By Kris Angevine / Posted on February 25th, 2017
One of my proudest moments as a Guide for the Penfield Green House homes was when one of the Shahbazim (self-managed team of direct care staff), Wendy, texted me and said “Hurray! We made it!” … I didn’t know what she meant and I was at our legacy building about 20 minutes away so I couldn’t just pop over to clarify the news. The therapeutic recreation specialist for our Green House homes, Mimi, has an office across from me, so I moseyed over to her and asked her if she knew what Wendy could mean? Mimi said “Nope, I don’t know anything.” So, I texted Wendy back and asked her “Made it where? What are you all up to?” She replied, “Check Facebook!”
I didn’t have time to check the site, as I was rushing off to another meeting so it was an hour later before I was able to close the loop. As it turned out, all 10 elders, the Shahbazim and a Nurse were buying grape pies in Naples, NY which is about 2 hours away. The team planned the whole thing, scheduled the van, grabbed the credit card, and even got the other House to come over and check on Lexi, the house dog, because this was her first time on her own. On their way home, they stopped for lunch, and enjoyed the iconic fall scenery in upstate NY. It was beautiful, well executed, and neither the “boss” or “activities” knew anything about it.
True empowerment at its best!
By Christie Tutschulte / Posted on February 25th, 2017
It’s another first for The Green House Project, as Missouri is welcomed into the list of innovative states to offer a Real Home to elders who need skilled care. The Cottages of Lake St. Louis, located in the western suburbs of St. Louis, opened the first of six cottages in January 2017. Now, residents of the “Show-Me” state will get to see firsthand what skilled nursing looks like when its designed — from the inside out — to be a home.
Al Beamer, CEO of the Cottages of Lake St. Louis, says people are struck by how different the community is from a traditional nursing home before they even step inside.
“When people think about nursing homes, they expect to see a large facility designed to house hundreds of residents,” says Beamer. Instead, the Cottages of Lake St. Louis is six cottages built alongside one another on a residential street. Each cottage is a stand-alone home that houses only 10 elders. “What surprises them most is that Green House homes are truly homes,” continues Beamer. “We are very deliberate in saying each cottage is a home — not ‘like a home.’”
This means no medicine carts rattling down long hallways, no big lights flashing above residents’ rooms, no large institutional kitchens and dining areas. In a word, the Cottages are “cozy.” Each elder has a private bed and bath. This supports their dignity and privacy — but privacy does not mean isolation.
Relationships are at the core of Green House communities. “There’s one big kitchen table in each cottage, so everyone eats together,” says Christie Tutschulte, vice president of care management for the Cottages of Lake St. Louis. This encourages the natural social interactions that happen around a family table. The elders in each cottage decide what they want to eat, and they see their meals prepared in an open kitchen so they can enjoy the smells and sounds of a busy kitchen.
The focus on relationships extends to those between the staff and the elders. A small, self-managed team of educated, universal caregivers is dedicated to caring for the elders in each cottage. Because this team works in only one cottage, they get to know their elders on a personal level. This helps them see health changes and reasons for concern much sooner than in a traditional nursing home, allowing for earlier interventions and better health outcomes.
In many ways, each cottage is its own little family — and this is exactly how this family owned and operated business wants it.
Al Beamer and his wife, Kathy, are the CEO and chief financial officer, respectively. Their daughter, Christie, is vice president of care management, and son, Matt, is vice president of operations.
Christie, who graduated with a master’s in Gerontology, says living in the community makes opening the Cottages of Lake St. Louis personal for her and her family, “Our kids go to school here, we go to church here, we have built our home and our lives here — and we really want to make a difference in our community.”
Family is so important to the business that five of the six cottages are named after the Beamer’s grandchildren: Ava, Ella, Grace, Harper and Kris.
“When it came to naming the cottages, my husband, Al, and I hit upon an idea that we feel really speaks to the ideals that we are trying to provide for our elders and our family,” Kathy explains. “We believe that it is important to build relationships across the generations, and to value the gifts within each of us. In this spirit, we chose to name each cottage after one of our five grandchildren and the sixth cottage to honor the late mother of our director of development.”
