Volume 51 | Number S1 | February 2016

Abstract List

Lauren W. Cohen, Sheryl Zimmerman, David Reed, Patrick Brown B.S., Barbara J. Bowers R.N., Ph.D., Kimberly Nolet M.S., Sandra Hudak R.N., Susan Horn Ph.D., , David Grabowski


To describe the Green House () model of nursing home () care, and examine how homes vary from the model, one another, and their founding (or ) .

Data Sources/Study Setting

Data include primary quantitative and qualitative data and secondary quantitative data, derived from 12 /legacy organizations February 2012—September 2014.

Study Design

This mixed methods, cross‐sectional study used structured interviews to obtain information about presence of, and variation in, ‐relevant structures and processes of care. Qualitative questions explored reasons for variation in model implementation.

Data Collection/Extraction Methods

Interview data were analyzed using related‐sample tests, and qualitative data were iteratively analyzed using a directed content approach.

Principal Findings

homes showed substantial variation in practices to support resident choice and decision making; neither nor legacy homes provided complete choice, and all homes excluded residents from some key decisions. homes were most consistent with the model and one another in elements to create a real home, such as private rooms and baths and open kitchens, and in staff‐related elements, such as self‐managed work teams and consistent, universal workers.


Although variation in model implementation complicates evaluation, if expansion is to continue, it is essential to examine elements and their outcomes.