Filial Responsibility Laws by State (2026 Guide)

If a parent's nursing home, hospital or care bill goes unpaid, adult children often hear that they can be made to pay it. In a handful of states that is true in narrow circumstances. In most states, we found no law that makes it true.

This guide explains what filial responsibility laws are, how they reach a care bill, who can enforce them, the defenses the statutes themselves give, and how they fit with Medicaid. The map and table below cover every state and the District of Columbia, based on the statutes and court decisions we read for each one.

What filial responsibility means

Filial responsibility (or filial support) is a legal duty running from an adult child to a parent. It is the reverse of the familiar duty parents owe their minor children. Many of these statutes still use the language of old poor-relief law, with words like "pauper," "poor person" or "indigent."

The laws that still exist take four broad forms:

• Civil support duties. A parent in need, or someone who paid for the parent's care, can ask a court to order a child to pay. Pennsylvania, South Dakota, California, Virginia, Louisiana and Delaware work this way.
• Public-relief reimbursement. A county, town or state agency that paid for a poor person's care can recover from listed relatives. Georgia, Mississippi, New Hampshire, New Jersey and Alaska use this model.
• Criminal nonsupport. Failing to support a destitute parent you can afford to help is a crime. Kentucky, Massachusetts, Ohio and Connecticut have criminal laws only; California, Indiana and Rhode Island have both civil and criminal provisions.
• Narrow, asset-based claims. Rhode Island and North Dakota let a care provider reach a child only in transfer situations: in Rhode Island, up to the value of assets the child received in a transfer that caused a Medicaid penalty; in North Dakota, for a child who benefited from a disqualifying transfer or in bad faith diverted the parent's assets.

Several states have repealed or narrowed these laws since 2011. Idaho, Iowa, Maryland, Montana and Utah repealed their adult-child support laws, North Carolina repealed its crime in 2025, and Vermont removed its adult-child provision the same year. Arkansas and West Virginia have laws that are sometimes described as filial laws but are much narrower than a duty to support a parent (more on both below).

How a filial law reaches a nursing home bill

The case most people have heard about is from Pennsylvania. In Health Care & Retirement Corp. of America v. Pittas (Pa. Super. 2012), a nursing facility sued a son under 23 Pa.C.S. 4603 for his mother's unpaid bills. The Superior Court affirmed a $92,943.41 judgment against him.

Two parts of that ruling matter to families. The court held that the facility had proved the mother was indigent. It also held that the facility did not have to wait for the outcome of her pending Medicaid application before pursuing the son.

That second point matters most in practice. A filial claim can arise in a gap: the parent has run out of money, but Medicaid has not yet started paying, has denied the application, or has imposed a penalty period because of earlier gifts. The bill for those months is what a facility may try to collect.

Pennsylvania's statute is broad on who can sue. A court can act on the petition of the indigent person or "any other person or public body or public agency having any interest in the care, maintenance or assistance" of that person, which covers a nursing facility. Intentionally failing to obey a support order can lead to contempt and up to six months in prison.

The facility still has to prove its case. In Rest Haven York v. Deitz (Pa. Super. 2014), a non-precedential decision, the court upheld a judgment for the daughter because the facility offered no evidence that her mother was indigent.

South Dakota

South Dakota requires an adult child with the financial ability to do so to provide necessary food, clothing, shelter or medical care for a parent who cannot provide for themselves (SDCL 25-7-27). In Americana Healthcare Center v. Randall (1994), the South Dakota Supreme Court affirmed a judgment holding an out-of-state only son liable to a nursing home for his mother's care, and rejected his constitutional challenges.

South Dakota claims have limits. The child must get written notice that the parent cannot provide for themselves, generally within 90 days after the care was first provided. In Accounts Management, Inc. v. Nelson (2003), the children were not liable for their late father's hospital bill because his estate was solvent, so he was not indigent.

Other states with civil claims

In the other civil states, we found no appeals-court decision holding an adult child liable for a parent's care under the current law. That does not make the statutes empty. A county, a facility or a parent can still file under them, and the state rows below explain who has that right in each place.

North Dakota is a useful example of how these laws change. Under its older wording, a trial court entered a $104,276.62 judgment against one son for his parents' nursing home debt; the North Dakota Supreme Court reversed it in 2013 (Four Season's Healthcare Center v. Linderkamp). A 2019 amendment then narrowed the statute, so a creditor can now recover only in the two narrow situations described under Medicaid below.

