Nursing Home Admissions- Things to Look Out for Before Signing the Agreement

The nursing home admission process can be immensely stressful for both the prospective resident and her family. During this difficult period, it is easy for the parties to overlook the complex language of the nursing home admission agreement. This, however, would be a mistake. The agreement is legally binding on the signor, creating serious financial obligations to the nursing home. Careful review is necessary to ensure that the resident’s legal and financial interests are protected.

The Ohio Department of Aging has warned families against unlawful or unfair provisions in admission agreements. Often, these documents are outdated and do not meet the current legal standards. Common problems include:

1.) The Agreement limits the care a resident can receive – Under the Nursing Home Reform Act, a nursing home must provide all the care necessary for the resident to reach “the highest practicable level of functioning.” This applies even if the resident’s needs are great. A nursing cannot limit a resident’s care, nor can they require the resident to hire a private caregiver.

2.) The agreement claims that visits are allowed only during certain hours – A nursing home cannot restrict a family member’s access to the resident. Family visitations are an important social outlet for the resident, and the nursing home must permit them at all hours.

3.) The agreement states that the resident may be evicted for being difficult or uncooperative – Federal law restricts a nursing home’s ability to discharge a resident. They may do so only when the discharge is necessary because: (1) the resident’s needs cannot be met at the facility; (2) the resident no longer needs the services provided by the nursing home; (3) the safety or health of individuals at the facility is endangered; (4) the resident has failed to pay or to apply for Medicaid assistance; or (5) the nursing home ceases to operate.

4.) The agreement makes a family member or friend a “responsible party” – As a matter of law, a nursing home cannot require a third party to guarantee payment as a condition of admission. But, if the third party has legal access to the resident’s income or access (e.g. a power of attorney or legal guardianship), the nursing home can stipulate that the third party must sign the admission agreement before the resident is admitted. Under this circumstance, the third party should indicate in writing that they are signing as the resident’s agent to avoid personal liability for the cost of care.

When reviewing an admission agreement, do not hesitate to ask about ambiguous terms or provisions. If necessary, have an attorney scrutinize the document and identify problematic terms, such as an arbitration provision or a liability waiver.

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