Does anyone know about the filial laws?

Well this really made me think, so I had to look it up in MD. Luckily it seems to have been repealed here a few years ago. It seems to have repealed in 2017

To anonymous839718: I too am in PA. My spouse had hired an elder attorney and was told because he is rated disabled by the VA, more than likely he keeps the home. If you have any experience or knowledge of things, please comment or msg me privately. Also anything with filial law changes please tell me. A couple of years ago something was submitted, but it never went further. I am ready to leave PA.

Here's the deal WorriedinCali. IF Medicaid (LTC) is denied due to gifting to children and nursing home has not been paid for services rendered to the parent who was denied Medicaid, THEN NH has the right to sue children who were gifted money from the patient parent. That is law written in the statues in my state. So in that sense, filial law can apply. But only if LTC Medicaid was denied because of gifting and the giftees are the ones who can be sued . Otherwise, children and other family members who were not gifted money that caused LTC Medicaid to be denied or delayed are NOT responsible for paying for parent's care. They will not be forced to pay and there is no law that says they must do so. An exception may be if they somehow sign paperwork at the nursing home stating they would be financially responsible. Is that clear?

I’m glad I live in New York where we have Medicaid and we don’t have the filial law. I heard Pennsylvania aggressively enforces the law.

Monica that’s correct. While filial laws for the most part were implemented long before we had Medicaid, states will be relying on these laws in the years to come. And I’ll say it again—filial laws allow nursing homes to go after children and sometimes other family members. We have no idea how many people have been sued by nursing homes & ordered to pay. And interestingly.....we have people here who like to tell OPs that the nursing home can come after them for payment yet they are on THIS thread saying the opposite & that people are worrying too much. LOL that’s the norm here there though.

I read comments that some of us may be worrying unnecessarily. I hope you are right. But I have talked extensively with my State Rep's office about this law and the indication is that states who have it still on the books will be relying more heavily on it due to the increasing costs of elder care and the increasing numbers of elderly needing that care. The states just cannot support everyone as they have in the past. Believe me...I hope none of us ever have to be caught in this archaic law but better to be prepared as more elderly persons live longer and run out of funds sooner

Yes, JoAnn, you are right. The Pittas case was very unusual and wouldn't apply to most people.

I also have read up on these laws. They were made before Medicaid. They are rarely enforced. And if they are, the income of the child/children is looked at. They will not impoverish a child.

If the Pittas case is where the Mother went back to her home country and left owing the NH then I feel she frauded the NH. I see it as leaving the US to get out of paying. In that instance, the son was held responsible. He had the option of getting the money back from Mom. And yes, if she was in an accident why wasn't insurance paying. There's more to that situation than we r being told.

PS, just read Igloos account. If this woman had not lived here for five years (I think that is it) then she was not entitled to Medicaid. I would think she needed a Green card to prove residency. Even if she was 65, she would not have been entitled to SS or Medicare if she hadn't worked in this country for 10 yrs (40 qtrs). I think her leaving the US was deliberate. In the son's instance looks like he signed paperwork saying he could be held responsible.

I think a lot of people are worrying unnecessarily. The states are not going to bankrupt the children of people in nursing homes because that is what would happen if filial laws were enforced. The children would be forced to declare bankruptcy and they themselves would be relying on state services for survival. The cost of nursing homes would bankrupt all but the very wealthy.

I live in PA. I believe the state was looking for a case and Pittas came up. I think PA is looking to refine their laws and trying to define which cases they will pursue.

I live in PA. I am a CPA. Filial laws may come into play as part of MERP as the law stands. I have not heard of a case pending as part of MERP. Not referring to Pittas in any way.

This law is not only unfair but it is and can be a financial disaster. As adult child we have no say what our parent(s) do with their money, but yet, made to be financially responsible for them!

I am sure that most of our laws are made up by people who have no real experience in dealing with these kind of situations. And really this will be another system that will fail at the end! Why?

Because let's say, we have to use our savings to pay for care whether it is for in-home care, MC/NH or whatever the need may be for our patient(s) then we have no money to pay for our own care then leaving our kids to pay for our care and the cycle continues. Where will it end?

