Parental support and nursing home bills

Retirement » Senior Living » Parental Support And Nursing Home Bills

As your parents age, they may spend a few months or more in a long-term care facility. Thanks to parental support laws, also known as "filial support," you could be on the hook for unpaid bills they leave behind.

These laws allow long-term care providers to pursue payment from a parent's adult children in 29 states and Puerto Rico.

A 2012 study published by Katherine Pearson, a professor of law at the Dickinson School of Law at Penn State University, found that long-term care providers are taking advantage of such laws in at least two states: Pennsylvania and South Dakota.

Nurse checking blood pressure © Andrew Gentry/

So far, however, such actions remain unusual throughout the country, says Howard Krooks, a partner at Elder Law Associates PA in Boca Raton, Florida, and Of Counsel to Amoruso & Amoruso LLP in Westchester County in New York.

"Filial responsibility laws traditionally have rarely been enforced," he says.

A case study

Nevertheless, Pearson recounts a cautionary tale about a high-profile case in Pennsylvania involving expenses incurred by Maryann Pittas, the victim of a car accident. Pittas was a patient in an Allentown, Pennsylvania, nursing home for about six months before relocating to Greece to live with relatives. Pittas' son got stuck with the bill for nearly $93,000.

After the case wound its way through the court system, in May 2012, the superior court found in favor of the nursing home, based on the son's ability to pay.

"By holding the son liable for a lump sum of close to $93,000 in the Pittas case, the superior court appears to confirm a significant tool for certain creditors of individuals who are unable to pay their debts personally, permitting the filial support statute to be applied retroactively to substantial accrued debt, without requiring evidence of fault on the part of the targeted family member," according to Pearson's study.

History of parental support laws

Parental support laws date back to colonial times and even earlier, according to Pearson's research. Such laws were established to make sure family members relied on one another rather than turning to public resources for help.

At one time, as many as 45 states had these laws, but many states repealed them as Medicaid began to take on a greater role in providing relief to the poor. However, such laws remain on the books in many states.

Check out parental support laws state by state

Laws in such states vary. Some examples of differences include the following.

  • Arkansas: Support requirement is limited to a parent's mental health services.
  • Connecticut: The law limits a child's legal obligation to support of parents younger than 65.
  • Nevada: Children are not bound to support parents unless they've made a written promise to do so.

The large cohort of aging baby boomers -- coupled with increased life expectancies -- threatens a surge in the use of costly long-term care services.

At the same time, recent restrictions have been placed on Medicaid, which traditionally has paid a large percentage of long-term care costs in the United States. For example, the Deficit Reduction Act of 2005 increases penalties on people who transfer assets for less than market value prior to applying for Medicaid.


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