# CMS Age Friendly Hospital Measure: Resources for Emergency Departments On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) released the Age-Friendly Hospital Measure that will take effect January 1, 2025. The measure, developed in collaboration with the American College of Surgeons (ACS), the Institute for Healthcare Improvement (IHI), and the American College of Emergency Physicians (ACEP), aims to improve older adult patient care and outcomes. The Age Friendly Hospital Measure targets five domains to prioritize older adults’ healthcare needs: Eliciting patient healthcare goals Responsible medication management Frailty screening and intervention Social vulnerability Age-friendly care leadership The emergency department (ED) plays an important role in ensuring your hospital meets the Age-Friendly Hospital measure. Below we highlight key resources relevant to each domain from our resource library and our collaborators. Through GEDC membership, we offer consulting services to help hospitals and healthcare systems align with the Age-Friendly Hospital Measure. Our team of experts assists your organization in integrating the 4Ms framework — What Matters, Medication, Mentation, and Mobility — into your clinical care practices. Join us for an expert panel discussion in collaboration with ACEP on the CMS Hospital Measure. Available on-demand, this webinar focuses on how GEDA Accreditation and GEDC resources can help your hospital reach its goals. Available On-Demand Domain 1: Eliciting Patient Healthcare Goals Determining the patients’ priorities is essential to providing the right care. In the ED this means having context-driven, direct conversations with your patient and learning what matters. The following resources give insight into this domain, and how to elicit goals of care. WEBINAR | April 7, 2025 The CMS Age-Friendly Hospital Measures and the Geriatric ED In this expert panel webinar, the team provided an overview of the measure, gave practical guidance for how to implement processes that target the five domains and also gave examples of dementia-focused care in the emergency department. Watch Webinar WEBINAR | November 21, 2022 What Matters Most in the Geriatric ED Dr. Don Melady and a panel of experts discuss what matters most in the geriatric ED and how this can be integrated into the care of older adults. Watch Webinar Patient Priorities | Printable PDF Condensed Conversation Guide for Identifying Patient Priorities (The One Thing) — Emergency Department Version A free, printable conversation guide for use by ED clinicians, developed by Patient Priorities Care Initiative in collaboration with the Age-Friendly Health System initiative at the Institute for Healthcare Improvement. Open PDF Northwell Health | Case Study Northwell Health GEDA Case Study — Goals of Care, Throughput, Clinical Outcomes Discover how New York's largest healthcare provider is improving patient care and reducing length of stay and readmissions. View Case Study Domain 2: Responsible Medication Management Medication issues in older patients in the ED are among the most challenging and important areas of their management. In this era of chronic disease management, most older people come to the ED already taking five or more medications. Screening for high-risk medications is an essential part of good care for older adults coming to your ED. Explore the following resources to learn more. WEBINAR | July 14, 2025 Medication Management and the CMS Hospital Measure Part 2 of the GEDC CMS Hospital Measure Webinar Series covers how emergency departments can prepare to meet domain 2 of the new CMS Hospital Measure by introducing policies and procedures for responsible medication management. Watch Webinar TOOLKIT | June 24, 2025 Enhancing Medication Management in the Geriatric ED This toolkit provides practical resources for emergency department (ED) administrators and teams to successfully implement medication management quality improvement projects. Explore Toolkit BLOG | March 30, 2021 10 Practical Tips for a Best Possible Medication History Pharmacists from Mount Sinai Hospital in Toronto share how to obtain a best possible medication history (BPMH) in the ED and provide an example script to follow. Explore Resource BLOG | November 13, 2019 A Pharmacist’s Role in the Age-friendly ED An interview with two age-friendly pharmacists highlighting the important role of medication reconciliation for older ED patients and the benefits of involving a pharmacist in the ED team. Explore Resource E-Learning for Domain 2 ONLINE LEARNING | Geri-EM Medication Management in the Older ED Patient This module reviews the physiologic changes that occur with aging and the effect they have on how the aging body both processes and responds to medications. It reviews points about polypharmacy, communication, and strategies to manage especially high-risk medication classes. Explore Course Domain 3: Frailty Screening and Intervention Older adults arriving in the emergency department are typically complex, with