Green House Blog

The Robert Wood Johnson Foundation Awards Third Major Grant to THE GREEN HOUSE® Project

On November 1, 2013, the Robert Wood Johnson Foundation announced a third, three-year grant to NCB Capital Impact to fund The Green House Project.  This $2.75 million grant is designed to build on the successes of the first and second grants’ activities and those of our pioneering provider partners. Thirty-five organizations have already adopted the evidence-based Green House model and built 153 homes across the country.  The new grant will aim to significantly expand those adoption numbers, with the goal of making Green House homes an affordable long-term care option in every community.

In a recently published collection of testimonials about The Green House Project for our 10th anniversary, Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, said, “Ten years ago, the idea that we could redesign nursing homes to create the experience of living in a real home was radical.  Today, The Green House model is the benchmark of quality and patient satisfaction for affordable, community-based skilled care nationwide.  As a catalyst for change in long-term care, The Green House Project inspires us to support a culture of health and well-being for older adults across the nation.”

The previous two grants from the Robert Wood Johnson Foundation have resulted in huge strides forward in replicating The Green House model.  The second grant catalyzed the spread of the model across the United States fueled by the excellent regulatory, clinical and quality of life outcomes achieved by the early adopters. Terry Simonette, president and CEO of NCB Capital Impact, which serves as the national replication and technical assistance center for the initiative said, “[The Green House Project] demonstrates that it is possible to provide the best care to the people who need it most, at the same cost as a traditional nursing home.”

This new grant will enable NCB Capital Impact and the Green House team to spread the model nationwide, expand financing opportunities for new projects, spread policy gains across states, pilot the model with new populations, and continue to strengthen the Green House brand nationally.  “The signal achievement of the Green House is it shows the world that the institutional model of care is obsolete,” said Green House Founder Dr. Bill Thomas.

Please contact The Green House Project with any questions at 703-647-2311 or


The Idea that Spurred the Movement: 10 Years of The Green House Project

It is hard to believe that it has only been 10 years since the first Green House homes opened in Tupelo, MS. It all began when Green House founder,  Dr. Bill Thomas, had a radical idea that people should age in real homes, rather than institutions.  The Robert Wood Johnson Foundation agreed, and this model has served as a catalyst for significant social change.  To date, 1579 elders, veterans and people with disabilities live as full and meaningful lives in Green House homes, and gaining momentum to bring this model to a community near you.

Be sure to watch the below video to see the impact that this model made on long term care, and what the future holds.

Visit the Support the Movement Page on our website to learn how you can bring America home.

Provider Magazine Highlights Flexible Funding for Green House homes

Provider Magazine tracks the pulse of the industry and serves as the leading source of business and clinical news for long term and post-acute care professionals.  Long term care providers know that the demands of the consumer are changing.  So why do many nursing homes still look the same way they did 20 years ago?  One barrier to transformation may be in the ability to find, “low-cost, flexible financing sources”.  New financing programs are being created to remove this barrier, and to support Green House home development.

In 2011, the Robert Wood Johnson Foundation (RWJF), the nation’s leading health foundation, made a $10 million Program-Related Investment (PRI) in NCB Capital Impact and The Green House Project to make it easier for more providers to obtain flexible financing and build Green House homes.  In making this investment, the foundation saw a unique potential for The Green House model to address the nation’s growing shortage of affordable, high-quality long term care options for low-income elders.
As an initiative of NCB Capital Impact, The Green House Project has also been able to leverage the financial expertise of this group, “Because NCB Capital Impact is enlisting additional investors—like the Harry and Jeanette Weinberg Foundation and AARP Foundation—to leverage RWJF funding in any individual project by a ratio of four to one, the total financing opportunity is actually substantially larger than the foundation’s initial investment.”  These resources are creating opportunities for long term care providers to meet the demand of their customer for small, real home environments.
The Green House model has a proven track record for delivering high quality care at roughly the same cost as a traditional nursing home.  Additionally, consumer research found that caregivers would be willing to drive further and pay more to have this type of home as an option for their loved one.
Because the RWJF and NCB Capital Impact loan pool needs to be entirely distributed by 2014, interested providers should begin exploring the option as soon as possible. To find out more about tapping into RWJF and NCB Capital Impact financing for Green House projects, contact Maura Porcelli at (703) 647-2311 or

THE GREEN HOUSE® Project in New York Press Article

Last week, the New York Press published an article  about the Health Policy Symposium recently hosted by Jewish Home Lifecare and the Himan Brown Charitable Trust in New York City. During the symposium, speakers discussed the needs of a rapidly aging population and the simultaneous decline in the health care workforce. One panelist, Dr. Ezekiel Emanual, a former special advisor to the White House, spoke to the importance of affordable and quality health care for aging adults.

