This chapter presents two cases that address leadership issues in long-term care. The first case, Bright Long-Term Care, is operationally based and the second case, Lutheran Care Center, has a strategic focus. Both of the cases will help the reader develop one’s knowledge base in the operational and strategic issues that face long-term care organizations. Increasingly, acute and long term care organizations are partnering to respond to changes in reimbursement for services. Therefore, even if one’s career is in the acute care sector of the healthcare industry, it is important that they understand the context and environment of the long-term care industry.