The system of services and supports for elders and people with disabilities has failed. The time is NOW to reimagine, redesign, and transform the entire system, including reimbursement, regulation, architecture, staffing, and person-centered care, with a culture that works for the well-being of each person,” Live Oak Project co-founders Barry Barkan, Rose Marie Fagan, and Jeff Jerebker said.
“We are pleased to see the results of the Altarum research, and at the same time, not surprised that elder-directed care resulted in such positive outcomes – even in the midst of a pandemic,” Patrick Bultema, president and CEO of the Eden Alternative, said. “After all, it only makes sense that empowering elders to live the lives they want – recognizing changing abilities and circumstances – leads to greater wellbeing. Furthermore, the research illustrates how this partnering approach to care is also better for staff.”
“This report shows us all what’s possible,” Pioneer Network CEO Penny Cook said. “If person-directed practices and principles can survive during a history-making pandemic, they can be implemented and practiced everywhere in the United States. It will take all of us to make that happen.”
Director of Communications
The Green House Project