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Medication administration (MA) plays a crucial role in managing the health of nursing home (NH) residents. MA is complex and often comprises five elements: (a) ordering/prescribing, (b) transcribing and verifying, [...], Purpose To gain a better understanding of the perceptions of RNs on medication safety concerns and potential solutions for nursing home (NH) residents. Method This prospective, qualitative study used semi-structured phone interviews with a description approach. We used purposeful sampling to recruit 12 RNs employed at two NHs in the northeastern region of the United States. The Systems Engineering Initiative for Patient Safety constructs informed the interview guide, coding, and qualitative theme identification. Results We categorized non–user-friendly charting systems and gained insights into more experience with paper-based charting under the technology component. For the organization component, participants identified the importance of teamwork, communication, and leadership. Participants also mentioned how education and nationality of training impact medication administration (MA) safety. Task-related concerns revealed how different care approaches, extreme workload variation, and task prioritization during the day are perceived as critical issues that need to be addressed. Staff shortages were also expressed as an environment-related concern. Conclusion Findings highlight the importance of appropriate nurse-to-patient ratio, the significance of user-friendly charting systems, and customizing the interface of MA in the charting system. [Journal of Gerontological Nursing, xx(xx), xx–xx.]