Recently, the Centers for Medicare and Medicaid Services implemented the Quality Indicator Survey (QIS) which is a computer-assisted and comprehensive survey process for long-term care facilities that is being phased in by regions and states. The speech-language pathologists will play an essential role in the transformation from the institutionalized care to which we are accustomed to a more patient-centered approach. The first step is to bridge the gap between traditional therapy techniques that have resulted in good clinical outcomes for the patient with the concept of more functional treatment approaches. The mindset of speech-language pathologists must change from knowing that some residents will be going home, to all residents will be going home regardless of whether that home environment is out of the facility or in a room down the hall. In order to support the necessary change in the skilled nursing facility, speech-language pathologists need to arm themselves with the tools and training necessary to make this successful transition happen.