Reform Overview

In recent years, the welfare home in Zhangbang Town, Qichun County, has broken away from the traditional elderly care dilemma of "government monopoly and inefficient operation" through reform and innovation. It has established a management mechanism characterized by high efficiency, meticulous service, humanistic care, distinctive medical-nursing integration, and diversified funding. This transformation has upgraded the facility from basic sustenance to modern elderly care services. Currently, the welfare home's bed occupancy rate has reached 82%, and the satisfaction rate among impoverished individuals is 95%. It stands as the only national-level four-star welfare home in Huanggang City.

Township welfare homes serve as the main front for grassroots elderly care and are crucial for safeguarding the happiness of impoverished elderly individuals in their later years. However, rigid management systems, high fiscal dependency, and low operational efficiency are common challenges for most grassroots elderly care institutions. To address this predicament, in recent years, the Zhangbang Town Welfare Home in Qichun County has abandoned the traditional "fiscal contract and government-only management" model. Instead, it has innovatively implemented a "dual-layer supervision + three-level management" operational mechanism to comprehensively activate the institution's internal driving force.

At the supervision level, led by the town's Civil Affairs Office, a diverse supervision alliance has been established, involving representatives of the residents, retired veteran cadres, and village committee members. A full-process supervision mechanism of "monthly inspections + quarterly evaluations + annual audits" has been implemented, focusing on key areas such as fund usage, service quality, and asset security. This ensures the protection of public welfare attributes and tightens supervisory responsibilities. At the management level, a three-tier system of decision-making, execution, and supervision has been built. Major decisions are jointly reviewed by the director, operations manager, and resident representatives, ensuring open and democratic decision-making. Simultaneously, four functional departments—nursing, medical care, logistics, and social work—have been established, with detailed job responsibilities and assessment standards.

"The systemic reform has effectively streamlined operating costs and enhanced service efficiency. The administrative costs of the welfare home have decreased by 18% compared to before the reform, and service response efficiency has increased by 40%," said a welfare home representative. A positive governance structure of "no lack of supervision, vibrant operations, and sustainable development" has now been formed, laying a solid institutional foundation for future service improvements.

The sound institutional framework provides a solid foundation for improving elderly care services, with meticulous care serving as the core support for ensuring the quality of life for the elderly. After streamlining the management mechanism, the welfare home has focused on the differentiated needs of the elderly, abandoning the uniform, rough support model. Instead, it has implemented a customized service approach based on individual needs. The welfare home has accurately assessed all 156 elderly residents, categorizing them into four groups based on self-care ability: fully independent, semi-independent, disabled, and cognitively impaired. Specialized files have been established for each category, with graded care implemented. In terms of living environment, a 6S management standard has been fully implemented, adhering to the "five lines and one level" specification. Facilities such as intelligent call systems, anti-slip handrails, and age-appropriate toilets have been installed, achieving full standardization of the living environment. For meal services, an innovative "three disclosures and one feedback" mechanism has been introduced, making menus, procurement lists, and expenditure details public. Regular feedback from the elderly is collected, and customized meals—low-salt, low-sugar, and liquid diets—are prepared for those with chronic conditions. A full-chain food safety system has been established, covering ingredient traceability, rapid pesticide residue testing, 48-hour sample retention, and sterile operations, ensuring food safety. Meal satisfaction has reached 98%, truly realizing a shift from "basic security" to "quality care" in elderly services.

High-quality elderly care involves not only material security but also the enrichment of the spiritual world. Adhering to the "elderly-oriented" philosophy, the welfare home has fully implemented the "six-heart" service method and the "five-light" operational guidelines, achieving a 100% certification rate for caregivers. To address the shortcomings in grassroots elderly psychological services, a "three-teacher linkage" service model has been established, involving psychological counselors, social workers, and nursing staff. Specialized spaces for emotional release and music therapy have been created, providing over 480 psychological counseling sessions for the elderly. This has effectively alleviated the loneliness and anxiety of the elderly, particularly those who are advanced in age or living alone. At the same time, the welfare home regularly organizes diverse recreational activities. Idle land has been utilized for planting and farming, yielding 75,000 kilograms of vegetables annually, allowing the elderly to gain a sense of value through manageable work. Regular activities such as collective birthday parties, traditional festival celebrations, and chess and card competitions foster a warm atmosphere within the facility. A "silver-haired classroom" has been established, inviting volunteers to regularly conduct training on using smart devices, health preservation, and legal knowledge. This has helped 75% of the elderly bridge the digital divide, truly enabling them to learn, enjoy, and feel secure in their old age.

The warm daily care and spiritual support rely on a robust professional medical and health system. Focusing on the health characteristics of the elderly, such as high rates of chronic diseases and disability, the welfare home has built an integrated "prevention-treatment-rehabilitation-care" medical and elderly care service system. This promotes a shift from passive medical visits to proactive health management. The facility has established a medical-nursing consortium with the town's health center, setting up a 200-square-meter dedicated medical room with two doctors and three nurses on 24-hour standby. An emergency green channel for hospital transfers has been opened, ensuring that minor illnesses are treated on-site and serious cases are quickly referred. In terms of health management, electronic health records have been established for the elderly. Using various smart monitoring devices, a three-color (red, yellow, green) dynamic management system has been implemented, with graded rounds and follow-ups for high-risk, moderate-risk, and healthy elderly individuals. Annual health checkups are conducted for all residents. A professional rehabilitation area has been established, staffed by a full-time rehabilitation therapist who creates personalized rehabilitation plans for semi-disabled and disabled elderly individuals. This integrates traditional Chinese medicine therapies like massage and moxibustion for precise intervention. These measures have yielded significant results: 65% of semi-disabled elderly have shown marked improvement in limb function, the management rate of hypertension and diabetes has steadily increased, and the average annual hospitalization rate for the elderly has decreased by 35%, protecting the health of the elderly with professional medical and nursing services.

Long-term and sustainable funding is the core foundation for upgrading elderly care services. The welfare home has innovatively built a "fiscal + operational + social" three-in-one funding guarantee system, achieving a dual focus on "policy blood transfusion" and "self-generated blood." The facility has fully revitalized idle resources, using 12 mu (approximately 2 acres) of land for planting and breeding industries. This has achieved a 60% self-sufficiency rate in food supplies, producing 75,000 kilograms of vegetables and 6,000 kilograms of fruits annually, along with 50 pigs for slaughter each year. This has saved 150,000 yuan in operating expenses. Healthy elderly residents are organized to participate in work such as making moxa sticks and handicraft weaving, generating 80,000 yuan annually. This allows the elderly to increase their income while realizing their self-worth. The facility moderately opens 40 idle beds to admit elderly individuals from the community at 70% of the market price, generating an additional 300,000 yuan in annual revenue. The facility actively engages with businesses, charitable organizations, and individuals, attracting an average of 80,000 to 100,000 yuan in social donations each year. "This diversified self-generation model has completely broken the single reliance on fiscal funding, significantly enhancing the institution's operational resilience. It provides a solid guarantee for continuous innovation and quality improvement in elderly care services," said the relevant official from the Zhangbang Town Welfare Home in Qichun County.