A review of mortality cases for persons with intellectual disabilities (ID) in the state of Connecticut (USA) revealed that the majority of deaths in residential settings occurred in nursing homes. However, it was not clear why individuals with ID were residing in nursing homes, or what brought them there. The authors conducted a preliminary study to elicit better understanding of the circumstances resulting in nursing home residency for people with ID. Charts for a small sample of deaths occurring in nursing homes were examined and select data extracted, including basic demographic data, the previous residential setting, the length of stay, medical conditions, case management intensity, and documented rationale for continued nursing home residency. The data revealed that many individuals were admitted to nursing homes at an earlier age than for the nondisabled general population. People with ID stayed in these residences longer, and died later than the general population of nondisabled individuals admitted to nursing homes. About half the sample received case management on at least an annual basis; a third had no documented case management. Lack of appropriate alternate residential settings, lack of support services for families, and lack of case management resources for adults with ID residing in nursing homes in Connecticut are all apparent from the findings. Failure to use existing resources such as group homes to their potential capacity, and other similar policies should be re-examined.