Facilities In Florida Research Articles

Characteristics related to family involvement in youth residential mental health treatment

Abstract This study examined family involvement among youth in residential mental health treatment facilities in Florida. Data were obtained from the provider reports from January 2005 through December 2007. Treatment episodes were divided into 30-day periods with family involvement measured by the number of contacts by all family members, the mother, and the father. In addition, we examined contacts by all family members for in-person treatment, treatment-related phone contacts, treatment planning, campus visits, and therapeutic home passes. Families averaged 3.4 contacts per 30 days for the 1333 treatment episodes. Sixty-seven percent of the contacts included mothers, while 22% of the contacts involved fathers. A majority of contacts were for family therapy, either by phone (29% of contacts) or in person (43%). Nearly twenty percent of residential stays had no family contact. After the first 30 days of treatment, contacts did not vary significantly over the course of the treatment episode, although there was some evidence that youth with longer treatment episodes had fewer contacts throughout the residential stay. Total contacts were lower for girls than boys, for blacks than whites, and for older youth, and were higher when the youth lived in the same county as the residential treatment provider. Outreach programs could target specific demographic groups with low involvement, and the alternative methods for involvement that use internet conferencing tools should be explored for parents that live far from the treatment provider.

Recent Legal Opinions Impacting Florida's Gaming Landscape

In the past six months, three legal opinions have impacted the opportunities for those interested in Florida’s gaming industry. The first two affect the regulated slot machine operations at pari-mutuel facilities in Florida and the slot machine operations of the Seminole Tribe of Florida. These appellate court opinions have the potential to increase the types of gaming devices at the slot machine casinos, as well as increasing the overall number of slot machine facilities in the Sunshine State. The third opinion, from a trial judge in Jacksonville, upholds local governments’ ability to regulate Internet cafe operations, which have exploded in Florida, with estimates placing this gambling industry at more than $1 billion annually. The first case involved a challenge by slot machine manufacturers to an administrative regulation requiring that random number generators (RNGs) be located inside of each individual slot machine cabinet. The rule at issue required that ‘‘[e]ach slot machine shall use an internal random number generator.’’ The manufacturers challenged the Florida Department of Business, Division of Pari-mutuel Wagering’s authority to promulgate such a rule, which denied them the ability to offer many of their slot machine products in Florida due to their use of a common external RNG. Both Interblock and Shuffle Master sought to market in Florida a roulette-themed slot machine that looks, feels, and plays very similar to a traditional roulette table game, but is tested and certified to meet the slot machine standards by an independent testing laboratory. The Division argued, among other things, that the slot machine statute authorized it to adopt rules concerning ‘‘[p]rocedures to scientifically test and technically evaluate slot machines,’’ which would include the ability to regulate the location of slot machine components, including the RNG. In holding that the Division lacked the authority to require slot machine RNGs to be inside each slot machine cabinet, the administrative law judge stated ‘‘there is no relationship between the object of agency regulation—internal random number generators—and the statutory assignment of duties listed above; Respondent [the Division] can meaningfully discharge each of these duties without requiring slot machine manufacturers or distributors to include a random number generator in each slot machine.’’ This holding allows new electronic table games into the Florida casino marketplace that, so far, have been very popular. Early reports from Florida’s casino operators indicate that these games are currently operating in excess of $1,000 WPU (win per unit), which is four to five times above house average. Clearly, these are very popular products both for Florida’s casino customers and for slot machine operators, since Florida does not allow true table game play except at the facilities operated by the Seminole Tribe—and the permissible table games for the Seminole Tribe are limited to only card games. Industry opinion is that manufacturers of

Experimental Investigation and Numerical Modeling of Surge Currents in Lightning Protection System of a Small Residential Structure

The distribution of lightning current in the lightning protection system (LPS) and the electrical circuit of two test structures simulating residential buildings was experimentally studied at two research facilities in Florida and in Poland. In Florida, the experiments were conducted using rocket-triggered lightning, and in Poland a mobile current surge generator was employed. The soil in Florida was sandy, while in Poland it was mostly clay. Simulations of lightning current in the LPS and the electrical circuit of each of the test structures were also performed. In this paper, we present results of experiments and numerical modeling of lightning current distribution in different configurations of LPS installed on the test structures at the two sites.

