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Business & Personal Services Blog

Can You Be Liable For Your Parent's Nursing Home Bills?

Tory Prasco

Filial Responsibility

I. Introduction

Filial responsibility laws purport to obligate adult children to financially assist their parents if the parents are indigent or financially unable to pay their bills for life’s necessities. Depending on the parent’s state of residence, these laws in varying degrees can be used by nursing homes and other long term care facilities located in the states that have such laws as a means to seek reimbursement for unpaid bills. U.S. filial responsibility statutes were derived from England’s Elizabethan Poor Relief Act of 1601, which required the grandparents, parents, and children of every poor, blind, lame and impotent person to financially support that individual if they were able to do so.

Currently, 29 states have filial responsibility statutes that establish a duty for adult children to care for their indigent parents. Some of these states even make it a crime to violate the civil statute. The civil statutes may compel adult children to reimburse state programs or institutions that have cared for their indigent parent with either a single contribution or through installment payments. Twenty-one states allow for civil court action, twelve allow for a criminal penalty, and three allow for both to obtain financial support. However, many filial responsibility laws limit children’s liability under a variety of conditions.

In the past, filial responsibility laws have rarely been enforced. Since the 1960s, federal law 42 U.S.C. § 1396(a)(17)(D) has prevented states from considering the financial responsibility of any individual (except a spouse) in determining the eligibility of an applicant or recipient of Medicaid or other poverty programs. Federal and state laws permit Medicaid to seek reimbursement from recipients’ estates. However, an increasing number of recipients are hiding their financial assets to meet Medicaid’s standards. Some seniors transfer their ownership assets to their children through trusts to become Medicaid eligible without risking their children’s inheritance. While the recipients’ children receive the benefits of these assets, taxpayers are left to pay for their parents’ care. To discourage these plans, federal law now allows states to count assets that were transferred to children within three years of the Medicaid application. However, with many states running deficits and looking for additional funds, it appears that this is a developing issue. Recent articles in the New York Times, Wall Street Journal and Forbes Magazine have discussed this issue.

II. Most Recent Case- Health Care & Retirement Corporation of America v. Pittas

In the most recent case involving filial responsibility, Health Care & Ret. Corp. of Am. v. Pittas, the son was found liable for his mother’s $93,000 nursing home bill. Health Care & Ret. Corp. of Am v. Pittas, 2012 Pa. Super. 96, 2012, Pa. Super. LEXIS 537, at *1 (Pa. Super. Ct. 2012). His mother was treated at a skilled nursing facility for injuries sustained during an automobile accident. Id. In March of 2008, his mother withdrew from the facility and moved to Greece. Id. She left a large portion of her bills unpaid. Id. at *2. As a result, the facility instituted a filial support action pursuant to 23 Pa.C.S.A. § 4603 against the son. Id. Pursuant to the statute, the spouse, child or parent had the responsibility to care for and maintain or financially assist the indigent person unless the individual did not have sufficient financial ability or if the parent abandoned the child for a period of ten years during the child’s minority. Id. at *4.

First, the Court found that the son had sufficient financial ability to support his mother. Id. at *5. The son failed to provide sufficient documentation as to all of his finances, income, expenses, assets and liabilities. Id. Second, the Court held that it did not have to consider other sources of income, such as his mother’s husband or her other two adult children. Id. at *9. Nothing in the statute required the Court to consider other sources of income. Id.  If the son had wanted to share his burden of supporting his mother, he was permitted to join those individuals in the beginning of the case. Id. at *10. Last, the Court held that an indigent person did not need to be completely destitute. Id. at *11.  The term “indigent persons” encompassed persons who had some limited means, but not sufficient to adequately provide for their own maintenance and support. Id.

