By Rachel Scher McLean / Posted on April 7th, 2017
As thought leaders Green House adopters lead the way by supporting, and deeply knowing each individual living in their homes. With the introduction of new CMS regulations comes the opportunity for Green House homes to demonstrate how the model is designed to ensure each elder is able to live on his/her own terms. “Language and being focused on the elder vs. the disease, makes a difference. At The Green House Cottages of Carmel, we developed our policies and procedures prior to these new regulations, and it felt great to see that what we knew in our hearts to be right, was reflected in government mandates.” said Melody DeCollo, Guide of The Green House homes of Carmel, in Indiana.
The Green House Project invited, Carmen Bowman, a nationally recognized expert in all things regulatory and culture change to facilitate two webinars exclusively for The Green House Peer Network about the new CMS regulations. In these webinars, Carmen highlighted where, specifically, the new regulations support The Green House Core Values, and how Green House adopters can leverage them to even more fully realize the benefits of the model. Says Carmen, “There is power in the institution to shut people down, and there is power in the home to bring people back to life.”
There were many areas to highlight, but here are a few of the hot topics:
Language – Words Matter! Where are the opportunities for Green House adopters to utilize language that is more person-centered and less institutional?
- Community (or home) vs Facility
- Individual vs Resident/Patient
- Real Home vs Homelike
- Meaningful Engagement vs Activities
- Approaches vs Interventions
Proactive Approach- How can we learn to be ‘preventionists’ and align with an elder’s natural rhythms, patterns and preferences to meet their needs before an issue escalates?
Daily Community Meetings – How does The Green House model support teams to approach issues in real time to emulate the concept of daily community meetings? Where are the opportunities to involve/engage elders in decision making
Care Planning – What are Green House adopters doing to ensure Shahbazim (direct care staff), elder, and family voices are heard in care plan meetings? How can we intentionally gain the rich information that yields deep, knowing relationships?
Highest practicable level of well-being – By intentionally focusing on the physical, social and mental wellness of the person, it expands and elevates the experience. What do individuals need to thrive?
Creating Real Home and Personal Belongings – “We really want to know who you are, so please bring in things that are special to you to decorate our home”. WHO is doing WHAT to ensure elder’s personal belongings are brought into the home/their room?
Meaningful Engagements – Take a moment and consider, is it real life, or fake life? Break apart the word to understand… What is meaningful? What is engaging? People want to make a difference, how can we support people to live lives of purpose?
Food and Nutrition – What are Green House homes doing that showcase the power of deep knowing that supports individual preferences? What can we do to expand ‘choice’ and offer it around the clock.
These new regulations were created in response to person-directed care, that means that our work to change the culture of aging is making a difference! We need to keep telling our stories, and letting the world know that aging and long term care can be different. We want to hear from you! If these new regulations are supporting you to shine—email us at firstname.lastname@example.org.
By Rachel Scher McLean / Posted on March 30th, 2017
Green House homes are dynamic and able to impact innovation in many different settings. The first Green House homes to be incorporated with a PACE community have opened as part of The Thome Rivertown Neighborhood in Detroit. It is an honor to be able to open the doors of accessibility for low income elders through this partnership.
PACE is the acronym of the Program of All-inclusive Care for the Elderly. PACE programs are government-funded managed care health plans that also provide comprehensive health services for individuals age 55 and over who have health needs classified as “nursing home eligible” by their state’s Medicaid program. The goal is to keep chronically ill elders independent for as long as possible –preventing avoidable hospitalizations, emergency visits and stays in nursing homes.
Roger Myers is CEO of Presbyterian Villages of Michigan, and Mary Naber is President/CEO of PACE Southeast Michigan. They are the leaders behind this innovation, and hold the belief in this partnership to evolve the healthcare system. “This is the future. Health is about more than medical care. To meet the needs of elders, the focus must be holistic, accessible and home based,” Naber says.
The goal of PACE is to keep people as independent as possible and to avoid nursing home stays. Despite that, nationally 7% of PACE participants still end up spending some time in long term care, according to Naber, “less because of a need for skilled care, and more because they are not safe to stay in their homes.”
“As we know, even the best traditional nursing home does not provide the greatest living experience, and now, for at least 21 people, The Rivertown Neighborhood is able to offer an alternative. The Weinberg Green House homes meet their needs, support them to thrive and enable them to remain in the community,” says Naber. “It’s very gratifying to be able to offer this option. I wish I had 10 Green House homes for people!”
