This book is a major contribution to regulatory theory from three members of the world-class regulatory research group based in Australia. It marks a new development in responsive regulatory theory in which a strengths-based pyramid complements the regulatory pyramid. The authors compare the accomplishments of nursing home regulation in the US, the UK and Australia during the last 20 years and in a longer historical perspective. They find that gaming and ritualism, rather than defiance of regulators, are the greatest challenges for improving safety and quality of life for the elderly in care...