Strategic challenges include integrating TL’s organizational culture and processes into acquired facilities to ensure a shared purpose and competitive success. When acquiring new facilities, TL has met significant resistance in some areas, and reorganization was necessary in some facilities. The sharing of information has brought the facilities closer together in terms of organizational identity. The implementation of health care reform and the advent of ACOs will require TL to assess its position relative to the new health care structures to ensure that it can support the ACOs and still maintain financial viability. In addition, operating margins for long-term care organizations are typically very low, so meeting unfunded mandates while preserving a high level of care for residents is very challeng-ing. Internal succession planning, another strategic challenge, is three years into development. To help maintain current retention rates, TL is working to have its leader development efforts fully in place by the end of 2012