This article describes a preliminary evaluation of the effectiveness of an inpatient geriatric acute care service (GACS) unit specifically designed to care for elderly nursing home residents. The study employed a retrospective, matched-control group design. Two separate control groups were used to provide a more thorough picture of the effectiveness of the GACS. Subjects for the study included a GACS “intervention” group consisting of 334 residents from nineteen nursing homes, an acute care “other hospital” control group consisting of 309 residents from the same nursing homes as the intervention group who were treated at other area hospitals, and an acute care “same hospital” control group, consisting of 74 matched nursing home residents who were hospitalized at the same hospital, but in a different unit than the intervention group. The length of the first hospitalization, the total length of stay during the study period, the number of re-hospitalizations of the patients, and mortality were examined. Patients treated at the GACS were less likely to die, had shorter lengths of stay, less rehospitalization, and longer times between hospitalizations than both of the control groups. The GACS unit is a successful answer to the complex acute hospital care needs of the elderly nursing home population.