In today's world, it is much harder to find a good paying job, buying a home then it was 20 yrs ago and then you add the cost of raising kids, the raise of cost-of-living and healthcare and to top it off paying for Our Parent(s) care. How can anyone get ahead? You can't!!

I am sure the people that came up with this law would re-think it if they found themselves in a similar situation as most of us are in...perhaps they would have change their minds about it!

The way I see it is a system that not only will fail, but put a strained on other systems.

I am a gen X and we find ourselves in no man's land...suck between what was and what will be! If that makes any sense!!!

Thank God that my state does not have this law!! But I feel for those who do!

Just my 2 cents!!

Ps: Monica you have a great point and I couldn't have said it better myself!

As Igloo said, the PA case, Pittas, is an outlier.  The mother had been in an auto accident, was in her 60s.   One has to ask, was there not insurance for that?  It was not a chronic condition.   The judge commented that the son was evasive in depositions.  Did he take the insurance money?   The mother may not have been a US citizen, may not have been entitled to Medicare or Medicaid.

You know what is really unfair about these laws?? There are children who see their parents getting older and know they will someday need assistance and they ATTEMPT to get the "big picture" of their parents' financial situation and are either lied to or told to mind their own business. Even if a parent (s) are squandering their money, falling for scams and/or living beyond their means, the children have NO LEGAL RECOURSE to reign things in early in order to not be financially responsible later. Getting guardianship is nearly impossible. So the laws tie our hands during the most critical time of our parents' financial lives then it hangs us by nooses when the parents' money runs out and we must now support them even when we tried tp inerve me early on. How can this be constitutional?? Even while my MIL was falling for scams our attorney told us there was nothing we could legally do to protect her money while she was still "competent." I no longer have living parents. My Dad died when I was 19, my Mom when I was 51. My Mom was so smart and had her entire financial future secured and figured out, even though she was widowed at age 47 and was left with very little income and money. But my 92 year old MIL (narcissist and pathogical liar) believes my husband will step in and pay the bills when her money runs out, and constantly harps on the fact that she had to downsize from a $4000 per month 2 bedroom 2 bath apartment to a studio apartment after my FIL died because they lived beyond their means and never planned on her losing most of their income when he died. My husband of 5 years is 67 and retired!! I refuse to support his mother.

igloo572: "I shudder to what boomers will have for LTC $. If NH run 8-15k a mo now, easily 15-25k in another decade. Gen Y or Z aren’t likely to caregive imo."

Yes. And medical advances will continue to lengthen lifespans, limited and compromised though those lengthened lives may be.

The younger generations are crying out for "free college!" for all. I don't hear or read much concern for all of us aging baby boomers and the impending LTC crisis!

No wonder people kill themselves. Especially when they see no way out. I’m talking about the adult child. Having to put up with the crap of a nasty parent, save for there children’s college education, save for retirement and then get sued 93,000 from a nursing home because you live in PA and your parents can’t pay for their own nursing home. Jumping off a bridge would sound like my plan if I were being sued.

Most work I do has to do with Medicaid fraud - both community and LTC and mostly during the application process.

Sorry mistake on my part and in wording. Effort in my area Is to make fewer people Medicaid eligible. Sorry

As of 2019 Maine does have pooled income trusts, but there is some sort of litigation pending in appeals court. No idea if that type of trust will be permitted long term.

There is long-standing opposition among some parts of the population in the state to LTC Medicaid. I think it should be available to those who are impoverished, but I do work on fraud prevention during the application process.

I was gonna say....Becky do you even know what a miller trust/pooled income trust is? It’s not a way to hide or protect assets. They are used to establish eligibility for people who cannot afford to self pay for a nursing home & are over the income requirements. These trusts are where excess income goes in to a trust account that Medicaid is beneficiary of. The money goes to Medicaid.

Becky, Miller trusts or pooled income trusts have nothing to do with protecting assets or allowing children to inherit money while Medicaid foots the bill. The money from a Miller trust still eventually goes to the NH.

