United States Department of Veterans Affairs
 Health Care
Just Don’t Call It a Nursing Home
Walls of a patient bedroom with pieces of art and memorobilia
Veteran Robert M. Ozment has decorated his room at the Community Living Center, a dramatic example of the new approach to allowing residents to make their rooms more like home.

Nobody at VA says ‘nursing home’ anymore; they are called Community Living Centers, where elderly Veterans will find employees taking a new approach to taking care of those men and women who served our country in the military.

One of the best places to see the dramatic transformation in the care for elderly Veterans is at the Community Living Center at the Murfreesboro, Tenn., VA Medical Center.

Dr. Marvin Stubbs leads the team there, and his mantra is “quality, comfort and compassion.”

The idea is to change Community Living Centers from institutional care to a vibrant community where the focus is on resident-centered care and a homelike environment.

Patients and their families get to decide a lot of the things they would normally decide if the patient was at home in his or her own room — what pictures to hang, what sports team banners to display and what kind of television they would like to watch.

Previously, all rooms looked alike, meals were all the same and someone took your blood pressure on the staff’s schedule, not the Veteran’s. This new cultural change affects not only the environment, but the mindset of all the individuals providing care at the community living centers to provide a warmer, home-like atmosphere.

Bed in hospital room with draped flag and flowers
VA Medical Center staff often decorate the bedroom of recently deceased Veterans using spiritual and patriotic memorabilia.


One of the symbols of life and its phases is the butterfly — a creature that moves through different cycles of life. All of the staff members at the Murfreesboro Community Living Center know what a picture of a butterfly on the door means and what to do when they see one.

A butterfly on the door means the Veteran in that room will not live much longer, and the staff wants to make sure that the patient will not die alone. So, every time a staff member walks by that room, they take a few minutes to stop in and visit the Veteran. This happens all day and all night. When the Veteran does pass away, someone is there.

The passing may come at a quiet moment at three in the morning with one orderly and one patient but by being there with the Veteran in their final moments, the staff is honoring them and their service. The same goes for birthdays; if a Veteran does not have close relatives who are able to visit, the staff throws a birthday party with balloons and cakes and presents. For the Veterans, this is another example of how the staff honors patients.

Juan A. Morales, director of the VA Tennessee Valley Healthcare System, explains that the cultural transformation “is a systematic change in the approach to delivering long-term care.” The movement is sweeping the country and represents serious reform of institutional culture to one that gives a voice like never before to the people living and working in such a culture.

“We are making concrete changes to policies and practices, such as how we manage staff, how we honor those in our care, and how we create a homelike environment.”

By Hans Petersen, VA Staff Writer

Next story: Patients Play Major Role in Transforming Long-term Care