Long Term Care Management Center (LTCMC) in Taiwan began in 2007 based on the Ten Year Long Term Care Project. It serves as the sole port to provide long term care assessment, referral and transfers to clients and their families. This article describes the two major challenges LTCMC encountered: organizational structure and management of human resources. Organizational structure differs in each region in management model, policies and goals, regulations and resources. The issues related to human resources management included uncertainty of employment, benefits, professional competency and promotion. Recommendations to improve the current situation to promote quality of long term care includes improvements in the personnel structure, recruitment, provide security in employment with benefits, on-the job training, professional accreditation, and marketing strategy.