This paper offers a conceptual model for understanding how and in what ways externally determined factors affect power arrangements within a for-profit nursing home setting. Specifically, this paper links the activities of nursing homes as profit seekers to federal legislation and the activities of strategically structured interests which seek to socialize their costs. Additionally, it shows how social distinctions and other factors which have their origins external to the nursing home setting have consequences for what takes place inside. The model posits that it is those people who are members of society's more privileged groups (professional white males) who will get access to positions of power in part because members must go outside the organization into the greater society to obtain the certification which will allow them to occupy powerful positions. Consequently, those who have power inside the organization (professional white males) are very similar to those who have power in the greater society. Moreover, observational data indicate that those statuses which members of the nursing home enter with are associated with patterns of interaction and levels of control and authority. Finally, there is an attempt to spell out the implications of such findings and an attempt to show how government and community (non) involvement (could) affect relationships internal to the nursing home.

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