By JUAN A. MORALES, RN, MSN Health System DirectorMemorial Day, every year, gives the chance to reflect and honor those who served and died for the freedoms of the United States. Through parades and pageantry, it represents the best of our country in how we are aware of the real price of our democracy and our way of life. But it also allows us a time to ask ourselves are we “keeping the promise” made by President Lincoln generations ago during his second inaugural speech. The high price of freedom is not always paid by loss of life. This price is not always paid immediately; the debt we owe for service often comes later in life for those brave souls who wore the uniform of our military. And for us at the Department of Veterans Affairs Tennessee Valley Healthcare System (VA TVHS), we do our duty to honor those who have fallen by paying the debt to their comrades by providing high quality healthcare. The Veterans we serve at VA TVHS receive care taking into consideration the latest advances and trends in healthcare practices. One of the latest initiatives in care to our Veterans is the Cultural Transformation approach to long-term care at our Murfreesboro Alvin C. York Campus. Cultural transformation of VA TVHS’s community living centers means transforming the way healthcare providers deliver care to Veterans. The community living centers is the new name at the VA for programs formerly called nursing home units. The change in name is representative of change in how care is provided on the community living centers. The purpose of cultural transformation is to transform our community living centers from the institutional care model which has been the long-standing systematic approach to a vibrant community where the focus is on resident centered care and a homelike environment. The cultural change not only impacts on the environment but on the mindset of all individuals providing care on the community living centers. Cultural transformation is taking place in the areas of care practices, work practices, and the environment. Hence, cultural transformation is a systematic change in the approach of delivering long-term care.The movement sweeping the country called culture change represents serious reform of institutional culture to one that gives voice like never before to the people living and working in such a culture. Pioneering leaders have adopted principles and worked toward making actual, concrete changes to their policies and practices such as how they manage staff, how they honor those in their care, and environmental changes to create a home. Culture change is not a singular item; it is multifaceted with homes deciding to make changes that may be different from other homes. The beauty of becoming more person-centered and less institutional is that it is based on what the persons living and working in each home decide. Culture is comprised of beliefs and values, basic underlying assumptions, and behaviors.Here are some examples of what is already in place at VA TVHS:• Establishing specialized units for special veterans. The eight Community Living Centers units provide a variety of care ranging from rehabilitation for veterans, who have recently had hip replacement surgery, to hospice care for veterans, who have terminal lung cancer. • Having the veteran patients renamed their units to more appealing names. The new names are more representative of a neighborhood destination that a veteran would want to call home. • Providing a full range of supportive services to veterans and their families receiving hospice care. These services include grief counseling for family members, special recognition for the veteran’s military service, full access to spiritual counseling for both veterans and their families in this time of need, individual commemorative services for the families of veterans upon their demise, an individual designed entertainment program based on the Veteran’s preferences .Through initiatives like this, VA TVHS has and will continue to raise the bar in providing care to those who served America. Cultural transformation is not an idea it is becoming a way of life at VA TVHS and allows us to honor our Veterans in need of this care and celebrate those we remember by keeping the promise. God bless our Veterans and the United States of America.