Britain and the United States alike face the question of how best to protect the growing and vulnerable population of nursing home residents through State regulation of private institutions. Despite marked differences in scale, organization, and financing between the two nations, there are striking similarities in the problems encountered and in styles of enforcement adopted in response. Analysis of the regulatory systems in practice shows a convergence in the regulatory process despite the dissimilarities between formal regulatory models. Both systems are responding--however imperfectly--to the social environment of nursing home care. Future regulatory policy will have to encompass formal and informal, legal and social control.