Green House Blog

Instead of a Resolution This Year…Make a Commitment!

The beginning of a new year is a natural time to consider changing our current ways…thinking about what improvements might be good for us.  We often decide to make a list of New Year’s resolutions.  But this year why not be different and make a New Year’s commitment!

According to the dictionary a resolution is a “firm decision to do or not to do something”.  A commitment is “the state or quality of being dedicated to a cause, activity”.  It’s that opportunity for dedication, devotion, allegiance, faithfulness.

The words are similar in definition, but commitment seems to take it a step above—asks for you to assist in the greater good of the world you live in.

In November at The Seventh Annual Green House Meeting and Celebration we asked our adopters   “What is one commitment you would like to make to Lead with Heart and Soul in 2015?”  You may remember “Leading with Heart & Soul” was the theme for our gathering.   We asked them write it down on a large notecard, and during the conference other attendees could drop by the table and see what commitments had been made.  As you can see, some were personal commitments to the Elders and others were commitments to continuing to improve the Green House model.

So when you ring in the New Year…consider a commitment instead of a resolution in 2015!



Click here to see all the commitments created in a Facebook album!

Shahbazim Provide Companionship and Comfort

Earlier this month, freelance writer, editor and journalist Beth Baker posted a blog on the Next Avenue website which explored the role of the Shahbaz in Green House homes. In her post, “Reimagining What a Nursing Home Can Be,” Baker explores how the culture change movement, and specifically the Green House model, has empowered staff that care for Elders needing skilled nursing care.

For Beth, the Green House model is especially unique because of its emphasis on elevating the role of care partners.

“The Green House is perhaps best known for its homey environment… But even more important than the setting may be the reimagined role of the caregivers who work there.” She goes on to say that beyond just the new title of Shahbaz, front line care aides in Green House homes are given far more responsibility and respect than what is typically seen in traditional skilled nursing care.

Steve McAlilly, CEO of Methodist Senior Services, Inc., shared his thoughts on the Green House model for Beth’s book Old Age in a New Age saying, “One thing I love is the Shahbazim. They have become these amazing professional people. I think they were stuck in jobs that were too small for them.”

You can hear Beth Baker share more of her insight on aging in America and the Green House model by listening to her closing plenary speech from our Annual Meeting in Memphis this year.

Highlights of 2014 for The Green House Project

2014 has been a whirlwind year for The Green House Project. There have been so many relationships, conversations and experiences with people around the country who are making deep change for elders and those working closest to them.  The year culminated at our 7th Annual Meeting and Celebration, where record numbers of Green House adopters came together to capitalize on the momentum, energy and knowledge that is collectively growing.   Working with innovative and high quality organizations, how can we not be inspired, and spurred forward to spread this model even further? It is hard to sum up the year in a way that honors all of these individual moments, but here is a sampling of some of the highlights to demonstrate that this model is not only the right thing to do, but also the smart thing.

There have been a number of firsts:
Green House Homes Opened in Colorado. The grand opening for The Green House Homes at Mirasol, located in Loveland, Colorado, was significant for many reasons. This project marked the first Green House homes in Colorado, the 27th state to open this model, and also utilized public/private partnerships to make this model accessible to low income elders. Read more about this project on Capital Impact Partners‘, website.
Green House Homes Approved in Rhode Island by the Department of Health. While a moratorium on building new nursing home beds has been in place for years in Rhode Island, the state acknowledged the need for an innovative model of long term care. St. Elizabeth Home has received approval to build 4 new Green House homes. Read more.
State Regulators Unanimously Approve Plans for the First Green House Homes in Missouri. Gaining a Certificate of need for new nursing home beds is no small feat. The Healthcare Facilities

Review Committee of the Missouri Department of Health and Senior Services granted approval for an 80 bed Certificate of Need to build Green House homes in Ozark. Read more.

Some great press coverage:
Atul Gawande’s Being Mortal. Chapter 5 of this best-selling book focuses on culture change and the Green House model. In the media coverage of the book, as well as interviews, there’s a lot of discussion about the Green House model. On Diane Rehm’s show on NPR he called the Green House model “revolutionary.” and The President bought the book to read over the holidays!

Kiplinger. In the retirement planning issue, which covers a variety of topics, including advice on finding the right nursing home. They recommend consideration of organizations that have implemented culture change or that offer Green House homes. Read more.

