Green House Blog

White Oaks Cottages at Fox Hill Village

Westwood, MA

Operating: 2 Green House homes

Project Description

Project News
To learn more, visit http://www.foxhillvillage.com/index.html

Click here to view Photos of Fox Hill Village

Sponsoring Organization History
The program at Fox Hill Village has been created by experts in the field of health care and retirement living. The underlying basis of the program is to maximize independence, enhance security and provide long term stability.

Sponsoring Organization Mission
Offer homeowners a comprehensive approach to retirement living. Thoughtfully planned with the assistance and expertise of Massachusetts General Hospital, local Westwood residents, and the evolving needs of seniors in mind, our elegant and active facility was created.

Contact
Tony Amico
tamico@foxhillvillage.com
10 Longwood Drive
Westwood, Massachusetts 02090
781.329.4433

Laurie Mante

Vice President, Residential Services Division
The Eddy/Northeast Health

We were a very early adopter of the Green House model. I feel the
Green House Project was very beneficial to our project, although now their
tools are much more sophisticated and comprehensive. Even with almost three years of operations under our belt, our relationship with the national
team continues to provide value in benchmarking our quality outcomes,
sharing best practices, and networking with other Green House projects, and continuing to research what works best and what areas we need to look
at doing things differently.

Continue reading “Laurie Mante”

Joyce Ebmeier

Strategic Planning
Tabitha Health Care Services

It has been Tabitha’s great fortune to have the NCB Capital Impact team
working with us starting in 2004 as we prepared to open our first Green
House Home in Nebraska. At that time, we all had a vision and shared a
passion for what this change could mean to Elders and caregivers. Up to
that point, we had tried to change, but the change was incremental and
seemed pulled back by the grip of institutional medical models. It was
the deep and knowledgeable resources of the NCB team that moved our work
forward.

Continue reading “Joyce Ebmeier”

Music and Memory

Providing music, a personally meaningful activity, for persons with mid and late stage dementia continues to pose a challenge for care communities. Many of us in direct care have witnessed the power of music to “awaken” and engage those with diminished cognitive ability. Musicians work their magic in nursing homes when they visit weekly or monthly. If only there could only be enough live music to maintain this impact, enlivening resident lives. As a second best, in group settings we play recorded popular music from their era. This works — to a point.

Enter the world of iPods and MP3 players where total personalization is the norm. Millions are benefiting; why not our seniors! For those of us who love to listen to music, this love will not disappear as we age.

According to Dr. Concetta Tomaino, Executive Director of The Institute for Music and Neurologic Function, “In a study funded by the New York State Department of Health, a music therapist played familiar music three times a week for people with mid and late stage dementia for ten months. At the end of ten months, these people had improved their mini-mental status scores, they were recognizing their loved ones, they were talking to each other, having conversations. We had neuroscientists assess them for their social ability and found that there was no difference between them and people who did not have dementia. We know that using this type of music consistently, day-in and day-out, does, in fact, stimulate memory and recall, and improves it over time.”

In the past, applying this approach was not practical. But now with digital music players, we have the opportunity to generate such outcomes. This is the premise of the nonprofit, Music & Memory, which promotes the use of personalized music to improve quality of life for the elderly and infirm. To learn more about this approach, visit musicandmemory.org.

Get Excited For Maryland's First Green House Project

Stadium Place Green House Construction Progress
Green House Residences at Stadium Place

Have you heard about the newest and biggest innovation in assisting frail elders to come to Maryland? Do you know someone who needs long-term skilled nursing care?

The Green House® Residences at Stadium Place in Baltimore, an innovative long-term care community for elders, and the first of its kind in Maryland, will be opening in spring, 2012. Developed by Dr. Bill Thomas, The Green House model replaces traditional nursing home facilities with inviting, comfortable, social living spaces and private bedrooms that research shows help elders to live happier, more satisfying lives.

As construction of the Green House Residences approaches the half way mark, the project’s developer, Govans Ecumenical Development Corporation (GEDCO), and operator, the Associated Catholic Charities, will host an open Orientation, Update and Celebration on Wednesday, August 31 at Stadium Place.

