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Introduction Electronic Health Record (EHR) compliance is expected to achieve better clinical outcomes, improved population health outcomes, increased transparency and efficiency, empowerment of individuals, and more robust data for research on health systems (Health IT). The determination of this paper aims to evaluate the flow of information as it travels with patients as they enter the emergency room, up to and including a skilled nursing facility stay. Over the last decade an emphasis has been placed on transitioning from paper based documentation to electronic based computerized systems. The centers for Medicaid and Medicare place such high emphasis on this transition that monetary incentive including higher reimbursement rates†¦show more content†¦The identified barrier in this transition of care from acute care to a skilled level when information is copied and the hard-copied chart is sent with the patient on their transport to the skilled facility. This process leaves room fo r many errors, when we rely on nursing personnel who are extremely busy to remember to send all the pertinent information for the accepting physician. Currently the admission process for potential admission starts with the clinical admission director a designated registered nurse (R.N.) that reviews the electronic health record and reviews that patient at the bedside. The designated RN faxes the centers admission director with progress notes and a history and physical for acceptance or a denial. The center admission director grades the patient against a pre-admission check list to determine if they are appropriate. The current length of stay in a skilled setting is based on payer source. For example, a straight Medicare patient has the skilled benefits that can occur for 100 days, whereas a patient with a managed plan like Humana have weekly progress reports that are sent to a case manager, and that case manager dictates their length of stay. 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