Is Nursing Home Culture Change Coming to the For-Profit Sector?

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Across the United States, an increasing number of nursing homes are undergoing "culture change" — transforming themselves from institutions driven by adherence to rigid routines into person-centered, homelike settings with the flexibility to accommodate residents' preferences and physical needs.

In the new Commonwealth Fund report, Culture Change in a For-Profit Nursing Home Chain: An Evaluation, Leslie A. Grant, director of the Center for Aging Services Management at the University of Minnesota School of Public Health, discusses results of a 12-month evaluation of Beverly Healthcare's resident-centered care initiative — one of the nation's largest nursing home chains. Beverly's undertaking, which was launched in 2002, marked the first time that a large, national for-profit chain implemented culture change.

According to the report, Beverly's resident-centered care initiative was successful in introducing new organizational practices, improving residents' quality of life, and creating better work environments for staff. And while the initiative did not achieve short-term financial gains, it also did not lead to higher operating expenditures in those nursing homes that implemented changes.

Most of the gains in organizational performance associated with Beverly's initiative were achieved without major capital expenditures for physical renovations. But to implement culture change successfully over the long term, Grant says that major investments in capital and human resources will be necessary.