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Assisted living (AL) is a growing option for housing for older adults with dementia in the United States. Typically, nurses are not employed in AL in California. The purpose of this paper is to describe the health care incidents and experiences of residents and their family members who are transferred from AL to an (emergency department) ED. Data were collected from two dementia-only AL communities in California over a period of six months. In this study, only 32% of ED visits resulted in admission to acute care. Of the 71 residents, eight (11%) were responsible for 47% of the ED visits. Qualitative interviews with 3 employees and 9 family members and focus groups with 11 employee caregivers were conducted to augment the quantitative data. The qualitative theme of frustration and helplessness by family and staff to prevent repeated falling and ED transfers was identified, which complemented the quantitative findings.