Activists in Maine fight against Miller trusts and pooled income trusts because there are no filial responsibility laws. Why be able to use trusts to acquire Medicaid or protect assets and then have no filial responsibility laws and kids get to inherit. Same with protecting houses for children. Personal responsibility for your own expenses would be the best.

Monica & Elaine I agree with you both. It is totally ridiculous that adult children should have to foot the bill for indignant parents who failed to plan accordingly.

I’d also like to point out that the Pittas case set a precedent and that filial laws ARE enforced in some states including PA. The Pittas case began in the 90s I believe. And that case set a precent for the people in PA. What we aren’t reading about on the Internet is about all the adult children who were sued by nursing homes & advised to pay the bill by their attorney rather than go to court and fight it. Because most people CANT afford to fight. There are probably a lot of families out there that have been affected by ridiculous filial laws :(

https://www.thebalance.com/what-is-filial-responsibility-3974828

Here is a good, reasonable explanation of filial laws. I'd suggest everyone read it, especially the highlighted "notes".

I agree with you Monica. It is outrageous to have an adult child pay for there parents nursing home care when they were so foolish with there money. My mother gambled hers away years ago. I am so sorry that you have the filial law in your state. I would be worried too. Can you talk to an elder lawyer about it? That would drive me right over the edge.

You don’t have to be a multi millionaire to afford a nursing home or be affected by filial law. In the pattas case, they disclosed the numbers. He wasn’t a millionaire at all and he was required to pay for his moms care. Read the numbers, you might be surprised. They looked at his annual income of $85,000 and determined he could afford to pay the $93k bill. He’s married with minor children. Point being, if filial laws enforced, you don’t have to be wealthy in order for the courts to make you financially responsible for your parents. And I know to some of the older folks, $85k a year may seem like a fortune but in many states, it doesn’t get you much. Especially after taxes come out.

Monica, most children are not going to be able to afford the cost of nursing homes to pay for their parents and need to work to just support themselves. If the children were somehow multi millionaires then I could see them being asked to contribute. Otherwise you can't get blood from a stone.

Monica, the trend that I’m seeing is a narrowing of access to LTC in a SNF and a bigger share of SNF/NH $ going to community based waivers so away from 1-on-1 care. A lot of this really imo panders to the “I wanna stay in my home” unrealistic chorus that elderly say they want.

Like in my state- Louisiana- PACE is being done. Catholic Charities Health Division is partnering with state to set up PACE day centers. All care coordinated from within PACE & only to providers affiliated with PACE. With everybody being a “dual” so between MediCARE & Medicaid all costs covered. (Although the PACE on the westbank has had dual requirements challenged). The PACE by us in Bywater is a great facility & tightly run. You see transportation buses filled, folks look happy. But the issue still is who is there to help elder when they are not at PACE. It still is dependent on family doing care for nonPACE time.

In TX, shift is to having those on Medicaid go to MCOs for all care. For NH who have had true independent medical directors those days are gone, facility & residents will have to align with a MCO. If your in a big city, there will be choices. But if your rural, there may just be 1. TX Medicaid reimbursement rate is super low & it’s less than daily costs of operating a NH. So between these 2 factors, there have been closures. It’s a narrowing of choices. If there's fewer NH, then more will have to stay at home with health care within MCO group & family providing caregiving at home unless you’re in a metroplex.

Another issue is the medically “at need” requirements of LTC NH Medicaid. So much emphasis (& worry) is all about $$$.... gifting / transfer penalty, selling folks home,spend down. But being medically “at need” is very important & kinda is out of your hands for getting done. Medicaid can review health chart & do a needs assessment; & if elder is found not at need for skilled nursing care then no LTC NH Medicaid. Years ago I got my 90+ Lewy Body Dementia but still good on ADLs mom to go from IL to NH bypassing the AL phase, it took abt 5 months of visits to gerontologist to get health chart to show “need”. There is no way imo this could be done now, she be either AL or MC and neither under LTC Medicaid coverage. By tightening review of medical “at need”, it narrows entry into SNF & onto Medicaid. If they can’t afford AL or MC and yet not medically needy enough to for skilled nursing care, then it’s living at home with family doing caregiving unless they have $.

