The challenge
The small house model, which offers private rooms in living communities of six to ten residents, has long been favored, but has gathered new interest during the Covid-19 pandemic as a way to reduce isolation. This model has the potential to address the psychosocial needs of nursing home residents by providing high quality of life alongside exceptional clinical care. The small house model promotes individualized resident care by empowered staff, home-like living environments, and close ties between staff, residents, and their families. Due to the reimbursement models of long-term care, these models are typically not profitable to the organization operating them.

The organization
Goodwin House Incorporated (GHI) is a 53-year-old nonprofit senior living and health care provider in Northern Virginia. They provide both skilled nursing care and home-and community-based services and serve 2,000 older adults each year.

The approach
GHI went through a campus repositioning in 2017-2019 of its Goodwin House Alexandria (GHA) Campus. As part of the repositioning, the GHA skilled nursing model was converted to a small house model and all nursing residents moved into a new state of the art health care center that opened in May 2017.

The result
Residents are highly satisfied with their small “houses”, and GHA has maintained strong performance on quality metrics. The small house model is in process to achieve margin favorable financial measures. In its three years of operation, it has contributed significantly to the GHA and GHI reputations for its innovative features, resident satisfaction, and health measures. Throughout the pandemic, the small houses have been less vulnerable to Covid-19, which has contributed to positive media coverage.