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Standards for Residential Care Contracts Needed, California Group Says

SAN FRANCISCO, CA — April 11, 2003 — Most admission agreements used in California residential care facilities for the elderly do not comply with minimum state standards and fail to provide basic protections or information, according to a recent report by California Advocates for Nursing Home Reform (CANHR), a nonprofit senior advocacy group. There are 6,300 residential care facilities in California, which are also commonly known as assisted living facilities or board and care facilities. Although they are not skilled nursing care facilities, residential care facilities for the elderly typically provide many senior services including meals, housing, and help with tasks of everyday living (See Choosing Residential Care).

The CANHR report analyzed 109 residential care or assisted living agreements as well as three statewide standard agreements provided by assisted living associations to their member facilities. (If you do not already have Adobe Acrobat Reader installed on your computer, you may download a free copy in order to access the CANHR report). Actual illegal contract clauses included:

“Lessor shall have access to Lessee’s apartment without Lessee’s consent.”
“The Facility may terminate this Agreement at any time, with or without cause…”
“…residents who do not show courtesy to fellow residents or staff will be relocated to another facility.”

In summary, the study found that:

  • Many admission agreements omit, distort or misrepresent consumers’ minimal legal rights.
  • Almost 93% of the assisted living admission agreements failed to comply with basic legal requirements. Thousands of agreements violate fundamental residents’ rights, ask residents to waive basic rights, fail to inform them of the costs and services provided, and fail to meet legal requirements provided by regulations.
  • About 58% of assisted living facilities had one or more statements attempting to relieve the facility of responsibility for lost or stolen property; 25% sought to waive responsibility for residents’ personal injuries.
  • Legalistic contract language, poorly organized agreements and small print size make many of these documents difficult to read and to understand.
  • Although there are some California regulations providing admission protections for residential care or assisted living facility applicants, there are no such statutory protections.

New Bill Would Establish Standards for California Assisted Living Agreements

Citing the CANHR report, a new bill was introduced in the California Senate to ensure that admission agreements used by assisted living or residential care facilities for the elderly do not violate residents’ rights. S.B. 211 would require that these agreements be written in clear language, organized by sections, and printed in black print of at least 12–point font size. In other provisions, the bill:

  • Requires that a copy of the agreement be posted within the facility.
  • Restricts the agreement from including unlawful waivers of liability for the health and safety or personal property of residents.
  • Restricts the use of binding arbitration, a procedure that can be biased against consumers.
  • Requires the agreement to include:
    • a description of and fee schedule for all items not included in a single fee;
    • an explanation of the use of third–party health and medical services;
    • information about a resident’s right to contact the Department of Social Services or the local ombudsman regarding any complaints;
    • a copy of residents’ rights;
    • a list of the reasons for possible eviction, as specified by law or regulation;
    • an explanation about the notice required prior to a transfer or eviction, and information about the appeal process.
  • Prohibits an agreement from including grounds for involuntary transfer or eviction that are inconsistent with state law.

Consumer Support for Standard Assisted Living Contracts

Proponents of S.B. 211 point out that assisted living or residential care facility agreements are usually entered into at a time of crisis. “Residents with physical and/or mental impairments, financial limitations, and lack of knowledge about long–term care options are particularly vulnerable and dependent upon the honest and full disclosure by facilities,” according to a statement in the Legislative Analysis of S.B. 211. “Consumers of residential care facilities need assurances that the admission agreements they are asked to sign under these conditions clearly disclose their rights as consumers, the obligations of the facilities, and that the agreements comply with applicable state and federal laws.”

S.B. 211 is sponsored by California Advocates for Nursing Home Reform, the National Senior Citizens Law Center, and Bet Tzedek Legal Services. Other supporters include the Congress of California Seniors, the Consumer Attorneys of California, and these branches of the Alzheimer’s Association: California Council, Central Coast, and Northern California.

You can find the full text of S.B. 211 on the California Senate web site. We urge you to contact your representative in the California Assembly or Senate to express your opinion about the bill. (See Official California Legislative Information if you need to know which legislators represent your area.)

At Brayton Purcell, we are concerned with the problems of the elderly. If you have questions about your legal rights or those of an elderly loved in a nursing home or residential care facility, please feel free to contact us. We are experienced in all facets of elder abuse law, including nursing home violations and inadequate pain management issues.

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