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This is the third of a three-case series (IMD-3-0918 to IMD-3-0920). This case series describes one of the world''s most remarkable communities, which for the past twenty years has continuously achieved extraordinary results working with marginalised individuals. Case (C) plunges into organisational structure issues and the realities of change management at San Patrignano. It also poses the fundamental leadership issue of what leadership profile is right for a community of this kind, and to what extent such leaders can be attracted from the outside and/or groomed from within. This issue is fundamental for corporations that look at the key aspects of non-profit communities such as San Patrignano as potentially alternative organisational and operational models. A video is available to accompany the case series ''IMD-3-0918-V''.