Sewickley Woman Sentenced for Bank Fraud Involving Guardianship Agency Funds

For Immediate Release

U.S. Attorney's Office, Western District of Pennsylvania

PITTSBURGH, Pa. - A resident of Sewickley, Pennsylvania, has been sentenced in federal court to two months of imprisonment, to be followed by two years of supervised release, on her conviction of bank fraud, United States Attorney Troy Rivetti announced today.

Senior United States District Judge Nora Barry Fischer imposed the sentence on Judith A. Hetzell, 64, on October 13, 2026, also ordering the defendant to pay $80,966 in restitution to her former employer.

According to information presented to the Court, between November 2023 and February 2025, Hetzell, the former business manager for a non-profit guardianship agency based in the Western District of Pennsylvania, fraudulently drafted checks against individuals’ bank accounts to which the agency had access as a provider of guardianship and other fiduciary services to the victims. The checks were drafted to cash and to Hetzell’s mother and deposited into two personal bank accounts that Hetzell controlled.

Prior to imposing the sentence, Judge Fischer stated that, while Hetzell had otherwise lived a law-abiding life, her criminal conduct was quite serious in that she stole funds from the accounts of vulnerable individuals who, for various physical and mental health reasons, required the services of a guardianship agency. Judge Fischer also observed that Hetzell’s conduct risked the viability of the agency for whom she worked.

First Assistant United States Attorney Carolyn J. Bloch prosecuted this case on behalf of the government.

United States Attorney Rivetti commended the United States Postal Inspection Service for the investigation leading to the successful prosecution of Hetzell. 

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Sewickley Woman Sentenced for Bank Fraud Involving Guardianship Agency Funds 

Harrison County Clerk arrested, charged with stealing more than $125,000 from elderly woman

by JoBeth Davis 

BETHANY, Mo. — The Missouri State Highway Patrol says Lee Ann M. Miles, the Harrison County Clerk, has been arrested and charged after an investigation into theft and fraud allegations.

According to a release from MSHP, the Bethany Police Department contacted the highway patrol's Division of Drug and Crime Control to investigate allegations of theft involving the Harrison County Clerk.

During the course of that investigation over the next several months, authorities said they discovered Lee Ann M. Miles, 46, had been entrusted or hired to oversee an elderly person's financial responsibilities.

Probable cause documents in the case state Miles was hired to pay rent, lawn care, house cleaning, medical and tax bills in addition to other tasks for an individual over the age of 60.

For her services, the victim agreed to pay Miles $300 per month.

After noticing discrepancies in her financial records, the victim requested her full bank account statements and discovered her bank account balances were very low.

Investigators discovered that from November 2023 through July 2026, Miles reportedly made more than 500 transactions from the victim's account into her own account.

Authorities noted transfers to Miles' accounts for payments to Ford Motor Credit, along with a storage unit, which the victim said was not hers. Transfers were found for other items like a Walt Disney World trip.

Detectives noted all the transfers to Miles' accounts were in familiar dollar amounts that the victim would recognize, such as what one of her other bills would cost. But sometimes those transfers were made multiple times a month, and even multiple times on the same day. After analyzing the transfers reportedly made by Miles and comparing them with the victim's actual bills, authorities said more than $125,000 could not be accounted for.

The victim also received notice that her quarterly taxes had not been paid. However, the victim told authorities Miles said they'd been taken care of.

Miles was charged with one count of stealing ($25,000 or more) and one count of financial exploitation of an elderly/disabled person.

When questioned by police, Miles told authorities she had originally requested payment of $25 per day from the victim for her services, but the victim said she couldn't afford that amount and instead offered $300 per month. Miles told police that she never had a written agreement with the victim, and the additional transfers were "backpay" to catch up on the amount the victim owed. Miles admitted she did not inform the victim of that increase.

The victim also said a 1099 form the victim filled out for tax purposes every year only reflected the $300 per month amount as compensation.

Miles told authorities she estimated that the victim owed her $118,000, a number she estimated from her memory. She said her computer that contained the Excel spreadsheet detailing what she was owed crashed. When authorities told Miles that she had transferred more than $200,000 to her account during that time, she said she may have made an error in her estimations.

Miles is currently being held at the Daviess/DeKalb Regional Jail without bond. 

