A follow-up office visit within 7-14 days after discharge for heart failure (HF) is a guideline-recommended intervention to reduce 30-day hospital readmission, but visit adherence varies. The purpose of this study was to determine predictors of adherence to an early follow-up appointment after a HF hospitalization. Hypothesis: In patients with HF, missed early follow-up appointments after hospital discharge can be predicted by a model of patient factors (age, gender, race, insurance, marital status, contact person, distance home to clinic, smoking, alcohol abuse, drug use, and comorbidities), HF factors(LVEF, time since previous admission, HF type, and number of HFspecific medications prescribed), and hospital factors (length of stay, ICU admission and LOS, admission source, discharge disposition, provider type, and appointment made pre-or post-discharge). Methods: This was a retrospective, medical record/administrative database research design within 3 community hospitals of a large health system in Northeast Ohio. All patients hospitalized for decompensated HF and scheduled for an early follow-up visit within 14 days of discharge were included. Sample size was determined based on having at least 10 non-adherent and adherent cases for each factor in a multivariate model. Data were retrieved using eMR or administrative record queries and manual review. MapQuest was used to calculate distance in miles from patients' home addresses to the clinic. Subjects were categorized into groups of visit-kept and visit-missed. Factors were assessed for their association with missed appointments using Pearson chi-square tests and Wilcoxon rank sum tests. Multivariable modeling was used to determine the odds of missing scheduled appointments. Results: Of 701 subjects, mean (SD) age was 73.5(13.8) years, 46.4% were female and 38.9% were non-white. Appointment adherence was 83.7% (587 visit-kept and 114 visit-missed). In multivariate analyses, 4 of 36 factors predicted missed appointments: drug use history (OR 3.95 [