The aim of this study was to analyze the impact of being pain-affected and fear of falling on functional performance among nursing home residents, longitudinally. We used 6-month follow-up data from a cluster-randomized trial of 12 nursing homes (cluster level) with 239 nursing home residents at baseline (mean age, 95% confidence interval [CI] = 83.04 [81.40, 84.69], 70% women). The longitudinal analysis provided data on pain, fear of falling, functional mobility, and activities of daily living (individual level). The data revealed a trend indicating that pain-relieved nursing home residents showed better functional mobility over time. The results on fear of falling demonstrate obvious differences in the functional performance of nursing home residents cross-sectionally but not longitudinally. Nevertheless, the results underline the importance of an effective pain treatment to prevent decline in functional mobility among nursing home residents. Further longitudinal surveys are needed to verify the findings on functional performance.