In this issue of CHEST, Micek and colleagues help fill this void in patients who develop NVHAP. In a retrospective, single-center study, they report several important observations. First, NVHAP clearly results in attributable mortality. This finding is key, given that the mortality penalty associated with VAP is rather small. In other words, most patients die with VAP, not of it. In contrast, NVHAP appears to contribute substantially to the risk of death. All the limitations inherent in a small, retrospective, single-center study notwithstanding, the relationship between NHVAP and excess mortality is concerning. Similarly, excess hospital length of stay resulting from a case of NHVAP appears longer than the added length of stay related to VAP. These are compelling arguments for expanding quality and safety efforts related to NP beyond the ICU, because a narrow focus on VAP only neglects a companion disease that may lead to even more avoidable deaths and costs than one that already requires public reporting. With the findings from Micek et al in hand, we need to demand more research into the early identification of those suffering from NVHAP and potential preventive measures.