Are you on the hook for Mom’s nursing-home bill? Blog by Joy Loverde

  • Posted on Oct. 15th, 2012

Background: A judge ruled May 7, 2012 that a Pennsylvania nursing home could collect an unpaid bill of $92,943 from the son of a patient who received care from September 2007 through March 2008.

Everyone knows that parents have an obligation to support their children. But, did you know that many states also require adult children to support their parents under some circumstances? Most families with elderly parents do not think about the fact that they could be held responsible for their parents’ nursing-home care bills. In fact, twenty-nine states have “filial support” laws that could be used to go after patients’ adult children for unpaid long-term-care bills.

Based on England’s Poor Law Act of 1601, the filial support laws originally held that the father, grandfather, mother, grandmother and children of “every poor, old, blind, lame and impotent person” had to step up and support their indigent relative to the extent of their ability.


Today, with skyrocketing costs of eldercare and increased longevity, providers and states are getting more desperate for payment from overstretched Medicaid programs and using filial support laws to prod families into either paying their elders’ bills or completing Medicaid paperwork on their behalf. (Medicaid, the health insurance program for low-income people, has always excluded children’s income and assets when considering an older adult’s eligibility.)


Nursing homes have to get paid like everybody else, and if there’s a law on the books that can be used to get paid, they will use it.


Who sues who? Here’s where it gets interesting: A parent can sue an adult child; county or medical providers can file; family members may also be pitted against each other – children who have been sued to demand that their siblings kick in as well.  And living out of state is no protection against a lawsuit.  Is anyone immune?  Children financially strapped may not be required to support their parents and children who were abandoned or treated cruelly by their parent may also be off the hook.  Each case is decided by the court.


In the meantime, aren’t we family members already doing enough? Plenty of sons and daughters are stepping up to plate and spend an average $5500 out of pocket annually on loved ones (2007 National Alliance for Caregiving survey). Many others sacrifice spending on themselves to care for their parents and some even quit their jobs because of caregiving.


Do filial support laws take “honor they father and mother” too far? And what about the individual’s own role in planning for long-term care needs? Let this be a warning to adult children whose parents are racking up long-term-care bills. The filial-support law doesn’t shield the assets of adult children and a judge may rule children pay the bill.


This is all the more reason for families to take action now:

  • Start talking. Do you know if your parents are financially strapped?
  • Have a back-up plan if parents refuse to cooperate with Medicaid process (divulging and admitting modest income and assets is not easy)
  • Gather your financial advisors: Elder-law attorney and certified financial planner
  • Get estate planning papers in order – yours and your parents
  • Know how Medicaid works and start planning ahead
  • Consider long-term-care insurance
  • Work with the nursing home to understand options and responsibilities
  • Make a plan to keep parents out of the nursing home

Click here to read the Wall Street Journal article, June 22, 201



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