As with all Green House communities, you won’t find any of the institutional markers of a traditional nursing home in the Cottages of Lake St. Louis — yet they still meet all state regulations for skilled nursing facilities. In fact, the Cottages provide a much better nurse to elder ratio. While state regulations require skilled nursing facilities to provide 208 nurse hours per 60 elders per week, the Cottages of Lake St. Louis will provide more than 500 nurse hours per 60 elders per week.
The Cottages of Lake St. Louis are opening gradually. The first two of the six cottages have opened, and the remaining four will open by the end of March. This staggered opening is intentional, says Christie, “We are so excited to welcome our first elders, but we want to do it right and get to know each person.”
To learn more about the Cottages of Lake St. Louis, visit www.cottageslsl.com or call 636-614-3510.
By Rachel Scher McLean / Posted on January 30th, 2017
There are 214 Green House homes, however there are 15,600 traditional nursing homes in our country. As we work to transform long term care, Beth Baker has been a critical voice in journalism, describing innovations in the field. She has spent the last decade telling the story of culture change to a wide audience and earlier this month, Beth Baker highlighted The Green House model as The Nursing Home of the Future, in Politico Magazine.
As a journalist and author, Beth Baker, writes about healthcare in outlets like The Washington Post and the AARP Bulletin, describing what is possible in long term care,”What [The Green House Project] does is to demonstrate that people can keep living and enjoying life until their last breath given the right environment and relationships.” This journey led her to Tupelo, the first Green House homes, and the transformative story of Mildred Adams:
Beth became intrigued by the rich human stories found throughout the culture change world, and eventually decided to write a book, Old Age in A New Age. Her work has expanded, in a second book, With A Little Help From Our Friends, that focuses on “the importance of community and social connection as we grow older.” Beth sees boundless opportunities to write about people who are,”looking at aging in our society and thinking about how to make it a richer and more respected time of life.”
When Politico approached Beth, they asked her to write a visionary piece about the nursing home of the future… when Beth pitched The Green House model, they were delighted to see the potential that exists today to create meaningful lives for those who live and work in long term care.
In her reporting for the Politico article, Beth visited Lebanon Valley Brethren Home in Palmyra, PA. After a three hour drive on a cold, rainy day she shared how warm and welcoming it was to ring the doorbell and walk into the home, ” there was a fire in the hearth and one of the women was doing a jigsaw puzzle… it felt so familiar and was just a reminder of why [The Green House] is such a wonderful model”. Through interviews with elders and Lebanon Valley Brethren Home CEO, Jeff Shireman, Beth was able to convey the comprehensive nature of the model, and how the interplay of the environment, organizational redesign and philosophy work together to create positive clinical, financial and satisfaction outcomes, “Having a strong case for the finances and business outcomes of The Green House Project has been really important, ” remarks Baker.
Beth Baker’s credible voice shines light on the potential for aging to be different, and it is so important that we continue, because as Beth shares, we have a lot of work to do, ” … It is going to take a culture change beyond long term care… [we need] a change in how we view aging, to get people to accept that it doesn’t have to be the way that it has always been.”
‘The Program of All-Inclusive Care for the Elderly’ and The Green House model: An Innovative and Cost-Effective Partnership for Comprehensive Care
By Lori Gonzalez / Posted on January 23rd, 2017
Lori Gonzalez is a PhD researcher at the Claude Pepper Center of Florida State University who studies alternatives to traditional nursing care and social inequality.
The first Green House homes included in a Program of All-Inclusive Care for the Elderly (PACE) partnership will open in early February, joining together two of the nation’s most promising long-term care models. The Harry and Jeannette Weinberg Green House homes, located in the Thome Rivertown Neighborhood in Detroit, Michigan will serve approximately 21 lower-income older adults who are otherwise able to live safely in the community, but who are currently residing in skilled nursing facilities. According to Capital Impact Partners, serving these older adults in Green House homes with the support of PACE, compared to providing care in a traditional nursing facility, is expected to save the state’s Medicaid system about $130,000 per year.
