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Son Liable for Mom's $93,000 Nursing Home Bill Under 'Filial Responsibility' Law
Some 29 states currently have laws making adult children responsible for their parents if their parents can't afford to take care of themselves. These “filial responsibility” laws have rarely been enforced, but six years ago when federal rules made it more difficult to qualify for Medicaid long-term care coverage, some elder law attorneys predicted that nursing homes would start using the laws as a way to get care paid for.
It looks like this is starting to happen. In May 2012, a Pennsylvania appeals court found a son liable for his mother's $93,000 nursing home bill under the state's filial responsibility law. Health Care & Retirement Corporation of America v. Pittas (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012). In March 2013 the state's Supreme Court declined to hear the case, meaning that the ruling is final.
Facts of the Case
John Pittas' mother entered a nursing home for rehabilitation following a car crash. She later left the nursing home and moved to Greece, and a large portion of her bill at the nursing home went unpaid. Mr. Pittas' mother applied to Medicaid to cover her care, but that application is still pending.
Meanwhile, the nursing home sued Mr. Pittas for nearly $93,000 under the state's filial responsibility law, which requires a child to provide support for an indigent parent. The trial court ruled in favor of the nursing home, and Mr. Pittas appealed. Mr. Pittas argued in part that the court should have considered alternate forms of payment, such as Medicaid or going after his mother's husband and her two other adult children.
The Pennsylvania Superior Court, an appeals court, agreed with the trial court that Mr. Pittas is liable for his mother's nursing home debt. The court held that the law does not require it to consider other sources of income or to wait until Mrs. Pittas’s Medicaid claim is resolved. It also said that the nursing home had every right to choose which family members to pursue for the money owed.
First of a ‘Wave of Lawsuits’?
The Deficit Reduction Act of 2005 made it much more difficult for the elderly to transfer assets before qualifying for Medicaid coverage of nursing home care. With enactment of the law, advocates for the elderly said that nursing homes would likely be flooded with residents who need care but have no way to pay for it, and that in states that have filial responsibility laws, the nursing homes might seek reimbursement from the residents' children.
After Pennsylvania re-enacted its filial support law in the mid-2000s, Williamsport ElderLawAnswers member attorney Jeffrey A. Marshall forecast that the new Medicaid law would trigger a wave of lawsuits involving adult children.
"Litigation between nursing homes and children is likely to flourish," Marshall wrote in the January 20, 2006, issue of his firm's Elder Care Law Alert. (To read Marshall’s recent blog post on the Pittas ruling, click here.)
In 2005, the National Center for Policy Analysis, a conservative policy group, released an issue brief proposing that states begin enforcing filial responsibility laws in order to reduce long-term care costs.
I'm concerned for if/when he can't walk anymore and needs a NH or Ass Living. He has only SS and a small Shell pension and no other assets. The house was reversed mortgaged years ago, so he doesn't even have that. I'm the only child and live out of state. I too wondered if I would be responsible for his debts.
I'd suggest you do a headline search for 'Son Liable for Mom's $93,000 Nursing Home Bill Under 'Filial Responsibility' Law'. At least 29 states have laws making adult children responsible for their parents if their parents can't afford to take care of themselves. Previously, “filial responsibility” laws have rarely been enforced.
In May 2012, a Pennsylvania appeals court found a son liable for his mother's $93,000 nursing home bill under the state's filial responsibility law. [Note: Health Care & Retirement Corporation of America v. Pittas (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012].
Very simply, John Pittas' mother entered a nursing home for rehabilitation following a car crash. After recovering, she left the nursing home, moving to Greece. She then applied to Medicaid to cover her care. (I'm not sure how or if this was ever resolved. Regardless, the nursing home sued her son Mr. Pittas for $93,000 under the state's filial responsibility law, which requires a child to provide support for an indigent parent.
In my opinion, the bottom line is that I foresee this case is "the tip of the iceberg". It is the beginning of a wave (of Tsunami proportions) of nursing home filing lawsuits to recover unpaid nursing home bills from the children of parents who can't pay their nursing home bills.
Allan
thanks again ... :)
I know in my state if your dad goes into a nursing home, and his spouse is dead/no longer living in the home, the house has to be sold to pay NH expenses. If the house is inhabited by a child - who has lived with and cared for the parent for a number of years prior to the NH admission and has no place else to go - it's possible the state will merely put a lien on the house for the Medicaid payments until such time as the house is sold, at which point that money has to be repaid to the state.
