The nursing home (NH) culture change movement advocates for residents to have choices about important aspects of their care. This mixed methods study examines the association between residents’ perceived choice and satisfaction with the way care preferences are met. Using the Preferences for Everyday Living Inventory (PELI), the study conducted cognitive interviews with 39 NH residents. The study found a significant positive association between NH residents’ perceived choice and feelings of satisfaction with their care preferences being met. Offering choices that are deemed favorable or solicited from NH residents is a key step toward increasing resident satisfaction with care.