Samhall’s recruitment, development, and transition constitute familiar human resource management practices of recruitment and selection, examination and documentation, training and development, testing, exiting, and so on. These common observations can fruitfully be explored by interpreting them according to my framework of ‘Medicalizing Management’ as a central idea for explaining the institutionalization of social welfare. To Samhall, medical ideas are relevant to its management of its clients; its management is also a medically conditioned phenomenon. Samhall draws on a standard medical model’s activities of managing humans through diagnosis, classifi cation, rehabilitation, treatment, and therapy, which become critical mechanisms for its institutionalization. In all, Samhall’s management practices enact its most important environment through medicalization that subsequently becomes the focus of the organization’s medicalized adaptation to its environment.