The digital transformation of long-term residential care is essential to address demographic change, rising care needs, and severe workforce shortages. Long-term care facilities face the dual challenge of maintaining quality while managing limited resources, positioning digital innovations as a key component of future strategies. Technologies such as electronic documentation systems, sensor-based monitoring, telehealth, and robotic assistance promise to reduce workload, enhance efficiency, and improve residents’ safety and participation. At the same time, significant barriers persist, including financing, interoperability, data protection, and limited acceptance among staff, residents, and families. This chapter examines three interconnected perspectives: first, the opportunities and constraints of digital innovations in long-term care; second, organizational digital readiness and maturity, including the transferability of existing maturity models to the long-term care sector; and third, the development of digital competencies among staff and leadership as critical enablers of sustainable transformation. Drawing on international frameworks, systematic reviews, and empirical findings, the chapter argues for sector-specific maturity models and emphasizes the need for strategic leadership, participatory implementation, and continuous competence development. Ultimately, digital transformation in long-term care is framed not as a purely technical project but as a socio-technical and cultural change process requiring the alignment of structures, competencies, and leadership.