How To Select Long Term Care Facilities


by Tim Colling~When you need to find a long term care facility for your elderly parents, the choices can be overwhelming.  Odds are, this is the first time that you’ve needed to know about the types of facilities, payment and funding for care, how to assess individual facilities and all the other details that are suddenly important.

How do you know what will be best for your loved one’s needs?

The way to make the best choices is to combine expert understanding of the care needs of elderly adults with expert knowledge about the facilities available in the area where you want your loved one to live.

If that’s not you, relax.  There are people out there who will help you.  The service you’re looking for is often called “Placement Assistance” and the companies are often called “Placement Services” or “Placement Agencies”.
But how do you choose one of them?

Types of Placement Agencies

There are two basic types of Placement Agencies available:  “Free” and “Fee-based”.
No matter which type you choose, the agency is getting paid.  Everyone needs to get paid in order to make a living.  The questions to ask, though are:

1. WHO is paying them?
2. WHAT are they getting paid for doing?

“Free” Isn’t Really Free
Most long term care placement services advertise themselves as offering a free service.  That probably sounds like a great deal, especially to families that are already struggling with the new stress of having to pay for their parents’ care.
But why is their service free? Remember to ask the two questions mentioned above and you’ll get the answer.

1. WHO is paying them:  they’re getting paid a commission by the facility that they steer your family into choosing.
2. WHAT they’re getting paid for: steering you towards the facilities that will pay them commissions, which may or may not be the best ones for your elderly parents.

It’s free because the facility you ultimately choose will pay the placement service a large commission for steering you to that facility.  The “free” placement agencies will only work with facilities that will be willing to pay them a commission.  How much is the commission?
Typical commissions paid to “free” placement services are between 50% and 100% of one month’s rent.  Here in my market in San Diego County, that’s an average commission of between $1,500.00 and $3,000.00 (or more!)
Also, ask yourself this question:  what happens when one facility offers a higher commission than another facility that’s actually better?  Which one of those facilities will the placement service steer you toward?

There are no standards, regulations, licenses or certifications for people who want to get into the “free placement” industry.  Most of them have no background in social work, geriatrics, nursing, gerontology or have any other sort of previous education, training or experience that qualifies them to assess and recommend senior care facilities.

One last thing to rememver:  this “free placement” industry has become a big, big business.  There are hundreds, if not thousands of these companies springing up all over the United States, because there are no barriers to entry.  There are a couple of really big companies that advertise on television, and they hire former celebrities as spokespersons to do their ads.  Just remember, those spokespersons are being paid too!

A Better Approach: Fee-Based

Fee-based placement services are typically offered by certified professional geriatric care managers (“GCMs”).  GCMs understand the care needs of the elderly, and, as local professionals involved in eldercare, they know what each of local long-term care facilities has to offer (or avoid!)

Certified professional GCMs belong to the National Association of Professional Geriatric Care Managers (“NAPGCM”).  The NAPGCM, requires its members to adhere to its code of ethics.  One of the provisions of that code prohibits geriatric care managers from accepting commissions from third parties such as nursing homes or assisted living facilities.

You, as the client, pay for the GCM’s placement service, and the facility you choose pays the GCM nothing. This means that the GCM works solely for your older loved one’s benefit and is motivated to recommend the facility that best fits your loved one’s needs.

1. WHO is paying them: you are.
2. WHAT are they being paid for: educated, professional advice that is based solely on your elderly loved one’s best interests, not on getting a commission.

…And, The Fee-Based Approach Is Often Still Free!

Here’s how:
Fee-based GCMs save you money because they can usually negotiate with facility managers to give you a discount of 50% to 100% on your parent’s first monthly rent payment. Yes, that’s right: it’s usually the same amount that would have been paid as a commission to a placement service.

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About Tim Colling

Tim Colling has more than 30 years of experience in management in a variety of industries and has served in the past as a member of the statewide steering committee for the Home Care Aide Section of the California Association for Health Services At Home (“CAHSAH”). He is a Certified Public Accountant (licensed but not actively in practice), and received his Bachelor’s Degree in Accounting from California State University at San Diego. He has held the credential Care Manager Certified ("CMC") from the National Academy of Certified Care Managers, and has practiced actively as a Professional Geriatric Care Manager. Tim has worked as a CPA in Public Accounting, a corporate Chief Financial Officer for a chemical manufacturing company, and a software engineering manager for several private and public software companies, in addition to working as an eldercare manager, in-home caregiver agency administrator and professional geriatric care manager since 2003. Learn more about his in-home caregiving company at A Servant's Heart In-Home Care

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