Why Nursing Homes Need A Total Redesign

“The kind of long-term institutional environment to which we relegate our most chronically ill elders is a model that we have almost entirely eliminated for persons with mental illness and developmental disabilities and for children in foster care, but we continue to tolerate it for older persons.

Small, household models of skilled nursing care are not new, but they have been largely overlooked until the COVID-19 pandemic, during which they fared far better than traditional nursing homes. At the same time, a growing body of research shows a multitude of quality advantages over traditional nursing homes.”

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  • “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.”

  • “Knowing how community ties can help providers obtain capital, and what type of loan is most industry-friendly can be successful steps towards garnering capital for senior care projects. Taking steps to minimize risk for the lender is another huge factor in attracting capital, according to experienced lenders and those involved in nursing home projects said during a recent webinar hosted by the Green House Project.”