 Methods: Three VAMCs in VISN 11 with 3 different methods of LTC referral are the study setting. This study was conducted from October 2007-June 2010 and utilized a variety of data sources throughout this timeframe. Data sources include: the Geriatric Extended Care GEC form, telephone and in-person interviews, online and paper surveys, Extended Care Screening Committee meeting minutes, and technical reports from the Health Economics Resource Center HERC. The GEC forms provided recruitment information for Veterans, caregivers, social workers and nurses in both the cost and satisfaction portions of the study and were randomly pulled by the Clinical Application Coordinators at each site. Recruitment information for VA and non-VA long term care LTC coordinators was supplied by Site Investigators. The cost portion of the study also utilized the Extended Care Screening Committee meeting minutes and salary information for VHA employees from the HERC technical report. 