Tuesday, May 30, 2023

Auburn nursing home cited by state after sleeping nurse video

Auburn Rehabilitation and Nursing Center.

By: David Wilcox

The Auburn nursing home where a viral video of a sleeping nurse was recorded in March has been issued citations by the New York State Department of Health over the incident.

Auburn Rehabilitation and Nursing Center at 85 Thornton Ave. was cited for failures to administrate efficiently and to keep the 37 residents in the nurse's care free from neglect, according to a report.

The report, dated April 14 and posted to the department's website this week, also sheds light on the nurse's behavior up to and including the night of the video, and the center's response to it. 

The March 26 video showed a licensed practical nurse at the 92-bed center slumping at a medical cart and swaying, apparently asleep on her feet. Days later the video was posted to Facebook, where it has been viewed more than 2.2 million times since. According to the department's report, the nurse blamed her posture on "disturbing news" she had received over the phone minutes prior.

The center's administrator, Judson MacCaull, told The Citizen on Monday that the nurse is no longer employed there. 

The nurse, who is not named in the report, began working at Auburn Rehabilitation and Nursing Center on Feb. 16. The report documents several instances of her appearing drowsy, arriving late and spending hours in the bathroom or her car during work, as well as broken lines of communication between administration, supervisors and staff as her behavior received increasing attention. 

The first major incident described in the report took place March 4, when the nurse was suspected of working under the influence by another staff member. They called the center's assistant director of nursing to come back to observe, but the nurse left before they arrived. The staff member also called 911 due to the nurse's inability to drive, as she was "barely even coherent to walk."

When the director of nursing asked the nurse about the incident days later, the report said, she blamed migraine medication. She was then placed back on the work schedule. During an interview in April, the director told the Department of Health they thought the staff member who called 911 was being "dramatic," then clarified that "they meant to say (the staff member) did the right thing."

The assistant director, however, told the department "they should have questioned more people and handled it in the wrong manner."

"There was no documented evidence an investigation was completed to address the concerns as reported," the report said. 

March 4 was the first of many times the nurse was relieved of medication cart duty. On March 20, she was found sleeping in her car. Administration "counseled" her for sleeping issues, the report said, and told her March 16 to stop working double shifts. But she continued to, logging six through March 27. Administration told the department they didn't know why she worked past her scheduled shifts.

The nurse also worked eight days in a row leading up to March 26, the night when the video was recorded, administration noted.

Before being sent home that night, the nurse was observed "on the floor crawling around, reaching around for things that were not there." One staff member said she was "worse than normal and something was definitely off." After working, she sat in her car for hours. Residents complained about its headlights and its horn repeatedly sounded, "as if they were falling asleep and hitting their head."

However, when asked about the incident by the director of nursing, the nurse blamed a "disturbing phone call" she received for her drowsy appearance in the video. She was putting her head down at her cart in response to the call when she was recorded, she said. The director of nursing said they believed her explanation, and that the nurse "followed directions and spoke clearly" an hour earlier.

A resident corroborated that account, telling the department the nurse gave them medication after the video was recorded and seemed OK. The resident thought the nurse had a headache when she slumped over. But when she called 911 that night to transfer another resident, her responses to the operator were slow and delayed, the report said. She was also confused when EMTs arrived.

MacCaull declined to elaborate on the center's response to the video, saying only that it "addressed the matter ... and has fully cooperated with investigators from the Department of Health."

While the video prompted anonymous staff members and the public to contact the department, the center itself reported the video because it showed the legs of a resident, the report said. The staff member who recorded the video, Certified Nursing Assistant Alexxis McNeil, told The Citizen she was informed she would be fired because it violated HIPAA. She decided to quit instead.

McNeil said she posted the video on Facebook after showing it to the center's administration because they weren't taking action fast enough.

"A lot goes swept under the rug that no one will speak on or share because they're afraid of losing their jobs," she said.

Another staff member told the department they were instructed by the center's administration to refrain from saying they suspected the nurse was under the influence. The director of nursing said they never suspected her of substance abuse, the report said. An audit of the center's medication records during the nurse's employment showed all narcotics accounted for and "no discrepancies."

The Department of Health told The Citizen it has imposed a direct plan of correction and a directed in-service training based on the citations, and that the center must be in compliance by June 13.

