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In the July issue of the PHI Training & Organizational Development Services (TOD) newsletter, Kathy McCollett, a PHI organizational change specialist, gives new meaning to “informed consent,” using the language of culture change.

Meanwhile, Renya Larson, a specialist with PHI’s Training & Organizational Development team, discusses why teamwork matters.

Visit the PHI Training & Organizational Development Services site to read past newsletter posts and to subscribe.

– by Deane Beebe

Logo of 2011 Pioneer Network National Conference

The Pioneer Network‘s annual conference will take place August 1-4 in St. Charles, Missouri, and will feature several sessions led by PHI experts.

Susan Misiorski, the national director of the PHI Training and Organizational Development Services team, and Kate Waldo, PHI organizational culture change specialist, will help guide day-long presentations during the four-day event.

PHI’s Cean Eppelheimer and Kathy McCollett will also present a 90-minute session on how to be an approachable leader.

According to the Pioneer Network’s website, the conference is the “only national conference devoted solely to culture change.”

Initiating Culture Change

Along with Joanne Rader of Rader Consulting, Misiorski will co-lead “Getting Started,” a day-long intensive session designed to help leaders of care facilities take the first steps toward culture change.

Misiorski and Rader will dispense practical advice to formal and informal leaders across care settings who are interested in de-institutionalizing services and individualizing care.

“For the last decade, the Pioneer Network conference has presented a great annual opportunity to spread the word about culture change,” said Misiorski, the founding president of the Pioneer Network’s board of directors.

“I hope that attendees will come away inspired to start their own culture-change journey — or, if they are already on the road to culture change, I hope they will redouble their efforts to implement organizational change,” she added.

Focus on LGBT Elders

Meanwhile, Waldo will co-lead a day-long intensive session entitled “Creating an Environment of Safety and Inclusion for LGBT Older Adults.”

During the session, Waldo and Hilary Meyer, the director of the National Resource Center on LGBT Aging, will present a curriculum designed to help staff, administrators, and volunteers at aging network organizations to provide better care for their LGBT residents.

The curriculum achieves those goals by:

• Teaching participants about LGBT older adults — their culture, their needs, their concerns.
• Identifying best practices to help LGBT elders feel safe and included in their aging networks.
• Identifying health disparities between LGBT and non-LGBT elders.
• Reviewing policy and practice areas to consider how to increase inclusiveness and safety for LGBT older adults.

Other Sessions

“Getting Started” and “Creating an Environment of Safety and Inclusion for LGBT Older Adults” are two of 13 all-day intensive sessions that conference-goers can choose to attend during the conference’s second day.

The topics of other intensive sessions include implementing culture change in a physically traditional facility; administering dining assistance for people with dementia; and sustaining culture change over the long term.

Shorter sessions and workshops will also be held throughout the event.

A full list of the intensive sessions can be found on the Pioneer Network’s website, along with a full conference schedule and registration information.

– by Matthew Ozga

Three brief stories on direct care:

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Pioneer Network Extends Early Bird Registration

The registration deadline for the Pioneer Network‘s 2011 National Conference has been extended until Tuesday, June 7.

This year’s conference will take place in St. Charles, Missouri, from August 1-4.

The Pioneer Network is a leader in the culture change (pdf) movement and an advocate for person-directed care.

Effective June 27, Peter Reed, Ph.D., M.P.H., will take the helm as the organization’s new executive director.

Visit the Pioneer Network website to learn more about the conference and to register.

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Fund Created for Nursing Home Employees Hit by Tornado

The Missouri Health Care Association (MHCA) has established a charitable fund and grant program to help employees and their families who suffered damage from the devastating tornado that ripped through Joplin, Missouri, on May 22.

At least 10 nursing home residents and one employee were killed in the tornado, and three Joplin nursing homes are no longer habitable, according to McKnight’s Long-Term Care News.

More information on the fund and information on how to donate is available on at the MHCA website.

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Consumer Voice Publishes New Guide on Choice and Advocacy

The National Consumer Voice for Quality Long-Term Care launched Piecing Together Quality Long-Term Care: A Consumer’s Guide to Choices and Advocacy, a national guide intended to:

• educate older adults and people with disabilities about options for long-term services and supports;
• empower consumers to become self-advocates for quality long-term care; and
• provide information and resources to assist people currently living in nursing homes to move back into the community.

The Consumer Voice has also created a document to assist groups that want to develop state-specific guides. Kansas, North Carolina, and Virginia have already published guides for consumers in their states.

– by Deane Beebe

The newest additions to PHI’s National Clearinghouse on the Direct Care Workforce:

Economic Contribution of Nursing Facilities — This February 2011 brief from the Alliance for Quality Nursing Home Care explains the economic significance of nursing facilities in the U.S. For example, the brief notes that $138 billion was spent on nursing facility care in 2008 alone. The brief also explains the negative impact that the economic recession has had on nursing facilities. Specifically, nursing facilities have had to grapple with a tightened credit market as well as cuts to or freezes on Medicaid payment rates.

