The nursing home industry is one of the most regulated businesses in the nation. Their operation has become so regimented to control risks and costs that buildings look alike and virtually every decision is made for residents, from when to get up to what to eat.
The regulations, although well-meaning, have combined with outdated payment system, to stifle innovation. There is little incentive to raise quality above minimum standards.
Today, too many nursing homes offer a passionless, hospital-like service built for efficiency. It may have made sense decades ago, but now turns off people, struggles with high employee turnover and continues to experience quality problems.
Against this backdrop, reformers in recent years have pushed for a radical rethinking of the long-term-care system known as "culture change."
A smattering of nursing homes around the country, including Buffalo, have adopted a few aspects of the movement. Now, advocates in Western New York want to turn culture change into a regionwide initiative, making this community the first in the U.S. to attempt a transformation in elder care on a large scale.
-- Henry L. Davis