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You can help caregivers spot illegal nursing home debt collection tactics

Deborah Royster is the Assistant Director for the Office for Older Americans, CFPB and Edwin Walker is the Deputy Assistant Secretary for Aging at the Administration for Community Living, HHS.

Today, the CFPB is releasing a new resource to help you identify and report illegal nursing home debt collection tactics. Whether you’re a long-term care ombudsman, care coordinator, elder law attorney, or other aging services provider, you can help caregivers:

  • Spot red flags in nursing home admissions contracts
  • Find help if a debt collector tries to collect nursing home bills from them
  • Report illegal activities to federal and state authorities

Caregivers should not have to put their own finances at risk to help loved ones get care

There are 48 million family members and friends providing support to an adult in the United States. It’s important for caregivers to understand their rights, especially when it comes to helping a loved one gain admission to a nursing home. Some nursing homes and debt collectors are billing and suing caregivers for residents’ cost of care based on illegal admission contracts. Whether you’re a long-term care ombudsman, care coordinator, elder law attorney, or other aging services provider, you can play a part in protecting caregivers.

Illegal nursing home admission contract terms can cause serious financial harm

During the nursing home admissions process, caregivers must decide whether to sign admission contracts. These contracts may be lengthy and confusing, and caregivers are likely unaware of the potential legal consequences of what they are signing. Some nursing home admissions contracts say that a caregiver, family member, or friend must pay the resident’s bill if the resident can’t afford to. This is generally illegal .

When nursing home bills go unpaid, some nursing homes hire debt collectors, including law firms, to demand that caregivers pay for a resident’s unpaid nursing home bills based on these illegal terms. They may report the debt to consumer credit reporting companies as the caregiver’s debt and file lawsuits in court. The financial impact of debt collection can be devastating for caregivers and their families.

My Mom passed away on October 3, 2020. It was just two days before … I had received mail which said that I was personally being sued by the nursing home for close to $80,000. I never had time to grieve. I kept so much inside; the stress was unbearable. I thought, I won’t be able to afford my mortgage – I am definitely going to lose my house. What will I tell my kids?

- Robyn King, Testimony before the U.S. Senate Committee on Banking, Housing, and Urban Affairs (Mar. 29, 2022)

This pressure may convince some caregivers to enter into payment plans and pay the resident’s nursing home bills, even if they have doubts about the legality of the contract. These actions may also violate the Fair Debt Collection Practices Act and the Fair Credit Reporting Act.

You can help caregivers spot and report illegal nursing home debt collection tactics

Caregivers may not realize what they’ve signed until the nursing home begins attempts to collect from the resident’s debt from them personally. That’s why it’s important for caregiver advocates, long-term care ombudsmen, elder law attorneys, and aging services professionals to help caregivers identify illegal tactics and report them.

What to look out for

Watch out for words such as “responsible party” and “joint and several liability” in the admissions contract. Some contracts say that if the responsible party doesn’t make sure the resident’s Medicaid application is complete, accurate, and on time, then they are responsible for paying the nursing home’s damages. Or they might say that the responsible party and the resident are both “jointly and severally” responsible for the nursing home bills.

If a third party has legal access to a loved one’s money or property, a nursing home can only request or require that they sign a contract, without incurring personal financial liability, to provide payment from the resident’s available money.

What you can do


This information may include links or references to third-party resources or content. We do not endorse the third-party or guarantee the accuracy of this third-party information. There may be other resources that also serve your needs.

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