By Rachel Klumpp / Posted on March 29th, 2018
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
By Rachel Klumpp / Posted on June 23rd, 2016
Last week, The New Jewish Home in New York City celebrated the Geriatric Career Development (GCD) program’s class of 2016!
The GCD program was launched in 2006 to train and support at-risk high school students from underserved areas get their academic careers back on track while building a knowledge base for positions in healthcare. A sister program trains young adults 18-24 who are underemployed and out of school to become Home Health Aides.
This year’s GCD class—the largest in the 10-year-old program’s history—is 59% Hispanic/Latino, 28% African-American and Caribbean, and 13% Asian and Pacific Islander, a diversity that reflects The New Jewish Home’s location in one of the most ethnically rich cities in the country. Of the 75 graduates, 99% will start college in the fall having earned scholarships worth more than $1,200,000. Many plan to major in Biology, Nursing, Pre-Med and other subjects that will prepare them for professional lives in healthcare.
High school students engage in a three year work study program at The New Jewish Home Bronx and Manhattan campuses where they become immersed in a long-term care setting shadowing staff, providing care (making hospital beds, transporting elders, taking vital signs), and building relationships through meaningful engagement with elders. This year’s class has spent more than 8,000 hours with The New Jewish Home’s elders. In addition, the program provides internships, professional mentors, professional development, career coaches, and college-readiness assistance.
Participants aim to complete the program with various allied healthcare certifications including Certified Nursing Assistants (CNA), Home Health Aides, Phlebotomy Technicians, Electrocardiography Technicians, Patient Care Technicians, and Medical Coding & Billing Specialists. The certifications offer both additional learning and a way for students to earn money to help support their college education. This year’s graduates have earned more than 80 certifications.
Since the GCD program began in 2006, over 500 students have graduated. Of those, 98% graduated high school or earned an equivalency diploma and 91% have either enrolled or graduated from a post secondary program or are fully employed.
What is most remarkable about GCD, however, are the relationships formed between the students and The New Jewish Home’s elders. Every student is paired with an elder who serves as a guide, mentor, and friend throughout the student’s GCD journey. The bonds that form as a result are incredible. One GCD graduate wrote, “My mentor, Robert, was like a grandfather to me…[offering] insight on his own personal life.”
This innovative program enhances the lives of elders and students through deep-knowing relationships and is shaping the next generation of high quality, person-centered healthcare professionals.
Congratulations to the class of 2016!
Photo Credit: The New Jewish Home
The New Jewish Home, one of the country’s largest and most diversified not-for-profit geriatric health and rehabilitation systems, is building The Living Center of Manhattan, New York City’s first Green House residence and the first Green House high-rise in a major urban center; creating the first Green House legacy project, seven Green House-based Small Houses at the organization’s Westchester campus; and training its 3,500 team members in the core Green House values of “meaningful life,” “real home” and “empowered staff.”
By Rachel Klumpp / Posted on January 29th, 2016
What Does it Mean to Lead Meaningful and Sustainable Change
The “Portrait of a Green House Leader” webinar series continues by highlighting the talents of Joyce Ebmeier, Senior Vice President of Strategic Planning for Tabitha Health Care Services in Lincoln, NE. Tabitha offers a continuum of services to elders, including the first Green House homes in Nebraska and the second built nationally. Joyce attributes her desire to work in elder care to her deep relationship with her grandmother and the wisdom she shared with her growing up. After graduating from the University of Nebraska with a bachelor’s degree in Education, she pursued a career in teaching before beginning her career with Tabitha in 1981, where she served as the administrator of their nursing and rehabilitation center for fourteen years. Currently, as the Senior Vice President of Strategic Planning, she is responsible for directing the overall planning, monitoring, communication, and progress of Tabitha’s business and strategic plan.
Joyce was inspired to champion the development of Tabitha’s four Green House homes after listening to Dr. Thomas speak about The Green House vision in 2001. As an administrator of a traditional facility, she knew the opportunity to imagine a blank page, and create more of what she knew elder care could be through The Green House model was the next step in writing Tabitha’s future chapters. After sharing the vision, the board approved the development of one Green House home after half the initial funds were raised. Joyce identifies that engaging with a grant writer to help locate available funding sources and network with organizational leaders was a crucial strategy to raise the initial funds for the Martin house, their first Green House home to nine elders. After they demonstrated the success of the model through the Martin house, three more homes were built, with plans to purchase property and build four additional homes in the future.
From a cost perspective, Joyce states that their Green House homes are major contributors to the success of the
entire company. Specifically, adding Green House homes for long term care into Tabitha’s continuum of services provided an opportunity to expand their capacity for post acute short term rehabilitation in their legacy building. This balance of costs and revenues combined aids in the growth of Tabitha’s entire organization. Further, Joyce describes that the quality of care associated with their Green House homes has become a hallmark within the community that is a “magnet” for people seeking long term care. This high demand results in a reliable, sustainable census that is crucial for overall operational success.
