The Green Houses face several obstacles, including regulatory issues. But some say they also face resistance from existing nursing homes, which are based on an economies-of-scale model — the larger the home, the cheaper it is to care for each individual resident.  While some nursing-home operators welcome the idea of Green Houses, others are reluctant to help pay for them, says Susan Reinhard, who heads the AARP’s Public Policy Institute. “You have owners who have their personal wealth invested in a model that was requested by society way back,” she says.

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