The department noted that it does not disclose any enforcement decisions, such as fines or other discipline, until they are final. 

Full Article & Source:
Auburn nursing home cited by state after sleeping nurse video

See Also:
State investigating video of sleeping nurse at Auburn nursing home

St. Clair Concrete Contractor Facing Charges From Missouri AG's Office For Fraud, Theft

A St. Clair contractor faces multiple charges after he allegedly defrauded five Franklin County customers.

Daniel Carbone, 49, was charged in March with 12 felony counts of deceptive business practice, stealing by deceit and financial exploitation of the elderly.

The charges are in connection with his businesses, Concrete Impressions and All Pro Concrete.

Carbone is being charged by the Missouri Attorney General’s Office.

According to Attorney General Andrew Bailey, Carbone promised to provide mostly concrete and other exterior remodeling work in exchange for large down payments. The charges allege that after taking these payments from the consumers, Carbone either did minimal work before abandoning the project completely, or did no work at all in spite of being paid by victims in advance to do so. Carbone left consumers with no materials for their payments and refused multiple demands for refunds. The consumers’ aggregate losses total just over $55,000.

The probable cause statement alleges that Carbone “willfully, knowingly and with the intent to defraud” made false promises to several customers.

The Better Business Bureau in November gave Concrete Impressions an “F” rating.

A Florissant woman told BBB she gave Carbone $14,000 in September 2021 to do various jobs, which were never performed.

Carbone was reportedly paid $4,000 in July 2022 to construct a concrete patio for a Eureka woman, another job he didn’t do.

A University City woman paid Carbone $2,866 to replace stairs, which he didn’t do.

BBB said there are two open civil cases against Carbone, one in St. Louis County and another run Franklin County.

In June 2022, BBB reports that he was found in default in Jefferson County and ordered to pay more than $4,000.

Carbone was charged in August 2022 for passing a bad check in Franklin County.

The case is being prosecuted by Assistant Attorneys General Don Re and Natalie Warner. Consumers who believe they may have been scammed by a contractor should file a complaint with the Missouri Attorney General’s Office by calling the Consumer Protection hotline at 800-392-8222 or by submitting a complaint online at ago.mo.gov.

Full Article & Source:
St. Clair Concrete Contractor Facing Charges From Missouri AG's Office For Fraud, Theft

Elderly man beaten, robbed in Queens

The NYPD is searching for the suspects they said attacked and robbed a 69-year-old man in the Rego Park section of Queens, then attempted to use his credit card to make a purchase at a Bronx smoke shop.

Full Article & Source:
Elderly man beaten, robbed in Queens

Monday, May 29, 2023

Lawyer is on trial for charges he stole from a client’s estate

By The Bharat Express News 

May 27 – All charges against a suspended Scranton attorney accused of stealing $94,000 from the estate of a man for whom he was appointed co-guardian were brought to trial after a preliminary hearing on Friday.

Edward James Kaushas was charged in April with stealing money from Ronald Rowlands estate. Police said Kaushas transferred money from Rowlands’ estate account in 2018 and deposited it into several bank accounts he had. He then used the money to pay for personal and business expenses.

Kaushas was suspended from practicing law in November 2018 following an investigation by the State Supreme Court Disciplinary Board. The suspension remains in effect.

The criminal investigation began in 2019 after the Disciplinary Board notified law enforcement that Kaushas made several transfers from Rowlands’ account to his law firm’s escrow account from July through September 2018. A forensic audit later revealed the inappropriate recordings, according to a statement from the arrest.

Magistrate Judge Kipp Adcock ruled that there was sufficient evidence to hold Kaushas for trial on charges of two counts of theft by deception and one count of theft by failure to provide required funds and receiving stolen property.

In an interview after the hearing, Kaushas’ lawyer, Paul Ackourey, said Kaushas insists he is innocent.

Ackourey said Kaushas paid bills for Rowlands’ care from his own account and was reimbursed. He said the case is a matter of poor accounting and he is confident that Kaushas will be acquitted at trial.

“There were a lot of very complicated financial transactions,” Ackourey said. “It was not my intention to steal anything from anyone.”

Full Article & Source:
Lawyer is on trial for charges he stole from a client’s estate

DA: Here's what it takes to investigate and prosecute an elder abuse case

The District Attorney General's Vulnerable Adult Protective Investigation Team examined 1,200 reports of elder abuse and neglect in 2022.

