Virtually every skilled nursing facility (SNF) deals with the challenges of cognitively impaired residents who are or desire to be sexually active. Both federal and state laws allow residents with decision-making capacity (DMC) to consent to sexual intimacy with another. However, many forms of Alzheimer's Disease and other dementias are characterized by waxing and waning levels of legally competent decision-making. The challenge for SNFs is to respect resident rights while assuring their safety. The level of DMC can vary from day-to-day, frequently making both the legal concerns and medical management difficult. This session examines successful risk management strategies centered on respecting the rights and safety of residents.