The Rhode Island coalition has held three meetings. The coalition membership is quite diverse. It consists of a Minister, an attorney, a CNA, a physician, administrators and DONs from both for-profit and non-profit SNFs, Ombudsman, the Chief of the Dept. of Health and a health policy analyst from the Dept. of Health.

The coalition has met to discuss RI state regulations which could get in the way of the principles of organizational culture change. After a thorough review of the state regulations by a sub-committee of the coalition, the group proposed three state regulations for rewording. The three regulations involved: very specific meal times, residents designating their visitors and a regulation that required every resident to have a "straight back" chair in their room. In addition, it was decided that the word "unit" should be stricken from all the state regulations and replaced with the word "residence."

The sub-committee, with the help of the attorney on the coalition, will now re-write these regulations and present them to the Dept. of Health in the next few weeks.

These state regulations are not frequently cited. However, the point is, they exist and legally could be cited. Therefore they should be changed now. In addition, it was a healthy first activity for this diverse group of coalition members. The representatives on the coalition from the Dept. of Health were incredibly helpful and open to this collaboration. This process and the subsequent changes to the regulations will also send a loud message to the providers in the state that this coalition is action oriented and, in collaboration with the Dept. of Health, is willing to open doors to providers willing to go down this journey.

On Feb. 10th, there will be a training provided to the entire group of surveyors in RI on the basics of organizational culture change. This will represent the first of four training events the coalition will conduct for the surveyors throughout the course of 2006.

The coalition has also taken the information posted earlier on the Pioneer Exchange about Civil Monetary Penalties and customized it for presentation to the LTC Coordinating Council chaired by the Lt. Governor here in RI. The hope is to make use of those funds for the coalitions efforts of spread.

Finally, the coalition is planning a day of training earmarked toward nursing students in RI. It plans to educate them about this movement and the positive aspects of choosing to specialize in Geriatric nursing and working in LTC.