There are almost 30 states that have laws making adult children finacially responsible for their parents’ nursing care costs if their parents are unable to pay for their own. Pennsylvania has always had this law on the books.  But now it's one of the few to start enforcing it.

These laws are now being used to enforce responsibility for nursing home costs as the new Medicaid law disqualifies more and more people who have attempted to move funds out of their names only to find that they need care during the long look back and disqualification period.

The state of Pennsylvania has now seen the first case in which a nursing home sought to have a child pay a parent’s care expense by asserting the state’s filial responsibility law.

In May of 2012, 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).

Here is a link to the entire appellate court opinion on the duty to
pay nursing home costs for a parent.

The Basic Facts of the Case

The Defendant, John Pittas’ mother entered a nursing home following injuries in a a car crash. She later left the nursing home and moved out of the United States leaving much of her nursing home bill unpaid.

While she did apply for Medicaid to cover her care, but that application was still pending at the time the nursing home sued for payment.

In this case, the nursing home sued her son (still in the US) for nearly $93,000 under the state’s filial responsibility law.

The trial court ruled in favor of the nursing home, and Mr. Pittas appealed. Mr. Pittas argued in part that the court should have considered alternate forms of payment, such as Medicaid or other family members such as his mother’s husband and her two other adult children.

The Pennsylvania Superior Court, in the attached ruling, agreed with the trial court and held that Mr. Pittas is liable for his mother’s nursing home debt.

The court also held that the law does not require it to consider other sources of income or to wait until Mrs. Pittas’s 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.

They also held that even though he made $84,000.00 dollars per year, that her son also had the finacial capacity to pay as required by the law.

If this is a frightening thought - that you (and maybe not your siblings) are laible for these costs, then you haven't heard the worst of it.

Many commentators feel that this may be the first of many more such legal actions.


The Deficit Reduction Act of 2005 made it much more difficult for the elderly to transfer assets before qualifying for Medicaid coverage of nursing home care. With enactment of the law, advocates for the elderly said that there would be increasing numbers of individuals seeking nursing care but cannot pay for it. Attorneys further speculated that in states that have filial responsibility laws, the nursing homes might seek reimbursement from the residents’ children.

For more information, you can also visit this link to the Wall Street  Journal article
on your responsibility to pay for nursing care.

Here is a link to the entire appellate court opinion on the duty to
pay nursing home costs for a parent.

To get the advice of an elder law attorney on the vital issues of planning and how to protect family assets, call our office at 610-933-8069 and ask
for an elder law appointment.


David M. Frees, III
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