Green House Blog

Provider Magazine Highlights Flexible Funding for Green House homes

Provider Magazine tracks the pulse of the industry and serves as the leading source of business and clinical news for long term and post-acute care professionals.  Long term care providers know that the demands of the consumer are changing.  So why do many nursing homes still look the same way they did 20 years ago?  One barrier to transformation may be in the ability to find, “low-cost, flexible financing sources”.  New financing programs are being created to remove this barrier, and to support Green House home development.

In 2011, the Robert Wood Johnson Foundation (RWJF), the nation’s leading health foundation, made a $10 million Program-Related Investment (PRI) in NCB Capital Impact and The Green House Project to make it easier for more providers to obtain flexible financing and build Green House homes.  In making this investment, the foundation saw a unique potential for The Green House model to address the nation’s growing shortage of affordable, high-quality long term care options for low-income elders.
As an initiative of NCB Capital Impact, The Green House Project has also been able to leverage the financial expertise of this group, “Because NCB Capital Impact is enlisting additional investors—like the Harry and Jeanette Weinberg Foundation and AARP Foundation—to leverage RWJF funding in any individual project by a ratio of four to one, the total financing opportunity is actually substantially larger than the foundation’s initial investment.”  These resources are creating opportunities for long term care providers to meet the demand of their customer for small, real home environments.
The Green House model has a proven track record for delivering high quality care at roughly the same cost as a traditional nursing home.  Additionally, consumer research found that caregivers would be willing to drive further and pay more to have this type of home as an option for their loved one.
Because the RWJF and NCB Capital Impact loan pool needs to be entirely distributed by 2014, interested providers should begin exploring the option as soon as possible. To find out more about tapping into RWJF and NCB Capital Impact financing for Green House projects, contact Maura Porcelli at (703) 647-2311 or mporcelli@ncbcapitalimpact.org.
 

THE GREEN HOUSE® Project in New York Press Article

Last week, the New York Press published an article  about the Health Policy Symposium recently hosted by Jewish Home Lifecare and the Himan Brown Charitable Trust in New York City. During the symposium, speakers discussed the needs of a rapidly aging population and the simultaneous decline in the health care workforce. One panelist, Dr. Ezekiel Emanual, a former special advisor to the White House, spoke to the importance of affordable and quality health care for aging adults.

Another panelist, Jane Lowe, Senior Advisor for Program Development at the Robert Wood Johnson Foundation, championed the Green House homes as “…better models for people to age with grace and dignity.” Ms. Lowe also showed her support for the Village model as another important new model of care for an aging population.

The New York Press article describes the Green House Project as a model that “…provides the support of a nursing home while still allowing its residents the autonomy, warmth, and respect of a traditional house or apartment.” The conclusion of the article is a description of Jewish Home Lifecare’s plan to develop Green House homes on a city scale at the Living Center of Manhattan. These will be the first Green House homes in New York City.

Currently, there are 146 Green House homes in 24 states, serving 1,539 elders. There are 123 homes in development.  Click here to find a Green House home near you!

California's First Green House® Homes Open, Ushering in New Kind of Nursing Care

CONTACT:
Leslie Lipsick, 415-901-0111, llipsick@fenton.com
Alyssa Singer, 415-901-0111, asinger@fenton.com

California to make small-scale, dignified nursing care available at 10 more sites across the state by 2020

Claremont, Calif. — California today ushered in a new era of nursing home care with the opening of the state’s first certified Green House homes at Mt. San Antonio Gardens, a senior community in Southern California. The opening is expected to usher in a new wave of similar projects across California as legislation designed to encourage a small-home approach to skilled nursing home care takes effect.

A total of 20 residents will live at the Evergreen Villas in two residential neighborhood homes, designed by Ewing Architects, Inc., AIA, of Pasadena, each with private rooms and bathrooms with showers. Unlike traditional nursing homes, Green House homes are specifically built from the ground up to be real homes—in every way. Residents socialize in cozy living rooms and enjoy meals cooked in open kitchens, by the same people that care for them each day.

The Green House model’s unique approach to care, including a versatile staffing model, produces better clinical outcomes, such as fewer hospitalizations and falls, and less staff turnover. Research shows that the model’s small layout, combined with its intimate and innovative staffing ratios, provides elders with four times more personal and social contact than typical nursing homes.

