Any journalist who covers nursing homes should check out this month’s special supplement in The Gerontologist, the Gerontological Society of America’s journal. It focuses on the two-decade long effort to change nursing home culture and many of the articles and studies raise important questions about whether enough progress has been shown.
For example, this study finds that nursing homes that are considered culture change adopters show a nearly 15 percent decrease in health-related survey deficiency citations relative to comparable nonadopting homes. This study looks at what is meant by nursing home culture change – the nature and scope of interventions, measurement, adherence and outcomes. Harvard health policy expert David Grabowski and colleagues take a closer look at some of the key innovators in nursing home care and what it might mean for health policy – particularly in light of the Affordable Care Act’s directive to provide more home and community-based care. Other articles look at the THRIVE study, mouth care, workplace practices, Medicaid reimbursement, and more policy implications.
Any of these studies — or several taken together — can serve as a jumping off point for local coverage. Are there nursing homes in your community that are doing things differently? Have any instituted policies or processes that show improvements in care coordination, outcomes, quality, or other key measures? Are there homes that are resisting change? Why? Which one(s) best exemplify person-centered care? How do these changes affect the workforce?
Nursing Home Compare from CMS provides the data behind complaints, violations, quality, and cost, among other metrics. This article in The Philadelphia Inquirer is a great example of interweaving research with personal narrative. Another approach might be to look at trends in the city, state, or region. How are nursing homes marketing themselves to consumers? To referral sources? Have their business models changed?
Experts on all sides have been talking about culture change for more than a decade. And in 2008, a Commonwealth Fund report explored culture change in nursing homes. Has the time finally come, for real?