Hospitals serve an important function in recovery-oriented systems of care, offering acute care for acute episodes. Since the Olmstead decision, however, hospitals can no longer be considered acceptable places to live. Systems that invest scarce resources in training inpatient staff in person-centered planning, hoping to transform care by offering patients choices of meal times, neglect the fact that most people confined to hospitals would choose to live in the community. Such individuals, who still number in the tens of thousands, need safe, affordable housing options with responsive supports. Although transformation can involve more than this, it should not involve less. As the commission report makes clear, we now know how to afford people a life in the community. Achieving this promise is where and when true transformation will begin.