Tips for Nursing Home Admission Agreements

Common Concerns with Agreements:

Concern: Some nursing home admission agreements assume that certain injuries are inevitable.  They limit the care for the resident and force the resident to hire private duty caregivers.

Response: Federal law requires the nursing home to provide the care necessary to reach the highest practicable level of function regardless of the resident’s care needs or financial resources. Skin breakdown, dehydration, wounds, weight loss can be prevented with a proper care plan.  Delegating the care obligation to the resident or family is not permitted.

Concern: Limiting visits to certain hours.

Response: Nursing home residents have the right to be visited by family at any time of day.  A resident, does however, have the right to refuse visitors.

Concern: Nursing home admissions agreement limits liability for injuries to a resident or for resident’s personal items that are stolen or lost.

Response: A resident or agent should not agree to these provisions and does not have to.

Concern: Nursing home admissions agreement requires disputes to be arbitrated and gives up the right to a jury trial.

Response: Do not agree to this provision.  The previous administration had restricted these types of clauses in nursing home admissions documents but the U.S. Supreme Court has allowed them in admissions agreements.  This is a contract and you do not have to agree to every provision in the contract.

Concern: Nursing home admission agreement authorizes discharge for being difficult or uncooperative.

Response: Any provision that allows this should be stricken. A nursing home should have the ability to discharge a patient that poses a serious risk to the safety of other residents or staff but not for some ambiguous, undefined lack of cooperation.

Concern: Nursing home admission agreement requires a financial guarantor.

Response:  No nursing home agreement should require a family member to guarantee the bill of the resident.  It is reasonable for the nursing home admission agreement to have the family member use all assets of the resident (excepting any resources protected by Medicaid) for the care of the resident and cooperate in accessing public benefits.

Remember, most nursing home admission agreements are signed after the resident has been admitted.  This gives you a bit more leverage in striking inappropriate provisions.

In Pennsylvania every long term care facility should have the contact information for the Long Term Care Ombudsman, who is associated with the Area Agency on Aging.  The Ombudsman tries to address complaints about the facility.  They can also act as a mediator to address concerns before you hire an attorney or file a complaint with the Department of Health.