This study examines the institutional and attitudinal changes in elder care homes in Tianjin, China. Based on a survey conducted in 2001 with 61 elder home managers and 265 elder residents, this study examines 1) factors that influence elder home managers' views about elder home development and 2) elders' evaluation of elder home quality and their levels of willingness to stay in such homes. Findings show that elder home managers view their autonomy in financing and administration as a very important factor for future development of an elder home industry. Elders' overall evaluation of elder home quality was high. Elders' willingness to stay in elder homes was related to two factors: their living arrangements prior to elder home placement and their assessment of the cost involved for such care. This suggests that the limited level of autonomy in private elder home administration and financing is hindering the development of elder homes. As adult children become increasingly unavailable due to the one-child policy and geographic mobility, institutional care for aging parents is likely to become a major option for familial care in China. The government should grant greater autonomy to private elder homes in order to encourage elder home development. (Contains 4 tables and 2 footnotes.)