While recent research has focused on the problem of elder abuse, most studies have focused on elderly populations living in community-based settings. Elder abuse occurring in nursing homes has received much less research attention. In the current study, researchers mailed a questionnaire to 400 nursing home directors in 4 States (Alabama, California, Colorado, and New York) in order to probe how cases of elder abuse are responded to and prevented in nursing home settings. Open-ended questions asked about obstacles confronted in the response to elder abuse, policies and programs used to increase the safety of residents, and opinions about the adequacy of the criminal justice response to elder abuse. Completed questionnaires were returned by 66 nursing home professionals; data were analyzed using standard rules of thematic content analysis. Routine activities theory was used as a guide for interpreting the results, which indicated that nursing home professionals regarded their responsibility of ensuring their client's safety and reducing opportunities for offending very seriously. Many prevention strategies were enumerated, including abuse policies, education, community outreach, and building security. Recommendations are offered for further changes in responding to abuse cases, including the development of consistent guidelines on the response to and reporting of cases of patient abuse and empirical evaluation of prevention strategies. Finally, policymakers are encouraged to include nursing home administrators in the development of future policies regarding the prevention of elder abuse. References