Culture Change Now in In CMS Interpretive Guidelines
Posted by Patti on April 22nd, 2009 / 
Print This Post
Will Culture Change be mandated? It appears so. Over at PHI, Aaron has a post about CMS’s new Interpretive Guidelines coming out, which address more homelike environments in nursing homes. We’ve posted often here about the benefits of Culture Change, and it’s about time CMS joined the band wagon on this.
The changes, which go into effect on June 17, 2009, are intended to support efforts underway to transform nursing homes into “homey” environments through both environmental changes and resident-centered caregiving. Whereas in the past, these changes were sometimes stymied by fear that regulators would cite organizations for deficiencies, CMS is now making it clear that the OBRA regulations should be interpreted to support personal choice in the full range of daily activities, including waking, bathing, dining, and sleeping. The new guidance also calls for visitors to have 24-hour access to residents, regardless of familial relationship.
The new interpretive guidelines call on nursing homes to begin or to continue de-institutionalizing their physical environments. Suggestions include: reducing noise such as overhead paging and alarm bells, eliminating nursing stations, taking down institutional signage, and refraining from serving meals on institutional trays.
Get ready for the complaining. Eliminating nursing stations!?! But how can they expect us to do our work…But we can’t…and so on.
Pony up folks. Culture change is much needed process and we’ll all be better off with it. Allowing the residents to control their environment and choices is really a human right. Safety, and all those other excuses we tend to use, are just that: EXCUSES. We don’t want to give up our “power”. It’s not about us. It is about our customers- the residents.
Some Culture Change Sites of Interest:
Pioneer Network
Check out the PN’s vast selection of resource links HERE.
April 23rd, 2009 at 7:40 am
A wonderful step. My concern is the need for increased staff to allow this to take place. Most states have a suggested ratio needed per caregiver and resident, which is below the needed limit for this to be successful. However, whatever small steps we can take towards resident centered care is past due.
April 24th, 2009 at 3:59 pm
Even baby steps are good as long as they are in the right direction. But I must agree, we have to work on the ratio of caregiver to resident to realy make this work. Hopefully as the boomers age, continued light will be brought to this topic.
April 26th, 2009 at 7:09 pm
Ratios will be critical to make a nursing home truly homelike. More individualized attention is going to be required. That, or have an increase in activity staff on all the shifts that residents are awake. Right now I don’t see it happening anytime soon. The current economic situations cannot fund such dreams sadly. One day, maybe, it will happen.
May 1st, 2009 at 11:10 am
Definatelly an increase in staff is going to be needed when the residents are awake. It is a change in the right step, but however, I agree with Patti that I dont see it happening any time soon.
May 3rd, 2009 at 8:42 am
I was so excited to tell my staff that there was no longer an excuse to call a resident a feeder!