This hour addresses all the paperwork — legal contracts — involved in a loved one’s transition to senior living. Sometimes you’re electronically signing your name and initialing a few signature blocks on an iPad, but you aren’t shown the 50 related pages that are on the document you just signed. You’re under the gun in an emergency and need to arrange for a care now, and you just assume you’ll sign this, and mom or dad will be taken care of, and everything will be OK. Usually it is. Today we’re talking about troublesome clauses that might be in the underlying contracts you were asked to sign with or for your loved one.
Elder law attorney Jim Koewler joins Suzanne to showcase red flags to watch out for. They apply to nursing home, assisted living, and memory care admissions. First off, this agreement must document what services are available that meet your loved one’s needs, and they must disclose limitations on service.
Lead image © Can Stock Photo / daisydaisy
View Episode Transcript
*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.
The following podcast is by Mr Jim Taylor, elder law and special needs attorney, helping and protecting those who need long term care. And welcome everyone to answers for elder’s radio network. And we’re excited today because a lot of you obviously maybe in a situation of looking at a change of how do you transition your loved one from maybe living at home or moving into from senior living into a more of a elevated period of care? And there’s all kinds of situations that we as families deal with, and so we’re here with our wonderful Jim Taylor from the Kaylor Law Firm. And Jim, welcome to the show. I’m glad you’re here because we don’t think about these legal contracts that they throw in front of you. And for those of you that are listening to us on podcast, please join us over on Youtube because we actually have slides for this hour with us. And so, Jim, I’m so glad you’re here. So tell us a little bit about I know that nursing homes and and nursing facilities things like that, they have paperwork that we sign on a lot of times we just sign it. We don’t even see what we’re signing, right. I’m sure that’s what it is. Literally, literally, sometimes you don’t see what you’re signing. The tiny, tiny, tiny print in the room. They put an IPAD in front of you and just say sign here and then they go the screen, sign here and they go another screen, sign here and you’ve signed three or four places and initial two, three places or whatever, and you have ideas, no idea how many other pages you never saw. Yeah, I’ve had that happen to people. They’ve they’ve signed what turned out to be thirty and forty and documents and all they saw was three signature blocks because it was all on a tablet at the nursing homes living. So yeah, you’ve got no clue. What’s there. Wow, wow. Well, you know, you think about it because obviously when we enroll it’s like we don’t even know what we’re rolling into because it’s just and a lot of times it’s an urgent thing. It’s going into a rehab or going into a situation where you’re kind of, you know, deer in the headlights in many cases, and I remember with my mother I was in that situation where all of a sudden on the hospital discharge planners says, uh, tell my mother, we’re sending you to be with your daughter and we’re gonna send you from my hometown, which was about an hour and a half away, down to where I lived. And my mom was mad because she didn’t want to be with me. Obviously she wanted to stay, you know, go home. So there was all this uproar and obviously we’re in a situation where, if you’re a power of attorney or if you’re not power of attorney, those things happened too. So I’m sure there’s all kinds of issues that happened at that time, lots of them. And you are right, you are under the gun. You, uh, you or your loved one need care and need care now, and you’re more worried about that. And people just assume I’M gonna sign this and they’re gonna take care of my mom or my dad and everything will be okay, and frankly, usually it is. We’re not talking quality of care here. This is these are contract issue you’re talking today. I mean I, as you know, uh, Susanne, and if you’ve listened to my podcast before, listeners Um, because it’s Susanne podcast. When I’m a guest. So if you listened to me with Susanne before, you know that I worked with nurses to look at after my client’s care because I’ve stopped trusting these places. But today we’re not talking about those issues. We are a little tangentially, but we’re talking about the underlying contracts that they ask you to sign for your loved one or you design with your loved one. Um, and the issues in clauses that you will see there, if you have to look that frankly, are let’s just put them squirreling. Yeah, yeah, yeah, well, that makes sense. It makes sense. And the fact that you know they’re obviously in to take care of themselves, and I know that I had some Gotchas put in front of me when my mom was in a Rehab facility. Um, and Um, all kinds of things that you don’t necessarily totally understand when you’re when you’re admitting a loved one. So this is really good information. Thanks, uh, for those of you who have tuned in before and when when I’ve used slides again, I’m using something I’ve prepared for the National Business Institute. It’s a Wisconsin based national provider of continuing legal education and Continuing Education for accountants. They may do some others as well, but I know they do those two and I speak for them frequently. So I had lots of slide programs that that I’ve prepared for them, so I just rather than writing something new, I use them here. So this is another of my NBI’s and, as you can see from this title page, this is