Background and Purpose: To investigate the effect of an individualized exercise program versus a generic group-based exercise program on balance, gait, and functional performance of older adults categorized as having mild balance dysfunction and living in residential care facilities. Methods: Single blind randomized control design. One hundred-twenty residents fulfilled screening criteria for mild balance dysfunction based on the BioSwayTM balance and the Multi-Directional Reach Test (MDRT) primary outcome measures. Secondary assessment was completed using the Modified Physical Performance Test (PPT), hand-held dynamometer (lower-limb muscle strength testing), and gait speed analysis. Sixty subjects received individualized treatment from physical therapists (8 weeks). Another sixty subjects received generic group-based exercises (8 weeks). All outcome measures were collected at baseline and post-intervention (ninth week); and BioSwayTM and PPT measures at follow-up (thirteenth week) for the individualized group. Results: Individualized group (n=60) showed significant improvement compared to the group-based group (n=60) on the two BioSwayTM scores (limits of stability, p < .001; and postural stability, p = .016), the MDRT scores (forward reach, p < .001; backward reach, p = .007; right lateral reach, p < .001; and left lateral reach p < .001), the strength scores (hip flexors, p = .010; knee extensors, p = .002; hip abductors, p = .009; and ankle dorsiflexors, p = .025), the PPT outcomes (p < .001), and the gait scores (p = .012). Effect sizes ranged from small to large, with the largest sizes for limits of stability and MDRT. There were no significant differences between groups for the mCTSIB (p = .538). However, 96.7% of subjects in the individualized group scored within one SD of the reference mean, relative to 75% in the group-based group. At follow-up, the individualized group showed significant differences over time with medium to large effect sizes on the PPT (p < .001), limits of stability (p < .001), postural stability (p < .001), and mCTSIB (p = .005) measures. Post-hoc analysis revealed retention of gains for all measures at follow-up, except the mCTSIB. Conclusion: The individualized group showed significant improvements in the areas of balance, strength, mobility, and functional outcomes.