How Senior Placement Agencies Get Paid
The care home pays, and the family pays nothing. A placement agency signs a contract with each home it refers families to. When a family it sent moves in, the home owes the agency a fee, often about one month's rent. No move-in, no fee.
That is not a guess. California's Assembly Committee on Aging and Long-Term Care described the arrangement in its 2018 analysis of a bill on referral agencies: they “receive a fee (often, reportedly, the amount of one month's rent in the facility) if an individual the agency has referred moves into that RCFE.” An RCFE is California's license for assisted living and board and care homes.
By Ed Brancheau, founder of Elevyr. Published October 21, 2026.
Who pays a senior placement agency?
The home pays. Families use the service for free, because the agency earns its income from the homes it places residents in. A Place for Mom, the largest national service, says so on its own site: it “is paid by our participating communities, therefore our service is offered at no charge to families.”
Local agents work the same way on a smaller scale, and many are one-person businesses. As Isabelle Guarino of RAL Academy describes the job, the agent learns the family's budget, location and care needs, recommends homes she has a signed contract with, tours them with the family and handles the paperwork. Once the resident moves in, she bills the home.
How much do placement agencies charge care homes?
Usually somewhere between half of the first month's rent and one and a half months, paid once, after the resident moves in. The only primary source, a 2018 California legislative analysis, puts the common figure at about one month. Everything else is what people who pay and collect the fee have said on the record.
| Who said it | The fee | Where |
|---|---|---|
| California Assembly Committee on Aging and Long-Term Care | Often about one month’s rent, paid by the home when a referred resident moves in. | Analysis of AB 2744, April 17, 2018 |
| Isabelle Guarino, RAL Academy | 50% to 100% of the first month from local agents, with 50% to 70% “very normal.” National services charge “over 120%.” | Assisted Living Network podcast, September 2025 |
| Christine Sevier, placement agent, San Francisco Bay Area | 75% to 85% of the first month for her agency. Listing with a large national service, she said, runs 150%. | RAL Room podcast, December 2024 |
| Shereve Smith, owner of a six-bed home in Wesley Chapel, Florida | 100%, “which is the first month rent.” | ALF BOSS podcast, October 2025 |
Each podcast row is one person's figure, said out loud. Nobody has published a survey of placement fees, so none of them is an industry average.
What do placement fees cost your home in a year?
Four numbers. Two of them you know cold, and the other two are sitting in last year's invoices. Nothing you type leaves this page.
Starts at the national median for assisted living, from the CareScout Cost of Care Survey, 2025. Type your own rate.
Starts at 6, which is a guess. Your admissions records have the real number.
Starts at 50%, also a guess. Nobody publishes this split for any state, so count last year's invoices from agencies.
Starts at 100%, one month's rent, the figure in the California Assembly's 2018 analysis. The slider runs from 50% to 150%, the range operators and agents quote above.
Placement fees, every year
$18,600
3 agency move-ins a year at $6,200 each. Every family who reaches you directly instead keeps $6,200 with your home.
Is a placement agency worth the fee?
Often, yes. An agent who brings you a family did real work you did not have to do: she found them, learned what they need, toured with them and handled the paperwork. One month's rent buys a resident who may stay for years, and an empty bed costs more than the fee.
Shereve Smith pays her agencies a full month on a six-bed home, and on the ALF BOSS podcast she said her home is “grateful” for them anyway. Keep any lead source that pays for itself until you find a better one.
The fee is the right price for a family you would never have met. It is the wrong price for a family who was already trying to reach you.
What can you negotiate in a placement agency contract?
The percentage, the timing and who found whom. Agents send their own contract, and the terms move. Isabelle Guarino of RAL Academy calls 50% to 70% of the first month normal, and says anything above 70% is worth a conversation.
- Split the payment. Guarino suggests paying half in the resident's first month and the rest in the second, so the fee lands alongside rent you have already collected.
- Know the trigger. In the arrangement the California analysis describes, the fee is owed when a referred resident moves in, not when a family tours.
- Settle who found whom. Read what the contract says when a family the agency sent had already called you on their own. More on working every referral source in our guide to assisted living referral sources.
When does a care home pay no placement fee?
When the family reaches you directly. A daughter who finds your home, calls, gets an answer and books a tour brings no invoice with her. Every direct move-in keeps the whole first month with your home.
A placement agent named the catch herself. Christine Sevier on the RAL Room podcast: “First to contact, first to contract. If you don't wanna pay my fee, answer the phone.” Families, hospital discharge planners and case managers call whoever picks up, and on a small home that phone is often the owner's own cell.
How often does nobody pick up? We called 100 Southern California communities three times each to find out, and the answer is in the after-hours study. What those missed calls are worth is on the Voicemail Tax.
The family who calls you directly should reach somebody.
Sloane is an AI admissions agent built for senior care. She answers the calls your team cannot get to, nights and weekends included. She learns what the family needs, checks the fit and books the tour.
She does not replace the placement agents who send you residents, because a good agent is a lead source worth keeping. She makes sure the families already trying to reach you get an answer, and those move-ins carry no fee.
The demo answers as Larkspur House, a made-up six-bed home. The demo call is not wired to a calendar.
Placement fee questions
Do families pay senior placement agencies?
No, not in the usual arrangement. The agency is paid by the home the family moves into. California's 2018 legislative analysis of AB 2744 says consumers commonly do not pay a fee to use a referral agency and do not sign a contract with it.
Is A Place for Mom free for families?
Yes. A Place for Mom says on its own site that it is paid by its participating communities, so its service is offered at no charge to families. The community the family moves into pays.
When is a placement fee due?
After the move-in. The California analysis describes a fee paid if a referred resident moves in, and agents bill the home once that happens. A family that tours and chooses somewhere else costs the home nothing.
Are senior placement agencies regulated?
Lightly, in California at least. The Assembly's 2018 analysis said that because of the relative lack of regulation, it is difficult even to estimate how many referral agencies operate in the state. Rules differ in every state, so check yours.
How much is one placement fee at my rate?
Multiply your monthly rate by the percentage in the contract. At $6,200 a month and a fee of one month, one placement costs $6,200. At 150 percent it costs $9,300. The calculator on this page runs your own numbers.