Health Care In The States

Maryland’s First Green House Project Nursing Home Aids Low-Income Seniors

By Shefali S. Kulkarni

April 20th, 2012, 11:16 AM

What was once a novel idea for  longterm care for the elderly — small, homey facilities of 10 to 12 residents each — is now a model cropping up around the country.

On Thursday The Green House Project– an alternative to senior institutional care created by Dr. William H. Thomas, a geriatrician and self-described ‘nursing home abolitionist’ — opened their 133th nursing home nationally and their first in Baltimore. According to Thomas, the homes are designed to emphasize quality living for seniors by creating a comfortable and independent space where residents sleep in private bedrooms, share family-style meals and have more freedom of movement  than in traditional nursing homes.

The four-unit facility on the site of the former Memorial Stadium is the first “green house” in the state of Maryland, and the first in the country to take advantage of special funding for low-income seniors thanks to a collaboration between the Robert Wood Johnson Foundation and NCB Capital Impact.

Sixty percent of the beds in the Baltimore facility, which will be run by Associated Catholic Charities, are reserved for low-income seniors on Medicaid.

Shortage of nursing homes in urban areas is a long-standing problem, according to Robert Jenkens, director of The Green House Project. According to a 2011 study in the Archives of Internal Medicine, “The relative risk of [nursing home] closure was significantly higher in zip code areas with higher proportion of blacks and Hispanics or a higher poverty rate.”

Photo by The Green House Project

In 2005 the first “green home” was built in Tupelo, Miss. and operated by Mississippi Methodist Senior Services. Jenkens says rather than the hospital-like facilities of yesteryears’ nursing homes, Green House units are small, private residences with personalized touches such as locked medicine cabinets in each room. Staffing is minimal, with the aim of building personal relationships with residents.

Jane Lowe, the team director of the Vulnerable Populations Portfolio at the Robert Wood Johnson Foundation says the facilities involve an entirely different philosophy of care. “You want people to age with dignity. You want people to have their individual needs met and you don’t want them to be institutionalized to die.”

Lowe says the foundation is gathering data to evaluate The Green House Project model. A small sample from a randomized trial at the Tupelo facility showed “significant” improvements in resident’s eating habits, social behaviors and overall quality of life.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

6 Responses to “Maryland’s First Green House Project Nursing Home Aids Low-Income Seniors”

  1. It’s about time. Never to late!

  2. Sharon Dillon says:

    Fantastic idea. Please don’t keep the staff too minimal, you don’t want too many residents per aide. Quality care also depends on how many staff members are available to assist your residents.

  3. A. M. Harris says:

    This approach certainly sounds like an excellent alternative to traditional nursing homes, especially for older adults who are still ambulatory and express a desire to remain independent. Providing low cost housing for minority populations receiving Medicaid is a positive step to reducing health disparities as well. …I agree with the previous comment regarding staffing, appropriate staffing is needed to not only ensure quality care, but a safe environment as well.

  4. James Cervantes says:

    What a great model of care. Hopefully they maintain a high level of quality care and incorporate resistance training to keep these elders active!

  5. This sounds a lot like assisted living in Idaho. However, in Idaho it appears the issue is not enough is paid through the daily rate by Medicaid to maintain adequate staffing which in turn results in shortage of staff and constant turn over in staff. However, it appears to be the same issue with nursing home that are privately owned. It is hard work for cna’s both physically and mentally. When a cna is paid $9.00 to $10.00 per hour it is not enough when you can earn just working at somewhere like Walmart and none of the liability. The methodology needs to be reviewed so that more of the funds goes to the primary care provider and less to high administration. Great article and good information. Thank you :)

  6. I would like to hear more about this model. I am currently in the social work program at Western Carolina University considering clinical practice.