PACE began in California in the 1970s as an alternative to institutional long-term care. A group of Chinese, Italian, Filipino, and other immigrants held cultural views about caring for their loved ones that departed from the larger culture of aging in nursing homes. They formed “On Lok” meaning peaceful, happy abode. By 1986, On Lok developed the nation’s first comprehensive model of coordinated care and by 1997, the program became a permanent provider under Medicare and a state option under Medicaid. Today, PACE operates 116 programs in 32 states and serves over 30,000 older adults, most of whom are dually eligible for Medicare and Medicaid. PACE operates with the belief that, “it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.” With the assistance of the PACE program, 90% of participants who might otherwise enter a nursing home are able to live in the community.
PACE provides comprehensive care to those who are eligible for the program. PACE eligibility includes being 55 or older, certified by the state to need a nursing home level of care, residing near a PACE care center, and having the ability to live safely in the community. When an individual enrolls in PACE, they (and their family) meet with a team of care professionals including social workers, nurses, primary care physicians, and nutritionists to help craft a plan to serve an elder in the community. PACE participants visit a PACE care center routinely where they, depending on their plan of care, might receive a flu shot, dialysis, dental care, respite care, a hot meal, physical therapy, transportation, or participate in social activities. Family members who visit the center receive counseling or advice on how to care for their loved one.
Green House homes also provide quality care and quality of life, but in a residential setting. In Green House homes, “elders and others enjoy excellent quality of life and quality of care; where they, their families and the staff engage in meaningful relationships…” and when licensed as ALFs, they provide a community-residential setting for elders that is expected to exceed the quality provided by other ALF models. Green House homes are not just homelike, they are places where elders call home.
The goals and values supported by PACE and The Green House model are similar and their partnership will honor elders’ preferences to avoid a nursing home and to live in the least restrictive care setting possible. Green House homes provide high quality residential living and PACE provides the physical health, mental health, social health, and family support for both acute care needs and long-term care needs. Furthermore, PACE and Green House value the belief that all elders should have access to quality care and a good quality of life. PACE serves mostly dual eligible, frail elders and Green House homes are meant to be available to all, regardless of income or wealth. The Green Houses at Rivertown Neighborhood, along with PACE will support these values by serving 21 low-income elders.
Aging in place is highly desired by older adults, but sometimes financially out of reach. The Thome Rivertown model demonstrates that creating a Continuing Care Retirement Community for lower income individuals is possible and that when PACE and Green House are integrated into that community, high quality, cost-effective care is achievable.
By Rachel Scher McLean / Posted on January 13th, 2017
In Rebooting The Nursing Home, Beth Baker shares the deep human stories that describe The Green House model and shaped her visit to Lebanon Valley Brethren Home. These Green House homes are a part of a “growing movement to transform nursing homes from medicalized institutions to places that feel much more like home.”
Resident choice and autonomy, a homey environment, and well-trained and invested staff are hallmarks of the Green House and similar models that are slowly and fundamentally changing long-term care for Americans who otherwise could be forced into traditional nursing homes.
Lebanon Valley Brethren Home has experienced the model’s benefits from a business perspective, as well. CEO, Jeff Shireman shared that after the capital investment, operating costs have been comparable or even lower than their traditional nursing home. This cost savings is directly correlated with the comprehensive paradigm shift of the model and fully leveraging the role of the versatile worker (known as a shahbaz), “What you must do as a leader is to support [the shahbazim] and empower them and hold them accountable,” says the Green House Project’s Senior Director, Susan Ryan. “That is where you’ll see the efficiency.”
This article paints a warm picture of a day in the life of a Green House home, and the elements that make it a viable model that is changing the landscape of long term care.
By Rachel Scher McLean / Posted on January 11th, 2017
An intentionally built environment is crucial to support the success a person-directed home. ProBuilder Magazine highlights innovation in senior care with a focus on the comprehensive transformation of The Green House model. Green House “has three core values,” says senior director Susan Frazier Ryan, “real homes, meaningful life (culture) and empowered staff (organizational change/human architecture, all of which help an elder live the best life.”
