Older adults after hospitalization for a cardiac event are frequently discharged to a skilled nursing facility (SNF) for post-acute care; however, cardiac rehabilitation (CR) services are not reimbursed during an SNF stay. The aim of this retrospective study was to identify the need, feasibility, and actual CR services delivered during an SNF stay for older adults after hospitalization for a cardiac event. Data were abstracted from medical records from 40 older adults who were admitted to 2 hospital-based SNFs in 2006 (preliminary results, final sample N = 80). The mean age was 78.8 (range = 65-95), 28% lived alone, and 38% were depressed. The mean length of SNF stay was 14 days; 65% were discharged to their home, 20% were readmitted, and 15% were sent to a nursing home. NEED was assessed by the presence of cardiac risk factors and 96% of the sample had 1 or more cardiac risk factors. FEASIBILITY was assessed by ability to participate in CR. Eighty-three percent were able to walk upon admission, and all patients were assessed as 'fair' to 'good' rehabilitation candidates by a physical therapist. There were no exercise contraindications in the majority of adults. CR SERVICES were assessed from nursing notes and documentation from 312 physical therapy and 308 occupational therapy sessions. There was no recorded warm-up/cool-down sessions during therapy. There was little evidence of cardiac monitoring during therapy as only 8 patients had oximeter readings that were done at baseline only. Additional endurance training was rare as there were no nursing reports of additional walking, only 4 patients used the NuStep (for less than a total of 15 minutes for the last 7 days), and only 12 patients used arm ergometry (for less than 40 minutes for the last 7 days). One third of the patients participated in strength training. The documentation indicated that only 1 patient received education on cardiac risk factors and survival management. Although 78% of the sample was identified as 'able' to participate in SNF CR, very few CR services were documented. The care in an SNF is focused on physical and occupational therapy to improve independence in activities of daily living and largely ignores the CR perspective. Integration of CR in SNF care has the potential to better meet the needs of older patients recovering from cardiac events.