Meet the Presenters

Creating Home: The New Quality of Life Revisions to LTC Surveyor Guidance — A Webinar Series for Providers

Karen Schoeneman
Deputy Director, Division of Nursing Homes, Centers for Medicare & Medicaid Services

Karen C. Schoeneman, MPA, is the Deputy Director of the CMS Division of Nursing Homes, which has the responsibility for survey and certification of nursing homes. She manages the Division Clinical Team which has responsibility for the long term care survey process, the interpretive guidelines, and the new Quality Indicators Survey process. She has trained over 5000 surveyors as part of their Basic training course. She has executive produced several CMS live satellite broadcasts including shows on the activities requirements, quality of life, culture change and dementia care, among others. She is a nationally recognized expert in culture change and is the CMS lead for this topic. She is one of the founding members of the Pioneer Network and is also an Eden Associate. She is the co-developer of the CMS Artifacts of Culture Change questionnaire. She was the CMS lead for the CMS/Pioneer Network "Creating Home in the Nursing Home" national public symposium on culture change and the environment requirements, which was held in April, 2008. She is the CMS representative on the Veterans Administration Culture Change Task Force and the Pioneer Network Small House/Household Project, and a CMS participant in the Pioneer Network National Life Safety Task Force.

Debra Swinton-Spears, MSN
Nurse Consultant, CMS Division of Nursing Homes

Debra T Swinton-Spears, MSN is a Nurse Consultant for the CMS Survey and Certification Group Division of Nursing Homes. Debra is the project officer, clinical expert and consultant for the long term care surveyor interpretive guidelines. She has developed surveyor interpretive guidance for nutrition, sanitary conditions and infection control.

Debra is a clinical expert for the Quality Indicator Survey process and leads the new Federal Oversight Quality Indicator Survey project. She is also the project officer for the CMS Survey and Certification Group Revisit User Fee program.

Debra is the lead for the basic long term care surveyor training and clinical expert for the tradition survey process. She developed and presented the CMS live satellite broadcast for surveyors on the Medicare Part D benefits program.

Debra is a CMS participant of the National Pioneer Network program and a strong supporter for culture change in long term care facilities.

Betsy Brawley
IIDA, AAHID, CID President, Design Concepts Unlimited

Betsy Brawley, president of Design Concepts Unlimited, is a consultant and senior interior designer with more than 30 years experience in environmental design and applying research to improve the lives of older adults and those with Alzheimer's disease. She specializes in designing supportive, therapeutic environments for Alzheimer's special care and encourages exploration and innovative design solutions to meet the special needs of older adults.

Betsy is a past member of the Alzheimer's Association National Board of Directors, a member of the International Interior Design Association (IIDA), a founding member of the American Academy of Healthcare Interior Designers (AAHID), and currently holds an advisory position with IESNA (Illuminating Engineering Society of North America), who developed the ANSI national building standards for lighting for senior environments adopted in 2001.

Ms. Brawley has gained national and international recognition as an expert and industry leader in the area of environmental design for aging. She is a summer lecturer at Harvard University's Graduate School of Architecture and the author of the recently released Design Innovations for Aging and Alzheimer's - Creating Caring Environments, a detailed guide for a broad range of design issues essential to maintaining independence and functional abilities. She was awarded the 1998 Polsky Prize for her landmark book Designing for Alzheimer's Disease: Strategies for Creating Better Care Environments.

Kim Clayton, BA, NHA
Senior Policy Analyst

Ms. Clayton has twenty years executive management experience, holding positions as Executive Director or Nursing Home Administrator for mid-sized and large health care facilities across the care continuum. Ms. Clayton is widely regarded as an exceptionally talented SNF operational leader, who has specialized in conducting large scale operational turnarounds for several special focus facilities, leading them to full regulatory compliance. She is regarded by many for-profit and non-profit homes in Maryland and by State and Federal officials as a regulatory compliance and operations expert.

Ms. Clayton is currently a Health Policy Analyst for the Maryland Health Care Commission. She also offers private operational consulting to nursing homes and provides guest lectures for Towson University Gerontology and Health Management Graduate students.

Since 2005 Ms. Clayton is a Captain in the volunteer Maryland Medical Defense Force, 10th Medical Regiment. Her specialty is disaster preparedness in long term care settings. In 2009 she will obtain her FEMA, "Incident Commander" certification.

