This study addresses the factors influencing decisions to send medicine-surgical (med-surg) patients home or to nursing facilities (NFs). The sample (n = 7,852) was taken from a large, urban, teaching, med-surg unit where discharges were documented and data collected over a two-and-a-half-year period. Using logistical regression, the factors found to most influence the decision were age (z = 26.99, p = 0.000; odds = 1.06); patients diagnosed with "musculoskeletal system" problems (z = 11.07, p = 0.000; odds = 5.36); and needing skilled professional care (z = -15.03, p = 0.000; odds = 0.21) or nonprofessional personal care (z = 6.62, p = 0.000; odds = 2.32). Having less effect, but important information for discharge planners, was being an African American (z = 3.82, p = 0.000; odds = 0.76) or Latino (z = -3.96, p = 0.000; odds = 0.54). A review of the literature found limited knowledge of the factors that influence hospital patients, family members, and professionals, including social workers, to make the decision to recommend home care or NF care.