“Residents living in skilled nursing facilities may have limited ability or need a considerable amount of care,” said Randy Stoll, CEO of Mt. San Antonio Gardens. “But they still want as much independence as possible. They want their dignity maintained and they want to be in a home, not an institution. We are extremely pleased that we can finally offer what they have deserved for so long.”

Many of the Gardens’ residents and staff have been waiting years for the homes to open, and have even personally pitched in to get them to this opening day. Over $1.3 million in private donations came from personal contributions by the community’s residents, board and management. Four of the community’s housekeeping staff even went back to school to get the additional training required by The Green House model so that they could join Evergreen Villas residents as care partners.

The opening of California’s first Green House homes marks a key milestone in The Green House Project’s larger effort to spread the model nationwide and dramatically improve the way all aging Americans receive skilled nursing home care. With support from the Robert Wood Johnson Foundation and oversight from NCB Capital Impact, The Green House Project has opened 146 homes in 24 states to date. Mt. San Antonio Gardens hopes to build more of the homes on their campus in the future.

With California’s number of seniors 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. It took almost seven years for the Evergreen Villas to gain the approval it needed from multiple local and state agencies. But future innovators will not face those obstacles, due to a bill inspired by the lessons learned along the path that Stoll and his team blazed.

Ten New California Projects to Embody Small-Home Approach
After years of collaboration among legislators, state and local agencies and aging advocates, in late 2012, 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 will authorize the development and operation of 10 pilot projects to deliver skilled nursing care in smaller, residential settings. This summer, the program will begin accepting applications for providers interested in building pilot projects. The data the state is able to collect from the 10-project pilot program will help inform a deeper, more permanent commitment to policies that encourage long-term care innovation.

The pilot project also holds promise for addressing one of California’s most pressing health care crises: dementia care. California is home to one in 10 Americans living with dementia or Alzheimer’s and, by 2030, the number of residents living with those diseases will nearly double. A recent RAND study found that the nation spent $109 billion on dementia care, including nursing home care, in 2010. Key features of The Green House model, including its real home environment, consistent and deep staff relationships and advanced staff training, produce better dementia care outcomes—at no greater cost. One study of select skilled nursing Green House homes showed an 86 percent lower rate of depressive symptoms, 41 percent fewer incidents of elders’ behavior affecting others and 41 percent fewer rehospitalizations.

“It’s simple: We all heal better and are healthier and happier when we feel at home. The unique elements of The Green House model are vital to the clinical success of our elders living with dementia. We look forward to helping Californians tackle the rising costs, both human and financial, of dementia by spreading our high-quality, cutting-edge care across the state,” said David Farrell, The Green House Project’s senior director.

About The Green House Project: The Green House Project, which receives significant support from the Robert Wood Johnson Foundation, is a radically new, national model for skilled-nursing care that returns control, dignity and a sense of well-being to Elders, their families and direct care staff. In The Green House model, residents receive care in small, self-contained homes organized to deliver individualized care, meaningful relationships and better direct care jobs through a self-managed team of direct care staff working in blended roles. Green House homes meet all state and federal regulatory and reimbursement criteria for skilled-nursing facilities. www.thegreenhouseproject.org

About Mt. San Antonio Gardens: Mt. San Antonio Gardens is a non-profit, nationally recognized Life Care senior community, set on a beautifully landscaped campus in the college towns of Claremont and Pomona, California. With a wide choice of residences for independent living and the comfort and convenience of outstanding assisted living and skilled nursing care on campus, the Gardens’ dynamic residents pursue their busy lifestyles and embrace new life-enriching experiences without the worry of home maintenance or future health care costs or needs. www.msagardens.org

About the Robert Wood Johnson Foundation: The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org

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Supporting a White House Conference on Aging for 2015

This month, in celebration of the 50th Anniversary of Older Americans Month, THE GREEN HOUSE® Project participated in the Healthy Aging Forum put on by the U.S. Senate Special Committee on Aging.  We were joined by congressional representatives, leaders in the aging field and elder advocates, all of whom demonstrated their passion and dedication to serving older adults by discussing policy frameworks and strategies that result in robust aging services for all.

