As Covid Spread nursing homes across the country last summer, Thomas settled on one idea: we need to push deinstitutionalization further.
The vision for the new project he is working on with Signature HealthCare – currently called ‘Canopy’ – begins with a group of small ADA accessible houses built close to each other, with communal green spaces and an intention that residents get to know their neighbors. The idea is that residents have much more autonomy than in a collective setting, living in their own house with access to the outside. And the goal is to enable them to tap into a tight network of services – from food and bathing assistance, to physiotherapy and nursing.
Details are still being worked out, says Nick Jacoby, director of development for Signature HealthCare, a long-term care provider. But he says the first community will likely be built in a small rural Tennessee town on the grounds of one of the company’s existing nursing home campuses. It can consist of eight to 16 houses, approximately 400 to 600 square feet each. This is about the size of so-called little houses, or “grandma’s apartments,” except that instead of being built in a back yard, the first houses will likely be built on the land of the one of the company’s full-service nursing homes.
They are still figuring out what exactly the first houses will look like, inside and out, thinking about questions such as, “Where is the world going in terms of preference, technology and care delivery?” – and how to create the house for it? Jacoby said.
But the idea is that if residents need nursing care and daily living assistance, they will rely on these services. inside their house, which they will rent. Thomas and his partners are betting that in the years to come, state and federal governments will turn more of their attention and money to what are known as home and community services, transforming the way the country pays for the disease. aging and ending the current regulatory emphasis on traditional retirement homes. .
This change is already underway. In recent years, the Trump administration has opened the door to allow private health insurance plans to start paying for non-medical services, such as meal delivery or a trip to the grocery store.
States have also started to move away from paying only for institutional care in retirement homes. Instead, they spend more of their Medicaid dollars on home and community services, which can include everything from home health aides to help with meal preparation.
“The swing of the pendulum towards home and community services,” Thomas said. “And for these services to really work, we need better homes and better communities – and that’s what Canopy is designed to provide.”
President Joe Biden’s Broad Infrastructure Plan Includes Massive $ 400 Billion Investment in Medicaid Home Care Coverage – What Thomas has Called the “Biggest Rebalancing” in Long-Term Care Payments Ever . And Biden’s massive coronavirus relief program adopted in March provided the first federal funding for home and community-based services since Obamacare’s passage. But the increase is only for a year, and defenders are already scrambling to find ways to continuously redirect more money to the advantage.
“The general public has always made it clear that aging people would really prefer to stay at home,” said Anne Montgomery, director of senior care improvement for the nonprofit research and advisory group, Altarum, and former senior official of the Senate Committee on Aging.
Yet waiting lists are still long in many states, and finding home care can still be a frustrating process for many Americans.
“It will be a challenge,” said Montgomery, who first learned of Thomas and Signature Healthcare’s project when contacted by a POLITICO reporter. “I’m pretty sure someone like Bill Thomas would give this some serious thought – where he builds or hopes to build the cottages, and what kinds of services are available in that area, and how do you help organize those services in. Something? which is accessible to residents of that community. ”