This pilot study investigated the importance of social, clinical, and discharge factors in predicting extended length of stay (LOS) in a state geropsychiatric hospital. The authors reviewed medical records of all first time admissions during a 22 month period. A total of 272 patients age 60 and older were admitted for the first time during this period. Nine variables comprised of medical, demographic, social, and discharge information were examined in retrospective analysis to assess their relationship to LOS. The mean and standard deviation of days spent in hospital was 392.3 +/- 752.81. The median number of days of hospitalization was 72.0. Single marital status, type of living arrangement, polypharmacy, and limited functional status were predictive of LOS. Our findings underscore the challenge within geropsychiatry of treating patients with coexisting medical conditions who also have significant behavioral, mood, and/or cognitive disturbances.