Pennsylvania Teaching Nursing Home Pilot Aims to Transform Care Model

The COVID-19 pandemic revealed to a nation the clinical, financial, social, emotional, and infection control vulnerabilities of our current facilities—for residents and workers. The urgency to learn from a pandemic that killed over 184,000 residents and staff in long-term care became apparent. In response, the Jewish Healthcare Foundation (JHF) is supporting a new initiative, the Pennsylvania Teaching Nursing Home project, to trial and validate a better model of residential care for the Commonwealth's frailest residents. JHF operating arm Health Careers Futures will launch the pilot in three teaching nursing home partnerships in Pennsylvania. In support of the pilot, Health Careers Futures received three grants totaling $974,110 from the John A. Hartford Foundation, the Henry L. Hillman Foundation, and JHF. 

The project will revive a model of care that proved successful in the 1980s: a "teaching" environment where students, academics, and healthcare workers collaborate to improve care for residents. This model provides opportunities for researchers to experiment with new methods of care, and for students to foster careers in nursing homes and geriatrics.

"The preceding fifteen months, while extraordinarily difficult for long-term care, yielded a number of natural experiments demonstrating that there are creative, innovative ideas in the field worthy of further review and study. This effort will provide a research and pilot platform for what we believe will be helpful concepts to improve quality of life in long-term care." added David K. Roger, President of the Henry L. Hillman Foundation.

The partnerships will equip existing nursing facility staff with clinical, training, research, and quality improvement support, creating a critical bridge between bedside care and academic innovation and clinical expertise. With increased opportunities to learn first-hand and in a real-life setting, students and staff will enhance their clinical skills while improving the functioning and health status of seniors. Project leaders hope the results of the pilot will inform a better model for ongoing clinical quality improvement and safety in long-term care.

For decades, JHF has advocated for improvements and reform to the holes in the long-term care system, and this project is a landmark in JHF's work. What COVID-19 Exposed in Long-Term Care, the short award-winning documentary JHF produced in 2020, illuminated how a history of lackluster resources and underfunding created a perfect environment for COVID-19 to wreak havoc. JHF commissioned a study by the LeadingAge LTSS Center @ UMass Boston, "The Case for Funding: What is Happening to Pennsylvania's Nursing Homes?," which documents the critical role that nursing homes play in the care of older and vulnerable adults in Pennsylvania. The resulting January 2021 report characterizes issues, including changes in Medicaid reimbursement, that will affect the utilization and financial viability of nursing homes in the state. JHF is supporting a forthcoming second study, The Quality of Care in Nursing Homes by the National Academies of Sciences, Engineering, and Medicine, which will present policy priorities to redesign current skilled nursing models. The study is convening a Committee on the Quality of Care in Nursing Homes over one year to examine how our nation delivers, regulates, finances, and measures quality of nursing home care.

The Pennsylvania Teaching Nursing Homes project will begin on July 1, 2021 and will run through 2023 in three regions of Pennsylvania (Eastern, Central and Western). The three funding organizations recognized their shared interest in improving the care of nursing home residents and supporting the current and future workforce of skilled nursing homes. The project will draw on the existing resources from the John A. Hartford Foundation's Age-Friendly Health Systems initiative and the Jewish Healthcare Foundation's Full Court Press Senior Residential Living Team, while integrating lessons learned from the Teaching Nursing Home implementation of the 1980s (originally supported by the Robert Wood Johnson Foundation). The pilot will engage key academic partners at The Pennsylvania State University College of Nursing, University of Pennsylvania School of Nursing (Penn Nursing) and University of Pittsburgh School of Nursing.

"The pandemic has shown us the multiple ways we have failed to appropriately integrate nursing homes into the continuum of care and the continuum of nursing education," said Terry Fulmer, PhD, RN, FAAN, President, The John A. Hartford Foundation. "This program, which has previously shown positive results without the benefit of the Internet, can now be revisited with these world class nursing schools."

"The pandemic tragedy in nursing homes brought attention to the serious challenges to our long-term care industry that have been building for decades. We are proud to bring together a coalition of funding, academic, and health system partners to test a new approach in our Commonwealth," said Karen Wolk Feinstein, PhD, President and CEO of the Jewish Healthcare Foundation and Health Careers Futures. "Inspiring examples like Hebrew SeniorLife in Boston have demonstrated the positive impact on patients and staff in a teaching nursing home model. We believe this pilot could help pave the way for better long-term care across the country."

Read the Pittsburgh Business Times' coverage here: JHF, Hillman Foundation launch program to improve long-term care

Coverage in McKnight's Long-Term Care News: Major nursing home pilot looks to the past for cues about collaboration, innovation

Read more in the Pittsburgh Jewish Chronicle: JHF partners in pilot 'teaching nursing home'

Read more in Businesswire here. 

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