What should be included in a nursing home’s admission contract?

A variety of housing options is available to the elderly population in Israel: private retirement homes, protected housing, each offering a different style of living.

Each of these options will require the new resident to sign a contract specifying his rights and obligations. It is therefore important to know what should be included in such agreements with institutions.

The importance of the contract between the resident and the institution

This contract expresses both the consent of the resident to enter the institution and the consent of the institution to care for him. Just like any other contract we may sign in our lifetime, it is designed to regularize rights, obligations and payment issues. Unlike a regular contract, however, the agreement with the institution deals with the life of the resident in the coming years, and is meant to define:

• The care he will receive

• His living arrangements

• The services to which he is entitled

It is important to note that signing this contract is required by law.

A standard contract

A standard contract, as its name implies, is a contract made in the same way with every resident of the institution. Most places have such contracts, and they should be read with great care, because they are written by the institutions’ legal advisors and protect their rights and not necessarily the rights of the residents. A court of law may intervene on the customer’s behalf if he does not accept one of the clauses, but for this purpose the contract must first be read carefully. As you read, make sure that all desired conditions are included.

Conditions that should be included in the admission contract

List of services – services of the institution include everything from meal menus to health and nursing services, laundry and religious services. Every agreement should specify the precise rights of the resident, emphasizing which services are provided as part of the overall fee, and which require extra payment. When additional payment is required, the exact fee must be specified.

Living conditions in the resident’s room – a description of the room, its size and furnishings, and how each item may be used (refrigerator, stove, etc. – in most agreements, this list is attached as an appendix) must appear in the contract. A list of items which the resident may place in the room must also be included, determining what should be done with them if he leaves the institution.

Payment – The rate, means and dates of payment must all be specified, as well as who is responsible for payment – the resident, a family member, the government, etc. Conditions under which the resident or his family will receive refunds must be determined – in case the resident leaves the institution. In addition, the method of future payment should be set – in case of recession, linkage to the consumer price index or to foreign currency, etc.

Responsibility of the institution – the institution’s responsibility for both the resident and his property must be defined. Examine security arrangements, as well as the institution’s policy pertaining to property loss/damage, accidents, injuries and medical negligence.

Departure/ hospitalization – at times the resident may have to leave the institution for medical tests or prolonged hospitalization. Therefore, refund conditions and conditions for keeping the room for the resident must be determined. Another issue that must be addressed is what happens if the resident leaves the home permanently – including refunds to be paid.  A clause entitled “termination of agreement” should be prepared.

Transfer to another department – the resident may stay at the institution for many years. During this time his condition might change, necessitating his transfer to a different department or requiring different care. It is very important to define the terms of this possible move – who makes the decision, how much it will cost and what care the resident will receive – in order to prevent any misunderstandings that might delay critical treatments.  In the majority of cases the decision to move a resident to another department must be approved by the resident and his guardian, who can object to the institution’s decisions.

Financial securities – both the institution and the resident have the right to verify each other’s financial securities, in order to prevent non-payment on the resident’s part or inability to provide the stated conditions by the institution, due financial difficulties.

Trial period – before moving into an institution, future residents have the option of a three month trial period. Afterwards the resident and the institution’s representatives, both together and separately, make the decision regarding the resident’ continued stay and care.

Before signing the contract

The first thing you should do, before signing the contract, is request a copy, so that you can look it over with family members at home and consider together if the agreement meets your needs. If you sign a standard contract, and discover later that one of the clauses is not acceptable to you, you can apply to a court of law. The courts usually assist  in the cancelation of clauses that are damaging to residents. Otherwise, if you find problematic clauses, it is your right to ask for changes, but then the agreement will no longer be a “standard contract”.  It is also important to remember: if you are not pleased with the contract and find you are unable to change it, don’t compromise. Look for another institution, more suitable to your needs.

Looking for the right institution is a long process, and not a simple one. You and your family must carefully examine every detail.  This process, however, is well worth it, because overcoming any obstacles now will prevent unnecessary complications in the future, allowing the resident to live in peace and security in his new home.

(Illustrative image  Unsplash)