The First Green House Homes in Rhode Island Are Open

By / Posted on May 22nd, 2017

THE GREEN HOUSE Homes at Saint Elizabeth Home in East Greenwich are open! These are the first new nursing homes to open in RI in over 25 years.


New CMS Regulations, a Win for Person-Directed Living

By / 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 inquiries@thegreenhouseproject.org.


A Grandaughter’s Externship Provides Insight into The Green House Model

By / Posted on April 5th, 2017

Breanna with her grandparents, Twylah and David Haun

The Green House model has added passion and purpose to my family in many ways. My grandparents, David and Twylah Haun, are Independent Living residents at John Knox Village (JKV) and they were instrumental in bringing The Green House model to their community. We have had many great conversations about the model’s potential over the years, and it has become close to my heart as well. Currently, I am pursuing my doctorate in Occupational Therapy at the University of Southern California (USC). When a professor challenged us to seek out opportunities and learn what it means to be a leader in healthcare, I immediately thought of my grandparents. This led to an exciting externship at The Woodlands at JKV. Before I stepped foot on the grounds at JKV, I was already destined to have valuable experiences simply based on the leadership skills I could learn from my grandparents.

John Knox Village, Pompano Beach, FL

I can still remember back in 2011 when bringing The Green House model to JKV became the main topic of our Thanksgiving meal ; My grandmother was interested and my grandfather was doubtful. Never ones to be easily convinced or to skimp on their research, they decided to take a road trip to eight different Green House homes to see this model in action. After visiting four homes, Grandfather was sold on the idea and came home to put their research into action. In the years since this initial exploratory trip, my grandparents have stayed very involved in The Green House initiative at JKV and also at a national level. They have spoken at the national Green House Meeting, contributed to The Green House blog, and helped with every aspect of creating and opening The Woodlands at JKV (including selecting paintings for the walls and dishes for the dining rooms, pictured right). Grandma has continued her active role in The Green House homes by becoming a Sage, a volunteer role that allows her to mentor and support the self managed work team to become a cohesive team and help create a real home for and with the elders.

In my program, we were discussing different models of care, and my professor brought up The Green House Project. It was something USC knew little about, but were excited to see how it could change the future. I was thrilled to be able to share my grandparents’ experiences with my 150 classmates and professors. I couldn’t wait to see the model in action! The Woodlands at JKV represents the first Green House homes in Florida, and they also offer homes dedicated to short term rehabilitation. Providing meaningful therapy in a natural environment is the ideal for an occupational therapist, and an exciting reality in the Green House homes.

I spent my externship running from meeting to meeting, soaking up as many experiences as possible, and asking questions about everything. From the staff in the homes to the people working across the whole community, I was continually impressed by the way they put the needs of the elder first, and balanced that with the success of the organization.

Some of my most meaningful interactions occurred with the elders, sharing stories of joy, belonging, and feeling safe in The Green House homes. In the end, this is why we do what we do, and it filled my heart with pride to be able to see this vision that my grandparents helped to carry forward, being lived out in such a beautiful way.

My time at JKV was a wonderful learning experience, and one that I will never forget. The Green House model is truly making a difference in the lives of the elders and those who are passionate about working with them. As a leader and therapist, I know that one of the greatest gifts I can give a client is to remind them that they are a unique individual who matters. From talking to the elders and listening to their stories, watching the direct care staff prepare meals in their home, participating in leadership meetings, and delivering mail to the homes with my grandmother, every experience taught me something valuable, and I am incredibly grateful.


The Visionary Leadership Behind the First PACE Green House homes

By / 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.

 

 


A Sage’s Testimonial of Short Stay Rehabilitation in a Green House home

By / Posted on March 29th, 2017

For the last few years, I have served as a Sage (volunteer who supports and advises the self managed work team) at The Green House homes of Mirasol.  Recently, my role was reversed, when I moved in to recover after an extremely taxing and debilitating surgery.  These homes are listed as 5 Star by Medicare and Medicaid, a wonderful professional endorsement.  I can tell you, however, that the essence of what I experienced, goes far beyond that checklist, and their stellar outcomes reflect something much deeper and more comprehensive.

The Green House homes were the only attractive option for rehab within 20 minutes from my home.  Because I know how popular The Green House homes are, I was worried that there would not be space for me.  I was delighted to be able recover in a Real Home. I knew that being a volunteer would be very different from being a guest in the community, but I couldn’t have predicted how impressed I would be, or the gratitude I would feel.

