Purpose: This study was done to develop a predictive model for quality of life of elderly residents in long-term care facilities (LTCF). The study was based on Brofenbrenner’s ecological system theory and a literature review. Methods: Data were collected using a convenience sample of 205 elderly residents in 2 nursing homes located in D city and 1 nursing home located in K province. The exogenous variables were individual factors, family support, and facility environmental factors. The endogenous variables were self-esteem, accommodation adaptation and quality of life of elderly residents in LTCF. Collected data were analyzed through structural equation modeling using AMOS 20.0. Results: Eleven of the twelve hypotheses were supported, but the hypothesis that facility environment factors effect self-esteem was not supported. Quality of life of elderly residents in LTCF was explained first by facility environmental factors, followed by self-esteem, individual factors, accommodation adaptation, and family support with an explanatory power of 83.0%. Conclusion: To improve the quality of life of elderly residents in LTCF, the service and environment preparation provided by facilities is important, and it is necessary to provide emotional counseling to improve the self-esteem of these elders.