-- Allowed nursing homes to offer less than the care required by the federal law. Under the law, a nursing home must provide care necessary for a resident to reach “the highest practicable level of functioning,”  whether a resident’s care needs are light or heavy.  Some admission agreements, however, said the responsibility would shift to the resident’s family to provide supplemental services, if the resident’s care needs become heavy.

-- Limited the nursing home’s responsibility for the resident’s health or personal items.  Many admission agreements waived or limited the nursing home’s responsibility for a resident’s health, sometimes for any and all injuries they suffered.   Almost three-quarters – 74 percent -- of the agreements asked the resident or family to waive or limit the nursing home’s responsibility for loss or theft of the resident’s personal property. 

-- Allowed nursing homes to evict a resident for reasons not allowed by federal law. Seventeen percent of nursing homes claimed unlimited rights to evict residents, although federal law allows only six limited reasons. Of admission agreements that listed reasons, almost half included at least one not allowed by federal law.  Many admission agreements claimed a right to evict residents who are uncooperative or unmanageable – behaviors often related to Alzheimer’s disease and other dementias, which are common in nursing homes.

-- Limited residents’ rights to visits from family in violation of the federal law. Federal law provides that a nursing home resident has the right to visits by a family member at any time of the day or night, but 5 percent of admission agreements applied visiting hours to family members.

-- Required a resident’s family or friends to take personal financial liability for a resident’s care in violation of federal law.  The federal law prohibits a nursing home from requiring such financial guarantees as a condition of admission or continued stay.  Nonetheless, about half of admission agreements required or asked a family member or friend to assume personal financial liability.