Facility Contract Checklist
Review fees, discharge rules, rate increases, arbitration, deposits, care levels, medications, and payer changes before signing.
Review what costs can change, when discharge can happen, what fees are refundable, and how disputes or payer changes are handled.
A facility contract can be the place where friendly tour promises become enforceable rules. Families should read it before the move becomes urgent.
Quick answer
Review what costs can change, when discharge can happen, what fees are refundable, and how disputes or payer changes are handled.
Plain-English Summary
A senior care contract is not just paperwork.
It can define what the family pays, what services are included, when rates can rise, what happens when care needs increase, and whether a resident may be discharged or transferred.
Before signing a facility contract, families should understand:
- Total cost.
- Included services.
- Extra fees.
- Rate increases.
- Care level changes.
- Medication fees.
- Discharge or transfer rules.
- Family liability language.
- Refund policy.
- Arbitration clause.
- Resident rights.
- Complaint process.
For nursing homes, the Consumer Financial Protection Bureau warns that nursing homes should not make a caregiver personally responsible for a loved one's bill as a condition of admission or continued stay. CFPB highlights contract terms such as "responsible party" and "joint and several liability" as words to watch carefully.
The Kefiw Contract Review Frame
Review the contract in five passes.
Pass 1: Money
Look for:
- Base rate.
- Care-level fee.
- Medication fee.
- Move-in or community fee.
- Supply fees.
- Transportation fees.
- Rate increase policy.
- Refunds.
- Deposits.
- Late fees.
- Private-pay requirements.
Pass 2: Care
Look for:
- What services are included.
- What services cost extra.
- What care needs the facility cannot support.
- How care levels are reassessed.
- How falls are handled.
- How medication support works.
- How family is notified of changes.
Pass 3: Exit Rules
Look for:
- Discharge policy.
- Transfer rules.
- Notice requirements.
- What happens after hospitalization.
- Behavior-related discharge rules.
- Memory care transfer rules.
- Medicaid transition rules, if applicable.
Pass 4: Liability
Look for:
- Responsible party language.
- Personal guarantee language.
- Joint and several liability.
- Third-party payment obligations.
- Collection language.
Pass 5: Rights And Complaints
Ask how resident rights are explained, how complaints are documented, and which outside agencies can help if concerns are not resolved.
Kefiw Tip: Ask For A Contract-To-Invoice Walkthrough
Before signing, ask:
"Can you show us where every possible monthly charge appears in the contract and what it would look like on a sample invoice?"
This catches gaps between the sales conversation and the legal document.
Family Script
"We are not trying to slow the process down. We need to understand what we are signing, what could make the bill increase, what could lead to discharge, and whether any family member is being asked to take personal financial responsibility."
Red Flags
- Verbal promises are not in the contract.
- Rate increase rules are vague.
- Discharge policy is broad or unclear.
- Medication fees are not explained.
- Care level pricing is not attached.
- Arbitration language is not understood.
- A family member is pressured to sign as responsible party.
- Refunds are unclear.
- The family is told not to have an attorney review it.
Checklist
- Ask for a complete contract.
- Ask for fee schedule.
- Ask for sample invoice.
- Ask for care-level policy.
- Ask for discharge policy.
- Ask for rate increase policy.
- Ask for refund policy.
- Review responsible party language.
- Review arbitration clause.
- Confirm Medicaid policy if relevant.
- Confirm resident rights information.
- Locate long-term care ombudsman.
- Have an elder law attorney review before signing when possible.
Related Kefiw Tools
- Assisted Living Cost Calculator
- Memory Care Cost Calculator
- Nursing Home Cost Calculator
- Family Care Budget Calculator
Professional Review
Recommended reviewer: elder law attorney, senior care advisor, or long-term care ombudsman-informed reviewer
Sources To Verify
Last reviewed: April 29, 2026.
Kefiw Insurance And Payment Disclaimer
Kefiw provides educational care-planning tools and guides. This content does not provide legal, tax, financial, insurance, Medicaid, VA, or medical advice. Rules, eligibility, covered services, tax treatment, account limits, provider participation, and benefits vary by person, state, employer, plan, policy, and year. Confirm details with the appropriate agency, insurer, employer, tax professional, elder law attorney, licensed insurance professional, or qualified advisor.
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Frequently asked questions
› Who should use this care facility contract checklist? How-to
Use it when the family needs a practical conversation starter, a checklist for provider calls, or a way to connect care concerns to costs and next steps.
› Can this guide replace professional advice? Trust & accuracy
No. It is designed to organize questions and decisions before speaking with clinicians, Medicare resources, insurers, elder law attorneys, care providers, or other qualified professionals.
› What should families do first? How-to
Write down the immediate safety concern, the care tasks that are already happening, the expected monthly cost, and the person responsible for the next call.
› How should I use this guide with a Kefiw tool? How-to
Use the guide as the plan and the linked Kefiw tool as the check. Read the steps first, try the move manually, then use the tool to compare outputs, catch edge cases, and decide whether the result actually fits your task.
› What mistake do tool guides help avoid? Troubleshooting
Tool guides help avoid using a utility mechanically without understanding what you are trying to accomplish. Most word, writing, and text utilities are fast, but speed can hide context mistakes. Know whether you are solving a puzzle, cleaning copy, drafting a line, or checking a rule.