The Green House team ensured that the process was smooth and dignified from the very beginning.  They managed all the hospital paperwork, follow-up appointments and coordination, which in my mind already goes leagues above 5 stars!  The driver’s vehicle enabled me to sit comfortably up front, and he even offered me clip-on sunglasses, my choice of music and a warm blanket (an important touch on a freezing Colorado day).  We quickly fell into a comfortable chat and discovered many things that we had in common.

When I arrived, I was greeted warmly, like a long-lost, favorite uncle!  The Shahbazim (direct care staff) offered me the choice of going to my room for a rest, or staying at the table for a meal.  Having already having discovered my dietary preferences, they offered to make something special, just for me.  The whole home smelled scrumptious when I came in the front door! Just being there made me feel better, and I had a renewed appreciation for the airiness of the dining area, the good smells of the kitchen, and the warm, inviting fireplace area.

We went to my room – private room with private bathroom, thank goodness.  As I was oriented, I was reminded that no room is more than six doors from the hearth, and this was confirmed the next morning by the aroma of breakfast wafting into my bedroom.  How refreshing to recover without the long and disorienting corridors lined with carts of stale food or unmentionables waiting to be taken out back.  At no stage
was I “parked” anywhere in the house, as I have seen in other nursing homes, left alone to wait.  To be treated like a person, rather than an object; what this did for my well-being, I can’t begin to measure.

Dinner was a very communal event, and I felt very welcomed by my fellow elders at the table.  Some required help with eating, which the Shahbazim did casually and warmly with considerable skill and NO DEMEANING BIBS.  It immediately felt like the elders were interested in me as a fellow member of the house and its extended family of elders, staff and family members. The feeling of family was beautifully illustrated, as one elder spontaneously went over to another elder, who seemed unhappy, and simply gave him a hug.  It was then that I was brought to tears, so moved by the atmosphere of support and caring. The elders are empowered to care and support each other, creating a community of reciprocity, where everyone has something to offer.

The hearth in the center of the house is a place where elders and Shahbazim could naturally get to know each other more deeply, creating mutually supportive relationships as our stories are shared. What a realization to know that the more deeply we know each other, the more we are valued.  These relationships enable the elders and Shahbazim to go beyond medical needs, and become connected, helping each other to live the best life possible.

The staff appeared to be encouraged to stop over each day and chat for a while just to get to know me better.  I felt understood, and like the things that were important to me, were important to them.  If I had a visitor (like my wife of 51 years) or was engaged elsewhere, my nurse would ask if I would prefer she come back later. She put me in the driver seat of my care, and made me feel like she honored my privacy and dignity. The Shahbazim seemed to anticipate my needs, incorporating what they learned about me from our conversations, and providing personalized care that went well beyond my physical needs.  Team members would stop by at the end of their shift to just chat about their plans for the rest of the day, to ask advice, or to ask me about my life stories.  This genuine caring, was something that I hadn’t experienced in other nursing home/rehab settings, and it was so gratifying and replenishing.  To be known and truly valued, this is better than the best medicine.

What a phenomenal rehabilitation experience, delivered by wonderful people who love their
job, love the people they work with and the elders they serve.  The Green House homes provide opportunities for these open-hearted people to grow and develop their already extraordinary gifts.  I am honored to be able to share my experience as a testimonial to others who are seeking a place where they can recover, not only physically, but holistically.  It is because of this experience that I healed so rapidly, with caring and the preservation of my dignity.

Learn more about The Green House homes at Mirasol>>

 


Green House Team Members Move “Heaven and Earth” for Patrick to Attend White House Reception

By / 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.

 

 

 

 


Ave Maria Home Receives Grant to Build Safe Havens for Victims of Abuse

By / 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.”

Maureen Conley, family member of one of the Ave Maria residents.

