The authors examined the rates and correlates of depressive symptoms in adults over age 60 admitted to community hospital settings and compared them with patients admitted to a tertiary-care medical center. Rates of depressive symptoms in patients admitted to five different community hospitals in North Carolina were compared with each other and with a sample of 542 elderly medical patients admitted to Duke University Medical Center (DUMC). Compared with patients at DUMC, community-hospital patients were older and had more cognitive impairment, but had less severe medical illness and shorter hospital stays. The proportion of depressed community patients was significantly higher than among patients admitted to DUMC. In four of the five community hospitals, rates of significant depressive symptoms exceeded 50%. Health correlates of depression were admitting diagnoses other than cardiovascular disease, poor cognitive functioning, and severe medical illness.