Another panelist, Jane Lowe, Senior Advisor for Program Development at the Robert Wood Johnson Foundation, championed the Green House homes as “…better models for people to age with grace and dignity.” Ms. Lowe also showed her support for the Village model as another important new model of care for an aging population.

The New York Press article describes the Green House Project as a model that “…provides the support of a nursing home while still allowing its residents the autonomy, warmth, and respect of a traditional house or apartment.” The conclusion of the article is a description of Jewish Home Lifecare’s plan to develop Green House homes on a city scale at the Living Center of Manhattan. These will be the first Green House homes in New York City.

Currently, there are 146 Green House homes in 24 states, serving 1,539 elders. There are 123 homes in development.  Click here to find a Green House home near you!

The Wall Street Journal Investigates: How Does Dementia Impact Health-Care Spending?

Researchers from the Rand Corporation recently published a study that found medical costs of treating dementia totaled $109 billion in 2010. This is more than was spent on heart disease or cancer! What can be done now to slow increases in expenses and improve care? The Wall Street Journal Real Time Economics Blog highlights the financial impact of The Green House model:          

RWJ and a nonprofit, NCB Capital Impact, have also funded the Green House Project. Each Green House accommodates 10 to 12 seniors with medical help provided by certified nursing assistants.

David Farrell, The Green House Project director, says the small homes allow for less administrative costs and allows residents to remain ambulatory, even with a walker, rather than depending on wheelchairs.

Plus, the nursing staff develop a closer relationship with a small number of [Elders]. “The [CNAs] can pick up on subtle changes in the elderly,” which leads to preemptive care rather than medical emergencies, Mr. Farrell says. 

In a Green House home more money is spent on care and less on administration.  The Elder to staff ratio makes for better care and less hospitalization of Elders.  To learn more, read about The Green House Project’s cost saving summary.  Read the full Wall Street Journal article here or learn more about The Green House model.

Fast Company, The Green House Project Brings Back Dignity to Aging

Fast Company, is a magazine focused on highlighting the most creative individuals sparking change in the marketplace. By uncovering best and “next” practices, the magazine helps a new breed of leader to work smarter and more effectively. Recently, they  published a piece about The Green House Project.  The article interviews, Jane Lowe, the senior advisor for this program with The Robert Wood Johnson Foundation, and she gives her ultimate endorsement, “”If I am frail and old and need nursing home care, I would be quite comfortable going to a Green House home. I would definitely not say that about going to traditional nursing home.”

The article, complete with beautiful photos of Green House homes, and a short video, highlights the fact that this model is creating real home, whether that is in a rural setting, an urban high rise, or the Veteran’s administration.  By putting the elder at the center of the organizational chart, it is clear that the goal is to deeply know the elder, and to help them live their best life, “Nursing homes are hierarchical, and patient’s needs are at the bottom of the chain. Bill [Thomas] had an idea that you could create these homes that could provide complete care for the elders in a more high-quality way and a way that really supported their lives,” explains Dr. Jane Isaacs Lowe, a senior adviser for program development at the Robert Wood Johnson Foundation. “We were all intrigued, because if you could build these Green House homes so they could be embedded in communities then this would make nursing homes more of a home and community-based service, because in theory someone could move from home to Green House home and still be in that community.”

As The Green House Project celebrates 10 years since the first Green House home opened in Tupelo, MS, the initive looks to the future, and how this model will create a viable and sustainable option for long term care.  Explore for more information about The Business Case of The Green House model, and to find a Green House project near you! 



Is There a Recipe for Culture Change?

