Early recognition of a change in pulmonary status improves the clinical management of residents of long-term care facilities. Health care personnel are frequently responsible for assessing the respiratory status of residents and identifying early signs and symptoms of a change in respiratory condition. This is essential to providing early intervention, but there are challenges in differentiating between onset of an acute illness and an exacerbation of a chronic condition. Optimal care requires skills and training that include education on accurately assessing physical findings, relevant patient history, vital signs and available diagnostics. This activity will discuss the etiology of respiratory illness and highlight assessment skills and interventions. Details on pneumonia and chronic obstructive pulmonary disease (COPD) will also be described.