For the last several decades the welfare system in the United States has ensured that our poor and needy get food, housing, and necessary medical care. As a compassionate society we decided that we could not let destitute people starve or die for lack of medical care. We decided that taxpayers would pay for it with systems like Medicaid and Social Security (along with programs like food-stamps and public housing). With these programs, we no longer looked to family members to support their relatives. However, most States never repealed those ancient laws that made family members responsible.
They are known as “filial responsibility” laws and at least thirty states still have them on the books. Most say that a parent, a child, and in some cases a sibling, of an indigent person (one who is financially unable to pay for his or her needs) is responsible for those costs. Filial Responsibility laws have been unenforced for years. Now however, with massive failures in the social safety net, draconian changes to the Medicaid program, and the near collapse of the elder care system, these laws are rearing their ugly heads. You need to be aware of this risk in your planning.
A recent case in Pennsylvania highlights the problem. For quite a while nursing homes have been left with massive unpaid bills for residents who could not pay and who were not found eligible for programs like Medicaid. Recently, those nursing homes have been looking for someone else to pay those bills. In most cases they have failed, but in some they have had success. In Health Care & Retirement Corporation of America v. Pittas the Pennsylvania Court found a son liable for his mother’s $93,000 nursing home bill under that state’s filial responsibility law.
It appears that the son didn’t really do anything wrong in this case. He had applied for Medicaid, but his mother moved out of the home and never paid the bill. The son had siblings who might also be responsible and the mother’s Medicaid case was on appeal. Nevertheless, the Court found the son liable under the state law. The mother didn’t pay and didn’t have much money (so she was indigent under the law) the son had a job, income and money, so he could afford to pay (as required by the law) so he had to pay.
What does this mean to you? Well, if your parent is in a nursing home, you had better make sure that the bill is paid, or that a correct application for Medicaid is filed and accepted. Even if you aren’t directly involved in your parents’ affairs, you may have to become involved if a sibling doesn’t do things correctly. All families need to consider these issues and work together to ensure a loved-one is not left paying a bill for another family member. You should review the law in your state (Mass and NH both have filial responsibility laws) and think about contacting your legislators to see if they would support a change. And, consult an Elder Law Attorney if you need advice on nursing home costs and Medicaid.