Senior Care Referral Services Under Scrutiny

The Washington Post recently reported on the dangers of relying on big-name, nationwide Senior Care referral services, calling the consequences of their broad reach “neglect.” As is often the case with media reports, the article was designed in a way to both inform and frighten readers. There is good reason for consumers to beware, but are things really as bad as the media presented? What truth is there to these accusations of referring poor quality facilities? And do these dangers also apply to Care Placement?

What the Article Said About Referral Services

The Washington Post article published May 16, 2024 outlines several neglectful practices that have been observed in the well-known Senior Care referral service A Place for Mom. The article accused the company of being less than forthcoming about how they are paid, allowing consumers to believe they are a non-profit organization. The rest of the claims are more frightening, such as, “more than a third of the popular website’s most highly recommended facilities have been cited for substandard care.” They enumerated nightmarish cases of homes mistreating residents. Elder abuse is a sad reality plaguing the nation, and people rely on their referral services to not recommend facilities guilty of such atrocities.

Unfortunately, in the case of A Place for Mom, some of those worst offenders ended up on the company’s “Best of Senior Living” list. How is this possible? One major determining factor in a facility earning the honor “Best of…” is having recent reviews with an average of 4.5 out of 5 or better. Some facilities that allowed harm to come to their residents earned an average of 4.5+ on their reviews. According to the article, this is due to misleading review practices, collecting only positive reviews to the exclusion of negative ones. For example, at one facility, “forty reviews were posted on a single day in March 2021, all with an identical headline…37 of them gave five stars.”

Using this designation of “Best of Senior Living” without properly investigating actual conditions at the facilities can lead families to make life-changing decisions based on incomplete information. The Terms on their website state, “nor do we recommend or endorse, any Participating Community.” But is not calling a facility the “Best of…” seen by the consumer as a recommendation?

The Truth About Referral Services

As a nationwide chain, A Place for Mom will never be able to offer families a personalized experience, nor will they monitor the conditions in thousands of homes on your behalf. They have only a surface-level knowledge about the homes they refer and can only provide people with general information. This can lead to less-than-quality service, but they don’t do so maliciously. That is merely the trade-off that comes with using big-name brands. Here is a deeper look into some of the accusations made against them by the Washington Post.

Caution sign showing many choices


Citations against a facility should be taken seriously. They represent a real risk to the safety of residents. However, it is important to understand what they mean before jumping to conclusions about a home. Nearly every licensed Senior Care Home has citations on their record. These issues range from incomplete paperwork to mistreatment of residents. They stay on a home’s record for years, long after the problem may have been rectified.

The best thing a person can do is to look up prospective facilities on the state’s website and investigate any complaints about the homes on their own. Regardless of any claims that a referral service might make about preferring the home, in the end it is up to the future residents to make sure they are satisfied with the care a home provides. The state of California is thorough with the information it provides, but the information can be confusing and overwhelming. If you don’t understand the information you see, ask. Our staff here at Care Placement, as well as most homes, are happy to explain what the citations mean.

Learn more about Understanding California State Citations for RCFEs.


What about facility reviews? Can you trust them? As the Washington Post article pointed out, the reviews for many homes listed on A Place for Mom’s website are incorrectly weighted toward the positive. A Place for Mom is not solely to blame for this. Yes, they encouraged homes to seek reviews. They told homes that pages with more good reviews are more likely to show up in Google search results. That is a true statement. It is, therefore, an issue across many industries (so much so that Yelp! deletes reviews that it thinks were solicited).

In this case, the Senior Care facilities were more to blame themselves. Employees of the facilities were sometimes incentivized by their employers for getting more good reviews. This led to employees only asking residents who appeared to be having a good experience. Mostly good reviews were submitted to A Place for Mom. Through their automated calculations, those homes appeared to be satisfying customers. Without personal relationships with the thousands of facilities in their database, they had no way of knowing the information was misleading.

What you can do about it: read the reviews, of course, but don’t stop there. Look for Google or Yelp! reviews that are unfiltered by the caregivers or referral agency. When you tour a home, ask a few residents and caregivers how they feel about the quality of their time there. Nothing will help you decide better than your own eyes and ears.

Free or not?

Senior Care referral services are not non-profit organizations. We are businesses, trying to earn a living by helping people. Even A Place for Mom never claimed to volunteer their services. Though the Washington Post accuses them of burying the truth of how they are paid deep in links at the bottom of the page, the company never attempted to mislead anyone.

Most Senior Care referral companies offer their services as free to people because it is the facility that pays us. This is the case for A Place for Mom and Care Placement, as well. The fee is usually an amount equal to one month’s rent and sometimes care costs. Homes expect this, and they set aside that money as a planned marketing cost. In that way, individuals never have to pay.

Since referral fees are a planned expense, homes cannot raise their rates to clients because they are using a referral service. If a home makes such a claim, this is a major red flag.

What Makes Care Placement Different

One of the most concerning issues brought up by the Washington Post was that A Place for Mom advertised many homes as their preferred choices despite being subpar facilities. This was based upon cold, impersonal numbers that turned out to be inaccurate, including those biased reviews.

As a local company, here at Care Placement, we have real relationships with the homes we refer. We regularly communicate with their staff and even visit many locations to see them with our own eyes. We do not promote homes that we know are failing to provide adequate care. And if a family lets us know that we included a poor-quality facility on a referral, we note that in our records to avoid referring that home in the future.

How we handle citations

First and foremost, we tell families not to make a decision on our word alone. We strongly encourage people to visit the communities we put on our referrals, ask questions, and make informed decisions. It is you or your loved one who will be living there. A PDF with 2D pictures and a list of amenities is not enough for such an important life decision.

It’s important for families to know, ultimately the choice is yours. We equip you with everything you need to make an informed decision, including directions to the California State website if you wish to check a home’s citations. If you’ve researched a facility’s record and can’t make heads or tails of it, we can explain what the different complaints and inspections mean. Our goal is to walk families through the process and clarify as much as possible. After talking with us, we will encourage you to ask the home about their citations as well. Only the home knows all the details of what happened. At the end of the day, the home has to meet your standards, regardless of what an online database says.

How we get our reviews

Rather than ask facilities to send us their best reviews, we speak directly to residents and their families. After moving in, as well as a few months later, we ask people themselves how they or their loved one is doing in their new home. There is no incentive to respond one way or another. We make it clear in our conversation that this information is requested specifically to help future families decide whether to choose a home or not. These testimonials can be shared with families upon request.

How we get paid

Like other Senior Care referral services, we are paid by facilities not by families. Perhaps the main difference here is that we are transparent about this fact. We inform families of this early on in our discussions, never leading them to believe that we are a non-profit or volunteer organization. It is even mentioned in our About page and FAQs. If a home tries to charge a family for our services, we note this in our internal records. We then fight for clients to receive the appropriate rate and are cautious about suggesting that home to people in the future.

The Verdict

Should you be cautious about using Senior Care referral services? Of course. Finding a safe and comfortable new home for yourself or your loved one is a life-changing decision that should be handled with attentive seriousness. Do we think Care Placement is a better choice than big-name companies? If we didn’t, we wouldn’t be working here. We pride ourselves on being a locally-based company with a personal touch and insider knowledge. At the end of the day, it is important for you to be fully informed of all the options and the potential benefits and risks of each one.

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