In healthcare, IT Sophistication has been defined as the diversity and maturity of information system hardware and software that support clinical services. Clinical services relevant to this study include resident care management, clinical support and administrative activities in nursing homes. An IT sophistication survey previously validated in acute care settings and adapted for nursing homes was used to develop a state profile of Missouri nursing homes. The IT survey was disseminated via paper and electronic methods as chosen by a selected responder that had IT oversight and knowledge of IT stakeholders. A census of 199 respondents completed the survey, representing a 41% (199/491) response rate. Findings support recent literature indicating a higher percentage of nursing homes are still using technology for administrative purposes; however, there is growing recognition that technologies with greater functionality, is used more extensively for electronic and automated transfer of resident care information.