The rise of chain nursing homes in Ontario, 1971-1996

Although chains may be this century's most successful organizational form, organization theorists rarely study them. This study of the rise of nursing-home chains in Ontario aims to shed light on how organizational, industrial, and institutional factors shape the rise of chains and the decline of their independently operated rivals. This study contributes to organization theory's understanding of chains in three ways. First, it provides an example of how government policy facilitates the rise of chains by increasing the survival advantages associated with economies of scale and stimulating the acquisition of independent organizations by chains. Second, it of offers a rationale for expecting chains in social and human service industries to rise where nonprofits are often the socially preferred form. And third, it demonstrates that mutual forbearance theory can provide new insight into chains' competitive advantage over independent organizations.