Organizations are increasingly looking to convert from facility-based services for adults with developmental disabilities to individualized supports. Such conversion involves not only a change in services but a transformation of organizational culture. This qualitative study involved four organizations that have made sustained efforts to transform. Although the approach taken by each organization was unique, there were also some common strategies, which included generating commitment to common values and mission, a turn or return to authentic person-centered planning, shifting power and control, using community supports and relationships, moving away from facility-based settings, and nurturing staff engagement. Ultimately, organizational change is an ongoing process that requires organizational perseverance and commitment.