You May Have to Pay for Your Parents' Nursing Home or Medical Care

About half of the states say that you must pay for your parents' medical or nursing home care if they cannot afford it.

It's legally well established that parents have a responsibility to financially support their children. In about half of all states, the reverse is true as well: adult children have a legal responsibility to support their parents when their parents don't have sufficient income to take care of themselves. In legal terms, this is called "filial responsibility."

Filial Responsibility Laws

Filial responsibility laws say that when parents cannot afford living expenses, medical care, or nursing home care, their adult chldren have to provide for them, if they can afford to do so. Most states had filial responsibility laws at one time, but about half of the states have repealed them. Today, California, Georgia, Pennsylvania, and about 20 other states have some form of filial responsibility law, but they aren't often enforced.

The details of these laws vary by state. Most state laws specify that a parent must be indigent or have very low income before the court will rule in favor of a filial responsibility lawsuit. In most of the states, a nursing home, hospital, or the state government can file a lawsuit against an adult child, but in California, only a parent or the government can file a lawsuit.

In some states, adult children can even be liable criminally for not supporting their parents, though in most of the states, adult children can only be forced to pay the parent's nursing home bills if they lose a lawsuit. A party collecting the court judgment could put a lien on the child's property or garnish wages to collect it, however.

Not Every Adult Child Must Pay

These state laws give courts some discretion when enforcing filial responsibility laws. Adult children who are barely making ends meet financially typically won't be required to pay for their parent's care. A "clean hands" doctrine also applies in many states: If a parent abused or abandoned the child, some state laws say that the parent is undeserving of the child's financial support. Likewise, in some states a parent is not entitled to financial care by a child unless the parent is moneyless due to "misfortune" (as opposed to squandering wealth).

When Filial Responsibility Laws Are Used

Most low-income and low-asset seniors qualify for Medicaid, or at least Medicaid-paid long-term care, if they need it. The Medicaid program is not allowed to go after the assets of a Medicaid recipient's children to offset costs. So the child of any parent who is covered by Medicaid isn't going to be held responsible for paying for their parent's care.

Elderly parents who don't qualify for Medicaid are often able to pay for their own care, at least until they spend down their assets sufficiently to qualify for Medicaid. Only when a parent is not eligible for Medicaid and the parent doesn't have enough money to provide for his or her own care will a child's ability to pay come into consideration. If, in this circumstance, a child does have the ability to pay for a parent's care, but refuses to, the parent or a care provider (such as a nursing home, hospital, or doctor's office) might decide to sue the child for payment.

This set of circumstances happens rarely, and of course, many states don't have filial responsibility laws that allow this, including the populous states of Texas, New York, Florida, and Illinois. But adult children have been successfully sued in several well-publicized cases over the last few years, including one by a skilled nursing facility where a mother was recovering after an accident; she hadn't applied for Medicaid but wasn't able to pay the bill.

What Can You Do?

If your parent needs financial help and you can't provide it, before you find yourself in court defending yourself against such a claim, help with your parent apply for Medicaid for health care, and if necessary, long-term care. If your parent doesn't qualify, speak with an elder care attorney in your state to find out how vulnerable you are to this law. You may live in a jurisdiction that doesn't recognize filial responsibility, or it may not apply to you.

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