Author: Katelyn Keenehan

KNOXVILLE, Tenn. — The Knox County District Attorney's Vulnerable Adult Protective Investigation Team (VAPIT) looked into 1,200 elder and vulnerable adult abuse and neglect reports in 2022. That's more than the 1,100 they reported examining in 2021. 

However, despite the high volume of cases. Few perpetrators face charges and even fewer face trial. DA Charme Allen said it's due to a number of factors that make these cases complicated.

A recent case elder abuse case ended in devastation. Brenda Crutchfield died at the hands of her nieces and nephews, who were also her caretakers, according to reports from Knox County Sheriff's Office. 

Police arrested Crystal Shinpaugh Dalton, Ira Shinpaugh, Teresa Shinpaugh, and Randy Shinpaugh on Sunday. Their charges include first-degree murder, aggravated neglect of an elderly or vulnerable adult, and tampering with evidence. KCSO reports point to an autopsy showing these four neglected her to the point of starvation at her home off Lakin Road in Knoxville.

Crutchfield died in 2020, at the hands of her family members. However, they were not arrested until three years later. It took the autopsy, financial records, and several other witnesses and source material to collect enough evidence of foul play. DA Charme Allen says sometimes that's what it takes to catch these abusers.

"In regard to elder abuse, you're typically looking at four different areas. You're looking at financial exploitation neglect, sexual abuse, and physical abuse. And so we had to take each one of those pieces and look at those independently as well, too," Allen said.

The first step is getting a tip about the abuse. Things can get sticky with elder abuse cases because in 60% of cases, it's a family member doing the abusing.

"That's a challenge because the elderly don't really want to turn in family members," Allen said.

Sasha Hammett with the CAC's Office on Ageing is the Elder Abuse Program manager. She looks at cases every day and said the ones involving family members are the most complicated.

"They are some of the hardest cases because, on one hand, we can have one victim that's like, yes, absolutely. Let me do something about this. But, then you have the ones that say this is my family member, I don't want to get them in trouble," Hammett said.

If it's not verbally reported, there is still a way authorities can be flagged of the potential abuse.

"It's the financial institution that reports in the first place. And when we get into looking at the financial aspect of what is happening, then we often find neglect or abuse with those crimes. Unfortunately, sometimes that abuse does lead to death," Allen said.

In the case of Crutchfield, reports allege the financial trail pointed back to one of the family members, Crystal Shinpaugh Dalton. 

The presentment to the court said Dalton "unlawfully and knowingly financially exploited the victim, Brenda Sue Crutchfield, and elderly or vulnerable adult of her property, specifically money of the value of $60,000 or more."

Credit: KCSO

Hammett said the other forms of abuse often stem from the desire to access those funds. 

"Once you have the financial exploitation piece that's going to come along with other pieces, most often the physical abuse, the neglect, the emotional abuse in order to gain the control of those funds," Hammett said.

Hammett said in the five years she's been working at the CAC's Office on Aging, she's seen a progression of the intensity of these cases.

"The cases I feel like are getting more severe, and they are resulting in bigger consequences such as death or losses of, you know, huge amounts of money," she said.

However, even with the growing intensity, few of these cases make it to trial.

"We don't prosecute all 1200. It's difficult to be able to prosecute these cases," Allen said. "Oftentimes, we don't have the evidence or oftentimes, our victims are not in a position where they can cooperate with us. Additionally, if we have strong proof, our defendants will plead and we won't have to take these cases to trial."

That's why the DA's VAPIT team, alongside case managers at the CAC are dedicated to catching them early.

"Oftentimes, we lose elderly during the prosecution, unfortunately, they pass away on us. So we have to be very vigilant to make sure that we lock down their testimony early on," Allen said.

Hammett said the main way to prevent these cases from happening is to check in on the older people in your life. Avoid allowing them to become isolated.

"Isolation is the number one risk factor for abuse. If we can prevent isolation, I think the numbers would lower significantly," Hammett said.

In Crutchfield's case, the Shinpaughs' collective bond is over $1.1 million with Ira's, Teresa's and Randy's bond set at $275,000. Crystal's bond is at $300,000, and she has a court date set for May 30 in Knox County Criminal Court.

KCSO's Detective Jim Shipley worked the case.

