Emergency Transfers of the Elderly from Nursing Facilities to CAHs (Policy Brief #32)


Research has shown that essential information is often missing during transfer of nursing residents to the Emergency Department (ED), and communication problems between nursing facilities and EDs are one of the most cited barriers to providing quality patient care. Tools, such as transfer forms and checklists, that improve communication between settings of care help improve patient safety and quality of care.  This Flex Monitoring Team study assesses the evidence base and best practices for improving the nursing facility-to-hospital transitions of care.

Key Findings:

  • Transfers to the hospital emergency department (ED) are common for many nursing facility (NF) residents, with over 25% experiencing at least one ED visit annually, and many encountering repeat visits.
  • Communication issues, including incomplete information during transfer, impact clinical care of the elderly NF resident transferred to the ED.
  • Several studies strongly recommend the use of standardized transfer forms as a way of improving communication, which ultimately improves patient safety and quality of care. However, standardized transfer forms, in and of themselves, are not sufficient to solve communication issues between the sites of care (NF, EMS, ED).
  • The establishment of ongoing relationships between hospital, EMS, and nursing facility staff help facilitate effective communication regarding patient needs during the transfer process and encourage the development of a systems approach to the transition of care.


Community Impact EMS (Emergency Medical Services) Nursing Facilities Patient Safety