We must not lose the momentum gained from this event! A national discussion on relevant aging issues, policy strategies and effective care delivery is necessary. Recently, in an article from the National Academy of Social Insurance, Anne Montgomery provides a call to action in order to gain support for a proposed White House Conference on Aging (WHCOA) for 2015. Included in her article is a Letter to the President, signed by 40+ organizations, which explains that now is a critical time for such a conference since, “…By 2015, twelve million baby boomers will have already turned 65 with sixty-six million more to follow.” If the proposal were to be supported, this would be “…the sixth White House Conference in history and the second of the 21st century.”

In order to ensure that core values such as meaningful life, real home, and empowered staff are a non-negotiable part of long-term services and supports, we need to participate in events like the Healthy Aging Forum and the proposed White House Conference on Aging.  

Join us in Unleashing the Power of Age for Older Americans Month by reading the article in support of the 2015 WHCOA and by telling friends and colleagues why we need this national forum.

 

Sunshine State to Welcome the First Skilled Nursing Green House Homes at John Knox Village

These are definitely exciting times at John Knox Village in Pompano Beach, Florida!  Last week their Board of Directors approved the development of THE GREEN HOUSE® residences at the Village and renovations to their current Health Center. 

“This project ensures our ability to fulfill our health care contract with our residents at the level and quality of care they expect from us,” said Board Chairman William Knibloe, II. “Further, it provides for our employees the opportunity to be part of the most important development and progressive care giving to seniors existing today.” 

The $34-plus million project will be located on the northwest corner of The Village’s 65-acre campus.  There will be seven floors, with the main floor featuring a community area for all Elders.  The other six floors will each have two Green House homes.  Each home will have 12 private bedrooms and bathrooms, plus a living area and kitchen.

Groundbreaking is slated for July, with the first Elders moving in October 2015.

Click here to read more about this development!

On the Frontline: Randy Stoll and Mt. San Antonio Gardens

Randy Stoll once watched a woman on staff wash a wall in the skilled nursing facility where he’s the president and CEO. He noticed how she washed—from the bottom up. Smart, he thought, that way there are no drip marks. But what he really noticed was that she was wearing high heels. She wasn’t a housekeeper—she was a director—but she knew how to do every job.

Randy knows about this. Not the drip marks maybe, but the idea of a versatile worker—everybody being able to do everything, everyone being responsible. While he’s currently the president and CEO of Mt. San Antonio Gardens, a Life Care senior community in Southern California, he started off in a completely different place and got there via a different route. Some people come up through academic programs in administration, which Randy would eventually do, but first, he worked at a hospital.

“My dad was a stickler,” he said. “When I quit college he told me to go get a job, so I did—first as an orderly—and I loved it. I was serving the patients—they were my customers, not the hospital.” Eventually he became a housekeeper, a supervisor, and then a director. And after doing almost all the jobs that he could within the hospital, only then did he go back to school in administration—another versatile worker.

Today Randy oversees an entire team of versatile workers at Mt. San Antonio Gardens, a senior community in Pomona, CA. This summer, the Gardens will open the Evergreen Villas—the first Green House retirement homes ever built in California.

“The Gardens has always been a ‘resident-driven’ community,” he said. “I inherited that when I came on board in 1995. There have been six residents on the board for years.”

And over time, the Gardens did everything they could to keep up with that ethos—remodeling social spaces and common areas, putting in flat screen TV, hiring skilled nurses and training the staff thoroughly and ethically—but the traditional medical-model skilled nursing facility just doesn’t lend itself to providing person-centered care that would be attractive to elders. Randy knew there had to be a better way.

Having tried all they knew, some key stakeholders visited the first-ever Green House home in Tupelo, MS. Intrigued by the model’s promise, they then sent five residents with a board member to visit The Green House homes in Lincoln, NE to gather information and stories about the concept. Everyone came back wanting to bring this model home to California.

“Green House homes gave us the best chance of surviving without creeping back to the old way of doing things,” Randy said. “The Green House Project provided the philosophical framework and the extensive training and support we needed.”

Green House consultants also shepherded Mt. San Antonio Gardens through regulatory and legislative processes by calling state senators and seeing it through to approval.

Randy knew that The Green House model would help the Gardens improve upon the delivery of their core set of values which are built on the principles of person-driven care. He knew it could be a complete culture change. They all knew. But Randy also understood that while the residents would approve it, and that eventually he would get the state to approve it, he also wanted something else.

“The CNAs, the front-line caregivers,” said Randy. “They’re the ones who are really there at the end of life. They’re the ones who should be enabled to be advocates for the residents.”

