Can a Nursing Home Sue Your Children? The Pittas Case and PA Filial Support Law

Most people are surprised to learn that Pennsylvania has a law allowing nursing homes to sue adult children for a parent’s unpaid care costs. That law, 23 Pa.C.S. section 4603, has been on the books for decades but was rarely enforced until Health Care & Retirement Corporation of America v. Pittas, 46 A.3d 719 (Pa. Super. 2012), put it to the test.

The Case

John Pittas’s mother entered a nursing home for rehabilitation following a car accident. She eventually left the facility with a significant unpaid balance and moved to Greece. The nursing home then turned to her son.

Under 23 Pa.C.S. section 4603, a person has a duty to support an “indigent” parent if the person has “sufficient financial ability.” The nursing home filed suit against Pittas under this provision, seeking over $93,000 in unpaid charges.

Pittas raised several defenses. He argued that his mother had applied for Medicaid and that the nursing home should pursue that avenue first. He argued that the statute should require courts to consider other potential sources of payment. The Superior Court rejected both arguments.

The Court held that the nursing home met its burden of proving Pittas had the financial ability to support his mother. Nothing in the statute requires the nursing home to exhaust other remedies first or to consider other family members’ ability to pay. The Pennsylvania Supreme Court declined to hear the appeal, making the Superior Court’s ruling final.

Why It Matters

Pittas confirmed that 23 Pa.C.S. section 4603 is alive and enforceable. Nursing homes can and do pursue adult children for unpaid bills. The liability is joint and several among the children, meaning the facility can choose to pursue the child with the most assets rather than splitting the claim among all siblings.

The common-law definition of “indigent” is broader than many expect. A parent does not need to be completely destitute. If their resources are insufficient to cover the cost of care, they qualify as indigent for purposes of the statute.

After Pittas received national media attention, elder law attorneys reported an increase in filial support claims, particularly in situations where a Medicaid application was pending or had been denied.

The Planning Takeaway

The best response to filial support risk is proactive Medicaid planning. If your parent qualifies for Medicaid, the nursing home’s incentive to pursue a filial support claim diminishes significantly because Medicaid will cover the cost of care. But Medicaid has a five-year lookback period for asset transfers, income and asset limits, and specific application requirements that demand careful handling.

For families where a parent is approaching the point of needing long-term care, planning ahead can mean the difference between Medicaid eligibility and a six-figure filial support claim. The five-year lookback period means that the earlier you start planning, the more options are available.

If your parent is in a nursing home or approaching the need for long-term care, contact our office to discuss Medicaid planning and filial support exposure.