New Research Illustrates Green House Model’s Resilience to COVID-19

As long-term care providers look to reinvent their models in a post-COVID world, Green House and small house nursing homes “are an especially promising model,” according to a study published online on Jan. 25 in JAMDA, the Journal of Post-Acute and Long-Term Care Medicine.

Titled “Nontraditional Small House Nursing Homes Have Fewer COVID-19 Cases and Deaths,” the study found that nursing homes created under Green House and small house models have significantly fewer cases and deaths from COVID-19 than traditional nursing homes do, including those with less than 50 beds and more than 50 beds, especially among the higher and extreme values.

The study analyzed data from Green House/small house homes and compared it to data from the Centers for Medicare & Medicaid Services for traditional nursing homes between Jan. 20, 2020, and July 31, 2020.

Researchers noted that Green House/small house homes “are beneficial above and beyond the mere benefit of size, perhaps due to their private bedrooms and bathrooms, limited ancillary staff, and fewer admissions.” Also noted is the potential advantage that small size homes offer elders with regard to psychosocial well-being. “Families may be more able to have socially distanced outdoor visits, and having consistent, universal staff may allow for the maintenance of social relationships,” the paper states.

“One of the things that most passioned me about studying the Green House model and COVID-19 is that it was a slam dunk to think this is a model of care that probably has fewer infections because they’re smaller, with less chance of people coming in and out with infections, and more ability to control exposure when it occurs,” said Sheryl Zimmerman, PhD, lead researcher on the study. “In addition, the model may be able to help residents avoid some of the negative components of COVID.”

Green House Senior Director Susan Ryan said of the study: “The results of this research are not a surprise to our adopters. We’ve known for some time that Green House offers superior customer satisfaction, better occupancy rates, and higher direct care time. This research takes us to a new level of evidence. We’re proud of this fact and we’re proud of the adopters across the country who believed in the model, dared to be different, and took the leap to revolutionize eldercare.”

The study’s researchers noted that more than half of Americans who survive to age 65 will require long-term care, yet most would rather die than live in a nursing home. “Nontraditional Green House/small nursing homes have better outcomes than traditional nursing homes in numerous areas; evidence now demonstrates they have lower rates of COVID-19 and COVID-19 mortality than other nursing homes as well. As such, they are an especially promising model as nursing homes are reinvented post-COVID.”

The study will be published in the March print issue of JAMDA.

Media Contact:

Alex Spanko
Director of Communications
516-587-2097
aspanko@thegreenhouseproject.org

Press Releases

  • LINTHICUM, Md. and ROCHESTER, N.Y., April 27, 2022 – The Green House Project (GHP) and Pioneer Network, two leading organizations in the movement to transform eldercare in America and around the world, today announced their intention to enter a formal alliance. Center for Innovation, Inc., the organization that owns the Green House trademark, is committed to maintaining and expanding both the Pioneer and Green House brands in the years to come, with plans to build a shared executive leadership team currently under active discussion. “For years, GHP and Pioneer have collaborated on a variety of eldercare reform initiatives, driven by our shared history and mission to improve the lives of nursing home residents today and in the future,” Pioneer Network CEO Penny Cook said. “Together, we will go farther than we could as parallel travelers on the same path.” The recent devastating report from National Academies of Science, Engineering, and Medicine on the state of nursing home care in the United States – which described the current system as “ineffective” and “unsustainable” – underscores the dire need for real change driven by increased partnership among changemakers. “In the wake of the COVID-19 disaster in nursing homes and other eldercare settings, reform-minded organizations must band together to amplify their voices and cut through the ineffective rhetoric that has held back true change for decades,” GHP senior director Susan Ryan said. “A Green House-Pioneer alliance is a vital step toward real systemic transformation.” The alliance will be formally structured as a contribution of assets, with the transaction expected to close in early fall. Once the combination is formally completed, the joint entity will serve as a full-continuum consulting, advisory, and education partner for eldercare organizations looking to spark cultural and physical change. Pioneer Network and Green House have an intertwined history. Founded in 1997 by a group of forward-thinking long-term care professionals, Pioneer Network has worked to foster elder-directed operational culture in nursing homes and other congregate settings across the country. Geriatrician and Pioneer Network co-founder Dr. Bill Thomas then launched The Green House Project in 2003 to dramatically reimagine the physical structure of the nursing home itself, abandoning institutional mini-hospitals in favor of small homes with private rooms and warm communal areas that don’t just feel like home – but truly are home. If there’s one overarching lesson from the COVID-19 pandemic, it’s that no one solution can fix the deep fractures in our eldercare landscape. Elders in the United States and around the world deserve to receive high-quality, dignified care and supports in the setting of their choice – whether that’s at home or in a congregate setting. By combining forces, GHP and Pioneer Network can draw on their decades of shared experience to improve the lives of people living in nursing homes today, while also building a better eldercare infrastructure for future generations. To publicly celebrate the combination, Pioneer and GHP are inviting the entire eldercare community to attend Pioneer Network’s annual conference in Denver from July 27-30. More information about the combined event is available at: https://www.pioneernetwork.net/pioneering-a-new-culture-of-aging-2022-conference. “Moving forward, organizations looking to break from the past and implement elder-directed care will have a single address for cultural and physical transformation,” Cook and Ryan said. “No matter where you may be on your journey to improve your eldercare offerings, Green House and Pioneer will be here to help.” Media Contact Alex Spanko Director of Communications aspanko@thegreenhouseproject.org

