Parental support and nursing home bills

Old woman with young woman in nursing home
  • Filial support laws make you responsible for parents' long-term care bills.
  • Providers have sought payment in two states: Pennsylvania and South Dakota.
  • Elder law attorneys can help you plan, protect you from having to pay.

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 recent 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.

So far, however, such actions remain unusual throughout the country, says Howard Krooks, president-elect of the National Academy of Elder Law Attorneys, or NAELA, and an attorney with Elder Law Associates PA in Boca Raton, Fla.

"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, Pa., 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.

Check out parental support laws state by state

"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.

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, new 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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