As popular as the Pioneer Institutes have been, many nursing home administrators are unable to attend. Many, furthermore, desire step-by-step guidance on putting into practice culture change concepts, such as empowering staff, as well as on meeting federal regulations and passing annual inspections. Stephen Shields, president and CEO of the Meadowlark Hills retirement community in Manhattan, Kan., and LaVrene Norton, president of ActionPact, a culture change consultant group, created a comprehensive set of resources to help nursing home leaders enact culture change. Developed with support from the Fund, the Sunflower Foundation, and the Kansas Department of Health, this culture change "toolkit" was released at the August 2006 Pioneer Network conference.
(5) (6) For the first time, all the elements of nursing home management have been tied to the concepts of resident-centered care. Included in the toolkit is a book on long-term care leadership,
Pursuing the Sunbeam; a policy and procedures manual tied to federal nursing home requirements; a human resources system; and a quality improvement process. Approximately 150 toolkits were purchased in their first month of availability.
Consumers can be an important catalyst for quality improvement in the nursing home industry. But in order to exert their influence, consumers need reliable information about quality standards and the actual performance of individual nursing homes. A Fund-supported nursing home guide published in the September 2006 issue of
Consumer Reports identifies the best and worst nursing homes in each state and offers tips for evaluating homes.
(7) The "Nursing Home Quality Monitor," available online as an interactive state map, also indicates whether a home is state-owned, for-profit, or nonprofit, and whether it is part of a chain or independently owned.
Consumer Reports found that nonprofit homes are more likely to provide good care than are for-profits, and independently run homes are more likely to provide good care than chains.
An accompanying investigative report, "Nursing Homes: Business As Usual," by Trudy Lieberman, director of the Center for Consumer Health Choices, was a wake-up call for the 12 nursing homes that were cited for poor care by Consumer Reports for five years in a row. It also captured the attention of the state agencies responsible for monitoring quality of care in these facilities.
Several other Fund-supported projects provide consumers with information needed to press for better care. Eric Carlson, J.D., of the National Senior Citizens Law Center, wrote the consumer guide,
20 Common Nursing Home Problems and How to Solve Them, which several state ombudsman programs, including those in New York and Oregon, have ordered for their staff. Following the guide's publication, Carlson was interviewed for a
Wall Street Journal article on long-term care.
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