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Creating Home Symposium Details

Creating Home in the Nursing Home: A National Symposium on Culture Change and the Environment Requirements

On April 3, 2008, the Centers for Medicare & Medicaid Services and Pioneer Network hosted a historic symposium on the impact of innovative environmental design on creating home and community for nursing home residents. Throughout the day, long-term care innovators, regulators, researchers, architects, advocates and public officials came together in an unprecedented discourse to highlight environmental innovations and to discuss regulatory challenges associated with transforming the physical environments of nursing homes into comfortable, pleasurable places for elders to call home.  This extraordinary event assembled a powerhouse of key stakeholders to enlighten, discuss, collaborate and move forward with recommendations to advance more widespread innovation in new care environments. Noted researchers presented foundational work on the impact of private rooms, household models, lighting, and home environments on quality of care, quality of life and organizational outcomes to a group of symposium attendees. Responder panels comprised of representatives of national stakeholder organizations and of the state survey agencies, leaders from the National Fire Protection Association, and members of state regulatory agencies that take an active role in their state culture change coalitions also presented, informed and shared in the dialogue. Many of the attendees made public comments and observations based on their own experiences and challenges with adoption and implementation of innovative, environmental design.  In all, the day exceeded expectations as the attendees came together, without bias or self-interest, in support of our elders.


The day following the symposium, an invitational workshop maintained the momentum of the previous day by asking, "How do we take action?" To answer this question, regulators, provider groups, advocates, architects, researchers and experts worked side-by-side to brainstorm on action plans for implementing recommendations in the areas of research and funding, life and safety code advancements, CMS regulatory interpretation, and the work of state coalitions to communicate and disseminate environmental change. Along with the symposium's achievement of bringing together interested parties to detail and highlight all aspects of innovative environmental design, these action plans and follow-up activities are fruits of the symposium efforts. We should all be proud of this great success. And, what did we learn from these two days as we begin the months and years of action on our journey ahead? We learned that the physical environment is an essential and vital aspect of "home" for our elders. It affects everything – how they see, how they feel, how they move, how they build satisfying relationships with others, and how they live. We learned that, although there is investment, these innovations are cost-effective in the long run and contribute to positive outcomes for staff. Most importantly, we learned that there is an openness to change and that regulators are listening. So, although there are notable individual efforts for environmental change in the past, we now begin a new journey as a powerful collective.

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Available for download:
This background paper set the stage for the April 3rd, 2008 Centers for Medicare & Medicaid Services (CMS) and Pioneer Network co-sponsored Creating Home in the Nursing Home: A National Symposium on Culture Change and the Environment Requirements. (PDF, 1.9 MB, Acrobat Reader required)

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The recommendations contained herein do not necessarily reflect the opinions of the Pioneer Network or CMS.