With a ‘Green House’ small is beautiful | Aging Matters | January


By now you’ve heard that Martha & Mary, which operates intergenerational services all around Kitsap County, will be partnering with the Bellevue developer, Shelter Resources, Inc (SRI) to build and operate the affordable senior housing project at the Village Green in Kingston.

That project’s timing depends on securing loans, grants and investment dollars, but it looks very likely to be accomplished during the next three to five years, just like the replacement community center itself.

In meetings with Martha & Mary staff and board members, I first heard the term “Green House.” Green House is a term that refers to small facilities for providing long-term, skilled nursing care.

The basic elements include providing skilled nursing care to six to 10 people who want an alternative to institutionalized care. As readers of this column may recall, it’s been my experience that some adult family homes provide almost this kind of alternative, with the important difference that adult family homes are not licensed to deliver skilled nursing care.

In every state until the last decade, providing skilled nursing care was the exclusive province of nursing homes licensed to provide that level of care, and they were almost always quite large. As an example, Martha & Mary is licensed to serve 190 beds. Don’t get me wrong, it’s a first-class institution that happens to be large.

The Green House concept appeals to me because it combines the intimacy of the adult family home with a license to deliver skilled nursing care.

Green House was the result of one medical doctor’s frustration with the nursing home industry, according to a 2008 Wall Street Journal article.

That doctor secured a grant to introduce an entirely different alternative, rather than wait for the industry to change its culture, which associated large size with economies of scale.

The article cites data showing that fewer and fewer of us want to live in large institutions. The AARP reports that that 1 percent of Americans over 50 with a disability want to move to a nursing home.

At present there’s one Green House in Washington, in Winthrop (www.thecovecares.com). The Robert Wood Johnson Foundation now partners with a not-for-profit group called NCB Capital Impact to fund new Green House construction. Sometimes they’re built by a traditional nursing home that wants to update or modernize its facility.

The building has to adhere to certain standards (mostly private rooms organized around a kitchen, dining room, and hearth) to be considered a Green House. There are regulatory hurdles to be cleared as well. Early studies about the health and well-being of Green House residents are encouraging.

For more about the concept, go to www.ncbcapitalimpact.org and click on “The Green House Project” in the lower right.

I offer one final clarification: Housing at the Village Green will be for people who can live independently — it will not be assisted living, nor a skilled nursing facility. But I’m grateful to Martha & Mary staff for opening my eyes to another option on the long-term care horizon.