Small board and care homes housing frail elders and other dependent ad
ults are gaining attention of researches and policymakers. In this ana
lysis, using data from a study of small homes and evidence from the li
terature, we show that such homes can be understood as being character
ized by, and suffering from, social marginality. Evidence of three asp
ects of marginality are presented, with discussion of both positive an
d negative outcomes. Much of the negative reaction to board and care a
nd difficulty in its operation may be seen to derive from its unrecogn
ized marginal status. In developing regulations, policymakers should r
ecognize the unique niche represented by small board and care homes.