Purpose: The purpose of this project was to develop a reliable and valid family satisfaction instrument for use in Ohio's nursing homes. Design and Methods: Investigators worked with an advisory council to develop the survey. Purposive sampling techniques were largely used to select 12 small, medium, and large for-profit and proprietary facilities in one large county for the pretest. A total of 239 families who were "most involved" in their relative's care completed an instrument with 97 satisfaction items. Results: Factor analyses identified nine factors that explained 59.44% of the variance in satisfaction. Investigator judgment modified some factors and developed scales. The scales had good internal reliability (alpha = 0.76 and above, except for one), test-retest reliability ranged from 0.49 to 0.88, and differences between families of short- and long-stay residents were in expected directions. A final instrument with 62 satisfaction and 17 background items was recommended for statewide implementation. Implications: Findings from the project can be used to further refine the instrument and protocols for use with larger populations in other states and by the federal government.