WEF/WERF Study Quantifying Nutrient Removal Technology Performance

The Water Environment Research Foundation (WERF) Nutrient Challenge Research Program and the Water Environment Federation (WEF) cooperated in a comprehensive study of nutrient removal plants designed and operated to meet very low levels of effluent N and P. Both existing and new technologies are being adapted to meet requirements that are as low as 3 mg/L TN and 0.1 mg/L TP, and there is a need to define their capabilities and reliabilities in the real world situation of wastewater treatment plants. This effort focused on maximizing what can be learned from existing technologies in order to provide a database that will inform key decision makers about proper choices for both technologies and rationale bases for statistical permit writing. To this end, managers of 22 plants, 10 achieving low effluent TP, 9 achieving low effluent TN, and 3 achieving low effluent ammonia, were asked to provide 3 years of operational data that were analyzed using a consistent statistical approach. Technical papers were compiled for each plant including a summary of influent loading, process design and operating conditions, unusual events, upsets and anecdotes related to process operation, and the statistical summary of final effluent data that considered both process reliability and the permit limits applied. The first year of this effort culminated in a workshop held in Chicago at WEFTEC 2008 and the second year in a workshop held in Orlando at WEFTEC 2009. Technological conclusions that can be drawn from the study in terms of what can be learned by comparing the different nutrient removal processes employed at these 22 plants and several additional BNR facilities in Florida are described in joint manuscripts submitted by Parker et al (2009) and Bott et al (2009). In a parallel effort using the data and conclusions generated from this study, Neethling et al (2009) proposed a set of quantitative descriptors that attempt to define the nutrient removal performance in terms of effluent quality percentile statistics referred to as Technology Performance Statistics (TPSs). The TPSs were defined as three separate values representing the lowest, median, and reliably achievable performance (Neethling et al, 2009). This title belongs to WERF Research Report Series . ISBN: 9781843393986 (Print) ISBN: 9781780403328 (eBook)

Analysis of Federal and State Policies and Environmental Issues for Bioethanol Production Facilities

The purpose of this work was to investigate incentives and barriers to fuel ethanol production from biomass in the U.S. during the past decade (2000-2010). In particular, we examine the results of policies and economic conditions during this period by way of cellulosic ethanol activity in four selected states with the potential to produce different types of feedstocks (i.e., sugar, starch, and cellulosic crops) for ethanol production (Florida, California, Hawaii, and Iowa). Two of the four states, Iowa and California, currently have commercial ethanol production facilities in operation using corn feedstocks. While several companies have proposed commercial scale facilities in Florida and Hawaii, none are operating to date. Federal and state policies and incentives, potential for feedstock production and conversion to ethanol and associated potential environmental impacts, and environmental regulatory conditions among the states were investigated. Additionally, an analysis of proposed and operational ethanol production facilities provided evidence that a combination of these policies and incentives along with the ability to address environmental issues and regulatory environment and positive economic conditions all impact ethanol production. The 2000-2010 decade saw the rise of the promise of cellulosic ethanol. Federal and state policies were enacted to increase ethanol production. Since the initial push for development, expansion of cellulosic ethanol production has not happened as quickly as predicted. Government and private funding supported the development of ethanol production facilities, which peaked and then declined by the end of the decade. Although there are technical issues that remain to be solved to more efficiently convert cellulosic material to ethanol while reducing environmental impacts, the largest barriers to increasing ethanol production appear to be related to government policies, economics, and logistical issues. The numerous federal and state policies do not effectively give investors confidence to commit to the construction and long-term operation of facilities under current economic conditions. Additional changes in policy and breakthroughs in technology and logistics will be required to address these hurdles to increases in ethanol production in the U.S. in the next decade.

Medical and Surgical Management of Otitis in Captive Bongo (Tragelaphus eurycerus)

Six cases of severe otitis media-interna, an uncommon problem in nondomestic ruminants, were diagnosed in five captive bongo (Tragelaphus eurycerus). The cases were geographically clustered at zoological facilities in Florida. A visible ear droop, head shaking, and otic discharge were common at clinical presentation. Medical management with prolonged systemic and topical antimicrobial therapy, combined with repeated manual removal of debris from the otic canal, was successful in resolving two cases and effectively controlled a third case. Two bongo with severe otitis did not respond to medical management and required surgical intervention. A bulla osteotomy and total ear canal ablation were performed on these animals (bilaterally in one bongo). Surgery was successful in providing complete clinical resolution of the otitis and is recommended for severe cases that fail to respond to less invasive management.

