What the fee quietly does
Referral fees vary between homes. So a service that is not careful will find itself recommending the same small set of buildings, not out of dishonesty but because those are the relationships it maintains and the ones it knows best.
In Pasadena that pull has a particular direction, and it is worth naming. The city has 14 homes licensed for twenty five residents or more and 17 houses licensed for six or fewer. The large buildings have admissions staff, a marketing budget and a standing fee agreement. A six bed house on a side street off Washington Boulevard usually has none of those, because the owner is also the person cooking lunch. Left alone, the economics of this trade quietly push every family toward the big end of that list, whether or not it is the right end for their father.
The check on that is publication. Every licensed home in this catchment, 75 of them across 9 cities, is listed on one page with names, capacities and licence numbers, including every home that pays us nothing. If the four names we give you never come from outside a narrow band of that list, you will be able to see it.
Ask us about a specific home on that register and you will get a straight answer, including where the answer is that we have no arrangement with them and you should call them yourself.
Referrals we make that earn us nothing
A good deal of what families need is not a care home at all, and none of the following pays us anything. We give these out several times a week.
- Home care agencies, when a few hours of help a day is the honest answer
- Adult day programmes, which often postpone a move by a year
- Hospice, which can come to a care home rather than replacing it
- The county long term care ombudsman, who investigates complaints in licensed facilities independently and at no cost
- The county ageing and disability services office, for benefits and in home support
- The Alzheimer's Association, which runs a helpline around the clock
How we shortlist in this particular market
Pasadena is a small enough field to know properly. 32 licensed homes in the city, 43 more in the towns around it. That is a market a person can hold in their head, which is exactly why a local referral is worth more here than a national form that emails your details to whoever is buying leads this month.
We ask about the level of help needed, the budget, the part of town that works for whoever will be visiting, and whether there is dementia in the picture. Four answers usually gets us to four or five homes worth your time.
Test any referral service with these
Ask us, and ask anyone else you speak to. The answers separate an advisor from a lead broker in about ninety seconds.
- How exactly are you paid, and does the fee differ between homes?
- How many homes do you have agreements with, out of how many exist?
- Will you tell me about a home you have no agreement with?
- Have you personally been inside the homes you are recommending, and when?
- Will you come on the tour, or does your involvement end at the introduction?
- What do you do with my contact details, and who else receives them?
What a referral will not do
We are not clinicians and we do not advise on medical decisions. We do not manage money, act as a power of attorney, or give legal advice on trusts and Medi-Cal planning, though we will tell you when it is time to speak to someone who does.
And we will tell you when the answer is no move at all. Nobody pays us for that conversation, which is a reasonable sign that it is an honest one.
Written and reviewed by Senior Placement Pasadena, , against the California Department of Social Services licence register.