Nursing Home and Assisted Living Admission Agreements – Are They Legal, and If So, to What Extent?

By Fredrick P. Niemann, Esq. of Hanlon Niemann & Wright, a Freehold, NJ Medicaid Attorney

Before a person enters a long term care facility they will be asked to sign an admissions agreement.  Sometimes a facility forgets to have one signed (but seldom does this happen).  Even if initially forgotten, the family will generally be asked to sign one by the admissions or business office. When asked to sign, what should you do?  Can you refuse to sign it? If you refuse, what happens next?  These are fair questions and the answers are fairly straightforward.


First off, if asked to sign before admission and you refuse, a facility can deny admission.  There is no legal remedy to force admission.  Facilities have the right to establish admission standards both medical and financial.  But if for some reason an individual is admitted without first having signed the admission agreement, then the answer changes. The nursing home is not permitted to discharge a resident for failing to sign the agreement.  That’s because both federal and state law have enumerated permissible grounds for discharge.  While there is no case law on point, I believe the same holds true for an assisted living residence.


The more complicated question and the one I am asked most frequently about is the legal and financial liability of the “responsible party” clause found in most admission agreements.


Like most agreements, an admission agreement is a contract and therefore is subject to contract law. To learn more about the law of contracts visit my website (CLICK HERE).  As a contract the admissions agreement is binding as on the aging resident as well it should be in most material ways (payment, services, etc.), but it is not binding upon the agent/power of attorney/guardian, unless there is a breach of their fiduciary duty to the resident and/or the facility.  Most third parties sign the admissions agreement because mom or dad can’t sign it for some reason. If mom or dad were to run out of money some facilities will look to the “responsible party” to pay.  That’s nonsense. Federal and state law make such a payment clause unenforceable, in my opinion.  Children and others are not legally obligated to care or support a parent or family member in New Jersey. But watch out for Pennsylvania. They have a different law.


There are many laws and regulations in place in New Jersey that regulate long term care facilities.  These laws and regulations also apply to admission agreements.  Know your rights!


If you’re unsure what to do or if you should sign, call and meet with me.  Together we’ll come to the right decision.  Please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at  Please ask us about our video conferencing consultations if you are unable to come to our office.