ABA Family Legal Guide

The Rights of Older Americans

Health and Long-Term Care Benefits

Paying for Long-Term Care

Must children pay for parents in nursing homes?

There is no legal obligation under federal law for children to pay for their parents' care. Only a spouse may be held legally responsible to help pay for the cost of nursing-home care, and as a practical matter, the responsibility is often difficult to enforce against an unwilling spouse. If Medicaid enters the picture, the special rules for spousal responsibility described above apply.

Some nursing homes give admission preference to private-pay patients over Medicaid patients because private-pay rates are often higher than the amount Medicaid pays. While admission priority for private-pay patients is permissible in some states, it is illegal in others. In all states, federal law prohibits nursing homes from requiring a private payment from families, or a period of private payment, prior to applying for Medicaid coverage. Federal law also prohibits nursing homes from requiring patients to waive their rights to Medicare and/or Medicaid and from caring for Medicaid and private pay residents differently.