Full Article & Source:
DA: Here's what it takes to investigate and prosecute an elder abuse case

Sunday, May 28, 2023

Public guardianship bill expanded, advanced

A bill intended to create public guardianships to assist individuals in applying for benefits was amended to include a variety of judicial matters and advanced from general file May 25.

LB157, introduced by Bennington Sen. Wendy DeBoer, would create temporary guardianships to assist an individual who is applying for private or public benefits. The bill would allow the temporary guardian to access personal and financial records necessary to apply for those benefits.

DeBoer said patients sometimes wait hundreds of days for help with signing the papers needed to get them moved out of a hospital.

“These are people who are in hospital beds who are waiting to get out and the only reason they cannot is because they do not have legal authorization to do so because they don’t have a guardian,” DeBoer said.

A Judiciary Committee amendment, adopted 33-0, narrowed the provisions to apply only to a county containing a metropolitan class city. Omaha currently is the state’s only metropolitan class city.

The amendment also added provisions of the following bills:
•LB82, introduced by DeBoer, which would update reporting requirements from the director of the state’s Department of Correctional Services;
•LB315, introduced by Omaha Sen. John Fredrickson, which would prohibit providers of medical or other services related to examination of injuries arising from sexual assault, domestic assault or trafficking from referring victims to collection agencies or taking other averse action for failure to pay the debt;
•LB330, introduced by DeBoer, which would allow a successor to a decedent to endorse a check, payable to the decedent or the decedent’s estate, for a debt owed to the decedent;
•LB436, introduced by Lincoln Sen. Carolyn Bosn, which would update the state Uniform Controlled Substances Act to conform with federal law; and
•LB757, introduced by DeBoer, which would extend the filing date for victims to apply for reimbursement from the Crime Victims Reparations Fund.

Bellevue Sen. Rick Holdcroft offered an amendment to the committee amendment, adopted 27-0, which would include provisions of his LB480 to add emergency medical service providers to the list of medical agencies that can file a lien on settlement awards received by injured parties.

An amendment offered by Bellevue Sen. Carol Blood, adopted 27-4, includes provisions of her LB11, which would specify that domestic abuse protection orders may explicitly provide for sole possession of a household pet and restrict contact with such pets.

Omaha Sen. John Cavanaugh also offered an amendment, adopted 31-1, which would include provisions of his LB183 to allow the District Court to waive fees related to a name change.

Finally, Omaha Sen. Justin Wayne offered an amendment, adopted 33-0, to include provisions of his LB240 that would prohibit a juvenile court from modifying the terms of a disposition order unless the juvenile has violated a previous order or all parties agree and the juvenile has consulted with or waived counsel.

Following adoption of the amendments, lawmakers advanced LB157 to select file 34-0.

Full Article & Source:
Public guardianship bill expanded, advanced

Nevada AB202 for Cameras in Nursing Homes is on its way to the Governor to sign into law.

Treasa Owens brother was neglected and abused in a Nevada nursing home in Las Vegas. This resulted in his death. Treasa wanted a law for cameras in nursing home and she got a representative to introduce the law and called me. We fought getting this law passed for three months, and we see no reason the Governor will not sign it into law.

Nevada AB202 for Cameras in Nursing Homes is on its way to the Governor to sign into law.

Two women arrested after elderly relative found with bed sores, maggots

By Natchez Democrat Staff

Two women of a small Mississippi River community face cruelty charges after an elderly woman in their care was found with infected bed sores covered in what appeared to be maggots.  


April Lowery, 42, and Becky Lowery, 65, were arrested Thursday.

Both are charged with cruelty to an infirm person, exploitation of a person with infirmity and negligent injuring.  

Police in Vidalia, Louisiana, first responded Thursday, May 18, to a home at 1211 Plum St. in Vidalia concerning a medical emergency, where they encountered a 73-year-old woman lying in a bed in the living room of the house nude and covered in feces, authorities said.  

“The residence smelled of a foul, pungent odor and it was unclean and extremely cluttered,” Vidalia Police Chief Joey Merrill said in a news release. “The older female was not verbal and could only moan as if she was in pain. An assessment of the elderly female found numerous sores on her body that were completely covered in what appeared to be maggots.”  

