The respiratory medicine department of another hospital in the Tokachi district closed in 2014. We were concerned about the increase in the number of patients at our hospital with pneumonia and the increased length of stay of patients with pneumonia. We made requests to other medical institutions for assistance and also tried to increase the number of transfers to other hospitals via the regional medical cooperation office, but this did not result in a decrease in mean days of hospitalization. We recently undertook a retrospective comparison of the days of hospitalization for nursing- and healthcare-associated pneumonia between 2015-16 and 2017-18. As a result, the mean days of hospitalization to discharge for patients was significantly lower in the latter group; furthermore, the improvement rate in the Barthel index was also significantly higher in the 2017-18 group among patients who had received rehabilitation before discharge. Improvement in daily living activities through rehabilitation may have contributed to the decrease in the mean days of hospitalization.