Who can sue, and what they must prove

The answer depends entirely on the state. Across the statutes we read, the enforcers fall into a few groups:

• The parent. California, Delaware, Indiana, Louisiana and Pennsylvania let the parent ask a court for support.
• A care provider. Pennsylvania (anyone with an interest in the parent's care), North Dakota and Rhode Island (in narrow transfer cases), and South Dakota (in the reported cases, the nursing home or hospital sued).
• A government body that paid. A county in California, Georgia and Mississippi; a town or city in New Hampshire; a welfare director or county in New Jersey; the state or a municipality in Alaska; the county in Nevada; the state medical assistance agency in Tennessee (only to the extent federal law allows) and, in limited cases, Virginia.
• A prosecutor. In the criminal states, the case is brought by the state.

Most statutes require proof of the same few things. The parent must be in real need: indigent, destitute, a pauper, or unable to work or support themselves. The child must have the ability to pay. Some states add their own conditions, such as South Dakota's written notice, New Jersey's requirement that the parent apply for and be eligible for public assistance, or Nevada's three-part test for county hospital bills.

Nevada's test shows how narrow some of these laws are. The county can recover hospital costs from a child only if the child promised in writing to support the parent, has access to and control of the parent's assets or income, and has enough money to support the parent.

Defenses written into the statutes

These defenses come from the text of each state's law. Which ones apply depends on your state, so check the row for your state in the table below.

Inability to pay. Most filial statutes limit the duty to a child who can afford it. Delaware ranks supporting a poor relative behind the obligor's own minor children and spouse. Virginia applies only after the child has reasonably provided for their own immediate family. New Hampshire, since January 1, 2026, lets a town seek reimbursement only from a relative who can pay without financial hardship.

Abandonment or lack of support in childhood. Many states excuse a child the parent abandoned or failed to support:

• Pennsylvania: a parent who abandoned the child for ten years during the child's minority.
• Connecticut: a parent who wilfully deserted the child for the 10 years before adulthood.
• California: a child abandoned for two or more years before age 18, while the parent was able to provide support, can petition to be released.
• Virginia: substantial evidence the parent deserted, neglected, abused or willfully failed to support the child before emancipation.
• Ohio: an affirmative defense if the parent abandoned or failed to support the child while a minor.
• Massachusetts and Rhode Island: refusal is not unreasonable for a child the parent did not reasonably support in childhood.
• Indiana: no civil duty unless the parent provided the child with necessaries until age 16.
• New Jersey: a court may revoke or reduce an order against a child the parent abandoned during minority.

Someone else comes first. In Delaware the spouse is liable first, then the parents, then the children. In Louisiana the spouse's duty comes first and the descendants' duty is secondary.

Age and caps. New Jersey's law does not apply to a child who is 55 or older. Virginia caps a child's responsibility at 60 months of a parent's institutional care. Connecticut's crime applies only to a parent under 65.

Contribution from siblings. In South Dakota a child who provides the care can seek a pro rata share from adult siblings who do not help, after giving them written notice; in Rhode Island a child who pays more than a fair share can sue other adult children for contribution. Delaware and Louisiana divide the duty among children according to their means.

States where it is a crime

In several states, failing to support a destitute parent you can afford to help is a criminal offense. These cases are brought by prosecutors, not by care providers.

• California (Penal Code 270c): a misdemeanor for an adult child able to provide necessary food, clothing, shelter or medical care to an indigent parent who does not.
• Connecticut (Gen. Stat. 53-304(a)): up to one year in prison for neglecting or refusing reasonably necessary support to a parent under 65, unless the person shows they cannot provide it.
• Indiana (IC 35-46-1-7): a Class A misdemeanor, up to one year in jail and a fine of up to $5,000.
• Kentucky (KRS 530.050): a Class A misdemeanor, and a Class D felony where a court or administrative order already requires the support.
• Massachusetts (G.L. c. 273, s. 20): a fine of up to $200, up to one year in jail, or both.
• Ohio (R.C. 2919.21(A)(3)): a first-degree misdemeanor for failing to support an aged or infirm parent.
• Rhode Island (Gen. Laws 15-10-1): a fine of up to $200, up to one year in prison, or both.

In Virginia, the duty itself is civil, but violating a court support order is a misdemeanor.

States that repealed their laws

These states have repealed the adult-child support laws we found:

• Idaho: repealed in 2011, including its rule making relatives share nursing home costs.
• Iowa: repealed in 2015; counties now recover poor-relief costs only from the person or the person's estate.
• Maryland: repealed effective October 1, 2017.
• Montana: repealed in 2021.
• Utah: repealed effective May 1, 2024.
• North Carolina: the crime of failing to support a sick or needy parent was repealed effective July 1, 2025 (we did not check its public assistance laws for a civil duty).
• Vermont: the adult-child provision was removed from the nonsupport law effective June 12, 2025; a related section still mentions an adult child, and we could not determine whether that leftover wording has any effect.

