Are Next of Kin Responsible for Care Home Fees?

Next of kin are only legally responsible for paying care home fees if they signed a contract with the provider saying they would. Generally, the next of kin in this situation includes spouses and adult children. In some cases, you might have a financial obligation to help cover care home fees if you have joint assets with the relative.

When your parent or spouse lives in a care home and passes away, the facility issues an invoice for any outstanding fees. However, the amount due would come out of your relative’s estate, due within 90 days of their passing. Nursing homes participating in Medicaid or Medicare are prohibited from requiring a third-party guaranteed agreement with next of kin, according to the Nursing Home Reform Act, enacted in 1987. However, you might feel pressured into signing one or not understand what you’re signing, making yourself financially responsible. Always talk to an attorney before signing any agreement you don’t understand.

Who might be responsible for a care home debt after death depends on your relationship to the deceased resident, your state’s law on medical bill debt and whether your relative paid their nursing home costs privately or using Medicaid. Only the resident is responsible for private pay, so the provider must attempt to get the money from their estate, assuming they have enough left to settle the debt. According to Genworth’s 2021 Cost of Care Survey, the average price of a semiprivate room in a nursing home is $7,908 per month or about $94,896 per year. A private room is even higher, at $9,034 monthly or $108,408 annually.

Depending on state laws, a spouse could be responsible for the debt in a community property state. Any relative might be responsible if they were the guarantor on the account. If you live in a filial responsibility state, you might be responsible for paying for your parent’s care if they don’t have the means. The care provider or a collection agency might try to collect the outstanding bill from your relative’s estate or come after you, but that doesn’t mean you’ll have to pay.

State laws are complicated and differ from one to the next. Even outside of community property states, you might be responsible for your spouse’s medical bills if the state enforces the doctrine of necessaries/necessities. This doctrine makes spouses liable for the necessary support of one another. A state’s doctrine of necessaries might allow creditors to file a lawsuit against you, but some states don’t allow lawsuits for medical debts.

In 2021, about half of all states held adult children financially accountable through filial responsibility laws. These laws hold adult children responsible for paying their parent’s bills if they can’t afford care. However, enforcement varies by state, and care facilities might not pursue the case even when they can. First, the care home must prove that the resident’s estate won’t cover the debt. Then, it must prove that the adult child has the means to pay the bill without hardship. If you’re unsure whether you’re responsible for a relative’s debt or know you’re not responsible but getting hounded by bill collectors, consult an attorney about your responsibilities and learn the best strategy for clearing up the situation.