Download this one page overview of the latest research findings of The Green House Project, as well as an up to date map of where there are projects open or in development.
• Improved quality of life: Green House elders reported improvement in
seven domains of quality of life (privacy, dignity, meaningful activity,
relationship, autonomy, food enjoyment and individuality) and
• Improved quality of care: Green House elders maintained self-care
abilities longer with fewer experiencing decline in late-loss Activities
of Daily Living. Fewer Green House elders experienced depression,
being bedfast and having little or no activity.
• Improved family satisfaction: Green House families were more
satisfied with general amenities, meals, housekeeping, physical
environment, privacy, autonomy and health care.
• Improved staff satisfaction: Green House staff reported higher job
satisfaction and increased likelihood of remaining in their jobs.
Green House homes relative to nursing home comparison sites3
• Higher direct care time: 23–31 minutes more per resident per day
in staff time spent on direct care activities in Green House homes
without increasing overall staff time.
• Increased engagement with elders: More than a four-fold increase in
staff time spent engaging with elders (outside of direct care activities)
in Green House settings.
• Less stress: Direct care staff in Green House homes reported less jobrelated
• Improved care outcome: Fewer in-house acquired pressure ulcers in
Green House homes.
Green House homes versus traditional and other culture change
nursing home costs4
• Cost neutral operations: Green House homes operate at the same
median cost as the national nursing home median cost.
• Lower capital costs: Green House homes provide private bedrooms
and baths and enhanced common space while building the same or
fewer square feet than other current culture change nursing home
models. Lower square foot costs lead to lower capital costs.
Role of direct-care workers5
• Comparable quality: Removal of formal nurse supervision of direct
care workers did not compromise care quality.
• Timely intervention: High level of direct care worker familiarity
with elders led to very early identification of changes in condition,
facilitating timely intervention.
1 Kane R, Cutler L, et al. “Resident Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program,” Journal of the American Geriatric Society