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#10 - Contracting for Nursing Home Services

Updated: Jun 30, 2022

One of the most stressful situations for a caregiver is having to sign the admission’s contract for a parent with a Skilled Nursing Facility. The document is long, has chapters, sections, and exhibits. Every other page mentions “waiver” of this and that. The admissions person is eager to get the new resident signed in. The family may feel pressure to commit. The admissions person presents the signing pages one after another and directs “sign here and here.” The caregiver is filled with doubt, but almost always complies.


When faced with this scenario, start by taking a deep breath. Ask politely for a full and complete copy of the contract for your Elder Law Attorney to review prior to execution of the contract. It is well worth the fee.


What are some of the issues of concern? The first is, who is the financially responsible party under the terms of the agreement? It is quite common for the document to use vague language that leaves open to interpretation whether the Power of Attorney (“Agent”) for a disabled parent signing the contract is agreeing to be personally financially responsible. This uncertainty is created by the headings for various signature lines and the associated definitions for each heading: “Resident,” “Financial Responsible Party,” “Responsible Party/Designee,” “Guarantor” just to name a few.


The rules for navigating through the signature pages are: (1) the parent is the resident, the responsible person, and the financially responsible party; (2) the Agent is never the financially responsible party; and (3) when signing for the parent, the Agent should sign as follows: “parent’s name, by Agent’s name, POA”. The Agent, when signing as the parent’s legal representative or designee should add POA after their name. With respect to financial obligations, the Agent has a duty to pay the parent’s bills with the parent’s money. Any language that directly or indirectly seeks to make the Agent the guarantor of the parent’s financial obligations violates state and federal law and the Agent should refuse to sign such a provision.


So, reviewing and signing a contract with a nursing facility is complicated and has far reaching consequences. Hire an Elder Law attorney to review the document with you before signing it. It is your and your parents’ right, and the facility knows this.



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