Date of Conferral



Doctor of Healthcare Administration, DHA


Health Services


Magdeline Aagard


The Centers for Medicare and Medicaid Services recommends new guidelines that shift healthcare delivery in nursing homes and long-term care facilities from an institutional model to a person-centered care model. Although clinical outcomes are measured and tracked, there was limited literature about the challenges non-clinical departments face in a nursing facility during implementation of a person-centered model. The purpose of this qualitative study was to explore the challenges non-clinical staff experience while transitioning to an Eden Alternative philosophy, a person-centered care model. The theoretical foundation of this study relied upon Bressers' Contextual Interaction Theory. The research questions for this study focused on the specific challenges that affect non-clinical staff from a staffing, operating, and risk management standpoint. The research questions focused on the internal and external motivations for staff as well as whether or not identifying such challenges will allow a nursing facility to achieve full Eden certification. The researcher for this study utilized a case study approach to explore the responses of 15 directors of non-clinical departments across the United States. Semi-structured interviews, Eden Warmth Survey data, and Minimum Data Set 3.0 data were used to gather data from participants and facilities involved. After using open coding for data analysis, significant findings in this study included that directors needed corporate buy in, continuous education, proper staffing and financial funding in order to achieve and maintain compliance. The study implications for social change involves addressing non-clinical department challenges directly and thus creating fewer barriers when embracing person-centered care models, such as the Eden Alternative model, as an environment for aging, compared to institutionalized approaches.