Nursing Home Culture Change

The federal Nursing Home Reform Law of 1987 (OBRA 87) requires that each nursing home “care for its residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident.” This requirement emphasizes dignity, choice, and self-determination for residents. Every nursing home is also required by law to “provide services and activities to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in accordance with a written plan of care which…is initially prepared, with participation to the extent practicable, of the resident, the resident’s family, or legal representative.” This means that a resident should not decline in health or well-being as a result of the way a nursing home provides care.

At its heart, culture change is about changing the culture of nursing homes so that they fully reflect these requirements. The culture change movement aims to de-institutionalize the environment of nursing homes. It involves the transformation of nursing homes from the traditional model to a more resident-centered model.

Some characteristics of a culture change nursing home:

  • Care is truly resident-centered: tailored to each resident to meet his/her needs as an individual, based on the individuals needs and preferences;
  • Care is delivered by caregivers who have a meaningful and valued role in the residence;
  • The environment is truly home-like, with residents having privacy of their own room and bathroom and the functioning of the nursing home - such as nurse stations, resident lounges and dining rooms - being small in scale and close in proximity to the residents' room;
Residents truly participate in life at the nursing home, making decisions for themselves regarding dressing, dining, bathing and partaking in activities, taking part in the functioning of the nursing home to the extent they wish to be involved, etc...

culture change nursing home

A culture change nursing home provides a more home-like, less institutional setting...


resident and staff in culture change nursing home which residents and workers join together to make the community.

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Long Term Care Community Coalition
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New York, NY 10119
Tel: 212-385-0355    Fax: 212-239-2801