Nursing home admission usually happens fast, often right after a hospital discharge, with a stack of paperwork placed in front of an exhausted family member. Admission agreements are legal contracts, and some of the clauses inside them deserve a second look before anyone signs.
Clauses about who is financially responsible
Federal law prohibits nursing homes from requiring a third party, such as an adult child, to personally guarantee payment as a condition of admission. Despite this, some admission agreements still include language asking a family member to sign as a "responsible party" or "designated representative," worded in a way that can blur the line between simply agreeing to use the resident's funds appropriately and personally guaranteeing payment. Family members should read this section carefully and consider having it reviewed before signing anything beyond what's legally required.
Arbitration clauses
- Many admission agreements include a binding arbitration clause, requiring disputes, including those involving injury or neglect, to be resolved through private arbitration rather than a court lawsuit.
- In many cases, arbitration agreements are optional and cannot legally be a condition of admission, even if they're presented as standard paperwork.
- Families should ask directly whether the arbitration clause is mandatory for admission or a separate, optional agreement, and should feel free to decline the optional version if they prefer to preserve court access.
Discharge and eviction provisions
Admission agreements typically describe the circumstances under which a resident can be discharged or transferred, and these should align with the specific, limited grounds allowed under New York and federal nursing home regulations. Families should watch for language that seems to give the facility broader discharge discretion than the law actually allows, and should know that residents and families generally have a right to receive notice and to appeal a proposed discharge.
Clauses about Medicaid application cooperation
Some agreements include language obligating the family or responsible party to cooperate with, or complete, a Medicaid application within a certain timeframe. While facilities have a legitimate interest in ensuring bills get paid, families should understand exactly what they're agreeing to do and by when, and should coordinate this with their own Medicaid planning rather than treating the facility's timeline as the only relevant one. This is a good moment to review our Medicaid planning services and make sure the family's broader strategy, not just the facility's paperwork, is driving decisions.
Autopay and financial account access clauses
Some agreements ask for automatic payment authorization directly from a resident's bank account. Families should think carefully about whether this makes sense given who holds power of attorney and how the resident's finances are otherwise being managed; our power of attorney guide covers how a properly authorized agent should be handling these kinds of financial arrangements.
Slow down before signing
Admission day is stressful, but an admission agreement is a binding contract, and most facilities will allow at least a short period to review it, even if they don't advertise that option. Whenever possible, have a family member, or an elder law attorney, review the agreement before it's signed, and don't feel pressured to sign optional provisions on the spot.
If you're navigating a nursing home admission and want a second set of eyes on the paperwork, or want to plan ahead of a future admission, contact us for a free consultation or call +1 212 518 3868.
