“For thousands of years, elders have been held in high esteem and involved in the community,” says Steve McAlilly, CEO of Mississippi Methodist Senior Services. As the world shifted and the role of elders changed, Steve sought a way to bring them back to a place of reverence and respect. 15 years ago, Steve courageously opened the first Green House home in Tupelo, MS, effectively building a home where elders could live full and meaningful lives, “Within hours of moving in, a peace came over the home,” Steve remarks.
Not only do these homes positively effect the elders who live in them, but also the direct care staff who take on expanded roles to become the managers of the home. The skills that they learn in The Green House homes affect every area of their lives, “I’ve watched team members grow and thrive in the Green House” says Michele Daniel, VP of Philanthropy & Strategic Implementation. Mississippi Methodist Senior Services currently has 19 Green House homes on four separate campuses.
Returning the elders to a place of esteem, honor and respect is an investment in the quality of life of the entire community.
This 15 year milestone began with the vision of Dr. Bill Thomas and was embraced by Steve McAlilly’s leadership. Thanks to the support of The Robert Wood Johnson Foundation, this radically simple innovation has become a proven movement that continues to grow with integrity and sustainability. Now with Green House homes open and operating in 33 states, small house nursing homes are a trend addressing many of the challenges in healthcare. The Green House model is demonstrating that the status quo is not good enough and that there is a better way. Thank you to Mississippi Methodist Senior Services, and all of The Green House partners who have opened their doors in the past 15 years. Together we are fostering environments of empowerment, dignity and respect, and a world where every individual can anticipate a hopeful future
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.
The data presented during this session stemmed from the recently updated financial survey of Green House partners by Terri Metzker of Chi Partners. In this survey, she explored the essential elements to achieve viability through comprehensive culture change.
To learn more about how Green House homes are faring in comparison to national trends and the importance of leadership to create sustainable results, please download the full webinar>>
It’s all about leadership, and The Green House is honored to work with wise leaders who exude such a presence of belief and trust in the culture that they are helping to shape. Check out these short interview that delve into the unique journeys of Southern Administrative Services, and Clark Lindsey, as they discuss the business and operational value of working with The Green House Project.
“The business model of The Green House model is self evident… It’s where people want to be. Rather than spending your money on an intense marketing campaign to promote your business, why not create something that attracts everyone.” – John Ponthie, Southern Administrative Services
Register Today for The Distinguished Speaker Webinar Series and OnSite Workshops
Cultural Transformation Through Green House, January 9 (3:00p ET). Join Green House Senior Director, Susan Ryan to hear an Overview of The Green House model as you’ve never heard it before! THE GREEN HOUSE believes that all elders deserve to grow and thrive no matter where they reside, and that to impact lives in a meaningful way, it takes more than environmental change. To make meaningful change a reality, it is imperative to infuse the entire organization with optimal systems and structural changes that create a cohesive approach to elder-directed care. Register>>
Innovations and Trends in Elder Care, February 1 (3:00p ET). Lisa McCracken, Director of Senior Living Finance Research and Development with Ziegler will provide an overview of the key trends and innovations in Elder Care. This is the opening session of our Business Case series which will shed light on how The Green House model is a viable solution amidst the backdrop of a dynamic economy and healthcare climate.Register>>
Improving Long Term Care Workforce With Strategies that Work, February 22 (3:00p ET).Robyn Stone, Senior Vice President of Research, LeadingAge, will provide an overview of the demographics, trends and challenges of the workforce in Elder Care. This is the opening session of our Workforce series. which will identify practices within The Green House model that create the potential for successful workforce development. Register>>
Living with Dementia: New Perspectives, March 22 (3:00p ET). Dr. Al Power, author of Dementia Beyond Drugs and Dementia Beyond Disease, will look at the experience of dementia through the frame of well-being, and explore how this perspective is challenged, both by brain changes, our attitudes, and care systems. Register>>
“Waves of Change, Oceans of Opportunity” became more than a theme for the 2017 Green House Annual Meeting, it became a rallying cry. The world is at a pivotal point, and the meeting tapped into the collective potential of an innovative group to help shape the future. Over 250 people from around the globe converged in sunny Florida to connect, learn and grow. Hosted by the progressive and gracious John Knox Village, attendees were able to experience the potential of The Green House model, firsthand. Coming on the heels of the devastating Hurricane Irma, The Green House community came together to raise over $1200 for disaster relief, including many in-kind donations. Engaged and generous sponsors add to the rich tapestry of learning, and enhance the conference experience. Through challenging speakers, interactive opportunities, and recognition of the global voice, the ripples of the time together will continue to be felt for a long time.
