Green House Blog

Green House Featured on Panel at Ziegler CFO Workshop

Small House Nursing Homes is a trend that providers are recognizing as a solution to the growing workforce crisis, the pursuit of high quality at a lower cost and consumer demand.  Green House Senior Director, Susan Ryan, was invited to the Ziegler/LeadingAge 2018 CFO Workshop join a panel with Otterbein, and discuss, “Keys to Operating Successful Small House Models” .

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>>

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.

Reducing Readmissions and Healthcare Costs: The Green House Solution

In a recent issue of McKnight’s, I saw this headline – “Reducing readmissions should be No. 1 priority for reducing healthcare costs, quality experts say.”    That was a key conclusion of a recent online poll from 300 members of the American Society for Quality (ASQ) , which describes itself as the “largest network of quality resources and experts in the world” and includes prominent long-term care quality consultants.

It doesn’t take a quality expert to realize that reducing preventable readmissions is a great way to reduce healthcare costs.  By definition, “preventable” means wasted money.  In addition to saving money, reducing readmissions improves the quality of life for Elders, by minimizing the stress and disruption hospital admission causes.

Another article in McKnights from a couple of months ago suggests that pressure ulcer stats are the most reliable indicator of the likely readmission rate from a particular nursing home.  Based on an analysis of data from 4,000 hospitals, HSR: Health Services Research found that pressure ulcer prevalence in particular predicts whether a nursing home will readmit residents.

Can Green House homes help reduce readmissions?  The answer is a resounding “yes!”  In preliminary research (a complete study will be available later this year from the THRIVE research team), traditional nursing homes had readmission rates that were 7 points higher than Green House homes.  A related study found that the incidence of pressure ulcers in Green House homes was “significantly lower” than the incidence in traditional homes.

The bottom line?  The THRIVE research team concluded that the “overall difference in total Medicare and Medicaid costs per resident over 12 months (sum of hospitalization and daily care costs (RUG costs)) ranged from approximately $1,300 to $2,300 less for residents in Green House vs. traditional nursing homes” depending on RUG rates in the state.

AARP Foundation and Weinberg Foundation Invest to Extend Green House Model to Low-Income Seniors

New collaborations build on the Robert Wood Johnson Foundation’s $10 million
program-related investment in THE GREEN HOUSE® Project

FOR IMMEDIATE RELEASE
July 11, 2013

CONTACT:
Leslie Lipsick, 415-901-0111, llipsick@fenton.com
Christine Clayton, 609-627-5937, media@rwjf.org

Princeton, NJ — The Robert Wood Johnson Foundation’s (RWJF) efforts to bring high-quality skilled nursing care to low-income seniors got a boost recently as both AARP Foundation and The Harry and Jeanette Weinberg Foundation announced new investments in The Green House Project. The new commitments bolster the national loan fund for Green House homes that RWJF helped to establish in 2011 with a 10-year, $10 million low-interest credit facility.

AARP Foundation unveiled a new $2.5 million program-related investment (PRI) in innovative housing options for the vulnerable, 50+ population, including The Green House Project. The Weinberg Foundation simultaneously agreed to formalize and grow its existing grant program for skilled nursing facilities that both adopt The Green House model and serve low-income populations. The Weinberg Foundation has committed to a minimum of $8 million in capital grants for Green House residences this fiscal year alone.

Though the three foundations’ investments differ in their details, they share the common goal of bringing a higher and more personalized standard of care to aging Americans in every community. The three also share a joint belief that innovative financing is a vital tool for giving lower-income communities the capital required to develop truly excellent, affordable long-term care options.

Unlike traditional nursing homes that have a more institutional feel, Green House homes are designed from the ground up to look and feel like a real home. In an effort to provide more personalized and dignified care, only six to 12 elders live in each home, and every resident has the comfort of a private room and bathroom, along with the freedom to set his or her own daily routine. Even the care in a Green House home is different, with a small team of trained universal caregivers meeting the majority of needs of the residents. Research shows that a Green House home’s intimate layout, combined with its innovative staffing model, provides residents with four times more personal and social contact than typical nursing homes.

“The Green House Project delivers on a bold vision of better, more dignified care for elders that is spreading widely in communities across the country,” said Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation. “We are thrilled to have the AARP and Weinberg Foundations join us in investing to spread the impact of this powerful model to all seniors, regardless of income.”

AARP Foundation: Leveraging Investment Instruments to Drive 50+ Housing Innovation

With the use of program-related investments, AARP Foundation aims to create new models of housing that are scalable and replicable, and to increase the sheer number of affordable and adequate housing units available for low-income Americans over 50. With at least 13 million Americans in low-income, 50+ households struggling to find affordable and/or adequate housing, AARP Foundation identified housing as an area ripe for impact investing.

In addition to funding the replication of The Green House model, led by NCB Capital Impact, the $2.5 million investment will also support Enterprise Community Loan Fund, Inc. and ROC USA. The former will use the investment to help finance the creation of affordable rental and rural housing for low-income seniors. The latter will use it to empower owners of mobile homes, a vulnerable and aging group, to cooperatively purchase the land on which their homes are located.

“All of these projects aim to build, retrofit, or purchase safe and affordable housing that not only helps older residents avoid high housing cost burdens, but also addresses their need for community—either by helping them age in place or create a new community based on a non-institutional model,” said AARP Foundation President Jo Ann Jenkins.

