To the Editor We appreciated Dr Greyson’s Invited Commentary1 in a recent issue of JAMA Internal Medicine on the trial of a mobility intervention for hospitalized older adults. He noted that the routine of bed rest, or functional bed rest imposed by culture and the hospital’s physical environment and workflow, is toxic to older adults. However, the article accepts as a premise that the only site of care for older adults who require hospital-level care is, in fact, the hospital.