Liability for parents’ nursing home bill in PA
Referred to as “Filial Support,” Pennsylvania has a statute that creates liability for certain family members of an indigent person for their care (23 Pa. C.S.A. § 4603). The classification of family members under the law that can be held responsible include, a spouse, child, and a parent. For the law to apply, the individual must be indigent which simply means that the person lacks “sufficient means” to pay for their care and maintenance.
It is important to understand that there is no requirement that the family member did something improper that resulted in the unpaid nursing home bill. Therefore, filial support can create liability regardless of whether the family member acted wrongfully.
There are two exceptions that may apply that would release the family member from financial liability: (1) if the family member does not have the money to support the indigent individual; and (2) if the parent abandoned the child for more than ten years while the child was a minor (23 Pa. C.S.A. § 4603(a)(2)).
Where an individual does not have the assets to pay privately for their nursing home care, they should apply for Medical Assistance for longterm care. If eligible, Medical Assistance will pay the cost of the individual’s care and therefore this lessens liability.
One of the most popular filial support cases involved a son being held liable for his mother’s $93,000 unpaid nursing home bill. This case is HCRA v. John Pittas, (2012 Pa. Super 96). In this case, John’s mother entered a nursing home after a hospital stay. The mother moved to Greece, and the nursing home was left with an unpaid bill of $93,000. The nursing home sought payment from John under the filial support law. John was not an only child, but it was only him that was sued. John advanced the argument that his siblings should also be held liable, however, the court did not find this to be a valid argument. The court found that John was liable for the unpaid bill. Some of the facts that the court pointed to was that he had the financial resources to pay the bill, his mother did not.
In another case, filial support law was applied in a different situation. In a 2014 Pennsylvania case, Eori v. Eori, one of three siblings sued the other two because he was providing support for their mother and the other two were not. The court ruled that the other two siblings were accountable for their mother’s support under the law.
To avoid the filial support liability, family members should educate themselves on the Medicaid rules and avoid unpaid bills from piling up and accruing. Never assume the nursing home will handle the Medical Assistance Application or that another family member will handle it. The nursing home will most commonly seek recovery under filial support where the family delays submitting a Medical Assistance Application or fails to provide the necessary verifications and financial data for the application. Filial support can also become a concern where a parent has made gifts or transfers of assets that exceed $500 in one month during the lookback period which creates a period of ineligibility. Another common situation that creates filial support liability is where there is a gap in Medicaid coverage due to a Medical Assistance application being denied, and a timely appeal is not filed.
Therefore, where a family member is being admitted to a nursing home facility, it is important and financially prudent to meet with an Elder Law Attorney that can advise the family concerning liability and the best course of action for paying the nursing home. An Elder Law Attorney can assist the family in applying for Medical Assistance or discuss a plan for paying privately. The important thing is to act and take control of the situation before there is an unpaid bill.
The legal advice in this column is general in nature, consult your attorney for advice to fit your particular situation.
Rebecca A. Hobbs, Esquire is licensed to practice in the Commonwealth of Pennsylvania and is certified as an Elder Law Attorney. Reach Hobbs at rhobbs@owmlaw.com.