Innovations and Trends in Elder Care

By / Posted on March 29th, 2018

Lisa McCracken, Ziegler

In the first of our four-part “Making the Business Case for Culture Change” series, Lisa McCracken, Director of Senior Living Research & Development at Ziegler shares an overview of key trends and innovations in elder care. Ziegler is one of the nation’s leading underwriters in financing for not-for-profit senior living providers and works with merger and acquisition activity in the private sector. As the Director of Senior Living Research & Development, Lisa conducts market research and trend analysis and contributes to educational articles and white papers on key industry topics.

Rising demographic changes are driving evolution and innovation in senior living organizations. Specifically, there are two key stakeholder groups providers need to target when thinking about their market audience, the baby boomers and millennials. As roughly 10,000 baby boomers turn 65 each day, the aging services spectrum enters a large period of scale. We now see a trend in non-traditional healthcare players entering the industry as they discover their unique role in solutions around aging, from technology to transportation. Senior living providers will need to adapt and evolve to meet the new preferences and characteristics of the baby boomer generation to connect with the new older adult. Specifically, Lisa discusses language changes, wellness initiatives, resident engagement and support services, and community life. As a major part of the workforce of the future, millennials have new values regarding recruitment, retention, and employee engagement. Lisa encourages providers to be “thinking smart” about attracting millennials into our field, particularly when competing with other industries. Four out of the six top projected in-demand occupations fall in our field, creating a growing number of professional opportunities for this rising workforce (Personal Care Aide, Registered Nurse, Home Health Aide, and Certified Nursing Assistant). Lisa shares labor challenges many organizations face and presents best practices to overcome workforce barriers to attract and retain great talent.

How is senior living changing and growing? There are significant differences between not-for-profit and for-profit growth and development. In the not-for-profit sector, organizations are focused on expanding and renovating current communities rather than building new locations to adapt to the changing demographic. Not-for-profit providers are also focused on repositioning their skilled nursing neighborhoods away from the institutional model and reinvesting in real home environments, such as The Green House model to support organizational culture change and provide elder-centered care. In the for-profit sector, Ziegler is seeing a growing number of new communities, particularly in the Assisted Living and Memory Care space across the country. However, in both sectors, there is a growing number of sponsorship transitions and mergers and acquisitions because of several factors, including the increased complexity of healthcare reform and organizational leadership turnover.

In our dynamic environment, Lisa provides an overview of the pressures many providers are facing, particularly in the post-acute rehab space. Decreased length of stay, higher acuity levels, narrowing hospital networks, and an increasing number of treatment plans that skip skilled care entirely place high pressures on skilled nursing providers as occupancy trends decline. Lastly, as we look toward the future, we see new technology entrepreneurs continue to emerge providing innovative solutions that are paving the future of resident care, organizational staffing, caregiver communication, and family engagement.

To listen to the full webinar, please register to receive the recording: https://attendee.gotowebinar.com/register/8988540930301490433


Social Responsibility Knows No Age

By / Posted on March 28th, 2018

Reposted from Association of Jewish Aging Services Newsletter

Don Shulman is the President/CEO of AJAS, a vital, relevant and forward-thinking organization.  Don has been working with elders his entire career.  Don is a Registered Dietitian and completed his internship at the Mayo Clinic in Rochester, Minnesota in 1979. Prior to leading AJAS, Don spent 23 years in senior dining with Marriott and then Sodexo. 

 

 

AJAS Communities Speak Out in March for Our Lives Events

 

Like our nation’s youth, AJAS communities around the country last week publicly expressed their views regarding violence and guns.

At 2:00 PM EDT on March 23, many communities held a moment of silence and recited Kaddish (the Jewish prayer of mourning) in memory of those who lost their lives to gun violence.

Elder demonstrations against gun violence was inspired by Green House Partner, Carol Elliott, CEO at Jewish Home Family, according to Don Shulman, AJAS President and CEO. “Ageism yields thoughts that our elders have little or no voice as they grow old. This is just not true,” Shulman said.

Their voices are powerful and as the age demographics continue to change, the voice of our elders becomes even more plentiful and powerful.


