In this short 23 minute podcast, special guest Ron Passaro talks with Moti Gamburd, CEO of Raya’s Paradise about the placement agency’s role in selecting the right senior living or assisted living residence for your loved one.
Moti Gamburd
In today’s discussion, I would like to talk about senior living in Los Angeles. We all have old parents, grandparents or someone that will sooner or later need assistance with placing their loved ones in a senior living community and I know that’s your specialty.
Moti Gamburd
Tell us a little bit about what a senior living placement agency is? How does it work?
Ron Passaro
We help guide the family through the process of identifying the best senior living options in Los Angeles for their loved one, and that involves many different elements like:
- How old they are?
- What their condition is?
- Do they have dementia?
- Where do they live?
- What their budget is?
- What type of person they are?
I help them through everything that they will need before they move in because families many times are looking for the wrong things when they call me. My objective is to identify what type of person they are and how I can best assist them.
It’s their choice, but my objective is just to give them the 3 best options to choose from. It might be more than 3 if the family is going back and forth between a good board and care home and a large assisted living community because they’re not clear on the differences between them.
Moti Gamburd
How do you categorize senior assisted living compared to residential board and care homes in Los Angeles?
Ron Passaro
Hospitals at the highest level of care, and right below that is skilled nursing homes and rehab facilities. And then right below that is a residential board and care home. So, smaller board and care homes can often give residents more care and attention than assisted living communities that are larger.
Assisted living communities might be anywhere from as small as 20 to 40 residents to as high as 150 or more. So those are more geared for people who can get around with a walker or a wheelchair. The ones that benefit the most from assisted living communities enjoy the amenities or the activities such as eating in a dining room, going and watching a movie, having a discussion, or going on an excursion.
Residential board and care homes will still have interaction and social activities, but they can offer a much higher level of care to someone who is bed-bound or someone who has advanced dementia and needs to be monitored if they are a fall risk.
Moti Gamburd
Don’t large-scale assisted living facilities have a memory care unit on their grounds?
Ron Passaro
They do but the ratio of their staff to the residents is much lower. If there are 30 residents in a memory care facility, the ratio might be 8 to 1. In a good residential board and care home it’s going to be 2 or 3 to 1. If there are 6 residents you’re going to have 2 or 3 caregivers during the day and then 1 at night that’s awake and constantly monitoring them. This is very important if they have dementia and are at risk for falling.
Moti Gamburd
So how long have you been doing this?
Ron Passaro
Ten years. We’re in our tenth year.
Moti Gamburd
So, in the last ten years that you’ve been an assisted living placement specialist, can you share with us what kind of mistakes families or loved ones do when they search for a facility if they do not use a senior living placement agency like yours?
Ron Passaro
Excellent question. I would say 95% of the time when a family or an individual is looking for some sort of assisted living, the main factors they focus on are:
- Is it convenient and where is it located?
- Can we afford it?
These things are relevant and important, but I always like to describe it as spokes on the wheel. They’re not the wheel. When they come to a placement agency like ours, what we do is we first start with:
- Who is the person, the resident, the loved one in need?
- What type of care do they need so that they can be well cared for and safe?
Number one is what care and safety is needed? And number two, what type of environment will they be happy in?
Our motto is always; “if a person is well cared for and happy, they will thrive.”
So, in our process we start with the care level and the environment, and then we worry about how close can we get it to where their family wants it to be. Almost 100% of the time when families call me that I didn’t originally help, and their loved one is in a facility that’s wrong for them, it’s a place that was very close to where they lived.
Moti Gamburd
Who reimburses for your senior living placement service? It’s not the family, is it?
Ron Passaro
No, it’s free of charge to the families. We cover a very big part of the San Fernando Valley, the Westside of Los Angeles, and the South Bay and we have over 800 agreements so we are objective. We’re not funneling them to just a few places that we work with. If we help the family choose the place and their loved one moves in, then that facility pays us a referral fee.
Moti Gamburd
What happens if you have a potential resident who needs placement and the family has found a place, let’s call it facility ABC. You do not have a contract with ABC, but the facility fits the level of care and suits the potential resident just right. However, you do not have a contract with them. You will not refer to the facility, will you?
