Authorization to Obtain Records, Statements and Documents. By execution of this Agreement, the Resident, Resident Representative and/or Sponsor authorize the Facility, its agents, representatives, successors and assigns to obtain from financial institutions, including, but not limited to, banks, insurance companies, broker and credit unions, and government agencies, such as the Social Security Administration and Department of Social Services, records, statements, correspondence and other documents pertaining to the Resident for the purposes of payment to the Facility and/or securing Medicaid coverage.
Authorization to Obtain Records, Statements and Documents. By execution of this Agreement, the Resident, Resident’s Spouse, Financial Sponsor and Designated Representative jointly and severally authorizes the Facility to obtain from financial institutions (including, but not limited to, banks, insurance companies, broker and credit unions), and government agencies (such as the Social Security Administration, the Human Resources Administration of the City of New York or appropriate County Department of Social Services), records, statements, correspondence and other documents pertaining to the Resident. Nothing contained herein shall be deemed or construed as any requirement or obligation on the part of the Facility to do so.