However, Joyce notes that the true success or “magic” of The Green House model comes from the incredible people who live and work in the homes and the culture created to foster deep knowing relationships. “It’s the most important part of getting The Green House model correct. If you don’t have the right people and you don’t provide an environment which empowers them to do their work with the elders… if that doesn’t happen the most beautiful and perfectly designed houses are really a waste of time and money.” At Tabitha, recruiting extremely creative, great people has resulted in
unique teams in each home where people feel empowered to bring who they are into their work. This results in extraordinary events and celebrations, such as their annual Green House carnival, and quiet everyday moments of compassion, love, and joy in the homes that couldn’t occur in a traditional setting. For Joyce, when talking about her accomplishments in her career, she identifies working with The Green House Project as the one she’s most proud of, yet is continuously striving for success in providing the highest quality of care for elders. When thinking about her Green House legacy in the future, she hopes it reads “But as remarkable as the Green House model became, what came next from these pioneers in elder care was even better.”
By Rachel Klumpp / Posted on November 14th, 2015
Terry Rogers, President & CEO of Episcopal Foundation of Jefferson County, in Birmingham, AL was recently highlighted in The Green House Project‘s Leadership webinar series. His organization includes, St. Martin’s in the Pines, a continuing care retirement community and home care service in Birmingham, with nine Green House cottages.
Terry’s inspiration for a career in health came from observing his mother as caregiver to family members and neighbors, graduate from nursing school, and enter the home health profession. After graduating from The University of Alabama at Birmingham, Terry began his healthcare administration career in business and operations positions with home health agencies, hospitals, and the Episcopal Foundation of Jefferson County, where he has served as President & CEO since 2000. In addition, he serves as a member of the Community Advisory Committee for the University of Alabama Comprehensive Center on Healthy Aging, the National Public Policy Congress, the Budget and Finance Committee, and the Business Strategy Council for LeadingAge, in addition to his service as member of the Green House Project Peer Network Steering Committee.
Terry began his career with St. Martin’s with a formal long range planning effort aimed at redeveloping the campus and replacing the skilled nursing building. His colleague, Linda Robertson, an Eden Alternative Associate, directed him towards the work of The Green House Project in Tupelo, Mississippi. After attending a workshop in Tupelo, he returned to Birmingham to inform the board about this innovative model of care and identify what a new nursing home may look like on their campus. Terry describes that seeing truly is believing; the enthusiasm for the model carried throughout the board and to the broader community and together they were committed to developing the first Green House homes in Alabama. He attributes this success to formally engaging with The Green House Project team to aid in the collaborative design process of their multi-story Green House homes and assist in overcoming regulatory hurdles by training state regulators about the Green House model.
During the development process, Terry notes that “we had a steep hill to climb” but felt confident given the robust training opportunities provided by The Green House Project team and the value of being associated with the model given the research supporting its success. He continues to be an advocate for the model integrity process and the importance of the Green House trademark as a method of accountability throughout the Peer Network to ensure the original guiding principles are instilled in every community. “We didn’t get into The Green House model because it was easy, we got into this because it was the right thing. Changing in the right way is why we’re having the outcomes we’re having. If we start letting “the right way” be diluted, the outcomes are going to change… we think The Green House model works and we want to do it in the right way and we want everyone in the Peer Network to do it the right way as well.”
At St. Martin’s, continuing team education is key in maintaining the integrity of the model and helps leadership “keep it fresh.” Terry describes that continuing assessment and evaluation creates an opportunity for leaders to revisit the beginnings of why they started and to continually engage in action plans for improvements. As the “keepers of the philosophy”, leaders must problem solve, motivate, and coach their teams through consistent messaging of the model. Since opening, St. Martin’s aims to serve as a role model and brand ambassador to encourage and invigorate The Green House model into future organizations and help them throughout their journey.
Upon opening, Terry observed the model’s financial success as a result of the shift in operational cost structure and the flattened hierarchy that creates a “middle management shake-up.” Furthermore, adding Green House cottages into the St. Martin’s continuum of care created a competitive advantage that drives demand at all levels of care, resulting in a corresponding increase in their assisted living and independent living occupancy of approximately 5%. This influx of revenue allows St. Martin’s to promote the community giveback component of their mission to ensure that Elders have the opportunity to live in their cottages regardless of their payor status.
In terms of quality of care, Terry describes that “there’s a little bit of magic taking place” in their Green House cottages that yields better outcomes. Specifically, their 100% occupancy rate, higher family satisfaction survey scores, and positive clinical outcomes are a result of better, deeper knowing in their Green House homes. The Green House principles “just makes sense.” Despite the Green House model’s success at St. Martin’s, Terry notes that they can always do better and are constantly seeking improvements. He is pleased to be a part of the Peer Network and associated with other courageous change agents that are never satisfied in knowing all they need to know in caring for elders.
