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Nursing Home Admission Agreements


Admission to a nursing facility is stressful not only for the resident, but for the family or friends who assist in the admission process. Many decisions and disclosures must be made and many forms and documents signed. The unfamiliar language of the documents and feelings of urgency add to the pressure.

The admission agreement is a binding contract between the facility and the signer. It is regulated by Ohio Law. The facility's policies regarding transfer, discharge and provision of services must be identical for each resident, regardless of the payment source. The admission agreement should include all the rights and obligations of the resident and the facility. It should be easy to read in bold, clear, 10 point type. Do not hesitate to question or clarify any provision in the contract, but be aware that it is the words in the document that are binding, not what you are told by the admissions director. Additions or clarifications should be made a part of the document.

The agreement should contain a description of the basic services provided as well as any ancillary (extra) services such as pharmacy, beautician and personal comfort items. Payment rates, deposits and refunds should be disclosed as well as the facility's policies regarding bed-hold days (when a resident is hospitalized or otherwise out of the facility), advance directives and rights regarding personal property.

Sometimes the admission agreement makes the signer a “guarantor” or “responsible party” meaning he or she must pay the resident's bill if the resident fails to pay. Be aware that federal law makes it ILLEGAL for a nursing home to require a third party (other than the patient's spouse) to guarantee payment as a condition of admission, expedited admission or continued stay at a facility. This law applies to any nursing home that accepts either Medicare or Medicaid.

If possible, the resident should sign the admission agreement. If someone else signs, it should be done in his or her capacity as guardian or power of attorney.

Residents in a nursing home have certain rights regarding their care and treatment. These rights are guaranteed under both federal and Ohio law. During the admission process, the facility must inform the resident both orally and in writing of his or her rights and all the rules governing the resident's conduct and responsibilities. The resident must be advised as to how to contact resident's rights advocates who will assist any resident who feels his rights have been violated.

The agreement should not attempt to have the resident waive any of his rights or shift away the facility's obligation to protect the resident or his property. This includes agreements that require the resident to submit his claims or grievances to binding arbitration while allowing the facility to choose to pursue claims against the resident either through a court of law or through arbitration.

Before signing an admissions contract, read it carefully. Have your attorney review the contract if you don't fully understand it. If you agree to changes, be sure they are written into the contract and all blanks are filled in before you sign.

If you are a member of a Health Maintenance Organization (HMO) or other insurance plan, consult with a representative regarding coverage. If you have Long Term Care Insurance, contact the company before admission to be sure of coverage. If you expect any part of the care to be covered by Medicare or Medicaid, be certain the facility you have chosen is certified and the level of care to be received is qualified.

The time to understand and negotiate a contract is before it is signed. Be sure you know exactly what you are agreeing to. Once a contract is signed it is binding, both to the resident and the facility. Although nursing homes occasionally update their admission agreements, the resident is under no obligation to agree to any change to the terms of the original contract.

If you have questions about the specific language in any contract, contact your attorney.

Prepared By:
Marta J. Williger
Attorney at Law
323-C South Main Street
P.O. Box 368
Munroe Falls, Ohio 44262
(330) 633-7373