Ask the legal expert ... how to avoid deadbeat families

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Attorney John Durso, Ungaretti & Harris LLP
Attorney John Durso, Ungaretti & Harris LLP

What's the best way to prevent deadbeat families?

The best practice to ensure residents pay for their care is to gather their financial information and try to identify and address potential problems before admission. If a resident meets your financial requirements, then take steps to avoid potential problems.

For example, if the potential resident is able to handle financial matters on her own, the facility's residency agreement should provide that she may not dissipate her assets, if it would undermine the means to pay for her care. 

If she has to rely on a family member to handle her finances, the facility should have the family member sign a personal undertaking agreement to pay for her care from her funds, which will give the facility a contractual right to take action against the family member, if the family member does not act responsibly. However, a personal undertaking cannot require the family member to guarantee payment since Centers for Medicare & Medicaid Services rules prohibit a facility from requiring a third-party guarantee as a condition of admission.

Another practice is to ask the resident to send certain payments directly to the nursing home (for example, her Social Security or pension payments), which will prevent a family member from intercepting them.  

Once a resident is in your facility, your options become limited in most states. Under CMS rules and some state laws, a facility may involuntarily discharge a resident for her failure to pay, but, as part of the discharge process, the facility must have a reasonable discharge plan for the resident. If the resident requires continuing nursing home care, the facility would have to find another facility willing to take a resident who is not paying her bill. Not many facilities are willing to do that.