Dimensions of quality of life were compared for people living in small
ICFs/MR versus other community living arrangements. Individual differ
ences were controlled by using a matched comparison design. The data s
et contained 35 indicators of quality. Primary analyses were restricte
d to data from 1988 to 1992. Fifty-one people from small ICFs/MR were
matched with people from community living arrangements. Subjects were
matched on adaptive behavior, challenging behavior, age, and gender. Q
uality outcomes were superior for people in the non-ICF settings on 10
of the 35 measures. The ICFs/MR were not superior on any of the indic
ators. Results suggest that less intensively regulated and more flexib
le models of residential supports may produce superior outcomes at equ
al or lower cost.