Entering a nursing home may be a stressful time for potential residents and their families. The potential resident's illness may have happened suddenly and there may not have been time for advance planning. Since the admission period may be an anxious and stressful time, it may help to know in advance what legal documents to gather and what documents must be signed.
It is a good idea to obtain a copy, in advance, of all contracts and documents you will be signing, if possible. That way, you and your attorney will have time to read the documents, write down any questions or make any necessary changes.
Documents Related to Decision-Making
When your loved one enters a nursing home, it is important to bring all pertinent information and documents with you. Bringing the following documents, if they exist, will ensure the proper information is on the resident's chart:
- Financial Power of Attorney: The person named in this document is responsible for handling only the person's financial affairs described in the document (this may include payment of bills) if the patient is unable, or does not wish, to do so.
- Advance Directives: These documents allow a person to make health care decisions in advance, so that those decisions may be carried out in the event that the person is no longer able to give informed consent. The advance directive may specify the type of care the person wants, and/or it may name another individual to give informed consent for medical treatment.
- Order for Guardianship of the Person: This document indicates who was appointed to give informed consent for medical decisions for a person who was determined by the court to be “disabled” and therefore unable to give informed consent for medical decisions.
- Order for Guardianship of Property: This document indicates who was appointed to make financial decisions for a person who was determined by the court to be “disabled” and therefore unable to make financial decisions.
- Do Not Resuscitate (DNR) Order: This document states that the person does not want to be revived if cardiac arrest occurs or if the person stops breathing.
- Prepaid Burial Arrangements: In what is called a pre-need contract, one purchases part or all of the goods related to the funeral, though some costs cannot be prepaid. If you choose to make prepaid arrangements, make sure there is a guaranteed price plan. Any funeral director can assist in these arrangements.
- Organ Donation Information: If your loved one has signed any forms regarding the donation of his or her organs, eyes or body for transplant or medical research, bring a copy of this information to the nursing home. (If it is still available, it may be helpful to check your loved one's driver's license for any indication about his or her previous wishes regarding organ donation.)
Papers You Will Be Asked to Sign
- Admission Contract
The admission contract is a legal document that defines the resident's legal relationship with the nursing home. It specifies what services the nursing home will provide, any fees attached to these services, as well as the payer's responsibilities.
- Release of Information Forms
These forms give the nursing home permission to share medical information about the resident with other providers (insurance company, Medicare, Medical Assistance, consultant physicians, laboratories, hospitals) as needed.
- Resident's Bill of Rights
The resident or legal decision maker will be asked to sign a form indicating he or she received a copy of the Resident's Bill of Rights. The Bill of Rights is part of Maryland regulations that protect the rights of nursing home residents. This is a very important document, and copies must be posted throughout the facility for all to see.
- Photographic Permission Form
This form gives the nursing home permission to take photographs of the resident for identification purposes. If your loved one could possibly wander from the nursing home and become lost, it is extremely helpful to have a recent photograph to give to the police so they can more easily identify him or her. Photographs for brochures or other marketing materials require a separate consent. It is not necessary to grant permission for pictures for marketing purposes.
Remember to ask for a copy of all papers signed by, or on behalf of, your loved one. Keep these documents in a safe place in case you need to refer back to them.
- If the resident is capable of understanding the documents and there is no legal decision maker (Power of Attorney or Guardian of Property) to sign, the resident is the appropriate person.
- If a family member or friend has informally agreed to pay bills for the participant, he or she should sign the forms pertaining to the payment of bills.
- If the resident is not capable of understanding the documents and there is a formal arrangement for decision-making (Power of Attorney or Guardian of Property), the Power of Attorney or Guardian of Property should sign the documents.
- If the resident is not capable of understanding the documents and there is no Power of Attorney or Guardian of Property, the surrogate decision maker identified under Maryland law may be asked to sign the documents.
Documents Related to Care or Treatment of the Participant
- If there is a Guardian of Person, that individual should sign the documents.
- If there is no Guardian of Person, the resident should sign if he or she is capable of understanding the documents. If not, the surrogate decision maker identified under Maryland law may be asked to sign.
A family member who is not Power of Attorney or Guardian of Property may sign the admission contract, but he or she should read the contract carefully to be sure it states clearly that the person signing is agreeing to pay from the resident's funds only.
For information about wills, estates and probate or to learn how to register a will, the Maryland Register of Wills offers information and links to local registers.