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HSR&D Research Provides Foundation for National Center to Improve Nursing Home Care

April 14, 2021

Takeaway: Developed based on HSR&D-funded research, the Community Living Centers’ Ongoing National Center for Enhancing Resources and Training (CONCERT) provides training and guidance to help VA Community Living Centers – and soon also State Veterans Homes – make meaningful improvements in quality of care.

VA’s 134 Community Living Centers (CLCs; nursing homes) provide long- and short-term health and rehabilitative care to approximately 9,000 Veterans daily. CLCs provide care in a person-centered environment designed to meet Veterans’ individual needs. The 151 State Veterans Home nursing homes (SVHs) are owned and operated by states but are certified and substantially financially supported by VA. SVHs serve approximately 20,000 Veterans daily. In 2016, VA’s Office of Geriatrics and Extended Care launched a national center to engage and support CLCs; this center will soon expand to also serve SVHs.

The CLCs’ Ongoing National Center for Enhancing Resources and Training (CONCERT) provides training and implementation guidance for CLCs to make meaningful quality improvements by integrating all staff, particularly those at the front lines of care, into quality improvement processes. CONCERT is co-directed by Christine W. Hartmann, PhD, a Research Career Scientist at HSR&D’s Center for Healthcare Organization and Implementation Research (CHOIR), and A. Lynn Snow, PhD, an investigator from the Tuscaloosa VA. The CONCERT approach is built on a strong evidence base originating from two HSR&D studies (PPO 09-266, CRE 11-349) led by Dr. Hartmann, with Dr. Snow as co-investigator. CONCERT supports high-functioning, interdisciplinary teams in implementing whole-health care, using a practice of frontline staff huddling to improve quality of care for Veterans and quality of work for staff. CONCERT provides training, guidance, coaching, and resources and has had numerous foci over the years, including supporting lower-performing CLCs and spearheading national quality improvement initiatives.  


Since 2016, VA’s Office of Geriatrics and Extended Care (GEC) has continuously funded CONCERT as a field-based center that integrates with other Office and national initiatives. Under VA’s Facility-Based Care Modernization Plan, CONCERT will move to VA Central Office. Within GEC, there will be one full-time CONCERT lead position along with four full-time CLC-focused and four full-time SVH (State Veterans Home)-focused CONCERT staff.

Hartmann C, Minor L, and Snow AL. Development of a program to support VA community living centers’ quality improvement. Federal Practitioner. May 2019; 228-231.

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