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Cognitive assessment and training are needed to avoid accelerated cognitive decline. We have developed BrainTagger, a suite of serious games that evaluate and potentially train cognitive abilities such as inhibitory control, processing speed, cognitive flexibility, and working memory. Ideally, cognitive assessments can be used as sentinels to detect problems that might damage brain functions (e.g., dehydration, poor nutrition, depression, delirium, inappropriate medication). In this paper, we report on a multi-year effort to develop hardware and software solutions that support effective implementation of cognitive assessment games (CAGs) in long-term care. Issues and constraints addressed include accommodating physical disabilities; making cognitive assessment enjoyable and engaging; providing scientific evidence that each game is measuring the intended construct; and reporting game results in a meaningful way. This article describes how we addressed some of these issues and demonstrates the sustained effort required to make this type of functionality work in practice. We also include some preliminary design guidelines, based on our experience, that may be useful in guiding future work on developing CAGs.