Could the Small Home Model Be the Future of Senior Living?

When many people picture a senior care community, they imagine a large, multi-story facility with dozens of private rooms. But a different approach is gaining traction. The small home model is emerging as an alternative that prioritizes scale, familiarity, and personalized care. 

In December 2025, Wellpointe Inc. opened Fresno Guest Home #28, a 2,600-square-foot residence featuring six private bedrooms and five bathrooms. The home also includes expanded living and dining spaces, an updated kitchen, and a finished outdoor area. It is one of 40 Fresno Guest Homes designed to address the need for affordable assisted living, reflecting a more intimate approach to care delivery.

Read on to learn how the small home model works, why demand is growing, and what challenges providers must navigate to scale it successfully.

The Appeal of a Smaller Setting

George Kutnerian, co-founder and chief executive officer of Wellpointe Inc.

The small home model is designed to complement, rather than replace, larger senior living communities. George Kutnerian, co-founder and chief executive officer of Wellpointe Inc., notes that both models serve distinct populations. “I work with a number of folks who own and operate those luxury or bigger box models and they are doing great work to serve a segment of the older adult population that wants that,” he says.

However, cost remains a key factor. Larger communities can become financially out of reach for older adults, particularly those relying on fixed incomes. Over time, rising expenses can make these environments unsustainable for many residents.

Kutnerian points to a shift in preferences as people age. “From our perspective, people like to visit a resort, but most don’t necessarily want to live at one permanently,” he says. Instead, as older adults age, they often want to live somewhere that feels more like home than an institution.

From Family Roots to Scaled Growth

The concept of the small home model is not new. Kutnerian’s parents opened their first residential assisted living home in 1984 as an alternative to the institutional skilled nursing facilities common at the time. Their approach emphasized a home-like setting with personalized care.

The model has since evolved. After completing graduate school around 2013, Kutnerian and his sister, Angela Kutnerian, joined the family business, which then operated six locations. Following their parents’ retirement in 2021, the company reorganized as Wellpointe.

Since then, the organization has expanded significantly, serving approximately 600 residents across 67 licensed residential assisted living locations. The continued growth of Fresno Guest Homes reflects increasing access to this model.

Inside the Small Home Model

Staffing and care delivery are central to the small home approach. At Fresno Guest Home #28, at least one staff member is present for every six residents at all times. “We provide all of the types of care services around activities of daily living that one would expect from licensed assisted living, but we provide those services at a higher staff-to-resident ratio than most, creating a ‘high-touch’ care experience,” Kutnerian explains.

Care extends beyond daily assistance. Staff members coordinate services such as primary care, specialty providers, home health, pharmacy support, and mobile lab services. “Older adults are living longer with multiple chronic illnesses. In order to drive value for them and their families, we go above and beyond to handle more than just the physical hands-on care that they need,” says Kutnerian.

Public funding has also supported expansion. Fresno Guest Home #28 was developed in partnership with California’s Community Care Expansion Program, which aims to provide housing for older adults and individuals with disabilities who are experiencing or at risk of homelessness.

Overcoming Perception and Scaling Challenges

Despite its benefits, the small home model faces perception challenges. Historically, these residences were often viewed as informal or less sophisticated. “People assumed all of these ‘small-home’ assisted living locations were all the same and they were viewed as ‘mom and pop,’ which was not meant as a compliment,” Kutnerian explains. “However, the model has evolved from what it was back in the early 1980s and we’ve differentiated our philosophy of care from others in the marketplace to create a strong reputation with highly professionalized operations.”

Though Wellpointe has worked to build a strong reputation and deliver highly professionalized care, building and maintaining trust remains an ongoing effort. “We have to go out and earn trust in the community every single day,” says Kutnerian.

Operationally scaling a small home model presents another challenge. In response, Wellpointe has focused on co-locating the homes and heavily investing in workforce development and technology. With 67 locations, the company has become the largest small home assisted living operator in California. 

Growing Demand and Future Considerations

Interest in the small home model has increased in recent years. During the COVID-19 pandemic, smaller homes made visitation easier, which further accelerated awareness and adoption of this model.

Greater public understanding of the small home model has also contributed to increasing demand. “More people began to realize what we have known for some time, which is that these settings are very approachable and can deliver more ‘high-touch’ care, while being affordable over the longer term,” says Kutnerian. “This unique combination creates tremendous value and broader appeal from my perspective.”

Even so, the model is not without complexity. Kutnerian advises careful planning for organizations considering this approach. “The model has unique challenges and we’ve been working on refining the model over a number of years,” he says. “It takes a lot of dedication, talented people, and intensive operations to do it well at scale.”

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.