NCB Capital Impact
At a Glance
Focus area(s):
Description
NCB Capital Impact harnesses the collective power of technical assistance, public policy and financial capital to improve the lives of low-income people and the communities where they live. Through our partnerships and investments, we seek and create innovations with our partners and investors locally but work to scale nationally.
Impact and Outcomes
What Major Funders Say
Mission & Goals
NCB Capital Impact helps people and communities reach their highest potential at every stage of life. As a national nonprofit organization and a certified Community Development Financial Institution (CDFI), we have delivered high-impact investments and development support for nearly 30 years. We improve access to high-quality health and elder care, healthy foods, housing, and education in low-income communities. We achieve this goal using technical assistance programs, public policy and financial capital.
NCB Capital Impact has a diverse and extensive network of alliances and partnerships with public and private organizations that are like-minded in mission and dedicated to long-term success. Our broad experience and proven track record of developing and replicating social innovations provide critical resources and support for people and communities.
Program
THE GREEN HOUSE® Project is a program of NCB Capital Impact, funded by The Robert Wood Johnson Foundation. NCB Capital Impact provides technical assistance, training and pre-development loans to organizations seeking to transform their communities by embracing The Green House model, a radically new, national model for skilled nursing care that returns control, dignity and a sense of well-being to elders, their families and direct care staff. In the Green House model, residents receive care in small, self-contained homes organized to deliver individualized care, meaningful relationships, and better direct care jobs through self-managed teams of direct care staff working in cross-trained roles. The philosophy of The Green House long-term care model is to enhance elders’ quality of life by:
- Creating small homes that offer intentional communities and high levels of care
- Recognizing and valuing individuality of elders and staff
- Supporting elders’ dignity
- Honoring autonomy and choice
- Providing privacy
- Creating an atmosphere of security
- Promoting maximum functional abilities
- Facilitating physical comfort
- Offering opportunities for reciprocal relationships between elders and staff
- Fostering enjoyment by offering meaningful activities
- Fostering emotional and spiritual well-being
- Offering comprehensive care
Impact
Currently 1,439 elders are served in 135 Green House homes.
Three evaluations conducted between 2003-2009 examined numerous measures of care and satisfaction in Green House homes. Please see Green House Project Guide Book for evaluation citations.
Green House elders relative to comparison group of nursing home residents
- Improved quality of life: Green House elders reported improvement in seven domains of quality of life (privacy, dignity, meaningful activity, relationship, autonomy, food enjoyment and individuality) and emotional well-being.
- Improved quality of care: Green House elders maintained self care abilities longer with fewer experiencing decline in late-loss Activities of Daily Living. Fewer Green House elders experienced depression, being bedfast, and having little or no activity.
- Improved family satisfaction: Green House families 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.
Green House homes relative to nursing home comparison sites
- Higher direct care time: 23-31 minutes more per resident per day in staff time spent on direct activities in Green House homes.
- Increased engagement with elders: More than a four-fold increase in staff time spent engaging with elders (outside of direct care activities) in Green House settings.
- Less stress: Direct care staff in Green House homes reported less job-related stress
- Improved care outcome: Fewer in-house acquired pressure ulcers in Green House homes.
Role of direct care workers
- Comparable quality: Removal of formal nurse supervision of direct care workers did not compromise care quality.
- Timely intervention: High level of direct care worker familiarity with elders led to very early identification of changes in condition, facilitating timely intervention.
Growth Plan
Projected Goals and Milestones
The goal of the Green House Project is to bring to scale a new model of non-institutionalized elder care that combines small homes with the full range of personal care and clinical services expected in high-quality nursing homes.
NCB Capital Impact operates on a three year strategic planning cycle. We are currently creating our three-year plan for 2013-2015 and will provide a summary upon Board approval (early 2013).
Our primary 2010-2012 goal for Green House has been to transition the Green House Project into a sustainable and growing replication initiative with the following objectives and measurements:
- Implement a total of 36 new homes (10 in 2010, 12 in 2011 and 14 in 2012) representing 12 percent of the market for new construction and major rehabilitation of skilled nursing facilities
- Provide support and education to Green House home operators and staff to continuously improve outcomes
- Glean best practices, modify the model as necessary and desirable, and assure adherence to core Green House Project principles and practices through increased participation in the facilitated peer-to-peer network
2013-2015 Projected Growth and Capital Requirements
|
Current |
2015 |
Increase |
% Change |
|
|
GH Homes |
135 |
217 |
82 |
61% |
|
Operators |
55 |
81 |
26 |
47% |
|
# of states |
21 |
37 |
16 |
76% |
|
Elders served |
1419 |
2239 |
820 |
58% |
Over the next three years, Green House expects to more than double the number of Green House homes and the number of elders living in them. By the end of 2015, 82 new Green House homes will serve 820 new residents.
Projected capital requirements between 2013-2015 are $205 million total, with a requirement of $47.5 million in 2013, $50 million in 2014 and $107.5 million in 2015.
Please see attached excel spreadsheet “Green House Projections 2013-2015” for more projection information.
Economic Model
Start Up and Average Maintenance Costs for Green House® Projects: The cost of starting up a Green House Home is generally between $1M and $2M per house depending on local construction, land, and labor costs. This cost range includes all development related costs (hard and soft costs), financing, and training expenses. The cost to maintain the homes ranges, generally, between $150 to $250 per elder/resident per day. Our median operating cost is the same as the median operating costs for traditional nursing homes in our comparison group. The majority of Green House residents (54 percent) are funded through the Medicaid program.
For a more in-depth look at the costs of maintaining a Green House home, please refer to the study “Financial Implications of the Green House® Model”, provided in the Evaluation section.
Location of Sites
To make a contribution to a program site:
- Click on the "Make a Contribution Now" button and include the name, city and state of the program you would like to support, in the "notes" text box on the organization's donation form, if available.
- If a "notes" or "designation" box is not available, write the city and state on your check in the "notes" section or call the national office to designate your contribution to a local program site.
Locations in the following states:
Alaska
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Alabama
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Arkansas
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Arizona
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Georgia
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Illinois
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Kansas
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Massachusetts
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Maryland
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Michigan
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Mississippi
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Montana
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Nebraska
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New Jersey
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New York
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Pennsylvania
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Tennessee
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Texas
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Virginia
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Washington
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Wisconsin
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Wyoming
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Financials
Most Recent Budget
Year Ended:
REVENUE
EXPENSES
Contractual services, professional fees, grant expense, depreciation, training/tuition, insurance, provision for loan loss.
Please see attachments section for a complete analysis of NCB Capital Impact's revenue and income figures. (Revenue and Expense 2011 and 2012, Excel worksheet.).
NET GAIN/LOSS
Prior Year Actuals
Year Ended:
REVENUE
EXPENSES
Contractual services, professional fees, grant expense, depreciation, training/tuition, insurance, provision for loan loss.
Please see attachments section for a complete analysis of NCB Capital Impact's revenue and income figures. (Revenue and Expense 2011 and 2012, Excel worksheet.).
NET GAIN/LOSS
Major Funders
The Robert Wood Johnson Foundation