A Person-Centered Approach to Rehab & Recovery

By / Posted on March 27th, 2018

 

Reposted from The Pioneer Network Newsletter

 

 

Lisa Milliken serves as the Director of Education for Select Rehab, where she researches evidence based practices and develops continuing education courses on current hot topics for therapeutic intervention in the post-acute setting. Her goal is to assist this field in the prevention of unnecessary re-hospitalizations and to help therapists deliver the highest level of rehab practices for the most optimal clinical outcomes. 

 

 

“If my therapist asks me to do something that makes sense to help me achieve I want to do, then I would be motivated to do it. It would make sense to me. But how is this bicycle thing going to help me work in my garden or wash my clothes? That doesn’t make sense, so why should I have to do them?”

These are often the thoughts of residents in a community’s rehab department who are there to regain a prior function. I’m reminded of a story shared by a colleague about one man (Tom) who was in short-term rehab following his stroke. His goal was to regain function of his left arm and leg to go home and resume work on his farm. Initially Tom did not like doing the same old exercises, which were assigned to him by the physical therapist to improve his leg strength. And he surely didn’t enjoy the tabletop pegboard and exercise putty his occupational therapist gave him to work on. His comment to all of this was, “This is ridiculous, why I am doing this?” So they stopped and asked “What would you like to be able to do again?” To this he responded, “Well, I want to go home and get on my tractor and get back to work!” So the therapist called Tom’s son and they arranged for the tractor to be brought to Tom’s senior rehab community and parked it in the parking lot. Every therapy task from that point included goals to get on and operate the tractor. This meaningful therapy had a purpose and Tom’s progress then increased dramatically.

Each elder’s rehab goal is different. We should not assume that everyone wants to walk 100 feet and improve standing balance to 15 minutes. There may be no meaning or purpose to such goals. But if we ask them, they will often tell us exactly what they want. It may be that they want to sweep their own floors, go get their mail or walk to the living room to visit with other elders by themselves. Or maybe it’s to independently work in the kitchen because they’re a chef and frequently volunteer at a local shelter to help with meals.

A successful meaningful therapy task includes the following components:
• Person-centered and individualized
o Based on preferences
o Meaningful versus rote
o Graded to abilities
• Volume and content are appropriate to skill level
• Therapy and nursing team members’ attitudes are supportive of the elder’s goals

According to a study by Port and others in 2011, we can effectively solicit an elder’s preferences through a series of steps, including the systematic narrative history of activities enjoyed prior to admission and a direct interview of the elder about activity preferences and available choices. We can then identify health-related or contextual obstacles and develop novel interventions to re-engage each elder in their preferred task. Historically, traditional therapy would focus on impairment-based treatment approaches. And components of such approaches may still be necessary and beneficial at specific points of treatment, such as to collect baseline data for range of motion, strength and activity tolerance.

But functional-based treatment approaches should also be included in the elder’s skilled plan of care. Each elder needs to be challenged and tested in functional skills that will be required of him/her in the following skilled rehab, whether that be within a community setting such as a nursing home or assisted living, , or in their own home. This approach prepares the client for the specific activities and skill sets which they will need to attain their optimal level of functioning in any setting, and where possible, to successfully transition and remain in their home without the potential risks.

The recently updated Rules of Participation for Long-Term Care now cites the resident’s preferences as a requirement in many of the codes of federal regulations. For instance, the Resident’s rights section includes this statement:

“A facility must provide a person-appropriate program of activities that should match the skills, abilities, needs and preferences of each resident with the demands of the activity and the characteristics of the physical, social and cultural environments.”

Furthermore, payer sources such as Medicare and various managed care and insurance companies stress the importance of quality outcomes in a timely manner. So it should be of no surprise that our detailed graphs and charts of outcome data per client shows better and faster improvements as a result of the functional based therapy where we focused on the residents’ personal goals.

Such regulatory and outcome requirements further support our priority to first seek the resident’s input regarding their preference and then help them to achieve their unique goals. Whether we’re working to get Tom back on his tractor, helping Louise to return to her kitchen, or supporting the best quality of life possible as defined by each resident in a community, we can cater each therapy session to their unique goals and the result is a win-win for us all.


