In ElderBranch’s effort to learn more about the revolutionary concept behind Green House Homes, we recently spoke with James Farnan. James is the Vice President & Administrator of Eddy Village Green in Cohoes, NY.
In an exclusive interview, James shares with us why the Eddy Village Green House homes are such an important part of the elder care ecosystem in and around Albany, NY.
What’s the affiliation between Eddy Village and The Green House Project
The Eddy Village Green (EVG) is a Green House Adopter with a contractual arrangement with NCB Capital (aka The Green House Project).
Tell us a bit about the 16 Eddy Village Green House Homes and how they differ from a more standard nursing home in Albany?
The main differences are:
Environmental: Elders live in 12 bed ranch style houses with their own private room and bath, accessible kitchens and outdoor spaces and smaller, more familiar common space (e.g. Dining room , living room and kitchen). Traditional nursing homes in the area are predominantly hospital environments with mostly semi-private rooms, long hallways and large multipurpose areas that serve as the dining room and main activity space.
Provision of Care: The Green House model focuses on restoring control and decision making to the elder. This manifests itself in the house looking to accommodate life routines when work processes are established. For example, elders are encouraged to get up and go to bed at times that are consistent to their preferences, have menus designed around the foods they prefer, and participate in life via leisure pursuits that meet their interests. In addition, each house is run by a self-managed team of staff who are charged with creating work schedules that fit their elders needs. This team is a group of people trained as universal workers (we refer to as shahbazim) who provide direct care to elders as well as cook, clean, run recreational programs and participate in care planning for their group of 12 elders.
Relationships: Continuity of staff is a hallmark of the model, with a small group of staff caring for a small group of elders.
The model focuses on the strong relationships that develop between elders and staff. It is through “knowing” the elder that staff are able to anticipate needs better.
You refer to your residents as “elders” in your community, living as part of a “family”. This is a revolutionary way of looking at nursing homes. Tell us why it’s so important…
As with other Green House adopters, the language used to describe those living and working at EVG is intentional. It serves to restore respect for all involved. The titles used traditionally in nursing homes (resident, aide, etc.) have a negative connotation that we want to distance ourselves from.
What services or types of care do the Eddy Village Green House Homes offer? Do you have any area of specialty or focus?
The services that are offered at EVG are very similar to those offered at other traditional facilities and are compliant with federal and state regulations. As mentioned earlier, the difference lies in the approach. We specialize in providing care to frail elderly requiring skilled nursing services.
You currently have 16 Green House Home locations. Based on the success you’ve had so far, are there plans to build more throughout Albany?
We are still working through our transition in Cohoes and have no current plans to build more in Albany.
What activities and recreation programs do you offer residents to enrich their experience at the home and enable them to engage with other residents and the community more broadly?
Part of honoring the routine of those who call EVG home is understanding what their interests are and trying to accommodate them through the creation of programs that meet those interests. Each self-managed team is charged with producing an activity calendar each month that reflects the interests of their elders. Our approach to “activities” is much different in that it is not focused on big, congregate productions, but rather on how one would like to spend their time at home. “Activities” may be elders participating in daily tasks that they find productive such as helping with laundry or chopping vegetables as part of meal prep. They may also be more individualistic such as reading the paper, doing crosswords or reading. They may be two friends playing chess or 4 friends playing cards. In addition, more traditional entertainment is also brought into the homes or to our community center. With the addition of our community center, we are now better able to offer larger gatherings such as mass and private family functions for our elders.
Staffing is always an important predictor in quality of care. How do you approach hiring and on-going training with regards to your nursing staff?
Staffing is a major concern in any SNF. Our hiring and training processes have changed numerous times as we learn from our experience. Due to the major change in responsibilities of our shahbazim (i.e. being trained as universal workers), our training and orientation program is extensive and typically lasts 6 to 8 weeks. Our hiring process includes a pre-employment survey that aims to identify characteristics that have proven successful in our environment. We are focused on finding the right people who are interested in working as part of a team and who possess a willingness to be active participants in decision making.
What trends do you see in the current economic, health care, and social landscape that affect seniors and senior care, and how is your home adapting to stay current or even ahead of the curve?
Our whole transition to Green House is predicated on the changing social landscape. In examining the options for moving away from the traditional model, we were drawn to Green House because it offered everything “we” (as in the leadership staff) wanted, should we require nursing home placement ourselves. Private rooms, private bathrooms with showers, easy access to the outdoors and to the kitchen, were all major benefits identified by staff and by our families when the decision to become a Green House adopter was made.
The model offers many benefits when it comes to facing the steep financial challenges that most providers are facing. First and foremost, it has been our experience that the model draws a higher percentage of elders who pay privately for services. In addition, the space itself allows for some flexibility should financial constraints force a shift in programming. In other words, if we had to reclassify beds to an alternate level of care, it would be much easier than attempting to do so in the traditional large institution.