Innovative Nursing Care Model Goes Mainstream With 100th Home

    • September 28, 2011

The Green House model, considered a radical innovation in skilled-nursing care only a few years ago, is fast becoming a mainstream alternative to traditional nursing homes. This week, the Robert Wood Johnson Foundation and The Green House Project marked the completion of America’s 100th Green House home and announced a goal of tripling the number of homes in the next three years.

“The Green House movement recognizes that just because someone can no longer live independently doesn’t mean that they must surrender their dignity and quality of life,” said Risa Lavizzo-Mourey, MD, MBA., president and CEO of the Robert Wood Johnson Foundation. “The Green House model represents a disruptive innovation that is transforming an entire field for the better. Our goal is to establish it as the benchmark of quality and patient satisfaction for affordable, community-based skilled-nursing care nationwide.”

The announcement comes amid new research that shows the financial feasibility, significantly improved clinical and satisfaction outcomes and strong demand for new models of long-term care -- research that should make the Green House model an even more appealing option to policymakers and long-term care providers.

New polling data from NPR, Robert Wood Johnson Foundation and Harvard School of Public Health reveals that older Americans are deeply concerned about the prospect of residing in a nursing home. In addition, a September 2011 article in Senior Housing & Care Journal concludes that Green House homes provide significantly better care at no greater operating cost than traditional nursing homes. Recent analysis of research data by the same authors also suggests that Green House homes may offer substantial savings to Medicare and Medicaid through avoidable hospitalization and pressure ulcers.

“Every community in America should have Green House homes as an option for elders and people with disabilities,” explained Robert Jenkens, director of the Green House Project. “For the same amount we are already spending to operate nursing homes today, people could be happier and healthier, and the system as a whole could save money each year because of avoided health problems. As a country, we can use some of those savings to fund the replacement of institutional buildings that no longer serve our health and quality goals for Medicaid recipients."

Welcome Solution to Concerns About Care, Cost
The model provides an environment in which residents receive nursing support and clinical care without the care becoming the sole focus of their daily lives. 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 facilities.

Because these improvements have been difficult to achieve in traditional nursing homes without significant cost increases, the fact that new, peer-reviewed research finds that Green House projects are essentially cost neutral comes as welcome news to long-term care providers, policymakers and consumer groups alike. In fact, the findings were so significant that the National Investment Center for the Seniors Housing & Care Industry recently acknowledged the research with its prestigious GE Healthcare Award for Best Paper of 2011.

The economic data is especially relevant in light of new nationwide polling data revealing that aging boomers are very anxious about how they will pay for long-term care and ensure a high quality of care for themselves and their spouses. The vast majority (nearly 80 percent) of Americans over 50 expect to have trouble paying for long-term care while three out of four worry about quality of care and quality of life. When it comes to the prospect of living in a nursing home, their biggest fear is that “being in an institutional environment is not as comfortable as home.”

Plans for the Future
The Green House concept has already spread nationwide, with Green House projects operating or in development in 29 states. In meeting its goal to triple the number of Green House homes in the next three years, both the Robert Wood Johnson Foundation and the Green House Project see major opportunities in states like California and Maryland, both of which have their first homes in development currently, and New York, where two completed projects are far from meeting the state’s mounting need for high quality, skilled-nursing options.

The Green House Project has also taken steps to use the model to meet the needs of two groups with increasing needs for non-institutional models of long-term care. Recently, the Robert Wood Johnson Foundation and NCB Capital Impact announced a new $10 million low-interest loan fund to build Green House homes serving low-income individuals. And later this fall, the Department of Veterans Affairs is to open the first Green House homes for older veterans in Danville, IL.

“If we want all Americans to be healthy in their later years, we cannot just focus on what happens in the doctor’s office,” added Lavizzo-Mourey. “We have to make sure that where they live promotes their health and happiness. The Green House model offers a revolutionary and practical way to do just that.”

About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For nearly 40 years the Foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.

About The Greenhouse Project
The Green House Project is a partnership between the Robert Wood Johnson Foundation, NCB Capital Impact and The Center for Growing and Becoming. The Green House Project provides technical assistance, financing and ongoing support to providers and local organizations to support the development and operation of Green House homes across the country. To date, more than 227 Green House homes are open or under development through partnerships with over 50 organizations across 29 states.