Improving the quality of long-term care for the elderly is an issue often debated but rarely resolved. Many ideas have been tried to improve the system, but formative evaluation has generally not been used as a resource for quality control. This paper has described the need for formative evaluation, its special characteristics and practices, and some hypothetical applications for long-term care issues. Above all else, formative evaluation is a philosophy that stresses the use of systematically collected information for program improvement. This implies a marriage of theory and practice, of need and response, of innovation and reflection. The elderly who require long-term care deserve the highest quality possible. Formative evaluation is one tool to ensure they receive what is needed.