According to an NPR Rochester investigation, nursing homes in the area, along with some homes elsewhere in the nation, are suing friends and families of residents in an attempt to collect unpaid debts held by the residents, despite federal regulations that are designed to prevent such actions.
While the investigation focused on Monroe County in upstate New York, where Rochester is located, consumer attorneys in California, Illinois, Kentucky, Massachusetts, and Ohio, in addition to New York, told the outlet that they regularly see similar lawsuits in their states.
"The level of aggression that nursing homes are using to collect unpaid debt is severely increasing," Lisa Neeley, a Massachusetts elder law attorney, told NPR.
In Monroe County, 24 federally licensed nursing homes filed 238 debt collection cases from 2018 to 2021, totaling nearly $7.6 million. Nearly two-thirds of those cases targeted the resident’s family or friends.
The legal basis for the lawsuits are admission agreements friends and family often sign when admitting their sick or old relatives and friends to the nursing home. These agreements are often buried inside piles of paperwork, and consumer advocacy groups argue that the practice is deceptive and that the homes often don’t tell the people signing the paperwork that it will make them liable for the resident’s bills.
"They are given a stack of forms and told, 'Sign here, sign there. Click here, click there,'" Miriam Sheline, managing attorney at Pro Seniors, a nonprofit law firm in Cincinnati told NPR.
Oftentimes, consumer advocates say, people are told they must sign the admission agreements, a violation of federal law.
In one case, a nursing home sued Chris Ferris for $11,000 two years after he admitted his mother. He says that when he was signing the paperwork, he asked the staff if anything he was signing would make him financially liable, and they told him no. Ferris does not have power of attorney over his mother, who he no longer speaks to, and therefore has no control over her assets. That is the case in over a third of the lawsuits filed by Monroe County against friends and relatives of residents.
In another case, a woman was sued for nearly $8,000 worth of debt owed by her brother after he stayed there for two months. She says she was never asked to sign anything and believes the nursing home forged her signature using the visitor log book.
In a few cases, the debts exceeded $100,000. In one case, a nursing home said a woman owed them $82,000 for her mother’s care when the resident was in fact her cousin.
The nursing homes often accuse the friend or family member of helping the resident hide their assets in a process known as “fraudulent conveyance.” However, it is rare that the nursing home presents any evidence of it. Only three of the 29 lawsuits in which Monroe County accused the defendant of fraudulent conveyance presented supporting records. Meanwhile, only five of the 70 cases filed on behalf of the county and nursing homes by a Rochester law firm included documentation supporting the claims.
A partner, Anna Lynch, says that her firm Underberg & Kessler has evidence of the crimes, but that they don’t always present it in the complaint. “The fact that the complaint does not make reference to the specific evidence does not mean there is not evidence," she told NPR.
But that was not the case for 81-year-old Barbara Robinson. She signed paperwork for her friend who was admitted to a county home. She says she helped the staff gather the information they would need to sign her friend up for Medicare. Three years later when her friend died, the county accused her of taking her friend’s assets and sued her for $21,000.
There was no documentation to back up the claim and a judge threw the case out. “[The] plaintiff must allege some facts to support its claims," Judge Debra Martin wrote in her judgment.
However, oftentimes the defendants, who often lack the means to pay lawyers, pay the bills out of fear of repercussions. "They believe not only that they're going to lose their own income and their own houses and assets, but also they're concerned that their loved ones who are still in the nursing home may be potentially kicked out," Anna Anderson, an attorney, told NPR.
And in over a third of the cases, the nursing homes win the judgment by default because the defendants didn’t respond, a common occurrence in debt collection cases.
But federal law prohibits homes from requiring friends and family to guarantee they will pay the bills of residents. They are not even allowed to ask.
“If you bring your child to a doctor, you should pay for the child's medical care. But if your adult child brings you to a nursing home and you're 80, the law doesn't bind you to pay those bills," said Paul Aloi, a Rochester attorney, told NPR.