Leaders Speak Out about the Value of The Green House model

By / Posted on February 23rd, 2018

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

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

 


Engage a Diverse Workforce to Increase Success

By / Posted on February 21st, 2018

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


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

By / Posted on January 22nd, 2018

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

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

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

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

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

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

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

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

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

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

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


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

By / Posted on January 19th, 2018

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

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

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

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

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

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


Person-Directed Lives Exemplified Through Interviews

By / Posted on January 16th, 2018

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


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

By / Posted on January 3rd, 2018

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

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

Grand Openings:

Green House Village of Goshen

Goshen, IN

Goshen, IN

3 homes

January

 

 

Ave Maria

Bartlett, TN

Bartlett, TN

5 homes

March/April

 

 

Poplar Grove

Little Rock, AR

Little Rock, AR

10 homes

July

 

 

West Vue

West Plains, MO

West Plains, MO

3 homes

Fall

 

 

 

Groundbreaking:

Lima, OH

Lima Home

Lima, OH

2 homes

 

Hover Community

Longmont, CO

Longmont, CO

4 homes

 

 

 

 

Sun Porch

Topeka, KS

Topeka, KS

2 homes – phase one/2 homes phase 2

 

 

 

Belle Meade

Paragould, AR

Paragould, AR

2 homes

 

 

 

Wyoming Department of Health

Lander, WY

Lander, WY

10 homes

 

 

 

 

Mustard Seed

Vaughn, WA

Vaughn, WA

3 homes

 

 

 

 

Solutions Healthcare

Las Vegas, NV

6 homes

 

 

 

 

 

 

 

 


Keep it Simple: How We’ll Take Aged Care Challenges

By / Posted on December 22nd, 2017

Evermore Founder Sara McKee writes about what she learned at the recent Green House conference about how we can tackle aged care challenges by keeping it simple, and the importance of celebrating differences. (Reposted from Evermore Blog)

I recently attended the annual Green House  conference in Fort Lauderdale. It was fantastic to be in a T-shirt in November – having left rather chillier conditions back in Manchester.  It was also great to be with hundreds of believers from across America who are delivering a better way of living in older age, every day.

I was the only English person at the conference alongside fellow international explorers from Panama, Brazil, Bermuda, Israel and Singapore. However, if you take the vast expanse that is the United States, then it felt truly multicultural with folks from Alaska to Colorado, Pittsburgh and Arkansas.

Whilst the language of the conference was English, this multicultural dimension made us all recognise our differences in culture, approach and, indeed, language. We may all be speaking the same words, but do we really understand each other’s meaning?

James Wright delivered a challenging keynote on diversity and inclusion, highlighting our scientifically proven hidden biases. He explained how we operate on an unconscious level which makes us have implicit preferences.  A book he referenced about the topic is ‘The Hidden Brain’ and I’m going to read it to find out more.

One example he gave was how we make assumptions based on accent. He said that coming from South Carolina, he’d trained out his southern drawl as that made him sound stupid in the eyes/ears of others. Good News for me was that he said the English accent was universally seen as the smartest sound!

He was keen to point out that it doesn’t make us racists or any particular “–ists” – it simply is how we’re made! His mission is to move from talking about equality to equity – a discussion deserving of a blog of its own.

What can we learn from all of this?

We had gathered at this conference, many colours, ages and backgrounds to talk about the challenges we all faced with an ageing population and a shrinking workforce. Yes, we had similar challenges, we could share experiences and our different solutions. And yet we were not all the same.  That’s where it felt we had real strength. If we celebrated our differences and built on our joint appetite for collaboration, we could continue to innovate and create new opportunities for living well in older age.

James shared this clever video which reinforced the point for me: “Be together, not the same

My take away from the conference – Keep it Simple:

  • Simplify our approach to engaging with customers – what matters to you? Not what’s the matter with you!
  • Simplify our language – let’s get rid of the jargon. We talk about ‘convivium’ at the heart of our family households, yet it’s hard to say and even harder to spell – so let’s talk about sharing our life together and breaking bread.
  • Be consumer driven – let’s develop and deliver services that are focused on what our customers want. Sounds obvious, but often feels like rocket science in the world of aged care.
  • Translate connectedness, meaning, purpose and exercise into everyday activities. Not make each element someone’s task.

I’ve come back from the conference feeling re-energised and determined to maintain our international collaboration as we can all learn and build new world thinking together.


