Older adult homelessness is rising across the United States, driven by structural determinants including shortages of affordable housing, fragmented systems of care, and barriers to long term services and supports. Permanent Supportive Housing (PSH), the primary intervention for older adults exiting homelessness, was not designed as a geriatric model, and limited evidence describes how aging related conditions intersect with life in PSH. This scoping review mapped existing evidence on post housing health, functional, cognitive, psychosocial, and system level outcomes for formerly homeless adults aged 50+ residing in PSH or Housing First programs. Guided by Arksey & O’Malley, Levac et al., and PRISMA ScR, searches across academic and grey literature yielded 29 sources. Findings reveal high burdens of chronic illness, functional impairment, cognitive decline, social isolation, and navigation barriers within fragmented systems. Results highlight that housing alone is insufficient; PSH must evolve into an aging capable model integrating geriatric informed, dementia capable, and cross system supports.