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In this article…Research into the decision to discharge acute hospital patients to a care homeDescription of a cohort of 100 hospital inpatients discharged to a care homeRecommendations for practiceAdmission to care homes following acute hospital admission is common, despite being contrary to UK health policy. Care home admission from hospital is also a care trajectory that is under-researched and poorly understood. A retrospective cohort study reviewed the case notes of 100 people who had experienced this transition, what happened during their hospital stay, and what led to the life-changing decision to discharge them to a care home. Only 37% of individuals were documented as having been involved in the decision-making process. This article describes the study methods, highlights some salient results, and makes recommendations for practice.