Elderly who are single or without relatives often struggle to secure spots at nursing care homes because they lack a guarantor, despite government warnings against such tactics, a survey showed Monday.

According to the state-commissioned survey, about 30 percent of respondents said they will not accept people without a personal reference or guarantor. The study was conducted in December by Mizuho Information & Research Institute Inc., and 4,900 care facilities were approached nationwide.

The ratio remains almost unchanged from a 2013 survey conducted by another private organization, despite the government notifying the facilities in 2016 that such refusals are unjustified.