Although The Nursing Home Reform Act, passed in 1987, established residents' rights and quality standards for nursing homes nationwide, serious concerns remain about quality of care and quality of life for nursing home residents. The "culture change" movement is working to radically transform nursing home care, and help facilities transition from institutions to home. This report presents results from the Commonwealth Fund 2007 National Survey of Nursing Homes, fielded to examine the penetration of the culture change movement at the national level and measure the extent to which nursing homes are adopting culture change principles and practicing resident-centered care. Results are mixed, with much room for improvement. The survey highlights important lessons, including the finding that the more a nursing home has adopted culture change principles, the greater the benefits that accrue to it, in terms of staff retention, higher occupancy rates, better competitive position, and improved operational costs.