Who in The Family is Liable for Nursing Home Bills?

When a parent suffers a stroke, or other sudden acute illness, the family is suddenly faced with difficult and costly decisions about where to get care and how to pay for it. But there may be another matter of great concern, and that is who is legally liable to pay for very expensive long term care.

The typical situation that arises is discharge from a hospital, to a rehabilitation facility, and then into that facilities long term skilled nursing section. The hospital discharge planner will be anxious to complete the discharge, and the admission director at the rehabilitation facility or nursing home will be anxious to have some family member sign the nursing home admission agreement. It is often presented to the family as a quick "sign here" on these standard papers. This is the very moment when caution should be exercised, and the advice of a knowledgeable elder law attorney should be sought.

The first thing to know is that children are not liable for the debts of their parents, including nursing home bills. However, many admission agreements use words like "Responsible Party" and if a child signs that agreement, the fine print may include language that can make the child liable. This can come about if the child has received gifts from the parent. It can also occur if the admissions agreement says the child will help the parent apply for Title 19 (Medicaid) and the application is unsuccessful. This can happen if the "Responsible Party" by innocent mistake fails to get Title 19 approved because of an unknown life insurance policy, or other asset that was worth more than the $1,600 eligibility limit. There have been successful lawsuits against well meaning children who signed such agreements and tried and failed to get Medicaid because of some overlooked asset.

The second thing to know is that no one can force a child to sign the admission agreement. There is often a great deal of pressure to sign, because this is probably the only time the child will ever be faced with this situation, and it is a very emotional time as the child wants the best for mom or dad. This is the time to have the admission agreement reviewed by an elder law attorney, before you sign it. Because, in reality, it is a contract, and that is what can make you liable.

A third thing to know is that many agreements take away your right to have a court rather than an arbitrator decide on nursing home malpractice or breach of contract.

And there are many other concerns. Does the home accept Medicaid? Does the agreement prohibit transfers of assets? When can the home discharge the resident?

The word to the wise is not to sign an admission agreement before an elder law attorney reviews it and advises on your responsibilities and your financial liability. Don't let the difficult emotion of the situation cloud your judgment. You wouldn't cosign a loan for someone leaving you potentially liable for approximately $12,000 a month, so get competent counsel who can advise you about the care to be provided to your parent, and who is going to apply for it. It only takes a day or two for such a review, as elder law attorneys understand the need for a quick response.