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

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An Outing To Enjoy The Season Reflects True Empowerment

By / Posted on February 25th, 2017

Kris Angevine with house pup, Lexi

 

One of my proudest moments as a Guide for the Penfield Green House homes was when one of the Shahbazim (self-managed team of direct care staff), Wendy, texted me and said “Hurray!  We made it!” … I didn’t know what she meant and I was at our legacy building about 20 minutes away so I couldn’t just pop over to clarify the news.  The therapeutic recreation specialist for our Green House homes, Mimi,  has an office across from me, so I moseyed over to her and asked her if she knew what Wendy could mean?   Mimi said “Nope, I don’t know anything.” So, I texted Wendy back and asked her “Made it where?  What are you all up to?” She replied, “Check Facebook!”

photo on Facebook of elders riding to their Naples adventure

I didn’t have time to check the site, as I was rushing off to another meeting so it was an hour later before I was able to close the loop.  As it turned out,  all 10 elders, the Shahbazim and a Nurse were buying grape pies in Naples, NY which is about 2 hours away.  The team planned the whole thing, scheduled the van, grabbed the credit card, and even got the other House to come over and check on Lexi, the house dog, because this was her first time on her own.  On their way home, they stopped for lunch, and enjoyed the iconic fall scenery in upstate NY.  It was beautiful, well executed, and neither the “boss” or “activities” knew anything about it.

True empowerment at its best!


Missouri’s First Green House Community Opens

By / Posted on February 25th, 2017

It’s another first for The Green House Project, as Missouri is welcomed into the list of innovative states to offer a Real Home to elders who need skilled care.  The Cottages of Lake St. Louis, located in the western suburbs of St. Louis, opened the first of six cottages in January 2017. Now, residents of the “Show-Me” state will get to see firsthand what skilled nursing looks like when its designed — from the inside out — to be a home.

Al Beamer, CEO of the Cottages of Lake St. Louis, says people are struck by how different the community is from a traditional nursing home before they even step inside.

A Home…

Cottages of Lake St. Louis, CEO, Al Beamer

“When people think about nursing homes, they expect to see a large facility designed to house hundreds of residents,” says Beamer. Instead, the Cottages of Lake St. Louis is six cottages built alongside one another on a residential street. Each cottage is a stand-alone home that houses only 10 elders. “What surprises them most is that Green House homes are truly homes,” continues Beamer. “We are very deliberate in saying each cottage is a home — not ‘like a home.’”

This means no medicine carts rattling down long hallways, no big lights flashing above residents’ rooms, no large institutional kitchens and dining areas. In a word, the Cottages are “cozy.”  Each elder has a private bed and bath. This supports their dignity and privacy — but privacy does not mean isolation.

A Community…

Relationships are at the core of Green House communities.  “There’s one big kitchen table in each cottage, so everyone eats together,” says Christie Tutschulte, vice president of care management for the Cottages of Lake St. Louis.  This encourages the natural social interactions that happen around a family table. The elders in each cottage decide what they want to eat, and they see their meals prepared in an open kitchen so they can enjoy the smells and sounds of a busy kitchen.

The focus on relationships extends to those between the staff and the elders. A small, self-managed team of educated, universal caregivers is dedicated to caring for the elders in each cottage. Because this team works in only one cottage, they get to know their elders on a personal level. This helps them see health changes and reasons for concern much sooner than in a traditional nursing home, allowing for earlier interventions and better health outcomes.

In many ways, each cottage is its own little family — and this is exactly how this family owned and operated business wants it.

A Family…

Al Beamer and his wife, Kathy, are the CEO and chief financial officer, respectively. Their daughter, Christie, is vice president of care management, and son, Matt, is vice president of operations.

Christie, who graduated with a master’s in Gerontology, says living in the community makes opening the Cottages of Lake St. Louis personal for her and her family, “Our kids go to school here, we go to church here, we have built our home and our lives here — and we really want to make a difference in our community.”

All of the namesakes at the groundbreaking

Family is so important to the business that five of the six cottages are named after the Beamer’s grandchildren: Ava, Ella, Grace, Harper and Kris.

“When it came to naming the cottages, my husband, Al, and I hit upon an idea that we feel really speaks to the ideals that we are trying to provide for our elders and our family,” Kathy explains. “We believe that it is important to build relationships across the generations, and to value the gifts within each of us. In this spirit, we chose to name each cottage after one of our five grandchildren and the sixth cottage to honor the late mother of our director of development.”

