Instruments assessing geriatric case managers’ perceptions of prescription abuse are limited. Based on a review of current literature and pilot testing feedback, 22 items were initially assembled to form an older adult Prescription Drug Assessment Questionnaire (PDAQ). Case managers (N = 161) at an older adult agency located in a Midwestern state were surveyed using the instrument. Data were subjected to exploratory factor analysis using principal axis factoring (PAF) and Promax rotation, and Horn’s parallel analysis determined the number of extracted factors. PAF generated a final 11-item three-factor model accounting for 51% of total variance explained: Standard Assessment (Factor 1; four items; = .83), Assessment Belief (Factor 2; three items; = .74), and Problem Scope (Factor 3; four items; = .62). The older adult PDAQ is a brief, data-driven instrument with acceptable psychometric properties for assessing perceptions of prescription drug abuse and misuse assessment and counseling.