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CANHR Report Reveals Problems with
Residential Care Admission Agreements


Pat McGinnis, CANHR
(415) 974-5171

Senator Joseph Dunn
(916) 445-5831

Report Reveals Problems with Residential Care Admission Agreements; Senator Dunn authors legislation to establish admission agreement standards

San Francisco, CA -March 21, 2003 - A report released today by California Advocates for Nursing Home Reform found that a majority of admission agreements used by California's 6,300+ residential care facilities for the elderly do not comply with minimum state standards and fail to provide elderly consumers with basic protections or the information necessary to make informed choices.

The report, Better Read the Small Print: An Analysis of Admission Agreements in California's Residential Care Facilities for the Elderly, made the following findings, among others:

  • Many admission agreements omit, distort or misrepresent the minimal legal rights afforded consumers.
  • 93% of the admission agreements reviewed failed to comply with basic legal requirements.
  • As a result, thousands of admission agreements ask residents to waive basic rights, violate fundamental residents' rights, fail to inform residents of the costs and services provided, and fail to meet even the basic requirements under regulations.
  • Legalistic contract language, poorly organized agreements and small font size make many of these documents difficult to read and even more difficult to understand.
  • There are currently no statutory protections in California that govern admission agreements for residential care facilities for the elderly.

There are over 6,300 residential care facilities for the elderly (RCFEs) licensed by the California Department of Social Services. Often referred to as "board and care" or "assisted living," these are homes to over 145,000 residents. Approximately 90% of RCFE residents pay privately for their care and services, with fees ranging from $2,000 to over $6,000 per month.

A 1999 Report released by the U.S. General Accounting Office (GAO), which studied admission agreement practices in four states, including California, found:

"providers do not always give consumers information sufficient to determine whether a particular assisted living facility can meet their needs, for how long, and under what circumstances. Marketing material, contracts, and other written material provided by facilities are often incomplete and are sometimes vague and misleading." (Assisted Living: Quality of Care and Consumer Protection Issues in Four States, U.S. General Accounting Office, April 1999)

SB 211 addresses many of the concerns identified in the CANHR and GAO reports and would provide residents with the consumer protections and disclosures they need regarding format, readability, basic services, costs and residents' rights.

A copy of the summary report in PDF format* is available here. A full report, with background information on the study and the evaluation instrument, is available from the CANHR office.