Does a Power of Attorney Make You Liable for Nursing Home Bills?

If you have a power of attorney from your elderly parent or relative who lives in a nursing home, does that mean you can be held liable for nursing home bills? The answer is no, but nursing homes may try to go after you anyway.

That is the short answer. Having power of attorney does not make you personally responsible for your parent’s nursing home bill. A power of attorney gives you the authority to act for the resident. It does not turn the resident’s debt into your debt.

But there are traps. Nursing home admission paperwork can be confusing. Some facilities use “responsible party” language that makes family members think they are signing only to help with paperwork, while the facility later argues they agreed to do more. Some nursing homes or debt collectors may send bills to adult children even when the child never agreed to be personally responsible. Some may suggest that having power of attorney means you owe the bill yourself.

That is not the law.

In this post, we will explain the basic law regarding power of attorney grants and liability for nursing home bills. We will also explain the difference between signing as an agent under power of attorney, signing as a responsible party, signing as a personal guarantor, and handling the resident’s money after the nursing home bill comes due.

Who Is Responsible for Nursing Home Bills?

Putting your elderly parent or loved one in a nursing home can be an emotionally draining experience. In addition to the guilt that often comes with this process, the cost of living in a nursing home or assisted living facility can be extremely high.

The national annual median cost of a nursing home semi-private room was $111,325 in 2024, and the annual median cost of a private room was $127,750, according to Genworth and CareScout’s 2024 Cost of Care Survey. Genworth and CareScout, 2024. That naturally raises the question of whether you may be liable for the bills.

Nursing home contracts are governed by federal regulations. These regulations state that a nursing facility generally cannot require a family member, friend, or other third party to personally guarantee payment as a condition of admission, expedited admission, or continued stay.

The federal rule allows a facility to ask a resident representative who has legal access to the resident’s income or resources to sign an agreement to pay the facility from the resident’s money. But the rule is clear that the representative does this without incurring personal financial liability. 42 C.F.R. § 483.15(a)(3).

So the basic rule is this: the nursing home bill belongs to the resident, not to the adult child or power of attorney. If the resident has money, the resident’s money may be used to pay the bill. If the resident later qualifies for Medicaid, Medicaid may cover qualifying care. If the resident dies owing money, the nursing home may be a creditor of the resident’s estate. But that does not automatically make you personally liable.

As a result of these regulations, adult children of nursing home residents generally cannot be held responsible for nursing home costs. There are, however, some limited exceptions and practical problems that families need to understand.

What Is a Power of Attorney?

A power of attorney, or POA, is the name of a legal document in which one person appoints and authorizes another person to act on their behalf. The person who is authorized to act is often called the attorney-in-fact or agent. That person takes on a fiduciary obligation to act in the interest of the person who granted the power of attorney.

There are many different types of POAs. Some give limited authorization for the attorney-in-fact to act. Others give much broader authorization.

If you have a power of attorney from your elderly parent or relative, it is probably a general power of attorney that authorizes you to act on behalf of that person in various legal and financial matters. For example, you may be able to sign contracts, open bank accounts, communicate with insurers, help with Medicaid applications, or pay bills from the resident’s account.

That authority is important. It allows you to help. But it does not make you the resident.

Power of Attorney and Nursing Home Bills

It is very important to understand that a power of attorney does not make the attorney-in-fact personally liable for the debts and obligations of the principal. This is true even for contracts that the attorney-in-fact signs on behalf of the principal.

So if you have a power of attorney for your mother and you sign a contract with the nursing home as her attorney-in-fact, your mother has the legal obligation under that contract, not you, assuming you sign only in your representative capacity.

As an attorney-in-fact for an elderly resident, a nursing home can ask you to pay bills on behalf of the resident using the resident’s own money that you have control over. In fact, in your role as attorney-in-fact for the elderly resident, you are probably obligated to pay valid bills from the resident’s funds and on the resident’s behalf.

The nursing home cannot, however, demand or force you to assume direct personal responsibility for the bills and pay this debt out of your own pocket simply because you have power of attorney.

There are specific federal regulations that prohibit nursing homes from holding third parties personally liable for bills as a condition of admission or continued stay. If you have a power of attorney for an elderly resident, all the nursing home can do is ask you to pay them with the resident’s own money.

A nursing facility must not request or require a third party guarantee of payment as a condition of admission, expedited admission, or continued stay. The facility may request and require a resident representative with legal access to the resident’s income or resources to sign a contract to provide payment from the resident’s income or resources, without the representative incurring personal financial liability.

See 42 C.F.R. § 483.15(a)(3).

How to Sign Nursing Home Documents With Power of Attorney

A lot of trouble starts at the signature line. If you have power of attorney, you want the document to make clear that you are signing for the resident, not for yourself.