The Green House homes are licensed as Homes for the Aged, a distinction that provides flexibility and enables elders with a high level of need to live in the least restrictive environment possible. As it happens, many of the people living in these homes have moved there from nursing homes. The PACE program provides a “wrap-around” so that elders receive all the services they need, enabling The Green House home will be their home for life.
“The great thing about the co-location of the Weinberg Green House homes to the PACE center is that the elders receive all the same benefits as if they were living in their own homes, which they are- Green House homes. Being right on the PACE campus will keep elders more mobile and socially engaged. It will also help PACE clinicians stay in touch, and we know that frequent interactions can help prevent ER visits and other medical concerns.” explains Myers.
“Health is not just about medical care, especially when you’re dealing with chronic illness,” declares Naber. By leveraging an interdisciplinary team rather than the typical doctor-driven model, the team at the Weinberg Green Houses are able to care for the WHOLE person: body, mind and spirit.
PACE Southeast Michigan is a 501c3 not-for profit government funded unique health plan and comprehensive care provider. It is a jointly owned by Henry Ford Health System, one of the early PACE innovators, and Presbyterian Villages of Michigan.
The Thome Rivertown Neighborhood includes Independent Living, Assisted Living, the PACE Center and now The Green House homes. Not everyone who lives on the campus is a part of PACE, but it is built as a continuum to enable low income and highly frail people to stay in their community as their health status changes.
Integrating residential living with PACE is proving to be an effective development that will hopefully spread throughout the country. PVM led the development effort for this supportive neighborhood during the recession, and the idea was so compelling that they were able to achieve their goals. A $2 million grant from the Baltimore-based Harry and Jeanette Weinberg Foundation provided much of the support to make their vision to add Green House homes to the community a reality.
By Rachel Scher McLean / Posted on March 20th, 2017
Patrick O’Brian lives with ALS at Leonard Florence Center for Living, a Green House Project in Chelsea, Massachusetts. His father, Mayor Kennedy O’Brian of Sayreville, NJ,was invited to the White House St. Patrick’s Day Reception, and he knew he had to find a way to bring his son. Patrick’s dad said that the team from Leonard Florence Center (LFCL) moved “heaven and earth” to get his son to the event. Patrick was able to shake the President’s hand and meet the Irish Prime Minister…It was certainly a once in a lifetime experience.
LFCL has a long history of connecting people to meaning and adventure. From trips to Cape Cod and Disney World, to sky diving, this organization believes that well-being is about a lot more than physical health.
Beyond this exciting event, Patrick O’Brian is a filmmaker. He was honored in 2015 at the Tribeca Film festival for, Transfatty Lives, a piece that he created with eye gaze technology, while living at LFCL.
We celebrate Green House homes who are pushing the envelope everyday to ensure people live full and meaningful lives, from simple pleasures like getting a cup of coffee just the right way, to traveling 12 hours with a full medical team and meeting the President. “I’m just a proud father and a grateful father,” Kennedy O’Brian said.
By Rachel Scher McLean / Posted on March 6th, 2017
Acting on a strong mission to serve elders in need, Ave Maria home, in Bartlett, TN is embarking on Phase II of their Green House journey. They are currently building five 12-bed Green House homes that will join four Green Houses built six years ago. The new homes have a special purpose, to serve as a safe haven for elders who have experienced abuse.
To support this worthy endeavor, The Harry and Jeanette Weinberg Foundation, Inc. has awarded them a grant of $500,000. Ave Maria CEO, Frank Gattuso, states “It’s exciting to have a national foundation’s involvement in recognizing the importance of care for our elders. The Weinberg Foundation is committed to assisting elders through post-acute care and culture change in our community with these Green House homes.”
The Green House model has within it, the power to impact those who live and work there. The comprehensive transformation of environment, philosophy, and organizational redesign creates an interelated web that supports people to flourish. Ave Maria home is a leader in Tennessee elder care, and we are so proud to be a part of their innovative and compassionate work.
The Harry and Jeanette Weinberg Foundation, Inc. are integral partners. Susan Ryan, Senior Director of The Green House Project shares, “Since 2013, the reach of The Green House Project has been expanded through the generous support of The Harry and Jeanette Weinberg Foundation. Their involvement enables the Green House® Project to make an even greater impact, bringing a highly and more personalized standard of care to elders in every community. These funds have furthered innovation in the field and are vital to extend truly excellent, affordable long term care to all people regardless of acuity level or ability to pay.”
