Blowing Up the Traditional Skilled Nursing-at-Home Model

Though it has historically been a design model prevalent among non-profit providers, one private-pay, for-profit senior living company is embracing the future of long-term care with a more home-like approach to skilled nursing.

Harnessing resident-centered design elements brought forth by the Green House model, Windsor Healthcare, a sub-acute care and rehabilitation provider with 10 campuses throughout New Jersey, is magnifying the small-house concept for skilled nursing and has applied it in a large-scale setting.

“The thing about the Green House model is that it provides wonderful care, however, we have yet to see a Green House that is revenue neutral,” Windsor Vice President Joshua Jacobs told SHN. “It’s just not feasible for a for-profit company or a non-profit company that doesn’t have very deep pockets. So we asked, how can we take the model and put it into a larger setting?”

The answer for Windsor was to employ principles from the Green House model into a bigger environment, the result being the Venetian Care & Rehabilitation Center, a 180-bed skilled nursing and short-term rehabilitation facility in South Amboy, N.J.

Whereas a typical Green House model provides smaller, more cottage-like lodgings for 10-12 residents, the Venetian inflates this design to accommodate its vast 93,000-square-foot structure.

The idea is to break down the community into smaller households that better resemble an environment that’s more home-like and less institutional for residents.

“A big part of resident satisfaction is creating a warm environment where [residents] can direct the care they receive instead of being a passive part of the care,” Jacobs said.

To achieve this desired appeal, the three-story, E-shaped building is divided into various neighborhoods self-led by residents and their care partners. These neighborhoods feature common appliances one would find in any residential home, including dining rooms and full kitchens outfitted with ovens, stoves, microwaves and refrigerators.

Each floor of the Venetian embodies a different theme with variously named neighborhoods. For example, the first floor of the Venetian carries a “trees” theme to symbolize continued growth during a senior’s elder years. Neighborhoods within that floor are Willow, Fern and Oak, each designed with its own color scheme and distinctive artwork.

Similar to a Green House, the Venetian is designed with principles of The Eden Alternative in mind. A 501(c)3 international organization founded by Green House creator Bill Thomas, The Eden Alternative is a person-directed approach to improve the well-being of seniors and their caregivers by transforming the communities in which they live and work.

Communities that embody these initiatives, among other criteria, can elect to join the Eden Registry for an initial cost of approximately $3,300. Joining the registry may take anywhere from 6-18 months, depending where an organization is on their path toward a culture change that includes not only a physical transformation of the facility, but also specific, dedicated staff roles that embrace resident-centered care.

Windsor currently maintains four communities on the Eden Registry, but the company’s goal is to have all nine of its communities certified, especially as it looks to improving quality outcomes and the prospect of rolling out similar initiatives at future properties.

“In the future, communities that have quality, performance and value will thrive and those that don’t will wither,” Jacobs said. “There’s a big chasm in skilled nursing, in that we provide transitional care and long-term care. We can use the Eden principles to drive our success in post-acute transitional care.”

A family-owned company headquartered in Norwood, N.J., Windsor operates nine communities located throughout the central and northern regions of its home state. The Venetian, which Windsor anticipates will open by mid-September, is the company’s tenth community.

Written by Jason Oliva