Assuming care is a relationship that builds on strengths and attends to individual needs, this chapter explores the skills, information, and structural supports required to develop and maintain these complex relationships and the multiple competing demands and tensions that are complicated by inequities in power and in continually evolving capacities. Understanding nursing homes as both work and living spaces, as well as organizations that provide medical, social, and living supports, it argues that it takes the village that is the nursing home, and the community in which it is embedded, to appropriately promote such relationships. It identifies some central ingredients and tensions that should be balanced for promoting nursing home care relationships, including risk tolerance, care designed for living, and structures that make such care possible in order to make nursing homes as good as they can be.