Abstract This study sought to develop and test a set of criteria to distinguish elders at high risk of an untoward medication event within community nursing caseloads. A descriptive correlational design was used to identify relevant risk factors for elders. Data on medication knowledge, regime, management abilities, and adherence were obtained from 111 elders receiving community nursing care. Four predictors—12 or more doses of medications per day, more than one prescriber, caregiver available, and sometimes forgetting to take medications—of complexity (R2 explaining 39% of the variance) and adherence (R2 explaining 49% of the variance) were identified as potential factors that subsequently confirmed a discrete group of high risk elders. The use of these four risk factors or screening criteria is recommended for older people within community nursing caseloads.