Study: Green Houses Had Fewer COVID-19 Cases And Deaths

Study: Green Houses had fewer COVID-19 cases and deaths

The study published in the Journal of the American Medical Directors Association found that residents of Green Houses and other smaller nursing homes (NH) are less likely to contract or die from COVID-19 than residents of larger facilities. 


The study compared rates of COVID-19 infections, admissions/readmissions and mortality among Green House/small nursing homes to rates in larger traditional nursing homes between 1/20/20 and 7/31/20.

covid shot

Study investigators included researchers from the University of North Carolina at Chapel Hill and staff from the Green House Project organization. They compared non-traditional nursing home facilities like Green Houses with under 50 beds against facilities with 50 beds or more. 

Key findings:

  • Case rates were significantly lower in Green House/small NHs than in traditional NHs that had <50 beds and ≥50 beds
  • The median rates of COVID-19 cases per 1000 resident days were 0 in both Green House/small NHs and NHs <50 beds
  • The median rates of COVID-19 cases per 1000 resident days were 0.06 in NHs ≥50 beds
  • The median mortality rates per 100 positive residents were 0 (GH/small NHs), 10 (<50 beds), and 12.5 (≥50 beds)
  • Differences were most marked in the highest quartile: 25% of Green House/small NHs had COVID-19 case rates per 1000 resident days higher than 0.08, with the corresponding figures for other NHs being 0.15 (<50 beds) and 0.74 (≥50 beds) 

The study abstract notes that Green House and other small-NH models provide home-like features and may limit viral infections due to fewer people living, working, visiting, being admitted, and using private rooms and bathrooms in such facilities – all of which is of interest to policy makers and NH providers in a post-COVID world.

Researchers offered this conclusion: “Green house/small nursing homes, which already are widely in favor, may constitute a promising future. Their model already exists, and in addition to being advantageous in relation to COVID-19, they benefit resident quality of life, improve satisfaction, reduce hospital readmissions and Medicare spending, and result in better quality indicators.” 

Read the entire study.

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