Increased competition for funding, complex accreditation requirements, shortage of skilled personnel, changing client needs and the necessity for innovative service delivery models are drivers for change within the aged care industry. Additionally, a new pro-business zeitgeist impacts dramatically on non-profit organisations. They have reorganised, restructured and implemented new management approaches and strategies while aligning their operations for a more corporate approach. Tensions arise from the interaction of demands for adjustment in both service delivery models and management styles. This paper reports on the research design of the study and some emerging themes from pilot interviews in one large non-profit provider of community, retirement and residential aged care services. In the first phase of this research study, a purposive sample of 30 middle managers from different areas of operation will be interviewed using a semi-structured interview guide. The data will provide an in-depth understanding of how working more 'business-like' matters in non-profit human services, what challenges middle managers are facing and how they respond to them. It will also provide information on how participants adapt to change while dealing with the tensions constantly presented to them. Conceptually, the research adds to the understanding of organisational factors and individual characteristics that are important in assisting managers to adjust to continuous change. At an applied level, the research provides guidelines for enhancing the performance of middle managers in the non-profit sector while increasing job satisfaction and well-being.