Be Careful When Signing Nursing Home Agreements

By Bernard A. Krooks, Certified Elder Law Attorney

A client recently told us about a family member who was sued by a nursing home seeking to recover money on behalf of a deceased relative who had spent some time at that nursing home.  While nursing homes suing family members is not a new development, many nursing homes have gotten way more aggressive recently in their attempts to collect monies they feel they are owed.  If someone you know is entering a nursing home, you might be wondering whether you could be liable for the cost of their care. 


Federal law prohibits a nursing home, as a condition of admission or continued stay, from requiring a family member or friend to guaranty payment of the nursing home resident’s financial obligations to the nursing home. Unfortunately, nursing homes regularly attempt to find creative ways to make others responsible, some of these efforts are legal and some are not.  One common technique is to require a family member or agent under a power of attorney who has access to the resident’s funds to use those funds to pay for care. Even if someone signs this type of agreement, they are still not responsible to use their own funds to pay for the resident’s care, unless they are considered a legally responsible relative. For these purposes, that generally means a spouse. 


If you are helping someone who is going into a nursing home, it is important that you carefully review the admissions agreement and related documents before you or someone else signs it. Often, this is easier said than done since the nursing home that you are seeking placement at may have limited openings and there could be pressure to sign papers right away and worry about it later.  The nursing home may even tell you that you could lose the bed for your relative and that others are waiting in line. 


In virtually all cases of nursing homes against family members and even friends, the family member or friend had blindly signed the admissions agreement where instructed in order to get their friend or family member into the nursing home.  Unfortunately, they didn’t read the fine print which included a provision in which the signer promised to pay any monies owed to the nursing home, even if the patient’s money ran out, even if the signer had no legal responsibility, and even if the signer was not a relative. 


Here are some tips in case you are ever asked to sign an admissions agreement on behalf of someone else as a “responsible party” or otherwise:  


When you are signing a family member or friend into a nursing home, read the agreement. Cross out anything that says or implies that you are accepting personal responsibility for the care costs. 


Review the agreement for arbitration clauses. These usually benefit the nursing home (that’s why they put them in there).  If you can, delete these provisions from the agreement. 


Pay particular attention to paragraphs where you are asked to initial or sign separately. Those are usually the ones where you are at the greatest risk. The nursing home will later say that not only did you sign the agreement, but you also initialed the provision which made you personally responsible. 


Make sure that you indicate your actual role in signing. Do you hold a power of attorney? Sign as “attorney-in-fact” (write that after your signature). And do it on the patient’s signature line, not on the “responsible party” line. 


If you’re not sure, don’t sign at all. Tell the intake worker that you’ll need to take the agreement home to read it.  Ask a lawyer for review it.  The best way to avoid a lawsuit is to plan in advance and work with a Certified Elder Law Attorney to protect your interests. 


While nursing homes can’t force you to sign any of these onerous provisions, they do sometimes rely on the anxiety, confusion, and discomfort of the moment to get you to sign something you don’t have to sign.  Proceed with caution.



Bernard A. Krooks, Esq., is a founding partner of Littman Krooks LLP. He was named 2021 “Lawyer of the Year” by Best Lawyers in America® for excellence in Elder Law and has been honored as one of the “Best Lawyers” in America since 2008. He was elected to the Estate Planning Hall of Fame by the National Association of Estate Planners & Councils (NAEPC). Krooks is past Chair of the Elder Law Committee of the American College of Trust and Estate Counsel (ACTEC). Mr. Krooks may be reached at (914-684-2100) or by visiting the firm’s website at