Predicting which rehabilitation patients will ultimately be discharged to a nursing home is a difficult task because methods used to evaluate preexisting home environment and quantify social support have been inadequate. To address this problem, the Beaumont Lifestyle Inventory of Social Support (BLISS) was developed. This questionnaire examines the family's willingness to care for, supervise and provide financial assistance to the patient. Organized into 10 weighted questions, BLISS results in a maximum score of 12. A prospective study was conducted to determine the correlation of the BLISS score with discharge disposition. Prior to rehabilitation admission, continuing care coordinators administered the BLISS to an involved family member of each patient. After 6 months, all BLISS forms were scored and compared with discharge disposition. Seventy-nine patients were included in this study and six (7.6%) were discharged to nursing homes. Comparison of BLISS scores obtained in patients discharged home versus nursing home revealed averages of 9.3 and 4.0, respectively (P less than 0.0006). These findings indicate that BLISS can quantify a patient's social situation and provide a predetermination of the social factors that lead to nursing home discharge. Consequently, BLISS will be a useful screening tool during the rehabilitation selection process.