The intensive investigation of Field and coworkers1 provides important information for those who care for nursing home (NH) residents. The findings are disturbing and might underestimate the true frequency of NH adverse drug events (ADEs) in the United States.
In earlier research, authors of this same group2 suggested that the NHs they observed were likely to provide above-average care and to experience below-average ADEs—particularly since the NHs participated voluntarily and the proportion of proprietary NHs was below the national average. The latter point requires emphasis, particularly because the proportion of voluntary, nonprofit NHs across the United States is much lower than in the present study1 (27% vs 39%), and residents of nonprofit NHs receive better quality services and experience better outcomes.3 It would be interesting to compare the frequency of ADEs in the voluntary, nonprofit NHs with that in the proprietary NHs observed by Field et al.1
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