The demand for long term care is growing as the population in need of services becomes older and frailer, and as the nature of the family, the economy, and the health care system changes. To investigate the long term care system, its characteristics, trends, financing, policies, availability, and quality of care, 700 health care professionals, patients, families, social workers, state officials, and advocates from eleven states participated in discussions. The results of those discussions showed that long term care is not a program, but an assortment of government and private efforts to meet the needs of chronically ill or disabled people. However, although no explicit public policy exists, in 1980 long term care cost $32 billion in federal, state, and private funds. Families remain the primary provider of health care, with institutional care seen as a last resort. With the decline in Medicaid and Title XX funds, reimbursement is the foremost concern of program administrators. The quality of care directly relates to reimbursement, with nursing home care generally considered to be good. Concern about privacy, independence, food, and personal attention outweigh medical and hygiene concerns. Staffing problems are widespread along the health care continuum, with disenchantment about nursing home licensing and certification very high. Placement decisions based on discharge objectives rather than long term planning are a continuing source of concern for both families and professionals. (BL)