Coming soon to Las Vegas: a nursing home where the residents call the shots.
After working as a nursing home executive overseeing institutional care, Michele Goldman decided to downsize.
Now she is working to bring Nevada its first “Green House Project” nursing home — a small residential-style home focused on providing skilled care and independence for the elderly in a less-institutional setting.
“You think of a nursing home and it’s like, ‘Oh, God, it’s the last place you want to be,’” said Goldman, whose project, The Villas at Centennial Hills, is set to open by the end of the year. “It has a lot of stigma in this country, and for good reason.”
Traditional nursing homes often resemble in-patient hospital wards and have recently come under scrutiny from federal Medicare officials after hospital readmission rates began climbing.
“It’s where people are basically going to get a very high level of care … and die,” according to Nancy Bernard, senior adviser for program development at the Robert Wood Johnson Foundation, a health care-focused nonprofit that has promoted the Green House model since its inception.
Goldman hated what she saw while overseeing nursing homes.
“Every time I walked into one of my nursing homes in Texas, my heart sank,” Goldman said. “I just felt like there has to be something different than this.”
The first Green House Project home opened in Mississippi in 2003. The model relies on creating a home-like feeling away from home. Though nurses staff the home 24/7, patients are encouraged to get involved in their own care.
Medication is stored discreetly in a locked cabinet within a patient’s room, instead of being distributed on a cart. There’s no set time for breakfast, dinner or activities. Patients decide what they want to eat and do and when, providing a sense of autonomy that can promote emotional health for those still in good physical shape.
The six-to-12-room homes (Goldman’s project will have room for 12 residents in each of six homes) even allow residents to take care of a house pet, like a dog or cat.
“It’s considered part of the future of nursing home care,” Bernard said. “There is a level of privacy that’s there, and at the same time, there’s a level of community.”
That leads to greater patient satisfaction, she said.
But it has its limitations. Each home can house only a handful of patients, and traditional nursing homes aren’t usually built to adapt to the small-house model.
“Green House is not going to become the dominant model for all skilled nursing care in this country anytime soon,” Bernard said. “But it’s made its mark. It has been successful in lifting the level of quality of care that we should all be striving for.”
The Villas at Centennial Hills has backing from state officials, including Julie Kotchevar, public and behavioral health administrator at the Nevada Department of Health and Human Services.
“One of the trends we’re seeing is traditional nursing home usage is down nationally,” Kotchevar said. “I think that’s more people wanting to stay in community-based settings.”
Goldman said she doesn’t anticipate her model will cost consumers more than other large nursing homes in town, though even the traditional models can empty the pockets of a loved one. AARP estimates the annual median cost for a private nursing home room at $100,000.
But she’s already receiving interest.
“When you start telling people about this new model, I always get the same reaction,” Goldman said. “If they’re older, they say, ‘Save me a room.’ ”