Green House Blog

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.

 

 

‘The Program of All-Inclusive Care for the Elderly’ and The Green House model: An Innovative and Cost-Effective Partnership for Comprehensive Care

Lori Gonzalez is a PhD researcher at the Claude Pepper Center of Florida State University who studies alternatives to traditional nursing care and social inequality.

The first Green House homes included in a Program of All-Inclusive Care for the Elderly (PACE) partnership will open in early February, joining together two of the nation’s most promising long-term care models.  The Harry and Jeannette Weinberg Green House homes, located in the Thome Rivertown Neighborhood in Detroit, Michigan will serve approximately 21 lower-income older adults who are otherwise able to live safely in the community, but who are currently residing in skilled nursing facilities.  According to Capital Impact Partners, serving these older adults in Green House homes with the support of PACE, compared to providing care in a traditional nursing facility, is expected to save the state’s Medicaid system about $130,000 per year.

PACE began in California in the 1970s as an alternative to institutional long-term care.  A group of Chinese, Italian, Filipino, and other immigrants held cultural views about caring for their loved ones that departed from the larger culture of aging in nursing homes.  They formed “On Lok” meaning peaceful, happy abode.   By 1986, On Lok developed the nation’s first comprehensive model of coordinated care and by 1997, the program became a permanent provider under Medicare and a state option under Medicaid.  Today, PACE operates 116 programs in 32 states and serves over 30,000 older adults, most of whom are dually eligible for Medicare and Medicaid.  PACE operates with the belief that, “it is better for the well-being of seniors with chronic care needs and their families to be served in the community whenever possible.”  With the assistance of the PACE program, 90% of participants who might otherwise enter a nursing home are able to live in the community.

PACE provides comprehensive care to those who are eligible for the program.  PACE eligibility includes being 55 or older, certified by the state to need a nursing home level of care, residing near a PACE care center, and having the ability to live safely in the community. When an individual enrolls in PACE, they (and their family) meet with a team of care professionals including social workers, nurses, primary care physicians, and nutritionists to help craft a plan to serve an elder in the community.  PACE participants visit a PACE care center routinely where they, depending on their plan of care, might receive a flu shot, dialysis, dental care, respite care, a hot meal, physical therapy, transportation, or participate in social activities.  Family members who visit the center receive counseling or advice on how to care for their loved one.

Green House homes also provide quality care and quality of life, but in a residential setting.  In Green House homes, “elders and others enjoy excellent quality of life and quality of care; where they, their families and the staff engage in meaningful relationships…” and when licensed as ALFs, they provide a community-residential setting for elders that is expected to exceed the quality provided by other ALF models.  Green House homes are not just homelike, they are places where elders call home.

The goals and values supported by PACE and The Green House model are similar and their partnership will honor elders’ preferences to avoid a nursing home and to live in the least restrictive care setting possible. Green House homes provide high quality residential living and PACE provides the physical health, mental health, social health, and family support for both acute care needs and long-term care needs.  Furthermore, PACE and Green House value the belief that all elders should have access to quality care and a good quality of life. PACE serves mostly dual eligible, frail elders and Green House homes are meant to be available to all, regardless of income or wealth.  The Green Houses at Rivertown Neighborhood, along with PACE will support these values by serving 21 low-income elders.

Aging in place is highly desired by older adults, but sometimes financially out of reach.  The Thome Rivertown model demonstrates that creating a Continuing Care Retirement Community for lower income individuals is possible and that when PACE and Green House are integrated into that community, high quality, cost-effective care is achievable.

Momentum Builds in 2016: Green House Homes Open Across the Country

home croppedMichigan can be a cold location in January for a Grand Opening of Green House homes, but it was certainly warm and welcoming on the inside!  These two homes were developed by Kalkaska Memorial Health Center.  415The festivities included a number of leaders from the area, along with Elders, families, staff and members of the press.  Lela, an elder moving into one of the homes attended the special Grand Opening event with special anticipation.  She had started the countdown to her move 191 days earlier and was most excited about her new home.

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This organization is not new to culture change having been an Eden certified home for 15 years, however the opening of the skilled nursing Green House homes takes their journey to a whole new level!  They opened the first home to 10 elders on January 14th and the second will open soon once the licensing process is completed.

 

Renee Cunningham, Service Line Director of Nursing, explained that the opening and move went smoothly and that the past two months have been great.  “It went really well, better than I had expected by our both the community and residents!  Staff feel very committed to the homes, and family members often stay and have meals with their loved ones.  It’s such a warm environment”.   Renee went on to say that Lela has expressed many times that moving to the Green House home “was the best decision she’s ever made”.  Renee explained that Lela has “blossomed” in the home.

Those thoughts are echoed by team member, Dana DeRousse, “The opening of the Dana DeRousse_cropped_shahbaz_KalkaskaGreen House homes have been a phenomenal and humbling experience for me.  It doesn’t feel like I’m coming to work, more so coming into a home of myfamilymembers.  Being a Concierge CNA [their Shahbaz] is the kind of health care experience I was looking for when I first became a CNA.  It also challenges me as a person to try new things, like cooking that I really had no prior experience with.  I would highly recommend a position in a Green House home to anyone who is working as a CNA and I feel like The Green House Project is the absolute future of long term care”.

