Green House Blog

Green House Model Integrity Initiative and Questionnaire

Since the beginning of this year, the Peer Network Model Integrity Committee has worked hard to establish goals for creating a benchmarking system based on the Green House Project core values and clearly defined essential practices. These goals are:

–          To develop a credible, efficient, and effective system to monitor, assist and promote excellence among Green House Model adopters

–          To create this system using a set of Standards of Excellence that in content and application become the gold standard in benchmarking superior performance in  Long-Term Care

This initiative, led by the Peer Network Model Integrity Committee in partnership with Peer Network Project Guide Marla DeVries and consultant Sandy Ransom, will include both quantitative and qualitative elements.  According to Sandy, “We want to be able to clearly show, in quantifiable terms, the Green House difference. This will enable both adopters and the Green House Project Team to definitively show that general long-term care expectations are exceeded in Green House homes, and people experience a greater sense of home and autonomy.”

In order to establish a system that will work for all communities, we will be sending a questionnaire to each adopter organization this summer that asks for information regarding Meaningful Life, Empowered Staff and Real Home and the essential practices that comprise each value. There will also be questions regarding each adopter’s current data collection processes.

This process will allow us to successfully implement and sustain the integrity of the Green House model now and in the years to come.


THE GREEN HOUSE® performance on Quality Measures

Eighty percent of Green House homes serve Elders with skilled care needs. The model strongly supports Elder choice and relationships but Quality of Care is also important to support meaningful lives in real homes. The case needs to be made for quality clinical outcomes from deeply transformative models like The Green House Project.

EQUIP for Quality* is the quality tool used for clinical benchmarking by The Green House Project and all skilled Green House Projects are encouraged to participate in data collection.

This report represents the MDS 3.0 data from 10 skilled Green House Project organizations from third quarter 2012. This is a snapshot in time, but very important in understanding quality of care in Green House homes. Below are Quality Measures where these homes performed significantly better than national benchmarks:

• Percent of Residents Who Self-Report Moderate to Severe Pain (Long Stay)
• Percent of Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine (Long Stay)
• Percent of Residents Assessed and Appropriately Given the Pneumococcal Vaccine (Long Stay)
• Percent of Residents Who Have/Had a Catheter Inserted and Left in Their Bladder (Long Stay)
• Percent of Residents Who Have Depressive Symptoms (Long Stay)
• Percent of Residents Who Received an Antipsychotic Medication (Long Stay)
• Percent of residents who have behavior symptoms affecting others (Long Stay)
• Percent of Residents Who Were Assessed and Appropriately Given the Seasonal Influenza Vaccine (Short Stay)
• Percent of Residents Who were Hospitalized in the last 100 days (Long Stay).

Other Quality Measures were similar to national nursing home benchmarks.

Two measures that are particularly targeted in long term care today are re-hospitalizations in the previous 100 days and the use of antipsychotic drugs. These show significantly better performance during this period of time and are considered areas of both high cost and clinical significance in understanding and managing care transitions. All indicators are important to guide the understanding quality of care in Green House homes. Having regular data provides deeper understanding of the model and sharper targeting for education and process redesign within the model. For more information contact

*EQUIP for Quality, Leading Age New York