Buy-in from nursing home staff is necessary in order to provide preference-based person-centered care (PCC). This qualitative study examined staff perceptions of factors that promote or hinder staff’s ability to meet resident preferences, as well as reasons why residents change their mind about preferences. Staff identified key facilitators (e.g., in their own approach and behavior) and barriers (e.g., facility policies) to preference fulfillment. Staff believe residents change their preferences depending on the global environment (e.g., weather), social context, and personal characteristics (e.g. health). The study recommends strategies to optimize preference-based PCC by reducing barriers and bolstering facilitators.