atypical presentations of disease related to normal changes in aging. Early detection of issues such as cognitive impairment, risks related to mobility, and frailty is advantageous to the emergency department care team’s plan for care, and results in improved patient experience. This website is filled with resources on these topics. Review the following materials and continue exploring. WEBINAR | October 27, 2025 What Matters: Eliciting Patient Healthcare Goals and the CMS Hospital Measure Experts discuss strategies for eliciting patient healthcare goals in an emergency setting with complex older patients, and how emergency departments can meet domain one of the CMS Age-Friendly Hospital Measure. Watch Webinar WEBINAR | November 17, 2022 Frailty in the Geriatric ED An expert panel discusses frailty in the geriatric ED and why it is an important concept in the care of older ED patients. Watch Webinar WEBINAR | January 16, 2020 Dementia in the Geriatric Emergency Department Experts discuss quality care for older adults with dementia in the ED. Watch Webinar TOOLKIT | May 20, 2020 Dementia Implementation Toolkit A dementia quality improvement implementation toolkit highlighting rationale, tools, protocols, and more. Explore Toolkit TOOLKIT | May 18, 2020 Delirium Management Implementation Toolkit An adaptable resource for implementing the best standards of care of older adults in the emergency department. Explore Toolkit TOOLKIT | May 10, 2021 ED-DEL Change Package and Toolkit This change package and toolkit is designed to provide a structured approach, change strategies, resources, and a step-by-step guide to help you set up a delirium program in your ED. Explore Toolkit TOOLKIT | May 20, 2020 Falls and Mobility Implementation Toolkit This toolkit offers resources that are designed to allow you to create sustainable quality improvement in the care of older adults who have fallen or are at risk of falling. Explore Toolkit PODCAST | July 20, 2022 How to Identify and Intervene for Geriatric Self-Neglect Dr. Christina Shenvi is joined by Dr. Lauren Southerland for a conversation about self-neglect; a complicated geriatric syndrome that is both a diagnostic and care coordination challenge. Listen Now PODCAST | May 31, 2022 How to Help Prevent the Next Fall in Your Older Patients Dr. Shenvi sits down with Dr. Elizabeth Goldberg to discuss ways to prevent and manage falls for older adults in the ED. Listen Now PODCAST | March 7, 2022 Safely Caring for the Agitated Older Adult in the Emergency Department Dr. Shenvi sits down with Dr. Maura Kennedy to discuss safe and effective management of agitated older patients, and the role of dementia in producing these symptoms. Listen Now PODCAST | December 12, 2021 Dementia Care in the ED Dementia in the ED is a critical and often overlooked issue. Dr Binkley and Dr. Shenvi discuss. Listen Now PODCAST | September 17, 2021 Failure to Thrive and Frailty Dr. Shevnvi and Dr. Selman discuss the value and importance of understanding and evaluating frailty in older adults in the ED. Listen Now Clinical Frailty Scale This app is designed for frontline colleagues to download on their mobile devices. It supports real-time clinical frailty scoring with patients. Download the App E-Learning for Domain 3 The following e-learning courses are accredited for AMA and ANCC continuing education and cover key areas of geriatric emergency care. COURSE COLLECTION Skills Fair: Mobility Risks and Falls These five brief e-learning modules provide comprehensive training on mobility risks and falls. Begin with understanding the gravity of falls, work through a case study, then learn interventions for falls prevention, communication strategies, and how to make the case for value-based falls protocols. Explore Course Collection ONLINE LEARNING | Geri-EM Atypical Presentations in the Older ED Patient This module uses a patient case to explore the anatomy, physiology, and pharmacology behind the patient's atypical presentation, and how to best manage such a patient. Explore Course ONLINE LEARNING | Geri-EM Cognitive Impairment in the Older ED Patient This module explores delirium, dementia, and depression in older adults in the ED, and best practices for screening, assessment, and management. Explore Course ONLINE LEARNING | Geri-EM Emergency Management of Falls in the Older ED Patient This module explores an approach to the management of the routine patient who has fallen, and what constitutes an adequate ED work-up of the first-time or frequent faller. Explore Course ONLINE LEARNING | Geri-EM Frailty in the Older ED Patient This module explores the concept and definitions of frailty and its clinical implication. It presents tools for screening for frailty and highlights discharge planning and frailty prevention in older ED patients. Explore Course ONLINE LEARNING | Geri-EM Functional Assessment and Transitions of Care for Older ED Patients This module follows three patients to the emergency department — all straightforward on the face of things, but complex