By Rachel Scher McLean / 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.
GREEN HOUSE® PROJECT CONTINUES TO LEAD LONG-TERM CARE TRANSFORMATION WITH NEW $650,000 ROBERT WOOD JOHNSON FOUNDATION GRANT
By Admin / Posted on June 6th, 2017
For more information, contact: Susan Ryan
firstname.lastname@example.org or 703.615.2359
GREEN HOUSE® PROJECT CONTINUES TO LEAD LONG-TERM CARE TRANSFORMATION WITH NEW $650,000 ROBERT WOOD JOHNSON FOUNDATION GRANT
BALTIMORE, MD – The Green House® Project has received a two-year, $650,000 grant from the Robert Wood Johnson Foundation (RWJF) to fulfill its mission of redefining—and humanizing—long-term care in the United States.
The Green House Project aims to end the institutionalization of older adults in America. Under this vision, all elders will have the opportunity to live in small, welcoming homes with dignity, autonomy, choice, and the best quality of life possible, while receiving the care they need.
The new RWJF grant will enable Green House Project leaders at the nonprofit Center for Innovation, which recently acquired the Green House trademark and intellectual property, to continue spearheading this movement. They will work with the leading Green House adopters to further refine the model while spreading it across the country.
Additionally, the national initiative plans to expand the impact of the Green House model through a specialized focus on people living with dementia, people in need of short-term rehabilitation services, and other areas of innovation. The Green House Project, the pioneer of the small house model, offers proven clinical and financial outcomes through a comprehensive cultural transformation across the entire organizational system.
“The Green House Project is a dynamic model that continues to evolve as an agile leader in the field,” said Scott Townsley, president of the Center for Innovation. “The success of the Green House Project has catalyzed a community of thought leaders who are discovering new ways to improve the lives of elders. We’re excited to work in partnership with them to change the way people age.”
The Center for Innovation, where the Green House Project is based, was founded by three members of the faculty at The Erickson School, University of Maryland Baltimore County. The Erickson School is the only program in the country offering both undergraduate and graduate degrees in the management of aging services.
The Green House Project launched more than a dozen years ago with the shared vision of its founder, William Thomas, M.D., and RWJF, for transforming long-term care. Today, 231 Green House homes are open and operating, serving elders in 32 states across the country, and another 150 are in the works.
“We owe a debt of gratitude to Dr. Thomas for his role in helping to get the Green House Project to where it is today,” said Susan Ryan, senior director of The Green House Project. “We wish him well in his future endeavors to move the field forward.”
The Green House Project has a solid evidence base. Supported by RWJF, the THRIVE Research Collaborative conducted a comprehensive and rigorous evaluation of the Green House model. A team of leading health care and long-term researchers conducted a half-dozen studies that addressed workforce issues, quality of care, cost savings, and culture change. These studies, all published in the journal Health Services Research, found that:
- Elders in Green House homes were less likely to be readmitted to the hospital, to be bedridden, to need catheters, or to have pressure sores than those in non-Green House homes.
- Annual inpatient and skilled nursing facility Medicare costs were significantly lower for elders in Green House homes.
- Caregiving staff in Green House homes spent more time per day with elders than caregiving staff in non-Green House homes.
“The Green House Project is what people want—for themselves and for their loved ones,” said Nancy Barrand, senior adviser for program development at RWJF. “We want to ensure that every community has a Green House home and that the Green House Project becomes the standard of quality for all nursing care.”
To learn more about The Green House Project, visit: thegreenhouseproject.org
By Admin / 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.
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 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 Lori Gonzalez / Posted on December 12th, 2016
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. She spoke at The 9th Annual Green House meeting about how she discovered The Green House model, and her passion to spread its message.
“Of those who were surveyed, most frail elders reported that they would choose death over a nursing home.” This was one of the first studies that I came across when I started working as a researcher at the Claude Pepper Center at Florida State University. As I delved deeper into the research literature regarding quality of care and quality of life in long-term care it became clear why the elders in the survey would say such a thing. Study after study reported resident lack of autonomy, lack of privacy, and lack of dignity. The physical environment in many nursing homes resembles the hospital instead of home. Staff and resident schedules are rigid. Unhappiness and dehumanization abound. Although the problems are well documented in the literature, few solutions are offered.
