Objective: Little activity has occurred in nursing home (information technology) IT adoption. The purpose of this study was to describe the range of IT sophistication for resident management processes and explore the association of IT sophistication with nursing home ownership, bedsize, and regional status. Methods: This descriptive, exploratory, cross-sectional study used an IT sophistication survey that was adapted for nursing home environments. The survey was administered between December 2006 and August 2007. All 491 nursing homes in Missouri were invited to participate. Results: Of the 491 nursing homes asked to participate, 349 initially agreed to complete the survey, but only 199 (41 percent) responded. The degree of functional sophistication adopted was most related to bedsize and location; ownership and location were also factors. IT integration was mostly affected by type of ownership. Conclusion: Nursing home administrators have a long way to go before they will be able to achieve the goals suggested by the Institute of Medicine in their report on IT adoption.