She has recently participated in the National Life Safety Task Force, sponsored by the Pioneer Network, n 2009 and the Pioneer Network 2009 Conference Planning Committee. Ms. Clayton believe the culture change movement is bringing to wide recognition the principles of the OBRA '87 law and regulations for quality of life in context of optimum quality of care, which she has made the key focus of her career.

Barbara Frank, MPA
Co-founder B and F Consulting

Barbara Frank is co-founder, with Cathie Brady, of B & F Consulting, which assists nursing homes to be better places to live and work. B&F focuses on the how of change and helps homes improve clinical performance through an integrated approach that applies quality improvement principles to stabilize staffing and implement culture change. B&F helps managers, supervisors and staff build systems and skills to work better together. Working with Quality Partners of Rhode Island, B&F produced a four part series of CMS web-cast training for surveyors called "From Institutional to Individualized Care" and a Staff Stability Toolkit used by Advancing Excellence to help homes improve staff retention. B&F leads a team helping nursing homes in the New Orleans area stabilize staffing after Hurricane Katrina, and is producing a film, with Louisiana Public Broadcasting, "The Big Uneasy: Katrina's Unsung Heroes," which captures lessons from the experience. Under Better Jobs, Better Care – VT, B&F worked with David Farrell to develop a process and tools for collecting and analyzing data to spend smart for staff stability. With Farrell, Brady and Frank co-authored A Case for Consistent Assignment, Provider 2006.

Frank has over thirty years experience in national, state, and local long-term care and workforce development work. For 16 years she directed policy and program work for National Citizens' Coalition for Nursing Home Reform in Washington, DC. In this capacity, she facilitated the Campaign for Quality Care, a coalition of national organizations that worked together to enact and implement OBRA '87. She helped develop OBRA's regulations and survey guidelines, and provided training to federal and state surveyors on their implementation. Frank also served for 4 years as Connecticut's State Long Term Care Ombudsman where she initiated Breaking the Bonds, a statewide coalition that educated providers on alternatives to restraints and on individualized care practices. She facilitated the founding meeting of the Pioneer Network in 1997 and in 2005, the St. Louis Accord, which sparked growth in state culture change coalitions. Frank co-authored "Nursing Homes: Getting Good Care There" and "Health Care Workforce Issues in Massachusetts." She has an MPA from the Kennedy School of Government.

Sue Misiorski, BSN
Director of Organizational Culture Change, PHI

Susan Misiorski, BSN, is the director of organizational culture change at PHI, a nationally recognized nonprofit whose mission is to transform the delivery of eldercare and disability services. In her role, Susan supports long-term care providers to build the skills to manage change and create dynamic relationship-centered organizations. Susan supports providers to design organizational structures and practices that place the preferences, needs, and interests of the person receiving care and support first.

Susan has supported multi-site organizations such as Genesis Health Care, in addition to partnering with clients to implement neighborhood and flexible household models. Susan participates in PHI's Center for Coaching Supervision and Leadership, a program funded by the John A. Hartford Foundation and Atlantic Philanthropies, which provides intensive support to 12 long-term care organizations to grow supervisory skills among managers and nurses.

Susan has been a leader in the Pioneer Network, a national organization whose sole purpose is to serve the culture change movement, since its inception in 1997. She served as president of the network from 2000–2003 and continued to serve on the board of directors through 2006.

Susan has authored several articles on culture change for professional journals and is also the author of Getting Started: A Pioneering Approach to Long-Term Care Culture Change. This handbook, published by the Pioneer Network, is a resource to nursing home providers who are looking for information and tools on how to create a high-involvement process for transforming institutions into homes.

Susan is a frequent speaker at state and national conferences on topics related to culture change, including person-directed caregiving practices, "I"-format care planning, and leadership. She participated in the CMS satellite broadcast titled Innovations in Quality of Life, and has testified before the Senate Committee on Aging concerning prevention of malnutrition among elders.

LaVrene Norton
Executive Leader, Action Pact, Inc.

LaVrene Norton is Executive Leader and Principal of Action Pact, specializing in the Household Model. She is recognized as the nation's foremost organizational change facilitator in long-term care. Norton pioneered the Household Model and has guided hundreds of organizations through deep change in the US, Canada and Australia. She is editor and publisher of Culture Change Now, a magazine dedicated to promoting change strategies in elder services.

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