First, among national “small house” models, GH is significantly inflexible and its small number of residents per household severely limits reimbursement, which in turn limits staffing. The proposed plan eliminates RNs on the floor,and, in fact, limits all staff with the exception of two aides who would be responsible for cooking, housekeeping, and laundry – in addition to care of the nursing home residents. And it would have only one aide at night. GH is known all over the country for not offering activities– neither meaningful nor meaningless activities – since there simply is not sufficient staff.
Secondly, one main goal of the original Green House model was to give residents the opportunity to participate in local community life, to socialize with other community members and enjoy the outdoors to the maximum possible. By locating frail, elderly residents on the upper floors of a 20-story tower, it is highly unlikely that these residents would have the opportunity to participate in local lifewhen they must wait long periods to get on an elevator.
In contrast, on its large existing West 106th Street property, JHL could build two interconnected 8-story wings of a nursing home.The frailest residents could be located on the lowest floors so they would be able to see street life and be accompanied outdoors. Short-stay rehabilitation individuals could occupy upper floors. And on street level, there could be a performing arts center so nursing home residents and their families and neighbors could enjoy plays, concerts, films, and lectures. The facility could become a cultural hub for nursing home and community residents – and show how a committed lower-rise urban nursing home could lead in developing a replicable national model.