Bradley Geller Roxanne Chang
A nursing home licensed in Michigan shall include the following language verbatim at the beginning of any contract for admission of a resident or continued stay of a resident.
These provisions are part of the contract, and no other provisions of the contract shall conflict with them. No contract provision shall conflict with federal or Michigan law.
Any provision of the written contract or any oral assurance in violation of these requirements is void. In addition, Michigan statute provides for criminal penalties and civil liability for a nursing home that violates the prohibitions below marked with an asterisk. MCL 333.21799c(1)(d).
1. The entire contract shall be in writing, using clear language and printed in at least 13-point type. MCL 333.21766(7).
*2. A nursing home shall not require an applicant, as a condition of admission, to waive his or her right to benefits under Medicare or Medicaid, to give oral or written assurance that the applicant is not eligible for Medicare or Medicaid, or to give oral or written assurance that the applicant will not apply for benefits under Medicare or Medicaid. MCL 333.21765a(1); 42 USC 1395i-3(c)(5)(A)(i);
42 USC 1396r(c)(5)(A)(i).
3. The only permissible parties to this contract are the nursing home, the resident, and any individual who has access to the resident's funds as an attorney-in-fact, trustee, representative payee, guardian or conservator. MCL 333.21766(1).
4. If an attorney-in-fact, trustee, representative payee, guardian or conservator signs the contract, she or he is only financially liable to the nursing home to the extent he or she has access to the resident’s funds. MCL 333.21766(9); 42USC 1396r(c)(5)(B)(ii)
*5. The contract shall not require as a condition of an applicant’s admission or a of a patient’s continued residency that a person pay on behalf of an applicant or patient the private pay rate for a specified period of time before the applicant or patient applies for Medicaid. MCL 333.21765a(2)(b); 42 USC 1395i-3(c)(5)(A)(ii); 42 USC 1396r(c)(5)(A)(ii).
*6. The contract shall not require that an applicant or patient remain a private pay patient for a specified period of time before applying for Medicaid. MCL 333.21765a(2)(a).
*7. The contract shall not require that an applicant, patient, or other person make a gift or donation on behalf of that applicant or patient. MCL 333.21765a(2)(c).
8. In the case of an individual entitled to Medicaid, a nursing home shall not accept a gift or donation from anyone as a condition of an applicant’s admission or expedited admission or a patient’s continued stay. 42 USC 1396r(c)(5)(a)(iii).
other person to disclose his or her income or assets, as a condition of admission of the applicant or continued residency.
10. A nursing home shall not require an application fee or a security deposit as a condition of admission of the applicant or continued stay of the resident, as it is a waiver, however short term, of the right to benefits under Medicaid.
11. The term of the contract shall be in bold type, in a conspicuous location.
MCL 333.21766(8)(a).
12. The contract shall specify the certification of the bed into which the resident will move, and the number of beds in the facility that are dually certified for Medicare and Medicaid, certified only for Medicare, certified only for Medicaid, or licensed only.
13. The contract is terminated within the term of the contract in any of the following circumstances:
a. There is a change in the resident's source of payment, at which point a new contract shall be entered into consistent with these provisions. MCL 333.21766(1)(c); MCL 333.21766(2).
b. The nursing home discharges a resident without the resident's permission, if the discharge plan is approved by the Michigan Department of Community Health; the discharge is for a permissible reason under federal and state law; and the resident has exhausted any appeals she or she chooses to pursue.
c. The resident is transferred to a hospital and does not return to the nursing home from the hospital.
d. The death of the resident.
14. The contract can be terminated within the term of the contract in any of the following circumstances:
a. The resident provides 30 days notice to the nursing home.
b. The resident no longer meets the nursing home level of care.
c. Agreement between the parties to this contract.
15. Unless there is a change in the resident’s source of payment, the contract is not terminated if a resident is admitted to a hospital and returns to the nursing home.
16. For a resident enrolled in Medicaid, a nursing home shall not require a person to pay the nursing home to hold a bed during a hospital stay.
17. During the term of the contract, a nursing shall not raise the daily rate for a resident paying privately.
18. At the end of the term of the contract, a nursing home can raise the daily rate for a resident paying privately only the amount it is raising the rate for all residents paying privately at the end of their respective contracts.
19. The contract does not provide a waiver of contract or tort liability of the resident, the nursing home, nursing home staff, or independent contractors of the nursing home.
20. The contract does not provide for mandatory arbitration of disputes between the nursing home and a resident.
21. The contract shall have all provisions required by Michigan law set forth in MCL 333.21766, including services covered by Medicare, Medicaid or the private pay rate, as applicable, and the cost of services available but not covered. MCL 333.21766(8)(b); MCL 333.21766(8)(c).
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Individual authorized to sign on behalf of nursing home (please print)
__________________________________ ___________________
Signature Date
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Applicant or resident (please print)
__________________________________ ____________________
Signature Date
_______________________________________________________________
Attorney-in-fact, trustee, representative payee, guardian or conservator (please print)
________________________________ ____________________
Signature Date
This form has not yet been approved by the Michigan Department of Community Heath pursuant to MCL 333.21766(7)