The Superior Court of Pennsylvania recently affirmed a lower court’s judgment entered in favor of a nursing home in a case under the Relatives Liability statute. Liberty Nursing & Rehabilitation Center filed a filial support action against a former resident’s son for the resident’s unpaid bills after the resident’s discharge in 2008. The parties submitted the case to arbitration, which found in favor of the resident’s son. However, the nursing home appealed to the trial court, which awarded a verdict in the amount of $92,943.41 to the nursing home after a non-jury trial. The resident’s son appealed, claiming that a) he did bear the burden of proof in showing he was unable to support his mother; b) that the trial court should have considered his mother’s alternate sources of income, including a pending Medical Assistance application, to satisfy the support obligation; and c) that the trial court erred in deciding the resident was indigent. 

            While historically not often pursued by nursing homes, Pennsylvania law does provide for a filial support obligation.  Pursuant to 23 Pa.C.S.A. § 4603, “Relatives’ Liability,” a spouse, child or parent of an indigent person has, “the responsibility to care for and maintain or financially assist an indigent person, regardless of whether the indigent person is a public charge.” The statute does not apply if the individual lacks sufficient financial ability to support the indigent person or to a child for the support of a parent who abandoned the child and persisted in the abandonment for a period of ten years during the child’s minority. 

In finding in favor of the nursing home and upholding the judgment, the court made the following key points:

  • The burden is on the nursing home to prove that the family member has the financial ability to pay the bill; it is not the family member’s burden to prove he or she cannot pay.
  • The nursing home presented sufficient evidence to show the son’s financial ability to pay by showing his net income was in excess of $85,000 per year, and presenting his individual and “S” corporation joint tax returns for the prior four years. 
  • While the son claimed he was unable to pay due to other bills, he failed to substantiate those bills and the court found his testimony lacked credibility. 
  • The statute does not require a nursing home, or a court for that matter, to consider other sources of income or to stay its determination pending the resolution of a claim for medical assistance.
  • The court was not required to consider that the former resident also had a spouse and other children who might have been able to provide support; it was the resident’s son to join those other family members in the case if he wanted them to share the responsibility.  
  • Pennsylvania courts define “indigent” as those persons 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.”
  • In this case, the former resident’s income as listed on her admission sheet, consisting of social security and a Veteran’s Administration benefit and amounting to only $1,000 per month, was insufficient to adequately provide for her maintenance and support, and this was adequate proof of her indigence under the statute. 

While nursing facilities are prohibited by Federal and state regulations from requiring a third party to pay a resident’s bills out of their own financial resources as a condition for allowing the resident to enter or continue to stay in the nursing home; clearly families in Pennsylvania do share some financial responsibility for their loved ones in nursing facilities should that resident be unable to pay their own way. And, as this case demonstrates, a pending Medical Assistance application isn’t necessarily a free pass.

Submitted by Stacy C. Mikelonis, Esquire