The public is welcome to attend a series of informational sessions to learn more about the Green House model and celebrate the progress in constructing Stadium Place.

The sessions will include an overview of the Green House model by Project Guide Melissa Honig of NCB Capital Impact, the nonprofit organization supporting national replication of the Green House Project. Catholic Charities will answer questions about living and working at the Green House Residences and GEDCO will provide updates on the construction progress as well as refreshments.

The event will be held at 2011 at Venable Apartments II at Stadium Place (1030 E 33rd Street), Baltimore, Md. GEDCO members and guests will have priority seating for the 12:30 p.m. and 5:30 p.m. sessions. You may also join us at 10:45 a.m., 2:00 p.m., or 3:30 p.m. Please park along Ednor Road. Since seating is limited for each session, please RSVP by August 26th.

Click here to RSVP!

Get Excited For Maryland’s First Green House Project

Stadium Place Green House Construction Progress
Green House Residences at Stadium Place

Have you heard about the newest and biggest innovation in assisting frail elders to come to Maryland? Do you know someone who needs long-term skilled nursing care?

The Green House® Residences at Stadium Place in Baltimore, an innovative long-term care community for elders, and the first of its kind in Maryland, will be opening in spring, 2012. Developed by Dr. Bill Thomas, The Green House model replaces traditional nursing home facilities with inviting, comfortable, social living spaces and private bedrooms that research shows help elders to live happier, more satisfying lives.

As construction of the Green House Residences approaches the half way mark, the project’s developer, Govans Ecumenical Development Corporation (GEDCO), and operator, the Associated Catholic Charities, will host an open Orientation, Update and Celebration on Wednesday, August 31 at Stadium Place.

The public is welcome to attend a series of informational sessions to learn more about the Green House model and celebrate the progress in constructing Stadium Place.

The sessions will include an overview of the Green House model by Project Guide Melissa Honig of NCB Capital Impact, the nonprofit organization supporting national replication of the Green House Project. Catholic Charities will answer questions about living and working at the Green House Residences and GEDCO will provide updates on the construction progress as well as refreshments.

The event will be held at 2011 at Venable Apartments II at Stadium Place (1030 E 33rd Street), Baltimore, Md. GEDCO members and guests will have priority seating for the 12:30 p.m. and 5:30 p.m. sessions. You may also join us at 10:45 a.m., 2:00 p.m., or 3:30 p.m. Please park along Ednor Road. Since seating is limited for each session, please RSVP by August 26th.

Click here to RSVP!

Workshop: Chelsea, MA, March 21-22, 2012

The Green House Model Workshop is an opportunity to spend time in an open and operating Green House site, learning the fundamentals of the model. The Green House workshops describe the key components of the model, including the foundational philosophy, the architectural characteristics of Green House homes, and the organizational redesign. The presentation will include an update on the progress of The Green House Project, including tools for adopters and Green House Project research outcomes. The workshop includes a visit to the homes and discussions with the host Green House project team.

Objectives:

•Review the fundamentals of the 3-part transformation from traditional skilled nursing services to The Green House model.
•Explore results from 3 research studies into the model’s effectiveness and viability.
•Visit an open Green House Home and converse with those living and working there

•Review and Discuss Questions regarding The Green House Model.

Continuing Education Credits are available for Nursing Home Administrators

Nursing Home Administrator
The National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) has approved the above named program for 7.5 continuing education credit. with an approval start date of 02/08/2011 and an expiration date of 02/08/2012.

The Green House Project Welcomes Lisa Maxwell as Project Guide

Lisa Maxwell, Project Guide

The Green House Project Team is so excited to welcome Lisa Maxwell, MBA, NHA, as our new Project Guide. While Lisa is new to the National Initiative, she has a long history with The Green House Project. Lisa is a pioneer of The Green House movement, serving as the guide for our third Green House project, The Village of Redford, a campus of Presbyterian Villages of Michigan. Lisa’s passion for the model, coaching leadership and belief in people enabled this project to thrive, experience excellent outcomes and of course, share beautiful stories.

