ABSTRACT A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.

中文翻译：

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通过政策驱动的文化变革检查疗养院的物理环境

摘要 由于严格的组织因素和类似医院的文化，迫切需要挑战养老院护理的方法。有人认为，居民护理需要通过解决疗养院设施中的组织、社会和物理环境来转向以人为本的方法，这一过程通常被称为文化变革。为满足这一需求，医疗保险和医疗补助服务中心 (CMS) 为按绩效付费 (P4P) 疗养院激励计划设立了资金，以允许疗养院提供者因设施的文化变革而获得 CMS 报销。通过护理人员访谈、现场观察和文件审查，这项定性研究评估了中西部州 P4P 激励计划在三个参与的疗养院中的影响。