Transferring assets isn't crazy but you do need to be careful if you want to do it in a non-taxable manner (you can't just give your kid $500k cash without them counting it as income).
I think it's worth noting that while this may be true if you're dead, it's not the case when you're still alive.[1]
Filial responsibility laws mean that adult children can be legally required to pay their impoverished parents' medical bills. The above cites a case where a man was required by the courts to pay $93,000 for his mother's rehabilitation.[2] From what I've read, Pennsylvania may be particularly onerous compared to other states, but it's not a slam dunk kids won't be on the hook.
[1]: https://en.wikipedia.org/wiki/Filial_responsibility_laws
[2]: https://abcnews.go.com/Business/pennsylvania-son-stuck-moms-...
More info is here:
https://www.nolo.com/legal-encyclopedia/your-obligation-pay-...
Because Wikipedia only talks about their existence, not a discussion of them.
I have to imagine that it's pretty rare, and I don't think it's appropriate to generalize from what appears to be a pretty sensationalist case. I expect the laws are usually structured to ensure that children don't fleece their parents out of money and turn them effectively into wards of the state, etc. It doesn't seem unreasonable to me that states would encourage families to take care of each other, though PA seems a bit of an outlier in this regard.
Typically when it's used it's to recover money in cases of fraud. For example, where the parent or child conspires to hide money from the state to avoid paying for care. To the best of my knowledge, PA is one of the only states that allows private entities to sue. Some states are like Ohio where it's a criminal statute, so only the state has standing to bring charges. All said, don't get legal advice on the internet, this is an armchair discussion by laypeople.
As an aside, I don't see why the children should have any specific burden to take care of their parents medical expenses now that we have Medicare and Social Security. We've decided it's better to have all of society to take care of our elderly rather than tie it to their children's ability to pay.
Pennsylvania has filial support laws which mean that children can be held directly responsible for the medical expenses of their parents. This requires that Pennsylvania have jurisdiction over the children, of course.
The parent does not need to live in PA at all, but a suit needs to be brought against the defendant to make them pay, and therefore the court needs to have jurisdiction over that person in order for the lawsuit to succeed.
France: https://fr.wikipedia.org/wiki/Obligation_alimentaire_en_Fran...
Germany: https://de.wikipedia.org/wiki/Elternunterhalt
Asia has a ton, I'm sure.
And if they do that well enough to have you make a payment, most legal systems will consider that acceptance of full financial responsibility on your part.
Hospital billing practice are pretty horrible. If a more compliant person had received this bill, they might have paid it, even though there is no way it was legit.