Jewish Home and The Green House Project

The Green House® Project is a revolutionary, non-institutional approach to traditional skilled nursing care. Elders receive the clinical support and personal care they need in a living space designed to look and feel like a private home, with a focus on the needs and desires of the residents. Physically and philosophically, The Green House® model puts the home back into nursing home.

Jewish Home is working to use this model to radically transform skilled nursing care in the New York area.

In Westchester, the Small House communities at Sarah Neuman embody the innovative Green House approach. From the opening of our first Small House in 2014, life there has centered around the interests of the residents. Wake-up times, activities and mealtimes are based on personal preference – not institutional convenience. Three Small Houses are already operating, and we plan to open five more over the next two years. Read more about the Sarah Neuman Small Houses.

In Manhattan, we are developing New York's largest eldercare capital project, the planned Living Center of Manhattan. The first Green House high-rise in an urban setting, it will enable older New Yorkers to continue living their lives the way they want, in the community they know and love.

The Living Center of Manhattan will fit the aesthetics of the neighborhood while combining skilled nursing and post-acute rehabilitation in one building that includes 32 Green House homes and a total of 414 beds, complete with terrace and rooftop gardens and extensive community space. As at Sarah Neuman, each Green House will include its own central hearth and dining area, with private bedrooms and bathrooms. Each has an open kitchen where elders and visitors can participate in meal preparation. Read more about The Living Center of Manhattan.

To discuss how you can help build The Living Center of Manhattan or Small Houses at Sarah Neuman, please contact Katie Katz, Capital Campaign Manager at 212.870.4763.

Comparing Satisfaction among Elders in Green Houses® to Traditional Nursing Home Residents

  • Improved quality of life – Elders who lived in a Green House® reported improvement in seven key areas that reflect quality of life (privacy, dignity, meaningful activity, relationship, autonomy, food enjoyment and individuality), as well as elevated emotional well-being, as compared with traditional nursing home residents.
  • Improved quality of care – Green House® elders maintained self-care abilities longer than traditional nursing home residents, with fewer experiencing decline in late-loss Activities of Daily Living. Fewer Green House® elders reported experiencing depression, being bedfast and having little or no activity.
  • Improved family satisfaction – The families of elders living in a Green House® were more satisfied with general amenities, meals, housekeeping, physical environment, privacy, autonomy and health care.
  • Improved staff satisfaction – Green House® staff reported higher job satisfaction and increased likelihood of remaining in their jobs than their counterparts in traditional nursing homes.

Operations of Green Houses® as compared to Traditional Nursing Homes

  • Increased interaction with direct care providers – Staff in Green Houses® reported spending between 23–31 minutes more on direct care activities per resident per day, without increasing overall staff time.
  • Increased elder engagement – Staff time spent engaging with elders (outside of direct care activities) increased more than four-fold in Green House® settings.
  • Less stress – Direct care staff in Green House® homes reported less job-related stress.
  • Improved care outcomes – Elders experienced fewer in-house acquired pressure ulcers in Green House® homes as compared with traditional nursing homes.
  • Cost-neutral operations – Green House® homes operate at the same median cost as the national nursing home median cost.
  • Lower capital costs – Green House® homes provide enhanced common space  and private bedrooms and bathrooms, all while building on the same, or fewer, square feet as other culture-change nursing home models.


1) Kane R, Cutler L, et al. “Resident Outcomes in Small-House Nursing Homes: A Longitudinal Evaluation of the Initial Green House Program,” Journal of the American Geriatric Society, 55(6):832-839, June 2007.

2) Kane R, Cutler L, et al. “Effects of Green House® Nursing Homes on Residents’ Families,” Health Care Financing Review, 30(2):35-51, Winter 2008-2009.

3) Sharkey S, Hudak S, et al. “Frontline Caregiver Daily Practices: A Comparison Study of Traditional Nursing Homes and The Green House Project Sites,” Journal of the American Geriatrics Society, 59(1):126-131, January 2011.

4) Jenkens R, Sult, T, et al. “Financial Implications of THE GREEN HOUSE® Model,” Senior Housing & Care Journal, 18 (1): 3-21, September 2011.