A Place for Mom Alternatives: What They Don't Tell You About Senior Care Referrals
You searched for help with your parent's care. Within 24 hours, your phone wouldn't stop ringing. That's not a glitch—that's the business model. Here's what the senior care referral industry doesn't want you to know.
Maybe you filled out a form online, or called a number that promised free senior living advice. You were worried about your parent. You needed help.
What you got was your contact information sold to the highest bidders. Those calls aren't from caring advisors—they're from sales representatives at nursing homes who paid for your data, competing to close you before the other facilities do.
You became a "lead"—a data point worth $3,000-$8,000 in commission fees. If you feel frustrated, even betrayed, you're not alone. And there are better ways to find care for your family.
How Senior Living Referral Services Actually Work
The largest senior living referral services—A Place for Mom, Caring.com, SeniorAdvisor—present themselves as free, helpful resources for families navigating elder care. And they are free to you.
But that's because you're not the customer. The nursing homes are.
Follow the Money
You Fill Out a Form
Your information—name, phone, email, care needs, budget, location—is captured.
Your Data is Sold
Typically 3-5 nursing homes receive your information simultaneously.
Facilities Race to Contact You
Speed matters—the first to reach you has the best chance of closing the sale.
The Referral Service Collects $3,000-$8,000+
When you move in, they receive one full month's rent as commission.
Lead Selling Pipeline
Visual flowchart showing: Your Contact Form → Referral Database → Multiple Facilities ($$$) → Sales Calls Flood Your Phone
Could include: phone icons with notification badges multiplying, dollar signs flowing from your data to the referral company
This model creates three problems that directly harm families:
The Three Problems With Referral Agencies
Problem 1: You Only See Paying Partners
Referral services only recommend facilities that pay them referral fees. Independent facilities, smaller operators, and many non-profit care homes don't appear—not because they provide worse care, but because they don't pay for leads.
A 2023 Washington Post investigation found major referral services showed families only a fraction of licensed facilities in their areas.
Problem 2: Commission-Driven Advice
When an advisor's income depends on placing you in a facility—any facility—their incentives don't align with finding you the best facility. They align with finding you the fastest facility.
Former referral service employees describe quotas, pressure to close quickly, and bonuses tied to placement volume rather than placement quality. The typical "free senior advisor" is a sales representative working on commission.
Problem 3: Quality Isn't Part of the Algorithm
Referral services don't filter out facilities with poor inspection records, staffing violations, or low Medicare quality ratings. If a facility pays for leads, it appears in recommendations—regardless of whether state inspectors found serious deficiencies.
You might assume that being "featured" or "recommended" means something about quality. It doesn't. It means they paid.
Photo: Frustrated Family Member
Image showing stressed adult child looking at phone with multiple missed calls, or elderly person looking confused/overwhelmed by paperwork
The State Disclosure Laws You Should Know About
Growing awareness of these problems has led several states to pass disclosure requirements:
Required Disclosures in CA, NY, WA & Others
- check_circle They receive compensation from facilities they recommend
- check_circle Their recommendations are limited to paying partners
- check_circle They may share your personal information with multiple facilities
info These disclosures are often buried in fine print. The fact that regulators felt the need to mandate them tells you something about how transparent the industry has been.
Three Ways to Find Care Without the Sales Pressure
If you want to avoid the referral agency trap, you have three main options—each with trade-offs.
DIY Research
Free (your time)You can research facilities directly using public databases that show all licensed options—not just paying partners.
search Medicare Care Compare
Star ratings, inspection results, staffing data, and quality measures for every Medicare-certified nursing home.
medicare.gov/care-compare open_in_newapartment State Licensing Databases
All licensed facilities including assisted living communities not Medicare-certified. Search "[your state] assisted living license lookup."
description State Inspection Reports
Violations, complaints, and enforcement actions that never appear on referral websites.
Hire an Independent Professional
$100-200/hourGeriatric Care Managers (also called Aging Life Care Professionals) are licensed social workers, nurses, or gerontologists who work directly for families—not facilities.
Because you pay them directly, their only incentive is to find you the best fit. They'll assess needs, research all options, accompany you on tours, and help negotiate pricing.
Look Beyond U.S. Borders
$1,500-3,500/moThis option isn't for everyone. But for some families, it's the escape hatch from a broken system.
The fundamental problem with U.S. senior care isn't just referral agencies—it's the underlying economics. American nursing homes charge $8,000-15,000/month while providing staffing ratios of 1 aide to 8-15 residents.
