Frederick, MD 
301-663-9230
Nursing Home Contracts
A nursing home contract needs to have the following:
Services and charges. A nursing home contract must describe what services the home will provide for the basic rate. The basic rate is usually a daily fee. The basic rate must include at least:
- room and board
- social services
- nursing care
- skin care, cleaning, and grooming
- protection from accidents and infections
- social and rehabilitative activities
Extra fees may be charged for services not included in the basic rate. Rates and fees may not be increased without at least 45 days written notice. The contract must state the reasons why rates and fees could increase. The contract must also provide information about late fees.
Medicare and Medicaid. The contract should explain how to apply for both Medicare and Medical Assistance (Medicaid). If the home accepts Medicaid, it cannot discriminate against you because Medicaid is paying for your care. It is also illegal for a nursing home to require you to pay privately for a period before the nursing home will accept Medicaid on your behalf. A deposit cannot be required if you are being admitted from a hospital under Medicare coverage.
Explanation of Rights. The contract must include an explanation of the Nursing Home Residents’ Bill of Rights. These rights include your right to:
- privacy
- dignified care
- your medical information
- be free from abuse or coercion
- choose medical providers
- meet privately with visitors of your choice
- form and participate in resident groups
- consent to or refuse treatment
The contract must also explain your right: (1) to challenge the nursing home if it wishes to discharge you (including your appeal rights), (2) to have an advance directive, (3) to keep personal property, and (4) to have your property be safe.
How to complain. The grievance or complaint policy of the nursing home must be clear and explain how to make complaints to one or more of the following: anyone working at the nursing home, the Long-Term Care Ombudsman, or the Department of Health and Mental Hygiene. The nursing home and state agencies have a duty to investigate complaints and attempt to solve them. It is illegal for anyone at the nursing home to retaliate against someone for making a complaint.
Bed-hold policy. This explains how and when you can return to the nursing home after a hospital stay. The policy must be included in the contract. The nursing home also must give you a copy of the policy when you are admitted and when you go to a hospital. Even if Medicaid or Medicare is paying for your stay in a nursing home, the home can charge you personally to hold your bed while you are in a hospital. If you do not pay, you may not be able to return to your room when you are discharged from the hospital. Regardless of whether you pay the bed-hold charge, if you are on Medicaid, you have a right to return to the first available bed at the nursing home.
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David Wingate is an estate planning and elder law attorney at Estate and Elder Planning by David Wingate. The Estate and Elder Planning office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick, Washington and Montgomery Counties, Maryland.
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