The services provided by a skilled nursing facility are very important. They are also very expensive. The person who arrives at an elder law office with a bill from a nursing home for $19,400—$646.66 per day—is often the same person who signed an electronic version of an admissions form without knowing what would happen.
This is one of many ways people are held responsible for loved ones’ nursing home bills, according to the recent article “Should you sign a nursing home admission agreement?” from The Bristol Press. The stress of having a loved one admitted to a nursing home is an overwhelming experience, usually taking place at the same time you’re managing all the details, just when someone from the nursing home very politely and usually firmly tells you “these papers” must be signed immediately.
It's important not to rush in this situation, because the agreement could contain illegal or misleading provisions. Try not to sign the agreement until after the resident has moved into the facility, when you may have more leverage. However, even if you have to sign the agreement before the resident moves in, have the agreement reviewed by an experienced elder law attorney and request that any illegal or unfair terms be deleted. Don’t take the nursing home’s word that they cannot do so.
Two terms to pay close attention to:
Responsible Party. The nursing home may try to get you to sign the agreement as the “responsible party.” Don’t do it. Nursing homes are legally prohibited from requiring third parties to guarantee payment of nursing home bills. However, there are some who try to get family members to voluntarily agree.
If at all possible, the resident should sign the agreement themselves. If the resident is incapacitated, you may sign but must be clear you are signing as the resident’s agent. Read carefully for terms like “guarantor,” “financial agent,” or “responsible party.” Before signing, you can cross out any terms indicating you are responsible for payment and clearly indicate you are only agreeing to use the resident’s income and resources to pay and not your own.
Arbitration Provisions: Many nursing home agreements contain provisions stating that all disputes regarding the resident’s care will be decided through arbitration and remove the ability to take the nursing home to court. This is not an illegal provision, although many feel it should be. Most people do not know they cannot be required to sign an arbitration provision. Cross out any language regarding arbitration before signing the agreement.
Private Pay Requirement. It is illegal for the nursing home to require a Medicare or Medicaid recipient to pay the private rate for a period of time, nor may the nursing home require a resident to affirm whether they are not eligible for Medicare or Medicaid.
Eviction Procedures: It is illegal for a nursing home to evict a resident for any reason other than the facility cannot meet the resident’s needs, the resident’s health has improved, the resident is endangering other residents, the resident has not paid, or the nursing home is closing.
Speak with an elder law attorney before facing the complexity of a nursing home admission agreement. The patient and their loved ones have rights to be protected.
Reference: The Bristol Press (Aug. 15, 2022) “Should you sign a nursing home admission agreement?”
Suggested Key Terms: Medicaid, Medicare, Nursing Home, Resident, Guarantor, Financial Agent, Arbitration, Private Pay, Responsible Party, Eviction, Admission Agreement, Elder Law, Estate Planning Attorney
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