  • LINTHICUM HEIGHTS, MD., April 6, 2022 – The Green House Project (GHP) today voices its support and appreciation for the National Academies of Sciences, Engineering, and Medicine’s in-depth recommendations for nursing home improvements – particularly its calls for developing small-home alternatives to traditional nursing facilities and investing heavily in the caregiving workforce. For nearly two decades, The Green House Project has helped providers build and sustain small-home nursing communities that closely align with NASEM’s vision of real homes with private rooms and bathrooms, open kitchens, and readily accessible outdoor areas. The NASEM report correctly identifies several barriers to small-home development in the United States, including a lack of incentives for operators to abandon the standard multi-bed model that Medicare and Medicaid continue to subsidize – as well as low per-day Medicaid rates that often discourage lenders from providing vital upfront capital to fund new construction and renovations. “Elders receive substandard care in outdated, undignified settings because the federal government continues to pay for that care,” GHP senior director Susan Ryan said. “Nursing homes derive the majority of their income from Medicaid and Medicare. Congress and federal agencies have the power to change what these programs will and will not cover – and, in turn, transform nursing home care for the better.” GHP further appreciates NASEM’s call for greater transparency and accountability for the nursing home industry at large. Such long-overdue measures are powerful tools for rebuilding the broken trust between long-term care providers and the public. “We are not asking for free money with no strings attached and no record of where it goes,” Ryan said. “We are asking the government to redirect some of the billions it already spends on nursing home care to the improvements that really matter, with robust oversight to ensure the money benefits elders and staff.” Finally, GHP applauds NASEM for highlighting the desperate need for new workforce development and compensation strategies, as well as their call for investment in novel staffing models that emphasize the vital role of certified nursing assistants (CNAs) within the interdisciplinary care team. GHP has built its workforce structure around CNAs, giving them the respect and power to run day-to-day operations within each home – a concept that has led to nearly four times lower CNA turnover in Green House homes as compared to the national average in nursing facilities. “Design alone cannot make a nursing community feel like home,” Ryan said. “It’s the people, properly compensated and empowered to do the job they feel called to perform, that truly make a difference in long-term care.” About The Green House Project Since 2003, The Green House Project has led a revolution in the way we provide eldercare services. With private rooms, warm communal areas, empowered care teams, and an emphasis on connecting with nature, Green House homes provide a vital alternative to institutional nursing facilities. GHP believes that elders, no matter their physical or cognitive challenges, deserve to live a meaningful life in a setting that doesn’t just feel like home – because it truly is home. Media Contact Alex Spanko, Director of Communications aspanko@thegreenhouseproject.org

