Preliminary Research Supports Nursing Home Culture Change Movement

ROCHESTER, N.Y. /PRNewswire-USNewswire/ -- A new study introduced today supports the nursing home culture change movement, spearheaded nationally by The Pioneer Network. Dr. Bonnie Kantor, Executive Director, delivered findings at the Second Annual Medicaid Congress. The study suggests that culture change potentially affects quality without a detrimental effect on cost.

Culture change, or deep system change, refers to the transformation of nursing homes from an "acute care" medical model to a "consumer-directed" model. It commonly refers to techniques associated with consumer-directed care, a more home-like environment, flexibility in sleep and dining schedules; as well as autonomy in personal choices for the residents and a less bureaucratic organizational approach.

Transformative nursing homes are posited to achieve quality of care and life for the resident as well as positive financial outcomes for the home. Yet up to this point, there has been very little research to support linkages between quality of care and financing. Measurable outcomes from this study may inform policy and create opportunities for strategies such as Medicaid waivers to reward homes that actively reduce morbidity and improve cost efficiency through innovative practices.

The study used participation in the network as the treatment variable to assess any differences in quality of care and financial outcomes between network participants and non-participant nursing homes. Examples of key findings include:

  -- Early adopter homes participating in the network experienced fewer
     survey citations than the Centers for Medicare and Medicaid Service
     dataset of the national sample of homes in 2003.

  -- Early adopter homes participating in the network achieved better
     differences in quality of care outcomes (as measured by survey
     citations) than comparable non-participant homes from the 1996 to 2003
     timeframe.

  -- Early adopter homes participating in the network achieved better
     differences in per bed net income and operating margins than comparable
     non-participant homes from the 1996 to 2003 timeframe.

The Pioneer Network's mission is to transform policies and practices regarding the culture of aging in America. The Pioneer Network includes professionals representing organizations from all disciplines of long-term care including nursing homes, regulatory offices, ombudsman, universities and government.

This brief is the first in a series made possible through support from The Commonwealth Fund. More information is available at http://www.pioneernetwork.net/