Admission Agreements for Care Facilities

Admission agreements might be a necessary evil in the process of securing care for a loved one. The facility where you hope to place your family member has plenty of lawyers and legal advice. The agreement they present you does not tend to protect you or the patient. You might want to consult your own attorney before signing.

But what is in admission agreements that a lawyer can help with? Most often the document is presented as a take-it-or-leave-it proposition. And time might be running out. There is another potential resident in the wings, and you don’t have time to slow down and consider.

Or so the facility might tell you. But you can and should get some good legal advice before signing. Let’s consider what your lawyer might be looking for.

What kind of facility might you be considering?

Are you signing a family member into a nursing home, an assisted living facility, an adult care home, or an independent living facility? Or maybe they are actually looking at a Continuing Care Retirement Community (a CCRC).

Each is different. And each of those has different access to legal advice for their corporate office, and different emphases in the care continuum.

In general, the larger the organization, the more elaborate the agreement might be. And more elaborate admission agreements might need closer evaluation.

Who is signing?

Too often, the person entering a care facility is unable to make their own financial decisions. But if they can, they can sign admission agreements themselves. And that may be preferable, though they may need legal assistance more acutely.

CCRCs and independent living facilities, especially, will ordinarily expect the new resident to be able to sign for themselves. And they might have more time, with less pressure and immediacy about placement and getting the documents completed.

But if you are signing on behalf of a family member or loved one, the next question is about your authority. Are you a guardian (of the person) or a conservator (or the estate)? Perhaps you are trustee of a trust handling your family member’s finances. Maybe you have a power of attorney (either health care or financial). Indeed, sometimes you are none of those things — some admission agreements are signed by family members as family members.

But here’s the thing: you want your signature to reflect the authority you actually have. No less, and certainly no more.

The facility might prepare admission agreements for signature by a family member as the “responsible party.” If you see that language, cross it out and write in your actual authority. Sign as “John Doe as agent under Julie Doe’s power of attorney” or “John Doe as guardian” (assuming you are actually one or both of those things).

Responsible parties

Watch out for language about you being a responsible party. The agreement might be drafted to try to make you individually liable for your loved one’s care costs. You might arguably be liable anyway (as when the new resident is your spouse), but don’t give away any arguments.

So look not only at the signature block, but also at any language in the agreement that purports to include a promise to pay costs and be responsible. You can assume that responsibility to the extent of your loved one’s assets, but without assuming any additional individual liability.

Arbitration clauses in admission agreements

Many facilities embed a provision on arbitration into their admission agreements. Those provisions are pernicious; if you agree, you might be giving up important rights for your loved one, other family members, or even yourself.

On this subject nursing home agreements are in a separate category. The facility can not mandate an arbitration agreement. But that doesn’t stop them from trying.

If you see a separate section (or even a separate document) in admission agreements asking you to sign and/or initial language about arbitration provisions, do not accept them. There is no set of facts in which the arbitration agreement benefits you or your family members. And you don’t have to agree in order to get your family member admitted to the facility.

We have written about arbitration agreements before — beginning more than a decade ago. Our view of these provisions has only hardened since then. And we are surprised to see (and hear) the kinds of misrepresentations facilities make to try to get you to sign or initial those provisions.

Just say no!

Publication rights

Admission agreements might also include (or be accompanied by a separate) waivers of privacy rights. They sound inoffensive: the facility might want to take a picture of happy residents enjoying meals or activities for their marketing. And they’ll need consent of everyone in the picture (or family members) before they can do that.

In fact, look at the picture we used to illustrate this very article. It is of a facility resident. They — or someone on their behalf — gave consent to our use (and the use of anyone else with a similar stock photo subscription) in whatever context we thought appropriate. We chose one that is backlit enough that you can’t really make out the patient very clearly. And we don’t know the patient, or where they live, or whether they were even a resident at the facility. But someone thought it would be OK to let us use this picture.

Someone waived this individual’s privacy. Maybe the individual themselves. And someone might have been paid for that waiver. Maybe they are very wealth as a result of having agreed to pose for this illustration.

For ourselves, we don’t want to appear in publications or happy ad copy for our nursing home or assisted living facility. Or if we do, we’d like to see the picture and the context first. So if you’re signing our admission agreements, please don’t waive our privacy rights in advance.

Our bottom line on admission agreements

We think these documents are comprehensive, sometimes dangerous, and lean toward favoring the facility. We hope you’ll get good legal advice before signing admission agreements. Your loved ones deserve that attention.