Altarum Report Details How Culture Change in Nursing Homes Improved Quality of Life During Covid-19

August 29, 2022

Nursing homes that embraced culture change principles prior to Covid-19 largely maintained or expanded their efforts to focus on resident quality of life and person-centered care principles, a new study from a group of leading culture-change organizations has found.

Altarum recently fielded a survey that found nearly three-quarters, or 71%, of key culture-change metrics were maintained or expanded within at least 60% of surveyed nursing homes. Other key findings from the group of 62 nursing homes in 30 states include:

  • 77% maintained or expanded efforts to learn and support residents’ interests
  • 87% had no restrictions on visitation as of March 2022, and 81% reconfigured or updated indoor space to better facilitate Covid-safe gatherings
  • 61% expanded support for virtual communication, such as assistance with video calls and e-mail

The surveyed homes consisted of communities affiliated with The Green House Project, Pioneer Network, the Eden Alternative, and the Live Oak Project—organizations dedicated to overhauling the institutional nursing home culture that far too often prioritizes operator convenience, efficiency, and profit over resident quality of life.

"Altarum is very pleased to learn that the creativity and flexibility inherent in person-centered care enabled these nursing home leaders to continue, and even expand, practices like resident choice in daily routines and supporting visits from people important to residents, during the pandemic,” Sarah Slocum, program director for delivery system transformation at Altarum, said. “We believe that person-centered care is key to resident quality of life and to nursing home quality improvement overall."

Despite the positive trends, culture change sites still faced challenges during the pandemic, with many reporting having to scale back group outings, intergenerational programming, resident input into mealtimes and menu selection, and other vital principles of nursing home culture change.

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These results emphasize the real need to incorporate culture-change principles both more widely within nursing homes and more broadly in long-term care policy and regulations, particularly during current and future public health emergencies.

“There is no one-size-fits all solution to the challenges facing long-term care in America, but we cannot go wrong when we put elders’ needs and wants ahead of all other considerations,” Green House Project senior director Susan Ryan said. “We must work together to ensure that these vital culture-change principles are incorporated into any and all post-Covid nursing home reforms.”

Altarum’s report and recommendations also build on other recent work that promotes both physical transformation of nursing homes—including conversions to all private rooms and bathrooms—and comprehensive culture change that puts residents, not finances or efficiency, at the center of all decisions.

Read the full report

Altarum is a nonprofit organization that works with federal and state agencies and foundations to design and implement solutions to improve the health of individuals with fewer financial resources and populations disenfranchised by the health care system. We achieve measurable results by combining our expertise in public health and health care delivery with technology, workforce training and continuing education, applied research, and technical assistance. Our innovative solutions lead to better health for beneficiaries and better value for payers.