The first part of the answer to that question is that bed bugs are as new to today's generation of pest management professionals as they are to the American public. As a result many of the pest management firms are still trying to figure out how to effectively deal with bed bug infestations. In fact most pest control technicians have never even seen a bed bug, let alone treated for them. It is difficult to find a company that is very experienced and really understands how to effectively manage bed bug infestations. Companies that are quick to offer a guarantee that they will eliminate or "solve" the problem in one or two visits may not really understand what they are up against. Of course consumers are likely to prefer a company that is confident that they can solve the problem in one or two visits compared to a company that explains that elimination cannot be guaranteed, and that it may take three to four visits or possibly more to resolve the problem. However, the later company probably has a better understanding of the pest and in the long run is probably better equipped to deliver a higher level of control. The consumer really needs to be very aware that it is very difficult, and sometimes impossible to eliminate 100% of the bed bugs in a dwelling.
Clutter is probably the single biggest obstacle that stands in the way of control. Closets that are filled with belongings, items stored beneath beds or furniture, piles of clothing or other items on the floor, etc. all provide an unlimited number of hiding places for bed bugs. In addition, clutter creates areas that cannot be effectively treated by your pest management professional. The more clutter, the longer it will take to gain control. In the case of very cluttered conditions, control may be impossible. For this reason control is much more easily achieved in a hotel room which is not permanently lived in as compared to an apartment or single family home.