  • LINTHICUM HEIGHTS, MD., March 2, 2022 – The Green House Project (GHP) on Wednesday announced its support for the Biden administration’s plan to overhaul nursing home care in America, particularly its focus on fostering the development of private rooms while phasing out multiple-occupancy units in long-term care.Each of the more than 200,000 COVID deaths – and counting – in long-term care since the start of the pandemic is unacceptable. Only through bold action will the U.S. achieve the long-delayed goal of creating an eldercare landscape that Americans truly deserve.”We cannot respond to historic tragedy in nursing homes with anything less than historic actions,” Green House Project senior director Susan Ryan said.GHP stands ready to assist the Biden administration, along with federal and state agencies, in its goal to make the multi-occupancy nursing home room a relic of the past. Undignified and institutional before COVID, shared nursing home rooms are infection-control liabilities in our new pandemic normal.We urge the administration and Congress to make private rooms a requirement of participation in Medicare and Medicaid, a move that would functionally eliminate shared units across the country by removing any financial incentive to maintain them. In addition, a $1.3 billion pilot program included in the currently stalled Nursing Home Accountability and Improvement Act of 2021 provides a vital blueprint for how the government, which provides the overwhelming majority of the nursing home industry’s revenue, can balance the need for payment incentives against the even greater imperative of transparency and accountability.GHP also calls on the wider provider community to approach the Biden proposal with the same end goal in mind: providing high-quality care for elders in dignified and safe settings. “Change is always difficult, and the natural reaction to any new regulation or requirement is resistance and skepticism,” Ryan said. “But the hard truth is that the current long-term care system failed elders and their loved ones – not because of one individual or organization’s actions, but because decades of misaligned incentives and ineffective policies made this tragedy impossible to avoid once the pandemic struck.” Real systemic reform will honor the sacrifices that frontline caregivers have made since the start of the COVID-19 crisis. Every day for two years, the people who work in nursing homes have put themselves – and, by extension, their families – at risk to continue performing their vital duties in a setting that became the most dangerous workplace in the country. “A failure to embrace this call for change, even if we may not all agree on every point, would be a failure to recognize the selflessness and heroism of the long-term care workforce,” Ryan said. “We collectively owe them a future where they can do the job they were called to do – providing comfort and support for elders – with the wages, benefits, respect, and safety they’ve always deserved.” With the right combination of new regulations and payment incentives, the federal government has the power to reshape long-term care in unprecedented ways. GHP applauds the Biden proposal as a necessary first step toward true change. “We can never undo the harm that residents, families, and workers have experienced in the wake of COVID and poor care in nursing homes,” Ryan said. “But we can honor them by refusing to fall back on old patterns and excuses, and instead joining the administration’s call for reform. We owe future generations of America’s elders nothing less than our full commitment to change.” About The Green House Project Since 2003, The Green House Project has led a revolution in the way we provide eldercare services. With private rooms, warm communal areas, empowered care teams, and an emphasis on connecting with nature, Green House homes provide a vital alternative to institutional nursing facilities. GHP believes that elders, no matter their physical or cognitive challenges, deserve to live a meaningful life in a setting that doesn’t just feel like home – because it truly is home. Media Contact Alex Spanko, Director of Communications aspanko@thegreenhouseproject.org

