This article uses a retrospective approach to critique the research base underlying the nursing home culture-change movement-an effort to radically transform the nation's nursing homes by delivering resident-directed care and empowering staff. The article traces the development of the movement from its inception 10 years ago to 2005, when the Centers for Medicare and Medicaid Services implemented its own initiative to support the movement, thus giving it new momentum, to the present day. This historical overview provides context for a proposed research agenda aimed at strengthening the movement's empirical base, thereby facilitating culture-change interventions as well as helping the movement navigate the next step in its evolution.
