Healthcare reform is going to change the way in which services to the elderly are provided. There will be a focus on keeping patients out of the hospital through better management of chronic healthcare conditions. Retirement communities, hospitals, physicians and other providers will need to cooperate and communicate with one another. All providers will need to be accountable and document outcomes. With our perspective and experience in both acute care hospitals and post-acute service providers, we can help retirement communities to become positioned for these changes.