Table 1.

Concepts of the Chronic Care Model Adapted for Nursing Homes.

Chronic Care Model Concept	Concept Description Adapted for Nursing Homes
Health systems	Administrator philosophy, facility culture, and facility regulatory environment determine the degree of priority placed on and the quality of productive interactions between the practice team (physicians and APRNs) and the patient (resident and family)
Decision support	Sharing of expert information, including evidence-based guidelines and exceptions to those guidelines, providing a venue for productive interactions, improving the residents' comfort level and willingness to participate in self-management
Self-management support	Acceptance of the resident as director of his or her own health care management, provision of ongoing education, support, and encouragement to participate
Patient	Nursing home resident/family member informed of illness treatment options and “activated” or aware of the importance of his or her role in chronic illness care
Practice team	Physicians and APRNs focused on placing the resident at the center of chronic illness care and providing proactive rather than problem-oriented care
Productive interactions	Quality, frequency, and mode of communication and resulting understanding and motivation between providers and resident/family

Note. APRNs = advanced practice registered nurses.