This project, being conducted in collaboration with the Rhode Island Department of Health (HEALTH), is a two-phase project to develop and pilot-test an enhanced survey process that would use regulatory mechanisms to promote resident-centered care in nursing homes and eliminate whatever barriers to culture change the standard survey process might imply. The goal of the project is to use the mandated regulatory process to motivate and enable all nursing homes to fully realize the potential for resident-centered care inherent in the Nursing Home Reform Law. Dr. Stevenson is leading the evaluation component of the work. In particular, he will assess the efficacy of using regulatory mechanisms to advance nursing home implementation of resident-centered care.