  • LINTHICUM HEIGHTS, MD., February 11, 2022 – The Green House Project (GHP) today announced the elevation of Michele Holleran to board chair and the addition of two new board members with diverse perspectives and experiences in eldercare. Left to right: Holleran, Adams, O’Brien Holleran, the founder and CEO of the eldercare-focused consumer research firm Holleran Consulting, has served on GHP’s board since 2019, bringing her decades of experience in customer and resident satisfaction to the Green House mission. “Ever since I toured the first Green House built in Tupelo, Miss. more than 15 years ago, I’ve been impressed by this innovative and humane approach to long-term care,” Holleran said. “Today, with nearly 400 Green House homes across America, senior living providers understand the amazing benefit to both elders and staff – a truly engaged living and working environment that boosts fulfillment and lowers turnover.” Holleran succeeds Steve McAlilly, the president and CEO of Methodist Senior Services who spearheaded that first Green House community in Tupelo. McAlilly will continue to serve on the board as a past chair. The GHP board also unanimously elected two new members: Marvell Adams, Jr. and Danny O’Brien. Adams is the chief operating officer of The Kendal Corporation, a leading non-profit eldercare provider. He had previously served as the executive director and CEO of Collington, Kendal’s affiliate in the Washington, D.C. metropolitan area, as well as the COO and administrator of The Highlands at Pittsford outside of Rochester, N.Y. “The mission of GHP is critical in our field’s continued evolution into becoming a truly aging-centric and person-driven society that honors the uniqueness of each person and supports all older adults,” Adams said. “It is an honor to join GHP’s board of directors in support of its mission to lead the transformation of institutional long-term and post-acute care.” O’Brien is the founding CEO of Avila Home Care, an agency serving the Baltimore area. Prior to launching Avila, O’Brien was the senior pastor of Grace Fellowship Church in Timonium, Md. He also spent 13 years at Erickson Living from 1993 to 2006, where he worked as the executive director for Charlestown and the senior vice president for new communities, overseeing start-up operations and government affairs. “I dream of a day when all those who require care will receive it with love, empathy, and excellence,” O’Brien said. “I look forward to being part of a team that accentuates the abilities of our elders, not their challenges, and that empowers seniors to live as full participants in life – not only receiving the care they need, but also contributing to the well-being of others.” GHP is a leader in the movement to eliminate the traditional nursing home in favor of more human, elder-directed alternatives. The flagship GHP small-home model, originally implemented in 2003, has become the national standard for communal nursing care: With private rooms, empowered care teams, and direct connections to nature, Green House homes boldly challenge the status quo in long-term care. GHP also supports a variety of other nursing home improvement efforts, including the cultural transformation of traditional facilities and the implementation of the Best Life dementia care model, which builds care plans around individuals’ abilities and desires – instead of their challenges. “These changes to our board strengthen our position as we look to build on the momentum for real change in long-term care after the devastation of COVID-19,” Susan Ryan, GHP’s senior director, said. “Michele’s leadership and deep knowledge of what elders and caregivers truly want is unparalleled. Her guidance and wisdom have shaped our work throughout her time on the board, and I’m excited to see her lead this group of eldercare visionaries into the future.” “I also thank Steve McAlilly for his service as board chair,” Ryan continued. “He is a true champion of the Green House model, and we will continue to rely on his input and perspective as past chair in the years ahead.” The two new members will help expand GHP’s reach outside of the nursing home space as part of an overarching goal to create a better eldercare continuum, Ryan noted. “Above all else, the COVID-19 pandemic has taught us that there is no one-size-fits-all solution to the problems in eldercare,” Ryan said. “The elders of today and tomorrow want – and deserve – a wider range of choices for services and supports as they age. We envision a future where every elder can receive high-quality care in the setting of their choice. Marvell and Danny’s experience in senior living and home health will be invaluable as our team works toward that vital goal.” About The Green House Project Since 2003, The Green House Project has led a revolution in the way we provide eldercare services. With private rooms, warm communal areas, empowered care teams, and an emphasis on connecting with nature, Green House homes provide a vital alternative to institutional nursing facilities. GHP believes that elders, no matter their physical or cognitive challenges, deserve to live a meaningful life in a setting that doesn’t just feel like home – because it truly is home. Media Contact Alex Spanko, Director of Communications aspanko@thegreenhouseproject.org

  • LINTHICUM HEIGHTS, MD., November 12, 2021 – The Green House Project (GHP) today announces the hire of Ann McLaughlin in the role of Project Coach. McLaughlin comes to GHP with a deep and unique perspective on the challenges facing long-term care reformers today – as well as their solutions. A licensed nursing home administrator with a master’s degree in healthcare administration from the University of Minnesota’s School of Public Health, McLaughlin has worked both on the front lines of eldercare and as a researcher probing racial disparities in the long-term care system. “Everyone deserves to age with dignity,” McLaughlin said. “It is a personal goal to do everything I can to make that possible.” Prior to joining GHP, McLaughlin was a Health and Aging Policy Fellow in the office of Rep. Jan Schakowsky of Illinois, where she wrote legislation and advised the Congresswoman’s staff on key policy issues. In addition to her research while at the University of Minnesota, she gained real-world experience at several eldercare communities in Minnesota – including a position as an artist-in-residence at The Waters of Highland Park in St. Paul, where she gave harp performances and developed music and social programming for elders. At GHP, McLaughlin will support forward-thinking eldercare organizations as they develop new Green House communities and implement culture-change programs across the country. She will also provide insights into the structural and policy reforms that must occur to create truly transformative change in long-term care. “We’re delighted to have Ann and her incredible talents on the Green House team,” Susan Ryan, GHP’s senior director, said. “We’re at a key inflection point in nursing home reform after the COVID-19 tragedy, and Ann will play a vital role as we work to break down the barriers to new and empowering models of care across the country and the world.” McLaughlin holds a doctor of musical arts degree and a master of music degree from the University of Illinois; she also received a bachelor’s degree in music from the University of North Texas. “For years, I have known about The Green House Project, its excellent work, and the high standard it sets for quality of life for older adults,” McLaughlin said. “It is such an honor to join the team!” About The Green House Project Since 2003, The Green House Project has led a revolution in the way we provide eldercare services. With private rooms, warm communal areas, empowered care teams, and an emphasis on connecting with nature, Green House homes provide a vital alternative to institutional nursing facilities. GHP believes that elders, no matter their physical or cognitive challenges, deserve to live a meaningful life in a setting that doesn’t just feel like home – because it truly is home. Media Contact Alex Spanko, Director of Communications aspanko@thegreenhouseproject.org