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Over the last few years, the rising cost of long-term care has become one of the biggest financial concerns for older Americans and their families. With nursing home expenses reaching thousands of dollars per month on average, even households that have carefully planned for retirement can find themselves struggling when someone requires extended care. As those bills mount, it’s not uncommon for adult children or other relatives to wonder what happens if those nursing home invoices go unpaid.
That uncertainty often compounds, though, after a loved one dies or when they’re no longer able to manage their own finances, meaning someone else has to step in to handle things instead. In these cases, families may receive phone calls or letters about outstanding nursing home care balances, leaving them unsure of whether they’re legally responsible for paying what’s owed or whether the nursing home is simply attempting to collect from anyone connected to the resident.
The answer isn’t always straightforward, unfortunately. In many cases, family members are protected from personal liability for a loved one’s nursing home bills, but there are exceptions to nearly every rule. So, can a nursing home really pursue family members for payment? That’s what we’ll examine below.
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Can a nursing home pursue family members for unpaid bills?
As a general rule, a nursing home cannot automatically pursue family members for a resident’s unpaid bills simply because they’re related. In most states, this type of debt belongs to the person who incurred it, not to their children, siblings or other relatives. However, several important exceptions can change that outcome, including the following:
You signed a contract accepting financial responsibility
Many nursing home facilities will ask relatives to help complete admission documents, particularly if the resident has cognitive or physical limitations. If those documents include language making the signer personally responsible for payment, the nursing home may attempt to enforce the agreement if bills go unpaid.
That’s why it’s important to read the nursing home admission paperwork carefully before signing. If you’re signing on behalf of your loved one under a power of attorney, ensure the documents clearly indicate you’re acting as their representative rather than agreeing to personally guarantee payment.
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You’re responsible under state law
While most states don’t require adult children to pay for a parent’s long-term care, some still have what’s known as filial responsibility laws. These laws, which exist in varying forms, may allow certain creditors — including nursing homes in limited circumstances — to seek payment from financially able adult children when a parent cannot pay what’s owed. In practice, these laws are rarely enforced, particularly when Medicaid is involved. Still, they remain on the books in several jurisdictions, making it worthwhile to understand your state’s rules if a loved one enters long-term care.
You’re a spouse
Marriage creates different legal obligations than other family relationships. In some cases, spouses may share responsibility for medical or long-term care expenses depending on state law, marital property rules and how the debt was incurred. What that means is that if the nursing home resident is married, the facility may have stronger legal grounds to pursue payment from the spouse than it would from adult children or other relatives.
The estate may still owe the debt
The resident’s estate may be held responsible for unpaid nursing home debt, even if family members aren’t. After someone dies, outstanding nursing home bills typically become claims against the estate. The executor uses estate assets to pay valid debts before distributing inheritances to beneficiaries. If the estate lacks sufficient assets, remaining unpaid balances generally aren’t passed down to family members — unless one of the exceptions above applies.
What should you do if a nursing home is trying to collect?
If a nursing home facility does come after you for a loved one’s unpaid balance, the first move isn’t to pay what they say is owed — it’s to figure out what you actually signed. Pull the admission contract and look for the word “guarantor.” If you signed as an agent or representative acting on the resident’s behalf, the underlying claim may not be enforceable against you and a consumer law or elder law attorney may be able to help.
But in certain cases, part of the debt may be genuinely yours, and that’s where your debt relief options come in. There are a few options you can consider, like debt settlement, which works to negotiate what you owe down to a fraction of the balance. A debt management program is another option. This approach can fold multiple obligations into one lower-rate monthly payment, making it easier and more affordable to pay off what’s owed.
Either route can keep a single disputed bill from snowballing into a wider financial crisis at an already exhausting time, and there are likely other routes you can take, too. Just make sure to fully consider all of the possible benefits and downsides before making a decision.
The bottom line
In most cases, family members are not personally responsible for a loved one’s nursing home bill. There are exceptions, though, like when you sign a responsible-party clause without reading, are a party in a community-property marriage or are subject to a rarely used filial law. Before you pay or promise anything, though, read what you signed, get the contract reviewed and direct debt collectors to the estate. And, if a balance is ultimately legitimately yours, one of your debt relief options is likely far cheaper than letting the debt compound over time.