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Louisiana Support for Culture Change

Survey Agency

The state survey agency, the Louisiana Department of Health and Hospitals (DHH), Health Standards Section (HSS), has championed culture change efforts since 2004 in a variety of ways. In 2004, the state agency partnered with the Long-Term Care Ombudsman Program (LTCOP) to send survey staff, ombudsmen and nursing home staff to tour a Missouri home with a strong national reputation for advancing culture change concepts. In 2005, HSS and the LTCOP sponsored a culture change conference to which an estimated 75% of nursing homes sent staff. The conference was paid for with the civil money penalty funds administered by DHH. Also in 2005, the HSS Manager, in conjunction with the Quality Improvement Organization and the LTCOP began hosting meetings with providers who had indicated strong interest in culture change. These meetings gave rise to LEADER (Louisiana Enhancing Aging with Dignity Through Empowerment and Respect), the state's current culture change coalition (incorporated as a 501(c)(3) in February 2008). The HSS Manager currently serves as a non-voting Board member for the Coalition as does the State Ombudsman. Most recently, the HSS has convened a workgroup to examine licensure requirements for impediments to culture change efforts. Largely as part of the response to the crises created by Hurricanes Katrina and Rita, DHH funded a coalition-led project in the New Orleans and Lake Charles regions to address staffing issues. While not promoted as culture change efforts, these projects are designed to help facilities improve staff stability and retention—elements fundamental and critical to the success of culture change efforts. This project will end in 2009, but its impact will be furthered by the creation of two tools for replication: (1) a film and training guide that focuses on the lessons learned in Hurricane Katrina; and (2) a detailed instruction guide to the exercises and methods used in the Lake Charles learning sessions. This project was funded with civil money penalties.