Nursing Home Contracts and the Elderly: More About Admission Agreements

Admission Agreements are introduced in an earlier blog entitled Nursing Home Agreements and the Elderly.

What Else Do You Need to Know About Admission Agreements?

  • Carefully review the house rules and policies. Pay special attention to policies that might impact your lifestyle choices, such as restrictions on leaving the facility, or your quality of life, such as quiet hours, times to go to bed, whether there are set or flexible meal times, etc.
  • Visiting policies should be designed to encourage the involvement of family and friends. Will the stated policies meet your needs? Is there any flexibility in how policies are interpreted and implemented?
  • The facility cannot require a resident to use a particular pharmacy or medical supply provider.
  • An increasing number of facilities are including legal language to protect the facility’s liability in their Admission Agreements. One is a requirement to arbitrate all disputes. This can eliminate the resident’s right to take appropriate legal action such as filing a lawsuit in the event of abusive practices.

When Does the Admission Agreement Take Effect?

An Admission Agreement must be entered into voluntarily to be legally binding. It must be signed and dated by both the facility and the resident (or the resident’s agent or legal representative). This applies to any attachments to the Admission Agreement as well, such as a copy of the house rules. Any future changes in the agreement must also be in writing, signed by both parties, and dated.

How Do You End the Agreement?

The resident or resident’s agent or legal representative must give a written thirty (30) day notice to end the agreement and to leave the facility, unless the agreement specifies a different time period. In the event of your death, the agreement is automatically terminated. A facility may not require advance notice for terminating an Admission Agreement upon a resident’s death.

The cost of a nursing home can be devastating to a family, so you will need to take the time to understand and establish Medicare and Medicaid procedures and applications in your state. Medicare often pays for the first 20 days at a rehabilitation center which may be in a skilled nursing home after you’ve been in a hospital, but longer stays have to be paid for by the residents and/or their Medicare supplemental insurance.

State-funded Medicaid programs also pay for long-term custodial care, but only if the resident is determined to be clinically and financially eligible. If the applicant is married, the spouse must also meet certain financial eligibility criteria. There is a five (5) year look-back period for Medicaid review of transfers of assets in determining Medicaid eligibility.

Seniors and their families can also review long-term care insurance to pay for the costs of a nursing home. Getting long-term care insurance minimizes your out-of-pocket expenses when you are clinically eligible under the policy, and after you have gone through an elimination period equivalent to a certain amount of days where there is no insurance coverage where you need to private pay. Your long-term care insurance policy should cover alternatives to nursing homes, such as assisted living facilities or care at home.

Be wary of contracts that limit the facility’s liability if the resident is injured or has his or her property stolen. Residents shouldn’t be required to deposit all their income to the facility, or be required to pay up-front money when they are eligible for Medicaid and before the state has ruled on a Medicaid application. You should also determine what plans the home has for holding a bed if you have to be hospitalized temporarily.

It is important for nursing home residents and their families to fully understand what is contained in a nursing home Admission Agreement prior to signing it. Your estate planning attorney can look over any nursing home or long-term care contract, ensuring the facility and treatments meet your standards. They can also help you ask the right questions of a potential nursing home, so you can have the assurance your loved one is getting the best of care.

To review your nursing home Admission Agreement or to begin your estate planning process, please contact us at Aaron J. Goldberg, PLC.



“Used with permission 2016”


Loading Quotes...


Attorneys with Aaron J. Goldberg, PLC are members of the Vermont Bar Association and the National Academy of Elder Law Attorneys.