Guidance Needed on Choosing Among Alcoholism Treatments

Guidance Needed on Choosing Among Alcoholism Treatments

Would the Employee Free Choice Act Effectively Protect the Right to Unionize?

This article examines in detail union busting in a nursing home facility in Florida and asks whether the Employee Free Choice Act (EFCA) would have protected workers' freedom to choose if it had been in effect at the time. It systematically applies EFCA's provisions to the events of the case and concludes that EFCA would have been helpful to the workers. However, EFCA would not have erased all obstacles to free employee choice, especially for low-wage workers like these. It also reveals that one of the least known features of EFCA would have been most crucial in this case.

Risk of Alcohol-Exposed Pregnancies among Low-Income, Illicit Drug-Using Women

Poor women of childbearing age who use crack, cocaine, marijuana, and heroin may be at risk for having an alcohol-exposed pregnancy because of concurrent alcohol use. Women who use illicit drugs may not know the harmful effects of fetal alcohol exposure. Fetal alcohol exposure is a leading cause of developmental disabilities and mental retardation. We report findings of a survey administered to 2672 women 18-44 years of age in settings serving low-income women, including an urban jail, a drug treatment facility, and healthcare facilities in Florida, Virginia, and Texas. We compared women who reported using more than one illicit drug (drug users) and women who reported never using illicit drugs (nonusers) for frequent alcohol consumption, binge drinking, failure to use contraception, unplanned pregnancies, and drinking during pregnancy. Of women interviewed, 75% (2000) reported using more than one illicit drug. Drug users were more likely to report frequent drinking (33%, relative risk [RR] 12.73, 95% confidence interval [CI] 7.9-20.4, binge drinking (39%, RR 5.7, 95% CI 4.9-7.6), and drinking during pregnancy (37%, RR 2.10, 95% CI 1.75-2.53) compared with nonusers (3%, 7%, 17%, respectively, p < 0.0001). Greater proportions of drug users (27%, RR 2.20, 95% CI 1.75-2.53) also failed to used contraception compared with nonusers (19%, p < 0.05). Notable proportions of both groups, drug users (91%) and nonusers (82%), reported unplanned pregnancies. The findings suggest that poor women who reported ever using more than one illicit drug were at greater risk for having an alcohol-exposed pregnancy. Unplanned pregnancies in both groups surpassed national averages. Poor women likely require enhanced education about the hazards of drinking during pregnancy and methods to reduce unplanned pregnancies.

USDA Inspected Livestock Slaughter Facilities in Florida

AN203, a 3-page illustrated fact sheet by Chad Carr, Larry Eubanks, and Ryan Dijkhuis, provides a comprehensive list of USDA inspected meat animal slaughter facilities in Florida. Published by the UF Department of Animal Science, July 2008. AN203/AN203: USDA-Inspected Livestock Slaughter Facilities in Florida (ufl.edu)

Batch Test Assessment of Waste-to-Energy Combustion Residues Impacts on Precipitate Formation in Landfill Leachate Collection Systems

Disposal practices for bottom ash and fly ash from waste-to-energy (WTE) facilities include emplacement in ash monofills or co-disposal with municipal solid waste (MSW) and residues from water and wastewater treatment facilities. In some cases, WTE residues are used as daily cover in landfills that receive MSW. A recurring problem in many landfills is the development of calcium-based precipitates in leachate collection systems. Although MSW contains varying levels of calcium, WTE residues and treatment plant sludges have the potential to contribute concentrated sources of leachable minerals into landfill leachates. This study was conducted to evaluate the leachability of calcium and other minerals from residues generated by WTE combustion using residues obtained from three WTE facilities in Florida (two mass-burn and one refuse-derived fuel). Leaching potential was quantified as a function of contact time and liquid-to-solid ratios with batch tests and longer term leaching tests using laboratory lysimeters to simulate an ash monofill containing fly ash and bottom ash. The leachate generated as a result of these tests had total dissolved solid. (TDS) levels ranging from 5 to 320 mg TDS/g ash. Calcium was a major contributor to the TDS values, contributing from 20 to 105 g calcium/kg ash. Fly ash was a major contributor of leachable calcium. Precipitate formation in leachates from WTE combustion residues could be induced by adding mineral acids or through gas dissolution (carbon dioxide or air). Stabilization of residual calcium in fly ashes that are landfilled and/or the use of less leachable neutralization reagents during processing of acidic gases from WTE facilities could help to decrease the calcium levels in leachates and help to prevent precipitate formation in leachate collection systems.

