Texas is illegally keeping people with disabilities in nursing homes, federal judge rules

By Stephen Simpson 

Texas has been violating federal law for decades by sequestering individuals with severe disabilities in poorly run nursing homes without offering them alternative living options and services in the community, a federal judge has ruled.

U.S. District Court Judge Orlando Garcia from the Western District Court of Texas ruled on Tuesday that the state has caused irreparable injury to people with intellectual and developmental disabilities by denying them specialized services, including federally-required services within the community.

“Although community programs are the most integrated setting appropriate to meet their needs, they remain unnecessarily institutionalized in nursing facilities, or at serious risk of such institutionalization. They are harmed by such institutionalization and deprived of living in a community setting and participating in integrated community programs,” Garcia said in his 475-page ruling.

The decision stems from a class action lawsuit, filed in 2010 by disability rights advocates and six institutionalized plaintiffs between the ages of 26 and 46, that alleges that state social services officials have violated the Americans with Disabilities Act by failing to provide appropriate treatment to some 4,500 Texans living in nursing homes.

Advocates say the state has consistently sent individuals who were receiving care for their disabilities at home or in the community to nursing homes by mistake after being hospitalized for an illness. Once there, they don’t receive the services they need because they haven’t been adequately screened, and they are effectively trapped, since many can’t argue for their transfer.

Garth Corbett, senior attorney for Disability Rights Texas, praised the court decision, noting it entrenches the rights of individuals to leave a nursing facility and transition to the community.

“It underscores the right of persons admitted to nursing facilities with IDD to be provided the necessary supports and services required by federal Medicaid law, so that those who want to live at home or in another community-based setting are able to do so safely,” he said.

The state coordinates services for the severely disabled through Medicaid waiver programs. Funded by the state and federally, the programs help pay for various services, including residential support, skill development, job coaching, home modifications and specialized therapies.

Most individuals with intellectual or developmental disabilities are placed on a waitlist for one of these Medicaid waiver programs at an early age. By the time they become adults, the state funds most of their care, making them reliant on the decisions made by state agencies.

Jennifer Ruffcorn, a spokesperson for Texas Health and Human Services Commission, said in an email this week that the agency is reviewing the judge’s decision.

In 1987, the U.S. Congress passed the Nursing Home Reform Act after a study found that many nursing home residents were not receiving adequate care and that neglect and abuse were common. This also mandates nursing homes to screen all applicants for evidence of severe mental illness and IDD before admitting them. The goal was to ensure individuals with severe disabilities were not inappropriately placed in nursing homes, which degraded their overall health more quickly than if they received services in the community, according to the study.

Garcia stated in his opinion that the state’s failure to provide these services constitutes a longstanding violation of several federal laws, including the Nursing Home Reform Act, the Americans with Disabilities Act, and the Medicaid Act.

The opinion included a multitude of stories about individuals with severe disabilities. Reports of broken wheelchairs, individuals trapped in facilities unable to see their families, and families who were advocating for more services for their loved ones but were ignored were all examples Garcia listed as ways Texas was violating federal law.

“Even if the State has made some changes since the trial of this case, past conduct has shown a likelihood of future repetition,” he said.

Steven Schwartz, special counsel from the Center for Public Representation, who represented the plaintiffs in this case, lauded the ruling as the most comprehensive and poignant opinion he has seen in his 50 years of practicing law.

“The opinion is sweeping in its scope and breathtaking in its impact for people with IDD,” said Schwartz. “He has made it clear that the rights Congress established through the Medicaid Act and the Nursing Home Reform Act are critically important rights, and Texas has systematically violated those rights.”

The state had previously reached an interim agreement with the plaintiffs in 2013 where they committed to expanding community living options for people with intellectual disabilities; to avoiding admitting individuals with severe disabilities to a nursing facility if those people can safely live in the community instead; and to devising educational activities to address community living options for affected individuals and their families.

However, when Gov. Greg Abbott took office in 2014, the state refused to sign the final settlement agreement, prompting the lawsuit that has been ongoing for the past decade.

“It would have clearly been a better resolution for everyone. It would have been more timely, safer, less expensive, and would not have required a federal judge to issue all these orders; instead, it could have been done by agreement,” Schwartz said.

Schwartz said the decision by the judge didn’t come with immediate requirements., Both the state and the plaintiffs must submit their proposals for changes by August 1. He said after that, he will impose requirements on the state.

“Texas knows how to serve people in the community with significant needs. Programs are in place that are effective, cost-effective, and clinically effective, serving the most challenged individuals,” Schwartz said. “Obviously, they don’t have enough, but this isn’t a new science or changing the fundamental way Texas operates; it just has to expand to do it.”

Full Article & Source:
Texas is illegally keeping people with disabilities in nursing homes, federal judge rules

AI-Powered Monitoring Gains Traction in Nursing Homes Amid Staffing Shortages and Higher Acuity

by Amy Stulick

Nursing homes are implementing clinical tech, especially AI, to support staffing.The trend could signal a broader shift as nursing homes pursue tech-enabled care coordination to remain competitive and meet increasing acuity demands.

Operators see the practice as a way to strengthen partnerships, especially with hospitals, in turn aiding in referrals. But, tight margins tied to subpar Medicaid and managed care reimbursement add financial barriers to unlocking cutting-edge tech systems that can help nursing homes level up.

