Evidence-based culture change partners provide professionals with supportive, interdisciplinary training.  “We need as many Green Houses as possible and households or buildings to be built with wise investment of public and private dollars,” Anne Montgomery said. “The EINSTEIN Option calls for this to happen and lays out a blueprint for it.”

“If we’re going to elevate the resident’s voice, we’ve got to include residents,” said Laci Cornelison, interim director of the Center on Aging at Kansas State University and coalition member, during her session at Pioneer Network and The Green House Project’s 2024 Conference on Wednesday. “We really wanted to take an approach where we’re looking at things through the lens of culture change and person-centered care. We focus mostly on quality of life rather than clinical needs.”

"At a time when hospitals continued to push more post-surgical patients straight to home care, Londonderry Village in Palmyra, PA, decided to invest in six Green House homes with 10 beds each. 'We believed in that culture and that quality of care,' said President and CEO Jeff Shireman. 'People have great experiences in that environment.'"

"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."

Based on a model designed by the Green House Project, which is dedicated to creating alternative living environments to traditional nursing home care facilities, Chelsea Jewish has condominium-style Green Houses ... "All of our homes already operate at [staffing] ratios that are equal to or greater than the minimum required."

"Knowing how community ties can help providers obtain capital, and what type of loan is most industry-friendly can be successful steps towards garnering capital for senior care projects. Taking steps to minimize risk for the lender is another huge factor in attracting capital, according to experienced lenders and those involved in nursing home projects said during a recent webinar hosted by the Green House Project."

"She calls it the Einstein option, and includes in her standards for innovation commitments to person-directed care, especially training; small home models; alternative payment policies; and development of a stronger direct care workforce. Even a $600 million investment to kick off such catalytic change, she said, would cost just one-tenth of 1% of SNF spending over the next three years."

“Innovative models are going to present themselves in some way to stop this train,” said Dan Hermann, president and CEO of Ziegler, a specialized investment bank. “The dual eligible folks are going to break the back of all the states, so this train is coming, but it’s going to happen organically.”

“There is always going to be a portion of people who require maybe a more intensive level of care and also always a proportion of people who would prefer to receive care in a communal setting. How are you setting yourself up to be that provider of choice in a market where maybe there’s less global demand for nursing home beds, but people want privacy, people want to really know their caregivers?”

"The evidence so far is that the staff is significantly more engaged with residents, avoidable hospitalizations and readmission rates are lower, and family satisfaction is higher. Perhaps most surprising to those who focus on costs, both interventions saw operating margins and market position tick up."

"We have seen significant positive outcomes with this model of care, and I really think it is the empowered staff and the meaningful life focus that we have at the Green House home that contributes to keeping our staff, having our staff engaged, and really having them feel like they are the key in that relationship."

"Providers pursuing Green House projects and prioritizing steps to enhance care quality such as private rooms have won significant victories on Medicaid reimbursement funding in Ohio. The state’s budget has added significant funding for skilled nursing facilities beginning in 2024, including incentives for providing quality care that are still unusual from state governments."

"Last year, his organization began working with the Green House Project to develop an eight-floor post-acute care center using the small house model for short-term residents only. Once built, after careful planning and a multi-year fundraising drive is complete, it will be the first of its kind."

"CFI and its two organizations, The Green House Project and Pioneer Network, are known for ensuring the advancement of person-directed, relationship-rich living among all aging services settings. In Green House homes and other settings committed to non-institutional models of care, contextualizing and normalizing activities as part of everyday life is key to operations."

"Three modest, low-cost experiments may help in small ways today and point the way to bigger, longer-term solutions ... One idea, designed by a group of creative nursing home operators under the banner of the Center for Innovation, is built around interactive training modules that teach staff how to better provide true resident-centered care."

"Long-term care leaders and managers have 'superpowers' that can improve their organizations’ return on investment in corporate training, according to experts speaking at a recent webinar sponsored by the Green House Project. Resources that can help managers avoid the challenges they face may be untapped, said Marla DeVries, chief learning officer at Green House Project’s parent organization, the Center for Innovation."

"At the Center for Innovation’s 2023 conference this summer, C-suite leaders were challenged to build the aging support system of their dreams. ... Relying solely on ideas and concepts presented at major industry conferences, the authors warned, is a risk for today’s aging services giants. 'There will be nothing stopping outside competitors from entering the scene and redefining aging for themselves.'"

"CFI leaders said their vision counters a 'stark decision' the sector faces. They can either stick with the status quo and fail to provide for the next generation of seniors, or pioneer breaking the cycle. But breaking out of a decades-old rut will mean creating something truly new and different. "

“Healthia is the first care home in Australia to implement the U.S.-founded Green House Project model of care, which is informed by person-directed care principles and supports residents to have increased input into their everyday living."

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."