Facilities could improve their ventilation systems. They could abandon “semiprivate” rooms for private ones. Dividing buildings into smaller units with consistently assigned staff — an approach pioneered by the Green House Project — would both bolster relationships and reduce residents’ exposure to infection from workers coming and going.

AARP Iowa state director Brad Anderson: "Another approach would be investing in Green House homes, which are small skilled nursing homes and assisted living facilities with private rooms, kitchens, and living rooms that look and feel like a home. These homes provide better care with lower staff turnover and are popping up in states across the country. Let’s start trying this model in Iowa."

"CEO Susan Ryan highlighted the advantages of small-home alternatives, particularly underscored by the COVID-19 pandemic, which demonstrated their resilience compared to traditional eldercare settings. She expressed her delight in collaborating with partners from around the world to share their knowledge and build the next generation of eldercare services and support."

"In May 2023, Susan presented at the ARIIA conference Facing The Future: Aged Care 2030 and Beyond #ariiaconference2023, in Adelaide, South Australia. She spoke with Re Aged Care about the Green House Project and its commencement in Australia."

“Our Best Life approach comprehensively and holistically looks at who the person is and [asks] how do we really ensure each person is living his or her best life? It’s really about seeing the person,” Ms. Ryan explained.  “As it pertains to somebody living with dementia, how many times do we just focus on loss and decline and say they can’t do that anymore? We have labels and we see the label before we see the person. “I challenge you to see who that person is. We’re going to shift beliefs.”

"Founded in Rochester in 1997 by a group of forward thinkers, the Pioneer Network has since evolved through a partnership with The Green House Project (GHP) into the Center for Innovation. The new alliance focuses on supporting eldercare reform initiatives and educating and advising eldercare organizations that seek to initiate changes to the cultural, organizational, and physical structures of the traditional nursing home."

"There is an increasing urgency and growing expectation for change in Australia – driven by residents, customers, workers, and regulators alike – to move to a model of care where the priority is the older person’s preferences and staff skills are developed and nurtured. The Green House Project delivers this."

ACH Group will be the first aged care provider in Australia to implement the U.S.-founded Green House Project (GHP) model of care, which promotes the autonomy and individuality of residents and staff. Informed by person-directed care principles, GHP maximizes the independence of residents, empowers staff, and enhances the benefits of the highly regarded small household design that Healthia has adopted.

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.

Private rooms alone won’t remedy nursing home system’s shortcomings. “The Green House model is a lot more than just the building,” says Alex Spanko. “It’s about the culture, too.”