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Understanding Filial Responsibility Rules

Elder care is expensive. No matter which way you slice it, coming up with the funds for home care, a move to an assisted living facility, or enrollment in a skilled nursing facility is an immense challenge. This usually adds up to tens of thousands or even hundreds of thousands of dollars a year.

Seniors generally only have a few options. If they are of significant means, they may be able to pay out of pocket. However, this is out of reach for most middle class families. Alternatively, the senior may be able to take advantage of long-term care insurance. When secured early on, this insurance is a good way to insulate oneself from the immense costs that may be necessary down the road. One benefit of most insurance of this nature is that it pays for a wide range of care. Instead of being forced to move, those with insurance are often able to secure home care so that they can age in place. However, even with these benefits, the use of long-term care insurance is relatively uncommon. That is because few think about it until they are already in their golden years and/or in need of care. By that point, the premium cost of the insurance is usually prohibitive.

So what options do families have without insurance or a stockpile of private funds? For most the answer is Medicaid. Medicaid is a joint state and federal program for lower income individuals. Unlike Medicare, Medicaid pays for the cost of prolonged long-term care.

Placing Responsibility on Adult Children
Interestingly, some nursing homes are actually seeking a fourth way to ensure their bill is paid. As an alternative to Medicaid (which has spending limits), a few facilities have taken the unique approach of trying to hold adult children financially responsible for their parent’s nursing home bill. Their ability to do so depends on interpretation on “filial responsibility” laws which force children to pay for their parents care in some cases.

The Consumer Voice published a primer on this situation which is helpful to review. The short summary can be downloaded here.

It should be noted that Illinois currently does not have a filial statute. So adult children here are unlikely to be faced with these legal issues. However, if anything changes here or a loved one is in a long-term care facility in a neighboring state (including Indiana, Iowa, Ohio, and Kentucky), then there is a chance these laws may affect you.

Each state version of these laws are slightly different, with varying rules regarding when a nursing home can go after a child and what they must show to recover. Essentially, most versions of these rules require adult children to provide for the basic needs of their parents (food, clothing, and shelter), just as a parent is obligated to do the same for the child. The most recent high-profile example of this comes out of Pennsylvania, where a court required an adult son to pay the $93,000 nursing home bill for his mother. In the expansive ruling the court noted, against the arguments made by the man’s lawyers, that the nursing home could pursue the son for recovery regardless of whether the senior had other children or had a pending Medicaid application.

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