Skilled Nursing Facility-to-Home Trajectories for Older Adults With Mental Illness or Dementia

•What is the primary question addressed by this study?This study's objectives were to examine how mental illness (MI) and Alzheimer's disease and related dementias (ADRD) were associated with whether skilled nursing facility (SNF) residents returned to and remained in the community and if receipt of home health services was associated with post-SNF home time.•What is the main finding of this study?Older adults with MI or ADRD admitted to SNFs were less likely to have a community discharge and, if discharged, spent less time in the community; these associations were mediated in large part by depressive symptoms, aggressive behaviors, and daily functioning. Receipt of post-SNF home health services was associated with increased home time among those with MI or ADRD.•What is the meaning of the finding?Care transition interventions targeting depressive symptoms, aggressive behaviors, and functioning and improving linkage with home health services may help decrease differences in post-acute care trajectories between those with and without MI and ADRD.