All the while, more higher acuity patients are moving into nursing homes.

“If the technology is not affordable, I think the nursing homes are going to lag behind,” Matt Nieukirk, director of operations for SNF practice and home health at OSF Healthcare, told Skilled Nursing News. “The care that we give to these patients will continue to evolve, and the nursing homes are going to need to look for that extra technology, or that extra push that’s going to get them to the next level.”

OSF is an Illinois-based health care system with a network of 17 hospitals, partnering with nursing homes for operations rather than owning them outright.

But, the use of AI and other technologies should be done with purpose and strategy, said Aimee Middleton, COO for the South Dakota-based Evangelical Lutheran Good Samaritan Society. Notably, without replacing caregivers. If anything, staff roles should evolve with the use of technology, she said.

“I don’t think we have an option to not look at technology being part of our future,” said Middleton. “What are our residents looking for, and how can we get those frontline caregivers back to the actual caregiving?”

Construction with tech in mind, and rethinking staff roles

Good Samaritan this year has automated its revenue cycle task to save staff significant hours. The operator also is baking in another tech initiative – robot vacuuming and food service – at a new campus construction project in Sioux Falls, South Dakota.

“Our existing campuses will benefit from this as well – we’re going to trial some of these technologies in some of our existing campuses,” said Middleton. Housekeepers could socialize with residents more, and dietary aides can work on making sure all residents have warm food at the same time when they sit down for a meal.

In terms of revenue cycle automation, the organization can tweak certain positions to focus more on bedside care, positively impacting the quality of care, she said.

“I know it doesn’t sound very exciting, but we have five employees spending about 80 to 100 hours every single month, closing out our locations. Well, we automated that system,” said Middleton.

Virtual nurse wraparound services for night shifts have also been considered by Good Samaritan, she said. Right now, if a nurse has a question at 3 a.m., she has to call the director of nursing.

“Imagine a world where the DON doesn’t get the call. There’s a world where a virtual care RN answers the question, and the team member on the front line gets the support that they need,” said Middleton. “My DON’s job satisfaction goes up. Her work-life balance is better. That’s the world we’re dreaming of right now, and really trying to make sure that we have the network in place to be able to do it, and that we could carry this to many locations.”

Catching up with hospital tech advancements

AI is a critical step in bridging the tech gap between hospitals and nursing homes, Nieukirk said. A lot of nursing home operators lack real-time patient monitoring systems, a common pattern among acute care providers.

Such tech adoption is seen as a way to strengthen hospital-nursing home partnerships and in turn referrals. But, cost remains a major barrier to a broader rollout across the nursing home industry, he said, especially considering tight Medicaid margins across the country.

“Nursing homes for the past 25 years have been relying on human interactions. They don’t have the monitoring systems like the hospitals do. This is a great first line for nursing homes to start rolling into new technology and having AI involved,” said Nieukirk. “It puts the hospital’s mind at ease too, knowing that these facilities do have an extra layer of monitoring.”

OSF HealthCare has partnered with AI company Somato to pilot predictive monitoring technology in 25 nursing homes across Illinois, Nieukirk said, with plans to further expand the program. The tech works to improve early detection of clinical deterioration by using AI to scan electronic medical records, and flagging “out-of-range” vitals and pattern deviations.

The tech flags subtle signs of infection along with gradual temperature increases and elevated heart rates, he added. Somato case managers review alerts before notifying staff at the nursing home. The tech acts as a second pair of eyes on patients in an attempt to reduce hospital transfers.

“What we have found is, a lot of times people that are turning septic, or they’re starting to get an infection, it doesn’t start overnight,” said Nieukirk. “[Somato’s case managers are] looking back and they’re alerting the nursing homes, and the nursing homes are taking action, whether they’re calling the physician, getting an antibiotic started, maybe getting some labs done.”

The biggest goal is to keep the patient in bed, and not have an emergency transfer to the hospital.

“We’re actually catching patients prior to them, you know, turning septic, or needing to go back into the hospital,” said Nieukirk. “It’s like you have an extra nurse sitting at your nurse’s desk and doing nothing but monitoring for you.”

Nursing homes are coming around to AI

OSF Healthcare launched the initiative in October 2023, and it took eight to nine months to get nursing home operators on board. That means the program has only been in facilities for about seven months. It’s part of a larger trend to incorporate clinical AI into post-acute care settings, Nieukirk said, especially as staffing shortages continue to challenge operations.

OSF’s nursing home partners Allure Group and Arcadia Care have implemented the technology, and initial results show a “positive impact,” Nieukirk said. Data is still rolling in and will inform any sort of refining as expansion occurs.

“I’m introducing it to administrators all the time. When you have 100 to 150 facilities using it and you’re collecting data, it’s that much easier to prove how the technology works and how the systems can help the facilities,” said Nieukirk.

Actionable alerts are limited to 15-20 per facility per month, enhancing care without overwhelming staff, Nieukirk noted. Somato filters through quite a lot of notifications, receiving between 12 and 1,500 per month for all participating facilities. 

Full Article & Source:
AI-Powered Monitoring Gains Traction in Nursing Homes Amid Staffing Shortages and Higher Acuity 

Tech plus touch is goal for senior living industry

Artificial intelligence has the potential to transform the senior living industry. From helping to drive resident satisfaction and supporting staff member retention to enhancing efficiency and streamlining processes, industry experts are optimistic about how AI can help support their operations.

