Leading with the New CMS Regulations: It’s in the Green House DNA!

By / Posted on October 17th, 2017

Many traditional nursing homes are scrambling to meet the new person-centered regulatory standards; however, it is business as usual for Green House homes.  What set’s Green House homes apart is the comprehensive transformation of the homes… physical design, organizational structure and philosophy of care are all changed to reflect elder-directed care. The three Core Values: Real Home, Empowered Staff & Meaningful life provide a guidepost for establishing operational practices.

CMS is placing a larger focus on use of non-pharmalogical interventions and staff having appropriate competencies and skills. Appropriate treatment and services for Elders living with dementia is also emphasized in the new regulations.

A key element of The Green House model is the use of specially trained versatile workers, whose responsibilities include food preparation and service, activities, light housekeeping, and laundry. The versatile workers are called Shahbaz, and are Certified Nursing Assistants who receive an additional 128 hours of education which encompasses all elements of their work including infection control procedures, culinary skills, dementia, communication skills and activities. Not only are staffed provided the training they need, but consistent staffing allows for Shahbazim to get to know their Elders, establish strong bonds of friendship. Being well-known supports allows for non-pharmalogical interventions to be effective.

 Residents Rights has become the largest section in the new CMS regulations.

Shahbazim understand that one of their fundamental roles is to nurture, sustain and protect the Elders in their care. Elders are in control, driving decisions in the home from menu choices to daily activities. Staff learn about how to provide Meaningful Life to elders in their care, including honoring their natural rhythms. Elders can sleep in and go to bed when they wish.

New regulations set new standards for care planning.

Elders can decide who attends and now must participate in setting goals. A nurse aide and a member of food services staff are required to attend care plan meetings. Again, this has always been part of the Green House model. Shahbazim lead the care plan meetings. Because they are consistently assigned to work in one home, they know their Elders well. Staff are coached on how to respect Elder’s wishes, while informing them of risks and benefits of proposed care. Ultimately, the Elder decides.

Grievances must be acted on quickly by staff and recommendations from Elders must now be considered. In a Green House home staff are talking to Elders daily, hearing their concerns and following up on their issues in “real time.”

Shahbazim are empowered and therefore can often make immediate changes to address Elder’s concerns, eliminating the need to go through a long chain of command to have issues heard and changes made.

CMS has put more emphasis on creating a “homelike” environment.

Green House takes it to another level providing “real home.” Every elder has a private bathroom and their own bathroom/shower. Elders can personalize their bedrooms, bringing in many items from home.

Meaningful Engagement is now a greater focus of new regulations.

Elders must be provided with a choice of activities that encourage both independence and interaction with the community. Activities in a Green House home include a combination of planned and spontaneous events, with a majority of activity occurring naturally and recorded as appropriate. Although the full-time activities director will act in a facilitative role, providing assessment and evaluation of activity preferences and individual engagement, assistance with activity programming, coaching and teaching; versatile workers within each home will have primary responsibility for leading meaningful and engaging activities on a daily basis. While anticipated activities can be scheduled, the spontaneity fostered in a Green House home means not all activities can be planned.  Some programs will occur naturally, such as folding laundry, a family visit, or assisting with the day’s meal.

The Green House team is proud of the work of our adopters and the strides we have made to lead the field, creating better lives and better jobs.  


Green House Team Presents to Osher Lifelong Learning Institute (OLLI) at California State University Long Beach

By / Posted on May 14th, 2016

IMG_1646Green House team members were honored to share their wisdom and insight about the Green House model on the evening of May 11th— the presentation was part of the Successful Aging Lecture Series, a program made possible through the generous donation by Lori and Don Brault.

CU Claire

Green House Project Guide, Claire Lucas moderated the panel of staff from Mt. San Antonio Gardens in Pomona, California.  A large group of interested community members were eager to learn about the model and to hear the special stories from the team members.

Andrea Tyck, Diana Marohn, Amanda Phos & Mary Jean Neault shared personal experiences working in the Green House homes.  Mary Jean was able to share her insight both as a staff member and former family member.  The audience was touched by their stories and eager to learn more about Green House homes, as evidenced by the swarm of people who stood in line to talk to staff from Mt. San Antonio Gardens after the program!

Osher Lifelong Learning Institute is a national organization that offers widely varied courses of interest to persons 50 years of age or older.  There is no academic prerequisite for admission or to participate in the classes, just a desire to learn.

California currently has two Green House Project homes in the state.  We are hopeful with California’s plans to release new “Small House Regulations” that many more will be built in the future!


Financing and Collaboration Brings Green House homes to Colorado

By / Posted on November 26th, 2013

It was a beautiful day in Loveland, Colorado for the historic groundbreaking ceremony of the first Green House homes in Colorado. The skies were clear and the beautiful Rocky Mountains provided a breathtaking view in the background. This Green House project is the result of a collaboration between Loveland Housing Authority and Vivage Quality Health Care Partners.  These innovative groups worked with NCB Capital Impact, AARP foundation, The Weinberg Foundation and many other sources of financing to bring this project to life for low income elders:

A $16 million project takes a significant numbers of financial partners, as well as time. Nearly four years in the works, financing for the project includes New Market Tax Credits, $584,000 in fee waivers from the city of Loveland, $2.6 million from the Colorado State Division of Housing and a $2 million grant from Maryland-based nonprofit The Harry and Jeanette Weinberg Foundation.

Local residents were an integral part of planning the groundbreaking ceremony.  The Reporter-Herald covered this collaborative event, “”The goal is to create rampant normalcy where people can feel at home,” said Nancy Fox, the chief life enhancement officer for Vivage Quality Heath Care Partners.
The program was kicked off by Sam Betters, Executive director of the Loveland Housing Authority. He shared the trials and successes of the long four year journey that led to securing financing for this important project, “It takes a lot of people to make this work, and we do this to meet the community’s needs,” Betters said Tuesday in remarks before a crowd Mirasol residents, local officials and a wide-range of partners.”  The determined spirit and “can do” attitude was palpable throughout the ceremony.

Next Sue Mendenhall, the Resident Ambassador of Mirasol Senior Living Community described The Green House Project as “breathtaking in its innovation.”  Major Cecil Gutierrez from the City of Loveland described Loveland as “one of the most innovative and creative cities demonstrated by art and projects the Loveland Housing Authority has come up with.”

“You are bringing something amazing to your state,” The Green House Project Chief Operating Operator Susan Frazier told the crowd. “You are becoming a part of something that is so much bigger than yourself.”

There are currently Green House projects in 25 states, with many more in development.