We congratulate the team at Kalkaska on their opening and look forward to many more Green House Homes opening in 2016:

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Green House Cottages of Carmel, Carmel, IN

6 Green House homes

Spring 2016

 

 

john knox exterior construction

 

The Woodlands, John Knox Village, Pompano Beach, FL

12 Green House Homes

May 26th Grand Opening

 

 

Washington County

 

 

 

Washington County Nursing Home, Akron, CO

4 Green House homes

Summer 2016 opening

 

 

robison

 

Cedar Sinai Park, Portland, OR

4 Green House homes

Summer 2016 opening

 

 

 

Clark Lindsey March 2016

 

 

Clark Lindsey, Urbana, IL

2 Green House homes

Fall 2016

 

 

JGS lifecare

 

 

JGS Lifecare, Longmeadow, MA

2 Green House homes

Fall 2016

 

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Presbyterian Villages of Michigan,   Detroit, MI

2 Green House homes – 1st PACE program

Winter of 2016

Notes from The Green House Director: Achieving the Triple Aim of Long Term Care: Quality, Health, Affordability

Recently, I was honored to speak at the Michigan LANE (Local Area Network for Excellence) conference in East Lansing that was attended by close to 300 dedicated leaders of skilled nursing facilities.  It was there that I was reminded of the Centers for Medicare and Medicaid Services (CMS) Triple Aim –

1.) Improve the persons’ experience of care – both quality and satisfaction

2.) Improve the health of people and the community’s health

3.) Reduce the cost and wasteful spending

I feel confident that The Green House Model addresses all three of these goals.  And we have a significant amount of independent research to support this feeling.   Thanks to the support of The Robert Wood Johnson Foundation, The Weinberg Foundation and AARP, model is spreading and Green Houses nationwide have the outcomes that hit these marks and outpace traditional SNF’s.

After the LANE event, I stayed in Michigan and I saw an excellent example of how visionary leaders in Michigan collaborated in order to hit the CMS Triple Aim while helping to revitalize downtown Detroit.  I had the opportunity to tour the new Rivertown Neighborhood, an affordable senior community that will provide over 770 seniors access to desperately needed housing and supportive services.   The grand opening is April 12th.

Presbyterian Villages of Michigan (PVM), in collaboration with Henry Ford Health System and United Methodist Retirement Communities, have creatively adapted an old dilapidated pharmacy plant and expanded The Center for Senior Independence (CSI) program (nationally recognized as PACE).  Two Green Houses serving 20 – 24 elders will be an integral part of the Rivertown Neighborhood.

At the end of the tour, Roger Myers, the President and CEO of PVM, and his incredible team of partners, brought us into bottom floor of a cold, open space of a four-story brick building attached to the beautifully renovated building.   None of the floors were in the building so that you could look up to the ceiling that was 4 stories up.  This is where a huge vat of cough syrup used to brew and this is where the two Green Houses will sit on two floors above a café.

The Rivertown Neighborhood demonstrates how we can tackle complex social factors that effect elders’ heath and their well-being.   Over 200 employees (and Shahbazim) at Rivertown will address the social determinants of health, and the healthcare, of hundreds of the community’s seniors every day.  In so doing, they will give peace-of-mind to thousands of the elders’ family and friends.   Its’ an exciting project and am thrilled the Green House Project is a part of it.

 

 

Pennsylvania Planning Construction of "Real Homes" for Elders

After years of planning, Beaver County, Pennsylvania, is getting ready to build a new senior living community. Comprised of 4 houses with yards and sidewalks, the homes will be part of The Green House Project, a national model that creates caring homes for meaning lives.

The Ellwood City Ledger explains: [Lutheran SeniorLife spokeswoman Mary Lou] Harju said construction is expected to begin this spring on four houses. Each house will be 7,000 square feet and will house 10 residents. Each resident will have his or her own private bedroom and bathroom, and they will share a living room and dining room, she said. The development will look like a residential neighborhood with sidewalks and landscaping.

She said the residents have input in their daily living, such as planning meals. The staff won’t just walk into the homes, but will knock and be admitted by the residents, she said.

“Basically, it’s creating a community of individuals,” Harju said. “It is truly their home.”

As Americans age, they worry about finding a place to live happily and comfortably, that provides the care and services they need. Many nursing facilities can feel like hospitals instead of homes, but since 2002, the RWJF-funded Green House Project has pioneered a radically different approach to long-term care. Today, 264 homes are open or under development in 32 states. These Green House homes have been designed from the ground up to look and feel in every way like real homes. Research shows that elders are healthier and happier in Green House homes, which cost no more to operate than traditional nursing homes. We will keep you updated on the progress of this new Green House home community. To find a home in your area, please click here

To read the full article in the Elwood City Ledger, click here