In an ageing population the number of those in need of long-term care increases. Fulfilling this need is not only a matter of providing additional nursing staff. It is equally important to establish the corresponding infrastructure on an adequate scale. By 2030 up to 220,000 additional places will be required nationally in residential care alone. With considerable differences in their demographic trends and the level of their existing facilities, Germany’s individual states all face different challenges. However, common to them all is the need to waste no time in taking strategic decisions for the development of a long-term care infrastructure appropriate to the needs and preferences of their populations.