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French law 2002-02 of January 2, 2002 put dependent older adults at the center of regulations for nursing homes (Ehpad). Levers exist to make these legal changes effective in the daily lives of residents and institutions. In spite of this, in some Ehpad there are abuse and a lack of respect for rights and freedoms, as highlighted by recent reports and Victor Castanet’s book “Les Fossoyeurs.” This study examines one of the reasons for this situation: an organizational culture in Ehpad that is insufficiently centered on the resident, and thus out of step with the law’s precepts, which provide top-down injunctions.First, we present a conceptual framework identifying the dimensions of an Ehpad organizational culture centered on the resident, based on the literature on organizational culture and its application in the health and medico-social sectors. Second, we compare this framework with studies on the challenges of supporting dependent older adults in France and with existing policies on old age. The study’s conclusion highlights the fragility of the resident-centered organizational culture, finding individual, institutional, and political factors that are still not closely aligned with the law’s philosophy of support for older adults.