It would be interesting to know not only about the number of senior living communities executives/leadership that read the book, but also about how many communities implemented the kind of environment that Jill Vitale-Aussem made happen.
According to Gemini:
"The formal Citizenship Model® has fundamentally not spread as an industry standard across the estimated 1,900 Continuing Care Retirement Communities (CCRCs) in the United States. [1]
The model remains highly localized and insulated. Several practical and structural reasons explain why the vast majority of CCRCs do not adopt it:
- The Hospitality Sales Trap: Most CCRCs are explicitly marketed and sold to seniors as luxury, resort-style "hospitality" experiences. Their business models rely on promising residents that they will be pampered and have everything taken care of. Shifting to a model that asks residents to take on "chores," operational responsibilities, or governance runs directly counter to what affluent seniors bought into.
- Legal and Liability Frameworks: CCRCs are highly regulated, corporate-structured entities. In a traditional CCRC, "management" is legally and financially responsible for everything from dining safety to facilities management. Giving residents genuine citizen-level decision-making power introduces complex legal and operational liabilities that corporate boards prefer to avoid. [2]
- The "I Paid for This" Mindset: Because CCRCs require massive, six-figure entry fees and high monthly maintenance costs, the prevailing culture among paying residents is often: "I paid a premium so I wouldn't have to worry about running a community." [3]
- Operational Friction: It is drastically easier for a corporate operator to run a top-down, standardized hospitality schedule than it is to manage the constant friction, debate, and consensus-building required to let hundreds of residents dictate community operations.
While Jill Vitale-Aussem champions this paradigm shift via industry panels and advocacy books, it remains a proprietary operational differentiator for Christian Living Communities (CLC) rather than a movement reshaping the broader American CCRC landscape. [4, 5]."
It is unfortunate that this model remains a small scale utopia, but it is not surprising. CCRCs do not care for "partnerships" with residents, they could not care less for sharing power, so they just re-enforce that with their one sided contracts, turning residents into hostages (or inmates as some call them).
Also Gemini might not realize that the good old days of "only" six figure entry fees are gone; by now 7 figures are quite frequent.
A 2021 interview talks about where the author was and what she was doing then,
https://seniorhousingnews.com/2021/06/03/changemakers-jill-vitale-aussem-president-ceo-christian-living-communities/
According to Gemini, after her years at Clermont Park, her career included the following positions:
- VP of Operations / VP of Consulting Services at Christian Living Communities (July 2015 – May 2018): Following her time as executive director, she was promoted to oversee operations and consulting for CLC's management division, Capella Living Solutions. [1, 2]
- President & CEO of The Eden Alternative (May 2018 – November 2020): She transitioned to lead this global non-profit organization focused on improving the quality of life for older adults and creating progressive eldercare culture shifts. During her tenure here, she published her book, Disrupting the Status Quo of Senior Living: A Mindshift. [1, 2, 3, 4]
- President & CEO of Christian Living Communities (November 2020 – Present): She returned to Christian Living Communities to take on the top executive role, where she currently oversees their entire network of senior living communities, home care, and adult day services. [2, 4]
As CEO, Jill Vitale-Aussem has pioneered senior living initiatives that shift away from traditional, resort-style "hospitality" and move toward empowering older adults. Her core initiatives focus on three primary pillars: [1, 2]
1. The Citizenship Model®
Her signature initiative is the deployment of The Citizenship Model® across Christian Living Communities (CLC). [3, 4]
- The Concept: Traditional senior living treats residents as passive "customers" whose needs are fully anticipated and met by staff, which Vitale-Aussem argues can actually accelerate decline and cause institutionalization. [2]
- The Practice: This initiative reframes residents as active citizens with a continuing purpose, a voice in community governance, and a responsibility to give back. Instead of asking residents "How may I serve you?" the culture is shifted to "How can we build this community together?" [2, 5]
2. Person-Directed Care & Longevity
Vitale-Aussem heavily champions person-directed care models over rigid, clinical schedules. [2, 6]
- Resident Empowerment: Decisions regarding daily schedules, community life, and programming are driven directly by resident feedback and choices, rather than institutional top-down mandates. [2, 6]
- Combating Ageism: She implements training to combat implicit ageism within care teams, ensuring that aging is looked at as a period of growth, continuous learning, and community belonging rather than a phase of purely receiving care. [1, 2, 7]
3. Progressive Campus Redevelopment
Dating back to her early work at Clermont Park and continuing into her CEO tenure, she has driven initiatives to change how eldercare spaces are physically structured. She advocates for mixed-market integration, bringing together affordable housing, middle-market rentals, and Life Plan apartment homes into single, cohesive communities to foster socio-economic interaction and reduce elder isolation. [8, 9]
Her "disruptive" cultural shifts recently earned her the 2025 Agent of Change Award at the McKnight’s Pinnacle Awards. [1]