Salisbury, N.C. – September 05, 2026 -- Fewer than 4 percent of U.S. homes offer basic accessibility features such as a no-step entry, single-floor living, and wide halls and doorways, according to the Harvard Joint Center for Housing Studies, even as clinical care increasingly moves into private residences. Home for Life Design has published research-backed evidence for its Accessibility Ratings, a standardized scoring system designed to measure whether a home supports safe, independent living.
Aging population and fall risk drive demand for home-based care infrastructure
The U.S. Census Bureau projects the population aged 65 and older will reach approximately 73 million by 2030. The CDC reports that one in four adults over 65 falls annually. Hospital-at-home programs, value-based payment models, and Medicaid home- and community-based services are pushing clinical care into living rooms, bathrooms, and kitchens not built or measured for it.
Peer-reviewed studies validate reliability and impact of the rating instrument
A 2019 study in the American Journal of Occupational Therapy reported inter-rater reliability of .92 among occupational-therapist raters, a finding replicated in 2023 research involving 52 raters. A 2025 study reported content-validity indices ranging from .875 to 1.0 across rating items, and a separate 2023 study evaluated the instrument's use in virtual, telehealth-based assessments.
HUD program data shows 52 percent gain in accessibility scores after modification
A 2026 mixed-methods study of HUD's Older Adult Home Modification Program, published in the American Journal of Occupational Therapy, found 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 found basic accessibility modifications average $5,400 per client as a one-time cost, compared with an average $5,900 per month for assisted living.