The senior living industry will never be the same

by John Montgomery ([email protected]) 1,120 views 

Our senior living industry has been due for a change, and small-home models like the Green House Cottages represent the epitome of progressive nursing home care right now.

The Green House model costs no more to the consumer than traditional facilities and offers a philosophy of care that emphasizes quality of life, emotional well-being, and elder choice. That has led to everything from better clinical outcomes to higher levels of family and elder satisfaction and lower depression rates among elders.

COVID-19 has only emphasized the need for a departure from a traditional, institutionalized nursing care setting. Reports show small-home facilities experienced fewer infections and deaths, partly because of the inherent benefits of the physical layout. The Green House model consists of private rooms surrounding residential-style, shared living spaces in self-contained cottages with 12 residents. By contrast, centralized facilities that have been the longtime standard in nursing care consist of long hallways of semi-private rooms, where up to 100-plus residents might share gathering spaces, in addition to laundry and food services.

While such entities as AARP and JAMDA have published research on the benefits of the Green House nursing home model, perhaps the most significant differentiator is something that studies can’t measure. You only know if you’ve walked into one of the facilities.

That is: it just doesn’t look, feel or smell like a nursing home.

Under the Green House model, the aim is to create the next best thing to home. Each elder has a private room with an attached bath. The shared living space comprises an open kitchen with state-of-the-art stainless steel fixtures and inviting living and dining areas, and all centered on a fireplace. Institutional cues like signs, buzzers and loudspeakers are eliminated when possible.

John Montgomery

The elders have direct and open access to all home areas, both inside and outside, on porches and in adjacent green spaces. They choose what to do with their time, whether engaging in planned activities and celebrations, or pursuing their interests, perhaps visiting the spa within the cottage, reading alone, or playing an impromptu board game with others. Elders decide when to wake up, in addition to when and what they will eat.

There is a 4:1 direct care staff ratio, substantially more than state and federal averages. Staff receives 120 hours of extra training in skills like critical thinking, clinical communications, and consensus-building.

While evidence shows benefits to the Green House approach, some in the industry question the model’s economic viability and point to operational challenges of a decentralized skilled nursing care facility. However, we believe quality will always win out, and we are prepared to invest in quality.

We’re betting on it. Southern Administrative Services has opened five Green House Cottage facilities across the state: The Green House Cottages of Poplar Grove in Little Rock, Green House Cottages of Belle Meade in Paragould, Green House of Southern Hills in Rison, Green House Cottages of Wentworth Place in Magnolia, and Green House Cottages of Homewood in Mena. The Green House Cottages of Walnut Ridge is under construction now and will open later this year.

From there, we intend to open more, with an ultimate goal for there to be a Green House Cottage within 60 miles of every Arkansan.

The plan is to continue building onto and adding cottages to our existing properties, some of which are assisted living facilities that we will convert into skilled nursing care homes.

We believe this approach is the right thing for our older generations, and the Green House Cottage model is the way forward for elder care.

Editor’s note: John Montgomery is the chief operating officer of Southern Administrative Services, which provides support services to a network of 30 long-term care facilities. The opinions expressed are those of the author.