The objective of this study was to identify whether spirituality mediates the relationship between empathy and elderly care performance among Long Term Care (LTC) hospitals nurses in Korea. Methods: The data collection was performed July 1st to August 31th, 2018. Participants were 119 nurses from three long-term care hospitals in Korea. Self-reported questionnaires were administered to assess general characteristics, empathy, spirituality and elderly care performance. The data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation coefficients, and three-stage simple and multiple regression analysis as proposed by Baron and Kenny. Results: The level of elderly care performance of participants was significantly different based on age (F=3.92, p=.010) and nurse's position (t=-2.18, p=.031). Spirituality had a significant mediating effect on the relationship between empathy and elderly care performance (Z=3.64, p<.001). Conclusion: As spirituality completely mediates the relationship between empathy and elderly care performance, it is necessary to develop a nursing education program that applies spirituality and empathy and supports religious activities at an institutional level.