She was transported to Trinity Medical Center in Ferriday, where she was treated and then transferred to Riverbridge Hospital for further treatment of her infected wounds. Further investigation later determined that Becky and April Lowery were responsible for the care of the elderly female, both of whom were living in the same residence at 1211 Plum Street.  

Arrest warrants were prepared by Seventh Judicial District Judge John Reeves, at which time officers were able to arrest both suspects without incident.

“My department and (I) care deeply for our senior citizens,” Merrill said. “To see this happen in our community to one of our own truly hurts our hearts, and it will never be tolerated in our community so long as I am your Chief of Police!”

Full Article & Source:
Two women arrested after elderly relative found with bed sores, maggots

Saturday, May 27, 2023

Psychiatrists: The Criminals Behind the Scenes of the Conservatorship Business

By Erica Loberg 

When I saw the email come in, I froze.

The message described a psychiatrist who had allegedly committed perjury, which sealed the deal for a conservatorship to be put in place for a vulnerable, elderly wealthy woman. The psychiatrist presented a psych evaluation in court, diagnosing his victim with a delusional disorder. She had no previous mental health diagnosis, nor a history of psychiatric treatment, but nonetheless, the diagnosis was accepted by the judge.

I remember thinking to myself, this criminal network runs deeper than I thought, and this is really bad.

It was the same conservator that my mom had been previously placed under, and I immediately started to panic. I had the same thoughts that I had during my mom’s conservatorship nightmare: If it was so easy to get someone with no psychiatric history seamlessly diagnosed and locked into a conservatorship, how many other vulnerable people out there were at the mercy of this network of corruption?

Around 1.5 million Americans are under a conservatorship. Many will point the finger at the conservators as the primary focus of criminal behavior; however, the web of corruption runs deep, with layers of complicit individuals that work in conjunction with the conservators to allow them to take over someone’s entire life—both financially, and in terms of their personal well-being.

Rarely do you find discussions about the doctors behind the scenes who are vital to establishing a conservatorship. For the most part, without a psychiatric evaluation, a conservatorship cannot usually be solidified, which means the psychiatrist plays a fundamental role in the process.

After years of exposure to these criminal practices, I have come to understand that there’s almost no escape, even if you have a loved one who will try to help you by fighting the system of conservatorship abuse. The doctor’s note rules; the psychiatrist’s evaluation is held as the proof and the high standard that anyone fighting a conservatorship must defy. Since psychiatrists and conservators work together to implement a conservatorship, it is no surprise that in addition to these cultivated relationships there are also established ongoing relationships with the same judges, attorneys, and court-appointed counsel.

Since it is crucial to have a doctor’s note, the power and influence the doctors have within the layered network of conservatorships is monumental. They can deem someone incompetent and submit it to the court, which seals the deal on an individual’s future. Most of the conservators have relationships with these doctors. They work in cahoots to make sure their victim’s liberties are usurped for pure financial gain. Consequently, these corrupt doctors receive kickbacks from conservators that want those clients for astronomical wealth. Psychiatrists charge an exuberant amount of money for a psych evaluation, and if you want a different doctor’s evaluation to be considered by the court that’s more money out of your pocket you have to spend. Even if you have the funds to request another evaluation, the chance of reversing a diagnosis is slim to none.

Sadly, if you are a family fighting for a loved one to get a new doctor for a new psychiatric evaluation, you are going to pay thousands of dollars. Even then, that evaluation is up against the conservator’s chosen doctor’s evaluation that is already in place and documented in court, so your chances are low and will only amount to more doctors’ bills when attempting to make a case to stop or change a conservatorship.

Since a mental illness can be for life, once a person gets a diagnosis that results in a conservatorship, it is practically impossible to remove it. Therefore, if you are diagnosed with a mental illness, you are caught in the conservatorship trap. Now you have a doctor that can stand in the way of anyone’s chance to fight a conservatorship, as the courts rely heavily on their evaluations. Whether you are alone with no one to fight for you, or with a family member willing to fight for you, either way you are up against a criminal system that makes a corrupt conservator almost impossible to resolve.

When you have a corrupt conservator working with these compromised doctors to gain and keep clients, tragedy unfolds. If the Department of Justice would examine the relationships the conservators have with their chosen psychiatrists penning these notes, they will find similar stories: the same doctor, working with the same conservator, over and over again, acquiring conservatees who get stuck in the system all along the way.

