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'Small Homes' Changing Indiana's View of Eldercare

November 28, 2011

GEORGETOWN, Ind. - Most people think of institutional settings when they think of nursing homes, but that's starting to change, thanks to a southern Indiana nun. Sr. Barbara Ann Zeller, with the Sisters of Providence of Saint Mary-of-the-Woods, is creating small "villas" fashioned more like a regular home. They have individual bedrooms and bathrooms located off a common living area and kitchen, she says, and they have taken anything that 'looks clinical' out.

"It's small, it's cozy, it's comfortable. The beauty of it is, because we have only 10 elders per villa, we can maximize each person's interests and capabilities - because there are only 10."

A moratorium in Indiana on new Medicaid nursing home beds created a major hurdle last year to passing new legislation, but the law now allows some new Medicaid beds in these small-home settings, so that nursing home residents who run out of funds do not have to move.

The nun explains that very often people in long-term care run out of money and have to go on Medicaid assistance, which means having to move to a nursing home that accepts Medicaid.

"It was critical for us to get this legislation through because we are building the Villas - obviously we don't want to build houses on sand. If we had all private-pay residents and suddenly they needed Medicaid, we would have had to say goodbye to them."

Jim Leich is president of the Indiana Association of Homes and Services for the Aging (IAHSA), which is soon to be known as Leading Age Indiana. Leich says the Medicaid small homes are all about quality of life.

"Our legislation, which we worked on with AARP and other groups, was designed to allow a limited number of beds - Medicaid beds - to be available for these unique, small-house models."

The IAHSA represents Sr. Barbara Ann's facility and other nonprofits around Indiana.

Paul Chase, associate state director of public policy with AARP Indiana, echoes that the small houses are limited to 10 or 12 residents, and are specifically designed to feel like a home.

"They don't have certain characteristics of an institutional setting - things like a nurse's station, room numbering or other signs that would not be found in a residential setting."

Another important feature is self-directed care, Chase says, meaning each resident determines when they get up, bathe and eat, instead of being on a schedule determined by the facility staff.

Leigh DeNoon, Public News Service - IN