What You Need to Know Before Entering a Nursing Home

An older man in a nursing home sits in his wheel chair while another man in bright blue scrubs helps him get his slippers on.

09 May What You Need to Know Before Entering a Nursing Home

Posted at 08:00h in Cancer-Related Legal Issues, Finances, Medicaid, Medical Care, Medicare by Triage Cancer

Choosing the right nursing home can feel overwhelming. While trying to make sure that you find a facility that will provide quality care for you or a family member, and be a comfortable place to stay, you also need to make sure that you can afford it.

Unfortunately, some nursing homes are taking advantage of people during this difficult time, by using illegal debt collection practices.

This blog post describes what you need to know before entering a nursing home, how to watch out for illegal terms in a nursing home admissions contract, and how to get help if you have signed one of these contracts.

How to pay for nursing home care

Generally, most health insurance plans do not cover nursing home care. Medicare has limited coverage of a nursing home stay, and Medicaid does provide coverage for long-term care. Private long-term care insurance that you but from an insurance company does provide coverage for nursing home care, but most people don’t proactively buy long-term care insurance. And once you have a pre-existing condition it is more difficult to get coverage. It is important to understand your options to pay for long-term care.

What you need to know before entering a nursing home

The government makes it illegal for nursing homes that accept Medicaid or Medicare coverage to coerce a third party, such as a family member or caregiver of the nursing home resident, to risk their own finances for the resident’s care.

However, some nursing homes will pressure or even require family members or friends to use their own money to pay for the resident’s care as a condition of that resident’s admission or continued stay. Even when those family members and friends are not legally responsible for the debts of the nursing home resident.

Nursing homes may also hire debt collectors to demand payments from family members, report the debt to credit reporting agencies, and file lawsuits to get repaid. These practices can cause serious financial and emotional harm on residents, their families, and friends.

Watch out for illegal terms in a nursing home admissions contract

During the nursing home admissions process, caregivers may be asked to sign lengthy paperwork related to the resident’s care.

These terms may be buried in the contract, so you need to know what to look for. And, it is important to not sign anything that you don’t fully understand.

Be sure to read the paperwork in detail and watch out for words such as “responsible party” and “joint and several liability” in the contract. These terms seek to make another person, other than the resident, personally responsible – or “jointly and severally” responsible — for paying for the resident’s care.

Consider refusing to sign a nursing home admissions contract that makes someone else personally responsible for a resident’s bills.

Also consider the danger of a contract that makes third parties personally liable – or financially responsible – if they fail to submit an application for Medicaid, or require “cooperation” in the Medicaid application process. Nursing homes may then threaten to sue the third party for the resident’s bills if the Medicaid application is denied for insufficient documentation.

How to Get Help

If you’re unsure about whether a contract is legal or if you are sued for a loved one’s nursing home debt, consider talking with a lawyer. You can also contact Triage Cancer’s Legal & Financial Navigation Program.

If a nursing home is insisting you sign a contract that you believe is illegal, you can report them to your State Nursing Home Survey agency and file a complaint with your State Attorney General.

If you’re having a problem with a debt collector, you can submit a complaint with the Consumer Financial Protection Bureau online or call (855) 411-CFPB (2372).

Needing to move into a nursing home can be stressful enough. Know what to look out for to protect yourself and your loved ones.

For more information about navigating insurance, medical bills, and other cancer-related legal issues, visit TriageCancer.org.

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through events, materials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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