The purpose of this study was to clarify the implementation of ACP in patients admitted to the university hospital after emergency transport from elderly care facilities. The subjects were 29 patients aged 65 years or older with medical symptoms of non-cancer diseases. Medical chart review was performed regarding the subjects’ demographic information and the implementation status of ACP before and during hospitalization. Data were analyzed using descriptive statistics. Results showed that the mean age was 85 years, 15 males and 14 females, and 12 patients suffered from dementia. The reason for emergency transport was loss of consciousness in nine patients and deterioration of respiratory status in eight patients. The emergency call was made by the facility staff. Of the eight patients with ACP prior to admission, five did not wish to receive life-prolonging treatment. Medical staff discussed ACP with four patients while hospitalized and facilitated two patients ACP discussions after discharge. Elderly patients residing in the facility had a wide range of symptoms in the event of a sudden change, and the facility staff, who were not medically qualified, called for emergency care. It was necessary to have specific discussions with family members and the facility about the desired medical care while the elderly was still able to express their wishes.