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Harrison County Clerk arrested, charged with stealing more than $125,000 from elderly woman 

When Guardianship Isn’t the Answer for Elderly Americans

It’s long been the default for aging people in cognitive decline. State policymakers have been moving toward an alternate arrangement that gives people more control over their lives. There are some things lawmakers should keep in mind.

OPINION | Oct. 16, 2026 • James A. Lomastro

Ask a state court system how many older adults are under guardianship, and often no one knows. When the Government Accountability Office examined elder abuse by guardians, court officials in six states could not provide exact numbers. That matters because guardianship falls under state law, run by state probate and family courts. It decides whether an older resident keeps control of where she lives, how she spends her money and what treatment she accepts.

Guardianship, in which a judge assigns someone (usually family, sometimes a professional) to make decisions for another adult, has long been the default for cases of aging-related cognitive decline. A guardian controls finances, medical care and living arrangements. It is permanent, sweeping and often imposed without consent. In an era of a rapidly growing older population, its limitations demand attention.

There is an alternative. In what are known as “supported decision-making” agreements, the person continues to make her own decisions but chooses trusted supporters to help her understand options and communicate choices. Unlike guardianship, the person remains legally responsible and in control. In 2013, a Virginia court treated a young woman's use of supported decision-making as a reason to limit her parents' guardianship petition. 

The case opened a door that states have been walking through ever since. Two years later, Texas became the first state to enact a statute recognizing such agreements. As of this September, at least 40 states and the District of Columbia had laws referring to supported decision-making, and those in at least 18 states required courts to consider less restrictive options before guardianship.

The laws vary widely in their approach. Florida, for example, requires guardianship petitions to describe efforts to use supported decision-making. Nevada requires a physician's assessment of alternatives. Model state legislation drafted by the Uniform Law Commission and supported by the American Bar Association offers a template for alternatives to be considered before guardianship is imposed.

Much momentum on the issue has centered on people of all ages with intellectual and developmental disabilities. Supported decision-making remains underused among older adults with cognitive decline — the population states will face most in the coming years. However state lawmakers approach the issue, there are some key provisions they and their states’ agencies and courts should keep in mind:

• Legislatures should give agreements teeth. A statute should require banks, hospitals and nursing homes to accept a supporter's presence and help, and it should require a statutory form, as Texas adopted, that gives all involved parties something standard to recognize.

• Legislatures should require written findings that less restrictive alternatives were tried or considered and found insufficient. Florida and Nevada put the burden on petitioners. States should demand this paper trail before any guardianship order is issued.

• Legislatures should guarantee counsel who argues for the person's wishes. When a respondent had an attorney, according to a Disability Rights Maine analysis, full guardianship orders fell from 76 percent to 56 percent and 33 percent of cases ended with no guardianship, compared with 21 percent of cases without representation.

• Legislatures should write safeguards into law. A supporter can exert undue influence as easily as a guardian can abuse authority. Texas's fiduciary duties and alternate-supporter provisions are a start.

• Medicaid and aging agencies should provide supporters where families are unavailable. States can fund trained community supporters, as Texas did with its 2019 pilot, reaching isolated older adults whom the model otherwise fails.

• Courts should make rights easy to get back. Guardianship should not be one-way. Periodic mandatory review means someone other than the person under the order must justify keeping it in place.

• And court administrators should count what happens. Report, by age, how many adults are under guardianship, how many orders were limited rather than absolute, how many were ended, and which alternatives were tried. Without that baseline, no state knows if anything works.

A state can test itself with three questions: How many older adults are under guardianship? What was tried first? Who argued for the person's wishes? Each is a reporting requirement a legislature can write. Together they ask the real question — not whether an older person is safe, but whose decision it is.

James A. Lomastro is a surveyor for the international Commission on Accreditation of Rehabilitation Facilities, an advocacy associate with Dignity Alliance Massachusetts and a member of the Massachusetts Board of Registration of Nursing Home Administrators.

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When Guardianship Isn’t the Answer for Elderly Americans

State opens Office of Guardianship and Conservatorship

 By MDN STAFF

BISMARCK - The Office of Guardianship and Conservatorship (OGC) is officially open and fully staffed, marking the launch of a new state agency dedicated to supporting vulnerable adults and families.

"Publicly launching our agency is an important step in making our services more accessible to people across North Dakota," said OGC Executive Director Rachel Sinness. "Our goal is to ensure individuals under guardianship and conservatorship, along with those who support them, have clear and dependable information at their fingertips. We want North Dakotans to know who we are, what we do and how we can help."

