Harry talks with Susan Ryan, CEO of AgingIN, who pursued a “call to action” after seeing physical and chemical restraints used in nursing homes, including a case where a woman suffered a fractured hip and returned from the hospital with stage four decubitus ulcers. Susan moved into home care and geriatric education but found home care costly and sometimes isolating, leading her to culture-change efforts and ultimately the Green House model, developed by Dr. Bill Thomas to replace sterile institutions with small, home-like settings of 10–12 residents, private rooms, decentralized kitchens, and access outdoors. Susan says over 400 Green House homes have been built since 2003 across about 35 states, and the model can operate at similar cost to traditional nursing homes, including with substantial Medicaid populations, when paired with empowered, universal-worker staffing and shared decision-making. She explains how the Green House Project and Pioneer Network combined under AgingIN to catalyze person-directed living across the broader aging ecosystem, urges policy incentives like Medicaid reimbursement bumps, and advises individuals to be intentional about aging in community to reduce isolation.   Visit https://aginginnovation.org/   Topics 00:50 Susan’s Call to Reform 02:17 From Home Care to Culture Change 03:46 What Is Green House 05:36 Scale and Market Reality 07:09 Costs and Medicaid Viability 08:22 Renovate or Rebuild 09:23 Core Values Real Home 12:26 Assisted Living Home for Life 14:46 Community Dining and Opus 16:56 AgingIN Origin Story 20:30 Preparing for the Boomer Wave 23:34 State Plans and Policy Incentives 24:58 Advice for Policymakers and Boomers 27:27 Closing Thanks