 The Beers list identifies medications that should be avoided in persons 65 years or older because they are ineffective, pose an unnecessarily high risk, or a safer alternative is available. In a recent study, we found a high rate of prescribing of Beers list medications to hospitalized patients. At Baystate, 41 of medical patients received at least one Beers list drug classified as high severity, meaning it carried a high risk for an adverse drug reaction, while 5 received 3 or more. Some Beers drugs have been associated with delirium and falls. When compared to Baystate patients who did not receive a high severity medication, those who did had an increased risk of mortality 7.8 vs. 5.2, longer length of stay 5.5 days vs. 3.9 days and higher costs 11,240 vs. 6243. 