Lisa is coming to us via Syracuse, NY where she continued to influence the success of The Green House Project. Lisa, joined the team of Green House adopter, Loretto Heath Systems, and served as the Administrator of their 556 bed nursing home community. She advised and supported this organization’s efforts to bring culture change across their campus and their future goal, to build Green House homes. As Licensed Nursing Home Administrator, Lisa brings many valuable experiences to the role of Project Guide, including a proven track record of effective leadership in organizational change, project management and extensive knowledge of long term care.

Lisa has already made a huge impact on the history of The Green House project, and we are honored that she will also have a huge impact on our future!

Green House Educator Program Graduates Largest Class Ever!

Last week, Green House adopters from across the country joined The Green House team for The Green House Educator Program. This program was held at Eddy Village Green (EVG), a 16 Green House home campus in Cohoes, NY. This “train the trainer” program, enables adopters learn the Core Team Education of The Green House model, and teach it to their developing organization.

It is so important for the people who are teaching this program to actually experience life in a Green House home, and EVG has been our gracious hosts to welcome us in their world. Seeing is truly believing, and during this week long program, the educators get to know an elder, and visit the same home at various times of day. The visits culminate with the elder and the educator engaging in a meaningful activity that is created through the process of getting to know each other’s interests and preferences throughout the week.

This program has a goal of inspiring the educators to be the champions of The Green House principles, and to create that slip resistant and ongoing culture change journey in their organization. Green House adopters in this class were represented from Maryland, Massachusetts, Wyoming, Alabama, Illinois and Alaska. Their passion will fuel this movement and grow the voice of culture change across the country!

How Does Your Garden Grow?

                                                     

“There can be no other occupation like gardening in which, if you were to creep up behind someone at their work, you would find them smiling.”  ~Mirabel Osler

The joy of gardening.  So many homes have a garden. Why?  Perhaps it is purely for its aesthetic appeal or the sense of satisfaction a harvest brings.  However, in a Green House home, gardening is not simply for the sake of the harvest, but more about the process.  When we focus less on the end result and more on the journey, we develop a keener sense of what really matters. 

What is growing in your garden?  Look beyond the flowers or the vegetables growing in your garden and reflect on what has actually transpired.  Were you able to engage elders in an activity that was fulfilling and meaningful to them?  Did you build stronger relationships?

The Green House Project would love to learn more about how you sustain and nurture your garden.  Please submit photographs and a brief description about your garden to hmarshall@ncbcapitalimpact.org by August 29, 2011.

The winning organization will be announced at the 4th Annual Green House Project Meeting, on September 8 & 9, 2011 and will receive a new flip camera!

 Ask yourself: How does your garden grow?

LeadingAge: Enough is Enough

By: Larry Minnix

LeadingAge President and CEO



What will it take for the nursing home to gain the respect it now deserves?

The nursing home continues to be treated like the illegitimate child in the health care family. Yet, it is an essential part of every community. Just ask any family when the hospital says you have a short time to find a nursing home bed. Or, ask any person caring for someone at home when incontinence, sleep problems or dementia can no longer be managed in the family home.

Granted, nursing homes are the place no one wants to be. We all understand that, dont we? Yet, when we need one, we really need one — and we want the best nursing home we can find. None of us wants to worry about where our loved one lives or what happens to them when were not around.

But society doesn’t trust nursing homes. In fact, we are just emerging from an era of mistrust exemplified by over-regulation, punitive public oversight, and constant battles over reimbursement. Why is that? There are many reasons. The underlying one is our denial about aging for ourselves and our loved ones.

I will never forget a Wesley Woods board member’s story of a corporate executive whose mom lived with his family. His wife kept telling him that mom had problems. He traveled a lot and had the attitude that his wife never liked his mom anyway and “mom is just fine.”

The corporate couple had a formal dinner party, including his boss. The boss’s wife asked where the powder room was. The hostess pointed to the hall door. The boss’s wife opened the door and there stood mom with no clothes on and no idea where she was. The corporate son finally had to admit mom had a problem and needed to be in a nursing home. Denial is a powerful force. None of us wants to think that we are aging, our parents are aging or that we may need a nursing home.

