[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-461466-105":59,"doc-detail-461466-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","frontline-caregiver-daily-practices-a-comparison-study-of-green-house-and-traditional-nursing-homes","Frontline Caregiver Daily Practices: A Comparison Study of Green House and Traditional Nursing Homes","","Investigates differences in frontline caregiver daily practices between Green House (GH) homes and traditional skilled nursing facility (SNF) units, focusing on staffing patterns and caregiver time with residents. Employs an observational, interview, and survey design across 27 participating sites. Measures nursing and nonnursing department staffing hours per resident day, certified nursing assistant (CNA) direct and indirect care time, and CNA time engaged with residents. Finds slightly lower combined overall staff time in GH settings while increasing CNA direct care and resident-engagement time.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/frontline-caregiver-daily-practices-a-comparison-study-of-green-house-and-traditional-nursing-homes/461466/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/frontline-caregiver-daily-practices-a-comparison-study-of-green-house-and-traditional-nursing-homes/461466.png","ImageObject",300,407,{"name":92,"@type":93},"Melati","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is the main objective of the study?","Question",{"text":113,"@type":114},"To describe differences in frontline caregiver daily practice in GH homes versus traditional SNF units, including staffing levels and direct and indirect care time per resident day.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was caregiver practice measured?",{"text":118,"@type":114},"Through an observational, interview, and survey study that quantified nursing and nonnursing staffing hours per resident day and detailed CNA direct and indirect care hours and resident-engagement time.",{"name":120,"@type":111,"acceptedAnswer":121},"What key staffing and care-time differences were found?",{"text":122,"@type":114},"Combined nursing and nonnursing staffing hours per resident day were slightly lower in GH homes, while CNAs in GH homes spent more time in direct care activities despite performing additional nonnursing tasks like laundry and housekeeping.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},461466,1790790647,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":29,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962085570644,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","BRIEF REPORTS  \nFrontline Caregiver Daily Practices: A Comparison Study of Traditional Nursing Homes and The Green House Project Sites Siobhan S. Sharkey, MBA, 􀀂 Sandra Hudak, RN, MS, 􀀂 Susan D. Horn, PhD, w Bobbie James, MStat, wand Jessie Howes, BA w  \nOBJECTIVES: To describe differences in frontline caregiver daily practice in two types of skilled nursing facility (SNF) settings, Green House (GH) homes and traditional SNF units, related to overall staffing (nursing and nonnursing departments), direct care and indirect care time per resident day, and staff time interacting with residents. DESIGN: Observational, interview, and survey study comparing frontline caregiver daily practice in GH homes and traditional SNFs.  \nSETTING: Twenty-seven sites (GH homes and traditional SNF units) .  \nPARTICIPANTS: Two hundred forty staff from participating sites.  \nMEASUREMENTS: Site and resident characteristics, nursing and nonnursing department staff hours per resident day (HPRDs), certified nursing assistant (CNA) direct and indirect care HPRDs, and CNA HPRDs engaged with residents.  \nRESULTS: Staffing from nursing and nonnursing departments combined, excluding administrative, was 0.3 less HPRDs (18 minutes) in GH homes than in traditional SNFs. CNAs in GH homes, although responsible for more nonnursing activities such as laundry and housekeeping, spent 0.4 more HPRDs (24 minutes) in direct care activities than CNAs in traditional SNFs.  \nCONCLUSION: The results challenge the assumption thatstaffing efficiencies cannot be achieved in small environments such as a GH home. Although the GH model has higher ratio of CNA staff to residents than traditional SNF units, overall staff time (combined total of nursing and nonnursing HPRDs) is slightly less in GH homes. The GH model allows for expanded responsibilities of CNAs in indirect care activities and more time in direct care activities and engaging directly with resident. J Am Geriatr Soc 2010.  \nFrom the 􀀂Health Management Strategies, Austin, Texas; and wInstitute for  \nClinical Outcomes Research, Salt Lake City, Utah.  \nAddress correspondence to Siobhan Sharkey, 9600 Escarpment Blvd, Suite  \n745-21, Austin, TX 78749. E-mail: [ssharkey@hmstrat.com](ssharkey@hmstrat.com)  \n[DOI: 10.1111/j.1532-5415.2010.03209.x](DOI: 10.1111/j.1532-5415.2010.03209.x)  \nKey words: Green House model; skilled nursing facility frontline caregiver daily practices; culture change in longterm care; Shahbaz and CNA comparison  \nSince the mid-1990s, there has been a focus on culture  \nchange in delivery of care to older adults in skilled nursing facilities (SNFs) . Many efforts have aimed to redesign structure, roles, and processes within existing SNFs, such as reconfiguring physical environment, developing processes and staff skills related to person-centered care, and redesigning staff roles to increase areas of responsibility and empowerment.1–9 One approach, the Green House (GH) model, provided a new concept for SNF care designed to‘‘create a small intentional community for a group of eldersand staff.’’10,11  \nGH homes aim to deinstitutionalize long-term care and create a supportive environment for elders. Important components are:  \nEnvironment and philosophy: A GH home is a ‘‘self-contained residence’’ for nine to 12 older adults, each with a private room and bathroom. Physical space is designed asa home (large great room with fireplace, communal dining table, and walk-in kitchen open to dining room and great room) .  \nRedesigned role of certified nursing assistants (CNAs): CNAs in GH homes are specially trained universal workers called Shahbazim (CNAs who take on extra duties and are responsible for managing the home). Scope of Shahbazim responsibilities includes personal care, meal preparation and service, housekeeping, laundry, and activities.  \nSelf-managed team approach: Shahbazim work as a selfmanaged team with coaching and supervision from a guide.  \nClinical support team: nurses, social workers, activities, th","cbCaigcuSlmmXPDZ","https://ap.wps.com/l/cbCaigcuSlmmXPDZ","pdf",86363,"English","# Objectives\n# Design and Setting\n# Participants and Measurements\n# Results\n# Conclusion\n# Background on Culture Change and the Green House Model\n# Methods\n## Settings\n## Study Questions","[{\"question\":\"What is the main objective of the study?\",\"answer\":\"To describe differences in frontline caregiver daily practice in GH homes versus traditional SNF units, including staffing levels and direct and indirect care time per resident day.\"},{\"question\":\"How was caregiver practice measured?\",\"answer\":\"Through an observational, interview, and survey study that quantified nursing and nonnursing staffing hours per resident day and detailed CNA direct and indirect care hours and resident-engagement time.\"},{\"question\":\"What key staffing and care-time differences were found?\",\"answer\":\"Combined nursing and nonnursing staffing hours per resident day were slightly lower in GH homes, while CNAs in GH homes spent more time in direct care activities despite performing additional nonnursing tasks like laundry and housekeeping.\"}]","Frontline Caregiver Daily Practices: A Comparison Study of Green House and Traditional Nursing Homes | PDF",1790761675,15]