Congratulations to Ave Maria Home, on this truly important work, and the national recognition and support
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.”
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 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 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.
By Rachel Scher McLean / Posted on August 9th, 2016
Over 200 Green House Homes Now Open in 30 States
BALTIMORE, MD (August 9, 2016)– THE GREEN HOUSE® PROJECT has spent over a decade creating a new vision for the future of elder care. In June, the organization reported an important milestone: more than 200 Green House homes are being operated by leading organizations in 30 states.
Upon reaching this new milestone, Green House Senior Director, Susan Ryan says, “It is beyond exciting to see this initiative gaining momentum. It took us 10 years to reach the first 100 homes, and only five years to add the next 100. As our numbers continue to grow, it means that more people are able to live full and meaningful lives. Both the elders who live in Green House homes and those who work there, benefit from the elements of the model that returns value and autonomy to those who it matters to most.“
John Knox Village, a lifecare community in Pompano Beach, Fl represents the 200th Green House home to open. In May 2016, they opened 12 Green House homes. Says CEO, Gerry Stryker, of the momentous occasion, “Being the 200th Green House home is incredibly emotional and fulfilling for John Knox Village. We recognize that we are a part of a rapidly growing national movement to change the face of care and rehabilitation. Our elders deserve this.”
Cedar Sinai Park, in Portland, OR, opened the first of four Green House homes in July, representing the thirtieth state to include this lifestyle model. Sandra Simon, CEO said, “This is the future of aging services, and we are proud to create the first Green House home in Oregon.”
Research finds that comprehensive adoption of the model has the potential to impact re-hospitalization rates, end of life care, and the quality of decisions made in the homes. A strong evidence base makes this model an appealing option to consumers, policymakers and long-term care providers and increases potential for scaling.
The Green House concept has already spread nationwide, with Green House projects operating or in development in 34 states. The organization’s goal is to increase the pace of growth, and have at least 300 homes open by 2020.
About The Green House Project
Based in Baltimore, MD, The Green House Project promotes an alternative to the traditional institutional skilled nursing, replacing it with an innovative new model of care that balances quality of life with quality of care. In the Green House model, large nursing facilities are replaced with small, self-contained homes that include private bedrooms and baths, home-cooked meals and access to the outdoors, while meeting all skilled nursing regulatory and reimbursement criteria. Incorporating the core values of meaningful life, real home and empowered staff, the Green House model creates a higher quality of life, improved medical outcomes, and greater caregiver satisfaction. There are currently more than 200 Green House homes in 30 states. The Green House Project is an initiative within the newly formed Center for Innovation. Visit our website at www.thegreenhouseproject.org.
By Rachel Scher McLean / Posted on July 13th, 2016
“Living the good life” is a blog series celebrating the lives of people living with dementia in Green House homes. In Green House homes across the country, elders are creative, resourceful and whole people who have a valuable story to share.
Sharla Lee lived a colorful life as a performer, gracing many stages and breaking many hearts. Legend has it that she was even asked out on a date by baseball superstar, Joe DiMaggio. When cognitive impairment made it unsafe for her to live on her own, this talented pianist may have faded away, but thanks to Baptist Retirement Community Green House homes in San Angelo, Texas, her star continued to shine bright.
Always the professional, Sharla would wake up at 5:00a every morning in her Green House home in order to practice the piano. She loved to play for the elders during the evening meal, choosing to eat later, after her performance. In Green House homes, the day is centered around the individual elders’ natural rhythms and preferences. The small size enables the home to run smoothly based on deep knowing relationships rather than task oriented schedules. As a musician, Sharla’s preferred schedule was different than that of others living in The Green House home, and by honoring that, her personhood remained intact despite dementia.
Sharla brought joy to others in The Green House home, through her music, and also by being an engaged member of the household. She was made an “honorary shahbaz”, the name given to direct care staff in Green House homes, because she was always willing to help by rolling napkins, setting the table and befriending the other elders in the home. Reciprocity, the ability to receive and also give care, is a key element of Green House homes. As humans, we need to feel a sense of purpose. It may seem like a simple thing, but the value of sharing your gifts with others is something that can’t be overstated.
Mae West once said, “You only live once, but if you do it right, once is enough.” Sharla Lee dazzled audiences in San Francisco supper clubs, on cruise ships and thankfully, in her Green House home as well. By knowing Sharla’s story, and creating opportunities for her to shine, her Green House family made sure that Sharla lived “the good life”.