This document discusses challenges with the current long-term care system and proposes a new vision. It argues that nursing homes should not be the central model and alternatives are needed that better meet patient preferences. It outlines key components of long-term care including personal care, housing, and medical care management. It emphasizes developing individualized care plans based on assessing each client's unique needs and goals. It also stresses the importance of merging medical and social care with shared goals and tracking client progress over time.