Is there a recipe for culture change? The Green House ‘recipe’ for culture change uses many ingredients. These include specific environmental features, like an open kitchen and private bathrooms, and also re-conceptualized staff (or Shahbazim) roles. Other nursing homes that have embraced culture change have a different recipe. Some, for example, have retrofitted, remodeled households, while others have more traditional environments; some utilize universal workers, but others do not. If culture change can appear unique on so many levels, what is it about the philosophy that really makes a difference? Are there any key ingredients for culture change? To better understand these questions, the THRIVE research team surveyed culture change adopters to learn more about their practices and environments.
What do most adopters report? These adopters most often reported certain relationship-based practices such as the use of staff consistent assignment or family member participation in care conferences. They also reported similar components of work organization and decentralized decision-making such as non-activity staff helping to choose activities and the ability of staff to fulfill requests without prior approval from an administrator. Adopters also reported similar mixtures of ingredients to enhance resident choice including dining in the small house or household to support choice in mealtime.
Are there differences in the culture change components that adopters report? Yes. There were distinct differences in the recipes of small houses, households and more traditional environments.  For example, small house models were more likely to report that direct care staff schedule themselves and choose care assignments, but these were some of the least adopted practices for other adopters. Small houses are also more likely to have CNAs attend care conferences and less likely to use overhead pagers or med carts than other adopters. Meal preparation varied for all three models. For example, small houses were more likely to prepare food in a kitchen in the home while households were more likely to use steam tables with food prepared in a centralized kitchen.
The THRIVE research team is in the process of studying the survey results to better describe the recipes of culture change adopters. As pay-for-performance and policy programs are developed to incentivize culture change, understanding the core ingredients in implementation can promote a recipe for change that is attainable for a broad range of providers.
The Green House Project has partnered with the Robert Wood Johnson Foundation’s
THRIVE (The Research Initiative Valuing Eldercare) collaborative to learn more about the Green House model as well as other models of care. Supported by the Robert Wood
Johnson Foundation, the THRIVE team is conducting a series of interrelated research projects that together will comprise the largest research effort undertaken to date in Green House homes.  Each month, a member of the THRIVE team will contribute a blog post to the Green House Project website.

Questions about THRIVE can be directed to Lauren Cohen ( or 919-843-8874).

The Green House Project included in Social Impact Exchange Index of High Impact Non-Profits

New national index, comparable to the S&P 500, has the potential to transform charitable giving

NEW YORK, November 15, 2012 — Today, the Social Impact Exchange launched the Social Impact 100 (S&I 100) (, the first-ever, broad index of U.S. nonprofits with proof of results and a high potential to reach even more people. Modeled on aspects of the S&P 500, the S&I 100 aggregates top-performing, evidence-based nonprofits so that funders – donors and foundations – can have confidence that they are contributing to organizations that consistently deliver impact.

The S&I 100 tracks the number of people served across the portfolio of these top nonprofits the same way the S&P 500 tracks the profitability of America’s large-cap companies. Donors are able to give directly to nonprofits in the S&I 100.

“Right now, donors have no easy way of knowing which nonprofits are truly effective at helping people in need, which means that fewer charitable dollars are going to those programs that can do the most good,” said Alex Rossides, president of the Social Impact Exchange. “The S&I 100 changes that. By taking the guesswork out of giving, the S&I 100 has the potential to transform individual philanthropy the same way the S&P 500 changed investing for individual investors.”

The S&I 100 is the most comprehensive donation platform of only evidence-based, growing nonprofits available to donors. Donors can choose from 100 high-impact nonprofits and nearly 16,000 local affiliates that are implementing their solutions. The Index features models that address the country’s most pressing issues across education, health, youth and poverty. The 100 nonprofits are rigorously screened for evidence of impact through third-party verified studies – made available to donors on the website – and are only included in the Index if they have the ability to serve more people in need. When donors visit the site, they are able to search for high performing nonprofits in the issue areas and locations that they care about most. Once they select a nonprofit, the S&I 100 allows donors to give directly to the organization in a few quick and easy steps. The number of organizations on the S&I 100 will grow as the Social Impact Exchange continues to reach out and identify additional nonprofits that meet the S&I 100’s criteria.

According to a Money for Good survey, nine out of 10 donors say nonprofit performance is important. Until now, funders have not had an easy way of knowing if their dollars are doing the most good. Of the over 1.5 million nonprofit organizations in the country, there is a dearth of rigorous information donors can trust to tell them which are the highest performers and are growing their impact.