OGC was created after the 2025 passage of Senate Bill 2029 during the 69th Legislative Assembly, which recognized the need for an independent entity dedicated to serving individuals under guardianships and conservatorships.

As part of its official public launch, OGC also introduced its new website, www.ogc.nd.gov, to provide information about the agency’s services and responsibilities, as well as guardianship and conservatorship ethics, best practices, funding, resources, education, training and other support for families.

"We are grateful to ND Protection & Advocacy, Vulnerable Adult Protective Services, Supreme Court administration and Human Resource Management Services for helping us build an agency that reflects our commitment to transparency, independence and compassionate service," Sinness said.

The agency provides Guardianship Establishment funding, Public Administrator Support Services (PASS) funding and general supervision of guardianship and conservatorship management. It also investigates misconduct and abuse involving disabled and aging adults currently under a guardianship or conservatorship order. This approach standardizes the process for funding reimbursement to guardians and conservators and provides families and individuals with centralized support, education and resources. 

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State opens Office of Guardianship and Conservatorship 

Clay County launches regional task force targeting guardianship neglect and exploitation

Clay County launches a regional task force to investigate suspected guardianship neglect and exploitation while protecting vulnerable adults and children. 

Author: Jasamine Lee 

CLAY COUNTY, Fla. — A new regional task force is bringing together Clay County court officials, law enforcement and criminal justice partners to investigate suspected fraud, neglect and exploitation involving people under guardianship.

Clay County Sheriff Michelle Cook announced the Guardianship Task Force Tuesday with Clay County Clerk of Court and Comptroller Tara S. Green.

Hundreds of children and vulnerable adults receive services through court-appointed guardians in Clay County. Guardians may be family members, court-appointed professionals or state-approved members of the public. The Clerk’s Office audits guardianship files and, in some cases, requires annual financial accountings.

Green said most guardians properly care for those entrusted to them.

“When a Guardianship is mismanaged, or worse, conducted in an illegal or even criminal manner, the results can be devastating,” Green said.

Cook emphasized that the task force is targeting bad actors, not responsible guardians.

“This is not about Guardians who are doing their jobs the right way – we know the vast majority in our community take proper responsibility – but this is about bad actors,” Cook said.

Officials said auditors and detectives have encountered cases involving depleted bank accounts, stolen pensions, property sales, unpaid medical bills and inherited money being quickly spent by guardians. One case involved an elderly woman who was abandoned at a care center or hospital without her belongings after officials said a family member depleted her finances and sold her property.

“Over recent years, our auditors have seen it all, sadly,” Green said.

Cook said the task force grew from a need to better coordinate investigations that had previously been handled separately.

“We were doing our job, but it was very piecemeal,” Cook said. “So when we got together, we started putting these pieces of a puzzle together.”

The task force brings together multiple agencies and jurisdictions to share information, identify potential criminal activity and investigate allegations involving vulnerable victims.

“When someone is appointed as a Guardian, they are entrusted with something so important – the care, well-being and sometimes financial future of another person,” Cook said. “It’s a position of trust – and when it’s abused, we as law enforcement and public officials have a responsibility to act.”

Cook said the effort is regional because some cases cross county lines and additional partners are being added.

“This is a regional effort to identify and hold accountable those who are taking advantage of our most vulnerable people,” Cook said.

Officials identified three main priorities: educating prospective guardians about their responsibilities, encouraging people to report concerns, and preventing abuse, neglect and exploitation.

Cook urged families, neighbors and others to speak up even when they are unsure whether a crime has occurred.

“What we would tell people to do is pay attention to what’s happening, ask questions of the guardian, make them provide proof,” Cook said. “And it doesn’t matter, even if you’re not sure there’s a crime that’s occurring. Let our team take a look at it.”

People with information about suspected fraud, neglect or abuse involving a current or former guardianship can visit clayclerk.com or claysheriff.com and search for “Guardianship” for reporting information.

The task force will evaluate complaints through a team of experts and determine whether concerns involve inappropriate conduct, legal violations or potential criminal activity.

Cook said the effort could lead to significant investigations across multiple jurisdictions.

“I look forward to our next big press conference on this issue, because we have some pretty significant cases that go across multiple jurisdictions,” Cook said.

Cook ended with a warning to anyone exploiting someone under guardianship.

“While these are complex cases, we want to make sure everyone knows that we will be watching and if you’re taking advantage of someone you have guardianship over, you will be held accountable,” Cook said.

