To reduce musculoskeletal injuries in employees and to lower the financial costs associated with them, a 525-bed county nursing home in upstate New York initiated a five-step ergonomics program and purchased mechanical lifting devices. The five steps in the program were (1) creation of a resident transfer evaluation team, (2) establishment of an accident review committee, (3) mandatory ergonomics training for new nursing aides, (4) regular maintenance checks for lifting equipment, and (5) direct access to the management and budget process. During the 7-year period of this study, 8 smooth movers, 10 hydraulic stretchers, 7 Hoyer lifts, 1 Arjo lift, 9 Sarita lifts, and 1 Maxilift were purchased. Comparisons in health and financial outcomes were made between the preintervention period (1992-1993) and the intervention period (1994-1998). There was a significant reduction in the number of low-back injuries per 100 full-time nursing aides from 15.7 in the preintervention period to 11.0 in the postintervention period (p<0.05). The total number of lost workdays was significantly (p<0.05) reduced from 1476 per year before the intervention to 625 per year after the intervention. In addition, the lost workdays per full-time nursing assistant was significantly reduced from 7.8 to 3.0 (p<0.05). Although the average number of lost workdays per injury decreased from 49 to 27 days, this decrease was not statistically significant. Financially, there was a significant reduction in the average yearly cost associated with low-back injuries from $201,100 before the intervention to $91,800 during the intervention.