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

Understanding the nursing home admission agreement you (or your loved one) are signing is important. Before you sign an agreement, make sure to note the level of caregiving that it will provide. Also, look at the quality of the room and care facilities, the long-term care costs, and any disclaimers or arbitration clauses in the contract.

Long-term care planning for you or your loved one is stressful, and considering a nursing home is difficult for any family member. Many long-term care facilities and assisted living options are available, but not all providers are equal. Federal and state laws set standards for clean and skilled nursing facilities, but standards or mistreatment can still happen. Here are some things to consider before signing a nursing home agreement.

Checklist for Nursing Home Contracts

Nursing home residents will deal with staff members, rooms, meals, and facilities 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 charges for items not included in the basic daily rate. It is also important to consider whether the services provided by the nursing home's basic daily rate address the special needs of you or your family member.

Medicare and Medicaid Planning

Residents have the right to apply for Medicare and Medicaid and appeal an eligibility denial. Ensure the home's bed hold policy meets Medicare and Medicaid requirements.

Eviction or Removal From a Nursing Home

Ensure 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 people is endangered
• The resident unreasonably fails to pay
• The facility closes

Room Changes

The contract should also address how the facility will decide on moving the resident to a different room.

You may have to pay extra for a certain size of room or window views. The contract should not allow for substitutions or room moves without your knowledge and consent.

Have an Attorney Check the Admission Contract

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

What Not To Do When Signing a Nursing Home Contract

From payment to liability to waivers — there are many loopholes or shady practices you must look out for when signing 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. Also, 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 an advanced directive such as 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 legal issues, but having an advocate on your side is often helpful. Contact an experienced elder law attorney if you are unsure about a contract or need legal advice on other elder law concerns.

Find Help for These Areas:

• General Older Adult Law
• Older Adult Health Care
• Nursing Home Abuse