This book represents a summary of a three-day Next Step Think Tank held May, 20-21, 2010 hosted by the University of Wisconsin-Milwaukee’s Center on Age & Community in partnership with the Institute on Aging and Environment at UWM. Next Steps Think Tank events are designed to explore critical issues in the field of aging and to foster deep thinking on a given question. The underlying premise for this Think Tank was that “Culture Change” is the right and necessary thing to do in long-term care, but more information is needed on the “Household Model” as an expression of Culture Change.