In Pennsylvania, if Your Elderly Parents Can’t Pay for Their Long-Term Care, Then You Might Be on the Hook for It

Colonial Poor Law Imposing Liability on Today’s Adult Children

Last April, Julian Gray and Frank Petrich, both elder law
attorneys, authored a Pittsburgh-Post Gazette article on a Pennsylvania law that can
potentially saddle children with the unpaid costs of their parents’ long-term
care. The law, 23 Pa.C.S. § 4603, states:

(a)(1) Except as set forth in
paragraph (2), all 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

(ii) A child of the indigent

(iii) A parent of the indigent

Section 4603 is described as a holdover from the Colonial “poor
laws.” Colonial poor laws, as defined by
the Social Security Administration
, “featured local taxation to support the
destitute; they discriminated between the ‘worthy’ and the ‘unworthy’ poor; and
all relief was a local responsibility.”

Liability for a Parent’s Long-Term Care

The Gazette article underscores the fact that § 4603 is now being
used “regularly” to tie family members to care costs. It offers two interesting

A nursing home sued an out-of-state adult child
to recover for care despite the fact that the adult child had no contact with the
parent; and

A nursing home sued two adult children after
their sibling stole money from the parent.

In May, a son was found liable, pursuant to 23 Pa.C.S. § 4603, for the outstanding debt incurred as a result of his mother’s treatment and care. Health Care Ret. Corp. of Am. v. Pittas, 2012 PA Super 96 (Pa. Super. Ct. 2012) [enhanced version available to subscribers]. The mother, after completing rehabilitation for injuries sustained in a car accident, had been transferred to a facility for skilled nursing care and treatment. The Pittas case reaffirmed a broad definition of “indigence:”

the indigent person need not be helpless and in extreme want, so completely destitute  of property, as to require assistance from the public. 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. Savoy v. Savoy, 433 Pa. Super. 549, 641 A.2d 596, 599-600 (Pa. Super. 1994) [enhanced version available to subscribers].

The Pittas court noted that despite the mother’s social security income and her share of Veteran’s Administration benefits, the sources of income were insufficient to adequately provide for the mother’s maintenance and support.

Difficult Exceptions to the Rule

Section 4603 does offer two exceptions. Section 4603 is inapplicable

an individual does not have sufficient financial
ability to support the indigent person; or

a parent abandons a child and persists in the
abandonment for a period of ten years during the child’s minority.

However, as the article notes, the exception is somewhat self
defeating. The authors pose the following question: “How does a person without
‘sufficient financial liability’ to assist a parent defend himself [against
expensive § 4603 litigation]?” The article further notes that proving indigence
is not necessarily an easy (nor cheap) thing to do.

The moral of the story: adult children in Pennsylvania need
to start paying attention to their parents’ health and wealth. There is, however, potential relief in sight. In early 2011, the Pennsylvania House introduced a bill to repeal §


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