A nursing home has three discharge tracks, determined at admission and reviewed periodically along with treatment plans. Advised by the admitting physicians, the nursing home social worker assesses each resident's discharge prognosis: (1) a discharge plan is in effect; (2) discharge is problematic; or (3) no discharge is planned. A substantial amount of the literature in the field portrays the nursing home experience as iatrogenic. A study was undertaken to determine the extent to which one nursing home's residents who were admitted with plans for discharge did not return home and to examine the resons for those patients' derailment. A 160-bed Rhode Island nursing home's case records for 1978-84 were examined. The results revealed that, of 419 residents, 79 were expected to return to the community. Only 13 of those 79 did not return home. Content analysis of those 13 residents' histories showed that two chose to remain in the nursing home, four had families who declined to fill caregiver roles, and two quickly deteriorated. Even the histories of the five who generally lost the ability to function independently did not suggest that institutional life was to blame. Their initial discharge plans may have been unduly optimistic. This research suggests that nursing home life does not prove iatrogenic for persons admitted with a positive prognosis. A four-page list of references concludes the document. (Author/NB)