Creating Home in the Nursing Home through Culture Change Training Focused on
Enhancing the Dining Experience
Goal of the Project
The main goal of this 18-month project, funded by the Winter Park Health Foundation, is to
provide culture change coaching to three Orlando area nursing homes focused on creating home
in the nursing home through enhancing the dining experience. Lessons learned from the pilot
home have contributed to a replicable program called Dining at Home, which will be used along
with FPN’s culture change coaching model to improve the quality of life of residents.
The Intervention
FPN will provide culture change coaching to enhance the dining experience in three Central
Florida skilled nursing facilities: The Mayflower Health Center in Winter Park, Mary Lee
Depugh Nursing Center in Winter Park and Sunbelt Health and Rehabilitation Center in Apopka.
Each of these homes was invited to participate in the project for specific reasons as follows:

The Mayflower Health Center: Winter Park location; provided with a stipend in 1999
from WPHF which resulted in their changing the culture of end of life care in the Center;
have begun to work with Dr. Kelly on Dining at Home but without the culture change
training provided by FPN and so the “buy in” needed for success is not yet fully there; is
building a new “household model” nursing home and staff and resident training for
transitioning into the household model is essential to their success.

Mary Lee Depugh Nursing Center: Winter Park location; primarily African American;
have had no culture change or Dining at Home training or coaching.

Sunbelt Health and Rehabilitation Center: began their culture change journey a few years
ago with assistance from FPN but has had no Dining at Home training or coaching; part
of the Adventist Health System which operates five nursing homes in the Orlando area so
they can be a model for those homes.
The coaching of each of the three homes will consist of the following (each home will be visited
once a month during the course of the project):
Visit #1: Assessment of the Home’s Current Culture: The coach will tour the home, interview
management and frontline staff, have lunch to experience and observe the dining experience, and
meet with the Culture Change Leadership Team (CCLT) which consists of the Administrator,
Director of Nursing, Department Heads and at least one frontline staff person, e.g., nursing
assistant, dietary aide, housekeeper, from each department. The coach will facilitate the CCLT’s
completion of the CMS Artifacts of Culture Change tool.
-OVER-

Visit #2: Seeing the Present and Envisioning the Future: The coach will meet with the
CCLT and present the findings of the assessment of the home’s current culture for
discussion. Based on the assessment, the coach will have developed individualized
training modules for each home and will teach Module #1 during this visit. Each home
will have homework to do between the second and third visits. The coach will call the
home in between to “see how it’s going.”

Visit #3: Listening to the Experts: The coach will meet with the CCLT to review their
homework, teach Module #2. Each home’s homework will directly relate to what they
learned in Module #2.

Visit #4: Dreaming: The coach will meet with the CCLT to review their homework, teach
Module #3 and facilitate the establishment of a Dining Action Team; the CCLT may
decide another to establish another action team as well. The homework will be to recruit
non-CCLT members, including staff, residents and families, to participate in the Dining
Action Team.

Visit #5: Creating the Blueprint: The coach will meet with the Dining Action Team and
facilitate a Learning Circle for ideas regarding the Team’s action plan. She will review
ideas that came up at previous meetings. The homework will be for the Dining Action
Team to meet without the coach and finalize their action plan.

Visit #6: Starting the Building: The coach will meet with the Dining Action Team and
review the action plan, providing coaching as needed. If the action plan requires purchase
of items to enhance the dining experience, up to $5,000 reimbursement per home for the
items will be provided.

Visit #7-17: The coach will meet with the Dining Action Team, review progress, and
provide coaching as needed.
A stipend will also be available for each home. The stipend is to be used by the home to
purchase supplies to enhance the dining experience which might include steam tables,
tablecloths, carts for soup and/or desserts, minor renovations or other items to enhance their
culture change journey. This would be in consultation with the coach and FPN would reimburse
them for approved expenditures of up to $5,000 per home.
Project Report
A final report and journal articles will be prepared on the process, findings and lessons learned
from the project that will be disseminated across the state of Florida and around the country.
Grant Amount:
$30,500 for 18 months