It took over two years to get it pushed through the state, and during that time, five housekeepers went back to school to become CNAs at the new Green House home. Instead of the director of housekeeping being upset that 25% of his housekeeping workforce were transitioning to the new homes, he knew that if the employees wanted to be there, that it would make a difference to the residents. In fact, he threw a party for them and invited the residents.

“ Isn’t it nice that my favorite friend will be there to care for me?” Randy heard one resident say.

Continuity of care is part of the culture. Everyone on staff at the Evergreen Villas were employees at Mt. San Antonio Gardens. And that’s just one of the reasons Randy says that from an operational standpoint, The Green House approach costs the same to operate as the model it is replacing, not including depreciation. “But we didn’t do it for the money,” he emphasizes. “We did it for the residents and staff.”

It goes both ways, as the residents have pitched in, privately donating over $1.3 million to the Gardens—not a couple lump sums, but a bit from each of the 400 residents currently living there. They knew they were all working towards something good. Something that should be universal: Real care.

Comfort First at Jewish Home Lifecare in The New Yorker

This week’s “Innovators” issue of The New Yorker includes coverage of Jewish Home Lifecare’s participation in the Comfort First palliative care program for elders with dementia. The full New Yorker article is accessible online to New Yorker subscribers on The New Yorker website or is available on newsstands now. All quotes below are from the New Yorker story.

Palliative Care for Elders with Dementia

Jewish Home has long recognized the benefits of palliative care for nursing home residents. Comfort First, developed at the Beatitudes Campus in Phoenix, is a program to adapt palliative care techniques for elders with dementia. Jewish Home was chosen as one of three long term care facilities in New York City to participate in this program funded by the New York City Chapter of the Alzheimer’s Association.

In The New Yorker story Tena Alonzo, Director of Education and Research at the Beatitudes Campus discusses the importance of learning how to understand elders with dementia, who may be unable to verbally express what they are feeling. Speaking of a nursing home resident who was agitated and moaning, Alonzo explained that “it can be particularly hard for people with dementia to identify the source of pain or to articulate their experience of it. But his body told the story… All behavior is communication.”

Jed Levine, Executive Vice President at the New York City Chapter of the Alzheimer’s Association says of his visit to the Beatitudes campus, “What was most impressive was not what was going on but what wasn’t going on – the absence of palpable distress.”

Overlapping with Other Innovations in Long Term Care

The New Yorker story sees Comfort First as overlapping with other innovative models for long term care, such as The Green House Project and small house models being implemented at Jewish Home. The models share a commitment to less intrusive clinical care and to creation of a

comforting, calming environment. They emphasize understanding an individual’s desires and choices and using that understanding to promote comfort and bring joy and pleasure to their lives. Ms Alonzo is quoted as saying “For people who no longer can think clearly, a life of small sensory pleasures is a considerable achievement.”

Staff Training and Participation is Key

The training provided to nursing home staff is critical to the success of Comfort First. All staff that work on a unit, Housekeepers, Certified Nursing Assistants, Social Workers, Nurses, Physicians… all are key players in understanding what residents are communicating and in finding creative ways to enhance each individual’s quality of life.

Deirdre Downes, Corporate Director of Social Work Initiatives at Jewish Home Lifecare, cites as a subtle but significant change, that Certified Nursing Assistants participating in Comfort First have, “stopped talking about residents ‘resisting care.'” Learning how to carefully observe and learn from a resident’s behavior is key to the training and even seemingly simple insights can lead to significant effects. For example, at Jewish Home, Certified Nursing Assistants observed that one resident likes to watch television while being bathed and are now careful not to block his view of the television while assisting him.

Reducing Psychotropic Medications

The Comfort First model also makes a concerted effort to replace the use of psychotropic medications. Psychotropic medications are seen as an inappropriate means to address symptoms of dementia. Such medications often mask a resident’s pain or other conditions that could be more effectively addressed by understanding and addressing an individual’s underlying needs and feelings.

Family Members Play an Important Role

Helping family members of residents to understand and accept dementia is also important to the Comfort First model. The daughter in law of a Beatitudes resident is quoted as saying of her mother in law that while she no longer recognizes her children or grandchildren, “she still makes us laugh and because of that we still feel that we have a connection with her.”

