The Big Idea Behind A New Model Of Small Nursing Homes

The Green House Project, which is a network model of nursing homes across states, has been able to largely avoid the spread of Covid-19 amongst residents, with five times fewer cases than the national nursing home average. While the small size of the nursing homes has played a role, it has also been beneficial that each resident has their own bedroom and bathroom and that staff employ a universal worker model that limits the number of nursing assistants coming and going from each facility.

Japan's model of prioritizing societal care for their elderly has helped the country achieve the highest life expectancy and be named the healthiest population in the world. Now amid the coronavirus pandemic, the country's senior citizen-focused policies and health care system are showing success in keeping the number of cases and deaths low in aging populations.

Health professionals today routinely help patients access support services, like food and income assistance, that are crucial for their mental and physical health. Organizations, like Health Leads, have stepped in to manage some of this support. They encourage doctors and social workers to “prescribe” resources like food, and volunteers help by managing the logistics of things like transportation or application assistance.

Nursing homes adapted to COVID-19 so that they could protect residents’ physical well-being while also preserving their social and emotional health. Staff at Belknap County Nursing Home modified popular activities to make them safe, like hallway bingo, where numbers were called from hallways so that residents could stay in or near their rooms. Participation jumped 30% from pre-pandemic levels. An adaptation to another popular game, “Price is Right,” had staff bringing items, like snacks and toiletries, room-to-room so that residents could guess the price, with the person coming closest winning the item.

After facing staffing shortages during the early days of the coronavirus pandemic, the Minnesota Department of Human Services developed an aggressive emergency hiring initiative ahead of potential new outbreaks. Using third-party staffing agencies and encouraging applicants from all backgrounds – like those recently unemployed from the service industry – the initiative has "provided rapid relief to dozens of nursing homes, assisted-living facilities, group homes, homeless shelters and substance abuse treatment centers."

When nursing homes in North Carolina realized that the coronavirus pandemic had arrived within the state, facility managers and staff began enacting measures to prevent the spread of the virus amongst their residents. Adapting existing infection control and prevention plans, many were able to ensure a robust supply of PPE and reinforce their staffing numbers, which has paid off as most of the facilities have avoided outbreaks.

Health care providers at Summa Health Pride Clinic in Akron, Ohio are transforming the way care is offered to trans and gender nonconforming people by working to reduce barriers that they often face. All staff undergo LGBTQ+ sensitivity training and the clinic is adorned with Pride flags – two parts of the clinic's overall "blueprint," which doctors say "can be duplicated anywhere in the country."

A residential senior center prevented the spread of Covid-19, with just 1 of over 700 residents contracting the virus. In addition to social distancing, hand washing, and outdoor visiting areas, the facility's residents wear colored wristbands, green for those staying on campus and red for those who want to leave. Those who leave cannot use the common areas, gym, or dining area for 10 days after returning, and then are tested for Covid-19 before reintegrating. There are some tensions between the two groups, but federal and state infectious disease experts have called the facility a model for best practices.

In New Hampshire, nursing homes and veteran's homes are turning to online video conferencing and outdoor socially-distanced activities to manage the patients' feelings of isolation during the coronavirus pandemic. Although it does not replace in-person contact, residents have expressed that it has helped and the facilities say that they plan to keep some of the technologies in place post-pandemic so out-of-state family can "visit" more often.

The Cedar Hill Continuing Care Community near Lebanon, New Hampshire, is one of many senior-assisted living facilities that has rapidly responded to the spread of coronavirus. The staff has set up personal bingo tables that allow residents to sit six feet apart, taught seniors how to call their loved ones while they're quarantined, and engaged in more personalized activities to keep morale high.