Perhaps the largest drawback of the ACE program is the necessity of a devoted unit with specialized features to care for patients. Given the skyrocketing prevalence of older adults in inpatient units, there may not be sufficient capital to create ACE units to treat all older adult patients. It may be necessary to pick and choose which patients and conditions warrant admission to the ACE unit. Unfortunately, the principles of ACE require environmental changes to the unit, which limits the ability of the ACE principles to be applied in non-ACE units.