At the same time, senior living leaders are mindful of the importance of human interaction in the industry and the need to maintain the right balance of what Alex Prough, chief commercial officer at Medical Guardian, called “tech plus touch.”

In a private roundtable discussion, “Exploring AI-Driven SaaS in Senior Living Operations,” sponsored by Medical Guardian, leaders from the company came together with senior living and care industry professionals to gain insights into how AI can best be used in the industry’s daily operations.  

When asked to pinpoint their most pressing operational challenges, panelists overwhelmingly cited staffing and regulatory issues. “It’s all about staff,” said Chris Winkle, a consultant and former CEO of Sunrise Senior Living. He said he believes “there’s a lot of opportunity for tech and automation to ease that labor pressure.”

“There’s not enough staff in the industry to fill positions,” agreed Mark Mitchener, corporate vice president for Greystone Communities. He added that, too often, staff members abandon jobs in the senior living industry to pursue higher-paying jobs elsewhere, with caregivers going to agencies. In states with a high minimum wage, operators find themselves competing with fast food or retail employers, and even Amazon, for employees.

Regulatory compliance issues also loom large for operators. “In some states, [senior living communities] are treated like nursing facilities when it comes to staffing ratio,” said Heather Tussing, president of The Aspenwood Company.

Valuable tool for reducing workload

From a regulatory compliance standpoint, it’s a moving target in certain states,  according toDivinia Nunez, director of operations for Sinceri Senior Living.

“All the regulatory demands are difficult for administrators,” noted Carrie Lund, vice president of operations at Principle LTC. “That’s probably one of the biggest challenges.”

The paperwork associated with meeting regulations also is a huge burden for staff members, and the panelists acknowledged that they are desperate to find ways to streamline their workflows. “Electronic records were supposed to make our job easier,” observed Mitchener. “The key is to use AI to take some of the paperwork load off caregivers and nurses and allow them to be on the floor with the residents.”

April Young, chief operating officer at Sinceri Senior Living, bemoaned “too many software platforms for employees to get lost in” at the expense of “customer service and engaging with residents and families.”

As with many other senior living companies that are beginning to explore ways that AI can assist in care and service delivery, resident engagement, documentation and compliance, Young said that Sinceri Senior Living is experimenting with AI to “determine how we could be more efficient and run more smoothly.”

Varied applications for AI

“I’ve seen applications from the marketing side to the procurement side to the capital side,” Winkle said. He described an AI tool that links procurement to the menu to lock in food cost.

Jenni Bost, vice president of marketing for Radiant Senior Living, described how her company has been more successful gathering survey information using an AI-driven chatbot than when using a live person. “We use it in our sales, marketing and with our [customer relationship management platform]. I use it for distilling survey information, and we’re able to do that faster than before,” she said.

Michener noted that his company is using AI to distill tome-like referrals down to two pages so staff members can more easily digest information and make decisions quickly. 

The panelists agreed that AI has the potential to enhance rather than detract from the level of human touch that residents receive. For example, AI can help ensure that the needs of all residents are being met. Winkle noted that AI can be applied to electronic health records data to determine which care plan residents should be on and whether their actual care reflects that assessment.

“Typically, the sickest people need the most attention, but we want to make sure that people that are less sick don’t get neglected,” observed Jim Reilly, senior director of MGLiving for Medical Guardian. 

AI also can be used to boost customer satisfaction. Howard Teicher, senior vice president for MGLiving and channel partners for Medical Guardian, explained that the company has created a wellness check-in campaign through which residents rate how they feel physically and emotionally. If a resident says he or she isn’t feeling well, then staff members receive a prompt to call the resident’s caregiver to suggest a check-in. 

“AI can give you visibility. You can make that outreach greater,” explained Terri Williams, senior director of healthcare marketing for Medical Guardian.

Tussing said that The Aspenwood Company has uploaded information on individual residents’ specific interests and is using AI to create unique experiences for residents, such as “one-on-one experiences or LinkedIn Learning courses.”

Enhancing outreach is an ongoing focus for Medical Guardian, company representatives said, adding that the firm is working to create an outreach coordinator program for its clients that can supply Silver Sneakers-approved providers to run activities.

Powerful tool to enhance care 

AI also can provide valuable insights into fall risk assessment, according to panelists.

“We’re seeing real promise in leveraging AI to work upstream to help prevent falls,” Prough said. “We are now doing dynamic fall risk scoring and starting to move the needle on emergency department utilization and other things for some of the communities we help support. We feel like there’s a lot of promise there.”

“There’s also an opportunity on the independent living side for a bot to answer a lot of the questions that nurses or staff members field, so that they can spend more time with residents,” Michener said.

Giving staff members the right tools can enhance job performance and job satisfaction, panelists said. 

“If staff members have something to help guide them through issues and give them the right answers, we’re better operators and have less liability risk,” Reilly said. That automation is especially helpful at helping keep those employees with the least experience from feeling overburdened, he added.

The panelists agreed that AI can be a huge benefit to lessening the workload of an overburdened workforce plagued by high burnout and turnover rates.

“It certainly helped with my staff burnout,” Bost said. “I could do much more than I could ever do before.”

“There is more we can do to prevent that burnout with our teams by utilizing AI,” Michener said. “We’re just scratching the surface at our organization.”

