SOURCE: Lumetra

August 01, 2005 12:00 ET

Statewide Coalition Kicks off Culture Change Caravan to Improve Nursing Home Care

Weeklong Bus Tour Promotes Organizational Change and Training Workshops for Providers

SAN DIEGO, CA -- (MARKET WIRE) -- August 1, 2005 -- A statewide coalition of federal and state agencies and healthcare organizations committed to improving nursing home culture and care have joined forces, kicking off the Culture Change Caravan to address areas of concern and offer training to facilities and staff on how to improve the quality of care for nursing home residents. The weeklong Caravan began its journey today at St. Paul's Senior Homes & Services in San Diego, and will travel to Los Angeles, Fresno, and San Francisco, ending in Sacramento on Friday, August 5.

"Changing the culture of nursing homes is imperative and possible," said Jo Ellen Hylind Ross, President and CEO, Lumetra, Medicare's Quality Improvement Organization for California. "Many states -- including Colorado, Kansas, Massachusetts, and Pennsylvania -- have developed statewide coalitions that are actively transforming the culture of nursing homes in their states. Based on those models, California's Culture Change Caravan is an effort to bring fresh ideas to particular areas of concern within facilities and among residents, and promote models to transform nursing home care for the future."

For example, nursing home staff retention is one key to improving nursing home care. When facilities have a stable source of qualified, committed and satisfied staff members, studies show that residents receive better care. In fact, a 2003 American Health Care Association (AHCA) study showed that staff satisfaction is directly linked to survey deficiencies -- the higher staff satisfaction, the lower the deficiency rates. To address this issue, Lumetra will work with a select number of nursing homes over the next three years to reduce annual turnover of Certified Nursing Assistants (CNAs) by 15%. CNAs provide the majority of direct, hands-on resident care in nursing homes. Nationally, AHCA estimated annual CNA turnover rate in 2002 at 71.1%.

"I'm excited about the Culture Change Caravan and the commitment it signals to improving quality of care for our nation's seniors," said Jeff Flick, Regional Administrator, CMS Region IX. "Culture change and improvements in nursing home care are taking place throughout the nation, and in California the Culture Change Caravan symbolizes the training programs and improvement efforts already underway to make our state's nursing homes warm, fulfilling residences with excellent quality of care for our elders."

Between 2001 and 2004, Lumetra worked with more than 10% of California's 1,349 nursing homes on a voluntary basis to provide better care to nursing home residents. Intensive work includes hands-on training with quality experts, instruction in best practices, and sharing in-depth resources. As of May 2005, Lumetra has also reached more than 408 nursing homes and 1,378 professionals by conducting a series of one-day workshops, teleconferences and other educational activities.

Over the next three years, Lumetra will be working with facilities throughout the state to improve on specific quality measures in key clinical areas of care, including:

In addition, Lumetra will work with facilities to improve chronic pain management in long-term care residents.

"As the State's advocate for nursing home residents, I'm pleased to see the Culture Change Caravan address some of the most common complaints of nursing home residents related to dignity and respect," said Joe Rodrigues, State Long-Term Care Ombudsman, California Department of Aging. "The training sessions offered by Lumetra present a great opportunity for nursing home providers to learn innovative techniques on ways to improve quality of care."

Brenda Klutz, Deputy Director, California Department of Health Services, Licensing and Certification said, "The state shares Lumetra's commitment to helping nursing homes reduce the prevalence of pressure ulcers and the use of physical restraints." Klutz added, "We support culture change concepts in nursing homes to improve the quality of care for residents throughout the state."

The tour will feature speaker Dr. William Thomas, author of "What Are Old People For? How Elders Will Save the World," as well as daylong seminars covering important topics for facilities interested in reducing pressure ulcers and restraint use, and improving organizational culture. The educational sessions, presented by the CMS Region IX Survey Team, will focus on new F-314 requirements for pressure ulcer assessment and care, as well as strategies to reduce the use of physical restraints.

Dr. Bill Thomas, Founder and President of the Eden Alternative -- a method dedicated to helping create enlivening environments and eliminate the plagues of loneliness, helplessness, and boredom among our elders -- will inspire participants with his insight and philosophies about changing nursing home culture.

"Culture change is about creating environments for human beings rather than facilities for the frail and elderly," said Dr. Thomas. "The Culture Change Caravan is making an important contribution to elder care by not only drawing attention to the opportunities to improve clinical care, but also helping nursing homes recognize ways to help their residents continue to lead fulfilling lives."

Nursing home professionals from facilities throughout the state will earn continuing education credits for participating in the Lumetra-sponsored workshops. Workshops are scheduled for August 1 at the Ararat Nursing Facility in Los Angeles; August 2 at the Fresno Convention Center; and August 5 at the Sheraton Grand Hotel in Sacramento.

The Culture Change Caravan is a joint effort of Lumetra, the Centers for Medicare & Medicaid Services (CMS) Region IX, the California Department of Health Services (DHS) Licensing & Certification program, the California Ombudsman, the California Association of Homes & Services for the Aging (CAHSA), the California Association of Health Facilities (CAHF), and the California Hospital Association (CHA).

Lumetra is a San Francisco-based, independent, non-profit organization dedicated to improving the quality, safety, and integrity of healthcare for providers and consumers. Lumetra provides innovation services and solutions in the areas of medical review, quality improvement, data analysis, and fraud detection and prevention. Since 1984, Lumetra has been contracted by CMS to be the Medicare Quality Improvement Organization for California. For more information please visit Lumetra on the Web at

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