Culture change is all about resident choice, resident individuality, and resident dignity. OBRA reforms resulting in the current set of regulations are based on resident choice, resident individuality, and resident dignity.
Historically nursing homes were almshouses turned money-generating enterprises (thanks to government funding) that housed the elderly. To improve their image and attract more residents nursing homes began to establish the hospital model of patient care instead of home. When the OBRA regulations were published systems were developed to provide efficient, compliant care, often overlooking the personal choices of the elder being cared for.
The OBRA regulations were needed. They positively impacted the care elders received. Menus were planning in advanced to provide nutritious food served three times per day seven days per week. The select menu was virtually non-existent, but the elder received safe, wholesome food. Residents were given rights that previously were non-existent.
Today organizations such as Pioneer Network are working with CMS to further the regulations and their intent of quality of life for every resident through choice, individuality, and dignity. They are trying to put the ‘home’ back in nursing home.
Makes sense to me.