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 Analysis Shows Promise For Green House Model

​Existing research on the Green House model shows "significant and sustained satisfaction and clinical improvements" compared to traditional nursing homes, according to a study released today in the Seniors Housing & Care Journal, published by the National Investment Center for the Seniors Housing & Care Industry (NIC). 

New research and analysis presented in the study addresses questions about the model's financial viability.

Titled "Financial Implications of The Green House Model,"  the analysis won NIC's GE Award for Best Research Paper, which was presented to lead author Robert Jenkens, director of the Green House Project at NCB Capital Impact, this morning at NIC's annual meeting in Washington, D.C.

The analysis found that three recent studies, each limited in scope but with similar findings, provides growing evidence that:

  • The Green House model’s operations are comparable in cost to traditional nursing facility operations, as well as those implementing culture change practices;
  • Capital costs are equivalent or less than similar to culture change models and higher than traditionally designed nursing facilities; and
  • Revenue enhancements from care and environmental upgrades are likely.

Whether or not the study will spur for-profit interest in the model remains to be seen. Following the release of the study today, NIC President Robert Kramer indicated that he would like to see more data on the model's capital costs compared with traditional nursing home capital costs. 

Jenkens and his co-authors found that in 2009, total operating costs per resident day, excluding interest and depreciation, for five Green House projects ranged from $161 to $237, for an average of $199, compared with a national median value of $197.51 for nursing homes overall--a difference of less than 1 percent, the study notes.

In addition, the study points out that Green House homes tend to serve a lower percentage of short-stay Medicare-funded residents than a typical nursing home, "and Medicare residents may increase ancillary costs," the authors wrote, suggesting that such higher costs should be offset by an associated increase in reimbursement.

Kramer expressed optimism about culture change models going forward. "The seniors housing customer of the future will demand the kind of service this model provides, such as all private rooms, 24-hour dining, and person-centered care," he said.

The emerging consumer of seniors housing will be much more demanding than the current client in long term care, Kramer noted. "The customers of the future are baby boomers who are entitled and demanding and accustomed to getting what they want" and culture change and the Green House model cater to this demand.

“These research results, coupled with anecdotal experience, indicate that Green House homes offer a strong option for organizations to explore as they seek to address current and future challenges in their nursing home operations and markets,” the study said.

See more details about the study in Provider's upcoming October issue, out next week. For more information about NIC, go to

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