Admissions paperwork violates state law

The Kansas City Star has an article about a study from the National Senior Citizens Law Center discussing clauses in nursing home agreements that violate the law.  Some admission agreements skirt state and federal laws, misleading consumers about the care they can expect and inducing them to sign away critical consumer protections.  Advocates for the elderly said the study raised serious questions about how some nursing homes operate.

The National Senior Citizens Law Center, a Washington-based nonprofit legal advocacy group for seniors and elder-care lawyers, reviewed 175 admission agreements voluntarily provided by nursing homes. The study found agreements which improperly limited a nursing home’s obligations. Others allowed discharges for vague reasons, or stuck relatives with bills they legally didn’t owe.

Toby S. Edelman, a spokesman for the Center for Medicare Advocacy in Washington, said similar studies in other states also show “ongoing concerns” with nursing home agreements.

The Missouri study found that nursing homes protect themselves by persuading seniors to waive their right to a jury trial. In 18 percent of the agreements, seniors were required to submit a dispute to arbitration, rather than sue in court.   Trial lawyers contend they have successfully fought the provisions in court as unconstitutional and unenforceable in health-care cases.

The study contends the agreements also thwart federal law by inserting provisions making it easier to evict residents. Federal law sets out six conditions that justify evicting a resident.

Carlson, the study’s author, said that under the federal reform law nursing homes cannot require a relative or a friend to become financially liable for nursing home expenses. Yet, the study found that 19 percent of the admission agreements required a financial guarantee “in direct violation” of federal law.   Such “co-guarantor clauses” are becoming more common.

Study critical of nursing home admissions paperwork

The Columbia Tribune of Missouri has an article about a new study that shows nursing home admission paperwork to be confusing and takes away a resident's fundamanetal rights without explanation to the residents.

Nursing home admission agreements are confusing, can run 10 pages or more with unfamiliar language, are often signed in moments of distress, and force residents to sign away fundamental rights.

"It’s a situation where they’re worried about health, they’re worried about their family, and often they’ll just sign anything," said Richard Royer, CEO of Primaris, a Medicare quality improvement organization.

A study released today by the not-for-profit National Senior Citizens Law Center evaluated 175 legal agreements signed by residents who entered Missouri nursing homes. The study found many agreements allow facilities to evict residents for almost any reason, limit their rights to be visited by family members and require family or friends to assume personal financial liability for care. All such provisions are in violation of the federal Nursing Home Reform Act of 1987.

The study found that 17 percent of surveyed nursing homes reserved the right to evict someone for any reason even though federal law lists only six valid reasons for eviction. Consequently, patients with Alzheimer’s disease and dementia or residents who complain about the care received are being evicted for being "difficult."

The survey also found that 19 percent of nursing homes required a guarantee asking a family member or sponsor to take financial responsibility for the cost of care. The study argues it’s illegal to require fiscal responsibility and that Medicaid is required to cover expenses when a resident is unable to pay.

The study found 5 percent of agreements instituted visiting hours for residents, also in violation of the federal law.

One of the things not mentioned in the study but is very disconcerting to many residents is the inclusion of an arbitration clause hidden in the admissions paperwork that waives the resident's right to a jury trial if the resident gets abused or neglected.

The study and a consumer guide outlining the rights of residents are available online at nsclc.org.

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