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Artifacts of Culture Change

The CMS Artifacts of Culture Change is a tool for providers to assess readiness, implementation and sustainability of person-directed care. The Artifacts of Culture Change tool fills the purpose of collecting the major concrete changes homes have made to care and workplace practices, policies and schedules, increased resident autonomy, and improved environment. It results from study of what providers and researchers have deemed significant things that are changed and are different in culture changing homes compared to other homes. The tool was developed by Carmen S. Bowman, the owner of the culture change consulting business, Edu-Catering: Catering Education for Compliance and Culture Change in LTC (click here for details) and Karen Schoeneman, Deputy Director of the CMS Division of Nursing Homes.

The Artifacts is one of several tools available to assess culture change transformations. The Development of the Artifacts of Culture Change Tool (click here to download) lists other assessment methods (pg. 5), describes the development of the Artifacts, and provides additional helpful information to support the use of the tool. The full Artifacts tool is available in Appendix A of the Development document or click here to download the tool separately.

Online Artifacts of Culture Change

Pioneer Network has designed and developed an interactive web-based version of the Artifacts of Culture Change tool for providers to input and score their data online.
To date, the Artifacts tool has been deemed so extraordinary by the culture change community that there was a desire to see how one's organization compared to benchmarks collected nationally. In response to the national interest, Pioneer Network proposed an online version and was able to gain funding from the Commonwealth Fund for the endeavor.

"CMS issued the new guidance to surveyors in 2009 clarifying some of the quality of life tags." Said Bonnie Kantor, Pioneer Network's Executive Director in a recent interview. "As a result, we knew that there would be an increase in the number of providers who would want to assess incremental progress, and to share implementation stories and ideas with others in the provider community. The Artifacts of Culture Change online tool will address these needs for providers. In addition to the benchmarking opportunities, the tool will aid organizations in assessing cost efficiencies and related savings. We are so pleased to have received funding from the Commonwealth Fund to develop the on-line Artifacts tool for their use."

During the development and testing process the Artifacts of Culture Change online tool was made available to a pilot group of coalitions, researchers, facilitators and providers with extensive experience using the Artifacts. Through the testing process the pilot group provided comments, questions and suggestions for revisions, all of which was considered prior to the completion of the project and the subsequent online launch of the tool.

Now available online and free of charge, the Artifacts of Culture Change tool affords the opportunity for an individual home to gauge its progress and do its own benchmarking of where they are on a culture change journey. This brand-new resource is available at or click on the button above to go directly to the tool.