Green House Blog

Leaders Speak Out about the Value of The Green House model

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


The Visionary Leadership Behind the First PACE Green House homes

Green House homes are dynamic and able to impact innovation in many different settings.  The first Green House homes to be incorporated with a PACE community have opened as part of The Thome Rivertown Neighborhood in Detroit.  It is an honor to be able to open the doors of accessibility for low income elders through this partnership. 

PACE is the acronym of the Program of All-inclusive Care for the Elderly.  PACE programs are government-funded managed care health plans that also provide comprehensive health services for individuals age 55 and over who have health needs classified as “nursing home eligible” by their state’s Medicaid program.  The goal is to keep chronically ill elders independent for as long as possible –preventing avoidable  hospitalizations, emergency visits and stays in nursing homes.

Roger Myers is CEO of Presbyterian Villages of Michigan, and Mary Naber is President/CEO of PACE Southeast Michigan.  They are the leaders behind this innovation, and hold the belief in this partnership to evolve the healthcare system.  “This is the future.  Health is about more than medical care.  To meet the needs of elders, the focus must be holistic, accessible and home based,” Naber says.

The goal of PACE is to keep people as independent as possible and to avoid nursing home stays.  Despite that, nationally 7% of PACE participants still end up spending some time in long term care, according to Naber, “less because of a need for skilled care, and more because they are not safe to stay in their homes.”

“As we know, even the best traditional nursing home does not provide the greatest living experience, and now, for at least 21 people, The Rivertown Neighborhood is able to offer an alternative.  The Weinberg Green House homes meet their needs, support them to thrive and enable them to remain in the community,” says Naber.  “It’s very gratifying to be able to offer this option.  I wish I had 10 Green House homes for people!”

The Green House homes are licensed as Homes for the Aged, a distinction that provides flexibility and enables elders with a high level of need to live in the least restrictive environment possible.   As it happens, many of the people living in these homes have moved there from nursing homes.  The PACE program provides a “wrap-around” so that elders receive all the services they need, enabling The Green House home will be their home for life.

“The great thing about the co-location of the Weinberg Green House homes to the PACE center is that the elders receive all the same benefits as if they were living in their own homes, which they are- Green House homes.  Being right on the PACE campus will keep elders more mobile and socially engaged.  It will also help PACE clinicians stay in touch, and we know that frequent interactions can help prevent ER visits and other medical concerns.” explains Myers.

“Health is not just about medical care, especially when you’re dealing with chronic illness,” declares Naber.  By leveraging an interdisciplinary team rather than the typical doctor-driven model, the team at the Weinberg Green Houses are able to care for the WHOLE person: body, mind and spirit.

PACE Southeast Michigan is a 501c3 not-for profit government funded unique health plan and comprehensive care provider.   It is a jointly owned by Henry Ford Health System, one of the early PACE innovators, and Presbyterian Villages of Michigan.

The Thome Rivertown Neighborhood includes Independent Living, Assisted Living, the PACE Center and now The Green House homes.  Not everyone who lives on the campus is a part of PACE, but it is built as a continuum to enable low income and highly frail people to stay in their community as their health status changes.

Integrating residential living with PACE is proving to be an effective development that will hopefully spread throughout the country.  PVM led the development effort for this supportive neighborhood during the recession, and the idea was so compelling that they were able to achieve their goals.  A $2 million grant from the Baltimore-based Harry and Jeanette Weinberg Foundation provided much of the support to make their vision to add Green House homes to the community a reality.



Nancy Fox to speak to the Imperative of Hope in Leadership

Nancy Fox is a nationally-recognized culture change consultant, and as a Green House adopter, we are especially delighted that she is going to be the closing plenary speaker at The 6th Annual Green House Meeting and Celebration. This event is exclusively for Green House organizations and serves as a venue for learning, networking and celebration!  Nancy’s long-term care career began in the 1980’s, serving at both the facility and regional levels.  Nancy served as the first Executive Director of The Eden Alternative. Nancy is a well-known speaker and educator and regularly conducts training on the Eden Alternative, Culture Change and Leadership. Her book, The Journey of a Lifetime: Leadership Pathways to Culture Change in Long-Term Care, was published in March, 2007. She currently oversees person-directed philosophy of care for Vivage Quality Health Partners.

Nancy believes that leadership is a behavior not a position. In fact, all leadership is volunteer work! Leaders bring hope into the world. In order to shift the leadership paradigm, we must work to redefine accountability. This is a challenge because, most of human behavior is driven by things happening on a sub-conscious level, and leadership requires self-awareness. At The Green House Annual Meeting, Nancy will distinguish between leadership in an institutional model and leadership in a person-directed model of care. Through this presentation, Green House adopters will be inspired to adopt new leadership behaviors.

McKnight's Features Green House Pioneer, Steve McAlilly

A recent profile in McKnight’s Long Term Care News, features Steve McAlilly, CEO of Mississippi Methodist Senior Services, the first Green House homes. “Thanks to McAlilly’s nurturing, the Green House model has grown from concept to phenomenon.”

