| In the absence of a viable, dominant theory or conceptual framework for understanding board and care (B&C), a grounded theory approach is used to explore the failure of market forces and regulatory policies to assure that B&C residents' needs are adequately met. This dissertation presents North Carolina as an illustrative case study of B&C policy which, by default, has let stand the principles of "market rule." Knowledgeable stakeholders' perceptions of B&C policy expectations, implementation, and effects on resident care quality offer evidence of the failure of this policy strategy to assure B&C quality. These findings, and observations of subsequent B&C policy reform in North Carolina, serve as the basis for suggesting a reconceptualization of B&C within the broader, long term care system. Illustrations are offered as examples of this reconceptualization and how it can assist in the development of policy incentives for care quality. |