Ron Passaro
In that hypothetical situation, what we’ve done is we call them and say, “I’d like to come to look at your facility. I don’t have an agreement with you but I want to preview it for the family.” And if they don’t want to give me an agreement, I have given the family my blessing to go there because it is the best place for their loved one. My reputation is much more important than anyone placement.
Moti Gamburd
So, you would refer?
Ron Passaro
I would.
Moti Gamburd
I’m just trying to make sure people understand how this industry works because 99% of people do not know how it works.
Ron Passaro
It’s a very good question because there are a lot of agencies that do not have wide coverage in certain areas and they will funnel them to a few places that they work with when the best senior living community might be just outside of that small service radius or one that they do not have an agreement with.
Moti Gamburd
You say you have 800 agreements with senior living communities in Los Angeles?
Ron Passaro
Yes, over 800 active agreements currently.
Moti Gamburd
So how often do you visit those 800 places?
Ron Passaro
When families call me, we go through our database based on:
- The care the person requires
- The location
- The budget
- The environment
Then I will visit the board and care or assisted living facility if I haven’t seen it. I have not seen all 800 but I would say I have seen well over 700 In the past 10 years. Any place I haven’t seen I typically will run out ahead of time and go see it. Board and care homes open up all the time and I will run out and go look at it.
Moti Gamburd
You make sure to check them out before you will send a family out?
Ron Passaro
Absolutely, because I want to see that what they’re representing to me is true or not.
Moti Gamburd
That leads me to the next question, can you educate us about the difference between a referral agency and a senior living placement agency?
Ron Passaro
Yes, excellent question. With a referral agency, their objective above all else is to get paid what’s called a referral fee. With a referral agency, there’s typically no telephone or in-person engagement. With a referral agency, it’s usually done over the internet and the family will fill out a form online, and then they will receive a list of sometimes as many as over 25 different options. It can include senior living communities, board and care homes, and sometimes even skilled nursing facilities so the families get very confused. But the reason they’re getting that long list is to cover the bases so the referral agency can earn their referral fee.
The problem with that is that it’s not personal and possibly there’s a better option outside of their exclusive service area. A senior living placement agency like the Passaro Group will take more time to learn more about the resident and their personal needs.
We do an intake process with the family member and the loved one to determine what type of person they are, where they live, what their budget is, and what type of care they require.
Then we review all the possible options and narrow it down to the best three options in order to guide them through the entire process from the beginning to the end to the placement.
Moti Gamburd
How do you make sure that the information you’re receiving is the true picture?
Ron Passaro
Very good question. So now of course we’ve had to reinvent the wheel with Covid since everything is now being done with Facetime and Zoom. During this intake interview sometimes it’s the smallest thing you observe with the resident where something clicks and I realize “oh, this is the level of care they need”.
I met him a man once years ago. He was on a very limited budget and I went to his apartment and he had dominoes all over his table. “Oh, you love to play dominoes?” At the time I knew of a community where I always saw guys playing dominoes. That’s all it took when he moved in there for him to be happy – the Dominoes.
You always have to advocate first for the individual that you’re trying to help and then go from there. I always tell families to think from the perspective of what their loved one is going to experience when living in the community or boarding care home from the inside out. It’s not just about location. I have hundreds of families driving half an hour or more to places, gladly, because their loved one is thriving in that community.
Moti Gamburd
Is there anything else that would you would like to share?
Ron Passaro
I got into this business ten years ago when my father-in-law had a procedure at the age of 87 and then he was bed-bound and we had to find assisted living for him. That process is what opened my eyes to the need for a good senior living placement agency in Los Angeles.
We actually engaged with a referral service back then and it was no help at all. That’s why we started the Passaro Group, where we always advocate for the resident first and then everything else.
Moti Gamburd
Well thank you very much Ron, it was very useful very informative and very educational, and hopefully, people will utilize this information for their own good when they need it.
Ron Passaro
Thank you it was my pleasure being here.
