To investigate the relationships among the nursing home work environment, emotional strain, and depression in Nursing Assistants in Ohio and West Virginia, this cross-sectional study was conducted with 395 Nurse Assistants in 49 nursing homes in Ohio and West Virginia. Organizational attributes were measured independently at the individual and organizational levels. Multilevel modeling techniques were used to analyze the data. Our methods examined nursing home organizational structure (ownership type, managerial style), and work organization (emotional strain) was examined in relation to the prevalence of depression among nursing assistants. Our findings suggest workplace emotional strain and age are associated with increased odds of depression. Implications of our work include that work in nursing homes for the environment it fosters has a strong effect on emotional strain and depression among Nursing Assistants.