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Culture Change

The culture of long-term care is undergoing profound change.  Philosopher Eric Hoffer once said, “In times of profound change, the learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists.”  I hope you will find something here that inspires you to either take your first step on the culture change journey, or your next one.  Please contact me if you are interested in sharing your culture change experience.


Sam Plaster, State Culture Change Coordinator
Telephone:  573-522-8318


The Missouri Coalition Celebrating Care Continuum Change (MC5)

by Sam Plaster, State Culture Change Coordinator

The Patient Protection and Affordable Care Act passed by Congress in 2010 requires that all nursing homes develop Quality Assurance and Performance Improvement (QAPI) programs, ensuring that homes continuously identify and correct quality deficiencies as well as sustain performance improvement.  While the Center for Medicare & Medicaid Services (CMS) has yet to promulgate the specific regulatory requirements, many homes are already initiating or improving their QAPI processes… to read more and view photos click here: MC5.


MC5 Regional Meetings

Please visit the Missouri Coalition Celebrating Care Continuum Change (MC5) website at or click on the regional links below to view upcoming meetings near you!

Central (Jefferson City/Columbia)
East Central (Rolla)
North Central (Chillicothe)
Northeast (Macon)
Northwest (St. Joseph)
Poplar Bluff
Route 71 (Nevada)
Southeast (Cape Girardeau)
Southwest (Springfield)
St. Charles
St. Louis
West (Independence)
West Central (Sedalia)

MC5 Regional Map

MC5 Brochure


Hot Topics:  Culture Change in Action

May 26, 2015: Safety vs. Autonomy for Elders: What if Maslow was Wrong

Presenter: Theresa (Terri) A. Harvath, Ph.D., RN, FAAN

During this webinar, we will examine case studies and generate ideas and strategies to help care providers make well-reasoned decisions when the values of autonomy and safety collide.

Please visit for more information and to register for this webinar.


Person Centered Care Tips

Tip # 1:  Where’s the Focus?
Just as a “selfie” is all about YOUR SELF, Person-Centered Care is all about the PERSON!  So why are we looking at Person-Centered Care?  Please see the flyer
here for more information.

Tip # 2:  My Life! My Choice!!
As we take a “selfie” and examine ourselves, we see the things that are important and unique to us.  We have a favorite color, a hairstyle we prefer, and favorite foods we love to eat.  We make many choices each day that make us satisfied or happy.  Please see the flyer
here for more information.

Tip # 3:  Care Conferences: Developing a portrait of the person
Care Conferences are the ultimate “selfie!”  The conference is an opportunity to really examine the person and their preferences and needs.  Please see the flyer
here for more information.

Tip # 4:  Consistent Staffing
Think of yourself in a new and unfamiliar situation, surrounded by unfamiliar faces.  Imagine this happens almost every day.  It feels like starting out in a new high school over and over again.  Who are all these other people?  How will I remember their names?  There are so many strangers-what do they really know about me?  Now, imagine you also have dementia.  Please see the flyer
here for more information.

Tip # 5:  The Power of Huddles: Making sure we all see the same picture
As in football, a caregiver huddle gathers to briefly exchange information, share observations and develop strategy.  Use huddles to pass insights about what really helps each resident feel comfortable and understood, so that all caregivers are equipped to provide the best person centered care.  Please see the flyer here for more information.

Tip # 6:  Me in My New Home
Just as a “selfie” is about YOU, Person-Centered Care is all about the PERSON!  Think of yourself in an unfamiliar situation.  Finding the bathrooms and where to get a cup of coffee or a bite to eat is likely a top priority.  And by the way… who are all these people and how will I remember their names?  Please see the flyer here for more information.

Tip # 7:  Don’t Call Me “Honey!”
Have you listened to yourself and the words you use?  Not only the words, but also the way you say them may be condescending to people.  Using person-centered language is one of the essentials in changing our culture.  Please see the flyer here for more information.


New Dining Standards Toolkit Available Now from Pioneer Network

Medical evidence from recent research studies has demonstrated that restrictive diets for elder individuals in long-term care are of little benefit, and in fact can be detrimental.  Please visit


Alive Inside Movie is Now Available to Purchase

Alive Inside: A Story of Music & Memory is now available on Netflix, DVD and Blu-ray! Click here for more information.


Artifacts of Culture Change Tool

There is a tool available to help you assess your home’s progress on the culture change journey. With the assistance of providers, researchers, and contractor Carmen Bowman of Edu-Catering, the Centers for Medicare & Medicaid Services (CMS) developed the Artifacts of Culture Change assessment tool. Through funding from the Commonwealth Fund, the Pioneer Network developed an interactive web-based version of the Artifacts of Culture Change for providers to input and score their data online. Use of the tool is FREE. All identifying characteristics of your home are coded and only you can monitor your home’s progress. However, you can check out the trends in homes across the country. Look at homes like yours: Under 50 residents, 50 to 100 residents, more than 100 residents, in big cities, small towns, urban or rural, profit, not-for-profit, or government ownership, Medicare-Medicaid certified and a combination of characteristics of homes just like yours. For more information please visit

Artifacts of Culture Change



On the Road…to Culture Change  

Marshfield Care Center

In February 2015, Section for Long-Term Care Regulation Communications Representative Leslie Sebastian and I visited Marshfield Care Center and Marshfield Place.  Marshfield Care Center is a 77-resident skilled nursing home and Marshfield place, next door, is a 40-resident residential care home… to read more and view photos, click here: Marshfield Care Center.

Good Shepherd Nursing Home

In February 2014, I visited Good Shepherd Nursing Home and Residential Care in Lockwood.  Good Shepherd includes a 69-resident Medicare/Medicaid Certified skilled nursing home and 20-resident residential care home, operated by a not-for-profit nursing home district… to read more and view photos, click here: Good Shepherd Nursing Home.

Chateau Girardeau

In February 2014, I visited Chateau Girardeau in Cape Girardeau.  Chateau Girardeau is a not-for-profit Continuing Care Retirement Community that was founded by the Presbyterian Church.  The 40-acre campus includes 37 individual Independent Living homes, 99 Independent Living apartments, a 55-resident Assisted Living Home, and a 75-resident Skilled Nursing Home.  The skilled nursing home includes a 16-resident short term rehabilitation neighborhood and 20-resident dementia neighborhood… to read more and view photos, click here:  Chateau Girardeau

Rockhill Manor Assisted Living

In November 2013, I visited Rockhill Manor Assisted Living located in the historic Southmoreland District of Kansas City.  Rockhill is a 190-resident home that serves individuals with chronic mental illness, including a 10-resident respite unit that provides a 30-day program under contract with Truman Medical Center Behavioral Health.  They are licensed by both the Missouri Department of Health and Senior Services and the Missouri Department of Mental Health… to read more and view photos click here:  Rockhill Manor Assisted Living.

Ravenwood – Assisted Living by Americare

In November 2013, I visited Ravenwood – Assisted Living by Americare.   Ravenwood is a 55-resident home in Springfield, which includes The Arbors, a 15-resident special care home that serves individuals with dementia.  They also provide adult daycare and respite care to support caregivers in the community… to read more and view photos click here: Ravenwood – Assisted Living by Americare.

Lake Stockton Healthcare Facility

In October 2013, I visited Lake Stockton Healthcare Facility in Stockton.  Lake Stockton is a 75-resident skilled nursing home and 37-resident assisted living home.  The skilled home includes an 11-resident special care unit that serves individuals with dementia… to read more and view photos click here: Lake Stockton Healthcare Facility.

To view more home visits, please select the category “Culture Change – Home Visits” in the search by topic box located on the right-hand column of this page.