Guidelines for hurricane and disaster preparation for animal facilities

Animal facilities are vulnerable to hurricanes and other natural disasters, which can endanger lives and disrupt critical animal care routines. Facility managers must therefore prepare a rigorous emergency plan that ensures human safety while considering the specific needs of all animals on site. The author presents guidelines and recommendations for disaster preparedness based on her experience at a facility in Florida, where hurricanes are relatively common. An effective plan must include a priority system, a well-trained emergency response team, efficient communication methods and concrete provisions for animals and employees.

Size distribution, chemical composition and acidity of mist aerosols in fertilizer manufacturing facilities in Florida

Strong inorganic acid mists containing sulfuric acid (H 2SO 4) have been reported to correlate well with lung and laryngeal cancers in humans. Phosphate fertilizer manufacturing facilities are listed as one of the many occupational exposures to strong acid. To better protect workers from potential exposure, a field campaign was carried out to investigate aerosol characteristics at eight phosphate fertilizer facilities using a UW-cascade impactor for size information and ion chromatography for water soluble species. The results show that acid mists were dominantly in the coarse mode when high concentrations were identified. An aerosol thermodynamic model was established to estimate the aerosol acidity. In the high-relative-humidity environment, the aerosol can reach its equilibrium size within 0.014 s, which is shorter than the traveling time of an aerosol in the upper respiratory system. The results indicate that aerosols sampled in this study may deposit in the upper respiratory tract, which is consistent with epidemiological evidence of a correlation between inhalation of strong inorganic acid mists and laryngeal cancer. However, extensive epidemiological studies of phosphate industry workers have not shown an increased incidence of any type of cancer.

Assisted Living Policies Promoting Autonomy and Their Relationship to Resident Depressive Symptoms

The objective of this study is to determine the relationship between facility policies regarding autonomy and depression among residents of residential care/assisted living (RC/AL) facilities. A stratified sample of RC/AL facilities in Florida, Maryland, New Jersey, and North Carolina participated in the study. Patient characteristics for individuals 65 years and older were obtained from medical record reviews and in-person interviews. Facility administrators provided data on facility characteristics. Data on 1,098 residents were used to examine the relationship between facility policies as measured by domains of the Policy and Program Information Form and resident depressive symptoms and its factors as measured by the Cornell Scale for Depression in Dementia. Generalized estimating equation regression analysis was used to examine this relationship and control for other explanatory variables and clustering. Among the policy variables examined, only the degree to which residents were involved in facility administration was consistently associated with depressive symptoms. Greater resident influence over facility policies and involvement in facility administration was significantly associated with lower levels of depressive symptoms. Resident control over their daily activities, the facility's tolerance for disruptive behavior, and the extent to which facilities had formal mechanisms for defining expected behavior were not significantly associated with levels of depressive symptoms. Although some facilities provide residents with opportunities to select activities or meal times, these policies were not associated with depressive symptoms. However, results are consistent with the hypothesis that resident involvement in facility administrative decision-making is associated with fewer depressive symptoms. Future research should explore the causal nature of this relationship and might provide guidance for policy and practice.

Depressive Symptoms among Older Residents in Assisted Living Facilities

Responding to the dramatic growth in Assisted Living Facilities (ALFs), the present study focused on mental health among older residents in ALFs. We assessed the effects of physical health constraints (chronic conditions, functional disability, and self-rated health) and psychosocial resources (social network, sense of mastery, religiosity, and attitude toward aging) on depressive symptoms. A sample of 150 residents (Mage = 82.8, SD = 9.41) from 17 facilities in Florida was used for analyses. Higher levels of depressive symptoms were observed among older residents with a greater level of functional disability, poorer self-rated health, lower sense of mastery, less religiosity, and less positive attitude towards aging. In addition, the linkages between physical and mental health were modified by psychosocial resources. For older residents with more positive beliefs and attitudes (a higher sense of mastery, greater religiosity, and more positive attitudes toward aging), the adverse effects of functional disability or poorer self-rated health on depressive symptoms were attenuated. The protective roles of psychosocial resources against physical health constraints yield important implications for designing prevention and intervention strategies for the mental health of older populations in ALF settings.

