We describe the frequency, characteristics and outcomes of emergency admissions to one large university hospital in England from residential and nursing homes. Any older adult (>/=75 years) admitted as an emergency over two years was included. Patient variables were retrieved from an electronic patient record and living status was established using an official register of care homes and manual inspection of medical records. The rate of emergency admission per bed-year was highest from residential homes (mean 0.68, SD 0.24), with lower rates from nursing (mean 0.49, SD 0.20) and dual-registered facilities (mean 0.49, SD 0.23). Older adults admitted from nursing beds had the highest frailty, illness acuity and inpatient mortality but those from residential beds had the highest odds of 30-day readmission, compared to older adults from their own homes (odds ratio 1.63, 95% confidence interval 1.30, 2.04). Residential home residents are frequent users of emergency inpatient services and may benefit most from enhanced community healthcare.