Building The Long-Term Care System Of The Future: Will The COVID-19 Nursing Home Tragedies Lead To Real Reform?

Replace aging and outdated facilities, particularly in low-income communities. Moving forward, nursing homes and other institutional settings should be smaller, with single-occupancy rooms and low staff-to-resident ratios (see, for example, the Green House Project). Environments that offer a more homelike setting can help with infection control and can lead to better health outcomes for residents with Alzheimer’s disease and other dementias. These efforts can be accelerated by strengthening federal and state standards on nursing home size, room occupancy, and minimum staffing ratios.

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  • “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.

  • The Green House concept just makes perfect sense for elder care, McAlilly said. “It’s built around the concept of home,” he said. “It’s their home, and we just happen to work there.”

  • 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.”