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Abstract: In an attempt to prevent premature institutionalization of disabled adults, some states have developed services funded under a Medicaid waiver to maintain these clients in their homes. Evaluation reports of these programs have emphasized cost analysis and have described various approaches to case management. No studies have reported on the quality of life of the clients receiving the services. In this exploratory study, the quality of life of 20 clients in a community long-term care program was compared with that of 20 persons requiring comparable levels of care but residing in a nursing home. Mean scores on the quality of life measure were virtually equal for the two groups, but the distribution of scores by group was very different. Demographically the groups differed. Community residents were younger than nursing home residents and included a larger percentage of blacks. Part of one's judgment of quality of life may stem from a comparison of oneself with one's peers. Verbal, oriented nursing home residents may rate themselves more favorably in comparison to peers with dementia, while community residents compare themselves with healthy adults and rate their quality of life as lower.