Research and resources to ensure growth with integrity:
The Research Initiative Valuing Eldercare (THRIVE) honored for studies: The longitudinal studies by researchers from top universities, and funded by The Robert Wood Johnson Foundation, has been completed. Their work has already received high honors, such as the Ollie Randall Symposium at the 2015 Gerontological Society of America conference. This research provides insights into the quality, cost and sustainability of The Green House and other culture change models.
Design Manual and Model Integrity Process: The Green House team has developed guidelines for architects and operators to build homes that are warm, smart and green (‘green’, meaning a place where people grow). This manual will be used as a tool for groups under contract with The Green House Project. Once opened, Green House homes now participate in a model integrity process to protect their investment in the model and to ensure that the elements of the model will grow and thrive.

And some other great news:
Dr. Bill Thomas’ Second Wind Tour. Susan Frazier and David Farrell joined Dr. Thomas on a 25 city tour to offer audience members powerful insights into slower, deeper, more connected ways of living & working. Watch Susan’s talk
Occupancy Growth Exceeds Expectations. At the Water’s Edge, with newly opened Green House homes, the rush of elders interested in moving in has exceeded expectations. Read more.
Tomah VA Medical Center Opens Two New Green House Homes. The Tomah VAMC became the fourth VAMC campus to offer Green House homes to veterans. Read more.

This is just a sampling of some of the wonderful things happening with The Green House Project. Along with amazing people and organizations, we are transforming the way that we age. To become a part of this movement in 2015, contact us or visit our website:

The New York Times Features the Green House Model

Word traveled quickly last week after The New York Times published an article by Jane Brody entitled, “The Green House Effect: Homes for the Elderly to Thrive.” It took only several days after the piece was published to our Facebook page for over 16,000 people to see the article, many of whom liked or shared Brody’s insights with their own social networks.

The author creates a clear and powerful image of the Green House model and its core values with support from interviews with Dr. Bill Thomas and Steve McAlilly, CEO of Mississippi Methodist Senior Services in Tupelo, MS. By showing readers that Green House homes provide Elders with a nurturing and respectful environment where they can continue to thrive, Brody exposes the “medicalization of old age” that many of the 1.5 million Americans living and working in nursing homes experience each day.

Today, nearly 2,000 Elders across the nation are living in Green House homes in partnership with caring Shahbazim, clinical support teams and families. The swell of national recognition that we have received over the past year is a clear indication that the Green House model is well positioned to experience rapid growth and adoption in the new year as Americans embrace the power of meaningful life, real home and empowered staff as they age.

Saint Elizabeth Home in Rhode Island Slated to Build Green House Homes

The journey to build Green House homes in Rhode Island officially got underway this week with The Green House Project team delivering the first educational session to create a coaching culture with Saint Elizabeth Home leadership.

While a moratorium on building or adding skilled nursing rooms has been in place for years in Rhode Island—Saint Elizabeth Home was one of three applications approved by the Department of Health to deliver a new model of care for skilled nursing.

Matt Trimble, Administrator of Saint Elizabeth Home says “We are thrilled with this approval and look forward to expand our ability to care for RI seniors in a new and creative way on our Saint Elizabeth Home campus.”

The plans call for the construction of four Green House homes.  12 Elders will live in each home which will include private bedrooms and bathrooms, a common hearth area, and meals cooked in an open kitchen area.

The leadership and trustees at Saint Elizabeth Community have been researching The Green House model for a number of years.  Steven J. Horowitz, President and CEO of Saint Elizabeth Community explained, “We have been very invested as an organization in bringing this new model of care to Rhode Island, and know that it will change the way long term care is delivered.”

The next step will be to apply for a certificate of need and Saint Elizabeth Home has been approved for an expeditious review.

Saint Elizabeth Home is a member of Saint Elizabeth Community, a not for profit, charitable organization that provides a variety of care and services to elders.  Founded in Providence in 1882, the organization now has ten RI locations which includes affordable apartments, adult day centers, assisted living, skilled nursing and rehab centers.

