A nursing home cannot require that a resident certifies that he or she is not eligible for Medicaid or Medicare nursing home benefits. Similarly, a nursing home cannot require a resident promise that he or she will not apply or become eligible for those benefits in the future.

Sometimes, a nursing home will request that a resident agrees to pay the private pay rate for a certain period of time.  These “duration of stay” agreements are illegal for the reasons discussed in the preceding paragraph.

At the present time, nursing homes are allowed to ask a resident for information regarding his or her income and savings.  Nonetheless, under certain circumstances, this practice could be challenged. This is because it could be classed as the nursing home’s submissive way of assuring that a resident will not become eligible for Medicaid in the future.

The answer to this question is “no”. Federal law prohibits a nursing home from requiring a third party guarantee of payment as a condition of a resident’s admission. Therefore, a resident’s family member or friend cannot be required to guarantee the residents payments to a nursing home.

Many nursing homes, however, use admission agreements which evade the spirit and arguably, the letter of the federal law.  These facilities often use admission agreements which correctly state that a guarantor is not required, but later claim the party signing the contract is “voluntarily” agreeing to be responsible for the bill.

No person should agree to become a responsible party for a resident’s nursing home bills. Such an agreement cannot be required and legally can offer no benefit to the resident. Consequently, a family member must be aware of signature lines entitled “Responsible Party.” Often, these signature lines do not define the term “responsible party” but implicitly refer to the fine print of the document, which will contain language making the signing party responsible to pay for the nursing home bill.

Furthermore, a person who has signed as a financially responsible party should not assume that he or she is financially responsible for the resident’s nursing home bills. Such a voluntary promise to pay is unenforceable, because the nursing home promises nothing in return for the financial guarantee. In addition, any voluntary guarantee should be unenforceable because it is grossly unfair and unconscionable.

A nursing home cannot require a deposit from a resident if either the Medicaid or Medicare program makes payments for the resident’s stay.  A nursing home, however, may require a deposit from a resident who pays for his or her stay without assistance from the Medicaid and Medicare programs.

Don’t sign as a responsible party. Under federal law, the nursing home cannot require you to accept financial liability for your mother’s nursing home bill, and N.J.S.A. 30:13-3.1a(2) expressly prohibits the same. By requiring you to sign as a “responsible party” the nursing home is breaking the law.  Explain this to them. If the nursing home continues to insist that you sign as a “responsible party”, ask for this requirement to be in writing. Alternatively, prior to signing the document, insist that it be amended to include a statement that you are signing under duress, only to insure your mother’s admission to the home.

Yes.  A nursing home may require a resident’s legal representative to apply the resident’s money to the nursing home charges, but may not require the legal representative to utilize his or her funds.

No, admission agreements can solicit consent only for routine nursing or emergency care.

Prior to signing the document, the resident and family members should have the contract reviewed by an elder law attorney.  The attorney can remove requisite provisions from the document which may pose liability and potential hardship to the resident or his/her family.They can also add provisions to protect both the resident and family members.

To summarize, keep in mind:

• Family members should never sign as a “responsible party;”
• Residents need not provide a deposit if they are receiving Medicaid or Medicare;
• All contracts should be reviewed by an elder law attorney BEFORE they are signed to protect the family and the resident.

• Physical
• Mental or Emotional
• Sexual
• Financial Exploitation
• Neglect

Neglect can take many forms as it relates to elder abuse. One example is withholding services that are essential to an elderly person’s mental or physical health. Essential services can be used as bargaining chips to coerce your loved one into doing something against his or her will, which is usually not in their own best interests.

This form of abuse is very difficult to identify, since the abuser rarely is forthright about his or her intentions. For example, let’s say an elderly person relies on someone to pick up and deliver their groceries, or drives them to and from the doctor or pharmacy. Although the elder is paying for the groceries and medications with their own funds, they still may need help doing the legwork. A person seeking to take advantage may attempt to condition an elderly person’s behavior by simply depriving (i.e. neglecting) them of these services without providing much of an explanation as to why. Other than neglect, this can lead to financial exploitation or even a claim of undue influence in the context of a will dispute.

Financial exploitation is an illegal or improper use of an elder’s resources to benefit another person. Some different types of financial exploitation are below:

• Theft or Conversion
• Fraud in the inducement
• Intentional Breach of Duty by a Fiduciary or Caregiver
• Negligence