Low-performing SNFs face more hurdles to resident-centered care, study finds

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Lower-performing nursing homes may have a more difficult time delivering resident-centered care due to turnover and lack of administrator guidance, a new study shows.

Researchers with the Veterans Health Administration set out to understand the barriers to implementing resident-centered care at their Community Living Centers, or nursing homes with a focus on homelike care.

The team conducted interviews with staff members at 10 CLCs on their person-centered care efforts, and found similar barriers to implementing the culture change for both high- and low-performing facilities. The study's results, published online this week in the August issue of Psychological Services, showed the five most cited barriers to resident-centered care were staffing, resources, resident acuity, regulations, and conflicts between resident-centered care and care quality.

For categories outside the top five, the facilities interviewed for the study began to diverge. Top-performing facilities reported fewer barriers to implementation, although coordination between departments was cited.

Low-performing facilities were found to have a more difficult time implementing person-centered care, with workers reporting additional issues including administrator turnover, lack of administrator guidance, staff morale and difficulty working with residents or families.

“As [resident-centered care] continues to spread, it is important to anticipate the barriers to implementing these practices,” the researchers wrote.

The researchers suggested that focusing on regulatory, leadership, organizational and workforce issues may help providers reduce person-centered care barriers, or avoid them altogether. Mental health providers may also be “uniquely situated” to assist providers in conquering those barriers, the study's authors noted.