Arkansas and West Virginia are sometimes described as filial states, but we found no general duty to support a parent in either. Arkansas's 20-47-106 covers state mental health service costs only and names no relative. West Virginia's 9-5-9 makes relatives of sufficient ability repay the state's direct cremation or burial payment for an indigent person. Nevada also has a burial-cost rule alongside its narrow hospital rule.

How filial laws interact with Medicaid

Medicaid is what usually pays for long-term nursing home care once a parent's money runs out. Federal law shapes how much a state can lean on family.

Your income does not decide your parent's eligibility

Federal Medicaid law requires a state plan to "not take into account the financial responsibility of any individual for any applicant or recipient of assistance under the plan unless such applicant or recipient is such individual's spouse or such individual's child who is under age 21" or is blind or disabled (42 U.S.C. 1396a(a)(17)(D)). A parent's eligibility is decided on the parent's own income and assets, and a spouse's, not on an adult child's paycheck.

Tennessee shows this limit at work. Its medical assistance law lets the state require responsible relatives, including children, to supplement or reimburse benefits, but only to the extent permitted by federal law. Virginia's statute likewise generally does not apply while the parent receives public assistance, except for a state reimbursement case where Medicaid and federal law allow it.

Where the gaps come from

Because Medicaid eligibility cannot count your money, filial claims tend to arise around Medicaid rather than through it:

• A pending application. In Pittas, the facility did not have to wait for the mother's Medicaid application to be decided.
• A penalty period. Gifts or transfers for less than fair market value within 60 months before a nursing home Medicaid application can delay coverage (42 U.S.C. 1396p(c)). Our Medicaid look-back calculator estimates how long such a penalty may run.
• Transfers to a child. Rhode Island lets a nursing facility recover unpaid care costs from an adult child who received a transfer that caused a Medicaid penalty period, capped at the value of what was transferred. North Dakota limits a creditor's claim to a child who benefited from a disqualifying transfer, or who in bad faith diverted the parent's income or assets, within five years.

The practical lesson is that money that moves from a parent to a child before a Medicaid application can matter twice: once for the parent's eligibility, and again in the states that tie a child's liability to that transfer.

Estate recovery is a different thing

Medicaid estate recovery is often confused with filial responsibility. It is not a claim against the children. For a person who was 55 or older when they received Medicaid, federal law requires the state to seek recovery "from the individual's estate" for nursing facility services, home and community-based services and related hospital and drug costs (42 U.S.C. 1396p(b)(1)(B)).

Recovery can happen only after the death of the surviving spouse, if any, and only when there is no surviving child under 21 or blind or disabled child (42 U.S.C. 1396p(b)(2)). It can reduce what children inherit from the parent's estate, but it does not bill the children's own income or savings. Some states define the estate more broadly, to include property that passed to a child outside probate, such as a jointly owned account or a home held in joint tenancy or a living trust (42 U.S.C. 1396p(b)(4)(B)).

The admission agreement trap

A second route to a parent's nursing home bill has nothing to do with filial statutes. It runs through the admission paperwork.

The federal rule for nursing homes that participate in Medicare or Medicaid is direct: "The facility must not request or require a third party guarantee of payment to the facility as a condition of admission or expedited admission, or continued stay in the facility" (42 CFR 483.15(a)(3)). The same rule says a facility may ask a resident representative "who has legal access to a resident's income or resources available to pay for facility care to sign a contract, without incurring personal financial liability, to provide facility payment from the resident's income or resources."

In plain terms, a facility can ask you, as the person handling your parent's money, to promise to pay the bill from your parent's funds. It cannot make admission or a continued stay depend on your promising to pay from your own.

Read every signature line before signing. Look for words like "guarantor," "responsible party" or "financially responsible," and ask whether you are signing for yourself or as your parent's representative. If you act under a power of attorney, see our power of attorney guide for how the agent role works.

Handling a parent's money carefully also matters under the filial laws themselves. Nevada's hospital rule turns partly on a child's access to and control of the parent's assets, and North Dakota's bad-faith route turns on a child diverting them.

What to do if a facility or agency contacts you

These steps follow from what the statutes and cases require. None of them is a guarantee of any outcome.

