Children in NY can be responsible for their parents’ nursing home costs

Long-term care is expensive. Recent estimates put the costs of nursing home care at over $400 per day. People who need long-term care generally pay for it using one or all of the below ways:

  • Personal savings (the AARP estimates one-third of nursing home residence pay for all their care)
  • Long-term care insurance
  • Medicaid coverage for those who qualify

In order to obtain Medicaid coverage, a nursing home resident must have exhausted almost all of his or her assets. Medicare, which covers medical care for people over 65, does not usually cover custodial costs provided by nursing homes.

Children's responsibility

Historically, many states enacted "filial laws" that made family members responsible for aging or ill parents. However, with the advent of Medicaid, Social Security and other programs, some of the burden has shifted from adult children to social programs. These have largely rendered filial laws moot. Still, 28 states and Puerto Rico have filial laws currently on the books.

New York is not one of those states. Even in those states that do have filial laws, they are rarely enforced. However, nursing homes have more recently begun attempting to collect from family members.

Federal Medicaid law does prevent nursing care homes from requiring that family members act as "guarantors" when admitting a new patient. This means that nursing homes can only request a child to be a guarantor before Medicaid coverage kicks in, and only when the child voluntarily agrees to be a guarantor.

High cost affects family members

Even if not a guarantor, family members usually end up paying some of the costs of a parent's nursing home care, whether by obtaining Medicaid for the parent or by private funding. If the child is a power of attorney, he or she must ensure that the parent is cared for and bills are paid. That child is legally responsible to use his or her parent's assets to pay for care or establish Medicaid coverage.

State law looks closely at the finances of a nursing home resident before he or she qualifies. For example, a parent can't "gift" assets to a child immediately prior to entering a nursing home facility in order to qualify for Medicaid; in fact, New York looks back five years prior to requesting Medicaid to determine if an applicant transferred non-exempt assets for less than fair market value. If so, then a "penalty period" will delay Medicaid qualification for a certain amount of time.

Planning ahead

Children with parents who may need long-term care can benefit greatly by planning ahead; reducing a parent's estate, buying long-term care insurance and establishing a power of attorney or just some ways to help with the costs of nursing home care. Children of aging parents should contact a skilled elder care attorney to discuss their best options.