The article profiles Steve’s upbringing, and the winding path that brought him to the helm of Methodist Senior Services in Tupelo, MS.  It has been 10 years since the first Green House homes opened, and it is astounding to look back at all the factors that aligned to make this dream a reality.  McAlilly says the “great adventure” of the Green House taught him how to “move forward without knowing all the answers.”

Chief Operating Officer,  Susan Frazier, decribes the leadership gifts that have contributed to the success of Steve’s organization and The Green House model, “He demonstrated you can work through the regulatory challenges, the capital challenges,” Frazier says. She calls him a “profound leader” who is warm and gracious, and known by all the direct care staff.

To read the full profile in McKnight’s >>



Empowered Staff Video: Celebrating 10 years of The Green House Project

In The Green House model, the core value that contributes most significantly to a deep and sustainable transformation is “Empowered Staff”. The hierarchy of the organization is flattened to bring power into the home, with the elders and those working closest to them. This group of direct care staff, who have a base education as  Certified Nursing Assistants and then receive 128 hours of additional training, become Shahbazim, an honored and valued group who work in self managed work teams to protect, sustain and nurture the elders. The self managed work team reports to a Guide, and partners with a Clinical Support Team to provide individualized and holistic care with the elders. The Green House Project provides over 200 hours of education across the organization to develop coaching leaders in an environment where Elder’s Rule!

Check out this video to highlight how the Core Value of Empowered Staff!

Leadership and Vision

If you are reading this blog post, three things are clear: You are an innovative leader, who values elders, and you have a definite vision for a better tomorrow.

So, I begin with the most important message: Thank you.
From a leadership perspective, you are driven by governing values, have a clear image of a positive future and have the foundation to take action and be effective.

As leaders in our community, we know 10,000 of our friends, family members and neighbors will turn age 65 every day for the next 19 years! What a blessing it is to be able to tap the energy, insight and expertise of Boomers as they become our elders! And what a challenge it will be to adapt care in terms of financing, engagement and wellness.

My life experience in the public, private, and not-for-profit sectors, working with our treasured elders, has helped me to identify several attributes of effective leaders that will be essential to our professional success going forward.

In creating communities of care inside and outside of centers, effective leaders will recognize the importance of and study effective techniques in communication and negotiation that puts people first, places shared interest over individual position, and separates a person from the problem or challenge with which they are identified.

These concepts of negotiation come from the hallmark text, Getting to Yes by Harvard scholars Roger Fisher and William Ury. For leaders working in a public/private intersecting space with features of home, hospital and community, and with varied voices of community members, families, staff teams, funders and regulators, negotiation is most certainly a necessary core competency for success.

Leaders know the importance of identifying crucial conversations as the intersection between opposing opinions, strong emotions and high stakes – as outlined by the authors Kerry Patterson, Joseph Grenny, Ron McLillan and Al Switzler in their powerful book of the same title. In the early pages of Crucial Conversations, the authors begin by offering important and powerful tools of dialogue – shared meaning, active listening, and starting from, instead of avoiding, the heart and emotion – to identify, and successfully navigate crucial conversations.

Today and tomorrow, effective leaders engaged in realizing the opportunities and overcoming the challenges of an aging America will study and work to not avoid crucial conversations with community members, families, employees, teams, and regulators (to name just a few in our broad circle of influence).

As Jack Welch and his wife Suzy point out in their book Winning, effective leaders recognize that “before you are a leader, success is about growing yourself. When you become a leader, success is about growing others.” Effective leaders in aging America recognize it is critical to learn from and nurture leaders in care, to grow leaders on staff and community teams, and to recognize the positive influence we can all have on other leaders in the broadest sense of community.

As leaders in our important work of helping elders to be as engaged, well, healthy and safe as they want and are able, we have a tremendous opportunity in our professional communities to envision and make the business case for sustainable care enterprises, whether for- or not-for-profit.

Effective leaders negotiate by putting people first, recognize and have crucial conversations, help others to grow as leaders and focus on all that connects us instead of that which separates us.

Steve McAlilly of Tupelo, Mississippi is this sort of effective, passionate and powerfully impacting leader. Steve can be counted among a handful of gifted leaders in our community of, for- and not-for-profit, large and small, government, private and philanthropic businesses, associations and scholars, who are working to guide us to a better tomorrow.

Our elder community is expanding exponentially. Green House homes have made a tremendous difference in the lives of real people. As long as we all put people first and recognize the various tangible and intrinsic values in caring, there is room for, and value in, various models of care and community.

About Joe:
Joseph DeMattos, Jr., is the CEO of the Health Facilities Association of Maryland (HFAM), Maryland’s oldest and largest nationally affiliated provider association representing skilled nursing, transitional, rehabilitative and long term care providers. Prior to joining HFAM DeMattos worked in the leadership of AARP in Hawai’i, in its national office in Washington DC., and in Maryland.