Sharing a Favorite Salad During This Holiday Season Can Bring Unexpected Joy

During the holidays we like to feature a recipe from an Elder in a Green House home.  This year we are featuring a Cranberry Jell-O salad that was a favorite of Millicent Stutzman who lives in the Showalter House at the Virginia Mennonite Retirement Community in Harrisonburg, VA.  Her daughter, Marliese Poskitt, shares the story below concerning this special salad.  There is no recipe for this salad…so her daughter made the salad this Thanksgiving from the memory of watching and helping her mother over the years.


“Thanksgiving at our house always involved getting out the metal food grinder that attached to the end of our kitchen counter like a vise. Mom washed the cranberries, peeled the apples, and Dad put them through the old hand-cranked grinder. Along with chopped pecans and Jell-O, it made a delicious and colorful salad. The holiday doesn’t seem the same now without her Cranberry Jell-O salad. So, when we were invited to have Thanksgiving Dinner with her at the Showalter House, I washed the cranberries, peeled the apples, and chopped the nuts (with my electric food processor) and brought Mom’s salad to share. At dinner, Mom tasted it and her eyes lit up a little. She said “That’s me! That’s me!” and pointed to the salad. At 94, having dealt with memory loss issues for many years, she struggles to communicate with us. We don’t know for certain what was going on in her mind, but to my brother and me, she seemed to be saying, “Hey, that’s my recipe!” The salad, and her response, was her gift to us this Thanksgiving.”
And so we share the gift with you and perhaps you might enjoy making Cranberry Jell-O Salad for or with your family for Christmas.”

Joan Lunden on Planning for the Future and Finding Resources for our Elders

The American Society on Aging’s bi-monthly newsletter, Aging Today, interviewed Joan Lunden about her work with A Place for Mom and the need for having a plan in place for your aging parents. Lunden uses her platform as former Good Morning America host to advocate for senior care.

Aging Today asked Lunden about her mother and the obstacles she faced while caring for her:

I was so unprepared, and had no plan in place. I’m sorry to say that I think [that’s] typical. It’s just part of human nature—we want to think of ourselves as kids and our parents as in charge, impenetrable decision makers. But there comes a time when they’re not. … The day you have to become a parent to your parent is unnatural, and uncomfortable. You don’t want to burden your parents by asking what their plans are for later life, you don’t want to be presumptive or make them feel awkward, but if we don’t ask, [their care] might financially devastate our own family. And our parents are reluctant to answer, which is also part of human nature because it represents their mortality.

It is important to establish a plan for the elders in our lives, so the people who mean the most to us are taken care of in a healthy setting. Green House homes offer home for life in an empowering environment so that our loved ones experience meaningful life.

Click here to read the full interview.

CMS Five-Star Rating Program Update

The President and CEO of The American Health Care Association (AHCA), Mark Parkinson, recently released a statement to AHCA members regarding President Obama’s Executive Action on October 6th to improve the Five-Star Rating Program.

As a result of the President’s Executive Action, the Five-Star Program, created by CMS six years ago, will change in two key ways. First, payroll data will be collected in order to improve accuracy of staffing information. Second, the administration has developed three new quality measures that will be added to the nine existing measures: rehospitalizations, discharge back to community and antipsychotic use.

According to Parkinson, “As CMS changes the staffing and quality measures, it will need to create new scoring and therefore, new cut points. This inevitably will impact the staffing scores and quality measure scores for a significant number of providers.”  In light of this, AHCA has issued a collective call to action in order to educate providers, legislators and CMS about the potential problems that may result from the Executive Action.

To learn more about the history of the program and AHCA’s call to action, read the full statement here.

The 7th Annual Green House Annual Meeting and Celebration, Smashing Success!

Dr. Thomas and David Farrell

The Green House Project recently joined 250 of our closest friends from around the country at the 7th Annual Green House Meeting and Celebration in Memphis, Tennessee! Together, with Green House model adopters, we brushed up on our Elvis impersonation, moved to some funky blues music and chowed down on some of the country’s best BBQ! The Robert Wood Johnson Foundation welcomed the attendees to the meeting.  As their generous grant funding nears its end, it was a powerful time to reflect with gratitude at all that has been accomplished, and our future momentum.  The theme of the conference was Leading with Heart and Soul, and with the passion and energy in the room, it was a befitting frame for our time together.

