Forbes: Adult Children Could be On the Hook for Parents’ Nursing Home Bills

With costs of long term care mounting for many individuals, Forbes takes a look at the direct impact—and responsibility—that can fall on a resident’s children when it comes to paying the bills. 

Filial responsibility, or the obligation of adult children to care for their indigent parents, was the topic of a recent Pennsylvania appeals court, Forbes writes. The court decided an adult son was responsible for $93,000 in nursing home bills accrued by his mother. 

Pennsylvania is one of 30 states that have filial responsibility statutes—laws that impose a duty on adult children to care for their indigent parents. About two-thirds of those states, including Pennsylvania, allow long-term care providers to sue family members to recover unpaid costs. The rest, including states such as Massachusetts, have no recovery provisions. However, failing to care for a parent is a criminal offense. In the Bay State, the penalty is a $200 fine or up to one year in jail.

The rules vary widely from state to state. But most take into consideration the adult child’s ability to pay. For example, a daughter would be protected if she also has extensive bills for her own child’s college education. In some states, such as Maryland, only the nursing home resident is responsible for a bill, although family members can voluntarily agree to help pay.

And federal law prohibits states from going after families after someone is already eligible for Medicaid long-term care benefits or from including an adult child’s income and assets when determining whether a parent is eligible for Medicaid. As a result, these laws apply only before people enroll in Medicaid.

In the case cited above, a woman spent six months in a nursing home while recovering from an automobile accident. Her stay cost far more than her monthly Social Security and pension income, and her Medicaid application was still pending by the time she left the facility—leaving the bill unpaid.

Many states have filial responsibility laws, but few have traditionally enforced them. That may be changing, says Forbes, as nursing home costs increase and residents have less ability to pay them.

“While these laws don’t directly apply to Medicaid recipients, they may force children to pick up their parents’ long-term care costs long before mom is ever eligible for Medicaid,” says the article. “Such a step could still shift significant costs from states to families.”

Read the full Forbes article.

Written by Alyssa Gerace

Alyssa Gerace



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