Weinberg Foundation: Expanding on an Early Investment in Culture Change

During the last five years, the Weinberg Foundation has made six capital grants for Green House homes, totaling just over $5.5 million, including some of the most innovative adoptions of the model. During that time, the Weinberg Foundation has seen demand for small home nursing models like Green House soar. At the same time, millions of vulnerable older adults have been unable to access the quality, skilled care they need—whether due to limited incomes, high costs of care, or isolation.

To fulfill its vision that every older adult has the opportunity to lead a life of dignity and independence, no matter their ability or income, the Weinberg Foundation has agreed to formalize and expand its Green House development grants program, committing to a minimum of $8 million in capital grants for these residences in the 2014 fiscal year. Among other requirements, applying providers must serve at least 60 percent Medicaid-eligible individuals, with 70 percent preferred, and be open to people of all beliefs.

“All older adults deserve the chance to lead meaningful, engaged lives and to maintain their independence for as long as possible,” said Donn Weinberg, Weinberg Foundation trustee and executive vice president. “Through the combined total of more than $13 million in capital grants already made or planned, the Weinberg Foundation hopes to extend the Green House and other culture-change models to more of our most vulnerable older adults so that they can continue to live robust, healthy lives.”

Robert Wood Johnson Foundation: Increasing the Impact of a Long-Time Investment

Since 2002, the Robert Wood Johnson Foundation has awarded $20 million, primarily to NCB Capital Impact, to develop, test, and evaluate The Green House model. In 2011, the Foundation made a new $10 million program investment to build on its existing support of Green House, with the goal of helping the model achieve greater reach and impact than its current presence (146 homes across 24 states).

Specifically, the PRI lowers the cost of financing Green House projects that serve low-income individuals and low-income areas. NCB Capital Impact serves as administrator for the loan fund and seeks investors to leverage RWJF funding in any one project by a ratio of 4-to-1. The investment was part of RWJF’s larger $100 million “impact capital” commitment designed to help the Foundation and its grantees leverage funding from multiple sources and spread innovative solutions that improve health and health care for all Americans.

About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable, and timely change. For 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Follow the Foundation on Twitter www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.

About The Harry and Jeanette Weinberg Foundation
The Harry and Jeanette Weinberg Foundation, one of the largest private charitable foundations in the United States, provides approximately $100 million in annual grants to nonprofits that provide direct services to low-income and vulnerable individuals and families, primarily in the U.S. and Israel. Grants are focused on meeting basic needs and enhancing an individual’s ability to meet those needs, with emphasis on older adults, the Jewish community, and our hometown communities including Maryland, northeastern Pennsylvania, Hawaii, Israel, and the Former Soviet Union. For more information, please go to www.hjweinbergfoundation.org.

About AARP Foundation
AARP Foundation is working to win back opportunity for struggling Americans 50+ by being a force for change on the most serious issues they face today: housing, hunger, income and isolation. By coordinating responses to these issues on all four fronts at once, and supporting them with vigorous legal advocacy, the Foundation serves the unique needs of those 50+ while working with local organizations nationwide to reach more people, strengthen communities, work more efficiently and make resources go further. AARP Foundation is AARP’s affiliated charity. Learn more at www.aarpfoundation.org.

About NCB Capital Impact
NCB Capital Impact helps people and communities reach their highest potential at every stage of life. As a Congressionally chartered, District of Columbia, non-profit community development finance institution, Capital Impact provides financial services and technical assistance nationwide to help make high-quality health care, healthy foods, housing, and education more accessible and attainable, and eldercare more dignified and respectful. Capital Impact has used its depth of experience, cooperative approach, and diverse network of alliances to generate over $1.825 billion in critical investments that create a high quality of life for low income people and communities. www.ncbcapitalimpact.org

About The Green House Project
The Green House Project is a radically new, national model for skilled-nursing care that returns control, dignity and a sense of well-being to elders, their families and direct care staff. In the Green House model, residents receive care in small, self-contained homes organized to deliver individualized care, meaningful relationships and better direct care jobs through a self-managed team of direct care staff working in cross-trained roles. Green House homes meet all state and federal regulatory and reimbursement criteria for skilled nursing facilities. http://thegreenhouseproject.org/
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Supporting a White House Conference on Aging for 2015

This month, in celebration of the 50th Anniversary of Older Americans Month, THE GREEN HOUSE® Project participated in the Healthy Aging Forum put on by the U.S. Senate Special Committee on Aging.  We were joined by congressional representatives, leaders in the aging field and elder advocates, all of whom demonstrated their passion and dedication to serving older adults by discussing policy frameworks and strategies that result in robust aging services for all.

We must not lose the momentum gained from this event! A national discussion on relevant aging issues, policy strategies and effective care delivery is necessary. Recently, in an article from the National Academy of Social Insurance, Anne Montgomery provides a call to action in order to gain support for a proposed White House Conference on Aging (WHCOA) for 2015. Included in her article is a Letter to the President, signed by 40+ organizations, which explains that now is a critical time for such a conference since, “…By 2015, twelve million baby boomers will have already turned 65 with sixty-six million more to follow.” If the proposal were to be supported, this would be “…the sixth White House Conference in history and the second of the 21st century.”

In order to ensure that core values such as meaningful life, real home, and empowered staff are a non-negotiable part of long-term services and supports, we need to participate in events like the Healthy Aging Forum and the proposed White House Conference on Aging.  

Join us in Unleashing the Power of Age for Older Americans Month by reading the article in support of the 2015 WHCOA and by telling friends and colleagues why we need this national forum.