DeMattos holds Masters Degree in Government from Johns Hopkins University and is an Adjunct Professor of Leadership at the University of Maryland Baltimore County Erickson School for the Management of Aging Studies. He has over 30 years of professional experience in labor, government, the private sector, and in association management with a focus on health care policy. He can be reached at

Grow Where You Are Planted

Written by: Cyd Mason, LCSW Green House Guide
VA Illiana Health Care System


On a mid-summer afternoon Veteran Thomas M. Booher (Korean War) sat looking out the front window of Liberty House (one of VA Illiana Health Care System’s Green House homes) at the front yard.  As the Guide I visit the Green House homes with regularity and on this day I pulled up a chair and asked him what he thought about the landscaping.  To my surprise I learned that Mr. Booher had a Bachelor’s Degree in Botany from the University of Illinois at Urbana-Champaign.  He pointed out that there was one tree in particular that was “too close to the house.”  He said, “as that tree grows it will destroy the foundation of this house.  It’s a Burr Oak and they get very large.  You have to remember there’s more under the ground than what you can see.  Trees have an extensive root system and that’s why one day the foundation and the roof will be damaged.  You really need to remove it and plant something smaller near the house.”

Korean War Veteran, Thomas M. Booher, Botanist and resident of Liberty House (one of VA Illiana Health Care System’s Green House homes).

Veteran Thomas M. Booher’s expertise was shared with our Green House leadership and with our staff that maintains and cares for our landscaping.  Several weeks later the Burr tree was removed and transplanted in the backyard and two crab trees were added to the front of Liberty House.  Their small stature of twelve feet will not interfere with the house foundation or its roof.  We owe a big “Thank you” to Mr. Booher for making us aware of this potential future problem!

We talked about his career  in designing and building custom homes.  “Impressive,“ I  thought.  He said, “That’s the hardest way to make an easy living!”  He grinned ear to ear as he shared that with me.

Our conversation turned to his experience living in Liberty House.  He said, “It’s just absolutely great here and that goes along with the staff.  This couldn’t work without them (shahbazim).  I can’t say anymore than that – that and with one of our RNs who ‘can spin a tale!’”

We are fortunate to have Mr. Booher residing in Liberty House.  He enjoys sharing his knowledge of plant life, music and a good joke now and then.  In the past ten months of living in Liberty House I have seen Mr. Booher “open up” and “blossom” with his fellow Veterans around the dinner table and with the  shahbazim and one RN in particular.  We truly see the building of relationships in Liberty House.  Mr. Booher is one very fine example of why embracing the Green House model was the “right thing to do.”

PEAK Leadership Summit Will Converge Strategic Innovators

Wise Leadership is the Lifeblood of any Organization

To make real change in an organization, leaders must cast the vision for change and inspire others to join them on the journey. A culture change journey is one without a destination, and often has many twists and turns along the way and thought of implementing change in an organization can seem overwhelming.  The Green House® Project is a proven model and process that can provide the roadmap. The Green House Project is a national initiative to transform the lives of elders and those working closest to them

Research on this initiative shows that by changing the environment, philosophy and organizational design of skilled nursing care, a financially viable system is created where people living AND working in long term care are happier, healthier and feel a strong sense of purpose.

The LeadingAge PEAK Conference  in Washington, DC April 23-25, is a wonderful venue for organizational leaders to meet with The Green House team members, and learn more about how The Green House Project can amplify an organization’s mission through a comprehensive technical assistance package.  Please See Us at Booth # 702

Ask Dr. Bill: Flattened Hierarchy in Green House Homes

Flat is Good


Flat tires are bad. Flat cakes are bad. Flat organizations, can be, good. So, what makes an organization “flat?”

All human organizations have leaders and followers. One thing that defines a free society is that people can be a leader in one organization and a follower in another.  All of us are part-time leaders and part-time followers. Some organizations create an enormous distance between leaders and followers.  For example, the United States Army has a very steep and very large hierarchy that separates the lowest recruit from the highest general. An army private has very little chance of every becoming a general and generals never get busted down to private. The Army is the opposite of a “flat” organization.

 A steep hierarchy is good for things like fighting wars and flying to the moon but steep organizations are pretty cold and very impersonal. 

 Flat organizations have a much smaller distance between leaders and followers. These two groups are able to challenge each other’s ideas. Green House homes are meant to be Flat organizations because the Elders need for all of us to work together.  Everyone in The Green House home has ideas and insights and everyone can contribute to the conversation.

 How can we tell if a Green House home is losing its “flatness?”

 The main symptom is a decrease in problem-solving conversations and an increase in “problem-solving” by the leaders.  In The Green House, leaders are not supposed to solve problems. In The Green House, leaders are supposed to help others solve problems.

 The loss of “flatness” can become a big problem if people are not aware that it is happening.  So, here is my challenge for you: Have a conversation about the flatness of your Green House home because when it comes to warmth and compassion, “flat is good.”