A lifelong resident of Birmingham, Terry loves fishing, Crimson Tide football (Roll Tide!), participating in barbecue competitions, and spending as much time as possible by the lake with his family. He is presenting at the 2015 Annual Meeting with Green House Project team members Susan Frazier and Marla DeVries on the Model Enrichment Resource and Integrity Tool (MERIT) and the research that supports this process for sustainability. To hear the full interview>>
By Rachel Klumpp / Posted on October 16th, 2015
What Does it Mean to Lead Meaningful and Sustainable Change?
The “Portrait of a Green House Leader” series seeks to highlight talented leaders in The Green House network. It is powerful on many levels to hear these thought leaders share their insight and wisdom. The first of these leaders is John Ponthie, founding member and managing director of Southern Administrative Services, LLC.
Southern Administrative Services is a progressive long-term care operating company with twenty-six affiliated nursing homes in Arkansas, including two Green House campuses (Green House Cottages of Wentworth Place & Southern Hills).
John’s interest in long-term care began as a teenager working at a nursing home where he developed a love and appreciation for interacting with Elders. He went on to receive a Bachelor’s degree in Business Administration from Louisiana State University and a Master of Health Administration degree from Tulane University. John’s healthcare career of over twenty-five years includes sixteen years of hospital administration in addition to serving on the Board of Directors for the Arkansas Health Care Association and the Multi Facility CEO Council for the American Health Care Association.
Despite being a “proud owner” of several traditional long-term care facilities, John and his colleagues witnessed many of fundamental problems of high staff turnover rates and the institutional plagues of loneliness, helplessness, and boredom among Elders. “We knew there had to be a better answer, and for us it was The Green House Project” John says when describing his journey to becoming a Green House adopter.
He identifies that partnering with The Green House Project was crucial to overcoming the fear of change and breaking free from institutional barriers
“We didn’t know what we didn’t know… you know the old model and you’re comfortable with it and to take off in a new direction is difficult. We were in a dark room searching around for a light switch and The Green House Project had the flashlight.”
Working with The Green House Project provided him with the education, training, and the “stamp of approval” from a credible organization necessary to create the right culture to provide a better quality of care. To show the value of the quality of care associated with The Green House model, John successfully led the request for a differential in payment from the Centers for Medicare & Medicaid Services through the first state plan amendment in Arkansas.
With two communities in operation, a third in development, and a fourth pending, John’s pride of association with The Green House model is spreading throughout Arkansas, proving that the model can be successful even in small markets. When discussing financial viability, John states that The Green House model creates a competitive edge that fosters the opportunity to do well through a payor mix while also providing high quality care. Specifically, maintaining a successful census of long-term care elders while incorporating 15-20% of short-term rehabilitation allows him to re-invest back into his business where is matters most; creating and sustaining the right culture to create and maintain a better quality of care.
From a value perspective, John relates that adopting The Green House model gives him the “trump card” over any other model of care. “Where there is an opportunity there needs to be a primary consideration for financial reasons, strategic reasons, and obvious reasons of care and quality.” Investing in The Green House model allows him to “plant his flag at the top as a market leader” and generates the opportunity for him contribute towards creating a better standard of life and care for future generations.
In his free time, John enjoys piloting and spending time with his wife and three children. Click here to listen to the webinar interview of John Ponthie.
“Any number of people can design or build the architecture but that doesn’t bring about the revolutionary change in culture that The Green House Project provides. For us to be able to leverage the successes and failures of so many other adopters is invaluable. The Green House Project has the expertise and structure to help manage our process in a manner that gives our project the highest possibility of success. “ -John Ponthie
By Rachel Klumpp / Posted on September 17th, 2015
Green House Project Guide Debbie Wiegand, LNHA and Rob Simonetti, Senior Associate with SWBR Architects highlight key Green House design lessons learned from over a decade of experience in the webinar “Build This, Not That: Lessons Learned From a Decade of Green House Home Experience.” These lessons are supported by research, and have helped Green House adopters to partner with regulators to build residential homes that meet the highest level of skilled nursing licensing standards.
The core values of Real Home, Meaningful Life, and Empowered Staff represent the physical, philosophical, and organizational transformation that allows those working, living, and visiting Green House homes to “feel the difference” when they enter the front door. Design topics are addressed as they relate to The Green House experience, focusing on insight and value of design concepts that foster how the core values are lived and integrated in Green House Homes. Real home design elements are crucial in supporting elders and empowering staff to create a meaningful life within The Green House home. A strong evidence base of research around the core values provides insight into what makes the model unique and sustainable, and provides an opportunity for positive outcomes. These data driven practices are crucial solutions to share with providers, policy makers, and consumers when beginning the design process and overcoming regulatory hurdles.