If we want to take a serious look at changing the conservatorship process and successfully have legislation set forth for reform, there needs to be a deep examination into these relationships with conservators and the doctors making these evaluations. Unfortunately, these doctors manage to stay out of the spotlight, when really they are just as predatory as the conservators that stand in line to steal someone else’s life.

The most troubling yet telling aspect of this process is that the psych evaluations are locked. There is no transparency on evaluations, so no one can even begin to dispute or question their analysis. When it comes down to it, the heavy hand the psychiatrists play in the mental health world of conservatorships is far larger and more dangerous than anyone can even imagine. If a patient has no family or friends for support and are stuck in a hospital alone and end up in a locked facility, that’s one thing. But a person that has friends and family to look after them, yet still can’t beat a system that initiates the same protocols and same process to allow a conservatorship with no end in sight is another thing.

Take Los Angeles, for example. My mom’s previous conservator has been operating for decades. Since my mom’s emancipation from him, I have come across numerous victims stuck in his trap. Currently, he is working with the same court-appointed attorney that was assigned to Britney Spears to get another wealthy woman placed under his care. Yes, Spears’ conservatorship was dropped after years of public advocacy, which brought attention to her case, but, to date, she’s the only one. No conservatorship has been lifted in the state of California except for Spears, but she is a celebrity and had an ongoing #FreeBritney moment to apply pressure on the courts, while the rest of us are civilians fighting on our own.

I remember my mom’s first conservatorship hearing at the Stanley Mosk Courthouse in downtown Los Angeles. The same courthouse in which Spears’ case was heard, which needs to be under investigation at this point. I walked in with evidence of victims all across LA County who had gotten sucked into that conservator’s grip, but the judge immediately shut me down. That judge has since retired, yet if my mom’s conservator was consistently leaning on the robes of the same judge, is that not a red flag?

Court-appointed attorneys working with the same conservators is an easy correlation to question, as would be a look into the doctors that pop up again and again in these cases. Why are the same conservators working with the same psychiatrists, often in front of the same judges? These doctors have managed to operate under the radar and rig the system.

We need to dig deeper into the doctors who conduct these evaluations, who hide behind their sealed documents with no transparency and zero accountability. If a family member wants to get rid of a conservator that is working in conjunction with a psychiatrist that is making money on their evaluations, the family most likely loses any chance to succeed. There are a lot people playing into the criminality of the structure of the judicial system that are all liable for foul play, as there are payoffs to all the complacent and compliant operators within this business.

There is a lot to be said about conservatorship abuse and who is to blame and who is in charge, but when it comes down to it, in my opinion, the doctors are the real criminals that no one seems to be talking about or questioning. The root of corruption in conservatorship abuse begins and ends with the criminality of the doctors. If we want to truly address the complexities of conservatorship abuse, we must look to the doctors that sit at the helm of this shipwreck.

Just recently, I heard yet another example of how conservators use psychiatrists to keep their hands in the cookie jar. A family member offered to take over and remove a corrupt professional fiduciary conservator, and the conservator’s lawyer argued that the conservatee needed a psych evaluation in order to determine his mental competency, which somehow would justify keeping his conservator tethered to his estate. The family and conservatee wanted the conservator removed, so the conservator, alongside his compliant psychiatrist, skewed the narrative and presented the conservatee as “unfit” to make that decision. This occurs across the board in numerous cases when the psychiatrist is at play.

Arguments like, “a transition wouldn’t be good for him,” or “I don’t want to lose his caregivers” are flat-out lies. I’ve dealt with that nonsense firsthand. My mom was hospitalized twice, and the first time, the caregivers remained at her side on their phones and I questioned why they were still on the clock when my mom had a professional treatment team at her disposal. The second time, she was hospitalized for Covid and was in isolation for three weeks so she couldn’t have any caregiver by her side, but everyone continued to get paid around the clock. Yet, any caregiver that advocates for my mom gets fired on the spot. Is that continuity of care? No.

Who picks the psychiatrist? The conservator. Who pays for the psychiatrist? The conserved individual. Who is left in the dark? You, me, and everyone else struggling outside of this locked-down, well-oiled criminal machine. I might not have a voice once a conservator takes charge, but I do have a say here and now. I refused to be silenced by this madness, and nor should you.

Full Article & Source:
Psychiatrists: The Criminals Behind the Scenes of the Conservatorship Business