Community Green House Proposal

Summary

St. John’s Senior Communities is pursuing efforts to bring New York State’s first Green Houses to the Rochester region. This is a radical new approach to skilled nursing care, where each element – care philosophy, organizational structure, and architecture – is carefully crafted to remove “institutionalization” from long-term care. Warm, caring relationships are the basis of each day. Residents, referred to as “Elders”, live as part of a ‘family’ in the community while still benefiting from the full range of clinical services provided by St. John’s. Another major component of the Green Houses is specially trained universal workers, who are empowered to manage the care of elders through self-directed work teams.

St. John’s is planning to build 15 Green Houses, placing them in neighborhoods in our community. The most efficient community model comprises two adjacent Green Houses, each housing ten Elders.

Click below to watch the Lehrer news video on Green Houses:

Community Green House Benefits:

• Provides an opportunity for Elders who need care to stay within their home town, near their families, neighbors, and/or congregations

• Elders in St. John’s Home may chose to return to their home communities

• Allows community's members to be actively involved in the care of elders

• Allows elders access to community resources

• Provides an opportunity for local employment and services

• Provides an opportunity for community service (volunteers, Boy and Girl Scouts, school age asset building, etc.)

What we need from you:

• Partnering opportunities

• Feedback on the community Green House Model

• Potential sites

The Green House Project

Green House Philosophy

The goal of the Green House project is to create living environments for the elderly, frail and disabled that are rich in meaning, vitality and joy. The focus is on autonomy, dignity, choice and keeping decision making as close to the elder as possible.

Sponsored by the Robert Wood Johnson Foundation

Sponsored by a $10 million grant from the Robert Wood Johnson Foundation, the Green House concept is a specific, licensed national model for skilled nursing care. Green Houses are the next evolution of the Eden Alternative, founded by Dr. William Thomas, who pioneered culture change in nursing homes in the 1990’s.

St. John’s, Rochester’s only registered Eden nursing home, has been selected as a demonstration project to create Green Houses in New York State. In recent meetings with St. John’s and Green House leadership, the NYS Department of Health has been encouraging, looking carefully at ways to support this innovative approach to care.

St. John’s Plan

St. John’s is planning to build 15 Green Houses, placing them in neighborhoods in our community. Our first community Green Houses will be located within close proximity of St. John’s Home. At the same time as Green Houses are established in the community, St. John’s will reconstruct the current St. John’s nursing home into multi-story Green Houses within the existing buildings at our 150 Highland Avenue campus. The cost for the entire project including 15 Green Houses in the community and 32 Green Houses in the nursing home will be $40 million. The State of New York will require an equity contribution of $6 million, which we will raise in a capital campaign.

A Home for Ten Elders

Each community Green House will be home for ten elders, located in a neighborhood in the Rochester area. Designed like a large ranch-style family home, each has a “hearth”, a central dining area with adjacent kitchen and living room, complete with fireplace. The hearth is easily accessible from large, private bedrooms, each with a private bath. The community model is most efficient when two Green Houses are located adjacent to each other.

Family Meals

Elders, their family members, friends and care giving staff share meals together around a large dining table, recreating the traditional family meal. If they are willing and able, elders can cook meals, prepare desserts and snacks and help with activities like caring for pets or plants or folding laundry. Even with severe disabilities, residents experience and participate in a high

quality of life. Discreet, ceiling-mounted lift technology ensures that they will have the assistance they need to be involved in the life of their Green House.

Comprehensive Care

A clinical support team consisting of nurses, social workers, physicians, therapists, nutritionists and pharmacists provides state-of-the-art care, but does so according to a revamped philosophy that places the needs of the individuals first. Nursing staff collaborate with elders and their families to customize care for each person, so that residents function more independently.

Results from several prototype Green Houses around the US are promising. Green House operators report increased occupancy; higher satisfaction levels from residents, family and staff; less decline in “Activities of Daily Living;" dramatic decrease in staff turnover; reduced incidence of depression; less use of medications; and strong testimonials to improved functionality and overall quality of life by elders’ family members. Operating costs are proving to be equivalent to current nursing home costs.

Summary

In summary, the Green House is a revolutionary approach to long-term care, and St. John’s is committed to bringing it to neighborhoods in our community. Plan highlights include:

• 15 Green Houses will be created in neighborhoods in the Rochester area. This decentralized approach is a first in the United States.

• 32 multi-story Green Houses will be created within the St. John’s current campus, replacing the traditional nursing home internal structure.

• The national Green House movement is sponsored by a $10 million grant from the Robert Wood Johnson Foundation

• Green Houses offer comprehensive care for the elderly in a radical new way, eliminating ‘institutionalization’ from long term care.

• Green House results show significant improved quality of life and increase resident/family satisfaction.

• Green Houses can operate at the current operation cost level for traditional nursing homes.

• Our total project cost is $40 million. The equity contribution of $6 million will be raised in a capital campaign.

First Green House Fact Sheet

New York State Department of Health licensed Long Term Care facility

Within close proximity of St. John’s Home

Two adjacent homes on one site

Ten elders in each home

~One acre per home

Approximately 6,500 square feet per house

Ten rooms with private baths

Large hearth area adjoining a kitchen that allows elders to participate in meal preparation

Laundry, spa, pantry, ample storage

2-car garage

Parking for staff & visitors—driveway parking for 2 staff, plus parking for 5 visitors per house. Parking can be on street or nearby as appropriate for neighborhood.

On bus line

Indoor and outdoor activity space and gardens; perhaps common outdoor space between two Green Houses

Future Green House Plan

In next 3-10 years, build 15 Green Houses in residential settings throughout Monroe County and reconstruct the existing campus to create a new community with 32 multi-story Green Houses.