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Persistent pain affects at least half of all older adults. The negative consequences of persistent pain are numerous and include depression, anxiety, and lower overall quality of life. However, pain is often underrecognized, underreported, underassessed, and undertreated, and multiple barriers to optimal pain practices exist. Although a solid evidence base exists for optimal pain practices, little progress has been made. This article reviews a study that developed and implemented a multifaceted intervention to improve pain practices in nursing homes and then examines the implications of those study findings for the home healthcare setting.