The current challenge of nursing homes (NH) is basically to attempt to stay the course towards fulfilment of their mission and role, while checking to ensure that their programming is efficient, suitable for residents and in keeping with their staff's abilities and ratios. Furthermore, NHs must re-examine how they deliver their strategies to optimize and improve overall quality. Finally, they must continually examine ministerial policy directives regarding the living environment as much in terms of the physical and human environment standpoint as in care practices and service delivery, while respecting the rules of professional ethics. Labour relations and relational approaches to residents are also realities to be recognized and challenges to overcome, in the context of respect for the needs and rights of residents. On the whole, currently, the various health profiles (ISO-SMAF) of the residential clientele, the available machinery and equipment, the allocated budgets and the healthy cohabitation of residents without ageism or bullying are major challenges. These are of serious concern when it comes to ensuring a tightened safety net for vulnerable residents and promoting a culture of proper treatment for all, residents and workers alike.