Register Today for The Distinguished Speaker Webinar Series and OnSite Workshops

By / Posted on December 22nd, 2017

Register Today for The Distinguished Speaker Webinar Series and OnSite Workshops
  • Cultural Transformation Through Green House, January 9 (3:00p ET). Join Green House Senior Director, Susan Ryan to hear an Overview of The Green House model as you’ve never heard it before! THE GREEN HOUSE believes that all elders deserve to grow and thrive no matter where they reside, and that to impact lives in a meaningful way, it takes more than environmental change. To make meaningful change a reality, it is imperative to infuse the entire organization with optimal systems and structural changes that create a cohesive approach to elder-directed care.  Register>>
  • Innovations and Trends in Elder Care, February 1 (3:00p ET). Lisa McCracken, Director of Senior Living Finance Research and Development with Ziegler will provide an overview of the key trends and innovations in Elder Care. This is the opening session of our Business Case series which will shed light on how The Green House model is a viable solution amidst the backdrop of a dynamic economy and healthcare climate.Register>>
  • Improving Long Term Care Workforce With Strategies that Work, February 22 (3:00p ET). Robyn Stone, Senior Vice President of Research, LeadingAge, will provide an overview of the demographics, trends and challenges of the workforce in Elder Care. This is the opening session of our Workforce series. which will identify practices within The Green House model that create the potential for successful workforce development. Register>>
  • Living with Dementia: New Perspectives, March 22 (3:00p ET). Dr. Al Power, author of Dementia Beyond Drugs and Dementia Beyond Disease, will look at the experience of dementia through the frame of well-being, and explore how this perspective is challenged, both by brain changes, our attitudes, and care systems. Register>>


A Global Community of Thought Leaders at The Green House Annual Meeting

By / Posted on December 22nd, 2017

“Waves of Change, Oceans of Opportunity” became more than a theme for the 2017 Green House Annual Meeting, it became a rallying cry. The world is at a pivotal point, and the meeting tapped into the collective potential of an innovative group to help shape the future. Over 250 people from around the globe converged in sunny Florida to connect, learn and grow. Hosted by the progressive and gracious John Knox Village, attendees were able to experience the potential of The Green House model, firsthand. Coming on the heels of the devastating Hurricane Irma, The Green House community came together to raise over $1200 for disaster relief, including many in-kind donations.  Engaged and generous sponsors add to the rich tapestry of learning, and enhance the conference experience.  Through challenging speakers, interactive opportunities, and recognition of the global voice, the ripples of the time together will continue to be felt for a long time.

Sharpen your skills in the kitchen!  This was the challenge put out to direct care staff who were invited to participate in a “Chop Chef” style competition in the onsite training kitchen at John Knox Village. Under the guidance of Chef Mark of John Knox Village and Chef Ian from Christian Cares in Kentucky, direct care staff gained valuable skills in the kitchen, build strong relationships with peers and deepened their understanding of being an empowered staff member.

Over 40 Executives including representatives from 8 countries participated in a stimulating and challenging session about Social Entrepreneurship led by Green House Board President, Scott Townsley. The commitment and vision of these leaders to share their voice, demonstrates the power of a community of thought leaders to change a paradigm.

The conference opened with keynote speaker, James Wright, challenging the group to explore the meaning and value of diversity in the workplace. Through interactive exercises to uncover unconscious bias and understand the difference between equity and equality, Mr. Wright’s message became a thread for meaningful discussion throughout the conference, and perhaps a new lens to view the world.

Monique, shahbaz at Weinberg Green House homes in Detroit, MI

The Green House Annual Meeting welcomes every role within The Green House model, believing that sharing an education space leads to some incredible conversations and epiphanies. For example, in the closing plenary session, when Monique, a direct care staff member from Detroit, stood up and said, “this is not a job, this is a career”, there was electricity throughout the room, and a heightened understanding that workforce development is essential to ensure sustainable success of Green House homes. The education sessions range from important macro topics like “What You Need to Know About the New CMS Regulations to Lead the Way” to nuts and bolts topics like how to engage in constructive conflict. Facilitated networking through an exercise called “Words Make Worlds”, led to

Words to Leave Behind was followed by a round of Words Make Worlds

spirited conversation, and many creative expressions of words to take forward, and those to leave behind. There is value provided at a strategic level and an operational level, and the interaction that occurs is priceless.

Yaron from Israel, and Janet from Alaska reunited after meeting 8 years ago at Seward Mountain Haven

Last year, one of the far reaching visions was that Green House would “Go Global”. At the time, it seemed like a dream, and then international visionaries began to reach out about bringing Green House to their community. This year, representatives from Bermuda, Brazil, Canada, Israel, Indonesia, Panama and Singapore participated in The Green House conference, and an International Think Tank where ideas and possibility spread through the room like wild fire. One participant remarked that what may have started as a ‘project’ is now far more than that… it is The Green House Movement! Everyone left with a ‘fire in their belly’ to make meaningful change. Conversations and plans have continued full force, and there are now expansive opportunities for Green House to impact the needs of aging individuals on a global scale.

The Green House Annual Meeting is always an energizing time for those who are exploring, implementing and sustaining the model to connect with their peers and deepen their understanding. This year brought new elements that challenged the group to deepen their role as a community of thought leaders and lead society as an inclusive and innovative force that celebrates the intrinsic worth of EVERY individual.   The Green House movement has the energy and vision to disrupt the status quo and propel a dynamic system to new heights amidst a rapidly changing world.


