Can children be held personally liable for the cost of their parent’s health and long term care? In Pennsylvania, the answer is yes. The child can be sued and held responsible if there is no other adequate source of payment for the care
Pennsylvania’s Domestic Relations Code imposes an obligation on a child to provide support for an “indigent” parent.
Here is what the law says:
[A]ll of the following individuals have the responsibility to care for and maintain or financially assist an indigent person, regardless of whether the indigent person is a public charge:
(i) The spouse of the indigent person.
(ii) A child of the indigent person.
(iii) A parent of the indigent person.
The above statute does not define the term “indigent person” but courts have held that a parent is indigent if they have insufficient means to provide themselves with the care and support they need.
One Pennsylvania court recently described indigency under this law as follows: “Indigent persons are those who do not have sufficient means to pay for their own care and maintenance. ‘Indigent’ includes, but is not limited to, those who are completely destitute and helpless. It also encompasses those persons who have some limited means, but whose means are not sufficient to adequately provide for their maintenance and support.” 
Clearly, a person who needs care in a nursing or personal care home and who runs out of money fits the definition of indigent person. The law applies as well to a parent who needs more care and maintenance at home than they can pay for.
Some people wrongly assume that a child is only liable if their parent gave them money or property. But the Pennsylvania law is much broader than that. Whatever the reason your parent became indigent, you are liable to support them if you have the means to do so, even if no gifts were ever made.
The law authorizes nursing homes and other care facilities to sue the children of their residents.  If the parent has run out of money, their care facility obviously has a strong financial incentive to pursue the children for support. Over the last several years, many such lawsuits have been filed. A recent case that has gotten a lot of attention is HCR v. Pittas – click here to read it. In that case the son was held liable for his mother’s $93,000 nursing home bill. And no gifts were involved.
Both parents and children need to be aware of this responsibility to support your parents. Children disregard their parents' declining health and financial circumstances at the child’s peril. A lack of planning by the parent, or poor planning, or general misfortune, can create this liability. When the need for long term care arises, effective planning combined with expert advice regarding the ever shifting Medicaid and support laws, can help protect not only the parent's assets, but their children’s finances as well.
Families should remember that the child’s liability is based on Pennsylvania’s family support laws, not Medicaid laws. While this liability can arise in situations where a parent is ineligible for Medicaid because they gave assets away, it can also arise where Medicaid and transfers are not involved. Consider the following example:
Mom has been residing in Green Meadows Assisted Living Facility for the past 18 months. Mom’s has income of $1,200 a month from Social Security. Green Meadows has a monthly cost of $3,000 per month. This means that there is a monthly shortfall of $1,800 between Mom’s income and the cost of her care. Mom needs an assisted living level of care and is not nursing facility eligible, so Medicaid is not available. Mom has not transferred any assets. When Mom exhausts her savings, the Pennsylvania Domestic Relations Code authorizes Green Meadows to pursue an action against her children for support to cover the shortfall.
Is your parent in danger of needing care that may someday exhaust their savings? If so, and your parent resides in Pennsylvania, you need to get expert help to make sure you don’t end up being personally liable for the cost of their care. Make an appointment with an experienced elder law attorney to find out about your family's planning options. In Pennsylvania, you can call Marshall, Parker and Associates, which has offices in Williamsport, Wilkes-Barre, Scranton and Jersey Shore. Check them out at www.paelderlaw.com.
 23 Pa.C.S.A. §§ 4602-4608.
 23 Pa.C.S.A. §§ 4603(c)(1)(2).