This article features innovative Green House homes, including St. John’s, the first
community integrated Green House homes as a model to influence future developers as they look to meet the needs of an aging population,”In 10 years, the first of the 77 million baby boomers will turn 80. That’s the age, say those involved in senior housing, where the intersection of the built environment and health is critical.”
By Mary Hopfner-Thomas / Posted on December 19th, 2016
While 2016 was an impressive year with more than 200 homes open and operating in 30 states, we expect to see that momentum continue in 2017! It will be a year where we will see our first PACE Green House homes open in Michigan…and the first Green House homes will be opening in Rhode Island, where Saint Elizabeth Home broke a 20 year moratorium on new nursing home beds.
Here’s a quick look at how the year is shaping up for Grand Openings and Groundbreaking ceremonies:
Presbyterian Villages of Michigan, Detroit, MI
The first PACE Green House Homes in the country–this development is part of the Thome Rivertown Neighborhood in Detroit, MI
Clark Lindsey Village, Urbana, IL
1st home opens in January, 2nd home
Cottages of Lake St. Louis, Lake St. Louis MO
1st home opens Jan 23rd with homes opening sequentially through Spring
Belle Meade Rehabilitation, Paragould, AR
Saint Elizabeth Home, East Greenwich, RI
2 AL homes
2 AL homes
Buckner – Calder Woods, Beaumont, TX
Jewish Senior Life, Rochester, NY
VMRC, Harrisonburg, VA
5 homes (in addition to their 3 existing)
3 homes open early fall (September) and 2 homes open 6 weeks later
West Vue, Inc.,West Plains, MO
Cave City Nursing Home, Cave City, AR
Southern Administrative Services, Little Rock, AR
By Lori Gonzalez / Posted on December 12th, 2016
Lori Gonzalez is a PhD researcher at the Claude Pepper Center of Florida State University who studies alternatives to traditional nursing care and social inequality. She spoke at The 9th Annual Green House meeting about how she discovered The Green House model, and her passion to spread its message.
“Of those who were surveyed, most frail elders reported that they would choose death over a nursing home.” This was one of the first studies that I came across when I started working as a researcher at the Claude Pepper Center at Florida State University. As I delved deeper into the research literature regarding quality of care and quality of life in long-term care it became clear why the elders in the survey would say such a thing. Study after study reported resident lack of autonomy, lack of privacy, and lack of dignity. The physical environment in many nursing homes resembles the hospital instead of home. Staff and resident schedules are rigid. Unhappiness and dehumanization abound. Although the problems are well documented in the literature, few solutions are offered.
Eventually, I came across the early research on The Green House Project. Not only were Green House homes the comprehensive answer to a complex problem, but the research showed that they were effective in reducing many of the ills facing both elders and staff in the traditional nursing home. Since then, I have been following The Green House movement and advocating for the model as an independent researcher. For example, my op-ed that appeared in the Tampa Bay Times earlier this year argues that Florida, during its temporary lift of the moratorium on new nursing home bed construction, has the opportunity to build more livable, human-scale residences like Green House homes instead of the traditional, large-scale institutional model.
I have also been documenting a story of elder empowerment at the Woodlands of John Knox Village (JKV) Green House homes in Pompano Beach, Florida. When the community’s rehab facility needed replacing, several elders used their vote on the board to bring The Green House model to JKV. It took several years, lots of back and forth, but in the end—it was the elders who insisted that The Green House model was what they wanted, that according to their research, it was right for their community. I had the honor of touring the beautiful, bathed in natural light, full of life homes, and the honor of speaking with elders, guides, direct care staff, and the CEO—it is a place where elders truly rule.
I will continue to try to help spread the model because The Green House Project provides the type of long-term care that elders want and deserve.
By Rachel Scher McLean / Posted on December 9th, 2016
2016 has been an amazing year for Green House adopters who represent some of the most innovative organizations in healthcare. At the recent Green House Annual Meeting, this video highlighted some of the awards and honors that our adopters have received this year.
