While investigators improve their design for non-randomized studies of outcomes of care involving nursing home residents, it is important that clinicians continue their efforts to improve processes of care for hospitalized nursing home residents. If we make a frail elderly nursing home resident to go through the near-traumatic and at times life-changing experience of hospitalization, then we are also obligated to provide them the standard of care that is received by other hospitalized patients. Individual exceptions are expected and should be well documented in charts. We should treat our nursing home residents in the same manner we would like ourselves, our parents and our grandparents to be treated. We need to keep in mind that our practice will set the precedence for future generations of clinicians who will treat us should we live long enough. .. !