Due to demographic change the German health service faces major challenges. The health care system and elderly care facilities must adapt to heavily increasing numbers of people requiring care in the future. Thus, in particular, elderly care facilities are struggling today with complex problems.The present work has the objective to analyze the most relevant factors that influence the success of elderly care facilities. Based on an empirical, qualitative study, the persons involved in elderly care facilities were interviewed to supportive of aged care facilities and hindering factors. The study uses as a basis a special form of the system theory, the personal system theory in the tradition of Bateson adapted for practical purposes by König und Volmer.In this theory, the characteristics of social systems are in focus. A social system, such as an elderly care facility, is defined by König and Volmer regarding to the participants of the corresponding social system.As critical to the success of elderly care facilities have resulted in the key factors subjective interpretations of the social system elderly care facility and its social rules and recurring patterns of behavior, the rule loops.From the knowledge gained new alternatives for the optimization of elderly care facilities are developed with the help of the personal system theory.