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Residents of long-term care facilities (LTCFs) are often exposed to polypharmacy. There is a possible association between polypharmacy and falls, hospitalizations, and mortality. Polypharmacy definition ranges between the use of more than 2 to 11 medications. The definition “9 or more regular medications” is the most common in LTCFs. Lack of a standard definition limits comparison of polypharmacy rates and adverse events. This study investigated evidence for an optimal cut-point to define polypharmacy in LTCFs to predict falls, hospitalizations, and mortality.