Community Meetings build Community and Compliance with many CMS Requirements

The recognized culture change practice of Community Meetings began as the Live Oak Regenerative Community Project in the 1970s at the Jewish Home in Oakland, CA. It was created by those who lived there and leaders Barry and Debora Barkan. The community meeting definition is beautiful.

The community meeting is a coming together to build community, create connection, explore meaning, gather as a community to discuss things of mutual interest and concern, to celebrate, to remember and to mourn.

Do those terms sound familiar? They are all a part of CMS Tag F679 Regulation and its Intent.

CMS Tag F679 §483.24(c) Activities.

The facility must provide, based on the comprehensive assessment and care plan and the preferences of each resident, an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community.

From Tag F679 Intent.

To create opportunities for each resident to have a meaningful life by supporting his/her domains of wellness/wellbeing security, autonomy, growth, connectedness, identity, joy and meaning.

In this article we will look at the original beginnings of the Live Oak Regenerative Community Project.

The Structure of Community Meeting

• Welcoming
• Opening Song
• Exercises
• News of the Home
• News of the World
• Discussion of the Day
• Conclusion

Welcoming

Welcoming provides the opportunity to connect with each person, shaking hands, making eye contact, and giving a warm welcome.

The community meeting becomes a fantastic avenue to welcome every newcomer to the community. A person moving in or coming for a stay, many refer to rehab guests, families/friends and certainly visitors as well. Instead of announcing, “This is Joe, he works in the kitchen” or “This is Mrs. Smith she lives in room 200,” ask the person if they are comfortable to take the mic so-to-speak. We do recommend a microphone so all can hear. Invite new-to-the-group people to share anything they want to help their new community get to know them. It’s fun and meaningful. One time a new cook asked, “Do you all know Jane the nurse? That’s my wife.” No one knew.

Opening Song

An opening song builds spirit, engages everyone, tells people the meeting has begun.

The brilliant Barkan’s asked those who lived there for a better way to communicate resident rights when a person moves into the community. The result is Our Rights Go Marching On to the tune of The Battle Hymn of the Republic.

Our Rights Go Marching On

Glory, Glory Hallelujah,

Glory, Glory Hallelujah,

Glory, Glory Hallelujah,

Our rights go marching on

We have the right to worship and to pray as we please,

We have the right to raise our own flags up in the breeze,

We have the right to watch the clouds and sit under the trees,

Our rights go marching on.

We have the right to greet our friends when we want to entertain,

We can recommend new changes and it’s our right to complain,

We’re entitled to our privacy and a room with our name,

Our rights go marching on.

Our bodies are our own from our heads down to our toes

When we ask about our meds, don’t you treat us like your foes.

We are a group of elders who have the right to know,

Our rights go marching on

Written by the Live Oak Poets’ Workshop Chorus

Considering adopting this song that reminds all the power in the rights bestowed upon those who live there and/or write a song that reflects your community. The right song builds energy. My Certification in Validation Groups also teaches this. God Bless America for instance is always fitting, consider the military branch songs, a song regarding the state or town, etc. The Barkan’s believed, discovered and remind us that rituals bind a community together.

Exercises

Exercises provide a physical learning experience, growth in capacity is acknowledged, builds alertness.

No need to think of this as silly, we all need more movement every day. Some turn this into stretching and deep breathing, all needed by all of us.

News of the Home

News of the home includes announcements and discussion of past events and coming events: rights of passage for community members, workers, and their families; logistics; planning and decision making.

We all know what it feels like to not be communicated with.  The community meeting affords this important opportunity to help all feel communicated with and not left out. Community meetings give the opportunity to discuss what is really going on – including illnesses and death. Hospitalizations are discussed, prayers and good wishes for recovery are shared, anyone returned from the hospital receive a warm welcome back home and encouraged to continue recovery with community support, teaches Barkan.  Homes obtain permission to do this either in disclosure documents when one moves in or before a meeting.

Rights of passage for community members refers to life events like birthdays, anniversaries and even death. Don’t shy away from talking about, remembering and celebrating individuals who have passed away. Consider moments of remembrance during community meeting but then also hold a memorial service for person (this is also a recognized culture change practice rather than the institutional practice of a group memorial for whoever died in the last six months).

Most institutionalized people are not planning their future. The community meeting gives this back to people. It gives people back the planning future events, in and out of the home, and to be a part of everything from decorating, to how to celebrate a certain holiday, to deciding on community service projects.

Decision-making is what goes on in a home by those who live there. The community meeting itself generates ideas for changes while everyone’s ideas are tapped for decisions about how to implement the changes.

News of the World

News of the world: Invites involvement in wider community affairs as they relate to the elders in the home; ongoing discussion of current topics of national and world interest.

The Barkan’s recommend identifying news that is particularly relevant to those who live there, putting it into a wider historical context that they can relate to. The Barkan’s didn’t shy away from sharing world news as it gives isolated people the opportunity to reach beyond their home, keep up with world happenings, weigh in and become involved when they so desire. Decide together as a community. People living in LTC homes have a lot of time on their hands. Maybe they can do something about issues that deeply move or impact them more than ever before i.e., committing to prayer, writing letters to soldiers or senators.

Discussion of the Day

A discussion of the day stimulates and challenges participants (talking, feeling, and thinking about a topic); provides a reference point for future conversations, planning, and decision making.

Closing Song

A closing song lets people know meeting is ending; ends the meeting with a good
feeling.

Bringing people together as a community has its own value. In a regulated nursing home or assisted living, we can add even better compliance with regulations. What a win-win.

The community meeting is a coming together to build community, create connection, explore meaning, gather as a community to discuss things of mutual interest and concern, to celebrate, to remember and to mourn. Because these are all mentioned at Tag 679 Activities, let that guide you, consider bringing the idea of community meetings to your community and be even more compliant with this good regulation and its intent. Community meetings truly build both community and compliance with many CMS requirements. More regulations were mentioned in the last article and more will be mentioned in the next.

For more information, look for Live Oak Regenerative Community on YouTube. A three-year grant in Colorado produced many videos. Also, “The Live Oak Regenerative Community” chapter in Models and Pathways for Person-Centered Elder Care. Baltimore: Health Professions Press by Barry Barkan, 2014.

Carmen Bowman, MHS, Regulator turned Educator of Edu-Catering: Catering Education for Compliance and Changing Institutional Culture is an activities/engagement/community life, regulatory compliance and culture change consultant.  She offers new or not-yet-qualified activity director consultation and personalized continuing education for professionals/teams/associations. Also, a new blog and eResource GUARDIANS OF NORMAL LIFE: How Activity/ Recreation/ Engagement/Community Life Professionals can Save the World of LTC at  www.edu-catering.com. At the Edu-Catering YouTube channel, see how turning rigid schedules into flexible ones creates all the outcomes everyone wants!