The physical structures of virtually all of today's nursing homes will be obsolete by the time baby boomers start to turn 85 in 2032. Recognizing the need to move away from the institutional model that prevails today, the investigators on this Picker Program Grant will test the feasibility of establishing small group homes for the elderly that are designed to foster more resident-centered care. Focusing on the Mississippi-based Green House Project, which has so far established four group homes of 10 residents each, the evaluation will examine the operational, financial, and regulatory issues associated with the small group design and assess its impact on staff and residents. Lessons learned from the evaluation will be used to enhance and refine the prototype, develop templates for replication and self-evaluation, and establish the business case for this new way of caring for frail elders. http://www1.umn.edu