You are cordially invited to attend the

Centers for Medicare Medicaid Services (CMS)

Nursing Home Improvement

Satellite Broadcast and Webcast

Four Part Series:From Institutional to Individualized Care

Part One: Integrating Individualized Care and Quality Improvement

Friday, November 3, 2006

1:00 PM–3:30 PM EDT

  • This broadcast is open to Nursing Homes with Medicare and Medicaid certified units, Nursing Home Provider Associations, State Survey Agencies, CMS Regional Offices, Quality Improvement Organizations (QIOs), State Long Term Care Ombudsman, and State Medicaid Agencies
  • Visit the CMS Survey and Certification Online Course Delivery System for registration, viewing instructions, satellite coordinates and handouts

- Agendaand handouts will be available no later than October 27, 2006.

- Satellite coordinates will be posted when they become available.

Background

This broadcast provides a framework and practical examples to help surveyors, providers, and consumers support individualized care. It offers a historical perspective on OBRA ’87’s mandate that each nursing facility “provide care and services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.” It relies on the seminal work of Judith Carboni, RN whose research about the experience of Home and of Homelessness among nursing home residents offers a roadmap for the transformation from Institutional to Individualized Care.

The broadcast draws on lessons learned from Improving the Nursing Home Culture, a 2004-2005 pilot byquality improvement organizations and major national nursing home corporations. Using a Holistic Approach to Transformational Change, 254 nursing homes considered the impact of workplace practices, care practices, and the physical environment on resident outcomes. They also explored forms of participatory leadership as they made systemic changes. Applyingquality improvement methods to their efforts to individualize care and improve workforce retention, they achieved improvements in retention and quality that confirmed that the best clinical practice considers the whole person and the environment in which care and services occur.

This broadcast examines how old paradigms of care actually induce harm and decline while individualized care promotes health and well-being.It debunks the myth that quality of life and quality of care are in conflict and demonstrates how quality of life and quality of care together produce better quality of care. Two Directors of Nursing share their experiences in integrating individualized care and quality improvement. One shifted from an institutional morning routine to individualized mornings for residents. The other eliminated alarms where residents were falling the most – on her dementia unit – and relied instead on individualized care. Both nurses found that consistent assignment was key to their success.

A key premise in quality improvement work is that systems create outcomes, that what we are doing now is getting us what we are getting in care outcomes. To get something different, we have to do something different. This broadcast provides a primer on a new brand of culture change that helps nursing homes improve their clinical outcomes by individualizing their care. By integrating individualized care and quality improvement, homes move closer to OBRA’s charge for the highest practicable physical, mental, and psychosocial well-being of each resident.

This is the first of a four-part series:

Part 1 / Nov. 3, 2006 / Integrating Individualized Care and Quality Improvement- This broadcast is Mandatory for managers of Nursing Home surveyors (to include anyone with supervisory responsibility over nursing home survey, such as SA directors and deputy directors). RO survey management staffs are also required to attend this training.This broadcast is Non-mandatory for surveyors but is highly recommended.
Part 2 / Feb. 2007 / Transforming Systems to Achieve Better Clinical Outcomes
Part 3 / Apr. 2007 / Clinical Case Studies in Culture Change-Mandatory for LTC surveyors
Part 4 / Sept. 2007 / The How of Change

Broadcast Information

OnNovember 3, 2006 from 1:00-3:30 p.m. (EDT), CMS is providing a satellite and Internet broadcast approximately two and a half hours in length. The broadcast will presentthe key practices for individualizing caretosurveyors, providers, ombudsmen, and QIOs. The Satellite Broadcast will provide the following important information:

  • As nursing homes across the country explore new individualized care practices, it is important that surveyors be aware of how these practices advance the mandate of OBRA ’87.
  • Having to conform to Institutional schedules rather than having individual needs and routines honored can lead to serious decline in a person’s physical, mental, and psychosocial well-being.
  • Many current practices that emphasize safety and risk prevention actually cause harm and decline. Instead we need to promote health and mobility. Restraints and alarms are good examples.
  • When quality of care is provided in concert with quality of life, clinical outcomes improve.
  • Quality improvement practices have added a rigorous evidence-base to culture change, helping nursing homes make systemic changes grounded in good clinical practice.
  • The integration of individualized care with quality improvement provides a pathway to better clinical outcomes.

This broadcast is open to Nursing homes with Medicare or Medicaid certified units, nursing home provider associations, State Survey Agencies, CMS Regional Offices, QIOs, State Long Term Care Ombudsman, and State Medicaid Agencies.

Viewing Options

There are three options for Nursing Home Broadcastviewing:

  1. As a satellite broadcast.

-Satellite coordinates are listed under Satellite Information Technical Fact Sheet that follows or at the CMS Survey and Certification Online Course Delivery System website:

  1. As a simultaneous webcaston November 3, 2006from 1:00-3:30 p.m. (EDT)

-Register and view attheCMS Survey and Certification Online Course Delivery System website:

  1. As an archived webcast beginning November 20, 2006 until November3, 2007, one year after the original air date.

-Register and view attheCMS Survey and Certification Online Course Delivery System website:

The agenda with satellite coordinates and handouts for this broadcast will be available no later than October 27, 2006. To obtain the agenda and handouts, you must register at

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11-03-06 Nursing Home Improvement Satellite Broadcast Page