New York Times Calls The Green House, “A Better Kind of Nursing Home”

By / Posted on December 22nd, 2017

Green Hill, West Orange, NJ

At The Green House, vision is merged with rigor, passion with determination, and a belief  that there’s never a best that can’t be made better.   In their article, “A Better Kind of Nursing Home”, The New York Times says, The Green House model is demonstrating that life in long term care can be different. With real life experiences to support the movement, and world-class research to keep improving, the potential for future impact is vast.

“Lots of things look different when you step into a small Green House nursing home.  The bright living and dining space, filled with holiday baubles at this season. The adjacent open kitchen, where the staff is making lunch. The private bedrooms and baths. The lack of long stark corridors, medication carts and other reminders of hospital wards.”

Robyn Grant, public policy director for The National Consumer Voice for Quality Long-Term Care, emphasizes that the goal of this shift that The Green House Project is leading means “deinstitutionalizing nursing homes, making them more like the way we’ve lived all our lives, with our own routines and familiar objects.”

Green Hill hearth decorated for holidays

The national initiative has committed itself to the rigors of research in pursuit of continued growth.  Research has shown that model components such as consistent and increased staffing, lead to deep knowing of the elder and early detection of health changes, “The [THRIVE] researchers found that Green House residents were 16 percent less likely to be bedridden, 38 percent less likely to have pressure ulcers and 45 percent less likely to have catheters. Avoidable hospitalizations and readmissions were also lower, reassuring observers who wondered if the Green Houses’ emphasis on quality of life meant sacrificing quality of care.”

In a dynamic world and healthcare landscape, it is essential to be a part of the solution. The Green House Project “Compared to traditional nursing homes, no doubt about it,” said Dr. Sheryl Zimmerman of the THRIVE research team. “It’s a preferable model of care.”

Read the Full New York Times Article>>


Green House Featured as Innovator at National LeadingAge Conference

By / Posted on October 20th, 2017

To care well for others, we need to reinforce our own passion for what we do—and actively work to improve how to support our country’s aging population today. That’s exactly what we do at the LeadingAge Annual Meeting & EXPO, our nation’s largest annual event for the not-for-profit aging services field. In education sessions, during general sessions and through eye-opening, one-of-a-kind experiences, you and your team will be immersed in our shared mission of helping older adults thrive.”

The Green House Project is looking forward to opportunities to connect with visionary organizations at this of this event.  Please visit us in the exhibit hall at booth #1913.  Also, don’t miss this informative, challenging and stimulating sessions that feature Green House expertise and innovation:

Monday, October 30, 2017

3:30 – 5:00 p.m.

22-C. Integrated vs. Segregated Environments for Persons With Dementia

  • Examine the pros and cons of integrating versus separating elders living with dementia in different settings.
  • Consider how the approach to dementia care and programming has evolved as the physical environment of memory care “units” continues to change from locked wings to neighborhoods.
  • Assess your organization’s philosophy and care practices as they relate to those living with dementia and their care partners.

Speakers:

  • Audrey Weiner, President & CEO, The New Jewish Home, New York, NY
  • Ann Wyatt, Manager, Palliative & Residential Care, CaringKind, New York, NY
  • Susan Ryan, Senior Director, Green House Project, Linthicum, MD
  • Tammy Marshall, Chief Experience Officer, The New Jewish Home, New York, NY
  • J. David Hoglund, Principal and Director, Perkins Eastman, Pittsburgh, PA

 Tuesday, October 31, 2017

3:30 – 5:00 p.m.

48-F. From Traditional Skilled Nursing to Green House® Model

  • Discover how resident leadership, administration and board members achieved consensus to transition toward a new model of care.
  • Understand how the new financial model created a platform for new funding opportunities and revenue streams.
  • Consider planning, forecasting, marketing and implementation pitfalls to avoid from both a financial and care perspective.

Speakers:

  • Gerald Stryker, President/CEO, John Knox Village of Florida, Inc., Pompano Beach, FL
  • Rob Seitz, Marketing & Communications Manager, John Knox Village of Florida, Inc., Pompano Beach, FL
  • Jean Eccleston, CFO, John Knox Village of Florida, Inc., Pompano Beach, FL
  • David Haun, Resident, John Knox Village of Florida, Inc., Pompano Beach, FL
  • Twylah Haun, Resident, John Knox Village of Florida, Inc., Pompano Beach, FL
  • Nanette Olson, Executive Director of the Foundation, John Knox Village of Florida, Inc., Pompano Beach, FL
  • Monica McAfee, Director of Sales and Marketing, John Knox Village of Florida, Inc., Pompano Beach, FL


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

By / Posted on October 17th, 2017

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

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

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

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

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

New regulations set new standards for care planning.

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

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

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

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

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

Meaningful Engagement is now a greater focus of new regulations.

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

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