Who Is Legally Responsible for the Assisted Living Bill in California?

Assisted living communities and board and care homes are licensed in California as residential care facilities for the elderly (RCFEs). Each resident has a written admission agreement, and that contract is where responsibility for the bill starts. What the agreement must contain is covered in our guide to the assisted living admission agreement.

Two rules matter here. Title 22, section 87507 requires the agreement to state the payment provisions, including the payor of all items and services and the due date. Health and Safety Code section 1569.887 requires it to be signed and dated by the resident or the resident's representative.

So the first question is who the contract names as payor, and in what role each person signs. This page describes the rules as written. It is not legal advice.

Not by itself. The licensing regulations define a representative as an individual who has authority to act on behalf of the resident, such as a conservator, the agent named in an advance health care directive, a spouse, a family member or a person the resident designates. The same definition, in Title 22, section 87101, then says: "Without other legal obligation to the contrary, acting as a resident representative does not mean that the individual assumes personal responsibility or liability for payment of any charges incurred by the resident." The regulations use "responsible person" to mean the same thing as representative.

The words "other legal obligation" are the catch. A separate promise in the contract to pay from your own money is one. California Advocates for Nursing Home Reform (CANHR), a consumer group, puts it this way: if someone other than the resident signs, make sure that person does not become a legally responsible party, one held personally responsible for paying the home's fees.

The roles a family usually meets are:

We read the admission agreement statutes, Health and Safety Code sections 1569.880 to 1569.888, and Title 22, section 87507 in their current text. They set what the contract must contain, how it must be printed and who signs it. They do not mention guarantors, co-signers or a personal guaranty by a relative.

That is different from nursing homes. The Consumer Financial Protection Bureau explains that under the federal Nursing Home Reform Act, a nursing home cannot require a caregiver, relative or friend to pay a resident's bill with their own money as a condition of admission or continued stay. We did not find an equivalent in the assisted living sections named above, so do not assume it protects you in an RCFE.

Some limits do apply. The agreement may not include any provision the home knows or should know is deceptive, or unlawful under state or federal law. For a resident on SSI, CANHR says families cannot be required to supplement the SSI rate as a condition of placing or keeping a person in the home, although they may make voluntary contributions.

Because the law is silent on personal guaranties, the wording of the contract carries the weight. Ask an elder law attorney to read it before you sign as a responsible party or guarantor.

California has a law on this, and it is short. Family Code section 4400 reads: "Except as otherwise provided by law, an adult child shall, to the extent of the adult child's ability, support a parent who is in need and unable to self-maintain by work."

Section 4403 says who may enforce the duty. A parent, or the county on behalf of the parent, may bring an action against the child. A county that has furnished support to a parent has the same right as the parent to seek reimbursement and continuing support, subject to limits elsewhere in state law. These sections do not name a care home as a party that may sue. If a case is brought, section 4404 tells the court to consider each party's earning capacity and needs, obligations and assets, age and health, and standard of living.

Section 4401 adds that an adult child's promise to pay for necessaries already furnished to such a parent is binding. Sections 4410 to 4414 let an adult child ask a court to be freed from the duty when the parent abandoned the child for two or more years before the child turned 18, while able to provide support.

The code does not say how often these sections are used, and we will not guess. Whether they could apply to your family is a question for an elder law attorney. How relatives share costs by choice is covered in family paying for a parent's assisted living.

Spouses are in a different position. Family Code section 914 makes a married person personally liable for a debt incurred for the necessaries of life of the person's spouse before the date of separation. Whether a particular care bill counts is a legal question. See couples paying for assisted living.

CANHR calls the admission agreement a legal contract and suggests having an attorney or consumer advocate review it. A home must give you a blank copy on request, at cost, so you can read it at home first.

1. 1

   Find the payor line and every signature block

   Note the title printed under each line: resident, representative, responsible party, guarantor.

2. 2

   Look for a personal promise to pay

   In its advice about nursing home contracts, the Consumer Financial Protection Bureau says to watch for the words "responsible party" and "joint and several liability". Look for the same words here.

3. 3

   Ask the home in writing which role you are signing in

   Ask whether signing as representative makes you personally liable, and ask for the answer on paper.

4. 4

   Show your authority if you are paying from your parent's money

   An agent or conservator pays from the resident's funds. See managing a parent's money to pay for care.

5. 5

   Get legal advice before signing as guarantor

   An elder law attorney or legal aid office can tell you what the clause would mean for you.

CANHR's fact sheet, citing Health and Safety Code section 1569.652, says a resident's relatives are not liable for any payment beyond that due at the date of death unless agreed to in writing or ordered by a court. A home may charge fees only while the resident's belongings remain in the unit, and prepaid fees for the time after that must be refunded within 15 days after the property is removed.

If the worry is that savings will not last, read when the money runs out in assisted living.

Hamssa Benrekia is a senior living placement specialist in Torrance who helps families in the South Bay and Harbor area find licensed assisted living communities, board and care homes and memory care. She goes on tours with families and helps them talk terms with a home. She does not give legal or financial advice. More topics are in the California Assisted Living Placement Guide. To talk about a search, contact Hamssa.