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Clay County launches regional task force targeting guardianship neglect and exploitation 

Woman accused of exploitation, using vulnerable adult’s funds

by Dejon Johnson

KERSHAW COUNTY, S.C. (WACH) — A 56-year-old Camden woman is accused of exploiting a vulnerable adult and fraud, according to the Office of the Attorney General.

Dionne L. Robinson is charged with exploitation of a vulnerable adult and financial transaction card fraud involving more than $500 in a six-month period.

She was arrested by the Attorney General’s Vulnerable Adults and Medicaid Provider Fraud unit and booked into the Kershaw County Detention Center on Oct. 12.

Authorities say Robinson used her position as a vulnerable adult’s power of attorney to illegally use the person’s money or assets.

Robinson is accused of using the victim’s debit card to obtain money, goods or services for her own benefit without the victim’s permission, according to authorities.

Authorities say at the time, the victim lived in a residential care facility and qualified as a vulnerable adult under state law. 

The Attorney General’s Office will prosecute the case. 

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Woman accused of exploitation, using vulnerable adult’s funds 

Observant Business Owner Helps Detectives Uncover Elderly Exploitation Scheme

NEWS RELEASE 26-053 - OCTOBER 12, 2026

An alert Sarasota jewelry store owner helped Sarasota County Sheriff’s Office (SCSO) detectives uncover an alleged financial exploitation scheme involving an elderly woman and her late husband, resulting in the arrest of two individuals accused of stealing more than $361,000.

The investigation began on July 20, 2026, when Imran Din, owner of A & Z Jewelers, contacted the SCSO after becoming suspicious of two customers, later identified as Reinier Reinoso, DOB 10/13/83 and Suyeng Daniels-Lopez, DOB 07/08/81.

The pair had made several jewelry purchases totaling more than $40,000 within a short period of time. When they returned to make a fourth purchase, Din requested identification, which neither individual was able to provide. Recognizing the suspicious circumstances, Din contacted law enforcement.

As detectives investigated, they discovered that the credit card used for the jewelry purchases belonged to a Sarasota man who had passed away in March 2026. Further investigation revealed that the man and his wife had been residing in an assisted living facility. Daniels-Lopez had been assigned to care for the couple from December 2025 until her employment was terminated in June 2026.

Detectives subsequently uncovered extensive unauthorized financial activity involving the couple’s accounts. Between June 2 and August 25, 2026, the victim’s credit card was used in more than 550 transactions totaling $240,272.85. During that same period, 21 payments totaling $361,938.23 were made from both victims’ bank accounts to the credit card company.

“Our elderly residents deserve to feel safe, especially when placing their trust in those responsible for their care”, said Sheriff Kurt A. Hoffman. “Taking advantage of that trust for personal financial gain is unacceptable. We are grateful to Mr. Din whose attention and willingness to speak up helped bring this case to light.”

Reinoso and Daniels-Lopez were both arrested and charged with Exploitation of an Elderly Person, Grand Theft from a Person 65 Years of Age or Older, and Criminal Use of Personal Identifiable Information. 

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Observant Business Owner Helps Detectives Uncover Elderly Exploitation Scheme 

Livonia Caregiver Accused of Draining Nearly $24K From 86-Year-Old

By Sarah Johnson

A caregiver who spent nearly a year working in the Livonia home of 86-year-old Cynthia Dame was arrested Tuesday afternoon, accused of taking almost $24,000, including through repeated $500 ATM withdrawals and alleged unauthorized credit-card purchases. Dame says she didn’t discover the pattern for months because the mailed bank statements that would have revealed it kept disappearing.

According to ClickOnDetroit, the caregiver had worked for Dame since July 2025 and had earned the trust of Dame’s family over nearly a year before the alleged theft came to light. The caregiver has not been publicly named because she had not yet been formally charged as of Tuesday, though police said charges could come as early as Wednesday.

Dame told the outlet the caregiver took her ATM card from her wallet and withdrew money without her knowledge, and that she also believes the caregiver used her credit card for groceries and other unauthorized purchases. Dame’s family says they eventually uncovered a long string of daily $500 withdrawals, and they believe the scheme escalated over the past six months before it was caught.

