Conducting hearing tests and hearing screenings in the nursing home environment can be a challenge. One issue which may affect the validity of the test results is the level of ambient noise in those facilities when a sound-treated booth is not available. This study sampled the ambient noise levels in ten different nursing homes and compared those results to the ANSI S3.1--1999 criteria for maximum permissible ambient noise levels. Based on the results of this investigation, the use of insert earphones for air conduction assessments is recommended when a sound-treated booth is unavailable and noise levels exceed the ANSI criteria. Other suggestions regarding air-conduction and bone-conduction assessments are discussed.