1. Ask what the claim is based on. Is it a filial statute (which one), a contract you signed, or a claim against your parent's estate? Each has different rules.
2. Ask for an itemized bill covering the dates in dispute, and compare it to the period when your parent had no coverage.
3. Check the Medicaid status. Was an application filed, is it pending, was it denied, or was a penalty period imposed?
4. Do not sign anything new as a guarantor. Federal rules bar a nursing home in Medicare or Medicaid from requiring it as a condition of your parent's stay; those rules do not cover assisted living.
5. Look up your state's defenses in the table below: inability to pay, abandonment, age limits, caps, notice deadlines, or a spouse who is liable first.
6. Write down dates. In South Dakota, for example, a claim needs written notice to the child, generally within 90 days after the care was first provided.
7. Talk to an elder-law attorney in the parent's state, especially if you have been sued, a judgment has been entered, or your parent's assets were transferred within the past five years.

If your parent can no longer make decisions and has no power of attorney, a court may need to appoint someone to apply for Medicaid and manage their money; see our guardianship guide. For medical decisions without paperwork in place, the surrogate decision maker lookup shows who your state's law puts first.

Filial responsibility laws in every state

The table lists each state's law, who can collect under it, the defenses the statute gives, and the court decisions we found, each linked to its source. States marked "None found" are ones where we found no statute making adult children pay for a parent's support; where our search had limits, the row says so.

Frequently Asked Questions

Can a nursing home make me pay for my parent's care?

Only in limited situations. A facility in a Medicare or Medicaid program cannot require a third-party guarantee as a condition of admission or continued stay. Separately, in a few states a filial law lets a facility or other party sue a child who can afford to pay; Pennsylvania and South Dakota are the states where we found an appeals court upholding such a claim. If you signed admission papers as a personal guarantor, that contract can create its own obligation, so read what you signed.

What states have filial responsibility laws?

States with a current civil or criminal duty on adult children include Alaska, California, Connecticut, Delaware, Georgia, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, Nevada, New Hampshire, New Jersey, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota and Virginia. Tennessee's medical assistance law lets the state ask relatives, including children, to reimburse benefits, but only to the extent federal law allows. Several are very narrow. Idaho, Iowa, Maryland, Montana and Utah repealed the adult-child support laws we found, North Carolina repealed its crime of failing to support a parent in 2025, and Vermont removed its adult-child provision the same year. In most other states we found no current law that makes adult children support a parent.

Is Pennsylvania's filial responsibility law enforced?

Yes. In Health Care and Retirement Corp. of America v. Pittas (2012), the Pennsylvania Superior Court affirmed a $92,943.41 judgment against a son for his mother's nursing facility bills, and held the facility did not have to wait for her pending Medicaid application. A facility must still prove the parent was indigent, and the law excuses a child who lacks the financial ability or whose parent abandoned them for ten years during childhood.

Does Medicaid count my income when my parent applies?

No. Federal law bars a state Medicaid plan, when deciding eligibility, from counting the financial responsibility of anyone other than the applicant's spouse or, for a child under 21 or a blind or disabled child, the parent. Your parent's eligibility depends on their own income and assets and those of a spouse.

Do I have to pay back Medicaid after my parent dies?

Medicaid estate recovery is a claim against your parent's estate, not against your own income or savings. Federal law limits it to recovery after the death of any surviving spouse and only when there is no surviving child under 21 or blind or disabled child. It can reduce what you inherit, but it is not a bill sent to you personally. In some states the estate includes property that passed to you outside probate, such as a joint account.

Do I have to support a parent who abandoned me?

In many states with filial laws, no. Pennsylvania, Connecticut, California, Virginia, Ohio, Massachusetts, Rhode Island, Indiana and New Jersey each excuse or allow relief for a child the parent abandoned or failed to support during childhood, though the rules differ. Pennsylvania, for example, requires ten years of abandonment during the child's minority, and California requires a petition to be released.

Can I go to jail for not supporting my parent?

In a few states, failing to support a destitute parent you can afford to help is a crime, usually a misdemeanor. Examples are California, Connecticut, Indiana, Kentucky, Massachusetts, Ohio and Rhode Island. Most of these laws turn on whether you could afford to help, and most give defenses for inability to pay or for a parent who did not support you as a child.

Does California have a filial responsibility law?

Yes. California Family Code 4400 requires an adult child, to the extent of their ability, to support a parent who is in need and unable to work, and the parent or the county can sue. Penal Code 270c also makes it a misdemeanor to fail to provide necessities to an indigent parent when able. A child abandoned for two or more years before age 18 can petition to be released, and no relative is liable for a person receiving state aged, blind and disabled aid under Welfare and Institutions Code 12350.