Nursing Homes

Part 3

Understanding the
Contract
When you enter a nursing home, you must sign a contract with the facility. It is important to read the contract closely and to do so before the day of admission. The contract sets out all of your costs and all of the nursing home’s responsibilities. You or your family members or friends who are helping you with the transition need to read and understand it. If you were promised something that is not in the contract, you need to insist that it be added in writing. The contract should include information about:

-The basic daily or monthly charge and what it covers (optional services should have pricing listed as well.
-Additional charges;
-Your right to apply for Medicare or Medicaid;
-When, how and why you can’t be transferred to a different room at the home;
-Any special diets you may need;
-Refund policy; and,
-Reasons for discharge.

You are one who will be signing the documents. Your family members will only be signing if they have power of attorney for you. Sometimes the nursing home might tell the family they need to sign as a guarantor or to indicate that they are next of kin or the responsible person to contact. This is unnecessary and they should not sign unless they are willing to take on financial responsibility for your bills.
The Nursing Home Reform Act is a federal law that governs nursing homes. The law lists some things that may not be included in a nursing home admission contract. On e of the important things included in the law is a restriction on discharges from the home. You can only be made to leave if:

-It is necessary for your welfare because the facility cannot meet your needs;
-Your health improves so that you no longer need to remain there;
-You endanger the safety or health of other residents;
-You do not pay; or
-The home closes.

Make sure the contract explains it bedhold policy. If you have to temporarily leave the nursing home (for example, for a hospital day) the facility can charge a fee to hold your bed until you return.
Be on the alert for contracts that:

-Limit the homes liability for damages or theft of your belongings;
-Require that the residents give all of his or her income to the facility directly;
-Have restricted visiting hours;
-Require a consent form for unneeded medical procedures as a precaution;
-Require a living will or health care proxy; or
-Require you to pay even though you are eligible for Medicaid.

NOTE: Be aware that the facility is always responsible for negligence (failing to use appropriate care to prevent harm) no matter what you sign. Some contracts may contain provisions asking you to limit their liability or to waive the right to sue. Do not sign these types of contracts.