What a Senior Living Placement Agency Does, and Why Families Never Pay

When I tell people what I do, the first question is always the same: who pays you? It is a fair question, and the answer shapes everything else about how a placement agency works. So I will answer it plainly, then explain what the work looks like, because most families have never used an agency like mine.

A senior living placement agency helps a family figure out what kind of care a parent needs, finds the communities that fit, tours them with the family and helps with the offers and the paperwork. The family pays nothing. The community compensates the advisor when a family moves in, the way a landlord pays a broker. That is the model, and the rest of this post is about how to use it well.

What a placement agency does, step by step

The job is to get the level of care right, then the community, then the contract, in that order. Here is how it runs with me, from the first call to the weeks after the move.

1. One call to assess care needs, personality, where your parent wants to live and what the money looks like, including the budget at month 24, not just month 1.
2. A shortlist of two or three communities, drawn from the more than 90 I have toured across Nassau County, Suffolk County and Queens.
3. Tours together, where I look at staffing, food, care levels, licenses and the contract while you look at the apartment.
4. Offers and paperwork, compared side by side, with the admission agreement read together before anyone signs.
5. Follow up after the move, and a plan that looks 18 to 24 months ahead so the next change in care is expected.

That is the whole service. It is what a senior living advisor does; my own version is on my what makes Mike different page.

Why families never pay

Families do not pay a placement agency because the community does. When a family I have worked with moves in, the community compensates me under an agreement it signed long before I met the family. The family’s rate is the same rate they would pay walking in off the street; communities do not add a charge to cover the advisor, a question I answer on my frequently asked questions page.

The honest part is that this model has a built in conflict. An advisor paid by communities could steer a family toward the building that pays the most or has an empty apartment. The way around it is the way around any broker: ask how many communities the advisor works with, whether they tour with you, and whether they ever talk you out of a building. I turn families away from communities regularly, and I say so when assisted living is the wrong answer altogether.

What to look for in a placement agency

Not every placement service is the same. The direct answer: choose someone local, who tours with you, who has walked the buildings and who will tell you no.

• Local knowledge. An advisor who has toured the communities personally knows which ones are stable and which are turning over staff.
• Tours together. A referral sent by email is a list. A tour with an advisor is advice.
• Breadth. Ask how many communities the advisor works with and whether that covers the whole area, from large communities to small residential assisted living homes, or a handful of buildings.
• Credentials. A certified senior living advisor has training in the care types; a dementia care certification matters if memory loss is in the picture.
• Transparency. The advisor should explain who pays and when without being asked twice.
• A planning horizon. An advisor who only talks about today’s needs will have you moving again within two years.

Then ask what happens after the move.

How to find a placement agency on Long Island

Most families find a placement advisor by referral. Hospital social workers, discharge planners, geriatric care managers, elder law attorneys, physicians and clergy on Long Island refer families to advisors they have watched work. Ask one of them who they would call for their own parent.

National placement networks have local offices, and that is my structure: Assisted Living Locators of Long Island is the Long Island office of the national Assisted Living Locators network, national resources with a local advisor who tours here. Online referral websites are different; they collect your phone number and send it to several communities at once, which is why your phone rings for a week after one form. Read reviews for specifics, and mine are on my family reviews page.

Beyond placement: the rest of the help

Placement is the center of the job, not the edge of it. Families also get help with the parts that have nothing to do with picking a building.

• Reading the admission agreement and rate sheet before signing.
• Lining up the physician’s evaluation, medication list and nurse assessment a community needs.
• Talking with a reluctant parent; I wrote about that in my post on persuading a senior to accept a placement.
• Referrals to elder law attorneys for Medicaid planning, veterans benefits and estate questions.
• Follow up after the move, and a second look when the care level changes.

What I do not do is provide care. I am not a nurse or a doctor. I am the person on your side of the table who knows the buildings and the contracts, and who has been through this with his own mother.

Independent living, assisted living or memory care: which one

The first thing a placement agency sorts out is the level of care, because the wrong level is the most expensive mistake a family can make. I cover three types.

Setting	Who it fits	What is included	What is not
Independent living	Someone managing well who wants meals, company and no house to keep	Apartment, meals, housekeeping, activities, transportation	Personal care and supervision
Assisted living	Someone who needs hands with bathing, dressing, meals or medication, with staff around the clock	Everything above plus personal care, medication management, a nurse overseeing the plan	Daily skilled nursing
Memory care	Someone with dementia who needs a secured setting, cueing and higher staffing	Everything in assisted living plus a secured neighborhood, trained aides, a structured day	Hospital level medicine

On Long Island and in Queens, 42 of the roughly 47 memory care programs sit inside assisted living communities, so a parent can start in assisted living and move down the hall later. My assisted living on Long Island guide and my post on comparing independent living and assisted living go deeper.

When people make the move, and the honest pros and cons

There is no typical age; I have placed people in their late sixties and past 95. What is typical is the trigger: a fall, a hospital stay, a spouse’s death, a winter alone, or a daughter who realizes she has become the night shift. Most families call about a year after they first thought about it, and most wish they had called sooner.

What assisted living does well

• Safety: staff around the clock, an emergency call system, no stairs and no stove.
• Meals and medication handled, two of the most common reasons for hospital visits.
• Company. Loneliness is the problem I see most at home and the one that improves fastest.
• Relief for the family, who go back to being a daughter or a son instead of a caregiver.

What it does not do

• It is not home, and the first month is hard for almost everyone.
• It is not medical care; daily nursing means a different setting.
• It is paid privately for most families; Medicare does not pay for assisted living rent, and Medicaid helps only through the Assisted Living Program.
• Care levels rise, and the bill rises with them, which is why the 18 to 24 month plan matters.

How to start with Assisted Living Locators of Long Island

One call to go through care needs, personality, location and finances, then tours together, help with the offers and contracts, and follow up after the move. My help is free to families; communities compensate the advisor when a family moves in. I am a certified senior living advisor with a dementia care certification, and I have toured more than 90 communities across Nassau, Suffolk and Queens.

Assisted Living Locators of Long Island is at 42 Prospect Ave, Glen Cove, NY 11542. Learn a little about me, and then reach out when you are ready to talk.

Questions readers ask

Read next

• Assisted Living vs Nursing Home on Long Island: Who Belongs Where
• Assisted Living vs Skilled Nursing: The Medical Line Families Miss
• Residential Assisted Living: The Small House Model on Long Island