Background/Aim Hospital transfers from residential aged care (RAC) are common, costly, and frequently traumatic for older residents. Research suggests between 55%-75% of RAC-to-emergency department (ED) transfers may be avoidable with appropriate in-place management, yet transfers rates remain stubbornly high. Despite this, Australian data on RAC to ED transfer epidemiology, avoidability, and resident-level risk factors remain limited. This study aims to describe the epidemiology of ED transfers across nine Western Australian RAC sites over a two-year period, classify potentially avoidable transfers, and identify resident characteristics associated with transfer risk. Methods Retrospective cohort study of approximately 850 hospital transfer episodes. Transfer reasons were coded by two independent reviewers. Avoidability was classified using established criteria. Multivariable logistic regression identified resident demographic and clinical characteristics independently associated with hospital transfer. Results Preliminary findings will be presented, including transfer rates, most common transfer reasons, proportion classified as potentially avoidable, and a predictive profile of residents at highest risk of avoidable hospital transfer based on age, functional dependency, comorbidity burden, polypharmacy, and advance care directive status. Conclusions/Implications Building an epidemiological picture of RAC-to-ED transfers — including who transfers, why, and what proportion is avoidable — is foundational to developing targeted prevention strategies and supporting care consistent with residents' documented preferences.