Abstract
“Culture change” the effort to transform long-term care institutions into communities where elders and workers thrive has become a significant part of the national agenda in long-term care. This article addresses the difference between programmatic change and the deep, organizational transformation known as culture change. There is a growing need to distinguish between these types of change in order to establish a clear definition of what it means to transform organizational culture This article explores how institutions can become true home by examining how their espoused values align with their values in action. Most importantly, it emphasizes the need to flatten the traditional hierarchy and involve residents and direct-care workers in planning and implementing changes that empower them as decision makers in their own lives.