Household model nursing homes weathering covid well

A NEW APPROACH The Green House Project was founded by Bill Thomas, M.D., a Harvard-educated physician. He earlier founded the Eden Alternative, an approach emphasizing older adult care

that's focused on people rather than institutions. The first Green House home opened in Tupelo, Mississippi, in 2003. Thomas had persuaded a top administrator to choose this model

rather than replace an old-style nursing home, said Renee Reid, spokesperson for Tupelo-based Methodist Senior Services, which runs Traceway Retirement Communities. Today, Traceway has 19

Green Houses in Mississippi, with open kitchen and dining areas. “The smell of good food pulls you right out of your room,” Reid said. Household Model homes also feature open kitchens, where

residents can ask staff for food during much of the day, rather than having to eat on a rigid schedule, Norton said. One Green House feature that stirred attention early on is the use of

certified nursing assistants (CNAs), or shahbazim, as home managers, rather than being overseen by registered nurses, the typical system in most nursing homes. Exterior of The Green House

Homes in Rhode Island. Courtesy Green House Homes But those concerns have waned over time, with evidence that shahbazim work closely with nurses, said Barbara Bowers, a professor and

associate dean for research at the University of Wisconsin-Madison School of Nursing and a Green House expert. "There is a strong effort [for nurses and CNAs] to work as a team,” Bowers

wrote in an email. Today, a number of Green House homes are built as their own neighborhoods, and others are on larger continuing care campuses, LaPorte said. Such campuses typically

include assisted living and independent living homes. And the model continues to evolve. A Rochester, New York, nursing home built the first two Green Houses in 2011, embedded in a

residential neighborhood in nearby Penfield. There, they blend into the suburban setting, said Tom Harner, spokesperson for St. John's Senior Services. Inspired by the concept, St.

John's is now renovating its traditional six-floor, 455-bed building to follow some Green House tenets. The onset of COVID-19 has altered the normal rhythms in many homes. Seating 12

people at the traditional large Green House hearth table, for instance, can be a challenge. "They've had to get creative,” said Ryan, the project's senior director. She has

heard of one home that instructed residents to eat in their rooms, and another that staggered six residents at a time around the large table so that they had more distance between them.