Why Nursing Homes Need A Total Redesign

Categories: In The News, National Media Items

“The kind of long-term institutional environment to which we relegate our most chronically ill elders is a model that we have almost entirely eliminated for persons with mental illness and developmental disabilities and for children in foster care, but we continue to tolerate it for older persons.

Small, household models of skilled nursing care are not new, but they have been largely overlooked until the COVID-19 pandemic, during which they fared far better than traditional nursing homes. At the same time, a growing body of research shows a multitude of quality advantages over traditional nursing homes.”

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  • “A small but growing group of nursing homes are already implementing these changes. Collectively called ‘household models,’ these nursing homes have generated enthusiasm among diverse stakeholders and long-term care experts. Because of its scale and consistency across homes, the Green House approach has been the most frequently studied household model.”

  • “Alternatives to traditional nursing homes for older adults who cannot remain in their own homes has prompted interest in smaller, community-style facilities such as the Green House model. Staff are used more flexibly in the Green House model, and work with small clusters of residents; the model’s success, especially during the COVID-19 pandemic, has attracted interest as an alternative to traditional nursing homes.

  • “The Center for Innovation and its Green House Project is promoting government incentives that support construction of modern, person-directed facilities through targeted grants or Medicaid rate increases. Providers in Arkansas and soon Ohio, for instance, receive Medicaid rate add-ons for private room nursing care.”

  • “Some suggestions included increasing state investment in home care, incentivizing a transition toward fewer-occupant rooms and Green House-style facilities, standardizing the Medicaid reimbursement system with data-based adjustments over time, increasing audits and financial transparency requirements for nursing homes, and building workforce pipelines into the sector through scholarships and more flexible training programs.”