Nursing Homes During the COVID-19 Pandemic—Resident and Staff Cases and Deaths

Green House homes are perhaps the ideal setting in which Elders live meaningful lives, where staff are empowered to provide high quality care, and given their physical design and focus on quality and data, the ideal setting to reduce the transmission of infectious diseases. Preliminary analyses here indicate that residents fared better in Green House homes, compared to traditional nursing homes (but not staff). Legislation at the federal and state levels could be introduced to incentivize the development of additional Green House homes–even encouraging their construction as the industry standard–including higher Medicare and Medicaid reimbursements and lifting the moratorium on new nursing home construction (in states like Florida, for example) exclusively for Green House home construction.

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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.”