Older people living in independent living units make choices about where they live and the degree of support required to maximize their health and well-being. This can include when to enter the acute care system. Using a multimethod, multistage qualitative approach, this study aims to explore and describe the decision-making process of older people living in independent living units to enter the acute care system. Based on the findings, recommendations are provided which can ensure that older people do not enter acute care facilities until they need to, or if they do need to, they can access the care they require and leave with the best possible chance of not re-entering unnecessarily. The findings highlight that it is not enough to focus on the older person at the point of entry into the acute care system so the recommendations aim to assist in the development of best-practice initiatives for older people living in independent living units.