Marketing activities in service organizations are increasingly focused on developing customer loyalty as a means to financial success. While satisfaction and behavioral intentions are important to organizations, both are at risk to decline over time. The purpose of this study is to examine the change in satisfaction and behavioral intentions over time for healthcare, a high level service setting. Satisfaction and behavioral intentions were measured immediately following discharge and one or two years later. The results indicate that for the majority of patients there was no change in satisfaction and intention. For patients who reported a change in satisfaction and intention, the majority reported a decline. The results indicate a consistent pattern for patients who were surveyed one and two years post-discharge. © 2001 Taylor & Francis Group, LLC.