New records of parasites for culture Cobia, Rachycentron canadum (Perciformes: Rachycentridae) in Puerto Rico

Intensive aquaculture sometimes provides conditions favorable for parasites that are not ordinarily found on culture fishes in the wild, and the use of introduced stocks sometimes introduces non-indigenous species to the habitat. When officially asked about the culture of Cobia Rachycentron canadum (Linnaeus) in Puerto Rico, the authors responded that it was unlikely to cause harm. It was assumed that a well-known culture facility in Florida would assure parasite-free stocks. Subsequent examinations of stocked juveniles surprisingly found parasites new to this fish. An outbreak of Slime-blotch disease, Brooklynella hostilis Lom & Nigrilli, 1970 (Dysteriida: Hartmannulidae) occurred in juvenile Cobia after they were shipped from Florida and stocked. This apparently represents a local parasite that took advantage of the weakened and/or crowded fish. The universal aquarium and culture superparasite, Marine Ich, Cryptocaryon irritans Brown, 1951 (Colpodia: Ichthyophthiriidae) was introduced with a shipment of juvenile Cobia from Florida. This may not be serious, since the parasite occurs worldwide, unless it represents a new strain to Puerto Rico. Marine Costia, Ichthyobodo sp. (Kinetoplastida: Bodonidae) was introduced into Puerto Rico with juvenile Cobia shipped from Florida. This parasite has caused some severe problems in aquaculture hatcheries in Hawaii and Texas after it was introduced with cultured organisms. Thus far, it has not caused any problems locally, but Puerto Rico lacks the marine hatchery facilities where such outbreaks would occur. The question of whether it is established locally will have to await the development of similar facilities in Puerto Rico. These three species of parasites represent new host records for Cobia. The non-indigenous Ichthyobodo sp. represents new locality records for the tropical Atlantic, Caribbean, and Florida and Puerto Rico. Cobia mature more quickly in culture than in the wild and thus female Cobia apparently mature sufficiently before harvest to attract wild male Cobia to the net pen culture facilities. This represents a potential source of parasite and disease infection for the cultured and wild fish. Rev. Biol. Trop. 54 (Suppl. 3): 1-7. Epub 2007 Jan. 15.

Size-Resolved Sulfuric Acid Mist Concentrations At Phosphate Fertilizer Manufacturing Facilities In Florida

Strong inorganic acid mists containing sulfuric acid were identified as a 'known human carcinogen' in a National Toxicology Program (NTP) report where phosphate fertilizer manufacture was listed as one of many occupational exposures to strong acids. To properly assess the occupational exposure to sulfuric acid mists in modern facilities, approved National Institute for Occupational Safety and Health (NIOSH) Method 7903 and a cascade impactor were used for measuring the total sulfuric acid mist concentration and size-resolved sulfuric acid mist concentration, respectively. Sampling was conducted at eight phosphate fertilizer plants and two background sites in Florida and there were 24 sampling sites in these plants. Samples were analyzed by ion chromatography (IC) to quantify the water-soluble ion species. The highest sulfuric acid concentrations by the cascade impactor were obtained at the sulfuric acid pump tank area. When high aerosol mass concentrations (100 micro g m(-3)) were observed at this area, the sulfuric acid mists were in the coarse mode. The geometric mean sulfuric acid concentrations (+/-geometric standard deviation) of PM(23) (aerodynamic cut size smaller than 23 micro m), PM(10) and PM(2.5) from the cascade impactor were 41.7 (+/-5.5), 37.9 (+/-5.8) and 22.1 (+/-4.5) micro g m(-3), respectively. The geometric mean (+/-geometric standard deviation) for total sulfuric acid concentration from the NIOSH method samples was 143 (+/-5.08) micro g m(-3). Sulfuric acid mist concentrations varied significantly among the plants and even at the same location. The measurements by the NIOSH method were 1.5-229 times higher than those by the cascade impactor. Moreover, using the NIOSH method, the sulfuric acid concentrations measured at the lower flow rate (0.30 Lpm) were higher than those at the higher flow rate (0.45 Lpm). One possible reason for the significant differences between the results from the cascade impactor and the NIOSH method is the potential artifact resulting from the interaction of SO(2) with silica gel and glass fiber used in the NIOSH method.

