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Unwary skilled nursing home


A Hidden Trap for the Unwary

Published August 22, 2022

By Nicholas N. Khayumov, Esq.

Are you helping a loved one going into a Skilled Nursing or Assisted Living Facility? Beware of some hidden traps for the unwary.

Imagine coming home to find a letter from a facility or their legal team addressed to you demanding payment for tens if not hundreds of thousands of dollars for services your spouse, parent, sibling or family friend received at that facility. That is a reality that many unprepared families are facing and this trend is growing at an alarming rate.

The facility’s legal claim is often based on the Admission Agreement that is placed in front of the family members prior to or during the Admission process. Think about how it works – an aging or disabled loved one needs to be transported (or has already been transported) to a Skilled Nursing Facility or Assisted Living Facility in order to receive the long-term care services that they need. This is often following an emergency that the family did not foresee. During that process, the Facility’s administrative team members rally to produce an Admission Agreement detailing the terms of the resident’s stay, including the services to be provided along with the fees that correspond with said services.  Does the resident ever see the Agreement? Almost never – and if they do, they do not normally have the faculties to truly comprehend what is going on. Rather, it is the family members of the resident that receive and sign the Agreement.

Families who have planned ahead may have Powers of Attorney in hand to give them the legal ability to stand in their loved one’s shoes, access their loved one’s finances and sign the Admission Agreement on their behalf. Others may have to seek Guardianship authority through the Court system.  Either way, these Agreements need to be signed at an alarmingly fast pace when families are at their most vulnerable and focusing primarily on getting adequate care for their loved one. Most of the time, families are not using an attorney during the Admission process. Instead, they are falsely relying on the good faith they believe exists in the system for families in their position. In turn, they quickly and blindly sign on the line designated as “Responsible Party.”

Unbeknownst to the caring family member who signs the Admission Agreement as a “Responsible Party” is a hidden clause that attempts to make them personally responsible for the costs incurred by the resident at the facility. When asked, the staff will often falsely deny that the required paperwork makes anyone other than the resident responsible for the care costs.

These facilities can cost anywhere from $13,000 to $25,000 per month, depending on multiple factors including the location, quality and level of care required – and Medicare is not always available to defray these costs, especially not for the long term.  A five-month stay can result in a bill ranging from $65,000 to $125,000 if not greater. 

What is a family to do? Planning ahead can help minimize the risk of these legal claims and lawsuits. Quite often, the facility files these lawsuits because no one has access to the resident’s funds.  By planning ahead and having a loved one execute a Power of Attorney, that can be avoided. If there is no Power of Attorney in place, perhaps the resident themselves can sign the Agreement. Most importantly, however, these agreements should never be signed without having an experienced elder law attorney review its terms and provide guidance as to how the particular Admission Agreement should be handled.

Another potential solution is to have the facility paid through another source, i.e. Medicaid.  Unlike Medicare, Medicaid can pay for long-term care services, whether they are provided in the community or in a Skilled Nursing Facility. Although Medicaid has very strict asset and income eligibility requirements, an experienced elder law attorney can guide families in how to structure a resident’s finances in order to minimize private pay periods and get Medicaid coverage sooner.

Navigating the long-term care system can be overwhelming. At Littman Krooks, our attorneys and trusted team are here to guide you and your family in protecting the assets and income that you and your family have worked so hard to build. To contact us to schedule a no obligation consultation to discuss your needs, contact us online or call us at (914) 684-2100 or (212) 490-2020.

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