The increased use of AI also will require additional staff training, so the panelists stressed the importance of communicating to staff members that the training will make their jobs easier in the long run.

Michener concluded that “AI is coming, whether we like it or not.”

“We need to learn how to use it in our industry to have the best impact on our residents’ and staffs’ lives,” he said. “We do need to put the brakes on a bit to make sure our systems are all in place.”

To get the greatest value from AI, the panelists said that data need to be integrated, and they stressed the importance of sharing data across platforms.

“There are even more opportunities to create a centralized hub of data to support residents in a more meaningful way,” Prough said.

Full Article & Source:
Tech plus touch is goal for senior living industry  

Wendy Williams' Ex-Husband Sues Her Guardian, the Judge Presiding Over Her Case and Others for $250 Million on Her Behalf

Williams' ex-husband Kevin Hunter claims she was "abused, neglected, and defrauded" in the June 17 complaint 

By Liza Esquibias and Danielle Bacher 

NEED TO KNOW

• Williams' ex-husband Kevin Hunter has filed a lawsuit — which he claims is on her behalf — for $250 million against 48 defendants who he claims participated in the implementation of her guardianship
• Williams was first placed under a legal guardianship in 2022 and it was later revealed that she had been diagnosed with dementia
• The lawsuit is not seeking an end to the guardianship, but is requesting a new legal guardian

Wendy Williams' ex-husband Kevin Hunter is taking legal action against the facilitators of her years-long guardianship.

According to court documents obtained by PEOPLE, Hunter filed a lawsuit — which he claims is on her behalf — demanding a jury trial on Tuesday, June 17, which named 48 defendants who he claims have violated her constitutional rights. Among them are her legal guardian Sabrina Morrissey, the judge presiding over the guardianship Lisa Sokoloff, Wells Fargo, her assisted living facility and several lawyers.

“Guardianship is a civil death. In New York, more than 28,000 adults, which includes [Williams], are being abused, neglected, and defrauded under the care of court-appointed guardians," the complaint alleges.

However, LaShawn Thomas, the attorney who filed the lawsuit, acknowledged in a statement to PEOPLE that Williams is "not legally aware of all of the evidence that supports our claims that she should not be forced to suffer from this guardianship."

"I plan on laying out sufficient evidence to support our claims and ensure that her rights are vindicated and she is made whole financially," the statement continued.

PEOPLE has reached out to Morrissey, Hunter, Sokoloff, Schiller and the assisted care living facility for comment while Wells Fargo declined to comment.

The filing notes that the lawsuit is not seeking an end to Williams' guardianship; however, Hunter's requests include “new impartial guardian," the unsealing of her case’s files, her release from “involuntary confinement,” a full forensic accounting and $250 million in relief for financial loss, reputational damage and harm, emotional distress, legal expenses and deprivation of liberty.

Hunter is named as a co-plaintiff in the case, and is seeking appointment as Williams’ “next friend,” which is a party who can legally act “on behalf of an individual unable to assert their own rights and when no guardian is acting in their best interests," per the complaint.

The complaint alleges that the proper legal standards were not met in the implementation of her guardianship.

In the complaint, Hunter claims that Williams “has been the victim of unrestrained abuse, maltreatment, and fiscal malfeasance” in the three years since her guardianship was first imposed, in what he alleges was “a secret proceeding” where she was not provided the opportunity to obtain "adequate legal representation.” At the time, it was attributed to her dementia diagnosis, although she has since denied being cognitively impaired.

The complaint further alleges that Williams “was not afforded an independent medical evaluation” before being placed under a guardianship and has since been “subjected to overmedication and undue restrictions.”

Hunter claims Williams has been taken advantage of by several people involved.

When she was placed in her assisted-living facility, Hunter via the complaint alleges Williams' care specialist took photos of her “in a state of undress without consent, disclosed [Williams’] location to third parties, and sold or attempted to sell the images and information to media outlets.”

Hunter is also accusing Judge Sokoloff of not allowing Williams' retained counsel to submit filings, make appearances in court and have access to previously filed documents.

“[Williams] remains a captive of a corrupt, criminal enterprise, and Plaintiffs submit this action to the Court in hopes of freeing her from this fraudulent bondage,” according to the complaint, which slams the guardianship as “a weapon, not a shield.”

Hunter makes accusations against the judge's bias in Williams' case.

In addition to claims that she passed “a competency evaluation” in March, which Morrissey previously told PEOPLE Williams “declined to participate in,” Hunter cites Williams' 2024 tax lien, the loss of profit on her NYC penthouse and the sale of her personal items as examples of financial mismanagement. 

Hunter, who estimates that Williams' has lost $20 million per year in earnings from not being able to work, also alleges that her son was not given access to his college fund and accuses the defendants of using her money to pay for the case against her.

Moreover, she claims her Wells Fargo financial advisor Lori Schiller paid a total of $60,000 from Williams' account to Dr. Rami Kaminski, who allegedly wrote the January 2022 medical opinion letter stating Williams “had impaired judgment and was incapable of making reasoned decisions.” Williams' lawyers allege they have information showing that Wells Fargo and her court-appointed attorney Linda Redlisky "are financial contributors to Judge Lisa Sokoloff’s re-election campaign."