Age In America Begins Their Series on John Knox Village

By / Posted on March 13th, 2018

For our next series, we visited Pompano Beach, Fla., where a retirement community known as John Knox Village is located–about 10 miles north of Fort Lauderdale. On the campus are 12 Green House homes, which are small, resident-centered homes designed intentionally to counter the institutional feel of traditional nursing homes. A key feature of a Green House home is that staff and residents are empowered to live and work together as a team. Helping to make this team operate smoothly are Sages, who hold an esteemed position within the home. For this series, we interviewed Sages, all of whom have a lifetime of experience from which to draw upon to assist elders and others within the home. We will let our first interviewee, Diane, explain the purpose of a Sage: “As part of structure of this place they look for volunteers to act as Sages, because we’re old and wise and we’ve had experience working with groups, mentoring people, and problem solving with people. There is a screening process and we were trained. There are homes in this building, and there is at least one Sage assigned to each home. We come in on a volunteer basis and our function is to council, mentor, encourage the shabazim, who are the trained CNAs, within the home, to help them create a self-managed work team. And we are also there to provide contact between the elders and the shabazim and to enable them to get to know each other better. We come in on a fairly regular basis to visit in the home, we attend team meetings, if we’re invited, and hopefully give them the support they need.” . . How often do you come to the home? “It varies. I try to come two or three times a week, and that’s hard because I’m involved in other things. But I try to make it two or three times a week. I’m a resident of John Knox Village, as all the Sages are. We are lucky that we have that volunteer base to work with because everyone is on the property.” . . . . . #changingaging #agewoke #disruptaging #agepositive #greenhousehomes #sages #wisewords @johnknoxvillage #florida #pompanobeach #johnknoxvillage #ageinamerica #oldandwise #olderandwiser

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Behavioral and Psychological Symptoms of Sonya

By / Posted on March 2nd, 2018

 

Reposted from, Being Heard: The Voice of A Revisionary Gerontologist

Sonya Barsness is a proud gerontologist with over 20 years of experience. Gerontology is the multidimensional, non-medical, study of aging. This is important because each one of us is multi-dimensional. Aging is multi-dimensional.  Her mission is to help person-centered values come to life in order to better support people in growing older and growing with dementia.

 

 

 

Hi. My name is Sonya and I have behavioral and psychological symptoms of Sonya (BPSS). Yes, it is true. You see, sometimes when I am doing something I don’t want to do, I get agitated. And then there are the times when I am tired or not interested and I have apathy. The other day I was combative when my husband tried to feed me a strawberry and I pushed his hand away (I really do not like being fed by others, although I really like strawberries.). I irritably yelled at my computer for several minutes this morning when I read the headlines. I am anxious any time I have to drive in this heavily congested area. Unfortunately, I also am paranoid. I KNOW that my husband took the car keys and hid them from me.

Maybe you are saying, “Sonya, what are you talking about? BPSS? Why can’t you just say you are angry or anxious? Why the labels? You are so weird.”

Maybe you are also wondering to yourself whether you have some form of BPSS. “I get angry too”, you might be saying to yourself. In fact, you are getting more angry and anxious as you read this. “Sonya, where are you going with this?” you are thinking nervously.

Have you noticed that we take actions of a person with dementia and ab-normalize and medicalize them? I have.

There is a term, called Behavioral and Psychological Symptoms of Dementia (BPSD) that is used to describe the following “symptoms” that occur in people with dementia: agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes.

A 2012 study¹ said that 90% of people with dementia have BPSD. Hmm. What percentage of the general population has BPSD? 100%?

I experience these symptoms and as far as I know, I do not have dementia. So, if I have them, and you have them, what are they symptoms of? Maybe of being human? So, because I do not have dementia, they must be Behavioral and Psychological Symptoms of Sonya. And if we are going to describe them that way for people with dementia, it is only fair that I describe them this way for myself.

Note: For the purposes of this article, I will refer to these “symptoms” instead as actions or expressions.

In everyday life we use these terms to describe our actions. They are, for the most part, considered “normal”. Yet, we seem to have a double standard when we are talking about people with dementia.

A person without dementia might be angry because he does not want to wake up. But a person with dementia is agitated when he does not want to wake up.

A person without dementia flirts with the waiter and it is just flirting. A person with dementia flirts with the waiter and she is disinhibited.

I am in no way minimizing the seriousness of these expressions/actions. These expressions are very distressful for both people with dementia and those who care for them. They are very real. But I want to suggest that they are not abnormal. They are human responses.

