Little research has focussed on nursing home residents with a history including a non-dementia related chronic mental illness (HCMI) that manifested before placement in a nursing home. Data from the 1993 Minimum Data Set for Nursing Home Resident Assessment and Care Screening (MDS) on over 70,000 residents in Kansas, Maine, Mississippi, and South Dakota were used to investigate differences in characteristics and care between these residents and more traditional residents. HCMI residents were more likely to be under 65 years of age, male, Medicaid recipients, less functionally impaired, to exhibit higher levels of problem behaviours, and to receive psychoactive medications and psychological therapy, though therapy prevalence rates were low. These data may indicate that appropriate care for HCMI residents is a concern.