“Beginning in February 2022, a coordinated and coercive campaign to silence and isolate [Williams] was executed through judicial orders and extrajudicial acts, depriving [Williams] of access to counsel, family, communication tools, and the ability to control her own narrative,” the complaint reads. 

Full Article & Source:
Wendy Williams' Ex-Husband Sues Her Guardian, the Judge Presiding Over Her Case and Others for $250 Million on Her Behalf 

See Also:
Guardianship Judge to Wendy Williams on Career: "It's Done"

Wendy Williams Originally Asked for a Guardianship, but Didn't 'Think Her Whole Life Would Be Taken Away' (Exclusive Source) 

Wendy Williams wants ‘to move on with my life’ despite guardianship: How she got here 

Wendy Williams begs medical guardian to 'get off my neck' as she insists she's not mentally incapacitated 

Wendy Williams's Ex-Husband Files to End Guardianship Without Her Knowledge

Wendy Williams' ex-husband, Kevin Hunter, has filed to end her guardianship, without Wendy's knowledge (per TMZ).  

Source:
Wendy Williams's Ex-Husband Files to End Guardianship Without Her Knowledge 

Chester County leaders dodge questions on Maisano’s record as guardian, expert witness, and bogus degrees

by Todd Shepherd

With one lone exception, Chester County’s top elected officials are refusing to comment on Treasurer Patricia Maisano, a woman who has twice faced credible accusations of financially exploiting elderly wards in her care while serving as a court-appointed guardian, according to a Broad + Liberty report published Monday.

Additionally, top officials in the county Democratic Party like Chairwoman Charlotte Valyo and Vice Chair Jerry Pyne also refused to offer any comment on Maisano’s past, including the fact that for years, Maisano has boasted of having a masters and doctorate degrees, but those degrees came from a diploma mill.

Only Republican County Commissioner Eric Roe acknowledged the report and the problems it conveyed.

“These allegations, if true, are really alarming. I hope Treasurer Maisano will address them publicly,” Roe said. “After all, the voters and taxpayers of Chester County have an important decision to make this November. Now more than ever, Chester County needs trustworthy elected officials who will look out for taxpayers.”

Democratic commissioners Josh Maxwell and Marian Moskowitz did not respond to a request for comment. U.S. Representative Chrissy Houlahan, whose 6th Congressional District encompasses all of Chester County, also did not respond.

Maisano has for years worked as an expert witness in court cases, a role in which the expert can usually charge hourly fees similar to that of a licensed attorney. She has also been a guardian of elderly wards, a role in which she might have complete legal and financial power over an elderly person who has been deemed incapacitated by the courts.

The Broad + Liberty investigation published Monday uncovered two cases in which Maisano was accused of fleecing her wards while working under her corporate name, IKOR. In one of those instances, the accusation wasn’t from a family member, but from a court-appointed factfinder stemming from a dispute in a guardianship in Delaware.

“IKOR, for their part, egregiously overbills. There is no way to soften, sugar coat, or otherwise explain this finding,” the factfinder wrote. “[A] thorough review of twenty-one (21) IKOR invoices from February 2007 through November 2008 evidenced disturbing billing trends and tens of thousands of dollars in overbilled amounts.”

A second attorney was also appointed by the same court to double-check the efforts of the first factfinder, and this second review resulted in the same conclusions.

“I have to agree with [the first factfinder’s] assessment that IKOR engaged in a pattern of significant and systematic over billing [sic] in the instant matter such that the disabled person was egregiously overcharged for professional guardianship [of the property] services rendered to it by IKOR,” the second reviewer found.

The original factfinder recommended IKOR’s billings of $104,000 be cut by $46,987.86, a suggestion the second attorney ultimately agreed with.

Those new revelations came on top of previous reporting about Maisano’s controversial past.

In a December report, Broad + Liberty highlighted that Maisano had been excluded from court cases in which she was an expert witness because her expertise was questionable.

“Here, the Report [authored by Maisano] contains two and a half pages of vague and conclusory assertions that Plaintiff has PTSD, and that Defendant is the direct cause of this ailment,” a judge wrote in one of the cases. “Nowhere in the Report does Maisano explain the criteria that she used to diagnose or confirm that Plaintiff has PTSD, nor does she explain how she came to the opinion that Defendant was the direct cause of Plaintiff’s psychological ailments.”

In October 2021, Broad + Liberty reported that Maisano’s masters and doctorate degrees were from Sheffield State University, a known diploma mill. This outlet went as far as trying to verify if Maisano had ever attended the University of Sheffield — a real university — but a spokesman with the university said it could find no records of her. (Broad + Liberty provided the university with other surnames beyond Maisano.)

Additionally, Maisano has never refuted the idea that her graduate degrees are not legitimate, and has never responded to numerous requests for comment about the matter.

Currently, Maisano’s professional website, Varna LLC, advertises her as an expert witness on elder abuse. 

The website for Chester County Democrats, meanwhile, lists Maisano among its endorsed candidates for the upcoming local elections this November.

Commissioner Roe’s statement seems to allude to another scandal lurking in the background. Last October, the county prothonotary resigned under a cloud of suspicion regarding financial irregularities in her office. 

Full Article & Source:
Chester County leaders dodge questions on Maisano’s record as guardian, expert witness, and bogus degrees 

Cher Begged Court for a Conservatorship Before Son Elijah’s Hospitalization

Cher has spoken about her son's issues with substance abuse.  

by Megan Elliott

Cher’s son Elijah Blue Allman was rushed to the hospital on June 14.  

