Safety problems—particularly medication errors—are common in nursing homes and other long-term care settings. Prior studies have also shown that safety culture in long-term care settings is generally poor. One manifestation of poor safety culture can be that errors go unreported, and this survey of nearly 400 nursing homes found evidence confirming that substandard error reporting is a problem in long-term care. Few nursing homes surveyed used computerized methods to report errors or to monitor adverse event data, and respondents reported both technological and cultural barriers to voluntary error reporting. As most nursing homes also did not use computerized provider order entry or any other form of electronic medical record, the authors recommend more widespread adoption of health information technology in general, and error reporting systems specifically, in the long-term care setting. One such system for voluntarily reporting medication errors has been successfully implemented in nursing homes in North Carolina.