Placement Agency vs. Searching on Your Own

No route is right for every family. The table gives the general shape of each. Individual websites and agents differ, so treat it as a list of things to ask about, not a verdict.

Everything you need to search alone is public. The Community Care Licensing Division of the California Department of Social Services keeps a facility search that lists every licensed assisted living community and board and care home, known in state law as residential care facilities for the elderly (RCFEs). The department's consumer guide says the site shows each home's license status, visits, complaints and licensing reports.

The guide suggests three steps: identify the person's needs and preferences, choose a sample of homes, then visit them. California Advocates for Nursing Home Reform (CANHR) adds two more sources. Ask people you know, such as friends, clergy, doctors and hospital discharge planners. And call the local Long-Term Care Ombudsman program, which cannot recommend a specific home but may have listings and public reports.

The strength of searching alone is that nobody filters the list. The weakness is what the list leaves out. It does not show monthly rates, whether a home has an opening, or whether it can care for a particular condition. You find that out one phone call at a time. A county the size of Los Angeles has a great many small homes, and families who are working, or who have a hospital discharge date coming, often run out of hours. Our guide on how to check an RCFE license explains how to read what you find.

A national referral website usually starts with an online form or a phone number. You give your contact details and a few facts about the person who needs care. An adviser then calls, asks more questions and sends a list of communities. The service is usually free to the family because the community pays the website when someone moves in.

This model has real advantages. It is fast, it works when you live in another state from your parent, and it covers areas where no local agent works.

It also has limits. None of them makes a website a bad choice. They mean the list you receive is a starting point, and the checking is still yours to do:

• The list may not be complete. The California Department of Aging says referral agencies may only be referring you to facilities that pay them.
• Your details may travel. Some services pass your name and phone number to several communities at once, and each may call you. Ask who will receive your details before you give them.
• Posted prices may be off. CANHR notes that monthly rates on an agency's website may be inaccurate, because a home sets its rate only after assessing the person.
• The adviser may not have been inside. CANHR also cautions that agencies often rely on a home's marketing materials. Ask whether anyone from the service has visited.

A local placement agent does the same job on a smaller map. The agent usually talks with you directly, suggests a short list of nearby homes, and may go on the tours with you. Because the agent works one area, they may know things a listing cannot show: which small homes take residents who need two people to help them move, how an owner handled a past citation, where there is an opening this week.

The trade-offs are just as real. A local agent covers only so much ground, so a family searching across several counties may need more than one. Skill and training vary widely from one agent to the next, and California does not license RCFE placement agencies, as our guide to what a senior placement agency is explains. And a local agent is usually paid by the home, the same as a website. CANHR's advice applies to every referral service: do not rely on a referral alone, and research the home yourself.

The differences between agents are large enough that choosing one deserves a few questions. See how to choose a placement agency.

You can combine the three. Many families use the state search to check the homes an agent suggests, or ask an agent about a home they found themselves. Whatever the route, one rule in state law is worth knowing: Health and Safety Code section 1569.47 bars any placement agency from referring a person to a care home that is not licensed. If you come across a home that seems to be operating without a license, or you see someone in danger, call 911 in an emergency and report the home to the Community Care Licensing Division at 1-844-538-8766.

Before you decide on any home, visit more than once. Our assisted living tour checklist lists what to look at and ask.

As a rough guide, based on what each route does well:

• Searching alone fits when you have several weeks, know the neighborhood you want and are comfortable making many calls.
• A national website fits when you are far away, need options in an unfamiliar area, and do not mind sorting through follow-up calls.
• A local specialist fits when time is short, the care needs are complicated, or you want someone beside you on the tours.

Hamssa Benrekia is a local placement specialist based in Torrance who works alone, so the person you call is the person who tours with you. She helps families with assisted living placement in the South Bay and Harbor area of Los Angeles County, not the whole state. Her help is free for families: the care home pays her a referral fee after a move-in, not every home pays one, and she still recommends a home that pays nothing when it is the right fit, as Is senior placement free? explains. To talk it over, contact Hamssa, or read the full California Assisted Living Placement Guide.