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Elder Law

Asset Protection Planning, Title XIX Applications and Review of Nursing Home Agreements

When the time comes that you or a loved one needs more care then can be provided at home, a little planning can go a long way toward protecting your assets and avoiding unintended consequences.  

Average nursing home costs in Connecticut can run over $14,000 per month.  These costs can quickly deplete financial resources.  Certain assets may be exempt from the requirement to "spend down" assets before applying for Title XIX assistance.  These rules are complex, so it is best to consult an attorney with knowledge in these legal matters. 


When you are seeking admission into a nursing home, you will be asked to sign an “Admission Agreement.” The Admission Agreement is a written contract between the resident and the nursing facility to provide care and services to the resident, and outlines your rights and responsibilities and those of the nursing home.  The person seeking admission to the nursing home should sign the Admission Agreement as the “resident.”  Family members may also be asked to sign the Admission Agreement on the line labeled “Responsible Party.” Nursing facilities, however, attempt to contractually bind family members for payment of their parents’ unpaid accounts, by arguing that the family member, upon signing, agreed to perform the duties of a Responsible Party as described in the Admission Agreement.

Beware that these contracts are written by big law firms who represent the interests of the nursing homes. In some cases, these contracts often contain unfair, deceptive or illegal terms.  Although both federal law (42 U.S.C. §1396r(c)(5)(A)(ii)) and state law (Conn. Gen. Stat. § 19a-550(b)(26)) prohibit a nursing home facility from requiring a third party guarantee of payment as a condition of admission to the facility. nursing facilities typically request that a family member or friend also sign the Admission Agreement as a “Responsible Party.” Often families will be told that a Responsible Party is merely an emergency contact person. That is not true, it is so much more. Signing the agreement as a Responsible Party may obligate you to pay the nursing home if the nursing resident is unable to, for example, if they run out of money, if insurance doesn’t cover all of the costs, or if Medicaid is denied or a penalty period is assessed.  

You or your family may be asked or encouraged to sign an Admissions Agreement while at the nursing home before you are even admitted for the first time. This often ends up being an expensive mistake.  Take your time. Tell them you want to take it home and review it carefully before you sign anything. 

The existence of federal and state laws prohibiting nursing facilities from requiring third party guarantees upon a resident’s admission has not stopped these facilities from suing Responsible Parties, who unwittingly signed or were misled into signing Admission Agreements.  While a nursing facility may request a family member to sign as a responsible party upon a loved one’s admission to the facility, they cannot be required to do so. If a family member signs as Power of Attorney, Conservator or as a Responsible Party, your family member could be held personally financially responsible for expenses incurred for your care, and end up in costly litigation when they are sued by the nursing home. If you don’t completely understand all the legal language in the agreement, you should consult an attorney to review it and revise unfair terms before anyone signs it. If you have already signed an Admissions Agreement but haven’t yet entered the facility, sometimes the facility will allow you to rip up the old contract and re-sign a new one. Therefore, you are well-advised to have the Admission Agreement reviewed by legal counsel in advance. 

Like all major milestones in life, nursing home admissions are best handled with advance planning.  Call us to see how we can help.