By Rachel Scher McLean / Posted on November 30th, 2016
The energy is always electric when Green House adopters are together. “As a national initiative, amazing things happen when so many changemakers are in the same room,” shares Senior Director, Susan Ryan, “The opportunity for rich discussion, relationship building and thoughtful questions is irreplaceable. ” That was certainly the case as over 250 Green House adopters gathered at The 2016 Green House Annual Meeting—Beyond Better.
Hosted in New Jersey, attendees were able to visit two open Green House homes, Morris Hall Meadows and Green Hill. Representing 30 states and over 200 open homes, the growing Peer Network is one of the greatest values of participating in this initiative. Green House stakeholder, John Grace, said, “It was nice to attend an intimate gathering where “practical application” is the theme of the day.”
Pre-Conference workshops provided role specific opportunities to explore areas that research proves are vital to the sustainability and success of the model, such as coaching and empowerment. Senior executives joined President of Center for Innovation, Inc., the sponsor of The Green House Project, Scott Townsley, to discuss the strategic trends impacting healthcare, and how The Green House model must continue to evolve in order to lead the way to a better tomorrow.
Marc Middleton, CEO of Growing Bolder, opened the meeting with an inspiring message that what the mind believes, the body embraces, and a call to believe in the potential of elders! This multimedia presentation thoroughly dismantled the myths of aging, and set a tone of possibility for the rest of the meeting.
With breakout sessions focused on key operational topics like convivium, spirituality, team building and hiring, adopters left the conference with a full ‘toolbox’ of new skills and ideas to enhance their homes and organizations. An original spoken word piece, called, “I Am Green House”, brought the crowd to their feet, as a shahbaz, a nurse, a family member and an elder shared what it really means to live this movement everyday.
This year, intensive sessions were offered as opportunities to take a deep dive in areas of dementia, coaching leadership and bringing Green House values into the legacy home. Hot topics, real discussion, and an impetus to keep growing, resonated throughout the conference. The “Inner Circle” was a unique networking space for attendees to meet their peers and help to co-create the future. Reciprocity of active learning and shared experience is making a difference and changing the world.
Sustainability is crucial in the work that we do, and a quality benchmarking resource was presented to attendees with a tangible charge to never stop improving. Exciting results are being discovered as the evidence-base for The Green House model grows.
The conference closed with Ashton Applewhite, anti-ageism advocate and author of This Chair Rocks, an Manifesto Against Ageism, sending a passionate appeal to fight ageism in all its forms. With humor and personal stories, Ashton served as the perfect way to end the conference feeling challenged and inspired.
“THE POWER OF THE MOVEMENT IS YOU!” says, Susan Ryan, to an empowered audience of Green House adopters. The national initiative is able to push the envelope of what is possible because of the innovative and excellent work of Green House adopters and those stakeholders who are changing what it means to age.
Next year marks the 10th Annual Green House Meeting. Held in Florida, with host site, John Knox Village, this meeting continues to grow in meaning and scope, as Green House adopters truly go, Beyond Better!
By Mary Hopfner-Thomas / Posted on November 10th, 2016
An estimated 200 people attended the ceremony November 3rd to officially cut the ribbon on the Sosin Center for Rehabilitation! JGS Lifecare in Longmeadow, MA has been working hard to develop the two Green House homes for short-term rehabilitation which are expected to open in December.
Among those attending included Congressman Richard Neal and Springfield Mayor Domenic Sarno. A number of JGS board members and staff were also on hand for the celebration.
Each home will provide rehabilitation for 12 people and are the first Green House rehab homes in western Massachusetts. Green House Senior Director, Susan Ryan, congratulated the team at JGS Lifecare and officially welcomed them to the Green House family.
Read more about the event:
By Rachel Scher McLean / Posted on October 27th, 2016
Saint Elizabeth Community in Greenwich, RI broke a 20 year moratorium on new nursing home beds with their development of 4 Green House homes that will provide both long term care and short term rehabilitation. Learn more about their project and progress in this news report.