On January 1, 1978, a new Long Term Care Program was introduced in British Columbia. Five levels of care are offered, any one of which may be provided at home or in a facility. This paper presents data from a longitudinal study of program clients (N = 3518) in two health districts, one urban, one semi-rural. The period of interest is the first twelve months after admission. Approximately one-quarter of these clients were discharged within one year of admission—one-half of them due to death. One-third of the deaths occurred in the first two months after admission and a further one-third in the following four months. Fewer than one-third of clients changed level or placement before death. Where transfers did occur they tended to be to higher levels of care and from home to an institution. The characteristics of clients who died are examined. These data may assist care providers to identify high risk clients. As well, they have implications for future resource allocation and planning.