WHO SHOULD SIGN THE CONTRACT?
Guardians, Guarantors, and “Responsible Parties”

Can the nursing home require that someone other than the applicant/resident sign the contract?

No. Federal and state laws forbid nursing homes from requiring third party signatures as a condition for admission or continued stay in a nursing home. The nursing home would like to have a family member involved with the care of the resident (for making medical decisions in case the resident needs emergency medical services, for example), but only the applicant/resident should sign the contract. 

Nursing home contracts often have places for a third person to sign (after the resident and the nursing home representative). This third party is often referred to as the “responsible party.” The contracts do not always make clear the nature of the responsibilities and obligations of this third party signatory. Federal and state regulations, however, are clear. A nursing home may not obligate a third party to pay the resident’s bills out of their own financial resources as a condition for allowing the resident to enter or continue to stay in the nursing home. No one, other than the resident, should sign the admission agreement. 

If the applicant/resident is incapacitated should the Guardian or Agent under a Power of Attorney sign the nursing home contract?

An agent (either a Guardian or the agent named in a Power of Attorney) acting on behalf of the principal (the nursing home resident) can agree to accept the authority and responsibility for handling the principal’s financial matters, which usually include paying the resident’s bill out of the resident’s own financial resources. When the agent signs the contract, the signature of the agent should include the words “as agent,” expressly designating the signer as one acting as agent on behalf of the principal.

Should someone sign a Power of Attorney form if one is included as part of the admission agreement to the nursing home?

Some nursing home contracts contain a Power of Attorney form within the document. Never sign a Power of Attorney form offered by a nursing home. The Power of Attorney is a very important legal document, and should be entered into only with the advice of legal counsel--speak with an attorney about a Power of Attorney. Although it is a good idea to have a Durable Power of Attorney, the Power of Attorney form that is part of an admission agreement is usually a guarantor agreement attempting to make the Agent personally liable for any amounts of money the applicant/resident may owe to the nursing home.

What should I do if my family member needs to go into a nursing home, but is unable to sign the contract?

Frequently, the new resident going into a nursing home is coming from a hospital, and might be incapacitated and unable to sign the contract. Under these circumstances, the nursing home might insist that someone sign the contract, as a precondition, before the nursing home will admit the new resident. If it is a member of your family, and there is no guardianship or power of attorney, should you sign the contract?

It would be best to avoid signing the contract, even in this situation. But, if you have no choice, and must sign the contract to obtain admission for your family member, you should sign and include a note protecting yourself from potential personal liability. That is, sign the contract, but, each time you sign, also write in the sentence: “In signing this contract, it is understood that I do not accept any personal responsibility for the charges, fees, or any other expenses incurred by the resident.” 

Occasionally, there might be an expense or fee you can accept--such as a charge for some special service for your convenience or the resident’s comfort--and you can sign a separate agreement for that expense, and that expense only.

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