Lessons Learned in Improving and Building 1,000 Homes

By: Gretchen West

Healthy Homes began at Nationwide Children’s Hospital with a simple idea: people are healthier when they live in high-quality housing. If we could give home improvement grants to current homeowners, and work to build or improve other housing, we would be improving health.

Nearly 17 years later, we have built or otherwise helped impact 1,000 homes. Hospitals are not known for their expertise in housing development, and we had to learn a lot along the way – about addressing the concerns of the community, mitigating gentrification, raising tens of millions of dollars in funding and so much more.

Here are some of our most important lessons:

Build trust with the neighborhood – listen to their wishes and deliver on your early promises.

Nationwide Children’s Hospital has not always been a good neighbor in the South Side of Columbus. For decades, community members felt we had expanded our campus without thinking how it would affect them.

We had a lot of relationships to build and repair before we could build and repair homes. Nationwide Children’s partnered from the beginning with a non-profit development agency, Community Development for All People, which long helped people on the South Side. We aligned with other community-based organizations that were already trusted.

In addition, some of our earliest projects were home improvement grants to existing homeowners, which they could use immediately for their needs. When our project expanded to a second Columbus neighborhood, our earliest efforts were in home repair grants as well. We also promised we’d complete 20 rental units in 18 months, and we did. . .we knew if we didn’t walk the walk, we could be easily dismissed.

Address gentrification.

We had to learn this lesson the hard way. Our initial strategy at Healthy Homes was to focus on single-family residences and home ownership. But new homeowners could (and sometimes did) sell their Healthy Homes, which led to higher values that became out of reach of some community members.

In 2017, we began focusing more on high-quality rental housing, so we could keep prices affordable and house the community members who needed it most. We have also partnered with the Central Ohio Community Improvement Corporation and others in a land trust model for single family houses, which separates ownership of the land and the home and helps keep real estate perpetually affordable.

Trust with the neighborhood isn’t just about friendly relations.

In Columbus, neighborhood commissions have real influence on zoning decisions. When Healthy Homes seeks to build multifamily, rental housing on lots zoned for single family homes in the Linden neighborhood, for example, resident commissions need to approve it.

As a hospital developing housing, we remain accountable to residents not only because it’s the right thing to do – it’s expected of us. A fully transparent relationship with the community allows more to be done more quickly.

Partner with local government agencies, businesses and housing nonprofits on their housing priorities.

Affordable housing is under increasing political and business pressure and is now widely recognized as an underlying economic development strategy. Communities cannot create and sustain jobs without ensuring that workers have stable, affordable places to live.

As a result, organizations that may not have engaged in housing issues are now deeply invested. For example, Nationwide Children’s Hospital may view housing development through the lens of overall community health, while city and county governments prioritize a thriving, supportive, and growing region. Corporations may have different motivations, but they also recognize that housing stability is essential to workforce attraction and retention. Strategic partnerships across sectors allow each entity to advance its own goals while collectively addressing the shared challenge of housing affordability.

Having said that, it’s also important to find partners who share your mission.

It is unusual to be a non-profit children’s hospital operating in real estate development, which is a for-profit industry. But there are sophisticated financial and development professionals who share our basic mission of affordably housing families.

To use just one example, the non-profit Ohio Capital Corporation for Housing and its affiliated Ohio Capital Finance Corporation have helped Nationwide Children’s use low-income housing tax credits and other financial mechanisms to fund our work. They have expertise that we don’t and have helped us secure millions of dollars in funding we wouldn’t have otherwise.

A health care organization can have an effect on housing without actually building housing.

Hospitals can buy land that another aligned organization can develop. They can loan money to affordable housing developers at a low interest rate – the first dollars invested in a project can convince other funders that an investment is worthwhile. Hospitals can also provide in-kind legal or other advisory assistance.

Developing housing isn’t for everyone, and hospitals can find a lane for themselves in affordable housing without actually building anything themselves.

The work does not get easier.

Just because you have gained a community’s trust, it doesn’t mean you will keep their trust. Just because you have successfully improved your 1,000th home, it doesn’t mean you know how you will get to the next 2,000 (or even 1,001).

You must continue to build partnerships, to get feedback, to address individual and group concerns. Yes, you did something helpful last year, but what have you done today? That’s a reasonable question for any community or partner to ask, and you need to keep answering it.

Build a team with members who have different skill sets.

The Healthy Homes team has 10 people who have managed to help a hospital impact 1,000 homes. We have people who work on community relations, on financing, on project management. We work with other teams focused on workforce development, infant mortality, educational opportunity and dozens of other issues.

We have to punch far above our weight and solve a lot of problems. Flexibility and dedication of your team members is key. 

Published January 2026