The Napa Valley Alliance on Aging will meet on Tuesday, June 12, noon, at 3448 Villa Lane.   The topic will be "Referral Agencies,  The Who, What, When and Why,"  and a panel of representatives from various agencies will present.  

Referral agencies are businesses  contracting with home care agencies, board and care home, assisted living and other senior living facilities to steer older adults towards those facilities when people are discharged from nursing homes or hospitals.  Fees are collected from the facility for the referral, often ranging between 80-120 percent of the first month's rent.  In Napa Valley, the average room rate, per month, ranges between $3,000-5,000.   Currently, there are 37 such retirement home in Napa County.   About 26 home care agencies  are operating  in Napa County. 

"Senior care is the only industry that actually has a separate business entity specifically paying for one business giving business to another," said Napa Valley Alliance on Aging President, Yvonne Baginski.    "We want to know more about this business model."

Currently, there is no requirement for a license or registration for this type of business, and many home care agencies have also incorporated placement for referral fees into their business model.  The service is "free" to the public, since fees are collected by the contracting entity when placement is completed.

"Referral agencies often work directly with families in finding the best match for the care needed, but sometimes the match may be contingent on whether a contract is in place, and the business relationship between the two entities," said Baginski. "There have been several attempts to pass legislation to regulate the referral agencies in California, but the bills have failed to progress."

At this time, the Alliance has identified 11 referral agencies doing business in Napa Valley.   There are also online referral agencies, regional agencies and one-person operations that are difficult to track.

"Basically, anyone can put together a contractual promise that if they bring business to a particular retirement home, they will be paid a fee," said Baginski.  "Older adults needing care are a  commodity to home care and assisted living facilities and discharge planners are incentivized to move them out of hospitals and nursing homes as soon as their medical insurance no longer authorizes care.  Sometimes people have less than 24 hours to find a place to live, or home care...that's when a referral agency might be called in to help."

The issue came to the attention of the Alliance on Aging a few months ago when a local retirement home sent out a mass email to senior care businesses promising $750  for each move-in referral.

While we are somewhat familiar with the protocols for referral agencies, this retirement home was asking anyone for a move-in referral, and they'd pay for it.   For the Alliance members, it brought up the question of the ethics of money changing hands for any referral, said Baginski.  "Many professions have established guidelines around this issue and anyone receiving money from Medicare (Hospices, home health agencies, for example), are strictly prohibited from paying for referrals.   This is a gray area, without much transparency."

The Napa Alliance on Aging meets the 2nd Tuesday of each month at noon at 3448 Villa Lane.  Anyone interesting in older adults and the business of caring for people is encouraged to attend.

More information, 226-7127.

Past dates

Download schedule


  • Starting Tuesday, February 12th, 2019, repeated every month on the 2nd Tuesday until Monday, March 11, 2019 @ 12:00 pm – 1:00 pm


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