Why the future of elder care may be fewer nursing homes

When geriatrician Bill Thomas first sat down to reimagine American nursing homes, the risk of a deadly pandemic wasn’t on his mind. His vision was of elder-directed care on a human scale, an alternative to the “big box” homes staffed and run like hospitals.

Nearly two decades on, the Green House movement he birthed has spread to 300 homes in 32 states. And when COVID-19 hit, its design features – clusters of small buildings with private rooms and bathrooms – helped to reduce infections, even in hard-hit cities like Boston...