Heart Failure (HF) is one of the most common cardiac syndromes encountered in the primary care setting amongst older adults; it affects more than 6 million people in the United States (Goroll & Mulley, 2009; Papasifakis, n.d.). HF is one of the most common diagnosis of patient readmissions. HF readmissions increase the cost of healthcare and affect the quality of life for individuals. Different strategies such as disease management programs with a focus on patient education have been widely used to reduce the risk of patient readmissions. Evidence-based research has shown that heart failure disease management programs that focus on patient education and telephone follow-up decrease the probability of patient readmissions and increase the individual’s quality of life. In Puerto Rico, there is a dearth of research in heart failure disease management programs and the effectiveness of advanced practice nurses in the management and treatment of patients with heart failure. The purpose of this toolbox is to provide a standardized program for veterans that have had a recent hospital admission (30 days or less) with a diagnosis of decompensated heart failure at the VA Caribbean Healthcare System in San Juan, Puerto Rico.