The transition to a nursing home is rarely a leisurely process. More often than not, it is a decision born of necessity. It might be a sudden health crisis, a fall, or a rapid decline that leaves a family scrambling. In the whirlwind of hospital discharges and emotional stress, a thick stack of paperwork is placed in front of you.
At Slutsky Elder Law, our office has seen “standard procedure” turn into a financial nightmare for families. Nursing home admission agreements are complex legal contracts. Hidden within the fine print are clauses designed to protect the facility’s bottom line, sometimes at the direct expense of your family’s inheritance, your home, or your right to a day in court.
Before you pick up the pen, let’s decode three specific clauses that could cost your family thousands. A qualified elder law lawyer can help you spot these traps before they spring. At Slutsky Elder Law, an experienced elder law attorney serving Malvern and the local area, Rob has decades of experience helping individuals and families dealing with a family member entering a nursing home.
1. The “Responsible Party” or “Third-Party Guarantor” Trap
This is probably the most lethal clause for the offspring of a resident. The contract will most likely require an individual from the family to sign up as the “Responsible Party.” On the surface, it seems you are merely volunteering to be the contact person or making sure that the Medicare checks of your parents go to the facility. But some of these clauses include hidden liabilities. It is imperative you read what the clause obligates you to do. An appropriate “Responsible Party” provision obligates you to work with the facility and cooperate with spend down and the application process for Medicaid.
As a “Guarantor” you are taking on personal liability for the cost of your loved one’s care. If your loved one runs out of funds and there are issues with the Medicaid application you could be personally responsible for costs of $15-18,000.00 per month until the issue is resolved. If your loved one is already in the nursing home there is no reason you should sign as a guarantor..
2. Mandatory Arbitration Clauses
Binding Arbitration Agreement is commonly found in the packet of documents for admission in nursing homes. When you sign this document, you are giving up your right and the right of your family member to go to court.
If your loved one has experienced neglect, medical errors, or even accidental injuries, an arbitration clause places the dispute into a private proceeding.
- High Costs: In contrast to a public court, there will be costs involved in having the matter decided by an arbitrator that could total thousands of dollars a day.
- Limited Discovery: You may have limited discovery when it comes to accessing internal documents or deposition testimony from employees.
- Reduced Judgments: On average, judgments awarded through arbitration tend to be less favorable compared to jury verdicts, and are kept secret meaning the facility will avoid negative publicity about their substandard care.
These kinds of clauses may be agreed upon voluntarily, meaning in some cases you can actually refuse to sign the clause without consequences to your loved one’s admission process. While the Obama Administration had prohibited nursing homes from requiring mandatory arbitration provisions, the previous Trump administration changed the rule in 2019 to allow nursing homes to require that residents and their families agree to mandatory arbitration. In rare cases nursing homes will remove the clause but unlike prior to 2019, they have no obligation to do so.
3. The “Medicaid Application” and “Asset Disclosure” Clause
Some t contracts also provide for the resident or his/her agent to “promptly apply for Medicaid” and give the facility the power to do the same in their name. Nursing homes know nothing about how to protect assets. They just want to be paid and are not going to guide the family in protecting resources for the spouse or other important people.
How to Protect Your Family
At Slutsky Elder Law, Rob has spent over three decades navigating the maze of Pennsylvania elder care. If you are facing a nursing home admission, follow these steps before signing:
| Action Item | Why It Matters |
| Request the contract in advance | Do not wait until you are in the admissions office. Ask for a PDF copy via email so you can review it at home. |
| Look for “Joint and Several Liability” | This legal jargon means the facility can come after you for the full bill. Strike it out. |
| Check the “Additional Services” list | Some homes charge extra for everything from laundry to wound care supplies. Know what is included in the base rate. |
| Consult an elder law attorney | A quick review by a professional can save you ten times the cost of the legal fee in prevented liability and asset preservation. |
Why “Standard” Is Not Good Enough
Robert Slutsky has been named a #1 Top elder law attorney by Main Line Today for a reason. He understands that these contracts are not just paper. They represent your family’s security. Pennsylvania law has specific nuances regarding Filial Responsibility (the law that can hold children responsible for a parent’s medical bills), making it even more vital to make certain your contract does not inadvertently trigger those obligations.
Let the pressure of the change in no way influence you into making a lifetime mistake financially. You have the freedom to strike clauses from the agreement, to question the terms presented to you, and most of all, the freedom to consult with an attorney.
Prepare for Your Nursing Home Admission
If you or a loved one are preparing for nursing home admission, call Slutsky Elder Law at (610) 940-0650. The best time to choose an elder law attorney is before you need one. Let us help you navigate the process with confidence.
If you are ready to take the next step in your estate planning journey, contact Slutsky Elder Law today. Our team is here to answer your questions, guide you through your options, and help you put a solid plan in place for the future. Contact us today!