Can You Be Held Responsible for Paying for Your Parent’s Long-Term Care Costs?

The Chamberlain Law Firm

With the cost of long-term care rising across the country, many adult children of elderly parents are rightfully worried about being held responsible for their parent’s long-term care costs. But is this something you really should be concerned about?

In general, it is unlikely that you will be held responsible for your parents’ care. But, you should still be careful. There are certain situations where you can be held responsible for your parents’ care. Further, recent interpretations of Medicaid laws in other states have found adult children otherwise responsible for their parent’s long-term care costs, which raises the question if this could happen in New Jersey too.

In this article, we will walk you through those situations where you can be responsible for your parents’ care, recent legal developments in other states, and how those developments affect long-term care users in New Jersey.

When Are You on the Hook for Your Parents’ Long-Term Care Costs?

There are primarily two situations where you could be responsible for paying for your parents’ long-term care costs: when you guarantee their long-term care costs or where you misappropriate funds.

Often, when your parents move into an assisted living facility, the facility will ask you to guarantee your parents’ care costs. In other words, if your parents are unable to pay, the facility will look to you to front your parents’ costs.

We typically do not advise adult children to guarantee their parents’ long-term care costs because it could create significant financial trouble for the adult children down the line. However, if you are considering guaranteeing your parents’ care costs, be sure to consult with an experienced New Jersey elder law attorney to ensure that you fully understand what you are committing to.

The other scenario where you can be responsible for parents’ long-term care costs is if you misappropriate their funds. Misappropriation of funds can include making unauthorized withdrawals, misusing a financial power of attorney, making fraudulent asset transfers, or using deception or coercion to financially exploit your parents.

We are sure that you would never purposefully misappropriate your parents’ funds. However, if you are unsure whether a certain transaction would be considered misappropriation under the law, consulting a knowledgeable attorney could be a wise move.

What is Filial Responsibility?

We now turn to the concept of filial responsibility, which plays an important role in the context of children being responsible for their parents’ long term care costs. In the context of New Jersey Medicaid, filial responsibility refers to the legal obligation of adult children to financially support their indigent parents who require long-term care. 

New Jersey, like several other states, has filial responsibility laws on its books. These laws can be enforced when a parent is unable to cover the costs of their care and does not qualify for Medicaid or fails to properly utilize its benefits. While these laws are not frequently invoked, the potential implications for adult children can be significant.

Filial Responsibility and Federal Law

In 2005, Congress passed the Deficit Reduction Act. The Deficit Reduction Act is a federal law aimed at reducing the federal deficit by making changes to several programs, including Medicaid. Importantly, the Act places an increased burden on filial responsibility laws. 

By tightening Medicaid’s eligibility rules and asset transfer regulations, the Act made it more difficult for individuals to qualify for long-term care benefits. The stricter Medicaid requirements forced families to rely more heavily on filial responsibility laws to cover the costs of long-term care. As a result, adult children face increased pressure to financially support their indigent parents. 

The possibility of unexpected financial burdens for adult children highlights the importance of proper long-term care planning and the involvement of elder law attorneys in navigating complex Medicaid rules.

Pennsylvania’s Pittas Case

A Pennsylvania case, Health Care Retirement Corp. of Am. v. Pittas, is illustrative of the drastic impact of filial responsibility laws. 

In this case, defendant John Pittas’ mother received care at a nursing home after a devastating car accident. She then left the United States and moved to Greece, leaving behind a massive bill of about $93,000. The nursing home sued John Pittas, seeking to hold him responsible for his mother’s unpaid nursing home bill under Pennsylvania’s filial responsibility laws.

The Pennsylvania Superior Court held that John Pittas was liable for his mother’s nursing home costs under Pennsylvania’s filial responsibility law, as his mother was considered indigent and unable to pay the debt herself. The court rejected Pittas’ argument that the nursing home should have pursued alternative sources of payment, such as Medicaid or his mother’s spouse, before suing him. 

Although the nursing home ultimately won the case, it faced significant time and financial costs to obtain the judgment and collect it. Furthermore, the son now must pay his mother’s bill, creating a losing situation for both parties.

The Pittas case highlights the potential consequences of filial responsibility laws and the financial risks for adult children with indigent parents requiring long-term care. Further, these risks are exacerbated by the stricter eligibility rules and asset transfer regulations implemented by the Deficit Reduction Act.

John Pittas could have avoided this outcome by hiring an elder law attorney to assist with the Medicaid application process. An attorney’s guidance could have ensured a timely, accurate application, providing a steady income stream to the nursing home and eliminating John’s liability for his mother’s long-term care costs.

Does the Pittas Case Impact Medicaid Users in New Jersey?

While the Pittas case occurred in Pennsylvania and directly involves the filial responsibility laws in the Keystone State, its implications can be felt beyond Pennsylvania’s borders. 

Like Pennsylvania, New Jersey has filial responsibility laws on their books. Although no similar case has yet arisen in New Jersey, the Pittas case raises flags about the potential consequences of these laws for adult children of indigent parents requiring long-term care.

Therefore, citizens of the Garden State should take note that you can theoretically be liable for your elderly parent’s unpaid care bills. This can happen if your parents cannot afford the costs of long-term care and do not qualify for Medicaid or properly utilize its benefits. New Jersey has laws that can make adult children financially responsible for their parents’ care, which can result in a surprise burden if you were not aware of these laws.


While it is unlikely that you will be held responsible for your parent’s long-term care in New Jersey, it does not hurt to be prepared for the worst. Engaging an elder law attorney for long-term care planning and Medicaid applications can save time, money, and stress for all parties involved. It is a worthwhile investment that can lead to better outcomes for nursing homes, residents, and their families. 

To ensure that you have a good plan in place for the future and/or know all your options to pay for your parent’s long-term care costs right now, contact The Chamberlain Law Firm at (201) 273-9763 to set up a free phone consultation. For more useful information about Medicaid, be sure to check out more of our Insight Articles.

This article is for informational purposes only. It is not intended as legal advice. In the event you would like to speak with a lawyer about the specifics of your case, contact The Chamberlain Law Firm at (201) 273-9763 to schedule a consultation.

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