The purpose of this paper is to provide information and resources for change in a rehabilitation department with the focus on making rehabilitation culture enjoyable for workers, as well as making the department viable. This topic is paramount with strategic organizational changes in response to limitations and lowered reimbursement mandated by the Affordable Care Act (ACA). It is imperative that organizational change incorporates employee satisfaction to encourage participation and retention of staff. This paper will supply research and information with viewpoints of organizational culture and change, the ACA and its indirect influence on health care culture, and resources necessary to achieve an enjoyable and viable rehabilitation department and culture. This paper will focus on occupational therapy and practice management in the health care setting.