Culture change is a movement that seeks to transform nursing homes from large institutional settings based upon a hierarchical, medical model to ones that center on the quality of life and the ability to make individual choices in a homelike environment. This brief provides insights for policymakers on culture change from a consumer perspective to ensure that nursing homes are reformed in a way that benefits residents, care staff, and the public. Download the full brief or access individual sections in the toggle boxes on the right.

LTCCC Brief for Policymakers

Consumer Perspectives on Nursing Home Culture Change

Culture change is a movement that seeks to transform nursing homes from large institutional settings to ones that center on the quality of life and the ability to make individual choices in a homelike environment. The purpose of this brief is to provide insights on culture change to ensure that nursing homes are reformed in a way that benefits residents, care staff, and the public.

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This two-part section highlights principles and foundations for implementing culture change (i.e. resident choice, homelike environments, sufficient staffing, financial integrity, etc.).

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This section provides descriptions of the major commercial models of culture change. These models offer key principles and practices that support meaningful reform.

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Culture change strategies have potential to improve outcomes for residents in long-term care. Yet, the growing body of research on culture change suggests that there is no one-size-fits-all approach.

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Nursing homes engaged in culture change must ensure ongoing reinforcement of its principles and avoid “institutional creep.” Support for culture change should encourage periodic self-assessment and evaluation.

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Culture change models, implemented effectively, could be attractive alternatives to the traditional settings. But what do they cost? This section explores the costs of the various culture change models compared to traditional designs.

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This section explores the various ways policymakers can promote culture change:

  • Affordable Care Act: National Demonstration Project on Culture Change
  • White House Plan to Improve Nursing Home Safety & Quality
  • Federal Housing Administration
  • Nursing Home Civil Money Penalty (CMP) Funds

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Though no single culture change model is an elixir, research shows that different culture change strategies, when implemented effectively, can lead to significant improvements in resident outcomes.

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LTCCC’s brief for policymakers, “Consumer Perspectives on Nursing Home Culture Change,” relies heavily on the following resources.

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In a rush? Check out the highlights from this policy brief.