The "Do's" and "Don'ts" of Nursing Home Contracts

You need to understand the nursing home admission agreement you are signing. It is essential to know the level of caregiving provided, the quality of room and care facilities, and any disclaimers in the contract.

Considering a nursing home for your loved one can be difficult for any family member. Many long-term care and assisted living options are available, but not all providers are created equal. Federal and some state laws set standards for clean and skilled nursing facilities, but standards or mistreatment can still occur.

To-Do's and Checklist for Nursing Home Contracts

Nursing home residents will deal with staff members, rooms, meals, and facilities while in an assisted living facility. The following topics are essential to review in your admission contract.

Basic Daily Rates

First, you should ensure that the agreement includes a clear statement of what services the home's basic daily rate includes. The contract should include a list of charges for items not included in the basic daily rate.

Medicare and Medicaid Planning

Residents should have the right to apply for Medicare/Medicaid and the right to appeal. Ensure the home's "bedhold policy" meets Medicare and Medicaid requirements.

Eviction or Removal From a Nursing Home

Make sure you understand what the contract says about a resident leaving the facility. Being evicted or forced to leave should apply only if:

  • It is necessary for the resident's welfare
  • The resident's health has improved such that nursing home care is no longer required
  • The health or safety of other individuals is endangered
  • The resident unreasonably fails to pay
  • The facility ceases to operate

Room Changes or Room Moves

The contract should also address how decisions will be made regarding moving the resident to a different room.

You may be paying extra for a certain sized room or certain window views. You also pay for a semi-private or private room. The contract should not allow for substitutions or room moves without your knowledge.

Have an Attorney Check The Admission Contract

Always ensure your attorney reviews the contract before you or the resident signs it.

Don't Do These Items When Signing a Nursing Home Contract

From payment to liability to waivers — there are many loopholes or shady practices you need to look out for on a nursing home admissions contract.

Payment and Income Accounts

You should not sign the contract as a guarantor or "responsible party" unless you intend to pay for the resident's care. Watch out for language that calls you the "resident representative" or "agent."

The contract should not include a provision requiring the resident to deposit all income directly into an account controlled by the nursing home.

Do not agree to a requirement of private-pay status or other up-front money if a resident is eligible for Medicaid.

Liability for Injuries or Property

Don't agree to a limitation on the home's liability if the resident is injured. Along those same lines, you should not agree to a limitation on the home's liability for the resident's personal property.

Agreeing to any of these items will waive your loved one's rights.

Visiting Hours

The contract should never include a clause restricting visiting hours.

Medical Procedures and Estate Planning

The contract shouldn't' include a provision requiring the applicant to:

  • Consent to medical procedures
  • Have a living will or health care directive
  • Have a health care power of attorney

Questions? Talk With an Attorney

You can try negotiating with a nursing home facility on some of these issues, but it's often beneficial to have an advocate on your side. Contact an attorney if you are unsure about a contract or any other older adult law concerns.

Can I Solve This on My Own or Do I Need an Attorney? 

  • For situations involving contracts, it’s best to ask an attorney their opinion
  • Cases with legal documents are rarely cut and dry
  • Get customized advice and ask your legal questions
  • Many attorneys offer a free consultation

 If you need an attorney, find one right now