Regional Geriatric Programs (RGPs) in Ontario, Canada support a network of nurses providing geriatric emergency management (GEM) services to older adults in emergency departments (EDs) across the province. In this paper, the results of a GEM practice survey, a network process mapping exercise and service stakeholder satisfaction measurement are described. The data suggest that while GEM services evolved in response to local needs and without common procedures, similarities exists with GEM nurses providing two service components: comprehensive geriatric nursing assessment and capacity building in the EDs. Data from stakeholders indicated uniformly high levels of satisfaction. The authors support the concept of integrating specialized GEM nursing services within Geriatric ED Guidelines and Senior-Friendly EDs.