A Pattern Hiding in Plain Sight

The caregiver, according to Dame, handled everyday tasks that built deep trust within the household — shopping, cooking, laundry, yard work, and even caring for Dame’s animals. That access is part of what made the alleged theft so painful for the family to process, and it illustrates a broader gap in Michigan’s oversight of home care: the state does not require licensing for non-medical home care agencies or private caregiving arrangements, according to Vitable Health, leaving families to rely on their own vetting rather than state oversight.

That regulatory reality contrasts with rules for licensed health facilities and home health agencies, which under Michigan law must run fingerprint-based state and FBI background checks on employees who have direct access to patients’ financial information and property, per the Michigan Department of Licensing and Regulatory Affairs. Private, independently hired caregivers like the one accused in Dame’s case generally fall outside that screening requirement.

Police Vow Full Investigation

Eric Marcotte said the caregiver was arrested early Tuesday afternoon and that police would investigate the alleged crimes fully, describing the conduct as exploitation of elderly people. Dame’s family has said they believe the total stolen reached nearly $24,000.

The case also drew comment from Dame’s daughter, Constance Wisniewski, who said she interviewed the caregiver after a referral from a previous client for work in her mother’s home. Wisniewski said she had given the caregiver roughly $4,000 as a gift along with an extra $100 every week on top of her regular salary. Wisniewski said her sister discovered the unauthorized withdrawals while reviewing their linked bank accounts, and that the caregiver admitted to taking the money and said she would put it back.

A Longtime Home-Care Provider Reacts

Connie Kincer, who now provides care for Dame and owns Compassionate Heart Home Healthcare, has worked in the home-care industry for 34 years. She described the alleged theft as extremely cruel and said she hopes the former caregiver is not doing this to another family.

Cases like this one sit within a much larger statewide problem. Michigan’s Adult Protective Services received 57,504 referrals alleging abuse, neglect, or financial exploitation of vulnerable adults in Fiscal Year 2024, investigating 21,137 of those cases and substantiating 41 percent, according to the Michigan Department of Health and Human Services. State officials have estimated that more than 73,000 older Michigan adults experience abuse or exploitation annually, a concern serious enough that Attorney General Dana Nessel established a dedicated Elder Abuse Task Force in 2019 comprising more than 55 public and private organizations.

The scale of the problem isn’t limited to Michigan. A Financial Crimes Enforcement Network analysis found that financial institutions nationwide submitted reports involving roughly $27 billion in suspicious activity tied to elder financial exploitation between 2022 and 2023. In Livonia specifically, the stakes are especially high: residents 65 and older made up 21.5 percent of the city’s 95,535 total population as of the 2020 Census, according to the City of Livonia, one of the higher senior concentrations among major Wayne County municipalities.

What Charges Could Look Like 

Under Michigan Penal Code MCL 750.174a, obtaining or using a vulnerable adult’s money or property valued between $20,000 and $50,000 through fraud, deceit, or unjust enrichment is a felony carrying up to 10 years in prison and fines of up to $15,000 or three times the amount stolen. Dame’s family believes the alleged theft escalated over the past six months. Separately, MCL 750.159i carries a maximum 20-year penalty.

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Livonia Caregiver Accused of Draining Nearly $24K From 86-Year-Old

‘Egregious case’ of elder abuse: Companies ordered to pay $30M after SC woman’s 2011 death

by Riley Edenbeck

COLUMBIA — Healthcare companies and a nursing center appealed a court decision requiring them to pay out millions in a wrongful death lawsuit.

Jean Watkins, representing her late mother, Mildred Watkins, filed wrongful death and survival actions against Sterling Healthcare, Countrywood Nursing Center and Guardian Resources following her mother’s death during her stay at Countrywood in Hopkins in 2011.

The circuit court that handed down that initial decision called the case “the most egregious case of elder neglect/abuse” it had ever witnessed. SC appeals court judges John Geathers, Blake Hewitt and Kristi Curtis found that determination “well supported by the record” in their September ruling, but they did poke some holes in that lower court’s judgment, reducing the damages the medical provider must pay from nearly $30 million to nearly $24 million.

Even though that total was reduced, it’s back up into the $30 million range by now — 7.25% percent interest has been accruing on the nearly $24 million since it was decided, Watkins’ legal counsel said.

After the businesses repeatedly failed to comply with discovery requests, the circuit court sided with Watkins. The businesses then appealed the award of punitive damages and an order compelling them to provide financial and insurance-related records. The appeals court found that the lower court erred in setting aside a statutory cap on the damages, thus lowering what the companies must pay.

