This study examines factors influencing the selection of nursing hospitals for elderly patients requiring long-term care, aiming to enhance user satisfaction. As Korea's aging population and longer life expectancy increase the demand for long-term care facilities, the research applies the SERVQUAL model to evaluate service quality dimensions, including tangibility, reliability, responsiveness, assurance, and empathy. Findings indicate that high service quality significantly boosts user satisfaction and influences the choice of nursing hospitals. The study also explores how satisfaction varies across demographic factors such as gender, age, education level, income, and decision-making authority. Results suggest that tailored, high-quality medical services can greatly enhance user satisfaction and influence future choices regarding long-term care facilities. This underscores the importance of customizing medical services to the needs of elderly patients, improving satisfaction and supporting better long-term care decisions. Additionally, by incorporating project management principles, the study offers practical insights for nursing hospital administrators, highlighting the critical role of strategic planning and execution in elevating service quality. This approach enhances the hospital's competitive advantage and contributes to more effective long-term care solutions. Healthcare providers are encouraged to prioritize quality improvements that address the diverse preferences of elderly patients, ultimately leading to better outcomes in long-term care.