Eventually, I came across the early research on The Green House Project. Not only were Green House homes the comprehensive answer to a complex problem, but the research showed that they were effective in reducing many of the ills facing both elders and staff in the traditional nursing home. Since then, I have been following The Green House movement and advocating for the model as an independent researcher. For example, my op-ed that appeared in the Tampa Bay Times earlier this year argues that Florida, during its temporary lift of the moratorium on new nursing home bed construction, has the opportunity to build more livable, human-scale residences like Green House homes instead of the traditional, large-scale institutional model.
I have also been documenting a story of elder empowerment at the Woodlands of John Knox Village (JKV) Green House homes in Pompano Beach, Florida. When the community’s rehab facility needed replacing, several elders used their vote on the board to bring The Green House model to JKV. It took several years, lots of back and forth, but in the end—it was the elders who insisted that The Green House model was what they wanted, that according to their research, it was right for their community. I had the honor of touring the beautiful, bathed in natural light, full of life homes, and the honor of speaking with elders, guides, direct care staff, and the CEO—it is a place where elders truly rule.
I will continue to try to help spread the model because The Green House Project provides the type of long-term care that elders want and deserve.
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 Jeff Shireman / Posted on January 6th, 2016
At Lebanon Valley Brethren Home we believe in empowering our elders and providing innovative ways to care for their needs both in mind, body and spirit. This video is the story about our Green House homes, which are designed to serve those who need the highest level of nursing care.
We decided to tell our story by video for a few different reasons. First and foremost, we wanted to create a clear and visual way to describe The Green House model to prospective elders and their families. Because we limit outside visits to preserve the value of ‘real home’,video is another way to create that “seeing is believing” experience.
Additionally, this video is a great way to educate our team, community and stakeholders about The Green House model. By ensuring that our network understands the value of this model and the life that we are creating at Lebanon Valley Brethren Home, we are looking forward to their support in building more Green House homes in the future.
Thank you for taking the time to watch our video, and if you would like to learn more about our community, please visit our website.
Jeff Shireman is the President and CEO of Lebanon Valley Brethren Home
By Rachel Scher McLean / Posted on November 23rd, 2015
“This is my home,” said Kay Larmor, an elder who currently lives at Porter Hills Green House homes. “And I feel cared for.”
The New York Times recently explored the movement toward smaller nursing home residences, highlighting The Green House Project as the premiere example of this trend, “Green House homes were developed from a blank sheet of paper,” said Scott Brown, Director of Outreach at The Green House Project. The results, he said, have been encouraging. Studies show that residents have higher-quality lives and significantly fewer hospital readmissions.
“This is the way that elders want to be cared for,” said Audrey Weiner, chief executive of Jewish Home Lifecare, who will open 22 Green House homes in Manhattan. Currently there are 185 Green House homes operating in 28 states; an additional 150 are in development. That compares with about 15,700 nursing homes in the United States housing 1.4 million people. There is still much work to do to make Green House homes an option for elders in every community. Whether you are an advocate, provider or developer, visit www.thegreenhouseproject.org to learn how you can get involved.
By Rachel Scher McLean / Posted on October 20th, 2015
Policy makers have the potential to make a huge difference in the lives of elders and long term care providers. Recently, The Green House Project participated in the Briefing on Association of Jewish Aging Services (AJAS) Innovation and Technology. Some innovations were technical in nature and some were a result of old fashioned intuition and common sense. The Administration and government representatives were duly impressed with what they heard through these AJAS presentations.
Green House adopter, The New Jewish Home, in Manhattan, NY, discussed their career growth program that develops young people for success in working with elders. This opportunity to be in the hallowed walls of the White House, where so many important decisions are made, reminded us of the gravity of our work, and the impetus to create better places where we can age and work.
By Rob Simonetti / Posted on June 4th, 2015
Rob Simonetti has worked with multiple Green House organizations to create real homes where where elders live meaningful lives. In this article, he highlights the innovation found in upstate NY, and The Green House model as a catalyst for significant social change.
