Responsible Parties

When it comes to providing care for a senior, one of the most important things to remember is that the senior is his own responsible party when it comes to signing any paperwork.  It doesn’t matter whether or not he has assigned you his Power of Attorney, you can save many financial headaches if he signs his own paperwork if at all possible. The biggest problems arise when your parent isn’t physically able to sign the admissions forms. 

There are several forms you’ll encounter while your parent or family member is being admitted for medical care.  It’s important to understand the differences and what to watch out for.  There is a form that gives them permission to treat your parent.  You should sign this form; without a signature they aren’t legally able to provide medical care for a patient and it’s possible that you’ll be delaying your parents’ medical care.  Most admissions forms clearly state that the person who signs at the bottom is financially responsible for the hospital bills.  It’s important that you do not sign anywhere personally accepting financial responsibility for your parents’ bills.  If your parent isn’t physically able to sign the forms, you don’t have to sign them – each patient is responsible for his own bills.  Nothing says that the family member has to sign accepting responsibility, although the nursing home can try to intimidate the family into signing on the patient’s behalf.  It can be intimidating for the family member when the administrator is threatening the family with a lawsuit and ruined credit – but hang tough.  You don’t have to sign the paperwork.  I’ve known some administrators with nasty collection techniques, but lack of payment is their problem - not yours. 

If you do feel obligated to sign the financials, sign them “John Doe by Mary Doe, Power of Attorney,” or “Mary Doe, Power of Attorney for John Doe.”  Across the bottom of the form, write “I am not financially responsible for John Doe’s bills,” and sign your name to that – and obtain a copy of the paperwork immediately. 

            For those patients who are admitted directly from the hospital, it’s typical for nursing homes to bring the intake packet in to be signed after the patient has been admitted.  The nursing home can’t force you to sign accepting financial responsibility once the patient is already there because “once the head is in the bed” the nursing home can’t discharge him without a safe place to send him that can meet his needs and he agrees to go.  If the patient isn’t physically or mentally able to give consent for the transfer, the nursing home can’t make him leave.  

If the patient’s family provided all of the patient’s financial information in good faith and has cooperated fully in the Medicaid application process, it’s difficult for the facility to force the family to pay for the placement unless they personally guaranteed that they’ll pay for their family member’s bills if the Medicaid isn’t approved.  If the relative doesn’t sign the patient into the facility it appears doubtful that he can be held legally responsible for a nursing home patient’s bills.  The facility can attempt to make a family pay by taking them to court - some states have a “responsible relative law” that requires people to pay for family members if they have the means to do so, but these laws are rarely enforced.  The facility will have to prove negligence and taking someone to court is expensive.

The belief that a patient’s power of attorney isn’t personally responsible for her nursing home payment was recently challenged in Connecticut – the courts found a power of attorney/family member, responsible for a patient’s bill because he signed the patient into the facility and didn’t write, “I am not personally responsible for my family member’s bills” on the admission agreement.  He hadn’t stolen from her or spent her money incorrectly; he simply hadn’t assisted with her Medicaid eligibility.  Because of his lack of assistance she wasn’t eligible for Medicaid – and the courts found him personally liable for over $100,000.  If he had written that disclaimer on the admission agreement, it’s doubtful that the courts would have found him liable. According to news reports, the family member filed bankruptcy and the nursing home never even recouped legal fees.

Be sure to read everything you sign on behalf of a family member; if you have any problems with a healthcare facility attempting to collect money from you, consult an attorney.