The obesity epidemic has touched all segments of society and every health care sector including the nursing home industry. Understanding the issues related to the care of obese nursing home residents is important in light of this epidemic. Such issues include the difficulties related to access to nursing homes, the structural preparedness of nursing homes to care for obese patients, and the potential for staff injuries. Policies regarding strategies to improve nursing home access for obese patients, mitigate disparities in quality of care and health outcomes owing to obesity, and better prepare for the growing obesity epidemic are needed.