It’s About Quality of Life

When the author of The New Yorker article, Rebecca Mead, asks after a resident she had met at the Beatitudes Campus, Tena Alonzo informs her that the resident has died. Ms Alonzo goes on to say, “She was singing and dancing up until the day before she died… If you have to go, that’s a good way to go.”

As the Comfort First program continues to make a difference in residents’ lives, the lessons learned will be shared and applied more broadly when the program is rolled out across Jewish Home Lifecare campuses.

Home Is More Than a Place to Live | A Caregiver’s Story

Susan could no longer deny she had a problem when her mother started to call her at 2:00 in the morning, asking her when she was coming to see her.

Her mother, Molly, is a vibrant, outgoing woman who raised three children and worked as a legal secretary, fully enjoying the job. She loves her family and being with people. Molly also has an impressive command of trivia questions.

Of the siblings, Susan lived nearest to her parents, and so she saw them the most often. Several years ago, she noticed that her mother seemed unfocused. Short, routine errands to nearby stores took hours. But her dad assured her that all was well.

Then Susan’s dad passed away, and Molly lived alone.

Susan assumed more responsibility for helping her mother, a role she termed as “Boss of the Bills and the Pills”. She continued to worry that her mother was “off” and she shared her concerns with her siblings, a difficult and emotional task. They were not convinced that Molly’s problems warranted taking her out of the home that she loved.

Susan increasingly worried about her mother’s confusion about time and space. She started getting calls from her mother in the middle of the night, asking her when she would come to visit. Neighbors called her to report that Molly was having difficulty driving. As Susan reports it, “I had a sick feeling in the pit of my stomach 24 hours a day.” The final straw was when Molly fell in her home and ended up in the hospital.

After the fall, the family moved Molly to an assisted living residence. Molly seemed to adjust to her new living situation, but Susan saw that her mother had lost the sparkle in her eyes. For a woman who was always busy and with friends, Molly now did not have much to do. She spent a lot of time alone in her room.

The staff at the assisted living residence reported that Molly wandered and had great difficulty finding her apartment. She left her stove on so frequently that the residence disabled it. Then Molly fell in her unit, fracturing her neck and nose. Molly did not use her emergency wrist pendant, so an aide found her long after the fact.

Molly was treated in a hospital, transferred to a rehab facility, and then she went back to her assisted living unit. Given her mental confusion, the residence required the family to hire 24 -hour care, at $600 per day. The family quickly decided they needed another solution.

Susan looked at memory care units near her home in Needham. When she walked into White Oak Cottages, she was surprised that it felt like a real home. Residents were coming and going through the living room, the smell of fresh laundry came from the dryer, and the staff was preparing dinner in the kitchen. Susan knew how much her mother wanted to be around other people, and she thought, “This is perfect!”

In September 2012 Molly moved into White Oak Cottages. Daily life is now much closer to what it was like when she was living in her family home. She has her own room to decorate and she can watch her television whenever she wants. Her children visit her, some having dinner with her, others watching movies with her in her room. They all appreciate the ability to focus on Molly, rather than on her care.

When Molly’s family is not visiting, she likes being in the action in the living room and playing word games. Molly is the recognized champ of the trivia contests. And she has made new friends. Susan enjoys the way the residents care for each other. “The residents ….are like family. They look out for each other.”

Since Molly has moved to White Oak, her medical condition has stabilized. According to Susan, “the spark is back in her eye”. Her favorite day is Saturday, when families visit with children and dogs. Susan says that the high level of activity is just what her mother needs. “She is thriving. I have nothing but positive things to say about White Oak. For me, it is peace of mind. When you walk out of White Oak and feel that all is well for your mother, it is worth everything.”

To learn more about White Oaks Cottages, of Fox Hill Villages in Westwood, MA, visit: http://whiteoakcottages.com/

 

Despite the Weather…Ground is Broken for the First Skilled Nursing Green House homes in Minnesota

We all know how crazy the weather has been this past winter…but who would have thought snowflakes would fall on a May 1st groundbreaking ceremony? Well, that’s exactly what greeted the guests for the Episcopal Homes of Minnesota ceremony to launch the construction of six Green House homes on their campus.

The $45 million project will provide a variety of living options for Elders including the skilled nursing services in the Green House homes which will be called “Episcopal Church Home – The Gardens”.  Episcopal Homes has been providing house and care for Elder for more than 100 years in St. Paul, Minnesota. The homes are slated to be open in late 2014.

