Charlie Sabatino

For more than two decades, designers, providers, and advocates have promoted household model nursing homes as alternatives to institutional long-term care environments. Yet implementation across the United States remains uneven, with some states advancing household model development while others continue to reinforce traditional institutional configurations. Drawing upon a national multi-phase policy analysis conducted through the Moving Forward Coalition's Financing Household Models & Physical Plant Improvements Workgroup, presenters will explore how often-overlooked policy, financing, regulatory, and planning frameworks influence the feasibility, scalability, and operational realities of household model environments. Using comparative state examples and a Household Model Environmental Taxonomy, the session will translate complex policy and regulatory systems into actionable insights for architects, designers, providers, and development teams. Attendees will gain practical strategies for recognizing how the alignment, or misalignment, of financing structures, licensure pathways, occupancy policies, and emerging planning and design standards can either constrain or accelerate residential, person-centered, and relationship-based care environments. The session will also examine how emerging FGI planning and design standards may create new opportunities for aligning environmental expectations with evolving operational, regulatory, and resident-centered goals across senior living and long-term care settings.