The nurse practitioner is responsible for providing the patient and family with understandable written information before discharge from the emergency department (ED) following an acute event. Patients are more likely to adhere to their treatment regimen and follow-up if they have a clear understanding of their instructions. Patients cannot correctly interpret information they cannot read. This study describes the ability of two age groups of rural ED patients or caregivers to read health information. The literacy level of 91 younger adults and 104 elderly adults from three rural hospitals was assessed at discharge with the Rapid Estimate of Adult Literacy in Medicine (REALM). While there was no difference in the REALM scores (t = 0.608) of the two age groups, there was a significant difference in the education levels. The REALM scores placed the reading level of the sample at between seventh and eighth grade. The preprinted discharge instruction forms used by the three rural hospitals had a Flesch-Kincaid grade level of 9.0, a reading level higher than 62% of the sample. By ensuring discharge instructions are developed at a reading level of sixth grade or below, nurse practitioners can provide teaching materials that encompass the reading levels of the majority of the rural ED population.