Green House Blog

‘Politico’ Hails The Nursing Home of the Future

politico1In Rebooting The Nursing Home, Beth Baker shares the deep human stories that describe The Green House model and shaped her visit to Lebanon Valley Brethren Home.  These Green House homes are a part of a “growing movement to transform nursing homes from medicalized institutions to places that feel much more like home.”

Resident choice and autonomy, a homey environment, and well-trained and invested staff are hallmarks of the Green House and similar models that are slowly and fundamentally changing long-term care for Americans who otherwise could be forced into traditional nursing homes.

Lebanon Valley Brethren Home has experienced the model’s benefits from a business politico2perspective, as well.  CEO, Jeff Shireman shared that after the capital investment, operating costs have been comparable or even lower than their traditional nursing home.  This cost savings is directly correlated with the comprehensive paradigm shift of the model and fully leveraging the role of the versatile worker (known as a shahbaz), “What you must do as a leader is to support [the shahbazim] and empower them and hold them accountable,” says the Green House Project’s Senior Director, Susan Ryan. “That is where you’ll see the efficiency.”

politico3This article paints a warm picture of a day in the life of a Green House home, and the elements that make it a viable model that is changing the landscape of long term care.

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Experiencing success, Buckner brings The Green House model to new communities  

Dallas, Tx — June 4, 2015 – Buckner Retirement Living, a non-profit organization located in Texas, has a long history of working with The Green House Project, a not-for-profit that is part of Capital Impact’s Community Solutions Group, and is now entering into a new contract to build new  Green House homes in Texas.

Buckner is partnering with The Green House Project to add Green House homes to their new Continuing Care Retirement Community (CCRC) in Dallas, to help reposition their community in San Angelo and to expand their Beaumont CCRC to serve more elders with skilled care needs.

“We believe The Green House model is the best way to serve elders who need 24-hour nursing.” says Pat Crump, Vice President of Operations of Buckner Retirement Living “Our current Green House homes have been hugely successful, as evidenced by high family and resident satisfaction surveys, great clinical outcomes and extremely low staff turnover.”

The Green House model creates real homes for 10 to 12 elders, complete with private rooms and baths, home-cooked meals, and access to the outdoors.  And by providing elders with dignity, autonomy and choice, Green House homes provide people with the best quality of life possible.  The Green House model delivers better outcomes than traditional nursing homes, with potential to reduce hospitalizations and the cost of care.

For Crump, his past success was key in his decision to expand this model throughout his company, “We have benefitted from having  a proven model and the great support from The Green House team.   We strongly believe that providing elders a home as opposed to “warehousing” them in a nursing home is the right thing to do, and our customers agree.  The higher census we experience with this model equates to solid financial performance.”

Buckner Retirement Living is part of a larger effort nationwide to dramatically improve the way aging Americans receive long-term care. With the number of 85-year-olds in the U.S. increasing by 50 percent by 2030, a new approach for long-term care has never been more important.

“The financial and clinical success that Buckner Retirement has experienced provides strong validation for The Green House model,” said Scott Brown, Director of Outreach for The Green House Project.  “The lower turnover, higher census, and positive clinical outcomes meet the growing demand to provide high quality care at a lower cost.”

“We commend Buckner Retirement Living for their vision, as pioneers of The Green House movement, and their commitment to never build another traditional nursing home,” Mr. Brown continues,   “We are honored to partner with Pat and his team to transform long term care in Texas.”


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.


About Buckner Retirement Living: Since 1879, Buckner has served people in need across Texas.  Expanding to 8 communities, Buckner one of the largest not-for-profit senior living organizations in Texas dedicated to enhancing the quality of life for senior adults and their families by promoting an active, healthy Christian lifestyle while maintaining their independence and dignity.  Over the years, Buckner has continued to refine, renovate and update their settings, programs and services to meet the needs of each new generation of residents. But one thing hasn’t changed: their faith-filled commitment to providing them with a rewarding way to live and the highest quality of living.







Power Belongs with The Elder and Those Working Close to Them

New research from The Journal of Applied Gerontology showed that involving Nursing Assistants in decision making has a positive effect on quality of service. From my experience with person-centered care, I can tell you that the research rings true. The Nursing Assistant is the person who works closest with the Elder, day in and day out, and gets to know them best. These staff members know Elders as individuals, rather than just a diagnosis, and when they are empowered to make decisions based on this intimate knowledge, both Elders and staff benefit.

We do a role play exercise during Green House education where we act out a Care Plan meeting. In the first round, the Care Plan meeting is handled as it would be in a traditional setting, with only the clinical staff involved in the conversation. In the second round, we include the Nursing Assistant, Elder, Family Member and Housekeeper. The reaction to this exercise is always astonishment, as participants realize how much important information is missing when all stakeholders are not represented. As the research states, “When nursing staff had the autonomy to make decisions, there was a higher relationship to service quality. The empowerment of nursing assistants had an even greater effect than empowerment of nurses…”

In The Green House model, the power shifts to the Elder and those working closest to them. Power means having the resources and authority to make and execute a decision. This creates a deep-knowing environment where the Elder’s natural rhythm and preferences are honored. Quality is also impacted because of this familiarity. Staff members notice the small things about the Elder’s well-being, that can lead to early detection of illness and acuity changes. When staff members are empowered to meet the needs of the elder, they feel ownership and valued in their job and Elders feel safe and content, because they are known. Ask yourself, “What is best for the Elder?”, when this question is central, it is clear that those who know them well must be involved with decision making.