Nursing homes ask adult children to pay up for parents

Elder law experts say Pennsylvania nursing homes increasingly are asking adult children to step up and start paying their parents’ outstanding bills.

The “filial responsibility” law has been on the books in Pennsylvania since Colonial times. In short, it means adult children are on the hook to help cash-strapped parents — and vice versa.

Elder law attorney Katherine Pearson, a professor at Penn State’s Dickinson School of Law, said some health-care providers are now using the law to get paid.

“Since 2005, there’s been a surge in nursing homes using the law to either require that children get involved in their parents’ life,” Pearson said. “Adult children who are estranged, for example, they’ll get involved and file the application for Medicaid, or be liable personally for the expenses. That’s one way the law is being used.”

Pearson said hundreds of “filial responsibility” lawsuits are settled out of court. In one recent case in Allentown, however, an appeals court ordered a son, John Pittas, to pay his mother’s $93,000 nursing home bill.

Elder law attorney Jeff Marshall, with Marshall, Parker & Associates in Lycoming County, Pa., said sometimes the filial responsibility law is evoked as a gambit to prod deadbeat kids.

“To get the family’s attention,” Marshall explained. “‘If you don’t file a Medicaid application, we can go after you personally.'”

Marshall and Pearson said nursing homes should get paid.

When the cases go to court, sons and daughters often argue that the filial responsibility rule is similar to the child support laws — that they should step in and help out — in the future. Meanwhile, nursing homes are using the law as a debt collection tool, to settle up past accounts.

“In the Pittas case, they just sued the son for this bad debt, after the fact,” Marshall said. “So that doesn’t really sound like a support case, so I think there are some issues he can raise on appeal, that perhaps have some merit.”

Marshall says knowing you are responsible for your extended family’s health-care needs may get some people thinking differently about the pro and cons of the Medicaid expansion in Pennsylvania.

“The children that I talk to don’t think this is fair, that they should be responsible for mom’s nursing home care, personally responsible, like this and they vote,” he said.

If the courts continue to side with nursing homes, Marshall says, lawmakers may look for a way to soften the financial blow on adult children.