Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.