In Austria, the responsibilities for long-term care mainly lie with the provinces, although federal and organisational-level initiative has grown. Quality assurance policies focus overwhelmingly on the health system and are only slowly appearing in the realm of long-term care (LTC). Although the Austrian LTC system is still very fragmented owing to the division of competencies, there are enhanced efforts underway to harmonise LTC provision, standards and quality nationwide. Currently, quality assurance remains mostly at the stage of setting general frameworks or launching small-scale projects, with some notable exceptions. Additional efforts are needed for concerted reforms and for furthering implementation activities.