The S&I 100 was designed and implemented through a broad, sector-wide collaboration of evaluation firms, ratings firms and other leaders. Financial institutions, funder groups and other leading organizations are helping to share the Index with donors. The Social Impact Exchange will continue to collaborate with leading organizations and experts across the field to expand and improve the Index, and to help make the platform more accessible to donors. The aim is that as donors give to a variety of worthy causes, the S&I 100 will make it easier for them to contribute to nonprofits that they are both passionate about and that have evidence of impact.

Major foundations, the Robert Wood Johnson Foundation, the William and Flora Hewlett Foundation, and others are supporting the Social Impact Exchange. The Social Impact Exchange is also working with donor advised funds, such as Schwab Charitable, to offer the S&I 100 to their philanthropic clients.

To find out more about the S&I 100, please visit:

About the Social Impact Exchange
The Social Impact Exchange is a national membership association dedicated to building a capital marketplace that scales high-impact social solutions to improve the lives of millions. The Exchange creates the conditions for breakthroughs to go big in order to deliver impact where it is needed most. Together, Exchange members are making it easier for philanthropic giving to achieve major positive change by supporting strategies that improve lives and change systems. By creating standards to evaluate impact, identifying and tracking highly effective nonprofits, and fostering significant collaborative funding to scale up top social interventions, the Exchange helps foundations, donors, business, and government increase the power of giving to achieve greater social good. To learn more, visit

Green House projects for Veteran's highlighted in GrantWatch Blog

In honor of Veteran’s Day, the Health Affairs GrantWatch Blog is highlighting those foundations that have supported programs to make life better for our nation’s heros. They pay tribute to the Robert Wood Johnson Foundation Funded Green House Project’s work with The U.S. Department ofVeteran’s Affairs.

“The U.S. Department of Veterans Affairs (VA) and the U.S. Department of Defense are moving toward revolutionizing delivery of skilled-nursing care for aging veterans in three locations this autumn. How? The VA is offering vets the opportunity to live in a Green House home”

To read more about these astounding project that are creating meaningful lives for veterans, click here:

Green House homes are crucial to California’s Aging Services

The Green House Project has been working hard to support Mount San Antonio Gardens (MSAG) open the first Green House homes in California. As part of our work to be sure that MSAG’s and Green House adopter’s enjoy broad support in the state, the GHP team worked with The Robert Wood Johnson Foundation (RWJF) and their skilled communication team to get the word out about why Green House homes are crucial to California’s aging services in an opinion piece written by RWJF’s CEO and President – Risa Lavizzo-Mourey:

Add a comment if you have time!

Green House homes are crucial to California's Aging Services

The Green House Project has been working hard to support Mount San Antonio Gardens (MSAG) open the first Green House homes in California. As part of our work to be sure that MSAG’s and Green House adopter’s enjoy broad support in the state, the GHP team worked with The Robert Wood Johnson Foundation (RWJF) and their skilled communication team to get the word out about why Green House homes are crucial to California’s aging services in an opinion piece written by RWJF’s CEO and President – Risa Lavizzo-Mourey:

Add a comment if you have time!

The Green House Project Highlighted in Forbes Magazine

Risa Lavizzo-Mourey was interviewed about Robert Wood Johnson Foundation’s recent $100M “impact capital” commitment, in the most recent edition of Forbes Magazine. This commitment is meant to signal to the market that health is the next frontier of impact investing.

In this interview, Dr. Lavizzo-Mourey highlighted The Green House Project as, “a powerful example of the kind of disruptive innovation we are interested in promoting through our impact capital commitment. Green House has the potential to transform the field of skilled-nursing care.”

The Green House Project, in partnership with NCB Capital Impact, have been awarded $10M through this “impact capital” program:

Our goal is to triple the number of Green House homes nationwide in the next three years. In order to meet that goal, the financing has to be there. That is why the first investment from our impact capital commitment is a $10 million low-interest credit facility to help finance new Green House projects specifically aimed at low-income seniors. Our partner, NCB Capital Impact, a national, non-profit community development finance institution, will leverage funding from other sources. Some experts anticipate our NCB funding to attract as much as five times more in additional investor funds for Green House homes.

Together with valuable partners like The Robert Wood Johnson Foundation and NCB Capital Impact, The Green House Project is in the business of social change. As Risa Lavizzo-Mourey puts it, “We wake up every day asking ourselves what we can do to make that change better, faster and to scale. This is our bottom line: The ways we give should and will evolve to enable us to achieve greater impact to improve the health and health care of all Americans.”

Click Here to read the full article in Forbes Magazine