Senior Housing providers are leaving industry standards behind to forge a culture of person centered care unseen in other areas of the US.
by Robert Simonetti, AIA, Design Director at SWBR Architects, 585-232-8300, email@example.com
Call it a hot bed of innovation and entrepreneurial spirit; Upstate New York senior care providers are establishing new standards and models of care well ahead of many other communities. Care providers are ensuring all New Yorkers a very bright future as the industry comes to terms with an antiquated system of institutional care.
Senior care providers from Albany to Buffalo are breaking new ground and setting standards for the remainder of the nation to follow. As early as 1999 Fairport Baptist Home was one of the first adopters of the household model of skilled nursing care and quickly became a precedent and resource for other nursing homes seeking to transform their environments for care. The Eddy Village Green at Cohoes was the first adopter in New York of the Green House model. With sixteen homes of 12 elders each The Eddy has become a training center for other Green House adopters nationally.
In 2007 St. John’s Home embarked on a project to bring The Green House model of care to twenty of their Skilled Nursing elders. When St. John’s approached the NYS Department of Health, the state challenged St. John’s to not just build Green House homes, but to build them away from their existing campus in the City of Rochester. St. John’s accepted the challenge and in February of 2012 opened two Green House homes in Penfield, the first in the nation to build off campus in a new residential town home community. The homes which blend right in with their surroundings have become some of the favorites of The Green House Project Senior Director Susan Frazier. “The difference between these homes and other Green House homes is palpable.” says Frazier. Operated on the concepts of person centered care and an empowered work force, the homes have achieved a 5 Star rating, the highest possible in the industry.
The private sector providers are not the only ones being innovative in Upstate; the Department of Veterans Affairs has adopted a new model for the veterans they serve. In Canandaigua plans are complete for ten skilled cottages based on the VA’s new Community Living Center principles. Since construction in the 1930’s veterans residing on campus have lived in very institutional H shaped buildings with double loaded corridors, small double, triple and quad occupancy rooms. The cottages are planned entirely as fully accessible one story homes with single occupancy rooms, private baths, safe outdoor courtyards, strong connections to the outdoors, and beautiful dining, kitchen, and living rooms. While being review in Washington, VAMC Central Office Architect Dan Colagrande noted that this new campus design “should become a national standard for our other VA campuses”.
With such excellence being set as a standard, other upstate providers are following suite to provide elders the best possible environments of care. In Scotia, Baptist Health has sixteen new small homes under construction. In Cicero, Loretto has just opened twelve new homes offering skilled nursing care. These homes and the neighborhood are modeled completely after a true residential neighborhood. The Rochester Presbyterian Home is starting construction on four new Memory Care Assisted Living Small homes in Perinton to compliment four they are operating in Chili. And in Brighton, the Jewish Home is embarking on an ambitious plan to build fourteen certified Green House homes to replace their aging legacy high-rise skilled nursing building.
Why Upstate New York? What’s behind our providers leading the industry? Upstate NY has historically been a leader in the Culture Change movement. Rochester is where the Pioneer Network was founded. A small group of prominent professionals in long-term care formed Pioneer Network in 1997 to advocate for person-directed care. The Network has grown significantly and is now a national resource headquartered in Chicago.
While working in an Upstate nursing home Dr. Bill Thomas founded The Eden Alternative; an international, non-profit organization dedicated to creating quality of life for Elders and their care partners. Recognizing three plights of the elderly in institutional nursing homes, Boredom, Loneliness, and Helplessness, Thomas sought to improve the well- being of Elders and their care partners by transforming the communities in which they live and work. Thomas, residing in Ithaca, has become an internationally recognized leader in the culture change movement and The Eden Alternative is headquartered in Rochester.
The legacy of innovation and advancement in the areas of senior care is growing in Upstate New York. Our providers, physicians, and educators are leaders and valuable resources to this rapidly changing industry. The St. John’s Green House homes have hosted visitors from around the country and as far as Iceland and New Zealand. The staff and administrator of the homes have become ambassadors of the culture change movement, encouraging, motivating, and educating others on the benefits of committing deeply to the ideals of person centered care and the Green House model.
The environments being developed here in Upstate are exemplary and promise each of us a bright future as we consider care options for our grandparents, our parents, and ourselves. Rest assured New Yorkers, when you decide to seek care, you will not find yesterday’s nursing home, rather you will find a true home filled with opportunities, committed staff, and an enlightened value of elderhood.