Green House Blog

The Green House Project Meeting 'State of the State'

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Lela Holmes, The Cottages at St. Martin's in the Pines

One of several big announcements from the first day of The Green House Project fourth annual meeting and celebration in Birmingham, Ala., is the upcoming publication this September of a major report on the financial and clinical outcomes from the Green House model.

In a presentation on the “State of the State of the Green House Project,” the organization’s director, Robert Jenkens, said the cumulative research answers the three major questions that always come up when people first hear about The Green House model:

  • Do the elders family and staff really like the Green House better?
  • If it’s really home, can the clinical care really be as good?
  • If it really is better, doesn’t it have to cost more?

The report analyses the findings of five major studies and is due out this month in NIC’s Seniors Housing and Care Journal, the leading journal reporting on the business and finance of long term care. It concludes that the Green House model operating costs are equal to or lower than traditional nursing homes and it produces better clinical outcomes and satisfaction. In addition, initial development costs of starting a Green House Project are at the low end of comparable culture change models and significant revenue increases are generated through higher occupancy rates and private pay days.

“This validates that in practice the model holds true to founder Dr. Bill Thomas’ theory and vision,” said Jenkens. “‘Yes’, satisfaction is higher in the Green House model; ‘Yes,’ clinical care is as good or better. And ‘yes,’ the Green House model provides better care and satisfaction without increasing operating costs.”

The studies report the average cost range per resident day in a Green House home is the same as in a traditional nursing home — $150-250. But the biggest finding is that Green House provides on average 28 minutes more direct care and four times more meaningful engagement than institutional models of care — all without increasing overall staff time.

Several Green House model adopters attending the conference can attest to these findings. Like many adopters, conference host St. Martins in the Pines in Birmingham also operates a traditional, large-scale nursing home and can directly compare financial and satisfaction outcomes with its Green House Cottages.

“We closely monitor the cost between our Green House homes and the legacy nursing home and what we hoped would happen has happened,” St. Martins President Terry Rogers said. “There is no additional cost in operating a Green House. But more important we are generating much higher satisfaction results across the board.”

The elders report much higher satisfaction in their living environment and their families are much more satisfied in their loved one’s care, Rogers said. St. Martin’s also reports dramatic reductions in staff turnover, which research has found to be a major benefit in the Green House model. Turnover in frontline staff in the St. Martin’s Green Houses is less than 10 percent. In their legacy traditional facility current turnover is 70 percent but has been as high as 100 percent turnover in a year, Rogers said.

High turnover is costly to employers — some estimates place cost at $5,000 per employee — and strongly correlates with low job satisfaction. Higher job retention can translate to more consistent and better care, which again translates to better elder satisfaction.

Better elder satisfaction can impact the bottom line in higher bed occupancy and private pay occupancy. The Green House model reports 95 percent or higher occupancy rates compared to 88 percent industry-wide with much of that increase in private pay days. In a 100-bed facility, these two impacts translate into an additional $529,980 in revenue each year.

Inside and outside the long term care industry these findings are turning heads, Jenkens said.

“It’s been very exciting in the past year to see in outpouring of interest from organizations all around the country who want to begin the financial analysis and exploration to launch a Green House Project home,” he said.


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