Sharpen your skills in the kitchen! This was the challenge put out to direct care staff who were invited to participate in a “Chop Chef” style competition in the onsite training kitchen at John Knox Village. Under the guidance of Chef Mark of John Knox Village and Chef Ian from Christian Cares in Kentucky, direct care staff gained valuable skills in the kitchen, build strong relationships with peers and deepened their understanding of being an empowered staff member.
Over 40 Executives including representatives from 8 countries participated in a stimulating and challenging session about Social Entrepreneurship led by Green House Board President, Scott Townsley. The commitment and vision of these leaders to share their voice, demonstrates the power of a community of thought leaders to change a paradigm.
The conference opened with keynote speaker, James Wright, challenging the group to explore the meaning and value of diversity in the workplace. Through interactive exercises to uncover unconscious bias and understand the difference between equity and equality, Mr. Wright’s message became a thread for meaningful discussion throughout the conference, and perhaps a new lens to view the world.
The Green House Annual Meeting welcomes every role within The Green House model, believing that sharing an education space leads to some incredible conversations and epiphanies. For example, in the closing plenary session, when Monique, a direct care staff member from Detroit, stood up and said, “this is not a job, this is a career”, there was electricity throughout the room, and a heightened understanding that workforce development is essential to ensure sustainable success of Green House homes. The education sessions range from important macro topics like “What You Need to Know About the New CMS Regulations to Lead the Way” to nuts and bolts topics like how to engage in constructive conflict. Facilitated networking through an exercise called “Words Make Worlds”, led to
spirited conversation, and many creative expressions of words to take forward, and those to leave behind. There is value provided at a strategic level and an operational level, and the interaction that occurs is priceless.
Last year, one of the far reaching visions was that Green House would “Go Global”. At the time, it seemed like a dream, and then international visionaries began to reach out about bringing Green House to their community. This year, representatives from Bermuda, Brazil, Canada, Israel, Indonesia, Panama and Singapore participated in The Green House conference, and an International Think Tank where ideas and possibility spread through the room like wild fire. One participant remarked that what may have started as a ‘project’ is now far more than that… it is The Green House Movement! Everyone left with a ‘fire in their belly’ to make meaningful change. Conversations and plans have continued full force, and there are now expansive opportunities for Green House to impact the needs of aging individuals on a global scale.
The Green House Annual Meeting is always an energizing time for those who are exploring, implementing and sustaining the model to connect with their peers and deepen their understanding. This year brought new elements that challenged the group to deepen their role as a community of thought leaders and lead society as an inclusive and innovative force that celebrates the intrinsic worth of EVERY individual. The Green House movement has the energy and vision to disrupt the status quo and propel a dynamic system to new heights amidst a rapidly changing world.
At The Green House, vision is merged with rigor, passion with determination, and a belief that there’s never a best that can’t be made better. In their article, “A Better Kind of Nursing Home”, The New York Times says, The Green House model is demonstrating that life in long term care can be different. With real life experiences to support the movement, and world-class research to keep improving, the potential for future impact is vast.
“Lots of things look different when you step into a small Green House nursing home. The bright living and dining space, filled with holiday baubles at this season. The adjacent open kitchen, where the staff is making lunch. The private bedrooms and baths. The lack of long stark corridors, medication carts and other reminders of hospital wards.”