Being with many people living with dementia, and those who care for them, has taught me that living with dementia is very, very hard. People with dementia are doing the best they can. They are trying their best to make sense of everything and everyone around them. Because they are human, of course they are going to experience the same human emotions as any of us. If not more, because of the challenges of living with dementia. Their actions are expressions. Normal, human expressions to what are often experienced by them as abnormal situations. I have sat with many of these humans, and heard their experiences. They made me change the way I thought about their “behaviors”.

For these reasons, and more, we need to reconsider this term of BPSD. Perhaps more importantly, we need to think about the meaning behind it.

I understand why we use this term. We needed a way of describing some things we were seeing, so we created a term. But there is a danger in this term that is bigger than these words, I am afraid. Because a term is often, if not always, a reflection of a paradigm.

When we define these actions and expressions as symptoms, we do several things:

 

  • When we describe these expressions as symptoms, we medicalize them. We also then frame them as “abnormal”.
  • We are suggesting that the only explanation for them is the underlying medical condition of dementia. Then we are less inclined to try to understand the reasons behind these actions. They are “just what people with dementia do”. When we don’t understand the reasons, or what people are communicating to us through their actions, we are not able to meet their needs.
  • When we medicalize expressions that might be normal for the person and his or her situation, although abnormal to us, we also contribute to a paradigm that sees people with dementia as different than us. Because WE certainly don’t ever have those expressions, but people with dementia do because of their dementia. A very concerning possible consequence of seeing people as different than us, “othering” them, is de-humanizing them.
  • When we frame expressions in medical terms, as a medical problem, the next step is to try to address them with medical solutions. This might mean using antipsychotics unnecessarily.
  • To take this a step further, when we frame these expressions in medical terms, even if we are looking for non-medical ways of addressing them, we still see them as medical problems to be addressed by these “non-pharmacological” solutions. The challenge with this is that we are still limiting ourselves to seeing these expressions through a medical lens, rather than trying to understand what they might mean for that person, and trying to address the underlying reasons behind the expressions, whether they be unmet needs, or emotional distress. Even a non-pharmacological solution can be a band-aid and not address the reason behind a person’s action and what it means.

We are already seeing ramifications of this paradigm in how we view and treat people with dementia. One of these areas is in the use of antipsychotic medications, which are used to address BPSD in people with dementia. A recent report by Human Rights Watch reiterated the overuse of antipsychotics for people with dementia. The article pointed out various possible reasons for overuse. Unfortunately, they are not untrue. Not having enough staff and training to meet the needs of people with dementia is unfortunately real in too many cases. In some cases, these medications are used for convenience. However, in my experience, I think it is more often due to people not knowing how else to respond.

Yet, I think it is something much bigger. It is a reflection of this paradigm of dementia – the story of dementia that we have told ourselves for too long. This is the story that tells us that the way people with dementia act are symptoms or “behaviors”. The story tells us that not only are behaviors bad, they are not normal. Because they are abnormal medical problems, we need to address them with medication.

However, what we are neglecting in this story is this – the way people act, i.e. behaviors, are not abnormal for them. In many cases they are perfectly normal responses to how a person is experiencing the world around him or her. They are an expression of what a person is experiencing, what she or he is telling us, and what needs we might not be meeting for a person.

Yes, it is true that there are changes in the brain that happen as a result of various types of dementia that influence the way a person acts. Parts of the brain that regulate emotions are affected, making it more difficult to control various emotions. There are indeed various part of the brain that cause a person with dementia to see and experience the world differently. So yes, dementia changes the way we might act.

I am also not dismissing the intent behind terminology such as BPSD – to attempt to understand and help people with dementia.

It is for all these reasons that we have to think differently. There is too much at stake, and we want and need to do better for people with dementia.

This term of BPSD can perpetuate a paradigm of dementia that does not honor the human experience of dementia. Who people are as individuals. What they need. What is important to them.

It is time for a new paradigm. One that sees people with dementia as no different than us. That strives to see things from the perspectives of people with dementia so we can find better ways to support them. A paradigm that truly sees people with dementia as whole, not broken. And one part of building a new paradigm is to critically and respectfully question how we are describing and thinking about the way people with dementia act.

Note: I am well aware that I am not alone in this desire to change the paradigm of dementia. I am being heard here, with my own voice, but know that there are many who are in this together. They are people living with dementia, their care partners, and people whose professional lives are dedicated to making life better for people with dementia. I learn from them every day. Rather than speak for all of you, I hope you will chime in, as much more needs to be said.