For example, if your mother is Mary Smith and you are John Smith, you generally want the signature to look something like this:

Mary Smith, by John Smith, agent under power of attorney

That is very different from signing only:

John Smith

The first version tells the nursing home that Mary Smith is the contracting party, and John Smith is acting as her agent. The second version may create confusion. It may let the nursing home argue that John Smith signed personally.

Do not sign any document that says you are personally responsible for all charges, personally guarantee payment, or agree to pay the bill from your own funds unless you have received legal advice and intentionally want to take on that obligation. Most family members do not want to do that. Most should not.

Do Not Sign as a Personal Guarantor

The biggest mistake a family member can make is signing nursing home admission paperwork in a way that makes them personally responsible for the bill. Having power of attorney is not the problem. Signing a personal guarantee is the problem.

Before signing any nursing home admission agreement, look carefully for language such as “guarantor,” “personally responsible,” “jointly and severally liable,” “I agree to pay,” “I guarantee payment,” or “responsible for all charges.”

If the document says you are signing only as agent, representative, or attorney in fact for the resident, that is very different from agreeing to pay the resident’s bill yourself.

The nursing home may hand you a stack of documents and act like every signature is routine. Do not treat it that way. Admission paperwork can contain language that matters later.

Liability as a Responsible Party

Some nursing home contracts require children or family members to sign as the “responsible party” for the elderly resident. The phrase sounds scary. It sounds like the responsible party is the person responsible for paying the bill.

That is not always what it means.

The “responsible party” does not usually have direct liability for bills, but they may have certain fiduciary-like obligations to make a reasonable effort to make sure that the elderly resident pays their bills from the resident’s funds.

For example, if the elderly resident runs out of money, the responsible party may have an obligation to apply for Medicaid on the resident’s behalf if the responsible party agreed to do that and has the authority and information needed to do it. If the responsible party fails to apply for Medicaid, the nursing home may try to sue for breach of contract to recover unpaid bills.

This is exactly what happened in the 2015 case of Jewish Home Lifecare v. Ast (NY Sup. Ct. 2015). In that case, a son signed a nursing home contract as the “responsible party” for his mother. The nursing home sued him for unpaid bills, claiming that he fraudulently misappropriated the mother’s money and then failed to apply for Medicaid on her behalf.

The court held that he could be liable for breach of contract as the responsible party. That does not mean every responsible party is personally liable for every nursing home bill. It means that the exact contract language and the responsible party’s conduct matter.

This does not happen very often simply because these lawsuits can be expensive, and the responsible party may not have any money to pay with. But it happens often enough that families should be careful about what they sign.

The same issue came up more recently in another case out of New York, County of Warren, on Behalf of Westmount Health Facility v. Garry, 188 N.Y.S.3d 914 (May 22, 2023). In that case, a son had signed a responsible party agreement for his father when he was first admitted to a nursing home. After being hospitalized, the son refused to sign the agreement again when the father was readmitted to the nursing home. At issue in the case was whether the son could be held liable for uncovered costs based on the first responsible party agreement.

The takeaway is not that you should refuse to help your parent. The takeaway is that you should understand the difference between agreeing to help manage the resident’s money and agreeing to pay the resident’s bill yourself.

Responsible Party Does Not Always Mean Personal Guarantor

Nursing home paperwork often uses confusing labels. “Responsible party” sounds like “person who is responsible for paying.” But in many nursing home agreements, the responsible party is supposed to be the person who helps handle the resident’s paperwork, benefits, Medicaid application, or payment from the resident’s own funds.

That role can create duties. It does not automatically make you personally liable for the resident’s bills. The exact language matters.

If you signed as responsible party, the first thing to do is read the agreement. Did you agree to use the resident’s money to pay the bill? Did you agree to help apply for Medicaid? Did you agree not to transfer the resident’s assets? Or did you actually agree to pay the bill yourself?

Those are very different promises.

Medicaid and Nursing Home Bills

Many nursing home billing disputes arise because the resident runs out of money and needs Medicaid to cover long-term care. The resident may have been private pay at first. Then the money runs out. Then Medicaid becomes the only realistic way to keep paying for the nursing home.

If you signed as a responsible party or resident representative, the nursing home may argue that you had a duty to help complete the Medicaid application, provide financial information, gather bank records, or respond to requests from the Medicaid office.

That does not mean you personally owe the nursing home bill. But it can create a separate dispute if you agreed to help with Medicaid paperwork and then failed to do it, or if you controlled the resident’s money and used it for something other than the resident’s care.

The practical takeaway is simple. If you have power of attorney and the resident needs Medicaid, keep records, respond to reasonable paperwork requests, and document what you do. The nursing home may not be able to make you a guarantor, but it may still try to blame you if the Medicaid process fails.