“It’s all about relationships” when introducing this new, different model of care. In order to achieve this radical
change in care, collaborating with state regulatory agencies is critical to develop strategies that create win-win outcomes for providers and regulators. Common goals are established through a formal meeting with the state regulatory agency to observe opportunities for insight on important topics and discuss strategies that honor the agency’s values while exceeding regulatory compliance through evidence based solutions. Green House has partnered with over 30 state agencies by creating opportunities to establish common ground and execute mutually shared goals through innovative strategies and model education. In the webinar, Debbie provides suggestions for adopters related to the top five regulatory hurdles that she has experienced; fireplaces, medication storage, elimination of the nurse’s station, open kitchens, and corridors. Green House adopters are encouraged to dialogue with regulators about ways to minimize potential harm while using evidence to support the impact the feature will have towards building quality of life.
When designing Green House homes, Rob encourages listeners to “think beyond the front door”, emphasizing that the experience of getting to the home should be integrated within the neighborhood and connect individuals back to their experiences and culture of that community through the location, regional architecture, and shared amenities of the home. Rob identifies lessons learned in various aspects of the home as the model has evolved over the past decade including home design, size, room layout, lighting, appliances, and furniture, highlighting responses of what works and what doesn’t from a recent survey of Green House adopter’s design experience.
Interested in learning more about Green House design? Listen to the webinar and learn more about the design process>>
By Rachel Klumpp / Posted on August 5th, 2015
The Green House model was originally designed as a long term care solution where elders could live for the remainder of their lives. Leonard Florence Center for Living (LFCL) has expanded their Green House homes to include three short term rehab homes within their ten home building in Chelsea, MA. In the webinar, Short Term Rehab in the Green House Model – A Case Study, Ina Hoffman, Director of Admissions, and Jill Tura, Director of Rehabilitation, describe how short term rehab can be delivered in a real home environment, and highlight their positive clinical and financial outcomes. Their decision to incorporate short term rehab into their Green House homes outlines how providing this service has made them a preferred provider in the community and creates a highly attractive environment that increases consumer demand.
In order to provide high quality care to elders and those who living with diseases such as Multiple Sclerosis or Amyotrophic Lateral Sclerosis, LFCL needed to create a financial situation that would enable them to serve Medicaid recipients, while managing organizational needs. Incorporating short term rehab into their Green House homes provides financial balance to their building and allows individuals to receive short term orthopedic, cardiopulmonary, neurological, or medical rehabilitation in a real home environment. Currently, LFCL has up to 30 individuals receiving short term rehab at any given time, averaging 45 admissions per month. Through strategic marketing, seeking connections with Boston area hospitals and Accountable Care Organizations, and referrals from elders and their families, they became a choice provider of short term rehab in their community – and a reputation that proves it.
“There are not many places that can do what we do.” Ina says when describing short term rehab in a Green House home as an “Occupational Therapist’s dream.” Rather than stimulating home-like environments, functional, practical therapy is provided seven days a week in a real home to ensure maximum safety and success upon discharge. Those who come to LFCL for rehab practice activities of daily living with their core rehabilitation team in the common areas of the home, while more personal tasks such as bathing, dressing, and toileting can be done in the privacy of their own bedroom and bathroom. The Green House environment fosters a sense of community and family within the home. The members of the house encourage each other during therapy sessions, discuss therapy goals and frustrations over meals, and exchange telephone numbers when they return to the community to keep in touch beyond their stay. Because LFCL is within the larger Chelsea Jewish Foundation, when a person is ready to transition to in-home care, they can continue to receive therapy from the same core team, allowing for a continuous, efficient transition of care.
By incorporating short-term rehab into their Green House homes, LFCL created a financial strategy that “keeps the building going.” Short-term rehab created an opportunity to stay true to their mission while providing high-quality, integrated care with positive outcomes, including decreased length of stay, higher overall satisfaction, and decreased rehospitalizations.
By Rachel Klumpp / Posted on July 15th, 2015
Rebecca Priest, Chief Operating Officer, and Jim Clark, Chief Financial Officer, of St. John’s homes in Rochester, NY share their Green House journey through the lens of delivering financial success to their organization and value to their customer. In the webinar St. John’s Journey: Providing the Best Quality of Care at the Lowest Operating Cost, Rebecca and Jim encourage listeners to “rethink all that you think you know” in order to provide the most incredible, elder engaged service at the best value in Green House homes.
Jim Clark, VP and CFO identifies that financial stability “is the side effect of doing things right.” Specifically, elder growth and well-being through positive clinical outcomes in addition to successful employees through retention and labor costs results in financial stability in two forms; revenue and predictability.
Listen to the webinar here: http://impact.adobeconnect.