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Are children legally obligated to pay for their parents’ nursing home care?

The children of nursing home residents may find themselves legally responsible for their parents’ care if their parents’ do not follow the advice of an elder law firm. Nursing home planning is more important than ever before, with nursing home care averaging more than $10,000.00 per month in Maryland.

With proper planning, government benefits, such as Medicaid, are available to pay for nursing home care. But if the patient does not receive Medicaid benefits and does not have the resources to pay the bill, the nursing home can try to collect the money owed from the nursing home resident’s spouse, children, and parents.

A filial support law assigns broad responsibilities to the family members of nursing home patients. These patients may be considered indigent, which gives their family members a legal responsibility to support them. Thus, a spouse, children, and parents may have an obligation to “care for and maintain or financially assist an indigent person,” and nursing homes may be permitted to collect under filial support law for care provided to a patient who is considered an indigent person.

Family members may avoid responsibility for the debt under certain circumstances. Under 23 Pa. C.S. Section 4603, a spouse, children, or parents may not have to pay for the indigent person’s debt if the family member does not have the financial ability to do so, and in certain cases if a parent abandoned the child while the child was a minor. The filial support law also provides a way to determine whether the family member has the means to pay the debt, and if so, what the size of the payments should be.

In a recent PA case, the nursing home was able to show that the son had the ability to pay for his mother’s care by presenting his tax returns and bank statements. Additionally, the nursing home proved that the mother was indigent and thus in need of support from her son. The key test to determine whether a patient is indigent is whether the patient can meet his or her current expenses, which he or she probably cannot do if living in a nursing home that costs $10,000.00 or more per month. In the above situation, only the son was forced to pay the nursing home bill, even though the patient had other children. The son himself, not the nursing home, had the responsibility to join his sibling in the lawsuit.

The best way to avoid a filial support action is to engage in proper Medicaid planning before long-term care is needed. 


David Wingate is an elder law attorney at the Elder Law Office of David Wingate, LLC. The elder law office services clients with powers of attorneys, living wills, Wills, Trusts, Medicaid and asset protection. The Elder Law office has locations in Frederick and Montgomery Counties, Maryland.

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