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The purpose of this nonexperimental, descriptive study was to explore and describe the current state of medication management for patients receiving services from certified home health care agencies (CHHAs). Data were collected by self-report from a convenience sample of 101 home health care nurses from 12 agencies in six states. Nurses reported on a total of 1467 patients. Results of this study support the findings from previous research on medication management of older people living in the community. The majority of older home care patients were taking more than five prescription drugs. Many patients were taking medications in ways that deviated from the prescribed medication regimen. The results also suggest that patients are experiencing many adverse effects from medication errors. The reasons for these errors were reported to be a result of individual patient characteristics and, most frequently, communication problems in the system. Results of this study support recommendations for technology application, regulatory and policy changes, further research, and nursing practice.