Culture Change

In 2004, Lutheran Services Carolinas began a “culture change” journey called New Pathways, a person-centered model of care developed by LSC staff members and clinicians.

New Pathways encourages the development of resident-centered practices and the creation of a nursing home “culture” that is more home-like and less hospital-like. New Pathways combines elements of two proven long-term care quality improvement methods, the Eden Alternative, which emphasizes resident quality of life and resident choice, and Wellspring, which emphasizes quality of care and empowerment of frontline staff through specialized training modules and multi-facility collaboration. This overall change in the nursing home culture enables residents to make decisions on those simple yet meaningful matters that most of us take for granted, such as when to get up in the morning, when to bathe, or what to eat.

From the implementation of New Pathways, LSC has learned that those who work directly with the residents every day know those residents best and that their knowledge regarding day-to-day care is usually more valuable than that of management. This led to the creation of specialized care resource teams that are better trained and are empowered to advocate for residents. The intensive New Pathways training creates more capable staff members, who have both the confidence and competencies they need to make good decisions along with their residents.

LSC has also learned that in order to continue on its culture change journey, significant changes would need to be made in the actual physical structure of its nursing homes. Instead of following a hospital design, LSC’s newest nursing homes, or senior living communities, are more contemporary and feature small neighborhoods, more private rooms, and more community features like Internet cafes, buffet-style dining, and playgrounds for visiting children.


To learn more, read about LSC’s culture change journey in Provider magazine.


To support LSC’s culture change efforts, donate now.

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