COVID-19 Crisis Advances Efforts to Reimagine Nursing Homes

We need small. Green House is a model that is very exciting. They have small locations of care. Maybe 12 individuals live in a setting. It’s personalized. It would look more like your living room than an institution. They have universal care workers who not only help you with your activities of daily living, but maybe help you make sure that you call your daughter that day. Or help you with your laundry or with your breakfast. I think Green House has a lot of merit. It’s the deinstitutionalization and personalization of care. It’s a very powerful model and I think it will really spread in scale after COVID.”

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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.”