Payment for Parents’ Long Term Care Could Shift to Children

Some notions are so ingrained in our consciousness that we cannot imagine them being handled differently.  One of them is that, if we run out of money paying for long term care in a nursing home, even if that is after years of private payment, the government would pick up the cost under Medicaid.

Suppose this were different.  Suppose instead, when you run out of money, your adult children had to pay for your care at the cost of $9,000 to $10,000 per month.  Could they afford it?  As an adult child would you rather pay a few extra dollars in taxes now so that the government would continue to fund Medicaid or pay all of your parents’ nursing home bills at over $100,000 a year?  These questions are not as theoretical as they might seem.

A Pennsylvania Superior Court case decided in May of this year interpreted a law passed in July, 2005 to find that a son was responsible for his mother’s nursing home bill of $92,943 merely because he was her son and not from any fault of his own.

The 2005 Pennsylvania law, referenced as Act 43,  took filial responsibility, the idea that a child could be responsible for the bills of a parent which was an old colonial idea, and moved it from the welfare law where it was not being used to the support law, the same code that controls support actions by spouses and minor children.  Medical providers including nursing homes are suing adult children directly.  The parent needs to be “indigent” as they define “indigent” and not have deserted the adult child for a lengthy period during his childhood.  Otherwise it can be open season on adult children unless Medicaid is paying.

In the Pittas case, Maryann Pittas of Schwenksville, Pennsylvania was injured with her husband, Andrew, in a head-on collision.  After being in a coma and suffering a stroke, eventually, after a lengthy rehabilitation, she was moved to Greece to be with other relatives, leaving her son, a local restaurant owner behind.

The nursing home owned by HCR Manor Care brought suit for the bill against her son under the filial responsibility law.  Mr. Pittas won in arbitration in 2008 but lost in Common Pleas Court when the nursing home appealed.  In May, a three judge panel affirmed the lower court decision and let the judgment against the son for almost $93,000 stand.  They found that he should be able to pay the bill based on his 2008 income of $85,000.  His own bills were irrelevant.

Several factors make the Pittas case especially disturbing,

First, it is an appellate Court decision.  This means that it would likely be followed in later decisions involving other adult children unless it is overturned on appeal or the law it is based on is repealed.

Second, there was no indication in the decision that the son had done anything wrong.  Typically, in these cases, there is some indication that the adult child had received money from the parent.  This was not indicated in this case.

Next, the judgment was against one son even though he has other siblings living including one out of state and another in Greece.  Mrs. Pittas’ husband was also living.

The requirement that the parent be “indigent” was interpreted to mean that she did not have enough to pay this bill.  By this definition, many of us would be considered “indigent.”

The Court assumed that the son had money to pay.

This decision is being watched in other states that also have older filial responsibility laws.  Pennsylvania, unfortunately, is in the forefront for claims against adult children.

As people complain about taxes, one point to keep in mind is the alternative.  In the Pittas case, for reasons unexplained, Medicaid was unavailable.  During this election season, the Republican proposal for Medicaid is that it become a “block grant” to the states.  This would remove many of the protections we currently have concerning Medicaid payment to nursing homes and open the possibility and likelihood of more lawsuits against adult children for the support of parents even for the cost of nursing home care at hundreds of thousands of dollars.  There are some government expenses worth paying for now to avoid problems later.  Nursing home Medicaid is one of them.

For more, listen to “50+ Planning Ahead” a weekly radio program on WCHE 1520 on every Wednesday from 4:30 pm to 5:00 pm with Janet Colliton, Colliton Law Assocs., PC, and Phil McFadden of Home Instead Senior Care.

About the Author Janet Colliton

Esquire, Colliton Law Associates, P.C. Janet Colliton has practiced law for over 38 years, 37 of them in Chester County, Pennsylvania, a suburb of Philadelphia. Her practice, Colliton Law Associates, PC, is limited to elder law, Medicaid, including advice, applications and appeals, and other benefits planning including Veterans benefits, life care and special needs planning, guardianships, retirement, and estate planning and administration.

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