A telephone call from a physician taking care of a patient in the hospital to a physician in the long term care setting at the time of discharge can improve transitional care for elderly patients. We believe direct communication between physicians can reduce re-hospitalizations, medication errors, morbidity and mortality. No studies have been done that involve physician-to-physician sign-outs after hospital discharge to the nursing home. In our study, we would like to address the breakdown in the transfer of information to the nursing home setting.