The physical, emotional, and social disabilities of patients in a proprietary skilled nursing home, as determined by a six-month study, require that they have nursing care which is quite different from that needed by patients in a general voluntary hospital. Marked contrasts are found in administrative relationships; psychosocial nursing; in the need for the nurse to be expert in making clinical diagnosis at a nursing level; in drug management as related to the elderly and chronically ill patient; and in the coordination of a comprehensive program of rehabilitation. Preparation for this specialized type of clinical nursing should begin, these authors believe, during the students' basic education and continue following graduation in formal courses and inservice education.