How Filial Responsibility Is Defined

What the Law Says About Your Parents' Medical Bills

Nurse supporting elderly woman
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Filial responsibility is defined as a duty owed by an adult child for his parents' necessities of life. So what happens when a parent in need of long-term ​health care is unable to pay for it? Many states have laws that can require adult children to be financially responsible for their parents' necessities of life when the parents don't have the means to pay for them on their own.

The extent of this responsibility can vary by state. These laws are referred to as filial responsibility laws, and nursing homes and other long-term care facilities can use them as a means to seek reimbursement for unpaid bills.

Pennsylvania Case May Point to a Trend

Although filial responsibility laws have rarely been enforced in the past, a case in Pennsylvania may indicate a trend. In Health Care & Retirement Corporation of America v. Pittas (Pa. Super. Ct., No. 536 EDA 2011, May 7, 2012), the Pennsylvania Superior Court upheld a lower court's decision making an adult son liable for $93,000, a debt resulting from six months' skilled nursing care and treatment received by his mother at a Pennsylvania facility. 

The court concluded that the state didn't have a duty to consider the woman's other possible sources of payment, including a husband and two other adult children or the fact that an application for Medicaid assistance was pending. Instead, the court found that the facility had adequately met its burden of proof that this particular son had the means to pay the $93,000 bill, and the trial court was correct in holding the son responsible for paying it.

This case is still perceived to be a turning point in nursing homes seeking to recover money for elder care.

The Importance of Long-Term Care Planning

This Pennsylvania case demonstrates the importance of long-term care planning from the perspectives of both elderly parents and their children. Without proper planning and legal advice from an experienced elder law attorney, adult children may very well be on the hook for thousands of dollars of care required by their aging parents.

Forty-five states once observed filial responsibility laws, but many repealed them. As of December 2017, only 29 states hold adult children accountable in some shape or form: Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia as well as Puerto Rico.

For example, Arkansas requires adult children to pay only for mental health care. Connecticut's law applies only to parents younger than 65, and adult children in Nevada are only liable if they have signed a written promise to pay for care. 

Adult children need to be aware of their filial responsibility laws and act accordingly. Proper planning can help avoid potential financial disaster in the future.

Note: State laws change frequently, and this information may not reflect recent changes. Please consult with an attorney for current legal advice. The information contained in this article is not legal advice and is not a substitute for legal advice.