about reading nursing home and mission agreements and spotting red flags. Now, the same concepts here can apply to assisted living agreements or memory care. Okay, but this is the title that that NB I chose and I just took it in and ran with it and gave their program and this was a national program okay. So, and remember I am Ohio based, so some of what I may be saying is true under Ohio Law, and your law may be better or worse for the consumer Um in your state. But some of this is also national because nursing homes and assisted livings that accept Medicare and Medicaid are regulated by the Center for Medicare and Medicaid Services and they have certain rules there for a nursing home and assisted living agreements under this MS. I don’t know why it’s C ms and at two Ms for Medicare and Medicaid, but it’s still cms rules. The at the national level, the nursing home and assisted living programs under the Center for Medicare and Medicaid services have their rules posted in chapter forty two of the code of federal regulations at starting at section four eight, three, point one zero. The ones that are there are the resident rights under nursing home and assisted living rules. Okay, this isn’t everything we’re talking about here. There is more here, and please are you to go look at that? Uh, but we some of what I’ll be saying does come from the resident rights summs. Come from specific clauses about nursing home and assisted living, residency agreements or admission agreements or whatever each place calls it. But the additional notes under these resident rights, and maybe that’s something you and I should discuss in some few your episodes. Absolutely so um in nursing home, and I’m just gonna call my mission agreements for the rest of this, at least my slides do. But in your neck of the woods or your particular loved ones Nursing Home, we’re assisted living. They may call that a rental agreement. They may call it at a mission agreement, they may call it a residency agreement, they may collect just about anything else. Okay, but this is the contract about your loved one staying there, or maybe it’s about you staying there. Okay, under whatever name they use. So then assisted living contract specifically must include services that meet the client’s needs. Okay. Now, this may be a state law thing, not a federal law thing, but even if you because we have this in Ohio, uh, your state may have it, your state may not have it, but it is a practical concern. So make sure that you have an idea of what your love one needs and the contract addresses that. Now, if you need to get a handle on what your loved one needs, you may want to get a care expert involved. An aging life care expert is what they call themselves, and you can find someone at Aging Life Care Dot Org and there’s a button for fine and aging life care expert. So if you aren’t if you don’t have the discharge notes from your loved one staying in the hospital and see what the needs are and you don’t have another assessment of what your loved one’s needs are, or even if you don’t understand it. You want to get something written in English, please look up an aging life care expert at Aging Life Care Dot Org and click the button and find someone in your area. Zip Codes seem to work best in that search tool. Okay. Now, in my world I’ve got the three nurses who worked for me, Rebecca every burden and Margi, and they take care of filling this gap in for my clients with their expertise and experience. But not everyone in the world has rebecca or burden margie and they only travel a certain distance. I’m not sending about to Seattle for you. And then your state law may also then flipping to the nursing home side, remember I just said was has to include services that meet the client’s needs. Nursing homes again, Ohio issue and may be copied in other states. Maybe not. The nursing home must disclose if it has limitations on its services. Okay, nursing homes tend to be more similar. One nursing home to another, and all nursing homes grouped together, then assisted livings tend to be all alike. Nursing homes forget quality care for a second, but just on services they offer. Nursing homes tend to be more fungible than our assist at livings. So that’s why this different approach, at least in my state, on how the services are described that are available to any resident. It’s just a living because they are very different from one assisted living to the other half to say what they do. And nursing homes they just assume they do the same as every other nursing element of his limitation they’ve got to say. So, you know, this is a good thing and the fact that we remember that all, you know, all nursing homes, skilled nursing facilities is what we call them today, are not not the same, right they have a lot of times a national footprint, yes, but again, Um, you’re there for different reasons and many cases you’re there for a short stay, on a rehab situation or if you’re there for a longer term, you may be under, you know, a real tied degree of twenty four hour care. So coming back, Um, Jim and I are going to talk in our next segment a little bit about what. Jim, I don’t even know what my next slide is. It is we’re gonna talk about mission agreements and whether you they can force you to give up your right to seek, medigate cover. Perfect, and Jim and I will be right back right after this. State of Ohio residents, you have a friend to help you navigate long term care while protecting your assets. You can reach Jim at www dot protecting seniors dot com, or just email him at J K O E W L E R Pyphen a F e. that’s J Kaylor a F E at protecting seniors dot com.
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Originally published September 18, 2022