James M. Berklan, McKnight's Editor
James M. Berklan, McKnight’s Editor

I almost feel like I’ll need to find a confessional booth after completing this blog post. I come not to bury the Green House project but to praise it. This is tough to do.

Why, you ask? Simple: From the first time I came across an email or promotional brochure about this pioneering type of seniors housing, I sensed it was something different and special. And I quickly realized that nobody was going to let me forget it, either.

If there is anything the Green House gang doesn’t really need, it’s more publicity. They are pros at getting it. Again. And Again. And Again. And yet here I am, voluntarily writing about it. Again. Just like countless of the biggest consumer media organizations in the country.

However, I’m sure the people who invented the paperclip, TV remote, and peanut butter and jelly sandwich, respectively, all had good reasons to keep reminding people what a good thing they had. As well they should have.

Nowadays, to have anything to do with long-term care and not know the Green House name or concept is unthinkable. If this were an entertainment or computer firm we were talking about, we might well be rolling out Disney or Apple references.

There are now literally hundreds of Green House communities in many states, with plans to put them in every state as soon as possible. What’s more, the concept regularly receives the highest compliment in the marketplace — an almost bittersweet one that the folks with Thermos, Xerox and Kleenex products know all too well. I’d need all the toes and fingers at an overflow Larry Minnix speech to count all the times I’ve heard people incorrectly say he or she is working on a “Green House project.” Instead, they’re liable to be referring to a generic version of a new living arrangement that hopes to mimic characteristics that Green House has now embedded in the everyday LTC lexicon.

Now that’s flattery — it doesn’t come lightly in the long-term care sector, you might have noticed.

That’s why it seems nearly impossible that the first Green House opened just 10 years ago next month. That’s right: 10 years ago.

Steve McAlilly was the first to run such a project. He’s still the top guy at Mississippi Methodist Senior Services in Tupelo, MS.

Green House founder Bill Thomas, M.D., whose next refusal of a media request would have to be his first, has been the driving force behind this new seniors care and housing trend. He’s ubiquitous, proud, and rightly so.

To review, Thomas’ Green House ideals are based upon Eden principles he devised earlier. They include designing separate buildings for 10 to 12 residents. They have private rooms, bathrooms and intimate common areas that lend themselves to the “family-type” feel. Staff include a central figure who helps run the household, from dining to laundry care, and more. These individuals, called Shahbazim, partner with nurses and other clinical team members to create an empowered clinical care team. The Shahbazim report to a Guide, who is responsible for providing the team with needed support, accountability and resources to succeed.

The result is residents getting four times the usual staff-to-resident contact, according to Green House officials. In addition, they say staff turnover is just a fraction of other long-term care settings’. 

Independent firms have studied the movement and generally praised its goals and achievements. There’s also something called The Green House® Project, a program of NCB Capital Impact that has received funding from The Robert Wood Johnson Foundation. It was in 2005 that RWJF pledged $10 million toward the establishment of Green Houses in all 50 states.That’s not exactly dipping a toe in the water.

Admittedly, not everything promoted about Green Houses can be peaches and cream. That’s just not realistic. In some cases, it’s simply still too early to make apples-to-apples comparisons. Yet it is undeniable this is a commodity that has enjoyed an incredibly sharp growth curve. This has not happened just because of strong self-promotion.


Oddly, it’s been at once a very long 10 years of Green House history and a very quick 10 years. One can safely say there will be many more to come.