Cultural Transformation Toolkit

The Green House Project is a nonprofit organization working to deinstitutionalize skilled nursing facilities through the creation and proliferation of a radical small home model that prioritizes person-directed care. The organization, which was founded in 2003, has now over 350 adoptees of the model throughout the country, and is slowly beginning to develop an international presence.

While one prong of The Green House Project’s approach is to encourage new builders to utilize The Green House Project’s model, another way the organization operates is through their Cultural Transformation program. Cultural Transformation comprises individualized coaching, workshops, webinars, and educational resources to equip existing nursing homes with the skills to transform their culture without significant capital costs. My fourteen weeks at The Green House Project culminated with the creation of a toolkit for the Cultural Transformation program that outlines steps to begin the process of culture change towards person-directed care in a nursing home. From this toolkit as well as my work at large, I’ve learned two main things: first, person-directed care is deeply intuitive and based in our worth as human beings, making it an arguably simple and theoretically more accessible model than the status quo; second, the system is no one’s friend. Although the recent COVID-19 narrative surrounding eldercare found an easy scapegoat in nursing homes, the reality is far murkier as the quagmire of CMS regulations often forces the hand of nursing home administrators and staff, despite their best intentions. While it seems to me that the best solution to eldercare reform will ultimately lie in large scale, policy-level change, it takes a lot of compromise, creativity, and visionary thinking to be able to work within the boundaries of the eldercare system and still enact change.