The Green House concept is challenging traditional views of long-term care. The project aims to establish small houses for long-term care needs, rather than the large-scale institutions traditionally associated with nursing homes.

Green Houses provide an environment in which residents receive nursing support and clinical care without the care becoming the focus of their existence. By altering the facility size, interior design, staffing patterns and methods of delivering skilled services to residents, the Green House model provides residents greater health and lifestyle benefits compared to residents of traditional nursing and assisted-living buildings. Early results show that Green House residents report higher satisfaction levels, less physical decline and less depression.

A Green House is designed to look like a private home or apartment, constructed with seven to ten bedrooms for seniors—so each resident has his or her own room. The common living space in the heart of the house consists of a shared living room, dining room and kitchen facilities. The common room centers around one big table where the group—residents, staff, caregivers, family and friends—sits down to dinner every night together.

"The Green House is based on deep relationships; nurturing, sustaining and protecting each person," says Joyce Ebmeier, a guide for a nine-person home in Nebraska. "Excellent medical treatment is a key component of life in a Green House, but it is delivered discretely and supportively, with respect to the rhythm of each elder's life."

The concept has spread from four Green House homes in Tupelo, Miss., to more than 40 homes operating in 10 states. NCB Capital Impact of Arlington, Va., under the leadership of Robert Jenkens, has received funding from the Robert Wood Johnson Foundation to replicate the Green House model on a national scale with the goal of developing 50 such projects by 2010. Editor's Note: The success of this model and the autonomy it provides its residents is so powerful that on December 5, 2008, the 50th Green House opened in the United States, one year earlier than anticipated.

"We are trying to create a nursing home that people will want to live and work in," says Jenkens. "We want to make nursing homes places where people get care but their lives have meaning and purpose."