We all know how important nature is to all of us, especially our Elders in Green House homes…so our friends at Episcopal Homes plan to do something special with the ground flung into that wheelbarrow. It will be saved and used in the future greenspace and two-story indoor garden. Such a wonderful and thoughtful idea!

Read more  about the project. Then tell us what you think!

Highlighting THE GREEN HOUSE Project ® Team: Margaret Stansbury, Project Manager

Margaret has always been concerned about the social injustices she noticed as a young person and the people who are “left behind” as result in our society.  So, it was no surprise that she chose a career in Social Work.   Margaret wanted to be part of a positive change in our society.  Her journey began with an undergraduate internship at Little Brothers Friends of the Elderly, it opened her eyes to the reality of aging without support in our society. This was a transformative experience and Margaret knew she had to pursue a career in aging services. 

Margaret went on to complete her Masters in Social Work with a concentration in Gerontology.  She completed a graduate internship at The St. Louis Area Agency on Aging where she gained hands-on experience in how cities support aging through a network of services.  After completing her MSW, Margaret worked as an Elder Abuse Caseworker in the Chicago area under the Illinois Department on Aging Elder Abuse and Neglect Program and Catholic Charities.  She has also worked as a Social Service Coordinator at nursing home in Chicago. 

Margaret brings her direct practice experience working with Elders and the systems that impact their well-being to her role at The Green House Project.  She says she loves working toward goals that support healthy and happy aging. 

  • Master of Social Work and Concentration in Gerontology from Washington University in St. Louis
  • Elder Abuse Caseworker in the State of Illinois
  • Community Based Service and Long-Term Care Experience

In her free time, Margaret loves to practice yoga, go running, and work on sewing projects.

REGISTER TODAY! Complimentary Green House Workshop in New Jersey (CEUs available)

The Green House Project invites you to attend a 1.5 day Workshop on June 5 (12-5) and June 6 (8:00-12:00). The Green House Workshop Presentation will provide a “seeing is believing” experience complete with all the information necessary to bring this transformative model to your community. The event will be held at Green Hill in West Orange, the first Green House Project in New Jersey.

Susan Frazier, Chief Operating Officer of The Green House Project, will discuss current trends in long-term care, the core values of the Green House model, the model’s clinical and financial outcomes, and the latest research about this cutting edge model of care.

Toni Davis, President and Executive Director of Green Hill, will share her experience in bringing the model to her community, and attendees will have a chance to visit The Green House homes, talking with staff and elders who are living this model everyday.

Come join us to learn how you can join the revolution of changing aging! Even if The Green House model is not in your immediate plans, you will not want to miss the compelling reasons why the Green House financial and market performance will make it part of the future of skilled nursing care. Bring your questions and join us for an engaging session and strategic discussion.

Please RSVP to Maura Porcelli (703) 647-2311 if you can attend. Or you can register on The Green House website. NHA CEUs are available for this event

Appreciating Nurses: Wise Mentors and Skilled Care Partners

As we continue to celebrate National Nurses Week, we want to take a moment to acknowledge that nurses play an integral role in THE GREEN HOUSE® model as care role models, partners, gerontological nurses, teachers and mentors. The role of the nurse significantly changes in The Green House model, as they are no longer the supervisor of the Shahbaz, but rather a partner.  Both the nurse and the direct care staff bring their perspective to work within scope of practice, as they commit to protecting, sustaining and nurturing every elder they serve.

Nurses are wise and trusted guides and advisors in the Green House model. As part of the clinical support team, they provide elders with skilled and clinical care and functional support.  While carrying out all of the traditional duties of a nurse, the small environment and consistent staffing of a Green House home enables the nurse to create deep relationships with the elders and other staff members, which translates to good clinical outcomes.

In traditional models of long-term care, the hierarchical power structure can become an obstacle to real team collaboration. Nurses in The Green House home however, work hand-in-hand with Shahbazim and elders. Their professional expertise combines with the deep knowing of the Shahbaz to create a clinical care team of excellence. This sense of familiarity, and value for the skill sets of everyone on the team, creates an empowered environment where care delivery is both individualized and relationship-based.

Take a moment today to appreciate the nurses in your Green House home and in your life and thank them for all that they do!