This study aims to understand the abuse of older adults at long-term care (LTC) facilities and suggest implications in Korea. Elder abuse at LTC facilities increased rapidly after the introduction of the Long-Term Care Act. The characteristics of abuse at LTC facilities are different from those at home in terms of abused older adults and abusers, abuse types, and obligated reporters. The most vulnerable older adults are women and those with dementia. It is necessary to consider residential environments and customizable strategies to prevent and intervene in abuse. However, the analytic results of four prevention levels have revealed that policies and programs for abuses exist, but they are not specifically suitable for abused older adults in a facility. Increasing abuse toward older adults cannot be avoided as society sees increases in the number of older and dependent residents. The guardian system's social policies, the ombudsman program, and the management of latent cases are suggested. Strengthening the functions of the Elder Protection Agency (EPA) is also suggested.