Should you sign a nursing home admission agreement?

Published on Monday, 15 August 2022 14:27
Written by Attorney Daniel O. Tully


CBS Mornings program recently carried a segment on family members and friends being held responsible for their loved one’s nursing home bills. 

I had a client come into my office this week with a bill from a nursing home.  The total bill for one month was $19,400.  That is $646.66 per day for those of you keeping score at home.

The services provided by a skilled nursing facility are expensive. It is extremely important that you are very careful in what you or a loved one sign regarding the financial responsibility to a skilled nursing facility.  That same client indicated to me that they were asked to sign an electronic version of an admission agreement.  The client signed electronically without even thinking that the admission agreement was legally binding.   IT IS!  

Admitting a loved one to a nursing home can be very stressful.  In addition to dealing with a sick family member and managing all the details involved with the move, you must decide whether to sign all the papers the nursing home is giving you.  Nursing home admission agreements can be complicated and confusing, so what do you do?

It is important not to rush, but rather to read.  Read the agreement carefully because it could contain illegal or misleading provisions.  If possible, try not to sign the agreement until after the resident has moved into the facility.  Once a resident has moved in, you will have much more leverage.  But even if you have to sign the agreement before the resident moves in, you should still request that the nursing home delete any illegal or unfair terms.

Two items commonly found in these agreements that you need to pay close attention to are a requirement that you be liable for the resident’s expenses and a binding arbitration agreement.

Responsible party

A nursing home may try to get you to sign the agreement as the “responsible party.”  It is very important that you do not agree to this.  Nursing homes are prohibited from requiring third parties to guarantee payment of nursing home bills, but many try to get family members to voluntarily agree to pay the bills.

If possible, the resident should sign the agreement him or herself.  If the resident is incapacitated, you may sign the agreement, but be clear you are signing as the resident’s agent.  Signing the agreement as a responsible party may obligate you to pay the nursing home if the nursing resident is unable to pay.  Look over the agreement for the term “responsible party,” “guarantor,” “financial agent,” or anything similar.  Before signing, cross out any terms that indicate you will be responsible for payment and clearly indicate that you are only agreeing to use the resident’s income and resources to pay.

Arbitration provision

Many nursing home admission agreements contain a provision stating that all disputes regarding the resident’s care will be decided through arbitration.  An arbitration provision is not illegal, but by signing it, you are giving up your right to go to court to resolve a dispute with the facility.  The nursing home cannot require you to sign an arbitration provision, and you should cross out the arbitration language before signing.

Other provisions

The following are some other provisions to look out for in a nursing home admission agreement.

Private pay requirement.  It is illegal for the nursing home to require a Medicare or Medicaid recipient to pay the private rate for a period of time.  The nursing home also cannot require a resident to affirm that he or she is not eligible for Medicare or Medicaid.  

Eviction procedures.  It is illegal for the nursing home to authorize eviction for any reason other than the following:  the nursing home cannot meet the resident’s needs, the resident’s health has improved, the resident’s presence is endangering other residents, the resident has not paid, or the nursing home is ceasing operations.  

Find a qualified elder law attorney near you who can help you review an agreement.

Attorney Daniel O. Tully is a partner in the law firm of Kilbourne & Tully, P.C., members of the National Academy of Elder Law Attorneys Inc., with offices at 120 Laurel St., Bristol. 860-583-1341 or

Posted in The Bristol Press, Bristol on Monday, 15 August 2022 14:27. Updated: Monday, 15 August 2022 14:30.