Two other reasons for society’s suspicion include past reports about poor quality and investigations into financial practices. The headlines of those dark days painted all nursing homes with the same brush, unfortunately. So, why does this happen? And more important, what do we do about it?

When I took the position as your president 10 years ago, I was confronted with the opinions of the U.S. Department of Health and Human Services (HHS) secretary, senators from both parties as well as others that the nursing home field had not taken responsibility for its own quality.

The Centers for Medicare and Medicaid Services (CMS) administrator at the time said to a large audience of our members, You are not going to get anywhere with less regulation and better reimbursement until you take responsibility for quality.

A tough message, but much truth to it. Not that we produced bad quality, but we had not taken responsibility for improving it and being transparent about our results.

So, we charted a course for quality improvement in collaboration with two other organizations who have nursing home members. The strategy is called Quality First, which ushered in the era of self-responsibility for nursing homes. Most nursing homes joined the initiative and the results show it.

Quality First spawned other quality activities, including the Advancing Excellence in Americas Nursing Homes Campaignthe most effective nursing home quality improvement program in the country in terms of results.

We now enter the next era of quality, which will be defined by outcomes, demonstrative value and transparency. It will be a more sophisticated era because thats what consumers need. Accountability will be immediate and constant.

The culture change movement has been a big help in creating more appealing settings to live including developing healthy atmospheres through programs like Pioneer, Wellspring, Eden, The Green House Project, small houses or neighborhoods.

They show great promise in improving quality of life for residents, families and staff.

Our research through the LeadingAge Center for applied research has been at the forefront of studies that prove success. To their credit, CMS’ quality division supports culture change and quality improvementa strong public-private partnership approach.

Yes, we are making progress in this self-responsibility era. Many nursing homes are doing a better job than those sensational headlines of a decade ago. You are telling your story more effectively. You are doing so through better annual reports, transparent reportseven through social media.

Recently, I saw a news clip of a member who had done a great “bucket list” event for a resident who is dying. The newscaster, obviously inspired by the story, stated something like: If you have to live in a nursing home, wouldn’t you want to live in one like that?

Though we have a ways to go, the self-responsibility era resulted in a minimum of new punitive regulations and a relatively stable reimbursement environment…until now.

Enter today’s pressing dilemma: the national budget deficit.

A member just wrote me an email message. He knows his state is one of the worst in terms of Medicaid reimbursement, yet he believes Medicaid is bloated with fraud and abuse. He wants to know how LeadingAge can advocate for no Medicaid cuts and protest Medicare cuts when our country is going broke. He sees that his state has hundreds of nursing homes that seem to stay in business on poor reimbursement. How could that be? Perhaps hes asking the wrong questions.

Here is my response: since the advent of human commerce, some people have made money delivering poor quality products, services and by cheating. His state has a history of quality scandals from which people became rich, and which prompted major national legislation that we all now live with.

My guess is that some providers still make money on poor quality while good providers need contributions to make ends meet. Still others create services that produce margins to help offset Medicaid, including Medicare. And, I know that some are thinking about closing their doors.

The real questions are these:

How do we define a decent quality of life in nursing homes for frail and vulnerable individuals and the people who work there?

How do we calculate the cost of providing that high quality care?

What should be our personal responsibility to cover these costs and how do we help people insure or plan for them?

And what should the public pay through our collective benevolence of taxes and charity to help poor people?

These questions represent the public discourse that needs to take place at every family kitchen table, in every state house and throughout the halls of Congress. We have a population that is aging, has multiple chronic problems to be addressed and has public and hidden costs that affect every state budget and most every family pocketbook.

These unprecedented dynamics can no longer be addressed with a return to the era of more regulations and arbitrary cuts like those that CMS announced, many states have just imposed and that some members of Congress are trying to advance. Another cycle of arbitrary cuts will inevitably lead to a new dark era of quality we dont like, regulations we don’t need, schemers who make money off of bad quality, tort lawyers and good providers who throw in the towel.

We have seen this cycle before. We’ve had enough of it. It is time to pay for quality. Enough of the crazy, arbitrary and capricious Medicaid and Medicare budgeting!

