Adult Children and Filial Responsibility Laws

​What happens if Medicare isn't yet applicable and the parents can't pay for their own care? If a patient can't pay for care received in such a situation, filial responsibility laws can require the patient's child or children to pay. However, they do take into account an adult child's ability to pay. But before you get caught up in a maze of local laws, get the basics.

How did these laws get enacted in the first place? They're designed to minimize parents' burden on the state's welfare system. Most allow any long-term care providers to sue family members for payment, but others actually make failing to care for a parent a criminal offense.
But the odd fact is that, very often, states with these laws don't enforce them. Why not? Most elders who can't pay for care receive federal assistance through Medicaid, and federal law specifically prohibits going after adult children. Indeed, most people who need help paying for nursing home care work on qualifying for Medicaid, and it's unusual for someone to rack up a large bill before qualifying. So, there is little opportunity to apply filial responsibility laws because they rarely affect families.

To be held accountable for a parent's bill, all the following would have to be true:

• The parent received care in a state that has a filial responsibility law.
• The parent didn't qualify for Medicaid when receiving care.
• The parent doesn't have the money to pay the bill.
• The child has the money to pay the bill.
• The caregiver chooses to sue the child.

​A rare case when all the arrows pointed in the direction of a child: A 2012 Pennsylvania appeals court ruled that the adult son of a nursing home resident did have to pay his mother's $93,000 nursing home bill. They based this on the state's filial responsibility law.

How did this come to pass? The mother made just enough money through a pension to not qualify for Medicaid. The court allowed a private institution to sue the son. In most cases, filial responsibility laws are designed to empower the state to recover payments to reduce the burden on welfare.

Some observers wonder if rising care costs are going to cause more cases like this.
If you're worried about becoming responsible for your parents' long-term care bills, see a lawyer for help. Experienced elder care lawyers know whether you live in a state that has filial responsibility laws and, if this is the case, whether it enforces them.