LIVING AMONG STRANGERS: THE NEEDS AND FUNCTIONING OF PERSONS WITH SCHIZOPHRENIA RESIDING IN AN ASSISTED LIVING FACILITY

Objectives: The purposes of this research were to describe the quality of care for severe and persistent mentally ill persons with schizophrenia who reside in an assisted living facility and to explore the characteristics related to the identification of need and the level of functioning of these individuals. The specific objectives of the study were to (a) describe characteristics of the residents, (b) identify relationships among characteristics of residents and the level of functioning, and (c) analyze relationships among these characteristics and resident needs. Design: Correlational, quasi-experimental design. Population/ Sample/Setting: Face-to-face semistructured interviews were conducted with 58 ALF residents with schizophrenia and eight direct caregivers from eight assisted living facilities in Florida, resulting in representation of 20% of the public assisted living facilities in one county. Method: Face to face, semi-structured interviews utilizing multiple scales and instruments. Findings: Findings indicated that the profile of a typical resident living in a public ALF consisted of a 43-year-old, never married Caucasian male who dropped out of high school and had suffered from a psychiatric illness for over 21 years. The most frequent reported current mental health treatment modality of residents was attendance at a community mental health center. This average resident had five inpatient psychiatric hospitalizations, had not been an inpatient at a state psychiatric facility, and was prescribed an average of four different psychiatric medications. Spearman correlational coefficients and stepwise multiple regression analyses revealed that significant relationships existed between level of functioning and the following characteristics: positive symptoms (p = 0.0003), negative symptoms (p = 0.003), medication knowledge (p = 0.0001), and GAF scores, current (p = 0.01) and past (p = 0.009). No significant relationships were indicated among resident characteristics and resident needs. Conclusions: This descriptive, correlational study provides the foundation for further research on the quality of care for individuals with severe and persistent mental illnesses who reside in assisted living facilities. Understanding the interactions among symptoms of schizophrenia, level of functioning, and unmet needs may provide a future focus for mental health treatment planning and intervention. Implications: National and international agencies develop and implement assisted living facility standards that impact the lives of residents with moderate levels of functioning and multiple unmet needs, having implications for both practice and mental health policy.

The Effectiveness of Juvenile Correctional Facilities: Public versus Private Management

Abstract This paper uses data on juvenile offenders released from correctional facilities in Florida to explore the effects of facility management type (private for‐profit, private nonprofit, public state‐operated, and public county‐operated) on recidivism outcomes and costs. The data provide detailed information on individual characteristics, criminal and correctional histories, judge‐assigned restrictiveness levels, and home zip codes—allowing us to control for the nonrandom assignment of individuals to facilities far better than any previous study. Relative to all other management types, for‐profit management leads to a statistically significant increase in recidivism, but relative to nonprofit and state‐operated facilities, for‐profit facilities operate at a lower cost to the government per comparable individual released. Cost‐benefit analysis implies that the short‐run savings offered by for‐profit over nonprofit management are negated in the long run due to increased recidivism rates, even if one me...

Medication undertreatment in assisted living settings.

Residential care/assisted living (RC/AL) is a rapidly growing, long-term care setting, where medication use has not been carefully examined. We sought to determine the prevalence and predictors of nonprescribing of selected medications whose value in decreasing morbidity has been established in clinical trials. As part of a survey of a stratified random sample of 193 RC/AL facilities in Florida, Maryland, New Jersey, and North Carolina, data were gathered on 2014 residents 65 years and older. Patient characteristics and diagnoses were recorded based on medical record reviews and in-person patient assessments; all medications administered at least 4 of the previous 7 days were recorded. Data on facility characteristics were obtained by interviewing facility administrators. Bivariate and multivariate logistic regression was performed to identify associations between medication nonprescribing and facility characteristics, physician visitation, and patient age, sex, race, comorbidity, functional dependency, and cognition. Of 328 subjects with congestive heart failure, 204 (62.2%) were not receiving an angiotensin-converting enzyme inhibitor; of 172 subjects with prior myocardial infarction, 60.5% were not receiving aspirin and 76.2% were not receiving beta-blockers; of 435 patients with history of stroke, 37.5% were not receiving an anticoagulant or antiplatelet agent; and of 315 patients with osteoporosis, 61.0% were not receiving calcium supplementation and 51.1% were not receiving any treatment for the condition. Resident age, race, sex, comorbidity, cognitive status, and dependency in activities of daily living were rarely associated with nonprescribing; in contrast, facility factors-particularly facility type and the frequency of physician visits-were somewhat more frequently associated with nonprescribing. Undertreatment appears to be prevalent in RC/AL facilities. Since preserving independence is often a primary goal of care in these settings, more attention may need to be paid to the use of treatments that have been shown to reduce long-term morbidity.