Although long-term care, including nursing homes, quality measures have improved in the last few years, residents’ care needs in long-term care have continued to become more complex. While quality of care is one of the main determinants of the standard of service provided by facilities, quality of life is a multidimensional concept that includes psychological, social, environmental, and functional perspectives of residents’ lives. Quality of life means a state that helps individuals to remain healthy, comfortable, and able to participate in or enjoy life events. Researchers are continually trying to identify quality indicators to help policymakers create policies to ensure long-term care residents receive high-quality care. Based on Donabedian’s structure-process-outcome model as a theoretical framework, this chapter discusses how facility characteristics (e.g., ownership status, reimbursement status, staffing) and resident characteristics (e.g., physical and cognitive health, duration of stay, payment source) impact residents’ quality of life and ways to improve residents’ satisfaction with health promotional practices.