Who’s Really Paying For So-Called “Free” Nursing Home Placements?

By Jack Halpern, CEO, My Elder

Many elder care agencies offer their services for free, but is the service really “free”?


Because the families we serve compensate us directly, we represent only them. We are never obligated in any way to serve or protect the needs or interests of the hospital, nursing home, insurance companies, private healthcare service providers, government agencies, and so on.

But My Elder is the exception in a world of allegedly free services that continually put elders at risk.

Here’s where I’m going with this.

A senior falls and breaks a hip or has a stroke. Suddenly there’s a scramble to find a nursing home or other long-term care facility. To meet a growing demand and lured by fast money, so-called “elder care referral services” have sprung up around the country. They claim to help in such situations.

Most elder care referral agencies in this multimillion-dollar although unregulated industry offer consumers their services for free. But free isn’t actually what’s happening. Nursing facilities and other adult care homes typically pay the referral service a sizable commission for any placement –– sometimes as much as $4,000.00.

Many of these services funnel elders to the facilities they contract with –– without regard to the facility’s quality. In an investigative report last year, the Seattle Times found that placement companies in Washington state had referred seniors to facilities that had documented histories of substandard care, including “residents with dementia locked in rooms to prevent wandering; mentally ill adults drugged into submission to control behavior; and bed-bound seniors abandoned without assistance for up to 16 hours.”

According to the Seattle Times report, “in 143 cases over the past three years, seniors were victimized after companies placed them in adult family homes, or other long-term- care facilities, that had a record of serious violations, a Times analysis of Department of Social and Health Services documents reveals.”

The report continues:

“Senior-placement companies, which rely on commission-only sales people, funnel the aged only to facilities that have agreed to pay thousands of dollars in finders’ fees. In addition, most placement companies do not screen homes for past violations. As a result, many have referred seniors to facilities with documented histories of substandard care, including fatal neglect.

“The nation’s largest senior-placement firm is A Place for Mom, a Seattle-based company that contracts with 18,000 elder care facilities in 45 states. Companies like A Place for Mom have embraced a Web-based business model that is becoming increasingly popular among such companies.

“Consumers looking for an elder care facility in a particular area fill out an online form and are quickly contacted by one of hundreds referral ‘advisors’ working out of home offices. While some of these ‘advisors’ are professionally equipped to handle issues dealing with the elderly, the majority are little more than ‘patient brokers’ who are dealing with a population whose needs are specialized.

“You will usually be asked to provide basic information about your senior’s current living situation: age, gender, care needs (help with daily personal care, medication management and getting around), and your budget (how much you have available to pay for care). Most free placement services will stop there. A Place for Mom has on its referral list dozens of homes with histories of substandard care, including homes currently on probation for abuse or neglect violations.”

Related Posts

Are So-Called “Free” Elder Care Referral Agencies Really Free?

Free Placement Companies Might Place Your MOM In A Substandard Facility

Hospital Patients Don’t Get Proper Information About Nursing Homes

In my own investigation, I found that when I questioned one advisor about a nursing home for an elder client, I was directed to a facility that is a very substandard facility. I then asked her how it is possible for the nursing home to pay her a commission, when a Medicaid facility is not allowed by law to do that? She claims that they “have a contract with the nursing home.”

10 things you should know about A Place For Mom and other so-called “free” elder care referral agencies:

  1. Good nursing homes do not have to pay a fee to a patient broker or “advisor.” They are usually full and have an ample supply of referrals. The opposite is also true.
  2. If a “free” service suggests a nursing home to you, you can’t and shouldn’t just assume that it is a quality facility. You must always practice due diligence and go see the facility for yourself.
  3. You must ask the advisor about their professional qualifications. If they don’t have any, they are likely to do more harm than good.
  4. Any service that touts itself as a free referral service is probably sub-contracting for A Place For Mom.
  5. Ask your “advisor” if they carry liability insurance. To the contrary, they are more likely to ask you to sign a document that they are not liable for ensuring the quality of their placement, don’t use them.
  6. Since there is no such thing as “free” ask an advisor how they get paid.
  7. Unlike My Elder or other advocates, a free referral agency like A Place For Mom will not monitor your elder’s care at a facility. Nor will they advocate for them. Buyer beware!
  8. Most of the so-called “advisors” are not professionals and in it just for a buck.
  9. These advisors are certainly not equipped to deal with specialized cases like Alzheimer or Parkinson patients.
  10. For the most part, free elder care referral agencies do not deal with indigent or Medicaid recipients. If the elder can’t afford to pay privately for the facility, there will be no fee to the agency. The placement service will then act as a “broker,” providing your contact information to the facilities they think are best suited to your needs. These facilities will contact you to provide their information and offer you a tour.

At My Elder, we have always believed that the wellbeing, protection and safety of elders must come first. Whenever a service is offered “free,” we see it as a sign that the elder’s wellbeing, protection, and safety could be severely at risk. Aging has its own inherent risks. Why add more?

That’s why we pride ourselves on our total independence when it comes to providing tailored eldercare choices to our clients. Our fee-based approach assures that we speak only for you and your elder family member.

My Elder provides elder advocacy services to families. Talk to us about long-term planning, finding the right home for your loved ones, preventing crisis and abuse, and ensuring they receive the best care possible.