Don’t assume the terms of a contract are written in stone. “A lot of times people are accustomed to just signing things, so you want to take initiative,” says Carlson. “Get the agreement and mark it up—make revisions and return it to the facility.” Carlson has seen contracts returned with arbitration clauses blacked out or information added to ambiguous phrasing about financial charges or discharge policies. “You want to firmly have a conversation about the things you want,” he says.
Are There Hidden Fees?
When the Mollens were searching for facilities, it was often the contract that turned them away. “We were never sure how much money went to what charge or what certain things meant,” says Tina Mollen. “We needed it broken down.”
Mary Ann Parker, an attorney who works for the DC long-term-care ombudsman, has seen clients whose bills have been inflated for dining services or ambiguous community fees. “Before finalizing your plans with a facility, make sure you understand the services and what the costs are,” Parker says. “You need to know up-front what you will and will not be charged for.”
Some facilities have an in-house optometrist, dentist, and rehabilitation unit. Vanessa Bishop, a geriatric-care specialist with Elder Care Consultants, suggests finding out how much these services cost. “Also, it is important to know if you can provide your own private medical duty,” she says. Most facilities try to use their specialists instead of allowing residents to hire someone for their own 24-hour care.
Can I Get a Refund?
Some assisted-living facilities are continuing-care retirement communities (CCRCs), in which an elderly person resides permanently, moving from assisted living to nursing care when necessary. These facilities often require a lump-sum deposit.
To make the deposit, some people sell their homes and other assets. In some cases, if an elderly resident passes away, part of the deposit can go to his or her beneficiaries. Other times, if a resident wants to leave, a refund is possible if he or she moves out within 30 days, or the person might get a percentage of it within six months. “It varies from contract to contract,” says Peggy O’Reilly of the firm Fairfax Elder Law. “There are some cases in which, if you put money in, you never get it back.”
Can They Kick Me Out?
In DC, regulations lay out the specific instances in which a resident can be discharged—for example, if he or she becomes physically aggressive—but Virginia and Maryland have no such regulations, and policies vary. Virginia long-term-care ombudsman Joani Latimer says you should review stipulations in contracts that explain when residents can be discharged—or, in the case of CCRCs, when residents will be moved from assisted living to nursing care. “You want to be careful of vague phrasing that gives the facility the discretion to make their own decisions,” Latimer says.
Wording that says the facility will discharge you involuntarily if “it cannot meet your needs” often gives the residence too much discretion to decide what needs it can and cannot meet. Says Eric Carlson: “You really want specifics, like ‘the facility will discharge you if you require more than two staff members to assist you out of bed.’ ” If you do face a disagreement over involuntary discharge, you can contact the state ombudsman, who may be able to mediate a solution.
For the Mollens, reading the fine print seems to have paid off. Alfred Mollen’s transition has gone smoothly. He attends weekly performances by musicians who visit the facility and sees Tina and Neal almost daily. Says Tina: “We’re satisfied—but more importantly, he’s happy.”
This article first appeared in the November 2009 issue of The Washingtonian. For more articles from that issue, click here.