On Saturday, deputies from the San Bernardino County Sheriff’s Department and EMS workers responded to a call about a man acting erratically. The 48-year-old son of the of the Mermaids star and musician Gregg Allman was taken to the hospital. Deputies also found drugs inside his home. 

Cher claimed her son was unable to manage his finances 

Elijah’s brush with the law is the latest in a series of personal challenges for the musician. A year and a half ago, his 79-year-old mother requested a temporary conservatorship over his estate. 

In December 2023, the “If I Could Turn Back Time” singer asked a court to grant her control over her son’s finances because of his substance abuse issues. Elijah was “substantially unable to manage his financial resources,” she argued, adding that a conservator was “urgently needed” because he was supposed to receive significant assets from a trust at the end of 2023. 

“Elijah is entitled to regular distributions from the Trust, but given his ongoing mental health and substance abuse issues, [Cher] is concerned that any funds distributed to Elijah will be immediately spent on drugs, leaving Elijah with no assets to provide for himself and putting Elijah’s life at risk,” Cher said in court documents obtained by People. 

Cher and Elijah eventually reached a private agreement and she withdrew her petition for a conservatorship. 

Elijah Allman’s wife says he has an ‘unwavering commitment to sobriety’

After Saturday’s incident, Elijah’s estranged wife Marieangela King Allman said she still supported her husband despite his “personal challenges.” She added that he had an “unwavering commitment to sobriety.” 

“Like many, he continues to confront his inner struggles — but it is important to recognize that he does so from a place of strength, not defeat,” she said in a statement shared with People. “Despite the assumptions that often color how his journey is portrayed, the reality is that Elijah remains grounded, focused and deeply committed to living with integrity and purpose.”

“I want to state, without hesitation, that I will always root for him,” she added. “My support is steadfast and comes from a place of deep respect for the person he is and the resilience he continues to show.”

Marieangela previously accused Cher of trying to have Elijah kidnapped as part of an intervention, an allegation the singer has denied. 

In a statement to People in 2023, Cher said she was dealing with a struggle sadly familiar to many American families. 

“I’m not suffering from any problem that millions of people in the United States aren’t,” Cher  said of her Elijah’s struggles with drug use. “I’m a mother. This is my job — one way or another, to try to help my children. You do anything for your children. Whenever you can help them, you just do it because that’s what being a mother is. But it’s joy, even with heartache — mostly, when you think of your children, you just smile and you love them, and you try to be there for them.”  

Full Article & Source:
Cher Begged Court for a Conservatorship Before Son Elijah’s Hospitalization 

See Also:
Cher Ends Conservatorship Battle With Son Elijah Blue Allman

Singer Cher Agrees to 'Pause' Fight to Place Troubled Son Elijah Allman Under Conservatorship After He Demands Sanctions Over Subpoenas

Cher’s Son Argues She’s ‘Unfit to Serve’ as His Conservator

Cher dealt another blow in her request for temporary conservatorship over her son

Look, I Don't Need Conservatorship ... Plenty Reasons Why!!!

Cher Files for Conservatorship of Son Elijah Blue Allman

Elijah Blue Allman Contests Cher's Request for Conservatorship

Cher's Son Elijah Blue Allman Looks Clean-cut in First Sighting Since Conservatorship Victory 

Eldercare Nightmare: A Tragic Family Story Raises the Specter of Widespread Guardianship Fraud

by JC Hallman

In 2021, Vietnam veteran Leroy Theodore, Sr., of New Orleans, suffered two catastrophic strokes that left him quadriplegic, unable to communicate apart from answering questions with eye movements.

Theodore’s life became a nightmarish tour through health systems in Louisiana and Oklahoma, bouncing from hospital to hospital for several years, until 2024 when one of his daughters, Valerie Parks, having completed training in order to care for her father, was able to provide a bedroom in her Sapulpa home that had been transformed into a fully outfitted hospital room.

In early April, the trach tube that Theodore needed in order to breathe properly became blocked and his breathing became strained; Parks called an ambulance to take him to St. Francis Hospital in Tulsa.

The nightmare got worse.

Without warning, St. Francis seized control of Theodore, 76, initiating an effort to obtain legal guardianship over his finances and health decisions, a legally murky practice that in the last decade has come to be associated with fraud.

Parks said she and her siblings were denied access to Theodore, even though Parks had been granted power of attorney over her father. The family called the police, but no report was made because Adult Protective Services had been called. The family was told they had to leave the hospital property.

They would not set eyes on Theodore again for one and a half months.

In that time, a saga would unspool involving St. Francis, the judicial system, APS and the Oklahoma Department of Human Services that would raise the specter of a horrifying proposition.

In recent years, elder guardianship scams have become common across the country. Hospitals and nursing homes have sought and obtained legal guardianship over thousands of poor and elderly adults for financial gain. A survey of recent literature on the subject reveals that millions of dollars are at stake, in what may be bilked of patients and the government in Medicaid fraud and what may be awarded when fraud is exposed and punished.

The case of Leroy Theodore suggests that a nationwide plague of guardianship abuse may have arrived in Oklahoma.

