The increasing age of the American population and the current emphasis on cost containment in health care make the 1980s an ideal time for building bridges to span the health care needs of elderly persons in acute care and long-term care. While hospitals often discharge patients to nursing homes as an intermediate step between hospitalization and community-based care, other patients also move between the nursing home, hospital, and nursing home. Patient needs are often similar in all of these settings, so nurses need to integrate care between acute and long-term care facilities and employ a means of communication that will augment patient progress. Each level of care currently assesses older patients upon transfer, with each institution emphasizing problem identification according to its own focus of care. When each institution functions as a separate unit of care, the continuity in dealing with the priority problems identified from the previous level of care may get lost. Nursing diagnosis may be the way to bridge care gaps and communicate nursing care along the health care continuum. This document lists advantages in using nursing diagnosis among all levels of care, offers suggestions for initiation of this system as a care bridge between acute and long-term care, and identifies problems in instituting nursing diagnosis as a bridge between levels of care. A sample nursing diagnosis and plans for all levels of care are included. (NB)