¹Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012). Behavioral and Psychological Symptoms of Dementia. Frontiers in Neurology, 3, 73. http://doi.org/10.3389/fneur.2012.00073


Leaders Speak Out about the Value of The Green House model

By / Posted on February 23rd, 2018

It’s all about leadership, and The Green House is honored to work with wise leaders who exude such a presence of belief and trust in the culture that they are helping to shape.  Check out these short interview that delve into the unique journeys of Southern Administrative Services, and Clark Lindsey, as they discuss the business and operational value of working with The Green House Project.  

“The business model of The Green House model is self evident… It’s where people want to be. Rather than spending your money on an intense marketing campaign to promote your business, why not create something that attracts everyone. ” – John Ponthie, Southern Administrative Services

 


Engage a Diverse Workforce to Increase Success

By / Posted on February 21st, 2018

James Wright, nationally recognized diversity and inclusion strategist, and 2017 keynote speaker at The Green House Annual Meeting, shares some wise words for effectively engaging a diverse workforce.


Goshen, Indiana Celebrates the Grand Opening of Their New Green House Homes!

By / Posted on February 5th, 2018

January 24th marked the official grand opening of The Green House Village of Goshen—three Green House homes with a fourth already slated for the community.

Two of the homes will be skilled nursing, with the third home dedicated to short-term rehabilitation.

 

The homes were developed by Blue Diamond Communities, an organization that prides itself on building homes to serve all ages.

Tonya Detweiler, President, Blue Diamond Communities

Tonya Detweiler is the president of the company—which she founded five years ago.  The Green House homes are part of Maplewood Estates and perfectly blend into the community.  Tonya says building the homes was really a dream for the organization for a number of years because seldom do people WANT to move to a nursing home, however she believes The Green House Village of Goshen will change that image for many people in Indiana.

 

 

The subdivision is 16 acres and in addition to the Green House homes, there will be 25 other private homes in the development.  It’s a wonderful setting for the 48 elders who will live in the Green House homes, they will be part of an inter-generational neighborhood and a vibrant part of the community.


My Mom Recovered in a Green House home and It Made All The Difference

By / Posted on January 22nd, 2018

Where does one begin to describe The Green House difference? There just are not enough superlatives.  So how about I start here? I do not believe that my mother would be alive today if she had received care anywhere else.

A Green House home is different, and you know it the minute you see the beautiful building, and step inside.  My mother was transported to The Green House homes of Green Hill by ambulance.  Both of the EMT personnel were taken aback when they arrived. They thought they were in the wrong place.  Surely this was someone’s private home, not skilled nursing!

My mother is 89, petite, and living with dementia.  She went to the hospital because she had a swollen tongue, trouble swallowing and they feared she may have had a stroke.   She was in the hospital only 4 days and she was so weakened by being confined to a hospital bed that she could no longer walk.  The hospital said that she would have to spend the rest of her life on a pureed food diet.

I did my research.  I looked at average hours of physical therapy and occupational therapy each day.  With every search, The Green House homes at Green Hill, were always at the high end.  But here is what numbers cannot capture.  My mother has dementia.  She drifts in and out of lucidness.  So if the physical therapist or the occupational therapist arrived when she was not fully present, they did not force her to participate.  (Did you notice that I said that they came to her not that she was brought to them in a sterile “workout” room?) They adjusted to her rhythms and came back when she could most fully participate and best benefit from the therapy.  Those statistics do not capture that every staff member of a Green House home is a champion of the elder and takes on whatever role the elder needs in order to help.  For example, with my mom, it would have been much easier for them to put her in a wheelchair and wheel her to the bathroom or to the dining table or to the open hearth.  But they walked with her.  And the statistics don’t count all those minutes that add up to hours… and add up to strength, mobility, dignity, resolve, hope and a  desire to get well.

