Disclaimer: This article has been posted for general information purposes only. You should not act upon the information in this article without first retaining legal counsel.
By Robert C. Gerhard, III, Certified Elder Law Attorney
If you’ve just received a large bill from your parent’s nursing home in Pennsylvania, related to a Medicaid transfer penalty period, you’re likely feeling shocked. Can they really hold you responsible for this debt? The answer, under Pennsylvania law, is: possibly, and it all comes down to something called Pennsylvania’s Filial Support Law.
What Is the Filial Support Law?
Pennsylvania is one of the few states that enforces a filial responsibility statute, found in 23 Pa.C.S. § 4603. This law states that adult children may be held financially responsible for the care of their indigent parents, including unpaid nursing home bills.
This liability can apply even if you didn’t sign anything, didn’t cause the debt, were not serving as their power of attorney, and weren’t involved in your parent’s financial decisions. The law has been upheld in several court cases, including the notable Pittas case, where a son was held liable for nearly $93,000 in Pennsylvania nursing home costs
What Is a Medicaid Penalty Period?
When someone applies for Medicaid to cover nursing home care, the state reviews financial transactions over the past five years. If assets were gifted or transferred for less than fair market value, Medicaid imposes a penalty period, a span of time during which Medicaid will not pay for long-term care, even though the person is otherwise eligible for Medicaid benefits.
During this penalty period, the nursing home still provides care, but Pennsylvania’s Medicaid program will not pay, and if your parent is out of funds, the facility may look to you under the filial support law.
Are There Exceptions?
Yes. You may not be held responsible if:
- You lack the financial ability to pay.
- Your parent abandoned you for 10 years during your minority (under age 18)
However, proving these exceptions can be challenging and may require legal representation.
What Should You Do?
- Consult an elder law before a senior makes gifts or applies for Medicaid. An elder law attorney can often identify and solve transfer issues before a Medicaid penalty is imposed. Have an elder law firm handle the application process.
- Don’t ignore the bill. Nursing homes often use the filial support law as a collection tool when other efforts fail. Sometimes the contract that was signed permits the nursing facility to add collection costs or their own legal fees to the bill, morphing the situation into an even worse financial problem.
- Consult a litigation attorney. You may have defenses or options to negotiate the amount. Did the nursing home or its recommended contractor handle the application process for you?
- Have an elder law attorney review the notice and evaluate appeal options. Was the penalty period caused by a gift or transfer? If so, was it for a purpose exclusively other than to qualify for Medicaid, or was the gift to an exempt transferee, such as a disabled child? There are some transfer situations where Medicaid penalties are wrongfully imposed, and an appeal may be appropriate.
Final Thoughts
Receiving a large nursing home bill due to a Medicaid penalty period is a serious matter in Pennsylvania. While you may not feel responsible, the law could say otherwise. Understanding your rights and obligations—and seeking legal advice—can help you navigate this difficult situation.
About Gerhard & Gerhard, P.C.
Robert C. Gerhard, III Esquire is the managing shareholder of Gerhard & Gerhard, P.C., an estate planning and elder law firm located in Montgomery County, Pennsylvania. Attorney Gerhard specializes in elder law, with emphasis on Medicaid Planning, Medicaid Applications, and Medicaid Appeals. He is the author of the Pennsylvania law treatise, Pennsylvania Medicaid, Long-term Care. If you would like to schedule an appointment with Attorney Gerhard, please contact us.
