A provincial survey was undertaken in Ontario, Canada concerning the prevalence of the use of practice guidelines in chronic care and long-term care facilities and the opinions of staff about the clinical conditions or problems important for developing clinical practice guidelines and the factors that promote change in clinical practice. Five hundred and fifty surveys were sent out and 306 returned from two mailings. Forty per cent of the facilities were aware of evidence-based guidelines while only 21.6 per cent were using them. They were being used most in government-funded agencies, then in acute care facilities with chronic care beds and nursing homes and least in non-government funded agencies. The clinical problems which agencies felt were important for guideline development were behavioural problems, continence, feeding problems and problems with skin care. The results of this survey have implications for funding of these institutions as well as for identifying the situations where evidence is needed for future care and where it is presently available but not being utilized and understanding the reasons for this approach to practice.