Bill Thomas: Home Care Agencies Are the ‘New Sheriff’ of Post-Acute Care

For decades, home care providers have been working to reduce hospitalizations, a challenging task that has gone largely unrewarded in the medical community. But finally, the industry is starting to recognize home care’s important — but difficult — role in the health continuum of care.

“Home care agencies are going to be the big new sheriff in town,” senior care leader Bill Thomas said at BUILD, a Chicago event hosted by HHCN’s sister publication, Senior Housing News, earlier this month. “If you’ve got expertise in keeping people out of the hospital, you are going to find a very bright and rosy future ahead of you.”

But with great power comes great responsibility. Apart from workforce shortages and a rapidly aging population, the home care workplace poses challenges of its own.


In other words, clients’ homes aren’t always safe for aging in place. For example, seniors with stairs in their homes face a higher fall risk than those living in a single-story residence, Thomas said.

“People want a home of our own,” Thomas said. “Every one of us wants that. The problem is, in American society, we have a housing stock that is increasingly mismatched with the demography of our nation.”

Data from the U.S. Department of Housing and Urban Development (HUD) recently compiled by the Harvard University Joint Center for Housing Studies backs up that claim.


Researchers found that only 3.5% of all U.S. housing stock offers all three of the following: no-step entry, single-floor living and hallways and doorways wide enough to accommodate a wheelchair.

All of these factors contribute to falls among seniors — which are projected to kill 40,000 seniors and cost $60 billion by 2020, according to HUD.

“Housing is key to keeping people out of the hospital,” Thomas said.

Not only are these factors dangerous for seniors, but they can also pose a challenge to caregivers, in turn increasing the likelihood of workers’ compensation expenses for providers.

To keep seniors and caregivers safe, a growing number of providers have turned to home modification to optimize aging in place. Common renovations include adding ramps and grab bars, some of which could soon be covered by Medicare Advantage plans.

Meanwhile, Thomas — a longtime fixture in the senior care space who developed the “Green House” model of smaller senior living properties — wants to get ahead of the problem entirely.

To do that, Thomas developed the Minka brand of tiny homes for older residents several years ago.

Because Thomas believes homes are typically too large to be safe for seniors, Minka homes are around 650 square feet and can be added as accessory dwellings on existing properties.

To make the houses affordable, Minka automates production of the homes, which are held together with bolts instead of nails.

Still, Thomas believes it’s up to the senior care industry to find further solutions to the problem.

“Houses kill a lot of people,” he said. “If we can do better and help protect and extend the real independence of older people, then you’ve got something new.”

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