The numbers and characteristics of white residents identified by medical and nursing staff as requiring more staff time and/or expertise and/or medical equipment than is available in homes for the aged were assessed. Only 27 out of 2447 (1 1%) extremely infirm aged persons resident in 93 homes for the aged would, in the opinion of institutional staff, benefit by admission to a long-term care hospital catering for chronically ill. The conditions affecting these residents are described and recommendations relating to their management made