Is an Adult Child Legally Responsible for a Parent's Nursing Home Bills?

1 answer | Last updated: Nov 08, 2016
A fellow caregiver asked...

Is an adult child legally responsible for a parent's nursing home bills?

Expert Answers

In general, an adult child is not responsible for any of a parent's personal bills, including the cost of a nursing home. This is true even if the adult child has power of attorney authority over the parent's finances.

It is often an adult child who contacts a nursing home, discusses financial arrangements with the facility administrator, and signs admission papers on behalf of the parent. During this admissions process, nursing homes often ask a family member to become a "responsible party" or "cosigner" for a new resident, sometimes requiring this commitment before the nursing home will agree to take the parent as a resident.
But it's not always clear from the discussions and paperwork what it means to be the responsible party. On one hand, it can just mean being the person who is contacted during emergencies and who is a decision-maker regarding medical issues (named in the parent's advance health care directive or financial matters (named in a power of attorney for finances) when the resident is incapacitated.

However, some nursing homes try to use responsible-party agreements to get the adult child to guarantee payment of the parent's nursing home fees before it allows the parent to become a resident. A nursing home does this because it gets higher fees from private-paying residents than from Medicaid, which is the program that pays if and when a resident runs out of funds.

Being put in this position by the nursing home can make for a very difficult situation: The adult child does not want to jeopardize the parent's chance to become a resident by refusing to pay. But accepting the responsibility could mean a tremendous financial burden down the road.

Requiring a family member to agree to be the financially responsible party for a nursing home resident is illegal under federal law, in Title 42 of the Code of Federal Regulations, section 483.12(d)(2). Under this law, nursing homes are not even supposed to ask if a family member wants to become a responsible party. Nonetheless, some nursing home agreements contain fine print that claims to make a responsible party or cosigner personally responsible for the resident's bills. If a nursing home attempts to enforce such an agreement, the person who signed the papers may need legal help to get out from under the nursing home's claim.

There is a circumstance in which it is legal for a nursing home to ask an adult child to agree to pay the nursing home bills. If the adult child has power of attorney over the parent's finances, it is lawful for the nursing home to ask the child to agree -- in the role of power of attorney -- to use the parent's funds to pay the nursing home bills. Signing that agreement, however, does not make the adult child personally responsible for the bills.

A different situation may exist if a nursing home initially rejects a person as a resident because the person has insufficient funds to pay for care, and an adult child or other family member then offers to become financially responsible for the bills. This may be a lawful financial-responsibility agreement if the offer to pay the bills is truly voluntary.