The population of chronically ill, older adults is expected to grow in the coming years as the baby boomer generation ages. The Institute of Medicine recommends that all healthcare providers have a basic competency in palliative care, also referred to as basic palliative care. The definitions and descriptions to date are vague and do not provide an in-depth description of how basic palliative care differs from the care provided by specialists. The purpose of this study was to describe nurses' understanding and perceptions of basic palliative care in the acute care setting. Focus group and individual interviews were utilized for data collection. The results of this study deepen our understanding of how acute care nurses practice basic palliative care and the challenges that exist in caring for homeless and culturally diverse patients who could benefit from palliative care. This study offers guidance for future research, policy changes, and integrating palliative care into practice earlier in the illness trajectory.