Healthcare Is Moving Into the Home. Home Accessibility Now Has a Validated Score.

Home for Life Design®, creator of the Home for Life Design Accessibility Ratings®, makes the case for a national home accessibility standard, backed by peer-reviewed reliability and validity studies, published program outcomes, and use inside HUD-funded programs.

SALISBURY, N.C., Sept. 1, 2026 /PRNewswire/ -- American healthcare is increasingly relocating into the home, yet fewer than 4 percent of U.S. homes provide the basic accessibility features of a no-step entry, single-floor living, and wide halls and doorways, according to the Harvard Joint Center for Housing Studies. Home for Life Design®, creator of the Home for Life Design Accessibility Ratings®, today published the case for a consistent national method of measuring whether a home supports safe, independent living.

The shift is accelerating. The U.S. population age 65 and older is projected to reach approximately 73 million by 2030, according to the U.S. Census Bureau, and one in four adults over age 65 falls each year, according to the U.S. Centers for Disease Control and Prevention. Hospital-at-home programs, value-based payment models, and Medicaid home- and community-based services are moving clinical care into living rooms, bathrooms, and kitchens that were never measured for it.

The Home for Life Design Accessibility Ratings® are standardized, research-validated scores of how safely and confidently a person can function in their home. Built from occupational-therapy science and data from thousands of client homes, the Ratings can be captured in any home, tracked before and after modification, and compared across a program or population.

The instrument is documented in peer-reviewed research. A study published in the American Journal of Occupational Therapy in 2019 reported inter-rater reliability of .92 among occupational-therapist raters, and the finding was replicated with 52 raters in research published in 2023. A 2025 study reported content-validity indices ranging from .875 to 1.0 across the rating items, and a 2023 study evaluated use of the instrument in virtual, telehealth-based assessment. In a 2026 mixed-methods study of the U.S. Department of Housing and Urban Development's Older Adult Home Modification Program, published in the American Journal of Occupational Therapy, homes assessed with the Ratings before and after modification showed a 52 percent improvement in accessibility scores and a 48 percent improvement in safety scores.

HUD's evaluation of the same program reports that basic accessibility modifications average $5,400 per client as a one-time cost; assisted living averages about $5,900 per month.

"Healthcare has moved into the home faster than anyone imagined. Surgical recovery, chronic care, whole lives now depend on living rooms and bathrooms that no one ever measured," said Carolyn Sithong, MS, OTR/L, SCEM, CAPS, FAOTA, founder and CEO of Home for Life Design and a 25-year occupational therapist. "The home does one of two things: it enables function, or it disables it. There is no neutral. For the first time, we can measure which one, and that changes what every family, every agency, and every health plan can do next."

The measurement is already proving itself where programs meet funders. When Finger Lakes Community Action used the Ratings to score homes before and after modifications under the HUD program's funding, the resulting data helped the program demonstrate outcomes and secure continued funding. The Ratings are in use by organizations including the NYC Department of the Aging, the Virginia Department of Aging and Rehabilitative Services, Inglis in Philadelphia, and Area Agencies on Aging, Centers for Independent Living, and housing organizations across more than 30 states.

About Home for Life Design®. Home for Life Design® is a home assessment software platform that generates the Home for Life Design Accessibility Ratings®: standardized, research-validated scores of home accessibility and independent-living readiness, used by agencies, universities, and independent-living programs across the country. The company was founded by Carolyn Sithong, creator of the Ratings, CAPS Designee of the Year, and former statewide lead of AARP's HomeFit program in Florida. Learn more at homeforlifedesign.com.

Media contact: Brooke Smith, The Variable, [email protected]

SOURCE Home for Life Design