Countries like the Philippines have emerging senior care industries operating on fundamentally different economics. Lower cost of living means facilities can provide dedicated, personalized care at a fraction of U.S. costs.
This isn't about finding "cheap" care. It's about finding care where the economics actually support quality. When a facility can afford one caregiver for every one or two residents, care is fundamentally different.
Photo: Philippine Care Facility
Warm, sunlit facility with tropical garden, showing 1:1 caregiver interaction with resident—personal, relationship-based care environment
Comparing Your Options
Here's how the different approaches stack up:
| Factor | Referral Agencies | DIY Research | Care Manager | International Care |
|---|---|---|---|---|
| Cost to You | "Free" (hidden in facility pricing) | Free (your time) | $1,000-4,000 | $1,500-3,500/mo care |
| Who Pays Them | Facilities | N/A | You directly | You directly |
| Options Shown | Paying partners only | All licensed facilities | Based on your needs | Vetted international facilities |
| Bias Level | High | None | Low | Varies by provider |
| Spam Risk | High | None | None | Low |
| Typical Staffing | 1:8 to 1:15 | Varies | Helps evaluate | 1:1 to 1:5 |
| Time Required | Low | High (20+ hours) | Low | Medium |
Questions to Ask Any Senior Care Service
If you do work with a referral service—or any advisory service—ask these questions upfront:
"Do you receive payment from facilities you recommend?"
If yes, understand that their advice isn't neutral.
"How many total licensed facilities are in my area, and how many do you work with?"
The gap tells you how much you're missing.
"What facilities have you NOT recommended to me, and why?"
A good advisor should be able to explain exclusions.
"Do you check state inspection records and Medicare quality ratings?"
If not, they're not doing due diligence.
"Will my contact information be shared with facilities before I agree?"
Know what you're consenting to.
Why the System Works This Way
It's worth understanding why senior care referrals became such a problematic industry. The root cause isn't evil companies—it's broken economics.
Medicaid Squeeze
Medicaid reimburses at rates that often don't cover actual costs. Facilities desperately need private-pay residents.
Marketing Gap
Most facilities can't afford robust marketing. Referral agencies fill that gap—but at enormous cost.
Private Equity Ownership
Research shows PE-acquired nursing homes have increased mortality rates and decreased staffing—while charging higher prices.
Understanding this context doesn't make the situation less frustrating. But it does explain why "just finding a good nursing home" feels so difficult.
The system isn't designed to help you. It's designed to extract value.
Finding a Better Path Forward
You came to this article because you're frustrated. Maybe you're drowning in sales calls. Maybe you sense that something about the "free help" being offered isn't quite right.
Your instincts are correct.
The good news: you have options. You can research independently using public databases. You can hire an unbiased professional to guide you. You can even look beyond U.S. borders to find care that operates on better economics.
What you shouldn't do is trust that "free" advice is truly free, or that the options being presented to you are comprehensive.
monetization_onIn senior care, as in most things: follow the money.
Your parent deserves better than being a lead in someone else's sales funnel. Take the time to find care on your own terms.
Considering International Care Options?
If you're open to exploring care in the Philippines—where many facilities offer 1:1 to 1:5 staff ratios at a fraction of U.S. costs—we can help you evaluate whether it's right for your family.
No sales pressure. No lead selling. Just honest guidance about an option most families don't know exists.
Get a Free Consultation arrow_forwardFrequently Asked Questions
How do senior living referral services make money?
Referral services like A Place for Mom receive commissions from facilities when you move in—typically equivalent to one full month's rent ($3,000-$8,000+). They only recommend facilities that pay them referral fees.
Why do I get so many calls after requesting senior care help?
Your contact information is sold to multiple facilities (typically 3-5) simultaneously. Each facility races to contact you first because speed improves their chances of closing the sale.
What are alternatives to senior living referral agencies?
Three main alternatives: DIY research using Medicare Care Compare and state databases (free but time-intensive), hiring a Geriatric Care Manager who works for you ($100-200/hour), or exploring international care options in countries like the Philippines with better staffing ratios.
Do referral services check facility quality ratings?
No. Most referral services don't filter out facilities with poor inspection records, staffing violations, or low Medicare quality ratings. If a facility pays for leads, it appears in recommendations regardless of quality.
Sources & Further Reading
- link Medicare Care Compare: medicare.gov/care-compare
- link Aging Life Care Association: aginglifecare.org
- article Gupta et al., "Does Private Equity Investment in Healthcare Benefit Patients?" NBER Working Paper, 2021
- gavel California Department of Social Services: Referral Agency Disclosure Requirements
- analytics Genworth Cost of Care Survey 2024
