Some of the best health promotion and education programs have been shortlived. This is such a common occurrence that eventually almost all nursing administrators experience the frustration of watching a good and promising program die prematurely. The authors compare and contrast two similar foot care and education programs based in Department of Veteran Affairs (VA) Medical Centers and discuss those components of planning and development that led to the long-term survival, or "institutionalization," of one of the programs. Elements of a checklist for assessing and promoting institutionalization are also presented.