Small House Visit – Mary’s Meadow, Holyoke, MA

Accompanied by Arlene Parmelee, Director of Assisted Living Services for Duncaster of Bloomfield, and facilitated and attended by Jude Rabig, RN, PhD, I recently had the opportunity and pleasure of visiting one of the first models of the Small House movement on the East Coast – Mary’s Meadow in Holyoke, MA. With the opening of Mary’s Meadow at Providence Place in 2009, the Sisters of Providence, pioneers in the health care and social service fields, began revolutionizing the delivery of long term skilled nursing care, focusing on a residential and social model vs. the medical model setting traditionally associated with long term care and short term rehabilitation services.

Mary’s Meadow at Providence Place consists of four individual residential cottages, with a fifth focused on Physical Therapy.  Each cottage features a traditional dining room, living room with hearth, kitchen, den, an outside accessible garden, with every resident having their own room with a window seat, a bathroom, as well as built-in storage said Sister Joan C. Mullen, president of the Sisters of Providence. While the four cottages are separate with their own front porch and foyer, they all are connected to a central chapel so sisters can still have full access to services.

Sister Mullen was kind enough to make herself available to answer any questions regarding operational, budget and design challenges associated with this model of service. When the Sisters of Providence converted its mother house into Providence Place, an independent senior living facility 12 years ago, they had to move the sisters who needed skilled nursing care to Mercy Medical Center’s third floor. The small house cottages were then constructed to provide the sisters, as well as residents from nearby towns, with an environment that provided empowerment and dignity.  Elizabeth Stroshine, administrator of Mary’s Meadow, elaborated on the role of their licensed nursing staff and “elder assistants,” a new category of staff with the educational background and training of certified nursing assistants, plus significant additional training, who are key to the concept’s success.

The elder assistant puts the elders she or he assists at the center of all decision making and assists them with meal planning, cooking, laundry, personal care, and other resident-centered activities.  This was designed specifically to provide deeper relationships between residents and staff, and increased sense of security, physical comfort and enhanced spiritual well-being.

Members of the Sisters of Providence said they knew they did not just want to create another typical nursing home with shared rooms, wide corridors and a cafeteria-style dining room. They found Jude Rabig, who helped them design what is called a “small house” concept of a nursing home. Jude was the first Director of the Robert Wood Johnson funded National Green House® Project, one of the initial small house models, and is the Director of NASH – the National Alliance of Small Houses.

Mary’s Meadow has earned a perfect, deficiency-free survey from the Massachusetts Department of Public Health (DPH) for the second year in a row and a five-star rating with the Centers of Medicare/Medicaid (CMS). To receive such a survey, skilled nursing facilities must successfully complete a rigorous evaluation for compliance with federal and state standards regarding staffing levels, quality of care, safety, food services and cleanliness of facilities.