Generations, Winter 2010-11 issue — This issue of Generations contains multiple articles that are pertinent to the direct-care workforce, including articles authored or co-authored by PHI experts.

In “Caregivers on the Front Line: Building a Better Direct-Care Workforce,” PHI National Policy Research Director Dorie Seavey gives a general overview of the workforce. Meanwhile, in “Federal and State Policy Strategies for Developing a Quality Eldercare Workforce,” members and staff of the Eldercare Workforce Alliance — including PHI President Steven Dawson — explain how the Affordable Care Act will benefit the eldercare workforce.

Other articles from the issue include:

• The Changing Face of Long-Term Care and How a New Immigrant Workforce Will Shape Its Future — This article explains the important role that immigrants and ethnic and racial minorities play in the direct-care workforce. The author examines several pressing issues facing the long-term services sector as the U.S. minority population expands over the next several decades, including the potential exploitation of immigrant direct-care workers.
• A Vision for the Future: New Care Delivery Models Can Play a Vital Role in Building Tomorrow’s Eldercare Workforce — This article details the increasingly important role that direct-care workers will play in the nation’s long-term care services and supports sector following the implementation of health reform provisions such as the CLASS Act. The article also provides a brief overview of the direct-care workforce. The authors are deputy assistant secretaries at the Department of Health and Human Services (HHS).
• Reinventing Management Practices in Long-Term Care: How Cultural Evolution Can Affect Workforce Recruitment and Retention — This article analyzes the extent to which the Better Jobs Better Care initiative succeeded in introducing elements of culture change into the management practices of long-term care providers. The authors write that incremental culture change — making gradual, visible changes to a long-term care facility — can be better at fostering sustainable culture change than a more radical, wholesale approach. As a result of these visible changes, workers feel more valued, and are more likely to stay.

PHI’s National Clearinghouse on the Direct Care Workforce is a national online library for people in search of solutions to the direct-care staffing crisis in long-term care. It houses over 1,000 articles, reports, issue briefs, and fact sheets on the direct-care workforce.

– by Matthew Ozga

The Pioneer Network, a coalition of organizations and individuals working to change the culture of aging and long-term care of elders in the U.S., is hiring an executive director.

This position requires a visionary leader who will serve as the organization’s representative and guide its efforts in:

• strategic development;
• fundraising;
• business planning; and
• financial management.

Interested applicants should contact James Zaniello at Vetted Solutions.

Pioneer Event Postponed

The Pioneer Network has postponed Creating Home in the Nursing Home III: MDS 3.0 as the Engine for Individualized Care and Quality Improvement, which was to be held in Washington, D.C. on April 10, 2011.

The Pioneer Network will, however, hold a series of webinars — to be scheduled this spring — and additional events on this initiative throughout the year.

- by Toccara Heath, PHI Communications Intern

A new study published in the 2010 Seniors Housing & Care Journal found that nursing homes that embrace and sustain culture change have a higher occupancy rate and greater revenue than traditional nursing homes.

In Occupancy and Revenue Gains from Culture Change in Nursing Homes: A Win-Win Innovation for a New Age of Long-Term Care, Pioneer Network Policy Analyst Amy Elliot, Ph.D., the study investigator, reports that a review of the literature finds that anecdotal accounts and empirical studies show that nursing homes that have adopted culture change have improved consumer outcomes and greater consumer and staff satisfaction.

Other Gains of Culture Change

The purpose of this study, explains Elliot, is to answer a question posed by providers and policymakers when considering innovation of any kind: “Culture change at what gain?”

The study compares traditional nursing homes to those that have adopted and sustained culture change for two years or more from 2004 to 2008. It found that both types of homes had occupancy rates of 86 percent in 2004, before culture change was instituted. For the facilities that adopted culture change, the occupancy rate increased to 89 percent in 2008, but the rate remained the same for the nursing homes that did not subscribe to the culture change philosophy.

The study also found that for the homes that adopted and sustained culture change, there was an increase in revenue of $11.43 per bed per day — which amounts to a $584,073 increase in revenue per year for homes with 140 beds.

“This data is particularly important to the growth of the culture change movement because it supports the business case,” said Sue Misiorski, director of PHI Training and Organizational Development services. “Culture change is not just ‘the right thing to do’ on behalf of elders and employees — it is good business.”

Culture Change Supported by Policy

Elliot reports how culture change has gone from a grassroots movement in the early ’90s to a practice supported by national policy. She notes that the effort was led by the National Citizens Coalition for Nursing Home Reform from which the Pioneer Network developed, with support for implementing person-centered care practices from advocacy organizations like PHI and the Direct Care Alliance and organizations promoting new models of care such as the Eden Alternative and Green House.

Federal and state policies have helped to incentivize and spur nursing homes to embrace culture change further, Elliot explains. She points out that the “National Demonstration Project on Culture Change” (pdf, see page 3), a provision in the Patient Protection and Affordable Care Act of 2010, is further evidence of how culture change has taken hold.

The study on occupancy and revenue gains from culture change in nursing homes was made possible with support from The Commonwealth Fund.

– by Deane Beebe