While there may be other “small house” homes, Green House homes are based on an evidence-based set of principles that make a big difference.  Therapy in their real home is just one example.  Another is that all meals are prepared in the home and the dining room table big enough for all of the elders, staff, and a few guests to have a place.  Elders eat when and where they are ready.  This really amazed me.  Someone was always cooking in the kitchen.  Breakfast at 6 am, no problem.  Breakfast at Noon, no problem.  Breakfast in your room, no problem – but never on a metal tray.  Dinner while watching TV in the living room – no problem.  Want your eggs soft, over easy, scrambled – no problem.  Don’t like what we are having for lunch, how about a sandwich of your choosing.  I found that most elders and their caregivers loved eating meals at the big table.  We had fun.  We supported on another – elders and caregivers and Green House staff.  Elders helped elders.  Caregivers helped caregivers.  If Dorothy’s daughter wasn’t there, I sat next to Dorothy and encouraged her to eat and I know Dorothy’s daughter did they same for me.

As soon as my mother arrived from the hospital with her pureed food order, the speech pathologist at the Green House home questioned that and asked permission to “challenge” my mother with non-pureed food under her supervision.  Of course, I agreed.  My mom had lost a good deal of weight and we discovered that if food had whipped cream on it, she would eat it.  In addition to her meals, the staff surprised her with special treats, healthy snacks topped with whipped cream, and my mother began to enjoy the pleasure of eating once again.

The Green House home at Green Hill have front porches with rocking chairs and  back patios with bar-b-qs.  There is nothing like fresh air and sunshine to heal the soul…except the joy of a four-legged furry friend.  Pets are encouraged to visit or stay.

The Green House staff, the physical, occupational, and speech therapists ,and the nurses and doctors all take great pride in where they work and the care they deliver.  They become family quickly, maybe even better than family.  They talk about how much they like where they work.  A number mentioned that they almost left their profession, being discouraged at traditional facilities.  But here they flourished.

My mom was getting better, which brought new risks.  She was strong enough to get out of bed on her own, but still unstable on her feet.  So when my mom could not sleep and had potential to get up and fall, the nurse invited my mom to sit with her while she did her work.  My mother loves helping, and this engaged time enabled her to naturally feel drowsy and go back to bed for a sound sleep. – no medication necessary.  Love and caring is the very best medicine of all.

Today, my mother’s wheelchair and walker are gathering dust in the basement and she can eat absolutely everything.  Where you receive care really does matter.  Green House homes are the very best care that you can get.  Anywhere else,  I believe that my mother’s spirit would have been crushed, her appetite less than zero, and her strength and ability to walk permanently drained.  The current paradigm, sets low expectations for an elder’s potential, and it becomes a self- fulfilling prophecy.  Green House homes believe that elder’s are whole people with ability to grow and thrive, and this attitude translates to supporting the best life they can live.

Green House homes have been around for over a decade and we all owe a big thank you to the Robert Wood Johnson Foundation and their commitment to proving that there is a better way to provide long term care, that is clinically sound and cost effective.  The Green House home is just better, it is as simple as that…for the elder, for the family, and for the people who work there.  If there is a Green House home where you live and you have someone or you know someone who needs care, go there.  If there is a Green House home in your neighborhood and you don’t need their care, stop by.  I guarantee you will volunteer there, especially at mealtime. And if there is no Green House home in your neighborhood, make some noise to your elected officials to correct the situation.  This is the way health care for elders needs to be, and it is the way we would want it for ourselves!  In my state, of New Jersey, there are only two Green House organizations.  I count my blessings daily that this was an option for my family, and I hope that one day, everyone will be able to have this same experience.


The Small House Pilot in California, Changing the Face of Aging

By / Posted on January 19th, 2018

It is a pivotal moment in California’s history.  The Small House Pilot Program is now live, and it has the potential to clearly demonstrate that there is a better way to deliver skilled nursing care. This profound opportunity requires that nursing home providers across the state, take a stand, and say, NOW IS THE TIME!

The wait has been long, making this moment all the more powerful.  In 2013, through a tenacious journey, Mt. San Antonio Gardens became the first Green House Project in California. The work that they did to make regulatory gains with stakeholders across the state blazed a trail and were codified in late 2012, as Governor Brown signed into law Senate Bill 1228 (introduced by Sen. Elaine Alquist). The bill created The Small House Skilled Nursing Facilities Pilot Program, which authorized the development and operation of 10 pilot projects to deliver skilled nursing care in smaller, residential settings, “It puts the ‘home’ back into nursing home”, said Senator Alquist (D-San Jose). However, it wasn’t until early 2018, that the regulations to support this bill were released, and the request for applications is now open to the public. As a perennial advocate for elder directed, relationship rich living, The Green House Project is eager to support every effort to ensure the success of this opportunity.

