As the New Year begins, it’s the perfect time to closely examine your loved one’s nursing home contract and policies. Whether your loved one is newly entering a nursing home or has been residing in one for some time, understanding these documents is crucial to ensuring they receive the best care. Nursing home contracts can be complex, but reviewing them carefully will help you make informed decisions, protect your loved one’s rights, and avoid any unexpected surprises. This guide will walk you through the key elements of nursing home contracts and provide helpful tips for ensuring the best care in the year ahead.
Why Reviewing the Contract Matters
A nursing home contract is a legally binding agreement between the facility and the resident (or their representative). It outlines the terms of care, services provided, fees, policies, and rights of the resident. While many families assume that all nursing homes offer the same quality of care, contracts help set the standards for what you can expect from the facility and what the facility expects from you.
By reviewing the contract, you can ensure that the facility will meet your loved one’s needs, that you are aware of any costs involved, and that you understand the policies governing their care. A clear understanding of the contract can help you navigate the situation more effectively if there are any issues or concerns.
Key Elements of a Nursing Home Contract
Services and Care Provided
The nursing home contract should clearly define the scope of services and care provided. This includes daily activities like bathing, dressing, eating, mobility assistance, and any specialized services such as physical therapy, speech therapy, or memory care. If your loved one has specific needs, such as dietary restrictions or behavioral health care, ensure that these are addressed in the contract.
Pay special attention to whether the facility can provide the level of care your loved one requires now and in the future. Will they be able to meet any changing health needs, such as long-term care or palliative services? If not, the contract may include provisions for transitioning your loved one to another facility that can better meet their needs.
Costs and Payment Structure
Understanding the costs associated with nursing home care is critical to managing your loved one’s financial health. The contract should include a breakdown of fees, including monthly charges, what’s covered, and what’s not.
Be sure to ask about any additional fees, such as charges for transportation, extra personal care, or medical supplies. Understanding whether the facility will cover specific medical treatments, therapies, or prescriptions is essential. Some nursing homes may also require an upfront deposit or charge admission fees.
If your loved one is eligible for Medicare, Medicaid, or private insurance, the contract should explain how these funding sources will be applied. Ensure you know what portion of the costs will be covered by insurance and what you will be responsible for paying. Check whether the nursing home is Medicaid-certified, as this can influence your choices if your loved one’s financial situation changes.
Admission and Discharge Policies
Nursing homes have specific admission and discharge guidelines, which should be clearly outlined in the contract. This section should explain the criteria for accepting a new resident and whether the facility can accommodate your loved one’s needs.
The contract should also specify under what conditions a resident can be discharged voluntarily or involuntarily. Some facilities may have policies about transferring residents to another facility if their medical needs can no longer be met at the nursing home. Understanding the discharge policies is important, particularly if your loved one’s health deteriorates or the facility fails to meet the expected care standards.
It’s also important to know if the facility has an appeal process in case of discharge or transfer. This ensures that if your loved one’s discharge is not in their best interest, you have a mechanism for challenging that decision.
Resident Rights
Nursing homes are required by law to uphold certain rights for their residents. These rights should be explicitly stated in the contract and may include the right to privacy, the right to participate in care decisions, the right to be free from abuse and neglect, and the right to access their medical records.
Be sure the contract outlines how the facility ensures these rights and the steps taken if a resident’s rights are violated. This may include grievance procedures, how to file complaints, and the role of family members in advocating for the resident. The facility should also provide clear guidelines on how the resident can voice concerns or request changes to their care plan.
Notice of Changes
The contract should include a provision that outlines how the nursing home will notify you of any changes in your loved one’s care, fees, or policies. These changes could include adjustments to the care plan, cost structure alterations, or facility rules.
Knowing how the nursing home communicates with families can help you stay informed and ensure you are involved in important decisions. The contract should specify the timeline and methods of communication for these updates, such as phone, mail, or email.
Dispute Resolution
Many nursing home contracts contain clauses related to dispute resolution. These clauses may specify that disputes between the resident (or their family) and the facility will be handled through arbitration rather than court. While arbitration can be a faster and more cost-effective method of resolving disputes, it’s crucial to understand how it works fully.
Before signing a contract, ask for clarification on what issues might require arbitration and whether the process allows for appealing a decision if you are unsatisfied with the outcome. In some cases, you may prefer going to court, so weighing the pros and cons of arbitration is necessary.
Tips for Reviewing the Contract
- Read the Entire Contract Carefully
Take your time to read every section of the contract. It’s easy to overlook details, especially when faced with dense legal language. If something is unclear, ask for a more straightforward explanation. Nursing homes should be transparent about the terms of the agreement. - Look for Hidden Fees
Some fees may not be evident at first glance. Look for extra charges for additional services or items, such as transportation, personal items, or unique medical treatments. Ensure you understand what’s included in the monthly fee and what will incur additional charges. - Clarify Termination and Discharge Procedures
Review the termination clause in the contract carefully to understand the terms under which the agreement can be terminated. This is important in case your loved one’s care needs change or the facility does not provide the expected level of care. - Consult with an Attorney
If you have any doubts or questions about the contract, consider consulting with an elder law attorney. They can help you interpret complex terms, protect your loved one’s rights, and offer legal advice if you have concerns about any aspect of the contract.
The Role of Family Members
Family members play a critical role in advocating for the care and well-being of nursing home residents. It’s important to stay actively involved in your loved one’s care by visiting regularly, attending care plan meetings, and communicating with staff. When you understand the terms of the contract, you can ensure that the facility is fulfilling its obligations and that your loved one’s needs are being met.
Moreover, family members should be familiar with the resident’s rights and prepared to act if violated. Knowing how to navigate the contract and the facility’s policies will help you advocate effectively for your loved one.
Ensuring the Best Care for Your Loved One in the New Year
As we enter the New Year, take the time to review your loved one’s nursing home contract and policies to ensure they are receiving the best care possible. By understanding the terms of the agreement and remaining engaged in your loved one’s care, you can help guarantee that their needs are met and that they are treated with respect and dignity. Use this opportunity to ask questions, clarify any uncertainties, and ensure you are fully informed. With careful attention and proactive involvement, you can help your loved one have a safe, comfortable, and well-cared-for year ahead.
Questions About a Potential Lawsuit Against a Nursing Home or Assisted Living Facility?
Michael Hill is a nationally recognized attorney who handles exclusively cases against long term care facilities. Michael and his firm, Michael Hill Trial Law, are headquartered in Cleveland, Ohio but handle cases across the country.
Disclaimer: This information is provided for informational purposes only. Nothing in this article should be construed as providing legal advice or the creation of an attorney client relationship. Laws are updated frequently and change from state to state. If you desire legal advice, you can contact Michael Hill Trial Law at www.protectseniors.com, send an email to info@protectseniors.com, call (800) 659-2712 to begin an investigation, or contact another attorney.
