Training was facilitated in two parts.  In the first session, she started by providing a comprehensive overview of history surrounding OBRA regulations.  Current regulations were highlighted, showing how they actually support culture change.  Then, common culture change practices were reviewed by putting participants in the role of surveyor, asking them which regulations pertain to each practice and how it is possible to remain compliant with the regulations.

In the second learning session, Carmen walked the participants through specific OBRA Quality of Life F-tags and for each one she discussed the deficient practice, the compliant practice and the culture change practice.  After she reviewed a few f-tags in this manner, the attendees participated by working together in small groups (the surveyors were spread out among the nursing home leaders) to review additional F-tags and each group listed deficient practice, compliant practice and culture change practice.  Next, the groups shared their findings with the entire room of people.

Carmen wrapped up the conference with a discussion about common nursing home terminology and how such language perpetuates the institutional nature of most facilities.  The attendees were engaged throughout the event and everyone indicated that it was an excellent event.  She was able to provoke people in their thinking to examine their paradigms and she debunked the myth that the regulations and surveyors hold back culture change.  Provider's left inspired to implement these changes and the surveyors left charged to assist them.