This cross-sectional study evaluated cow comfort measures in free stall dairies across the United States as part of the National Animal Health Monitoring System\'s Dairy 2007 study. The study was conducted in 17 states and evaluations were completed between March 5 and September 5, 2007. Assessors recorded hygiene and hock scores, number of cows housed in the pen, the number of cows Nike Cortez standing with only the front feet in a stall, standing fully in a stall, and lying in a stall. Facility design measures included bedding type, bedding quantity, stall length and width, presence of a neck rail or brisket locator, and relevant distances from the rear and bed of the stall. Of the 491 operations that completed the cow comfort assessment, 297 had Holstein cows housed in free stalls and were included in this analysis. Negative binomial models were constructed to evaluate the following outcomes: the number of cows that were very dirty, had severe hock injuries, stood with front feet in the stall, stood with all feet in the stall, and were lying in the stall. Hygiene was better on farms that did not tail dock cows compared with those that did (5.7 vs. 8.8% were dirty) and on farms located in the study\'s west region compared with nike Cortez Uk those cheap Nike Cortez Uk located in the east region (5.2 vs. 9.7% were dirty). Severe hock injuries were less common on farms in the west than those in the east (0.5 vs. 4.1%). In addition, severe hock injuries were less common on farms that used dirt as a stall base or sand as bedding compared with farms that did not. A higher percentage of cows was standing with front feet in the stall at higher ambient temperatures (incidence rate ratio=1.016) and as time since feeding increased (incidence rate ratio=1.030). A lower percentage of cows were standing with front feet in the stall when the stalls were shorter and when there were fewer cows per stall. Standing fully in a stall was nike Cortez Trainers performed by a higher percentage of cows during the summer than during the spring (13.6 vs. 8.1%), when cows were provided free stalls with rubber mats or mattresses, and as the distance from the rear curb to neck rail increased. A higher percentage of cows were lying in a stall when sand bedding was used, when bedding was added more frequently, and during the spring months. Results of this national survey indicate that tail docking provides no benefit to cow hygiene and that stall base and bedding are key factors influencing hock injuries and stall usage on US free stall dairy farms.Copyright © 2010 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.