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Who Will Pay for Mom's or Dad's Nursing Home Bill? Filial Support Laws and Long-Term Care

Who Will Pay For Mom's Or Dad's Nursing Home Who Will Pay For Mom's Or Dad's Nursing Home
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Who Will Pay for Mom's or Dad's Nursing Home Bill? Filial Support Laws and Long-Term Care

Insights & Ideas Team •  March 25, 2015 | Home and Family

Imagine this: One day you’re sifting through your mail. In the pile of letters, bills and junk mail, you find a letter from a law firm informing you that you need to pay $50,000 to cover the cost of your father’s recent nursing home stay, or the care facility will sue you.

While this may seem farfetched, depending on your parents’ state of residence, this could be a possibility.

If your parents live in one of 29 states or Puerto Rico that has filial responsibility laws on the books, you could potentially be held legally responsible for their care under certain circumstances, such as when your parents are ailing and without sufficient financial resources to take care of themselves. Until recently, these statutes have been largely ignored. However, several recent court decisions indicate that there might be renewed interest in enforcing them.

States Currently with Filial Responsibility Laws
















New Hampshire

New Jersey

North Carolina

North Dakota




Rhode Island

South Dakota





West Virginia

Puerto Rico


Filial support laws aren’t new. In fact, they were initially derived from England’s 16th century “Poor Laws.” At one time, as many as 45 U.S. states had statutes obligating an adult child to care for his or her parents. Some states repealed their filial support laws after Medicaid took a greater role in providing relief to elderly patients without means. Other states did not, and a large number of filial support laws remain dormant on the books.

Now, with long-term care costs on the rise and funding sources under pressure, nursing homes and other health care providers may have increasing incentive to seek to use the courts to compel children to either help a parent financially or be at risk for covering the cost of his or her care.

In the last decade or so, a few court decisions in both South Dakota and Pennsylvania have opened the door to using filial support statutes to recover medical expenses. Underlying the earlier decisions was generally a finding of “unclean hands”—that the children had engaged in fraudulent conduct or had illegally transferred mom and dad’s assets. Recently, however, there has been at least one court decision that found a child responsible for his mother’s nursing home bill without any evidence of wrongdoing on the part of the child.

In 2012, the Pennsylvania Superior Court upheld a lower court ruling (Health Care & Retirement Corporation vs. Pittas1) that allowed a nursing home to obtain payment from the son of Maryann Pittas for her nearly $93,000 nursing home bill after she relocated to Greece with her bill unpaid. Maryann Pittas had applied for Medicaid but had left the country before there was a decision on her application. The nursing home then sued her adult son, John Pittas, for payment. This case was significant because, unlike the previous rulings in other jurisdictions, the court made no finding that John had engaged in any fraudulent transfers to divert or hide his mother’s assets.

Could you be legally liable for paying for your parents’ care?

Filial support laws differ from state to state. Some states’ statutes impose criminal penalties. Other states’ statutes, such as the Pennsylvania statute in Pittas, impose financial responsibility. However, all state statutes require the court to find that the parent is indigent or unable to provide for his or her own support. Additionally, there are defenses to the filial support obligation, such as the child’s financial inability to pay for such care or evidence of neglect or abuse by the parent prior to the child’s emancipation.2 For example, the Pennsylvania statute states “a child shall not be liable for the support of a parent who abandoned the child and persisted in the abandonment for a period of 10 years during the child’s minority.”

1Health Care & Ret. Corp. of Am. v. Pittas, 2012 PA Super 96, 46 A.3d 719, 723 (Pa. Super. Ct. 2012), reargument denied (July 18, 2012), appeal denied, 63 A.3d 1248 (Pa. 2013)

2Va. Code Ann. §40-6-301

323 Pa. Cons. Stat. Section 4603(a)(1)(ii)

4Mass. Gen Laws ch. 273Section 20

5N.C. Gen. Stat. Section 14-326.1

This publication is not intended as legal or tax advice. It is intended as educational information and must not be used as a basis for legal or tax advice. Northwestern Mutual and its Financial Representatives do not give legal or tax advice. Taxpayers should seek advice regarding their particular circumstances from an independent tax advisor. Tax legislation is subject to change.

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