As a nation and a community, we must all work to maintain the dignity of the 1.6 million citizens residing in nursing homes. Moreover, since one in every five deaths in the United States occurs in a nursing facility, and 30 to 50 percent of people admitted to nursing home die within their first year of resident (Keay et al. 1994; Hing et al. 1989), our commitment includes ensuring a good death for nursing facility residents.