The Elder Law Forum

The Elder Law Forum By Michael Myers
USD School of Law  Caution: Do Not Sign Admissions Agreement! When and in the event you accompany a spouse, a parent, a grandparent, or anyone else to a hospital, clinic or nursing home, do not—I repeat—do not sign the admission agreement; particularly on the line captioned "responsible party." "What did you sign?" I asked a caller to the USD Senior Legal Helpline.  She is 59.  Last summer she took her mother to a nursing home for physical therapy following discharge from a hospital.  Her mother exhausted the 20 days of skilled care fully covered by Medicare. She died five weeks later, leaving behind an estate consisting of $100 in a checking account. "Now," she said, "seven months later I receive a letter from the 'care center' demanding that I pay an outstanding bill in the amount of $12,800.  They say it is for deductibles and copayments not covered by Medicare.  Am I stuck?"  She faxed a copy of the admission agreement.  Her mother had signed as the "patient."  The caller had signed as the "responsible party."  I advised her not to pay; that under these circumstances she was not "responsible" for the outstanding bill. I wrote the care center, stating: "I have advised the caller she is not responsible for such payment and that the care center may be in violation of federal law by attempting to condition admission to its facility upon private guarantees outside the Medicare program." "The care center," I continued, "is a Medicare participating provider and subject to CMS rules and regulations.  Please advise whether your facility has an established practice of securing private guarantees under its admission agreement. Further, the daughter signed in her capacity as her mother's agent under a power of attorney and not on behalf of herself." Three days later I received a call from the care center administrator.  "Our letter to her was for information purposes only," he said.  "I agree she is not responsible for the bill.  We thank you for your assistance in this matter." He knew—and I knew—the care center had been caught engaging in a practice commonly employed at admission desks of hospitals, clinics and nursing homes: securing the signature of a person other than the patient in the capacity of a "responsible party" and later demanding payment for costs not covered by insurance, Medicare or Medicaid. Family members are compliant during the stress of an admission, responding to the instruction, "Please sign here."  Politely refuse. (Pro bono legal information and advice is available through the USD Senior Legal Helpline, 1-800-747-1895;  Opinions are solely the author's and not those of the University of South Dakota.)

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