Robyn Grant, public policy director for The National Consumer Voice for Quality Long-Term Care, emphasizes that the goal of this shift that The Green House Project is leading means “deinstitutionalizing nursing homes, making them more like the way we’ve lived all our lives, with our own routines and familiar objects.”
The national initiative has committed itself to the rigors of research in pursuit of continued growth. Research has shown that model components such as consistent and increased staffing, lead to deep knowing of the elder and early detection of health changes, “The [THRIVE] researchers found that Green House residents were 16 percent less likely to be bedridden, 38 percent less likely to have pressure ulcers and 45 percent less likely to have catheters. Avoidable hospitalizations and readmissions were also lower, reassuring observers who wondered if the Green Houses’ emphasis on quality of life meant sacrificing quality of care.”
In a dynamic world and healthcare landscape, it is essential to be a part of the solution. The Green House Project “Compared to traditional nursing homes, no doubt about it,” said Dr. Sheryl Zimmerman of the THRIVE research team. “It’s a preferable model of care.”
“To care well for others, we need to reinforce our own passion for what we do—and actively work to improve how to support our country’s aging population today. That’s exactly what we do at the LeadingAge Annual Meeting & EXPO, our nation’s largest annual event for the not-for-profit aging services field. In education sessions, during general sessions and through eye-opening, one-of-a-kind experiences, you and your team will be immersed in our shared mission of helping older adults thrive.”
The Green House Project is looking forward to opportunities to connect with visionary organizations at this of this event. Please visit us in the exhibit hall at booth #1913. Also, don’t miss this informative, challenging and stimulating sessions that feature Green House expertise and innovation:
Monday, October 30, 2017
3:30 – 5:00 p.m.
22-C. Integrated vs. Segregated Environments for Persons With Dementia
Examine the pros and cons of integrating versus separating elders living with dementia in different settings.
Consider how the approach to dementia care and programming has evolved as the physical environment of memory care “units” continues to change from locked wings to neighborhoods.
Assess your organization’s philosophy and care practices as they relate to those living with dementia and their care partners.
Audrey Weiner, President & CEO, The New Jewish Home, New York, NY
Ann Wyatt, Manager, Palliative & Residential Care, CaringKind, New York, NY
Susan Ryan, Senior Director, Green House Project, Linthicum, MD
Tammy Marshall, Chief Experience Officer, The New Jewish Home, New York, NY
Next week, visionary leaders will come together at the 2017 Pioneer Network Conference. The theme, ‘Be The Future’, is a powerful charge to change the way society views aging, and create a better world for elders and those who work closest to them. The goal of this conference is to showcase innovative thought and best practices in the long-term care culture change movement. The Green House model is featured throughout the conference, and the national initiative is leading two sessions, one on the value of short term rehabilitation with a Green House home, and one on Best Life for elders living with dementia.
Short term rehabilitation presents an opportunity to position an organization for the future. The small house model provides a consumer-driven experience that leads to positive outcomes. During the education session, The Green House Project will highlight The Woodlands of John Knox Village, an organization who has captured their market by utilizing The Green House model for short term rehabilitation. They will share how they achieve positive outcomes using functional rehabilitation in the home, establish credibility with key stakeholders, and positively impact their bottom line.
As the population of the United States ages, the prevalence of Alzheimer’s and related dementia is growing. Dementia was estimated to cost the United States more than $236 billion in 2016. To address this challenge, The Green House Project has developed Best Life, an initiative that aims to connect elders with life and community through the philosophical, architectural, and organizational elements of The Green House model. It requires dedicated teams, extensive knowledge of the types of dementia, and a fervent belief in the unique ability of every individual to enjoy a meaningful life.
The Green House Project is a proud leader of what is possible in long term care. This conference is a time to connect with like-minded visionaries. As the paradigm shifts to view elders as creative, resourceful and whole, their potential is unlocked, and we all benefit.
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
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 firstname.lastname@example.org.