This year’s conference took place at the historic and beautiful Peabody Memphis hotel, with a true Memphis welcome from elder, and owner of the Peabody, Jack Belz. The voice of the elder was found throughout the conference, with a “Ted Talk” by Twylah and David Haun, elders who were the driving force behind bringing The Green House project to John Knox Village in Pompano Beach, Fl, and videos of elders from Green House homes around the country talking about their lives and what this model means to them. The shahbaz, the versatile house manager and direct care staff in The Green House model, also had a prominent role in this year’s conference. Dr. Bill Thomas honored the many shahbazim in attendance with the continued imperative to protect, sustain and nurture the elders,-and he issued a challenge for everyone to consider: “What’s next?”

The team from Penfield Green House homes in Rochester, NY

The Green House Annual Meeting is an energy boost for everyone in attendance.The networking, shared experiences and speakers all inspire us and challenge us to grow. The THRIVE collaborative is a group of esteemed researchers from top universities around the country, who have joined together to conduct studies on The Green House model that will illustrate the impact of this model on the cost and quality of health care. The results of these studies will highlight how we can continue to evolve and grow this model. They shared outcomes to date, and implications to Green House adopters. In a dynamic and innovative time, protecting the value of The Green House brand is key. This research, along with the newly unveiled, Model Integrity Process, will ensure that while Green House homes look different across the country, they all uphold the core values of real home, meaningful life and empowered staff.

Carman Bowman gave a provocative and illuminating talk as she uncovered some of the mystery around regulations, and described how certain “F-Tags” can be utilized by nursing home operators to support person-directed care. She challenged the group to educate themselves and educate their surveyors about how we can met the elders’ needs while responsibly moving away from chair alarms, certain dietary restrictions, and other institutional practices that don’t serve our field.

As Manager of Social Responsibility at FedEx, Rose Jackson Flenorl directs and implements the company’s community outreach strategy in the areas of Disaster Relief, Safety, Environment, Education, and Diversity in national and international markets. Rose wowed the crowd by drawing parallels between FedEx and The Green House model as initiatives that started as a dream and became a reality that changed a field. Rose shared the personal story of her upbringing and her desire to provide her parents with the love and care that she thought only could come from her, until she visited the Ave Maria Green House homes in Memphis. She now she has hope that long term care can be different. Rose’s open hearted presentation of leadership, risk, and those ideas that change the world, riveted the audience, and validated the work that we do.

Beth Baker, insightful author of With a Little Help From Our Friends, Creating Community as We Grow Older, closed the conference with a message of interdependence. We need to take care of each other and age in community. As Michele Kort, Senior Editor of Ms. Magazine describes, “Beth Baker courageously and empathetically asks the question many Baby Boomers avoid: How will we make it through our aging years with dignity, independence and pleasure? The answers she receives from folks around the US, straight and LGBT, reassure us that there are already promising paths being carved.”

Linda Robertson, St. Martin’s in the Pines, Birmingham, AL

Beyond educational sessions on team building, leadership, policy quality outcomes and Green House operations, site visits to the Ave Maria Green House homes created a “seeing is believing” experience for many of organizations who are still in the financial exploration phase, and a chance for those implementing and sustaining the model to learn from each other. The Green House Annual Meeting & Celebration is an excellent opportunity to connect with fellow Green House pioneers, to learn, grow, and leave inspired to lead as we continue to champion change that meaningfully impacts the lives of Elders.

To see recorded videos of selected sessions, please visit our YouTube Page. We, at The Green House Project thank everyone for making this the best meeting yet, and look forward to seeing even more Green House adopters next year for the 8th Annual Green House Meeting and Celebration in Colorado!

Kiplinger Highlights Green House Homes

While those of us who work with Elders in Green House homes know what a wonderful place it is…it’s always nice when the model is included in an article for a national financial organization.

Kiplinger’s Retirement Planning 2014 booklet includes information on finding the right nursing home, and this month an article includes information on culture change advocates including The Green House model.  Here is an excerpt from the article:

Rather than making incremental changes, some culture-change advocates are starting from scratch. The Green House Project, for example, builds skilled-nursing facilities that house about 10 residents around an open kitchen. Each resident has a private room with a private bath. There are no nursing stations, room numbers, call bells or medication carts, says David Farrell, senior director of the Green House Project. Each Green House is “built from the ground up to look and feel like a real home,” Farrell says.

Click here to read the entire article including information about culture change and nursing homes.