Creating a Revolution in Nursing Homes: Putting Home and Heart In to Long-Term Care

RWJF Celebrates the 100th Green House Home

    • September 26, 2011

On September 27, 2011, the Robert Wood Johnson Foundation and NCB Capital Impact celebrated an inspiring milestone – the opening of the 100th Green House home, which employs a revolutionary long-term care model that provides seniors with improved care without increasing costs. Green House homes provide elders with a high quality of life and quality of care in a setting that feels like a real home. As a result, residents are happier and have better health outcomes. They enjoy life more fully, remain independent longer, and receive more direct care time daily from skilled Green House providers.

The announcement comes on the heels of a recent survey on health and retirement commissioned by RWJF that reinforces the need for improvements to long-term nursing care. Nearly 80 percent of respondents (pre-retirees and retirees) expected to have trouble paying for long-term care, for either themselves or a spouse. Aside from cost, respondents were highly concerned about the quality of care (73 percent) and the quality of life in institutional facilities (82 percent). But one of the most pressing findings is that eight out of ten were very or somewhat worried about being in an institutional environment that is not as comfortable as home. And roughly three-fourths of pre-retirees worried about having too few nurses to provide the care they needed or losing their privacy in a traditional nursing home facility.

These same consumer concerns are also being echoed by policy makers. At a time when federal and state budgets are under increasing strain, our older American population is growing. With that growth comes demand for long-term care and for high-quality home and community-based alternatives to traditional nursing homes. The Green House model provides policymakers with a viable alternative to institutional care that meets the needs of families and older Americans, but does not cost more than the traditional nursing home model.

The Green House movement recognizes that just because someone no longer can live independently, it doesn’t mean they must surrender their dignity and realize their worst nursing home fears. RWJF has supported this concept since its inception, long before the 100th Green House home was erected in West Orange, New Jersey. In 2005, RWJF provided funding for Green House to develop a business and development plan, followed by the first model Green House built in Tupelo, Mississippi. Since then, RWJF has invested approximately $20 million in building the evidence related to the model's effectiveness and its continued spread.

One hundred homes later, preliminary research indicates the model is succeeding. Aside from improving the quality of life for seniors, Green House residents also receive better and safer care. For example, residents experience far fewer bed sores which can turn into deadly infections. And they need to be hospitalized far less as well.

For all these reasons, the Foundation is launching an accelerated expansion of the Green House initiative by following a three-pronged strategy:

  • Phasing Green House into the mainstream of long-term care
  • Creating viable financing options for new Green Houses through the creation of a $10-million loan fund
  • Researching and evaluating the quality, cost and outcomes of Green House care