This article describes a quality improvement program to reduce the prevalence of psysical assaults in a university-affiliated, 234-bed Vaterans Affairs (VA) long-term care (LTC) facility, which experienced a rise in the number of psysical assaults to >4 per 1,000 bed days of care in four long-term care units. Analysis of 55 events (29 patients) at this Vaterans Affairs long-term care site during 2007 revealed 19 resident assailants (8% total population), 10 victims, and 30% repeat events. Of the residents who exhibited assaultive behavior, 44% had dementia and 32% had schizoprenia as a major diagnosis. Following a process improvement plan, new occurrence assaultive behaviors declined from >4 to