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

The Chamberlain Law Firm

Many adult children of elderly parents worry about being held responsible for their parent’s long-term care costs. In the past, this hasn’t been a significant concern unless the child misappropriated their parent’s funds, for example, by making unauthorized withdrawals, misusing power of attorney, making fraudulent asset transfers, or using deception or coercion to financially exploit their parent. However, recent interpretations of Medicaid laws have shifted that landscape and have held adult children responsible for their parent’s long-term care costs—even where funds have not been misappropriated. Luckily, hiring a New Jersey elder law attorney can help avoid such unexpected costs.

What is Filial Responsibility?

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, which 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 enforced, the potential implications for adult children can be significant, as they may be held responsible for their parent’s unpaid long-term care costs.

The Deficit Reduction Act of 2005, a federal legislation aimed at reducing the federal deficit by implementing changes to several programs, including Medicaid, is of particular importance to the concept of filial responsibility. One of its impacts on filial responsibility is the tightening of eligibility rules and asset transfer regulations for Medicaid, making it more difficult for individuals to qualify for long-term care benefits. As a result, adult children may face increased pressure to financially support their indigent parents, as stricter Medicaid requirements might force families to rely more heavily on filial responsibility laws to cover the costs of long-term care. This can lead to unexpected financial burdens for adult children and highlights the importance of proper long-term care planning and the involvement of elder law attorneys in navigating complex Medicaid rules.

The 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 run by Health Care & Retirement Corporation of America (HCRCA) after a devastating car accident. She eventually left the United States and moved to Greece, leaving behind a massive bill of about $93,000. HCRCA sued John Pittas, seeking to hold him responsible for his mother’s unpaid nursing home bill under Pennsylvania’s filial responsibility laws.

The trial court ruled in favor of HCRCA, and John Pittas appealed the decision. In May 2012, the Pennsylvania Superior Court affirmed the trial court’s ruling, finalizing the decision and establishing a binding precedent in the state. The 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 HCRCA should have pursued alternative sources of payment, such as Medicaid or his mother’s spouse, before suing him. While the nursing home 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.

Although the Pittas case does not have a direct connection to the Deficit Reduction Act, the case highlights the potential consequences of filial responsibility laws and the financial risks for adult children with indigent parents requiring long-term care, which can be exacerbated by the stricter eligibility rules and asset transfer regulations implemented by the Deficit Reduction Act for Medicaid. The heightened awareness of filial responsibility laws and their implications, in part, can be attributed to the challenges families face in navigating the complex Medicaid rules affected by the Deficit Reduction Act.

How could this outcome have been avoided? Had the son hired an elder law attorney to assist with the Medicaid application process, the situation might have unfolded differently. The attorney’s guidance would have ensured a timely, accurate application, providing a steady income stream for the nursing home and eliminating the son’s liability for his mother’s bill.

How Does This Case Impact Medicaid Users in New Jersey?

While the Pittas case occurred in Pennsylvania and directly impacts filial responsibility laws in that state, its implications can be felt beyond Pennsylvania’s borders, including New Jersey. Both states have filial responsibility laws on their books, and the case raises awareness about the potential consequences of these laws for adult children of indigent parents requiring long-term care.

Therefore, New Jersey Medicaid users should be aware that if their elderly parent is unable to cover the cost of their long-term care and fails to qualify for Medicaid or properly utilize its benefits, adult children might be held responsible for the unpaid bills under New Jersey’s filial responsibility laws. This could result in financial burdens for adult children who were previously unaware of their potential liability.


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 will not be held responsible for your indigent parent’s long-term care costs, contact the Chamberlain Law Firm today to set up a consultation and begin planning for the future.

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