The Green House Project has come to be recognized as the leader of the small house movement to create a high-quality, cost-effective, human-scale alternative to the traditional nursing home. Studies of the Green House model have found that:
• Residents have a better quality of life and receive higher-quality care than residents in traditional nursing homes.
• Staff report higher job satisfaction and increased likelihood of remaining in their jobs.
• Family members are willing to drive farther and pay more to have access to a Green House home for a loved one.

Real Home, Meaningful Life, and Empowered Staff: these core values align well with the regulations of the Small House Pilot in California, and they drive change in Green House homes, creating quality outcomes, consumer demand and preferred partnerships in the healthcare system.

With 15 years of expertise in design, education and evaluation, The Green House Project is a strong partner to support the expedited timeline and in-depth requirements of this pilot. The first deadline for submission is June, 2018. Design tools, like The Green House Prototype, along with educational protocols and policy and procedure expertise, will ensure an organization is able to successfully navigate this application. Susan Ryan, Senior Director of The Green House Project says, “The Green House Project specializes in a comprehensive cultural transformation that shifts the beliefs, behaviors, and systems to ensure a lasting investment across an organizational system. It is more than simply a process from ‘this’ to ‘that’; a real transformation unleashes the best of what can be by accessing collective wisdom.” The national initiative stands ready to support nursing home innovators in California, to ensure better lives for elders and those who work closest to them.

With California’s number of individuals 85 and older expected to triple by 2030, the market for Green House homes and others like them is rapidly growing. Consumer demand for the kind and quality of care that The Green House model provides has long existed, but until recently, California’s regulatory and approval process had been unable to accommodate non-traditional models of care. In fact, it took almost seven years for Mt. San Antonio Gardens to gain the approval it needed from multiple local and state agencies. Inspired by their lessons learned, Senate Bill 1228, and the newly released regulations, will enable innovation without obstacle. The Green House Project calls every organization interested in creating a real home, meaningful life and empowered work opportunities for the citizens of California to contact us, and together we will forge a trail to a brighter future.


Person-Directed Lives Exemplified Through Interviews

By / Posted on January 16th, 2018

Lori Gonzalez, is a researcher with Claude Pepper Center at Florida State University. She wrote an Op-ed for a Tampa Bay newspaper about the need for Green House homes in the state, and the national initiative reached out to discuss further collaboration. Recently, The Claude Pepper Center had the opportunity to capture interviews at The Woodlands in John Knox Village, and highlight the words of the people living this model everyday.  Check them out here:


2017: A Record Breaking Year of Growth for The Green House!

By / Posted on January 3rd, 2018

Last year was a record breaking year for The Green House Project and it appears 2018 will continue that momentum!  41 homes were opened in nine states of which two were “first in state” openings!  Such an impressive year for our Green House partners—we look forward to continuing that momentum in 2018!  Right now, more than 20 Green House homes are slated to open next year and groundbreaking ceremonies are anticipated at seven organizations for a total of roughly 30 more Green House homes.

Here’s a quick look at how 2018 is shaping up for grand openings and groundbreaking ceremonies:

Grand Openings:

Green House Village of Goshen

Goshen, IN

Goshen, IN

3 homes

January

 

 

Ave Maria

Bartlett, TN

Bartlett, TN

5 homes

March/April

 

 

Poplar Grove

Little Rock, AR

Little Rock, AR

10 homes

July

 

 

West Vue

West Plains, MO

West Plains, MO

3 homes

Fall

 

 

 

Groundbreaking:

Lima, OH

Lima Home

Lima, OH

2 homes

 

Hover Community

Longmont, CO

Longmont, CO

4 homes

 

 

 

 

Sun Porch

Topeka, KS

Topeka, KS

2 homes – phase one/2 homes phase 2

 

 

 

Belle Meade

Paragould, AR

Paragould, AR

2 homes

 

 

 

Wyoming Department of Health

Lander, WY

Lander, WY

10 homes

 

 

 

 

Mustard Seed

Vaughn, WA

Vaughn, WA

3 homes

 

 

 

 

Solutions Healthcare

Las Vegas, NV

6 homes