The purposes of this study were t examine the relationship between: (1) nurses' ratings of pain and corresponding administration of pain medication to elderly long-term care residents, and (2) cognitive status the elderly and pain medication orders/administration. Participants were 83 residents, 60 years of age and older, in two groups: cognitiveIy impaired (n = 64), and cognitively intact (n = 19). For comparison purposes, 19 of the cognitively impaire subjects were matched on age an diagnosis to provide control fi potentially painful conditions. A retrospective medication review of the residents' charts was conducted to compare medication orders and administration on analgesics that were scheduled and p.r.n. (given needed). The pain ratings of 25 RN using a visual analogue scaie wen correlated with pain medication given to the resident on the day o the rating. Results indicated that RNs' ratings of resident pain and the administration of pain medications were not significantly correlated. In addition, cognitively impaired residents were prescribed significantly less scheduled medication and received significantly less pain medication (either p.r.n. or scheduled) than the cognitively intact elderly. Implications for practice and research are discussed.