III. Indiana’s Filial Responsibility Statutes

Any individual whose parent provided the individual with necessary food, shelter, clothing, medical attention and education until the individual reached 16-years-old and who is financially able due to the individual’s own property, income or earning shall contribute to the support of the individual’s parents if either parent is financially unable to provide his own necessary food, clothing, shelter and medical attention. IND. CODE ANN. § 31-16-17-1 (1) (West 1997). An action for support may be instituted against a child for violating the duty to support his parent by filing a verified complaint in a circuit or superior court in the parent’s residential county. IND. CODE ANN. § 31-16-17-1(2) (West 1997). An individual who knowingly or intentionally fails to provide support to his parent, when the parent is unable to support himself, commits nonsupport of a parent, which is a Class A misdemeanor. IND. CODE ANN. § 35-46-1-7 (West 1998). It is a defense if the accused had not been supported by the parent during the time he was a dependent under 18-years-old, unless the parent was unable to provide support. Id. It is also a defense if the accused was unable to provide support. Id.

IV. Indiana Case Law

A.  Pickett v. Pickett

The appeal arose from a decision imposing a duty to support appellant’s mother pursuant to Burns Ind. Stat. Anno., Sect. 3-3001 which read: “Any person being over twenty-one years of age and who is financially able by reason of his or her property, income or earnings, and who has been provided with necessary food, shelter, clothing, medical attention, and education until he was sixteen years of age, if a male, or seventeen years of age if a female, by his or her father or mother, shall have the legal civil duty to contribute to the support of his or her parent or parents having so furnished such food, shelter, clothing, medical attention and education, if such parent or parents be financially unable to furnish themselves with necessary food, clothing, shelter and medical attention.” Pickett v. Pickett, 251 N.E.2d 684, 685 (Ind. Ct. App. 1969).

The son was the only child born to his parents. Id. His parents obtained a divorce, and the custody of the son was granted to the father. Id. at 686. The son ’s father died leaving an estate of $238,000 to the son. Id. The son also owned several properties. Id. The mother remarried and divorced. Id. Upon hearing the death of her first husband, she moved back to Evansville and began moving from the home of one relative to another. Id. In the mother’s complaint, she alleged that she was destitute and in need of care and that she had provided for her son until he had reached sixteen years of age. Id. She also alleged that her son had the financial ability to support her. Id.

The court believed that the intent of the General Assembly was to relieve the general public of liability for support of those individuals who had children financially able to contribute to their maintenance and support.  Id. at 687. Financial ability must be determined by the individual circumstances present in the case. Id. The court held that there was enough evidence to properly find that the mother was entitled to support contributions from her son. Id. at 688.

B. Davis v. State

The mother was a widow and had been struck by an automobile. Davis v. State, 240 N.E.2 d 54 (Ind. 1968). She was seriously injured and was in a nursing home. Id. After the accident, she became depressed. Id. Her home and property were liquidated to pay for her medical, hospital and nursing home expenses. Id. She had three sons and six daughters. Id. All of the daughters contributed to the financial support of their mother; however, they could not get their two brothers to contribute.  Id. Thereafter, one of the sons was convicted and ordered to pay $7.00 per week for the support of his mother. Id. The son appealed and contended that there was no proof that he was financially able to support his mother. Id.
The Court held that the State had failed to show that the son, even though gainfully employed, was financially able to support his parents or anyone. Id. at 56. Although he was employed, the income was not sufficient for any surplus over and above the necessary for his own support and his family’s support. Id.

C. Lanham v. State

This case involved a criminal action against adult children, who were financially able but failed to maintain and support their father without reasonable cause. Lanham v. State, 194 N.E. 625, 626 (Ind. 1935). The father was sick and unable to work. Id. The trial court found the children guilty and fined each of them. Id. The children appealed. Id. The statute stated that if the child willfully refused to care for his parent who was physically and financially unable to care for himself and the child was financially able to do so, the child was guilty of a misdemeanor. Id. The statute excluded all adult children who had not lived with or who had not been supported by their parents when they were minors. Id. The evidence showed that the father had made no effort to maintain a home for his children when they were minors. Id. at 627. The father paid child support from 1919 to 1926, but it was not enough to provide the children with even the barest accommodations. Id.  The mother was only able to keep the family together through the two eldest sons’ earnings. Id. The Court held that children were not supported by a father who had abandoned his family and whose forced contributions to support them were inadequate to furnish the necessaries of life, including an education. Id. The judgment was reversed. Id.

For more information on Filial Responsibility please contact Tory Prasco.