once you dig deeper. We suggest a framework, some tools, and strategies for assessing ALL the components of their presentations. And we suggest some best practices for the most complicated of transitions — ED to nursing home. Explore Course ONLINE LEARNING | Geri-EM Major Trauma in the Older ED Patient This module addresses resuscitation of the older trauma patient. It reviews normal changes of aging and their effect on standard trauma resuscitation, and makes suggestions for major trauma resuscitation best practices. Explore Course Domain 4: Social Vulnerability This domain ensures that the ED is aware of the social vulnerability of older adults and that the ED is sometimes the best positioned to intervene to identify and address social issues. The Educational Development Center (EDC) has developed a series of educational modules alongside a quality improvement implementation toolkit that can be applied in any emergency department to meet this domain. The EDC also supports emergency departments to adapt their toolkit to suit their organization’s unique needs. When you download the toolkit, you will receive more details. BLOG | July 31, 2024 Elder Mistreatment Resources for Interdisciplinary Clinicians Get useful implementation and education resources to help you and your fellow clinicians identify and address elder mistreatment. Explore Resource TOOLKIT | The National Collaboratory to Address Elder Mistreatment | February 21, 2022 Elder Mistreatment Emergency Department Toolkit Easy-to-use resources to help emergency department staff identify and address mistreatment in older adults. Developed by the National Collaboratory to Address Elder Mistreatment. View Toolkit E-Learning for Domain 4 COURSE COLLECTION Elder Mistreatment Emergency Department Toolkit Training Program Four modules designed to train ED professionals in the use of this toolkit. Explore Course Collection COURSE COLLECTION Critical Topics in Elder Mistreatment These five brief e-learning modules explore the following topics as they relate to elder mistreatment: falls and medications; caregiver burden; decision-making capacity; delirium, dementia and depression; and lessons from forensic nursing. Explore Course Collection Domain 5: Age-Friendly Care Leadership This domain seeks to ensure consistent quality of care for older adults through the identification of a clinical champion. A significant part of their role is to facilitate compliance with all components of age-friendly care. For many geriatric EDs, this includes a GEM nurse role and/or physician champion. Read more about GEM nurses here. BLOG | December 13, 2016 Nurse-Led Geriatric Case Management — the GEM Nurse Role A general FAQ about Geriatric Emergency Case Management (GEM). Explore Resource BLOG | April 21, 2023 GED Nurse Champion Education Resources Aaron Malsch shares many great resources for training staff in principles and clinical topics related to geriatric care in the ED. Explore Resource WEBINAR | January 30, 2023 Geriatric Emergency Management Nurses in the Geriatric ED This expert panel webinar explores the role of GEM nurses and provides guidance about how to implement a GEM nurse in your geriatric ED. Watch Webinar WEBINAR | October 19, 2020 Models of Nurse Led Geriatric Case Management Our interdisciplinary expert panel discusses the role of the GEM nurse. They explore how this position can create significant improvements in ED care of older adults — from system-wide implementations to small rural EDs. Watch Webinar Institute for Healthcare Improvement Resources Institute for Healthcare Improvement Age-Friendly Health Systems Resources and News A collection of resources from the Institute for Healthcare Improvement (IHI) to help your team and organization practice age-friendly care and guide you toward becoming an Age-Friendly Health System. Visit Website Institute for Healthcare Improvement | July 2019 Age-Friendly Health Systems: Guide to Electronic Health Record Requirements for Adoption of the 4Ms This IHI implementation guide was designed as a resource for health systems to build the 4Ms, and associated care practices, into the EHR. It summarizes key actions that can dramatically improve care when implemented together, and offers a list of tips and resources to get started with each element in your setting. Visit Website Looking for more support and access to clinical experts as you work toward improved geriatric ED care? Become a GEDC Member Today We offer comprehensive assessments and tailored strategies for process improvements, and we support your efforts to create a truly age-friendly environment. Whether you are looking to enhance patient-centered care, reduce potentially inappropriate medications, or improve mobility and cognitive health outcomes, our consulting services are designed to guide you every step of the way. With GEDC’s expertise, your institution can achieve compliance with CMS guidelines while fostering better health outcomes and patient satisfaction among your geriatric patient population. Sign Up