The purpose of this study was to evaluate the reliability and validity of the Basic Physical Capability Scale when used with older adults having moderate to severe cognitive impairment and consider the utility of the measure in establishing function-focused care (FFC) goals for these individuals. The study was a secondary data analysis using data from 2 intervention studies testing FFC interventions in older adults with moderate to severe cognitive impairment in nursing homes and assisted living settings. Participants included 96 recruited from 4 assisted living facilities and 103 older adults from 4 nursing homes. There was support for validity of the measure based on construct validity and hypothesis testing, internal consistency (Cronbach's α of .79), and utility of the measure. Recommendations are provided for additional items that might help better differentiate individuals with moderate to severe cognitive impairment who are particularly high or low in basic physical capability.