California's First Green House® Homes Open, Ushering in New Kind of Nursing Care

Published On: May 28th, 2013By Categories: Blog

Leslie Lipsick, 415-901-0111,
Alyssa Singer, 415-901-0111,

California to make small-scale, dignified nursing care available at 10 more sites across the state by 2020

Claremont, Calif. — California today ushered in a new era of nursing home care with the opening of the state’s first certified Green House homes at Mt. San Antonio Gardens, a senior community in Southern California. The opening is expected to usher in a new wave of similar projects across California as legislation designed to encourage a small-home approach to skilled nursing home care takes effect.
A total of 20 residents will live at the Evergreen Villas in two residential neighborhood homes, designed by Ewing Architects, Inc., AIA, of Pasadena, each with private rooms and bathrooms with showers. Unlike traditional nursing homes, Green House homes are specifically built from the ground up to be real homes—in every way. Residents socialize in cozy living rooms and enjoy meals cooked in open kitchens, by the same people that care for them each day.
The Green House model’s unique approach to care, including a versatile staffing model, produces better clinical outcomes, such as fewer hospitalizations and falls, and less staff turnover. Research shows that the model’s small layout, combined with its intimate and innovative staffing ratios, provides elders with four times more personal and social contact than typical nursing homes.
“Residents living in skilled nursing facilities may have limited ability or need a considerable amount of care,” said Randy Stoll, CEO of Mt. San Antonio Gardens. “But they still want as much independence as possible. They want their dignity maintained and they want to be in a home, not an institution. We are extremely pleased that we can finally offer what they have deserved for so long.”
Many of the Gardens’ residents and staff have been waiting years for the homes to open, and have even personally pitched in to get them to this opening day. Over $1.3 million in private donations came from personal contributions by the community’s residents, board and management. Four of the community’s housekeeping staff even went back to school to get the additional training required by The Green House model so that they could join Evergreen Villas residents as care partners.
The opening of California’s first Green House homes marks a key milestone in The Green House Project’s larger effort to spread the model nationwide and dramatically improve the way all aging Americans receive skilled nursing home care. With support from the Robert Wood Johnson Foundation and oversight from NCB Capital Impact, The Green House Project has opened 146 homes in 24 states to date. Mt. San Antonio Gardens hopes to build more of the homes on their campus in the future.
With California’s number of seniors 85 and older expected to triple by 2030, the market for Green House homes and others like them is rapidly growing. Consumer demand for the kind and quality of care that The Green House model provides has long existed, but until recently, California’s regulatory and approval process had been unable to accommodate non-traditional models of care. It took almost seven years for the Evergreen Villas to gain the approval it needed from multiple local and state agencies. But future innovators will not face those obstacles, due to a bill inspired by the lessons learned along the path that Stoll and his team blazed.
Ten New California Projects to Embody Small-Home Approach
After years of collaboration among legislators, state and local agencies and aging advocates, in late 2012, Governor Brown signed into law Senate Bill 1228 (introduced by Sen. Elaine Alquist). The bill created The Small House Skilled Nursing Facilities Pilot Program, which will authorize the development and operation of 10 pilot projects to deliver skilled nursing care in smaller, residential settings. This summer, the program will begin accepting applications for providers interested in building pilot projects. The data the state is able to collect from the 10-project pilot program will help inform a deeper, more permanent commitment to policies that encourage long-term care innovation.
The pilot project also holds promise for addressing one of California’s most pressing health care crises: dementia care. California is home to one in 10 Americans living with dementia or Alzheimer’s and, by 2030, the number of residents living with those diseases will nearly double. A recent RAND study found that the nation spent $109 billion on dementia care, including nursing home care, in 2010. Key features of The Green House model, including its real home environment, consistent and deep staff relationships and advanced staff training, produce better dementia care outcomes—at no greater cost. One study of select skilled nursing Green House homes showed an 86 percent lower rate of depressive symptoms, 41 percent fewer incidents of elders’ behavior affecting others and 41 percent fewer rehospitalizations.
“It’s simple: We all heal better and are healthier and happier when we feel at home. The unique elements of The Green House model are vital to the clinical success of our elders living with dementia. We look forward to helping Californians tackle the rising costs, both human and financial, of dementia by spreading our high-quality, cutting-edge care across the state,” said David Farrell, The Green House Project’s senior director.
About The Green House Project: The Green House Project, which receives significant support from the Robert Wood Johnson Foundation, 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 blended roles. Green House homes meet all state and federal regulatory and reimbursement criteria for skilled-nursing facilities.
About Mt. San Antonio Gardens: Mt. San Antonio Gardens is a non-profit, nationally recognized Life Care senior community, set on a beautifully landscaped campus in the college towns of Claremont and Pomona, California. With a wide choice of residences for independent living and the comfort and convenience of outstanding assisted living and skilled nursing care on campus, the Gardens’ dynamic residents pursue their busy lifestyles and embrace new life-enriching experiences without the worry of home maintenance or future health care costs or needs.
About the Robert Wood Johnson Foundation: The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit