Rib fractures are the most common blunt chest injury in adults. Older populations with rib fractures are particularly at risk for complications. The purpose of the study was to examine the relationship of the rib fracture score (Easter, 2001) to ICU length of stay and hospital length of stay in patients over 50 years of age with rib fractures. Utilizing a predictive correlational design, bivariate correlations and linear regression were conducted, comparing the rib fracture score (RFS) to hospital length of stay and ICU length of stay in patients over 50 years of age with rib fractures hospitalized at a Level 2 Trauma Center. Results: Correlations between the RFS and hospital length of stay (r = .306; p = .005) and ICU length of stay (r = .371; p = .006) were found to be significant. Linear regression revealed 9.4% of the variance in hospital LOS was explained by the RFS (F = 8.169; p = .005) and 13.8% of the variance in ICU LOS was explained by the RFS (F = 8.30; p = .006). When RFS was regressed onto other variables (pre-existing conditions and other injuries), explanation of variance rose to 50.4% for hospital LOS  and 54.1% for ICU LOS.  Conclusion:  While the rib fracture scoring system is a useful tool for assessing risk levels of older patients with rib fractures, co-morbidities and other injuries must also be considered in patient management and prediction of outcomes.