Research-based model home for persons with dementia closes: policymaking and regulatory constraints on nursing innovation... including commentary by Horgas AL, Rantz M, Brower L, Smoyak SA and Conway-Welch C with author response

Document Type


Peer Reviewed


Publication Date


NLM Title Abbreviation

Nurs Health Policy Rev

Journal/Book/Conference Title

Nursing & Health Policy Review

Start Page



This article analyzes the experience of the authors, two nurse faculty entrepreneurs, who developed and operated a research-based nursing alternative model of long-term care, Liberty Country Living (LCL), for persons with middle and advanced stages of dementia in Iowa. The innovative nursing facility had to close abruptly after 5 years of highly successful operation due to a change in the oversight agency and in the regulatory environment. The policymaking and regulatory environment coincident with developing and opening LCL, the development and operation of the research-based LCL nursing model and outcomes, and the regulatory environment that resulted in its closing are described with implications for nursing and the long-term care of elders with dementia examined. Efforts made to change the rules after closure of the facility are described. Legislation was introduced in the state legislature to allow demonstration models of dementia care. The bill passed the house and senate unanimously but was subsequently vetoed by the governor.


Dementia -- In Old Age, Health Facility Closure -- Iowa, Long Term Care -- In Old Age, Public Policy -- Iowa, Skilled Nursing Facilities -- Iowa, Aged, Assisted Living -- Legislation and Jurisprudence, Entrepreneurship, Gerontologic Nursing, Government Agencies, Government Regulations, Health Facility Environment, Inpatients, Iowa, Legislation, Licensure, Nursing Practice, Evidence-Based, Outcomes (Health Care), Personnel Staffing and Scheduling, Politics, Quality of Health Care, Quality of Life

Published Article/Book Citation

Nursing & Health Policy Review, 3:1 (2004) pp.49-.

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