As with all Green House communities, you won’t find any of the institutional markers of a traditional nursing home in the Cottages of Lake St. Louis — yet they still meet all state regulations for skilled nursing facilities. In fact, the Cottages provide a much better nurse to elder ratio. While state regulations require skilled nursing facilities to provide 208 nurse hours per 60 elders per week, the Cottages of Lake St. Louis will provide more than 500 nurse hours per 60 elders per week.

the first elder to move in with her family

The Cottages of Lake St. Louis are opening gradually. The first two of the six cottages have opened, and the remaining four will open by the end of March. This staggered opening is intentional, says Christie, “We are so excited to welcome our first elders, but we want to do it right and get to know each person.”

To learn more about the Cottages of Lake St. Louis, visit www.cottageslsl.com or call 636-614-3510.


The Evolution and Impact of The Green House model: Interview with Journalist and Author, Beth Baker

By / Posted on January 30th, 2017

Beth Baker, Journalist

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.”

To read the full Politico Article>> 

 

 


‘The Program of All-Inclusive Care for the Elderly’ and The Green House model: An Innovative and Cost-Effective Partnership for Comprehensive Care

By / Posted on January 23rd, 2017

Lori Gonzalez is a PhD researcher at the Claude Pepper Center of Florida State University who studies alternatives to traditional nursing care and social inequality.

The first Green House homes included in a Program of All-Inclusive Care for the Elderly (PACE) partnership will open in early February, joining together two of the nation’s most promising long-term care models.  The Harry and Jeannette Weinberg Green House homes, located in the Thome Rivertown Neighborhood in Detroit, Michigan will serve approximately 21 lower-income older adults who are otherwise able to live safely in the community, but who are currently residing in skilled nursing facilities.  According to Capital Impact Partners, serving these older adults in Green House homes with the support of PACE, compared to providing care in a traditional nursing facility, is expected to save the state’s Medicaid system about $130,000 per year.

PACE began in California in the 1970s as an alternative to institutional long-term care.  A group of Chinese, Italian, Filipino, and other immigrants held cultural views about caring for their loved ones that departed from the larger culture of aging in nursing homes.  They formed “On Lok” meaning peaceful, happy abode.   By 1986, On Lok developed the nation’s first comprehensive model of coordinated care and by 1997, the program became a permanent provider under Medicare and a state option under Medicaid.  Today, PACE operates 116 programs in 32 states and serves over 30,000 older adults, most of whom are dually eligible for Medicare and Medicaid.  PACE operates with the belief that, “it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.”  With the assistance of the PACE program, 90% of participants who might otherwise enter a nursing home are able to live in the community.

PACE provides comprehensive care to those who are eligible for the program.  PACE eligibility includes being 55 or older, certified by the state to need a nursing home level of care, residing near a PACE care center, and having the ability to live safely in the community. When an individual enrolls in PACE, they (and their family) meet with a team of care professionals including social workers, nurses, primary care physicians, and nutritionists to help craft a plan to serve an elder in the community.  PACE participants visit a PACE care center routinely where they, depending on their plan of care, might receive a flu shot, dialysis, dental care, respite care, a hot meal, physical therapy, transportation, or participate in social activities.  Family members who visit the center receive counseling or advice on how to care for their loved one.

Green House homes also provide quality care and quality of life, but in a residential setting.  In Green House homes, “elders and others enjoy excellent quality of life and quality of care; where they, their families and the staff engage in meaningful relationships…” and when licensed as ALFs, they provide a community-residential setting for elders that is expected to exceed the quality provided by other ALF models.  Green House homes are not just homelike, they are places where elders call home.

The goals and values supported by PACE and The Green House model are similar and their partnership will honor elders’ preferences to avoid a nursing home and to live in the least restrictive care setting possible. Green House homes provide high quality residential living and PACE provides the physical health, mental health, social health, and family support for both acute care needs and long-term care needs.  Furthermore, PACE and Green House value the belief that all elders should have access to quality care and a good quality of life. PACE serves mostly dual eligible, frail elders and Green House homes are meant to be available to all, regardless of income or wealth.  The Green Houses at Rivertown Neighborhood, along with PACE will support these values by serving 21 low-income elders.

Aging in place is highly desired by older adults, but sometimes financially out of reach.  The Thome Rivertown model demonstrates that creating a Continuing Care Retirement Community for lower income individuals is possible and that when PACE and Green House are integrated into that community, high quality, cost-effective care is achievable.


‘Politico’ Hails The Nursing Home of the Future

By / Posted on January 13th, 2017

politico1In 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 politico2perspective, 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.”

politico3This 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.

Read The Full Article>>