Responses of schools of nursing to physically, mentally, and substance-impaired applicants and matriculating students were assessed in a 12% simple random sample (n = 132) of the 383 baccalaureate and 715 associate degree nursing schools and programs accredited by the National League for Nursing. A self-administered questionnaire concerning experiences, policies, procedures, and factors influencing decision-making was sent to the 132 deans and directors of the nursing schools and programs. Criteria for defining impairments, resources for developing criteria, methods of identifying impairments, actions taken, and individuals involved in the decision were also assessed. While the schools used external resources to guide decision-making, the majority of the responsibility was with the school of nursing faculty and administration. Schools offered a range of options for impaired individuals continuing in the program while under treatment; nevertheless, seeking treatment was a frequent requirement for continuation in the program.