The CEO of a large elder-care organization with two main facilities faces a number of challenges: jealousy between the two main units, difficulties in finding and retaining staff in competition with fast-food chains, and rumblings of concern about his leadership style from both the board and his immediate staff. In this largely undisguised case, set in the growing elder-care industry in urban Washington, D.C., the CEO must decide what to do next; how, if at all, to change his style; and how to build a stronger organization as the parent considers further expansion.