Thousands of nursing home residents are sent to the hospital each year because of a breakdown in medical care at facilities, according to a major newspaper.

One reason is physicians affiliated with facilities often unavailable, according to the Boston Globe story. Doctors who are filling in are less likely to be familiar with residents and their conditions. As a result, hospital transfers are more likely to be recommended when residents’ conditions change, the paper reports. Moreover, hospitalizations can result in bedsores, infections and other immobilization-related problems.

These findings follow a recent National Institute of Aging study that examined resident hospitalizations in urban areas during five-month period. Investigators concluded that more than a third of the hospitalizations (37%) were potentially avoidable.