Green House Blog

New CMS Regulations, a Win for Person-Directed Living

As thought leaders Green House adopters lead the way by supporting, and deeply knowing each individual living in their homes. With the introduction of new CMS regulations comes the opportunity for Green House homes to demonstrate how the model is designed to ensure each elder is able to live on his/her own terms. “Language and being focused on the elder vs. the disease, makes a difference.  At The Green House Cottages of Carmel, we developed our policies and procedures prior to these new regulations, and it felt great to see that what we knew in our hearts to be right, was reflected in government mandates.” said Melody DeCollo, Guide of  The Green House homes of Carmel, in Indiana.

The Green House Project invited, Carmen Bowman, a nationally recognized expert in all things regulatory and culture change to facilitate two webinars exclusively for The Green House Peer Network about the new CMS regulations. In these webinars, Carmen highlighted where, specifically, the new regulations support The Green House Core Values, and how Green House adopters can leverage them to even more fully realize the benefits of the model.  Says Carmen, “There is power in the institution to shut people down, and there is power in the home to bring people back to life.”

There were many areas to highlight, but here are a few of the hot topics:

Language – Words Matter! Where are the opportunities for Green House adopters to utilize language that is more person-centered and less institutional?

  • Community (or home) vs Facility
  • Individual vs Resident/Patient
  • Real Home vs Homelike
  • Meaningful Engagement vs Activities
  • Approaches vs Interventions

Proactive Approach- How can we learn to be ‘preventionists’ and align with an elder’s natural rhythms, patterns and preferences to meet their needs before an issue escalates?

Daily Community Meetings – How does The Green House model support teams to approach issues in real time to emulate the concept of daily community meetings? Where are the opportunities to involve/engage elders in decision making

Care Planning – What are Green House adopters doing to ensure Shahbazim (direct care staff), elder, and family voices are heard in care plan meetings? How can we intentionally gain the rich information that yields deep, knowing relationships?

Highest practicable level of well-being – By intentionally focusing on the physical, social and mental wellness of the person, it expands and elevates the experience. What do individuals need to thrive?

Creating Real Home and Personal Belongings – “We really want to know who you are, so please bring in things that are special to you to decorate our home”.  WHO is doing WHAT to ensure elder’s personal belongings are brought into the home/their room?

Meaningful Engagements – Take a moment and consider, is it real life, or fake life? Break apart the word to understand… What is meaningful? What is engaging?  People want to make a difference, how can we support people to live lives of purpose?

Food and Nutrition – What are Green House homes doing that showcase the power of deep knowing that supports individual preferences?  What can we do to expand ‘choice’ and offer it around the clock.

These new regulations were created in response to person-directed care, that means that our work to change the culture of aging is making a difference! We need to keep telling our stories, and letting the world know that aging and long term care can be different. We want to hear from you! If these new regulations are supporting you to shine—email us at inquiries@thegreenhouseproject.org.

A Grandaughter’s Externship Provides Insight into The Green House Model

Breanna with her grandparents, Twylah and David Haun

The Green House model has added passion and purpose to my family in many ways. My grandparents, David and Twylah Haun, are Independent Living residents at John Knox Village (JKV) and they were instrumental in bringing The Green House model to their community. We have had many great conversations about the model’s potential over the years, and it has become close to my heart as well. Currently, I am pursuing my doctorate in Occupational Therapy at the University of Southern California (USC). When a professor challenged us to seek out opportunities and learn what it means to be a leader in healthcare, I immediately thought of my grandparents. This led to an exciting externship at The Woodlands at JKV. Before I stepped foot on the grounds at JKV, I was already destined to have valuable experiences simply based on the leadership skills I could learn from my grandparents.

John Knox Village, Pompano Beach, FL

I can still remember back in 2011 when bringing The Green House model to JKV became the main topic of our Thanksgiving meal ; My grandmother was interested and my grandfather was doubtful. Never ones to be easily convinced or to skimp on their research, they decided to take a road trip to eight different Green House homes to see this model in action. After visiting four homes, Grandfather was sold on the idea and came home to put their research into action. In the years since this initial exploratory trip, my grandparents have stayed very involved in The Green House initiative at JKV and also at a national level. They have spoken at the national Green House Meeting, contributed to The Green House blog, and helped with every aspect of creating and opening The Woodlands at JKV (including selecting paintings for the walls and dishes for the dining rooms, pictured right). Grandma has continued her active role in The Green House homes by becoming a Sage, a volunteer role that allows her to mentor and support the self managed work team to become a cohesive team and help create a real home for and with the elders.

In my program, we were discussing different models of care, and my professor brought up The Green House Project. It was something USC knew little about, but were excited to see how it could change the future. I was thrilled to be able to share my grandparents’ experiences with my 150 classmates and professors. I couldn’t wait to see the model in action! The Woodlands at JKV represents the first Green House homes in Florida, and they also offer homes dedicated to short term rehabilitation. Providing meaningful therapy in a natural environment is the ideal for an occupational therapist, and an exciting reality in the Green House homes.

I spent my externship running from meeting to meeting, soaking up as many experiences as possible, and asking questions about everything. From the staff in the homes to the people working across the whole community, I was continually impressed by the way they put the needs of the elder first, and balanced that with the success of the organization.

Some of my most meaningful interactions occurred with the elders, sharing stories of joy, belonging, and feeling safe in The Green House homes. In the end, this is why we do what we do, and it filled my heart with pride to be able to see this vision that my grandparents helped to carry forward, being lived out in such a beautiful way.

My time at JKV was a wonderful learning experience, and one that I will never forget. The Green House model is truly making a difference in the lives of the elders and those who are passionate about working with them. As a leader and therapist, I know that one of the greatest gifts I can give a client is to remind them that they are a unique individual who matters. From talking to the elders and listening to their stories, watching the direct care staff prepare meals in their home, participating in leadership meetings, and delivering mail to the homes with my grandmother, every experience taught me something valuable, and I am incredibly grateful.