Now, it sounds like your dad can live somewhat independently, but doesn't care much about his own hygiene or cleaning the house. He needs someone to monitor his meds. You CAN hire someone to come in and do that for him - give him his meds every day and do some light cleaning. It's a LOT cheaper than a nursing home. Have you looked into Assisted Living? They won't let him smoke, but they can help him with the small daily personal care issues. Again, Assisted Living is expensive, but if you're that worried, it would be worth looking into.
As far as the endless cycle of hospitals/rehab/etc., when my dad was in a rehab center after a bad fall, once Medicare ran out at 100 days, they offered to keep him - at their standard rate and completely self-pay. Frankly, you can refuse to let him check out of the NH once he's in there. But then he will have to pay.
Good times, eh? :-) I love him, but man can he drive me crazy. My mom was an awesome "patient", LOL. He's a whole other situation.
NH cost between 5K - 15K a month so realistically unless you are generationally wealthy, you are going to run out of money if you live long enough. There is planning you can do but again realistically it is very hard to get your parents to do what's needed easily or have them give up what they feel is control of their life. It's probably one of the most difficult situations for a child ever to do for their folks.
Its a balance of doing for them while still safeguarding your life & livelihood.
Getting into a NH on Medicaid requires that they qualify both medically (for skilled nursing care) and financially (basically impoverished). The financial in general is under 2K in income & 2K in non-exempt assets but varies by each state as Medicaid is a joint federal & state program but managed by the state. The medical you have to work with his MD's. Is your dad still living at his home alone? It sounds like that is the case, if so you may have some challenges in getting him into a NH. The vast majority of NH admissions are from a hospital discharge to the NH for "rehab". The rehab is a MediCARE paid benefit and then after maybe 3 weeks it;s determined that they either are OK to go back home OR usually stay in the NH and then family either applies for Medicaid or does private pay. For those who are @ home, there can be a issue with medical history as it doesn't show the imminent need for skilled nursing. This is what we faced with my mom…if this is you, post that & I'll let you know how I approached this hurdle.
About Medicaid, there should be a list on-line of what your state requires for financial documentation to accompany the Medicaid application. Their SS & retirement statements, all life insurance policies, banking (my mom's review was 3 years & 6 months), citizenship, health insurance info, and details on all other assets. You want to make sure that the NH accepts residents as "Medicaid Pending". The NH will likely give you a list of what they want to see (which they look over to see if they detect any problems) and then they companionize your application with their bill to the state Medicaid program. It is the Medicaid caseworker who ultimately reviews all this.
His home - if it is his homestead - is an exempt asset. He does not have to sell the house but if he keeps it, then someone other than him will have to pay for everything on the house for the rest of his lifetime or as long as you have the house. The state requires them to do a co-pay of all of their monthly income to the NH less the small personal allowance they get ($ 35 - 90 a month) so he will not have any $$ to deal with the house if you all decide to keep the home. The house can be subject to estate recovery when he dies (MERP). Just how this part is done really depends on your state law on death and probate. For these reasons, family usually sell the home and then the proceeds from the sale (which the state WILL know about as all real property info is in the state's database) is used towards a spend-down for dad to get qualified for Medicaid. If you are going to sell the house and plan to wait for dad to go into the NH before it goes on the market (which makes sense as it;s hard to sell a house with elderly living in it plus all their stuff), you need to make sure you do whatever you can to get a diversion of dad's required Medicaid co-pay for a period of time that the house is on the market.
About the NH, just make sure that you never ever sign anything as your name. Every item you sign needs to be "Jane Smith Jones in her limited capacity as DPOA for John Smith" and wait to get copies of everything you sign.
If you have other siblings, I'd really suggest that you have a family meeting to go over dad's finances & health before the move to a NH. This site is filled with posts from all sorts of family friction so whatever you can do now to deflect that the better. Good luck and keep your sense of humor going…...
These filial laws are hard to, if ever, enforce. I would pay for nothing and sign nothing making me responsible for any debt. Also, don't let any nursing home bully you into thinking you are responsible.
So I guess the answer would be no way.
Also look over carefully the contract for the NH. Did you sign anything agreeing to be responsible?
Medicaid is designed for the situation when an elder's money runs out and he needs care.