Getting Old Needs a New Look

The advantages of thinking smaller can be illustrated by the Green House Project, a national organization founded in 2003 that has created a network of 300 intimately scaled residential alternatives to nursing homes. Every Green House home has 10 to 12 residents, with each resident having a private room and bathroom.

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  • “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.”