What Kind of Nursing Homes Have Had the Fewest COVID-19 Cases?

The best-known type of nontraditional, small house nursing home is the Green House model, which operates 300 homes across 32 states, each housing only 10 to 12 residents. In addition to their small size, Green House homes also feature consistent, universal staff assignment (meaning the facilities try to assign the same staff to the same residents and that staff perform a wide range of responsibilities in addition to their nursing role, like cleaning and cooking), private rooms and bathrooms, smaller overall space, and a central entry.

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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.”