Let’s define quality.

Pay providers to deliver it.

Assure competition through value and transparency.

Root out the cheaters and send them to jail.

Create a self-planning model like the CLASS Act so people can take more responsibility for their own futures.

Make sure the genuinely needy get help.

Pay the direct-care people livable wages, benefits, respect, and training.

And go to bed at night knowing your mother is well cared for.

Let’s make the nursing home a legitimate part of our health system where quality is an automatic public expectation, not a risky venture to be feared by all and punished when it does not measure up.

As one of our colleagues exclaimed after these recent reimbursement cuts, enough is enough!

Here is how that will happen:

Continue your hard work on quality improvement, culture change, innovative services, ethical business practices and transparency. This is the only path to progress! And punish only those who dont deliver.

Tell your policymakers about the success of your work and the impact of arbitrary cuts. Tell them where legitimate savings that improve quality can be achieved.

Tell your story of the great people who care for the most vulnerable every day and why they are one of the best investments in quality outcomes in all of health care. You have the thank-you letters, accolades and outcomes to prove it. And, tell them why your nursing home is absolutely an essential part of the health care family in every community.

Dont let policy makers recreate the darker era. Enough is enough!

We have made real progress!

http://www.leadingage.org/Enough_is_Enough.aspx

Fighting the Dragon: The Recipe for Successful Convivium

Each day, one in four Americans visit a fast food restaurant and a total of 40% of American meals are eaten outside the home. These facts are not only reflective of a culture lacking healthy eating habits, but they also suggest that there may be a loss of value in the opportunities that meals provide for building relationships, reminiscing on past experiences, and nurturing one another.

During his presentation at THE GREEN HOUSE® Project 3rdAnnual Meeting, “Food for Thought: How Choices Enhance Memory and Pleasure in Dining”, Dr. Judah Ronch encouraged us to ask the question, “How can the dining experience help elders to thrive?” Dr. Ronch, Dean of The Erickson School at UMBC, suggests that the brain is the “missing link” between dining and positive outcomes. Because our sensory memories go straight to the brain, as opposed to taking a pit stop in the language center to be altered before being stored, tastes and smells have a special ability to evoke strong emotional responses. In recognizing the emotional relationship with food, mealtime becomes not only a source of necessary calories and nutrients, but it also has the power to play a valuable role in achieving meaningful lives. Dr. Ronch explained that the potential positive outcomes can be optimized by expressing food preferences and balancing the brain’s desire to try new things.

While the experience of dining holds a number of opportunities for providing meaning in the lives of elders, meals in traditional long-term care tend to take the form of what Dr. Bill Thomas calls a “down-to-the-minute ballet”.  Food preparation and delivery is a large-scale, fast-paced, precisely-choreographed process, leaving little time (if any) to spice meals up with the principles of person-directed care. The Green House model, however, takes a radically different approach to dining, so as to support the “slow food” movement. The concept of convivium creates a shift in the traditional environment, philosophy, and practice surrounding meals that support the experience of sharing good food for pleasure.

So what is the recipe for successful convivium? Combine elder preferences with local foods, cultural traditions, and feedback from dieticians. Mix in a handful of family and community involvement, as well as ambiance to ensure that each meal is an occasion worth celebrating. And of course, the secret ingredient- a strong relationship and a true sense of knowing of each individual elder to ensure that his or her needs and wants are being met.

Consider how the meal preferences of each individual living in a Green House home may be valued and shared with all staff members, whether it is choices about flavor, meal time, or serving size. Build off of the innate emotional responses that are linked with food and take time to share memories or experiences with certain tastes and smells.  Finally, don’t let the ticking clock be a distraction from enjoying the company of others to feed the body and soul.  Bon Appétit!

**This post was written by Emily Duda, Project Associate at The Green House Project, as part of the Fighting the Dragon series.  This is a repeating topic addressing issues of Institutional Creep. Please let us know of issues you have encountered or opportunities you have had in combating institutional behaviors or ideas that are often lurking. aortigara@ncbcapitalimpact.org