Maryland no longer has a filial responsibility law that forces adult children to pay for a parent’s care. The General Assembly repealed that part of Family Law Title 13 in 2017, so a nursing home, hospital, or state agency cannot sue you for your parent’s bills based on the family relationship alone. You can still end up on the hook through other routes, mainly admission paperwork you sign yourself and Medicaid’s claim against your parent’s estate.
The 2017 Repeal
Before 2017, Maryland’s Family Law Title 13 ran in both directions. It defined a “destitute parent” as one with no means of subsistence who could not be self-supporting because of old age or a physical or mental condition, and it allowed a court to order an adult child to provide food, shelter, and care for that parent.1Justia. Maryland Code Family Law 13-101 (2005)
Senate Bill 676, enacted in 2017, stripped the child-to-parent obligation out of the statute. Courts in Maryland no longer have authority to order you to pay for a destitute parent’s living or medical expenses based on that former law. A number of other states still have filial responsibility statutes on the books and a few actively enforce them, so Maryland’s repeal is a meaningful difference if your parent lives here.
What Title 13 Still Covers
Family Law Title 13 was not deleted. It now runs only one way: parents supporting destitute adult children. Under Section 13-102, a parent with sufficient means may not neglect or refuse to provide a destitute adult child with food, shelter, care, and clothing. A “destitute adult child” is someone who has no means of subsistence and cannot be self-supporting because of a mental or physical condition. A violation is a misdemeanor punishable by up to $1,000 in fines, up to one year in jail, or both, and it is triggered by a sworn written complaint filed with a State’s Attorney.2Maryland General Assembly. Maryland Code Family Law 13-102
None of this runs in reverse. There is no current Maryland statute making an adult child criminally or civilly liable for a parent’s care simply because of the family tie.
Admission Agreements Are Where Liability Actually Starts
The most common way Maryland families end up paying for a parent’s care has nothing to do with filial responsibility. It happens at the admissions desk. When a parent enters a nursing home or assisted living facility, the facility typically asks a family member to sign the admission agreement. Inside that paperwork there is often language naming someone a “responsible party” or “guarantor” for the resident’s bills.
Signing a financial guarantee changes your legal position from concerned relative to co-debtor. If your parent runs out of money or Medicaid has not been approved yet, the facility can pursue you personally for the balance. That is true even though federal law prohibits a facility from requiring such a guarantee, because once you voluntarily sign, the facility can argue you agreed.
Read every page before you sign. Cross out or refuse any clause that imposes personal financial liability on you. You can sign as a representative of the resident, meaning someone who helps manage the resident’s finances and coordinates their care, without personally guaranteeing the debt.
Federal Law Bars Required Guarantees
Any nursing facility that accepts Medicare or Medicaid is prohibited from requiring a third-party guarantee of payment as a condition of admission, expedited admission, or continued stay.3Office of the Law Revision Counsel. 42 US Code 1396r – Requirements for Nursing Facilities The same prohibition appears in the Medicare rules for skilled nursing facilities.4Office of the Law Revision Counsel. 42 US Code 1395i-3 – Requirements for, and Assuring Quality of Care in, Skilled Nursing Facilities A facility can ask someone who already has legal access to a resident’s income or resources to sign a contract committing to use those resources for payment. It cannot make that signer personally liable.
The Consumer Financial Protection Bureau reinforced this in a 2022 circular. Collecting on a debt based on a contract term that violates the federal guarantee prohibition can itself violate the Fair Debt Collection Practices Act, and reporting that kind of invalid debt to credit bureaus can violate the Fair Credit Reporting Act.5Consumer Financial Protection Bureau. Debt Collection and Consumer Reporting Practices Involving Invalid Nursing Home Debts
If you already signed a guarantee clause and the facility is billing you now, the federal prohibition gives you a strong argument that the clause is unenforceable. Facilities sometimes win narrower claims, such as when a representative promised to use the resident’s own money to pay bills or to apply for Medicaid and then failed to follow through. But a facility cannot condition your parent’s admission on your personal financial guarantee.
Medicaid Estate Recovery
Even without filial responsibility, a parent’s long-term care costs can reach the next generation through Medicaid estate recovery. When Maryland’s Medicaid program pays for a parent’s nursing home or other long-term care, the state has the right to seek reimbursement from the parent’s estate after death. Recovery covers services rendered on or after the parent’s 55th birthday, and the covered services include nursing home care, hospital services, home and community-based waiver services, personal care, physician visits, and pharmacy costs.6Maryland Department of Health. Medical Assistance (Medicaid) Property Liens and Estate Recovery Fact Sheet
The claim covers all real and personal property in the estate, including a house you expected to inherit. Maryland cannot pursue estate recovery, however, if the deceased recipient is survived by a spouse, an unmarried child under 21, or a blind or totally disabled child.6Maryland Department of Health. Medical Assistance (Medicaid) Property Liens and Estate Recovery Fact Sheet A hardship waiver is also available when recovery would displace a dependent who lived in the property at the time of the recipient’s death, had lived there continuously for at least two years before the death, and has nowhere else to live.
One point to hold onto: estate recovery runs against your parent’s estate, not against you personally. Creditors cannot shift the parent’s debts to adult children unless you signed a separate guarantor agreement or have some other independent legal obligation.
The Five-Year Look-Back on Transfers
Families sometimes try to protect assets by moving them from parent to child before a Medicaid application. Federal law anticipates that. When someone applies for Medicaid long-term care coverage, the state reviews all asset transfers made during the 60 months before the application. Any transfer for less than fair market value triggers a penalty period during which the applicant is ineligible for Medicaid-covered long-term care.7Office of the Law Revision Counsel. 42 US Code 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets
The penalty length equals the value transferred divided by the state’s average monthly nursing home cost. With Maryland nursing home costs running over $13,000 a month for a semi-private room, even a modest transfer can produce a penalty of several months during which your parent has neither Medicaid coverage nor the assets to pay privately. A hardship waiver exists for cases where the penalty would threaten health, life, or basic necessities, but it is a gamble.8Centers for Medicare and Medicaid Services. Transfer of Assets in the Medicaid Program – Important Facts for State Policymakers Planning with an elder law attorney more than five years before care is needed is the safer route.
Where to Turn If a Facility Pressures You
If a Maryland nursing home or assisted living facility is pressuring you to sign a financial guarantee, pushing questionable charges, or billing you for a parent’s balance, call the state’s Long-Term Care Ombudsman program before the situation escalates. Ombudsmen are trained advocates for residents and families. They handle complaints about quality of care, billing practices, and residents’ rights, and their services are free and confidential.9Maryland Department of Aging. Ombudsman Program Every Maryland county has a local office; the Maryland Department of Aging lists contacts at aging.maryland.gov. Family members and friends can use the service, not only residents.