Commentary by Karen Graham: Despite the successful expansion of PAs into many medical specialties, US PAs have not made significant inroads into geriatric practice. Not only do NPs far outnumber PAs in long-term care and home healthcare employment (6,340 versus 210 in 2016), but the overwhelming majority (85%) of PA and NP job openings for the care of older adults and people with disabilities are listed solely for NPs.1 With a generalist training and career flexibility, PAs are well positioned to respond to the healthcare needs of the aging US population in a variety of settings, including long-term care. The limited research demonstrates an association between use of a PA in a long-term care facility and lower hospitalization rates.2,3 But such research also is outdated. The American Academy of PAs and other advocates should develop strategies to educate administrators of long-term care systems about the education and role. Concerted efforts are needed to increase the clinical training opportunities for PA students in these settings.