California nursing home residents have certain rights under both federal and California law, including certain rights about the content of admission agreement contracts.
Under California law, admission agreements must meet certain minimum requirements, including the following laid out by California Advocates for Nursing Home Reform:
• A contract may not require that the resident pay with private funds for a specific period of time, meaning the contract cannot forbid a resident to pay with Medicare or Medi-Cal funds;
• A contract may not require, at the time of admission, that the resident give notice that he or she intends to convert to Medi-Cal status;
• A contract may not require the resident to promise not to apply for Medicare or Medi-Cal benefits; and
• A contract may not require a third-party guarantee of payment as a condition of admission or expedited admission.
Unfortunately, despite the requisite rights provided for by law, in the past, these admission agreements were written by the nursing homes themselves and often contained deceptive or illegal terms. However, California became the first state to outlaw the use of admission contracts written by nursing homes. In fact, as of April 6, 2012, all California nursing homes are required to use the Standard Admission Agreement (the “Agreement”) developed by the California Department of Health.
As a representative or resident, it is imperative to know the rights and responsibilities that the Agreement provides in order to help prevent elder abuse. Among the rights that the Agreement provides are the following:
1) The person being admitted to the nursing home is the only person required to sign the Agreement. If the resident is unable to do so, a representative may do so for the resident.
2) Signing the Agreement as a resident’s representative does not make a representative responsible for using his or her own money to pay for the nursing home care.
3) Neither a resident nor a representative can be required to sign any other documents at the time of admission or as a condition of admission–while the nursing home may ask you to sign additional documents, it is best to take time to review these documents in advance as these documents may conflict with the Agreement and attempt to restrict a resident’s rights.
4) A resident cannot be required to sign an arbitration agreement as a condition of admission to a facility and the nursing home cannot present an arbitration agreement as part of the Agreement.
Despite the recent change in law requiring all California nursing homes to use the Standard Form Agreement, it is still important to remember that an admission agreement for nursing home care is a legal contract and should be thoroughly read prior to signing. Although a nursing home cannot legally change the Standard Form Agreement without permission from the California Department of Health, a nursing home may have amended the form without permission, and in violation of state law. In addition, while reviewing the Agreement, residents and their representatives should make sure that all questions are answered and use the Agreement as an opportunity to clarify expectations, and negotiate care needs and costs.
Some important questions to ask when reviewing the Agreement include:
• What initial payments are required?
• What is the fee?
• What services are provided for that fee?
• Are there additional charges for certain services / products? If so, what are they?
• How often and when can fees change?
• If a resident is away from the facility for an extended period of time (for example, in the hospital), what fees apply?
In addition, the Agreement requires the facility to give you copies of the signed agreement, all attachments, any other documents signed at admission, and a receipt for any payments made at admission, so make sure to obtain these copies.
If you have questions or concerns about the admission agreement being presented to you or your loved ones, or if your nursing home is not using the Standard Admission Agreement, contact an experienced California elder abuse lawyer at (866) 338-7079 for a free and confidential consultation. Christopher Walton has significant experience providing caring, compassionate representation to victims of elder abuse and their families. He can help you reach out to any appropriate agencies and advocate for your rights.
Related Blog Posts:
Guidelines to Prevent Abuse in Long-Term Care Facilities, California Elder Abuse Lawyer Blog