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Promoting an Alternative to Traditional Nursing Home Care: Evaluating the Green House Small Home Model. An Introduction from the Funders and the Green House Project

Although the number of nursing home residents has decreased slightly in the last decade and the community is often the preferred setting for those requiring long-term care (AARP Public Policy Institute 2005), the need for skilled residential care remains. Within the field of long-term care, there has been an ongoing interest—known broadly as culture change—in improving the look, feel, and delivery of skilled nursing home care (Centers for Medicaid and Medicare Services 2013). These efforts date back to the 1983 publication of the Consumer Statement of Principles for the Nursing Home Regulatory System by the National Citizen's Coalition for Nursing Home Reform, which was endorsed by 60 organizations (Koren 2010). Over the past decades, numerous programs have sought to create person-centered care where the voices of elders and those who work with them are considered and respected, and the principles of choice, dignity, respect, and purposeful living are valued. These programs exist within traditional nursing homes and also led to the development of more transformative programs, including small home residential models. Still, culture change remains an evolving movement with little evidence to guide providers in implementing changes with proven impact (Shier et al. 2014). As a result, many nursing home providers are eager to learn more about what works to improve care and quality of life.

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