Improve quality in nursing homes or institute community placement? Implementation of OBRA for individuals with mental retardation

A matched sample longitudinal design was used to compare the outcomes for individuals with mental retardation who were either retained in nursing homes or transferred to community based living arrangements. Persons who moved from nursing homes to community residences experienced increased performance in adaptive behavior skills, whereas persons who remained in nursing homes regressed. Individual habilitation plans became nearly universal in both environments, but those plans prepared in the community were more focused on vocational type goals. Hours of service also increased in both environments, with the greatest increases being observed in habilitation training. Nursing services dropped to near-zero levels in community-based programs.