Even if elders have SS & savings, if they live long enough, they will run out of $ unless wealthier with good investments. I shudder to what boomers will have for LTC $. If NH run 8-15k a mo now, easily 15-25k in another decade. Gen Y or Z aren’t likely to caregive imo.

some states seem to now have it so they need to be discharged from a hospitalization to rehab patient to transition to LTC Medicaid resident. They can’t easily enter a LTC NH on their own & apply day 1 for LTC Medicaid. For facilities this is great as they get paid higher MediCARE rehab $ for at least 20/21 days or even up to 100 days; & there is a fat health chart to clearly show need so less assessment review; & it gives facility time to determine if they want the resident. Plus MediCARE days gives families time to do decisions, paperwork & spend down to get elder ok for LTC Medicaid. But again it narrow choices as you gotta wait till a hospitalization & then into a rehab/NH & then they stay in the NH.

When the tsunami of boomers start hitting needing facilities & cannot afford private pay, it’s not going to be pretty in the US.

If the filial law PA case referred to is “Pittas”, it is NOT an elderly mom with an outstanding NH bill scenario.

For Pittas, the mom was early 60’s & involved in an auto accident; was hospitalized & then to rehab for 2 -3 months. Mom too young for Medicare & was not on Medicaid. (& hospital did not sue). As it was auto accident, there was anticipation of auto insurance/tort lawsuit & payout.

AND importantly Pittas mom was Greek & her husband lived there.

At rehab facility, an application was done for Medicaid. She did not complete paperwork as she left facility and and and wait for it..... she moved back to Greece! Opa! Now her son - in his 30’s- signed her admissions documents. Within documents, there was the standard arbitration clause..... that if there were issues with billing or care that the case would go to arbitration. Pittas & his attorney went to arbitration hearing and they won. Arbitration ruled in Pittas favor.... he was not responsible for his moms bill. The facility - large national chain - was not happy with decision and took Pittas to court citing PA filial responsibility laws. PA has it that it’s before a judge & not a jury trial. Judge ruled in corporations favor. Judgement abt 90k.

imo he & his attorney did not take the lawsuit seriously enough. I bet the thought was “we won at arbitration so it will be the same when before a judge”. And his attorney DID NOT enjoin his 2 sisters as sharing in filial responsibility in the case (mom lived with 1). Had they done that judgement would have been shared @ 1/3 of bill, interest and attorney/ court costs. It would be a waaay better negotiation position.

to me, Pittas is a fearfilled boogie man story.
You envision frail sweet little old lady in her 80’s or 90’s adrift in a NH racking up a bill. But a lady in that scenario would be on Medicare & w/Medicare paying 100% of first 20/21 days post hospitalization rehab & then 80% up to 100 days. Little old lady likely has a Medicare gap / supplement policy or an advantage plan. And is retired with SS monthly income & maybe other retirement income. There would not be huge almost six figures rehab bill but just 20% mediCARE copay (abt $170 day) for rehab days after day 21 till day 100. 60 days of 20% rehab copay would be under 11k. That Pittas moms bill was so high in 2-3 months in rehab, to me, means she had no insurance coverage; it was full tilt billing on everything as no prenegotiated rates for services.

Pittas scenario is an outlier.
Our moms are likely not 61 & not likely getting on a plane hightailing it back to Europe where they have a home & a husband & citizenship. Our moms (& dads) will probably be in their 80’s or 90’s & have MediCARE & a secondary policy and SS and be living & staying in the US.
Theres lots on Pittas in Thomson/ Reuter’s (WestLaw) website but you need an account to access. Some bigger library systems have WestLaw available to the public. It’s a good read.

I do see the commentsame regarding "it rarely happens." We may see that change due to the high cost of elder care. Less burden on the government. And Medicaid is great...IF they qualify when their funds run out. If funds run out before they are eligible for Medicaid...that is a problem.

Filial laws only come into play if parent is denied Long Term Medicaid AND children have the means to pay or the reason parent was denied LTMedicaid was the child was gifted money from the estate. The vast majority of people don'
t have to worry about paying for their parent's care.