I stood on the firm land!

In this issue (page 1441) Gina Bravo and colleagues reporton their study in which they assessed the quality of careprovided to 301 impaired elderly residents in 88 unli-censed and licensed nursing homes in Quebec.1 They used a standard tool to assess care processes in 6 dimensions of care (environmental, physical, medical management, psychosocial, human rights and financial). Overall, care processes were adequate in both types of facility; however, the unlicensed homes performed significantly worse than the licensed facilities in 2 areas: physical care and medical management. Deficiencies were found in other areas as well, but the differences between the 2 types of facility were nonsignificant. Overall, 25 % of the facilities were found to provide inadequate care to at least one resident; this was es-pecially true in homes with fewer than 40 residents, where up to 20 % of the residents received inadequate care. Bravo and colleagues are to be commended for thei