Purpose - This study aims to, chronicle literature, case studies and applied research to suggest that communications and public relations play a key role in the success of the best nursing homes and long-term care facilities. Design/methodology/approach - Research employed included a case study of four highly qualified nursing home facilities, followed by an electronic survey offered to all licensed nursing homes throughout New York State. Results from each segment of the research were compared and contrasted. Findings - This research confirmed the thesis that long-term care facilities which are independently identified as being high quality have a propensity to focus on communications with all stakeholders particularly their residents and family members. Communications with all stakeholders are key to facility success. Research limitations/implications - The case study focused only on larger facilities; and survey response was limited without individual e-mail addresses. Practical implications - A set of guidelines for Communications in Nursing Homes and Long-term Care Facilities was prepared as an outcome of the research. Originality/value - This segment of the population is expected to more than double in the next 25 years, reaching nearly 90 million by 2050. The topic presents an important issue and sensitively considers it amidst a backdrop of change in western society.