“We are very happy that the Court of Appeals recognized the severe trauma that Mildred Watkins and her family endured,” attorney Jennifer Purdy said, who has represented the Watkins family for over a decade and secured the initial judgment. “This has been a long road for the Watkins family, and much work lies ahead of us. However, we are committed to continuing this fight until justice is achieved for Mildred Watkins.”

It’s not yet clear whether the businesses will request an additional hearing or a writ to the state Supreme Court, Robert Eaton, the attorney representing Sterling Healthcare and Countrywood Nursing Center, said on Oct. 1.

Watkins’ legal counsel requested a rehearing Oct. 8 to recoup about $5 million of the damages shaved off by the Court of Appeals. If the businesses decide to continue the case, it could be another year or two before those numbers are certain.

Watkins has since filed a companion case in federal court in an attempt to hold the companies’ owners at the time of her mother’s stay accountable for what happened. That case awaits a state Supreme Court decision to move forward.

Mildred Watkins’ stay at Countrywood

Less than nine months into her stay at Countrywood Nursing Center in Hopkins, Mildred Watkins died from urosepsis at 73 years old.

According to the appeal decision, on March 8, 2011, Mildred Watkins was admitted to Countrywood for rehabilitation after falling at her home. Watkins had several pre-existing conditions at the time of her admission, but they were all managed through treatment and medication. She was listed by a Countrywood physician as having high rehabilitative potential, and her family expected her to return home after she regained her strength.

She weighed between 100 and 115 pounds at the time of her admission, which decreased over time to 79 pounds. Watkins was hospitalized eight times while in Countrywood's care. Her first hospitalization occurred within the first 24 hours of admission, though doctors found nothing wrong with her and immediately released her.

• On March 15, Jean Watkins visited her mother and found her unresponsive. At Jean’s urging, Mildred was taken to the hospital where she was diagnosed with a urinary tract infection.

• On August 22, 2011, Mildred Watkins was transported to her dialysis appointment, where workers “noticed her altered mental state” and took her to the hospital. Doctors diagnosed Watkins with another UTI and admitted her for three days.

• On October 8, 2011, Jean Watkins noticed her mother was acting strangely, had a fever, and was complaining about her thumb, which appeared swollen. Jean testified in court that when she asked about the injury, Countrywood staff said that her mother banged her hand on the bedrail. Jean demanded that her mother be taken to the hospital for an X-ray. Doctors diagnosed Watkins with a severely dislocated thumb and another UTI.

Jean testified that an ER doctor raised suspicions about Watkins' thumb injury. She stated that the doctor was doubtful Watkins caused the injury herself and that her thumb had to have been "twisted or turned or pulled back." That detail wasn’t reflected in her mother’s medical records and only appeared in the record through Jean’s testimony. Mildred Watkins was unable to tell her daughter what caused the injury.

Countrywood staff then called Jean Watkins on Nov. 7, 2011 to tell her that her mother cut her leg while getting into bed. When Jean arrived, she discovered her mother bleeding from a large laceration on her leg. A certified nursing assistant informed her that while staff was getting Watkins into bed, Watkins cut her leg on a piece of metal that was protruding from the bed. Jean again demanded that Watkins be taken to the hospital. Mildred’s leg wound was five centimeters long and required ten staples to close.

Jean filed a complaint with the now defunct state Department of Health and Environmental Control regarding the incident. The complaint and Countrywood's response were admitted at the damages hearing, and in the response, Countrywood's nurse manager reported that the staff "found a metal projection on the lower bed frame that could have caused the skin tear."

Staff then performed an audit on all of the beds in the unit and found 15 other beds with the same metal protrusion from the bed frame.

Jean Watkins later testified with photo evidence that Countrywood sawed off Watkins' bedrails and left behind an exposed, jagged piece sticking out from the bottom of the bed. Mildred Watkins returned to the hospital on Nov. 17 for surgery to repair her dislocated thumb.

On Nov. 20, Jean visited her mother again and learned she was not eating, had been vomiting, and had diarrhea. She again insisted her mother be taken to the hospital. Upon admission, Watkins was diagnosed with a severe UTI with possible systemic response syndrome.

Due to a cast on her arm from surgery on her thumb, doctors had to insert a central line in her leg for her IV. Over the 10 days she was in the hospital, nurses and doctors noticed multiple bruises, skin tears, open wounds, abrasions, and decubitus ulcers on her body. These skin conditions were also noted by Countrywood upon her readmission to the facility.

