INDUSTRY INSIGHT
ELDER CARE
SPONSORED CONTENT
AN ADULT CHILD CAN BE LIABLE FOR A
PARENT’S NURSING HOME BILL
A
lthough a nursing home cannot require a child to be
personally obligated for their parent’s nursing home bill,
there are circumstances in which an adult child can be
liable to pay the bill. With the average cost of nursing
home care in Pennsylvania exceeding $10,000 per month, this is not a
circumstance many can afford to navigate.
Federal regulations prevent a nursing home from requiring a third
party to be personally liable, or guarantee payment, as a condition of
admission. However, children of nursing home residents often sign
the nursing home admission agreement as the “responsible party.”
This is a confusing term and it isn’t always clear from the contract
what it means. It is important to read the contract very carefully
because some nursing homes still have language in their contracts
that violates the regulations.
Typically, the responsible party is agreeing to do everything in
his or her power to make sure that the resident pays the nursing
home from the resident’s funds. If the resident runs out of funds,
the responsible party may be required to apply for Medicaid on the
resident’s behalf. With most Medicaid applications being improperly
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denied, if the responsible party doesn’t follow through on properly
applying for Medicaid, appealing a denial, or providing the state with
all the information needed to determine Medicaid eligibility, the
nursing home may sue the responsible party for breach of contract.
In addition, if a responsible party misuses a resident’s funds instead
of paying the resident’s bill, the nursing home may also sue the
responsible party. In both of these circumstances, the responsible
party may end up having to pay the nursing home out of his or her
own funds.
Another way children may be liable for a nursing home bill is
through filial responsibility laws which obligate adult children to
provide necessities like food, clothing, housing, and medical attention
for their indigent parents. 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). 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 had applied for Medicaid to cover her care, but that
application was still pending at the time of her discharge.
The nursing home then sued Mr. Pittas for nearly $93,000 under
Pennsylvania’s filial responsibility law. The trial court ruled in favor
of the nursing home, and Mr. Pittas appealed. He argued that the
court should have considered alternate forms of payment, such as
Medicaid or his mother’s husband and her two other adult children.
The Pennsylvania Superior Court agreed with the trial court and held
Mr. Pittas liable for his mother’s nursing home debt. The court stated
that the law doesn’t require consideration of other sources of income
or waiting until a 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. In March 2013 the state’s Supreme Court
declined to hear the case, meaning that the ruling is final.
In the past, filial responsibility laws rarely have been enforced, but
as it has become more difficult to qualify for Medicaid, states are
becoming more likely to use them. Pennsylvania is one state that has
used filial responsibility laws aggressively.
The importance of having an Elder Law Attorney represent the
applicant throughout the long term care continuum cannot be
overstated. The process is complicated, confounding, and potentially
catastrophic for those blindly entering the long term care maze
without competent legal counsel.
Christine Brown Murphy is a partner with the elder law
firm of Zacharia Brown P.C. Zacharia Brown is one of
the oldest, most established elder law firms in western
Pennsylvania. Their practice focuses on Medicaid eligibility,
Veterans Benefits planning, estate administration, and
estate planning including wills, powers of attorney, living
wills, and trusts. Pittsburgh area office locations include
McMurray, McKeesport and Wexford.
Phone: 724.942.6200.
Website: www.pittsburghelderlaw.com.
E-mail: [email protected]
NORTH ALLEGHENY
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SUMMER 2019
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