Family Liability for Nursing Home Bill

When a parent suffers a stroke or other acute illness, the family is suddenly faced with difficult and costly decisions about where to get care and how to pay for it. There is also another matter of great concern, and that is who is legally liable to pay for very expensive long term care, either at home or in a nursing home.

A common situation that arises is discharge from a hospital, to a rehabilitation facility, and then into that facility’s long term skilled nursing section. The hospital discharge planner will be anxious to complete the discharge, and the admission director at the rehabilitation facility or nursing home will be anxious to have someone sign the nursing home admission agreement. It is often presented to the family as a quick “sign here” on these standard papers. This is the very moment when caution should be exercised, and the advice of a knowledgeable elder law attorney should be sought.

The first thing to know is that children are not liable for the debts of their parents, including nursing home bills. However, many admission agreements use words like “Responsible Party” and if a child signs that agreement, the fine print may include language that could make the child liable. Federal law prevents a nursing home from requiring a child to sign as a “Responsible Party.” This liability can occur if the “Responsible Party” by innocent mistake fails to get Title 19 approved because of unknown assets that are worth more than the $1,600 eligibility limit for the sick spouse, or the limits for the healthy spouse. There have been successful lawsuits against well meaning children who signed such agreements and tried and failed to get Medicaid because of some overlooked asset, or other rule they did not know about.

The second thing to know is that no one can force a child to sign the admission agreement. In part, federal law prohibits making someone a “Responsible Party.” There is often a great deal of pressure to sign, because this is likely the only time the child will ever be faced with this situation, and it is a very emotional time as the child wants the best for mom or dad. This is when to have the admission agreement reviewed by an elder law attorney, before you sign it. In reality, it is a contract, and that is what could make you liable. It’s okay to sign a contract as the Power of Attorney for a parent, but that should be made clear on the contract. Never sign as a “Responsible Party.”

A third thing to know is that many agreements take away your right to have a court rather than an arbitrator decide on nursing home malpractice or breach of contract. No one can force you to agree to arbitration. You should not give up your right to use a court if there is a contract disagreement.

There are also other concerns. Does the home accept Medicaid? Does the agreement prohibit transfers of assets that the law allows? When could the nursing home discharge the resident?

The word to the wise is not to sign an admission agreement before an elder law attorney reviews it and advises on your responsibilities and your financial liability. Don’t let the difficult emotion of the situation rush your judgment. You wouldn’t cosign a loan for someone leaving you potentially liable for approximately $16,000 a month, so get competent counsel who can advise you about the care to be provided to your parent, and who is going to pay for it. It only takes a day or two for such a review, as elder law attorneys understand the need for a quick response.