In Pennsylvania, a child can be held financially responsible for the cost of their parents’ long-term care. Pennsylvania’s filial support law obligates children to pay for parents’ medical expenses where the parents are unable to pay themselves (23 Pa. C.S.A. § 4603). For the law to apply, the individual must be indigent which simply means that the parent lacks “sufficient means” to pay for their care and maintenance. There is no prerequisite of wrongdoing. Therefore, even if the child did nothing improper, they can still be held liable for an unpaid nursing home bill.
There are two exceptions that may apply that would release the child from financial liability: (1) if the child does not have the money to support the indigent parent; 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 the parent is in a long-term care facility and does not have the assets to pay privately for their nursing home care, they should apply for Medical Assistance for long-term care. If eligible, Medical Assistance will pay the cost of the individual’s care and therefore this lessens liability. A common trap for families is where the parent is in a facility that does not accept Medicaid, and the parents run out of money. In this situation, the family must proactively look for a facility that will accept Medicaid to not incur medical debt.
Filial support cases are not limited to just nursing home bills. This could include any kind of medical care or long-term care (care at home, assisted living, day care, nursing home care, etc.).
To avoid the filial support liability, family members should educate themselves on the Medicaid rules and avoid unpaid bills from stacking up. 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 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.
To avoid the legal nightmare of a filial support lawsuit, it is financially prudent to meet with an elder law attorney that can advise the family concerning liability and the best course of action for payment of long-term care. 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.
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Rebecca A. Hobbs, Esquire is licensed to practice in the Commonwealth of Pennsylvania and is certified as an Elder Law Attorney by the National Elder Law Foundation as authorized by the Pennsylvania Supreme Court. She is a principal of the law firm of O’Donnell, Weiss & Mattei, P.C., 41 High Street, Pottstown, and 347 Bridge Street, Phoenixville,610-323-2800, www. owmlaw.com. You can reach Ms. Hobbs at rhobbs@owmlaw.com
