Background and Objectives: Casino hotels employ increasingly large numbers of service-sector workers in hospitality occupations that are associated with high injury rates/negative health effects. The main objective of this study was to examine health- and safety-related experiences of non-union casino workers, mostly Spanish speakers, from four job categories: guest room attendants, porters, kitchen workers, and front-of-house staff. Methods: Thirteeen focus groups (FGs) using purposive, criterion sampling obtained an approximately equal distribution of participants (n=97) across job categories. Domains addressed by a semi-structured topic guide concerned health and safety impacts of work, job task views, workplace hazards, management responses to injuries among others. FG discussions were recorded, translated and transcribed. Applying grounded theory methodology, emergent themes were identified using Dedoose™ analytic software. Results: A total of 97 codes applied across all FGs were collapsed into seven categories: activities/exposures negatively affecting employees' health/safety; barriers to health/safety; injury/pain complaints; self-treatment/other coping mechanisms; job vulnerability/reporting problems; management policies/enforcement; lack of management concern for employees. From these categories emerged a Dynamic Theoretical Framework of Employee Health and Safety comprised of intersecting constructs located in a hierarchical structure: 1) employees' work activities/exposures; 2) employer-controlled factors; 3) employee job vulnerability; and 4) lack of management concern for employees' health/safety. Conclusions: The supra-level construct of ‘lack of management concern' creates an environment where lower-level factors jeopardize employees' health/safety, i.e. fear of job loss, job-site conditions, work-related exposures. Interventions targeting management's concern for employee health/safety offer the greatest potential for favorably changing work organization risks at multiple levels.