To synthesize new findings from the Research Collaborative (The Research Initiative Valuing Eldercare) related to the Green House () model of nursing home care and broadly consider their implications.
Interviews and observations conducted in and comparison homes, Minimum Data Set () assessments, Medicare data, and Online Survey, Certification and Reporting data.
Critical integration and interpretation of findings based on primary data collected 2011–2014 in 28 homes (from 16 organizations), and 15 comparison nursing home units (from 8 organizations); and secondary data derived from 2005 to 2010 for 72 homes (from 15 organizations) and 223 comparison homes.
Implementation of the model is inconsistent, sometimes differing from design. Among residents of homes, adoption lowers hospital readmissions, three measures of poor quality, and Part A/hospice Medicare expenditures. Some evidence suggests the model is associated with lower direct care staff turnover.
Recommendations relate to assessing fidelity, monitoring quality, capitalizing opportunities to improve care, incorporating evidence‐based practices, including primary care providers, supporting high‐performance workforce practices, aligning Medicare financial incentives, promoting equity, informing broad culture change, and conducting future research.
