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Long Term Care Filial Responsibility

Barry Boscoe

Believe it or not, twenty-nine states, including California, have filial responsibility laws on their books. These laws can be used to go after long term care patients’ families for unpaid bills. Beware states are beginning to use these laws to get families into paying their parents’ unpaid long term care bills or completing Medicaid paperwork on their behalf.


As more and more providers and states become desperate for payment due to their overstretched Medicaid programs, you may start to see these laws applied. A recent court case in Pennsylvania proves the fact. The mother was unable to pay her bill and subsequently relocated to Greece, leaving the long term care facility in search of payment. A panel of three state court appellate judges ruled on May 7 that Allentown Nursing Home could collect their unpaid bill of $92,943.00 from the son of the patient who received the care from September 2007 through March 2008.



This may seem like an isolated event, but these laws have actually been on the books since the Deficit Reduction Act of 2005. The actual filial responsibility laws date from the early 1600s and now may be used even more due to the tight budgets.


This experience serves as a warning for children with parents who may be compiling long term care bills. In many states the filial-support law doesn’t require lack of cooperation or asset shielding on the children’s part; they simply have to be deemed by the judge to have the means to pay the bill.


The best means against such action would be a preventative measure of acquiring long term care insurance to help provide the payment in the event of a long term care need. However, the drawback with most long term care policies today is the fact that the premiums are very expensive, non-guaranteed, and if the insured does not need the coverage all of the premiums are lost. Another approach would be to self-insure with leverage. There are new long term care products on the market known as asset-based which provide 100% guarantee of return of all premiums that are not used and in addition allow the insured to utilize some of their money along with the insurance company’s money to provide the extended care protection.


There are many options to protect against the filial support laws. It is incumbent not only upon the parent but upon the adult child to have these discussions in order to protect the family.

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