Proactive Culture Change


When Byron Health Center CEO, Deb Lambert, arrived at the community in March of 2012 for an interim stint, she saw that the culture focused more on discipline rather than on a positive environment for residents and staff. Her philosophy was twofold—that employees should have fun at work, as well as realize that their place of employment was the residents’ home. In fact, she realized that many of the behaviors were ones she wouldn’t tolerate in her own house. Byron’s CMS star rating was 2, their report card score was over 280, and it was the second worst in their county out of more than 30 organizations. Byron is unusual in that it serves a vulnerable community with multiple diagnoses such as psychiatric and developmental disorders, along with medical issues. This combination can lead to challenging behaviors, which means the community has a lot of interaction with the law enforcement and mental health community.


Deb worked with all staff to develop a formal culture at Byron based on six principles: commitment, communication, compassion, integrity, passion, and respect—all of which guide their community today.

Implementation Details:

As a new interim CEO, Deb asked staff about whether they wanted to work in the current culture. The majority said “no,” but that they stayed because of the residents. Deb went to the board of directors and asked them to allow her to start a process of culture change. She tapped at least two front-line people from each department to serve on an internal group to develop their core values, team member credos, and resident credos. The group started by asking “how do you want to feel when you come to work,” and a few months later took dozens of words and distilled them into the six principles.

The new culture permeates the community and the principles and values are part of new employee interviews, coaching and, employee evaluations. In fact, most employee infractions are due to not following Byron’s culture.

Factors for Success:

  • Get support from the board—this is a long, challenging process.
  • Get support from all team members, especially from those closest to the residents, such as the direct care staff.
  • While the majority of your staff may support the change, expect some percentage to leave voluntarily—or be invited to leave.
  • Realize that you are building a culture of excellence. Instead of teaching everyone about the regulations, hold them accountable to the culture and you will meet state and federal guidelines.


  • In less than two years, Byron’s CMS 5 star rating went from 2 to 5 and their report card score dropped into the 50s, which allowed them to get the full reimbursement for quality.
  • They are now in the 90th percentile in the state of Indiana.
  • Employees are happier: one former housekeeper has gotten her master’s degree and is now a department leader due to the culture change.
  • Law enforcement and mental health professionals say that residents are behaving better than they have ever seen them before.
  • They have become a community where state surveyors enjoy coming to do the survey.
  • Referral sources gladly refer potential residents to them with confidence.

Need more information?

Contact Deb Lambert at Byron Health Center.