Providers, policymakers can take concrete steps today to improve system
Linthicum, Md., January 20, 2023 – After a federal report this week recommended “significant changes” to the nursing home system after the failures of the COVID-19 pandemic, the Center for Innovation (CFI) calls on both policymakers and providers to clear the path for the development of small-home alternatives backed by decades of research.
The HHS Office of the Inspector General found more than 1,300 nursing homes with COVID infection rates of 75% or more during the severe outbreaks of 2020, with mortality rates reaching 20%.
The January 19 report marks the latest in a string of analyses showing the deep systemic problems that put residents of nursing homes at risk during the pandemic.
But policymakers and providers have a host of evidence-based answers to the call for change. As early as July 2020 – months before mass vaccination helped to curb the spread of the virus in communal care settings – researchers from the University of North Carolina found substantially lower COVID-19 infections and deaths in Green House homes than in traditional facilities.
Since 2003, Green House homes have provided vital alternatives to hospital-style nursing homes, with all private rooms and bathrooms, dedicated outdoor space, and an elder-directed care philosophy that puts residents’ needs, wants, and abilities at the center of every decision.
“Green House/small nursing homes are a promising model of care as nursing homes are reinvented post-COVID,” the UNC researchers concluded.
Internal data compiled by the Center for Innovation, the non-profit parent of The Green House Project, reinforced those early findings: In 2020, Green House homes recorded half of the COVID-19 infections of traditional homes, with even fewer cases than the national average in 2021.
“The time for reports and recommendations is long over,” CFI CEO Susan Ryan said. “We know what works: Small homes with private bedrooms and bathrooms aren’t just good for infection control, but they also provide superior dignity and quality of life than outdated, institutional-style nursing homes.”
Policymakers can encourage the development of Green House homes through a range of levers, including:
- Targeted state-level Medicaid rate increases to encourage new development
- Lending incentives from HUD, which already backs billions in loans for traditional nursing homes
- Capital grants, such as those proposed in the federal IMPROVE Nursing Homes Act
- The gradual phase-out of shared rooms and bathrooms through changes to the federal Requirements of Participation for Medicare and Medicaid
- Finally implementing Section 6114 of the Affordable Care Act, which requires the development of a national demonstration project on culture change in nursing homes
- Operationalizing the recommendations from the 2022 NASEM report on nursing home improvement
“Transforming our broken eldercare system may seem daunting, but we have the tools to create real change at our fingertips,” Ryan said. “Elders and caregivers can’t wait for more retrospective reports and suggestions. We must take action, and we’re ready to help policymakers and providers every step of the way.”
About the Center for Innovation
CFI is the new home for both The Green House Project and Pioneer Network, two leading organizations dedicated to changing the design and culture of eldercare in the U.S. and around the world. Learn more at https://thegreenhouseproject.org/pioneer-alliance/.
Alex Spanko, Director of Communications