When you’re searching for the right nursing home, assisted living or other senior living option, there are many questions and many decisions to be made. Many families turn to elder care referral services for help. While it may appear that these companies strive to ensure quality care and treatment for the elderly, recent reports suggest that it’s all about the money.

The elder care referral industry is very lucrative–a multimillion-dollar one, to be exact. A referral company can earn thousands of dollars for every senior placed in a facility. A referral company in Washington state, for example, may earn over $3,000 for one referral. Until recently, elder care referral companies were unregulated. In 2011, Washington became the first state to start regulating elder care referral businesses. It is expected that other states will follow suit as these companies come under more scrutiny.

Referral services are free, but the companies earn a commission from nursing homes and other facilities that are contracted with them. Therefore, unless you properly vet the facilities yourself, you cannot be certain of the quality of care they provide. The Seattle Times published an investigative report in 2010, which uncovered that elder care referral companies were referring seniors to facilities with histories of providing substandard care. Improper practices included locking residents with dementia in rooms to keep them from wandering, drugging mentally ill adults to control them and leaving bed-bound seniors without assistance for up to 16 hours.

Elder care referral companies can point you in the right direction when you’re looking for the best living option, but you should still do your own research to make sure the facilities they recommend are as good as these companies claim they are.