What happens when a person who is in need of long term care is not able to pay for it? Currently a majority of the states (see the list of states below) have laws on their books which in varying degrees can make adult children financially responsible for their parents' necessities of life when the parents do not have the means to pay for such necessities. These laws are referred to as "filial responsibility laws" and can be used by nursing homes and other long term care facilities located in the states that recognize them as a means to seek reimbursement for unpaid bills.
While filial responsibility laws have rarely been enforced in the past, a recent case in Pennsylvania may indicate a new trend. In Health Care & Retirement Corporation of America v. Pittas (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012), the Pennsylvania Superior Court upheld a lower court decision which made the adult son of a woman who had received skilled nursing care and treatment at a Pennsylvania facility for a period of six months liable for the $93,000 bill. The court concluded that the state did not have the duty to consider the woman's other possible sources of payment, including a husband and two other adult children, or the fact that an application for Medicaid assistance was still pending. Instead, since the facility had adequately met its burden of proof that this particular son had the means to pay the $93,000 bill, the trial court was correct in holding the son responsible for paying it.
This Pennsylvania case demonstrates the importance of long term care planning from the perspectives of both elderly parents and their children. Without proper planning and legal advice from an experienced elder law attorney, children may very well be on the hook for thousands of dollars of care required by their aging parents.
The states that have filial responsibility laws on their books in some shape or form are Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, and West Virginia.
For an in depth look at the history of filial responsibility laws and a chart which lists the current state statutes, see Filial Support Laws in the Modern Era: Domestic and International Comparison of Enforcement Practices for Laws Requiring Adult Children to Support Indigent Parents, by Dickinson Law Professor Katherine C. Pearson. Note that the article can be downloaded for free.
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