A small house is an intentional community of 10, 12 or 14 residents and a staff of highly trained workers who live and work in a well-designed environment organized and operated around the guiding principles of autonomy and dignity. When successfully implemented, the Small House (SH) Model provides exceptional rehabilitative and hospice care and chronic disease management, with sufficient staff and equipment to support all personal care and assistance needs. While comprehensive data on outcomes is limited, the currently available evidence suggests that implementation of the Small House (SH) Model leads to better resident outcomes and higher resident satisfaction at comparable or lower overall cost. VHA is committed to use of the Small House (SH) Model of care in all of its facility-based settings, including Community Living Centers and State Veterans Homes.