Since 1992, hospitals accredited by The Joint Commission have been required to have an “ethics mechanism.” This requirement is usually satisfied with an ethics committee and/or an ethics consultation service. In the intervening years, there has been a trend of both shorter hospital stays and a higher acuity patient population in post-acute and skilled nursing care. Also, patients who were previously in skilled nursing/nursing homes are now often found in their own homes or residential care. In 1997, the Society for Post-Acute and Long Term Care Medicine (formerly the American Medical Director’s Association) recommended that nursing facilities have bioethics committees. Nevertheless, an ethics committee and/or consultation service has not become commonplace in post-acute care. It is our objective to change this and make these same resources available to help patients, families and care providers outside the hospital: in assisted living, home health, palliative care, hospice and skilled nursing facilities (nursing homes).