The purpose of this study is to explore why and how Management Accounting and Control Systems
(MACS) enact and are enacted upon in the Dutch branch of nursing homes, homes for the elderly and
home care. In search for answers, this study chooses an actor-network theory (ANT) perspective
combined with case study research as research frames. Central theme in ANT is the theory of
translation. This theory offers opportunities for a close empirical inspection of how and why MACS
enact and are enacted upon by other actants in a complex set of sociotechnical relations. The theory
of translation is applied in a case study research at The Relief Group (TRG), a healthcare organization
which comprises a total of 10 nursing homes and homes for elderly. This case study shows how the
application of MACS expands both in numbers of employees involved and in amount of information.
Due to an increase in perceived environmental uncertainty and reorganization to a more
decentralized model of management all TRG management levels asked, to varying degree, for broad
application of MACS information in general and for non-financial information in particular. This
initiated a process in which MACS did not diffuse unchanged but was manipulated and aligned with
different interests of various stakeholders. At first sight, the TRG case study reveals MACS as a
boundary object. In second instance however, this study questions whether this epistemological point
of view, denoting the differences between the various TRG stakeholders as differences in
interpretation and perception, obscuring an optimal application of MACS, offers sufficient in-depth
understanding. Therefore this study draws on post ANT studies and chooses an ontological point of
view, delineating MACS as different objects, enacted in different sets of relations and contexts.
