Nursing homes that initiated culture change between 2004 and 2009 saw a noteworthy decrease in health-related survey deficiency citations, according to recently published research. The investigators describe their study as the first of its kind.
The culture change movement has emphasized making long-term care facilities less institutional and more homelike, with a focus on “person-centered care” that takes resident choices and preferences into account.
There has been little analysis of how culture change affects quality of care, the researchers noted. They are affiliated with a variety of institutions, including Harvard Medical School and the Dartmouth Institute for Health Policy and Clinical Practice.
Using data from The Pioneer Network, they identified 251 nursing homes that adopted culture change between 2004 and 2009. They then identified a group of comparison facilities that did not adopt culture change.
The adopting facilities exhibited a 14.6% decrease in health-related survey deficiencies relative to the comparison group, the researchers found. The adopting facilities improved their survey results while maintaining consistent staffing levels, according to the data analyzed by the investigators.
Despite the survey improvement, culture change adoption did not have a statistically significant association with changes in Minimum Data Set quality indicators, such as catheter use, the researchers found.
“Nevertheless, the deficiencies finding suggests culture change has the potential to improve care outcomes moving forward,” the authors wrote.
In a separate report, the researchers identified which nursing homes have been most likely to adopt culture change: They tend to be nonprofit facilities that are fairly large, with fewer residents paying through Medicaid and Medicare. Public policies, such as higher Medicaid per diem rates, also encourage culture change implementation, according to the findings.
Both reports appear in a February supplement to The Gerontologist.
