This survey study of 433 admissions to four health-related facilities and 738 admissions to 40 skilled nursing facilities in the Rochester region describes the reasons for placement, the patients' physical, mental, and functional characteristics and their personal, nursing, and other care requirements in the institutional setting. The differences and similarities between the two levels of care and between the four HRF's are analyzed in the light of national data; the appropriateness of placement is evaluated and the implications for regulatory systems are discussed.