Twenty-nine HHAs in a mid-Atlantic state participated in this study during its first year. As part of the design, attempts were made to represent all major metropolitan, suburban, and rural areas of the state. The HHAs range in size, from small (150 patients per year) to large (35,000 patients per year). Both not-for-profit and proprietary organizations are represented. Six of the HHAs are hospital affiliated or part of a hospital-based system, and one is a division of a continuous care retirement community