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Katherine and Charles Hover Green Houses

A Green Initiative to Save the Nursing Home Industry?

With all the problems facing nursing homes, some experts have suggested the entire nursing home system is an idea that needs to be scrapped and replaced – but maybe not. A not-for-profit organization called the Green House Project is on a mission to make nursing homes work the way they were intended.

The Green House Project vision is to create “homes in every community where Elders and others enjoy excellent quality of life and quality of care; where they, their families, and the staff engage in meaningful relationships built on equality, empowerment, and mutual respect; where people want to live and work; and where all are protected, sustained, and nurtured without regard to the ability to pay.” If it sounds like a fantasy, it isn’t. The first Green House project homes opened in Tupelo, Mississippi in 2003, and today there are more than 260 Green House homes in 32 states.

One man’s vision

The Green House Project began in the early 2000s as the brainchild of Dr. Bill Thomas, a physician specializing in aging. Dr. Thomas sought to transform the nursing home experience from living in something that looks and acts like a hospital to thriving in a place that feels like home. At the heart of his vision, each Green House Project home would only have around 10 residents (called Elders), who live in private rooms with attached bathrooms, a cozy common area with a fireplace, an open kitchen and dining area, and access to nature through gardens and porches on the grounds.

Less is more

Upscale accommodations are great, but the key to the innovation and success of the Green House Project model is this idea of making nursing homes work with a small number of residents. Forgetting the financial question of fewer customers, the idea of having fewer residents makes a ton of sense.

The key problem with most nursing homes is that staff members simply do not have enough hours in the day to attend to the needs of too many patients, many of whom need assistance to accomplish simple daily activities. This can create a miserable experience where staff are too busy to help everyone who needs it, and residents commonly are left to remain in their own filth for hours, go hungry or thirsty despite unanswered pleas for help, and generally exist without their basic needs met for extended periods of time.

The residents of nursing homes suffer more than just the loss of quality of life and dignity. The understaffing issue creates a situation that puts the lives of residents in danger, and the nursing home operators know it. The business model of for-profit nursing homes is to maximize the number of beds while keeping staff members to the bare minimum. Numerous studies have shown that low staff-to-patient ratios lead to serious injuries and deaths for residents. Nursing home abuse and neglect is a common problem at nursing homes, and it’s a problem that has only gotten worse as private equity groups bought independent nursing homes and began squeezing out every penny possible by reducing service and quality.

Green House Project vs. COVID

The COVID pandemic has been a perfect example of the failure of traditional nursing homes and how the Green House Project model gets it right. Traditional nursing homes were the worst hit by the pandemic with tens of thousands of resident deaths due to poor infection controls, especially with residents sharing rooms with one or more infected roommates. Thanks to better staff ratios, private rooms, and other advantages, The Green House Project homes have had a much better track record than their traditional counterparts. According to data from the University of North Carolina “among the 229 skilled nursing Green House homes that submitted data between Feb. 1 and May 31, 2020, 95% were COVID free.”

Too good to be true?

The big question is how the Green House Project homes can run an operation with more and better services while having fewer paying customers. The answer seems to be that the success of the Green House Project homes means that they can run regularly at full capacity while traditional nursing homes struggle to fill beds due to the poor reputation of their nursing homes.

According to John Ponthie in Skilled Nursing News, “…you’ve got a much higher level of occupancy and demand for your product, and you can offer a more attractive payer mix — the right mix of Medicaid, private pay, and Medicare — and your revenues go up proportionate or greater than a traditional facility.”

If this sounds like a boutique service only accessible to the wealthy, you’d also be wrong. According to Ziegler Investment Banking, roughly four out of 10 Green House residents are covered by Medicaid.

To find a Green House Project home near you, click here.

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If you suspect nursing home abuse or neglect, trust your instincts and know the signs. To learn more about your legal rights and options, contact Brown & Barron’s Baltimore attorneys online or at (410) 698-1717 for a free consultation.

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