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Paper Examines Green House Model’s Financial Viability

Paper Examines Green House Model’s Financial Viability

Wins GE Award for Best Research Paper in 2011 Seniors Housing & Care Journal

FOR IMMEDIATE RELEASE: September 29, 2011

Annapolis, Md. – The white paper “Financial Implications of THE GREEN HOUSE® Model” was announced by the National Investment Center for the Seniors Housing & Care Industry (NIC) as the winner of the GE Award for Best Research Paper from its annual call for applied research papers. The article appeared in the 2011 Seniors Housing & Care Journal and analyzes several recent studies to determine the Green House model’s initial and long-term financial viability.

The article, written by Robert Jenkens, MSRED, Terri Sult, MBA, Newell Lessell, MBA, David Hammer, MS and Anna Ortigara, RN, MS, FAAN, reviews core Green House practices, published research, and two new studies in order to address questions about the model’s staffing, organizational, and environmental design, and their costs relative to traditional nursing home models and other culture change models.

The Green House model, founded by Dr. William Thomas, is among a growing number of culture change initiatives that seek to improve the quality of life and care in SNFs. In the first quarter of 2011, 97 Green House homes were open on 26 campuses across 21 organizations in 17 states. Another 130+ homes are in development on 25 campuses and in 10 additional states. The Green House model offers an alternative to traditional nursing home practices, significantly redesigning the philosophy of life and care, physical environment, and operational approach within state and federal requirements for licensed SNFs. The model’s deep, integrated, and rapid restructuring in each of three domains of culture change – resident care, staff culture and environment, and the physical structure – make it a comprehensive change model, distinguishing it from culture change initiatives that pursue a more incremental and à la carte approach.

The authors conclude that the studies reviewed and referenced in the article provide growing evidence that The Green House model’s operations are comparable in cost to traditional nursing homes as well as nursing home providers utilizing some culture change practices in their SNFs. Capital costs are found to be equivalent or less than similar culture change models but higher than traditional designs, which provide much less space per resident. Increased occupancy and more private-pay days found to be associated with Green House home implementation may offset these capital cost increases. Major Findings Incude:

  • Significantly more direct-care and nursing time is delivered in The Green House home.
  • Overall staffing needs and costs do not increase compared to traditional settings due to a shift from supervisory and department hours to direct care hours.
  • The Green House model uses time more effectively, delivering significantly more direct care and nursing hours within lower total direct service hours.
  • Average operating costs for Green House homes are between the 50th to 60th percentile of nursing homes nationally.
  • Consistent and financially important differences were found in Green House providers’ overall occupancy (7% higher) and private-pay occupancy (a 24% increase) compared to nursing home averages.
  • No hidden or unexpected costs were associated with The Green House model.
  • Green House homes’ capital costs, including all private rooms and bathrooms, were found to be at the low end of culture change models.

This is the 14th year the peer-reviewed Journal, published annually by NIC, continues its tradition of disseminating empirically based research and commentaries about quality and progressive practices in the seniors housing and care industry. The authors of the Best Research Award paper received a $2,500 total cash prize sponsored by GE Capital, Healthcare Financial Services.

Linda Hollinger-Smith, RN, Ph.D., FAAN, Mather LifeWays Institute on Aging, serves as managing editor of the Journal. The Journal’s editors are Joan Hyde, Ph.D., Gerontology Institute, University of Massachusetts/Boston; David A. Lindeman, Ph.D., Center for Technology and Aging, Center for Innovation and Technology in Public Health; and Margaret A. Wylde, Ph.D., ProMatura Group LLC.

In addition to the winning paper, a special commendation was given to the paper “Valuation of Real Estate within Senior Living Facilities” by William “Trey” Beazley III, MAI, Steven Sparks, MAI, and Michael Bates, MAI, ASA. The article builds on growing market knowledge and provides a quantitative analysis to support reasonable allocations of the real estate component of various seniors housing properties.

NIC offered a New Investigator Award for the second year in a row, presented to researchers in graduate school or who have recently graduated,” said Robert G. Kramer, president of NIC. “We’re pleased to have an opportunity to recognize up-and-coming leaders in the industry.” This year’s New Investigator Award was given to Mary E. Byrnes for her paper “Moving Behaviors of Very Low-Income Inner-City Older Adults.”

The other papers included in this year’s Journal are: “Board Members: Are You Making Decisions in a Vacuum?,” “The Emerging Role of Health Care Supervisors in Assisted Living,” “Impact of Housing Type on Nutritional Status and Oral Health of Rural Older Adults Residing in the Midwestern United States,” “Evaluation of a Culture Change-Focused Learning Circle Program in a Long-Term Care Setting,” “Satisfaction with Your New Home: Advantages and Disadvantages to Living in a CCRC,” “The Market for Independent Living: Understanding Drivers of Demand,” “Personal Emergency Response Services: Do the Benefits Justify the Cost in Seniors Housing and Care Properties?,” “Without Walls: Helping Older Adults Age Well in Their Own Communities,” and “Empowering Direct Care Workers: Lessons Learned from the GREEN HOUSE Model.”

Copies of the 2011 Seniors Housing & Care Journal are available through NIC for $95. Limited quantities of the Journal from previous years are also available. To order, visit or call NIC at (410) 267-0504.

About NIC

For 20 years, the National Investment Center for the Seniors Housing & Care Industry (NIC) has been committed to advancing the quality of seniors housing and care by facilitating informed investment decisions for investors, lenders, owners, operators and developers through groundbreaking research, actionable data and dealmaking events. NIC is the leading provider of historical and trend data on the industry through its NIC MAP® Data and Analysis Service that tracks more than 12,000 properties on a quarterly basis in the 100 largest metropolitan markets. Proceeds from its annual conference and other events are used to fund data and research on issues of importance to lenders, investors, developers, operators, and others interested in meeting the housing and care needs of America’s seniors. For more information, visit or call (410) 267-0504.

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