Charges of Neglect Were Unsubstantiated

St. Francis Health System has refused all requests for comment on this story.

St. Francis had a history with Theodore; he had been in and out of St. Francis facilities, most recently in January.

At that time, St. Francis initiated an investigation with APS based on a claim of caretaker neglect; Parks was incapable of caring for her father, it was said.

On March 10, APS Specialist Abby Walden issued a report after visiting Parks and Theodore in Sapulpa: the allegations of neglect were unsubstantiated, Walden’s report concluded.

After that, Parks and her siblings said, St. Francis began to quash the flow of supplies that Parks needed to properly care for her father, including products intended to keep his trach tube clean.

In April, the trach tube began to crust over, resulting in difficulty breathing; trained in trach tube care, Parks removed Theodore’s tube before calling an ambulance.

Since then, family members said, the hospital and APS have offered conflicting explanations for the effort to seize guardianship of Theodore: the removal of the trach tube and long-standing bedsore problems.

It wouldn’t be that easy to win guardianship.

On April 25, Parks and her siblings initiated their own action; Creek County District Court Judge Pam Hammons awarded a 30-day guardianship to Parks and a sister and brother, Larissa Dudkiewicz and Leroy Theodore, Jr.

Four days later, on April 29, Tulsa County District Court Judge Loretta Radford awarded a 30-day guardianship to the APS division of DHS.

It was a standoff.

By that point, Theodore’s family didn’t even know where he was.

Down to the Bone

Leroy Theodore served in Vietnam when he was very young, so long ago that his family wasn’t sure what he’d done during the war. It had to do with supplies, and it was sometimes dangerous.

“He made it through Agent Orange and all that,” Parks said.

He returned home to New Orleans and fathered three girls and a boy; a marriage didn’t survive, but the family did, even as a move first took all of them to New York. Eventually, Theodore returned to Louisiana and the children spread out across the country.

One daughter, now deceased, settled in Moore.

After Theodore’s first stroke in 2021, a stent surgery at Tulane Hospital intended to prevent future strokes caused his second stroke by mistake, which resulted in his entire body locking up, his family said.

His children descended on New Orleans to care for him.

“Every day I would teach him the word,” Parks said.

Theodore was moved to a nursing home, but it was a disaster; within weeks, he developed bedsores that cut down to the bone.

The family decided to take him to Oklahoma, inventing a makeshift ambulance for the 10-hour drive.

As each of the surviving children arranged to relocate to Oklahoma, St. Francis performed a surgery on Theodore for his bedsores; Parks lived in a hotel while she was searching for a home and training in trach care.

Theodore bounced from St. Francis to swing beds and long-term acute care hospitals, known as LTACHs.

At one of the LTACHs,  the family said, they found maggots in Theodore’s bed.

The family was left with the sense that the hospitals wanted to put Theodore on hospice care and let him die; that’s not what their father wanted.

“He’s fighting to live,” Parks said.

When Parks was seeking power of attorney, a lawyer was brought in to bear witness to Theodore’s wishes; Theodore signaled yes by looking up, no by looking down.

When Theodore was asked if he wanted Parks to make his decisions for him, his eyes went up; when he was asked if he wanted to be on hospice, his eyes went down.

“Oh, yeah, that’s clear as day,” the family recalled the lawyer saying.

This is Probably New to Oklahoma

In May, the family said, the Tulsa judge, Radford, called them on the phone with an APS lawyer on the line to ask them to drop their guardianship status.

They refused.

Radford told the family she would call the Creek County judge, Hammons. A short time later, Hammons vacated the family’s guardianship, and Radford awarded temporary guardianship to APS, pending a hearing scheduled for July 1.

Radford, Hammons, the APS, DHS, and a public defender assigned to Theodore in Tulsa all refused comment for this story.

In recent years, guardianship schemes ranging from defrauding Medicaid to the outright looting of individual estates in New York, Nevada, and Virginia have received extensive coverage from ProPublica, The New Yorker and the Richmond Times-Dispatch. A common refrain in the coverage is the scarcity of reliable data on the breadth of the problem.

Experts estimate that 1.5 million individuals are under some form of guardianship in the United States, but that’s a guess. A 2015 New York Times piece, “To Collect Debts, Nursing Homes are Seizing Control Over Patients,” lamented the dearth of information.

“Throughout the country, data is lacking on the most basic facts about guardianships, even how many there are,” the Times said.

“The Use and Misuse of Guardianship by Hospitals and Nursing Homes,” by Michigan Elder Justice Initiative Director Alison Hirschel and National Consumer Voice for Quality Long-Term Care Executive Director Lori Smetanka, list numerous financial incentives for hospitals seeking dubious guardianships.

Ensuring hospital bill payment, avoiding penalties for excess readmissions and fear of negative media coverage for discharging incapacitated patients may motivate an institution to seize control of a patient, regardless of the wishes of the patient or the patient’s family.

“Petitions for guardianship filed by hospitals or nursing homes should be viewed cautiously—especially because of the extraordinary imbalance of power between the healthcare institution and the individual,” Hirschel and Smetanka wrote. “Great care should be taken to avoid conflicts of interest when health care facilities are involved in the litigation.”

