Are Family Members Responsible for Nursing Home Bills?

Even though these laws are rarely enforced, many states have filial responsibility laws that might have adult children on the hook for their parents' nursing home bills if the aging parents cannot pay.

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Even though these laws are rarely enforced, many states have filial responsibility laws that might have adult children on the hook for their parents' nursing home bills if the aging parents cannot pay.

Many aging parents do not wish to become a burden on their children as they age or lose independence. Unfortunately, they often find themselves in situations where their retirement funds dwindle and have no choice but to rely on their adult children to pay for their care expenses. To some degree, adult children may feel the obligation to take care of their aging parents when they are no longer able to care for themselves. And if your aging parents are unable to pay for the costs of living in a nursing home perhaps because they didn't take the required steps of planning for the costs of living in a nursing home, you and your siblings may be held responsible for paying the nursing home bills under the filial responsibility laws.

Also known as parental-support laws, filial responsibility laws place a personal obligation on adult children and/or other relatives to pay for unpaid nursing home bills if their aging parent(s) cannot pay. These rules do not apply if the patient (parent) qualifies for Medicaid. Under this scenario, Medicaid should settle the unpaid bills. Although they're rarely enforced, the filial responsibility laws are put in place to minimize the parents' burdens on the states' welfare systems.

In this article, we'll look at everything revolving around filial responsibility laws and the circumstances under which family members may be responsible for paying their parents' unpaid nursing home bills.

Table of Contents

An Increasing Aging Population

The American population is aging at a faster rate more than ever. Unfortunately, the country is being confronted with the ultimate challenge: who's liable for providing long-term care for the aging population? While this is an ongoing debate that may not come to an end anytime soon, we should all be prepared for the possibility of having to chip in or be held accountable for unpaid nursing home bills.

Filial responsibility laws are designed so that nursing homes can bring civil suits and legal actions against adult children or family members of an aging parent who is unable to pay nursing home bills. 

What Exactly is Filial Responsibility Laws?

Filial responsibility laws are based on the historical tradition that calls for respect and duty towards aging parents. And because there's no federal filial responsibility law, these statuses may vary from state to state and also on how they're implemented. While the main aim of filial responsibility laws is to recover the costs of care from family members and adult children, it's meant to ensure that adult children have the obligation of paying for their aging parents' care.

With the enactment and wide acceptance of social insurance programs such as Medicaid and Medicare, the enforcement of filial responsibility laws have taken a back seat in many states. This, however, doesn't mean that you won't be held accountable if your aging parent is unable to pay for nursing home bills. The filial responsibility laws have been around for centuries but have been under the radar. But because long-term care is massively underfunded, many states have decided to go back to the old rules. 

So why are Filial Responsibility Laws not being enforced?

Although most states have filial responsibility laws, they generally do not enforce them. And why is that? Well, many senior citizens who cannot pay for their medical care often receive assistance through Federal social programs such as Medicaid and Medicare. As such, adult children may not be held accountable if their aging parents are on Medicaid or Medicare.

With that in mind, an adult child can be held responsible for his/her parent's nursing home bills if:

  • The parent is unable to pay the nursing care bill
  • The parent received nursing home care in states that have filial responsibility laws.
  • The parent wasn't under Medicaid when receiving nursing home care.
  • The nursing home decides to sue the adult child or family member for the unpaid nursing home bills
  • The child is capable of settling the bill

A typical case occurred in 2012 when a Pennsylvanian court ruled that a son of an aging woman named Maryann Pittas pay $93,000 to her nursing home under the state's filial responsibility law. The elderly woman had applied for Medicaid but it was still pending when the case was brought to court. For this reason, the nursing home bill had to be settled privately so the nursing home held the woman's adult son liable. The court ruled that it didn't matter whether the son had signed the nursing home admission agreement.

What is a Responsible Party?

When an aging person is admitted to a nursing home facility, many nursing homes require a third party who is generally tasked with signing various documents that grant consent for the nursing home to provide care. In most cases, the third party is tasked with certain responsibilities. One of the documents may include a third-party agreement that may include a clause that the third-party will be responsible to settle any bill should the aging parent be unable to pay. By agreeing to sign such a document, you become the "responsible party."

As a responsible party, the nursing home holds you responsible for paying any pending nursing home bill if the aging resident is unable to pay the bills. And if the resident (in this case your aging parent or relative in the nursing home) is unable to pay the bill, it becomes your responsibility as the responsible party to apply for Medicaid on behalf of the resident. If you do not follow through on the Medicaid application or fail to provide the information required to determine the resident's Medicaid eligibility, the nursing home may choose to sue you, as the responsible party, for breach of contract.

A responsible party may also be sued by the nursing home if he/she misuses the resident's fund instead of paying for the resident's nursing home bills. In short, a responsible party may be held liable for paying the nursing bills in case the resident is unable to pay. However, keep in mind that there's no federal statute that requires an adult child of an aging parent to sign any admission agreement or guarantee that he/she will settle any unpaid bill.

It's, therefore, of great importance that you read the admission agreement carefully before signing or agreeing to anything. This is because many nursing homes use certain terms that may violate federal regulation. In other words, requiring a family member to sign or agree to be financially responsible to pay the nursing home bills if the resident is unable to pay is illegal under federal law. This means that nursing homes should not ask or make it a condition of admission for any family member to become the responsible party or to become legally responsible for future nursing home bills.

On the other hand, there are certain scenarios where a nursing home can legally ask the adult child to pay any unpaid nursing home bills. For example, the adult child or family member may be liable for paying any unpaid nursing home bill if he/she has the power of attorney over the aging parent's finances. Again, the adult child may be liable for settling unpaid bills if the aging parent had insufficient funds to pay for care but the adult child or family member offered to become responsible for paying the bills. Under such a scenario, the adult child will be held accountable and may be sued if he/she fails to pay the bills.

That being said, it's always advisable to read all the documents carefully and never agree to become the responsible party if you do not intend to use your money to pay for your parent's nursing home care should they run out of money. Again, the language used in the admission agreement may be confusing or deceptive, so it makes a lot of sense to seek legal expertise before signing anything. 

Exceptions to the Filial Responsibility Laws

As we've noted several times in this article, there's no federal filial responsibility law. Instead, filial responsibility laws are state laws and may vary from state to state. As such, it's important to understand whether or not these laws are applicable in your state and whether they're being enforced.

Additionally, there two exceptions to the filial responsibility laws:

  • If the adult child was abandoned by the now aging parent(s) for at least a decade in his/her minority.
  • If the adult child is financially unable to support the aging parent or settle the unpaid nursing home bills. You should, however, keep in mind that the threshold for being considered financially able to settle the nursing home bills is very low. If anything, most courts have held the adult children to pay the nursing home bills even though they have their families to support.

States that Implement Filial Responsibility Laws

Many people are unaware that more than 50% of the states in the country have filial responsibility laws. They include Pennsylvania, California, Arkansas, Alaska, Georgia, Delaware, Kentucky, Iowa, Indiana, Connecticut, Mississippi, Nevada, Montana, Massachusetts, Louisiana, North Carolina, New Jersey, Oregon, Ohio, North Dakota, South Dakota, New Hampshire, Utah, Rhode Island, Tennessee, Virginia, West Virginia, Vermont, and Puerto Rico.

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