The Nursing Homes Admissions and Residents Study were initiated for two general purposes. A major purpose was to generate reliable information on nursing home clients in Washington State. The data collected included extensive descriptive and service need information and will be published separately. A second major purpose, the subject of this report, was to identify the number of Medicaid-supported clients who: 1) are appropriately placed in nursing homes given currently available alternatives; 2) are appropriately classified as requiring skilled or intermediate levels of nursing care; and 3) have potential for alternative, perhaps more appropriate placement, given the enhancement of existing or the development of new programs. The study was conducted from July through October 1976. A sample of 67 homes was selected (approximately 22% of the total facility population) so as to proportionately represent the nursing homes in Washington with respect to number of beds and DSHS Region. From these homes, 822 clients composing two separate random samples were drawn consisting of a total of 822 clients; an admission sample totaling 272 clients and a resident sample totaling 549 clients. Only clients supported by Medicaid were included; data were not collected on privately or Medicare-supported individuals. Approximately 60% of the persons in nursing homes are supported by Medicaid (about 16,000 persons). Weighting and estimation procedures were developed so that statewide estimates of all Medicaid and specifically skilled and intermediate care client characteristics and service needs could be made.