Filial Responsibility Laws

A number of states have filial responsibility laws. These laws can require adult children to provide certain necessities for elderly parents, such as medical care, food, or housing, when the parent cannot pay. The National Conference of State Legislatures reported in 2025 that filial responsibility laws exist in 27 states but are rarely invoked. NCSL, 2025.

These laws are separate from power of attorney. You do not become liable under a filial responsibility law because you agreed to serve as a power of attorney. If liability exists, it comes from the state statute and the facts of the case, not from the POA document itself.

Filial responsibility laws are very rarely enforced. The main reason is that most elderly parents who cannot pay for long-term care eventually qualify for Medicaid. When Medicaid covers the care, the nursing home usually does not need to pursue adult children under filial responsibility laws.

But “rarely enforced” does not mean “never.” If your parent lives in a state with a filial responsibility law, and the nursing home is claiming that you personally owe the bill, you should talk to a lawyer before assuming the threat is meaningless.

The Estate May Be Responsible for Nursing Home Bills

While power of attorney is not liable for nursing home bills, the resident’s estate may be responsible for unpaid charges after the resident dies. The nursing home can act like other creditors and may file a claim against the estate.

That is not the same as suing the child or power of attorney personally. If the resident dies owing money, the debt generally belongs to the resident and may be paid from estate assets if there are assets available.

If the estate has no money, the nursing home may have no practical way to collect unless someone else validly agreed to be personally responsible or mishandled the resident’s funds.

This distinction matters. A nursing home may talk as if the family “owes” the money. But legally, the question is whose debt it is: the resident’s debt, the estate’s debt, or a valid personal obligation of the person being billed.

What If the Nursing Home Sends You a Bill?

If a nursing home sends you a bill for your parent’s care, do not assume the bill is legally valid just because it looks official. Nursing homes and collection companies sometimes send demand letters to family members even when the family member is not personally liable.

Start by asking a simple question: are they billing you personally, or are they asking you to help pay the bill from the resident’s funds?

Those are not the same thing.

If you control the resident’s bank account under a power of attorney, the facility may ask you to use the resident’s money to pay the resident’s expenses. But that does not mean you owe the money from your own pocket.

If the letter says you personally owe the debt, ask for the contract language they claim makes you liable. Do not make a payment from your own money unless you understand whether the facility has a valid legal basis to collect from you personally.

Debt Collectors and Invalid Nursing Home Debts

If a nursing home or debt collector is trying to collect your parent’s nursing home debt from you personally, federal consumer protection law may matter.

The Consumer Financial Protection Bureau has warned that attempts to collect invalid nursing home debts from third parties may violate the Fair Debt Collection Practices Act and the Fair Credit Reporting Act. The CFPB specifically addressed debt collection and consumer reporting practices involving invalid nursing home debts in Consumer Financial Protection Circular 2022 05. CFPB Circular 2022 05.

That means a debt collector should not falsely tell you that you owe a debt you do not legally owe. It also should not report the resident’s nursing home debt as your personal debt if there is no valid basis for doing so.

If you receive a collection letter, keep it. Save the envelope. Save voicemails. Do not rely on phone conversations. Ask for the alleged basis of your personal liability in writing.

What Should You Do Before Signing Nursing Home Admission Papers?

If you are admitting a parent or relative to a nursing home, the paperwork can be overwhelming. The facility may hand you a long packet of forms while your family is under stress. That is exactly when mistakes happen.

Here are the practical rules:

• Sign only in your representative capacity if you are acting under a POA.
• Do not sign as a personal guarantor.
• Do not agree to pay the resident’s bill from your own funds.
• Keep copies of every document you sign.
• Keep records of how the resident’s money is used.
• Get help with Medicaid paperwork early if the resident may run out of money.

The most important point is the simplest one. You can help your parent without becoming your parent’s debtor.

Is Power of Attorney Responsible for Nursing Home Bills?

If you have a power of attorney to act on behalf of your elderly parent or loved one, the nursing home might try to go after you for unpaid bills or expenses incurred by the resident. The nursing home representative might even claim that you are personally liable for the bills because you have power of attorney.

This is not true. Having a power of attorney to act on behalf of an elderly nursing home resident does not make you personally liable for their financial obligations, including nursing home bills.

It is important that people understand this idea because the last thing we want is loved ones refusing to take over the power of attorney because they fear they will be personally liable for the medical bills.

Serving as power of attorney is often an act of love and responsibility. Nursing homes should not use that role to scare family members into paying debts they do not owe.

Frequently Asked POA Questions

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If you have a loved one who has been harmed by negligent or abusive care at a nursing home, contact our nursing home negligence lawyers today at 800-553-8082 or get a free online consultation.