Shared Rooms Helped Fuel COVID-19 Deaths in Nursing Homes. Are a Million Private Rooms Possible?

Private rooms alone won’t remedy the nursing home system’s shortcomings. “The Green House model is a lot more than just the building,” says Alex Spanko. “It’s about the culture, too.”

For example, moving residents into private rooms without investing in communal spaces or activity programs or more staff that bring them out of those rooms could cause increased loneliness and social isolation, an issue nursing homes really struggled with during the pandemic.

“Private rooms are really just step one,” says Spanko. “There’s another 25 steps that also need to be done to get to where we really want to be.”

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  • “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.”

  • In the long term, nursing homes may need to explore entirely new models of care, Brown assistant professor Elizabeth White added, pointing to the Green House model, which establishes smaller scale facilities and emphasizes self-sufficiency and community, as an example. “There’s work around really innovative solutions out there.”