Current long-term residential care (LTRC) policy emphasizes the need for collaborative, team-based care planning that actively involves families and/or residents. Resident care conferences are one of the more common ways in which care providers, families and/or residents come together to discuss and coordinate resident care needs and evaluate care goals. To date, research in this area has focused on evaluating conference outcomes (e.g., improved end-of-life care); far less is known about the care conference process such as how care is negotiated and how care decisions are made. Drawing on data from a critical ethnography examining the negotiation of care work among families and staff in three LTRC facilities in British Columbia, Canada, this presentation explores the process, structure and content of care conferences. Thirty-seven care conferences were observed and informal conversations held with families and staff following the conference. Additional information came from interview data from the larger study (n=37 family, 35 care staff). Grounded in critical theory, thematic analyses identified two key themes, Following Script and Devaluing Knowledge. Following Script reveals how the conference agenda and ensuing discussion was a tightly-controlled, homogenized process, in which opportunity for meaningful input from families was severely curtailed. Devaluing Knowledge outlines how adherence to script and clinical ways of knowing subjugated family members’ knowledge of residents’ needs and care goals, again limiting family contributions. A series of practice recommendations outline how to engage and empower families as active participants in care conference decision-making and planning.