I applaud the attention given to assisted living in the August 2003 issue. The Editorial and Ethel L. Mitty's Policy Perspectives article were enlightening.

One important point needs to be made: The Centers for Medicare and Medicaid Services (CMS) is not authorized to enforce quality-of-care standards in assisted living facilities, as it does in skilled nursing homes. Nurses must address this limitation in CMS's authority.

Nancy C. Sharts-Hopko, PhD, RN, FAAN