The Richmond Times-Dispatch came to very similar conclusions after a year-long investigation of hundreds of guardianship cases involving low-income patients and the Virginia Commonwealth University Health System. Veronica Williams, a Newport News elder law attorney heavily consulted for the Times-Dispatch story, said that hospitals may pursue inappropriate guardianship petitions even when a suitable caregiver is available, either because a hospital wishes to move a patient out of an acute care bed or because of disagreement over the family’s treatment preferences.

The cases described in the Times-Dispatch’s comprehensive three-part series bear an uncanny similarity to the case of Leroy Theodore.

In a 2021 article for the Oklahoma Bar Journal, Edmond elder law attorney Sarah C. Stewart praised laws that were passed to protect vulnerable adults. Those measures may not have been enough.

“The circumstances surrounding guardianships have always been ripe for abuse,” Stewart said. “Those who wish to harm the vulnerable have used these laws to embezzle assets and take away the rights of those who cannot protect themselves.”

The State of Tulsa

Oklahoma Watch met with an individual who has intimate knowledge of the inner workings of the St. Francis Health Care System. The individual described a sudden and recent uptick in the number of instances in which the hospital has sought legal guardianship of low-income individuals.

The guardianships were a closely guarded secret, the person said. The individual said that as many as 15 people under guardianship were being hidden at the Laureate Psychiatric Clinic and Hospital, attached to the St. Francis campus in South Tulsa.

To repeat, St. Francis refused all comment for this story.

Esther Houser served as the Oklahoma Long-Term Care Ombudsman for many years before retiring a decade ago, though she has remained in close contact with her successor and with APS staff.

Houser recalled attending conferences and learning of bad practices that might make their way to Oklahoma; she attempted to install best practices to head off abuses, but said that times seem to have changed.

Provided with the details of Theodore’s predicament, Houser was incredulous.

“That’s the most bizarre story I think I’ve ever heard,” Houser said. “There are times when hospitals and families are in conflict about who is abusing who, but in a creepy way, it’s human trafficking.”

Houser offered praise for APS, but acknowledged that the service varied county to county; she recalled Tulsa as a wholly different breed of cat.

“We used to refer to Tulsa DHS as the State of Tulsa, because they would just do things their own way and say they were using a different model,” Houser said.

Models aside, there was no explanation for why Theodore’s family had been denied access to him.

“Even a guardian cannot restrict access unless there is special permission from a judge,” Houser said.

When Houser became aware of Theodore’s predicament, she contacted the head of APS and her successor at the ombudsman’s office, William Whited, triggering an inquiry into the case.

The ongoing investigation may take weeks to complete, Whited said in an email.

You Know Why

It’s unclear whether the July 1 hearing specified in Judge Radford’s order awarding guardianship to APS will be affected by the investigation from the ombudsman’s office.

Regardless, the order revealed Theodore’s location: Cross Timbers Nursing and Rehabilitation in Midwest City.

On June 4, Oklahoma Watch accompanied Parks, her sister Larissa Dudkiewicz, and Theodore’s former wife, Deborah Theodore-Hill, to Cross Timbers to visit Theodore for the first time in six weeks.

When the family indicated a desire to visit Theodore, the nursing home staff responded with hostility.

“You must leave our property immediately,” a staff member who refused to identify herself said. “We’ll call the police.”

“Why?” Dudkiewicz said.

“You know why,” the staff member said.

The family didn’t know why; they refused to leave. Two police cruisers arrived.

After the two-hour drive from Tulsa, the family was compelled to endure a second standoff in the nursing home parking lot, a two-hour delay as police officers examined court documents on smartphones and communicated with staff, APS officials, and Whited from the ombudsman’s office.

A 2015 order from then-Attorney General Scott Pruitt tipped the scale: Title 30 does not provide a guardian with the power to restrict visitation with a nursing home resident without a court order.

APS had not been given a court order to deny visitation.

Despite the clear order from the AG’s office, the beleaguered police officers opted for compromise. Parks, the daughter who knew best how to communicate with Theodore, was denied access. Dudkiewicz and Theodore-Hill were granted a brief, supervised visit.

Theodore was heavily medicated, but he was very excited to see his family, Dudkiewicz said.

“He immediately opened his eyes, especially when he saw my momma,” Dudkiewicz said. “They were dating when she was 16, so he loves to see her.”

Theodore-Hill chuckled. She recounted reading various psalms and Bible passages to Theodore, including Jeremiah 30.

“Those who plunder you will be plundered; all who make spoil of you I will despoil. But I will restore you to health, and heal your wounds,” the verse reads. 

Full Article & Source:
Eldercare Nightmare: A Tragic Family Story Raises the Specter of Widespread Guardianship Fraud 

Report: FBI, Hamblen County police catch international scammer who preyed on the elderly

A man the FBI says had his hand in several million dollar scams around the world is jailed in Hamblen County, Tennessee. Samuel Bobby Campbell, 48, posed as a rep for Publishers Clearing House to bilk thousands from local elderly residents, according to authorities.

Sheriff Chad Mullins said Campbell has been under investigation for a year by his office and the officers with the FBI in Johnson City and the money he stole from elderly residents was more than $1 million.

Campbell would allegedly call the resident claiming they won but needed money for the tax payment on the winnings that the victims gave to Campbell when he came to their homes. Campbell was caught by officers when he arrived at a person’s home to collect $75,000, according to Mullins’ report.  

Full Article & Source:
Report: FBI, Hamblen County police catch international scammer who preyed on the elderly