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Nursing Homes and What You Need to Know About Admission Agreements

Putting a love one in a nursing home is very difficult. When I had to place my Mom in a facility I cried the whole way. The last thing you need when you get there is to be bombarded with paperwork and pressured to complete it by the nursing home. This blog is intended to give you some advice on what to look for during the admission process.

California prohibits the use of admissions contracts drafted by nursing homes. All nursing homes in California must use the Standard Admission Agreement [“Agreement”]. The standard agreement was developed by the California Department of Public Health. You can find all forms and parts to the Agreement at

Make sure that you read the entire Agreement and understand all its terms before signing it. Do not let the nursing home staff pressure or hurry you into signing the forms. The nursing home cannot force you to sign any other documents as a condition to your admission to a nursing home.

The Standard Admission Agreement’s main purpose is to protect your rights and the rights of the loved one who is being admitted, to make sure you are not exposed to any unexpected financial liability.

It is recommended when you read and review the Agreement to:

  • List any questions you may have for the nursing home.
  • Make sure you get them answered before you sign the document.
  • Consult with an attorney or an advocate if you do not understand the form.
  • Bring a copy of the Standard Admission Agreement with you and compare it to the one that the nursing home gives you to sign. Although a nursing home cannot legally alter or amend the Agreement, it is possible they may have altered it and you end up signing a different document.

Once you have read the Agreement and all your questions have been answered then sign the document.

WHO SIGNS THE DOCUMENT? The person being admitted to the nursing home is the one who should sign. However, if the person being admitted cannot sign the document, the agent in the Durable Power of Attorney or the Residents’ Representative can sign the document.

NOTE: MAKE SURE THAT YOU IMMEDIATELY GET A COPY OF THE AGREEMENT AND ANY OTHER DOCUMENT SIGNED AT THE NURSING HOME. If you ask for them later, they are difficult to get. Also get copies of all receipts of payments you made at admission. The person being admitted, or the resident, is responsible for paying any of the nursing home bills under the Agreement. Please note that if you are an Agent in the Durable Power of Attorney or a Resident Representative and you sign the Agreement you are not financially responsible for paying any nursing home bills out of your pocket.


Do not sign a Binding Arbitration Agreement when being admitted to a nursing home. The nursing home wants you to sign one because it prevents the resident from suing for abuse and neglect. Make sure to give the nursing home a copy of your Advance Health Care Directive. An Advance Health Care Directive is a document used to describe instructions and your preferences for your future medical treatment. If you don’t have an advance directive have an attorney prepare one for you.

If you are trying to place a person in a Medi-Cal or Medicare approved nursing home, first you need to find out if the facility accepts Medi-Cal and Medicare patients. Once you find out that they are an approved facility then insure that the Admission Agreement clearly states whether or not they participate in Medi-Cal and Medicare.

It is also important to know that prior to admission to a Medi-Cal certified nursing home you are entitled to know the eligibility standards and the home should give you the State mandated notice. They are not allowed to blind side you. If this all seems confusing there are attorneys that can help you specifically with all the rules and stipulations of Medi-Cal and Medicare approved nursing homes.

The Medi-Cal experienced attorneys at Santaella Legal Group, APC, located in San Ramon, serving the bay area, is available to assist you through this process.