Mildred Watkins' final hospitalization was on Dec. 7, 2011. Jean Watkins visited her mother on that date and found her unresponsive and "slumped over" in her wheelchair, drooling, and wearing a saturated bib. Jean noted that her mother's clothes were filthy. Jean testified that when she asked staff to call an ambulance, one staff member asked her why they should when Watkins "wasn't going to get any better."

Mildred Watkins was eventually transported to the hospital via ambulance and admitted to the medical intensive care unit. She was diagnosed with urosepsis and an advanced bed sore on her lower back. Doctors also noted scratches on areas of her body that she was unable to reach herself, and that she weighed only 79.36 pounds. Watkins died on Dec. 15, 2011, from complications of urosepsis.

During her time at Countrywood, staff performed weekly "skin audits" documenting the condition of Watkins' skin. To accurately perform the audit, staff must not only visually examine the patient's skin but must touch the skin as well. Jean Watkins testified at trial that when she reviewed her mother's medical records, she found several skin audits that reported her mother's skin condition on dates when she could not have been examined by Countrywood staff because she was hospitalized.

History of the case

Jean Watkins filed suit on Aug. 22, 2014, and served the businesses with discovery requests the same day. A month later, the businesses filed answers denying all allegations, but did not provide the necessary information.

After nearly a year of the businesses refusing to share information, Watkins filed a motion to compel in July 2015. The circuit court ordered the businesses to produce the requested information by Dec. 20.

When the businesses failed to comply by the deadline, Watkins sought sanctions, and the court ordered a damages hearing. The businesses appealed the sanctions order, and the Richland County appeals court affirmed it.

The circuit court held a damages hearing in November 2022. Two witnesses testified, including Jean Watkins and her sister Kim Watkins.

The circuit court set aside the noneconomic damages cap that had been set because it found the businesses "repeatedly acted in a grossly negligent, reckless, willful, wanton, and reckless manner" which resulted in Watkins' injuries and her untimely death.

Further, the court pointed to the skin check audits as proof that the businesses "knowingly and willfully falsified medical records, pretending to provide treatment and services that they could not have provided, because [Watkins] was hospitalized at the time the alleged examinations were performed."

The court set aside the cap on punitive damages, with Judge Frank Addy finding:

“[T]his is the most egregious case of elder neglect/abuse I have ever witnessed — and most of the similar cases I have seen involve the criminal side of my jurisdiction. … If any of the three corporations were a person, they would be jailed for the rest of their lives.”

Damages reduced

The original damages awarded by the circuit court, just short of $30 million, were arrived at in part by setting aside the statutory cap on punitive damages for the survival action brought by Jean Watkins, due to the judge’s determination that there was “intent to harm” on the part of the healthcare companies.

That led to the circuit court ordering payment of nearly $17 million in punitive damages for that action, and nearly $20 million in total. The court ruled that the companies owed $10 million for damages in Watkins’ wrongful death action.

The appeals court determined that the circuit court was wrong in assigning “intent to harm” to the companies, thus limiting the punitive damages to four times the compensatory damages awarded in the case, which landed just shy of $2.8 million. Thus, the appeals court reduced the punitive damages owed in the survival action to just over $11 million, settling on a total of nearly $14 million in damages for that action.

Raising the issue to federal court

It’s not required for nursing homes to have liability insurance, according to federal law.

In this case, all three of the business entities were owned and operated without that insurance. Countrywood Nursing Center, while still a company on paper, divested itself of all its assets, attorney Graham Newman said, who also represents Watkins.

That essentially makes it impossible to collect on the judgment issued by the appeals court, requiring Watkins to file a companion case in federal court seeking to “pierce the corporate veil” of the businesses’ entities, Watkins’ legal counsel said.

“A $23 million judgment now is obviously still a big deal,” Eaton said, “but the other case has a bit more of an impact on how much money is going to be recovered by [Watkins].”

Such a case essentially allows Watkins to pursue legal action against individual investors, owners and other stakeholders in the businesses in an attempt to prove their fraudulent behavior, remove their liability protections and recoup money against their personal assets.

“The judgment on paper is not a judgment in reality,” Newman said. “We think it is fundamentally unfair to Mildred and her family that this company chose to exist without liability insurance in an industry in which potential damages include misery and death, and did include both of those things in this case.

“While there is no liability insurance available to us from the corporations,” Newman added, “we do believe that there are monetary assets available from those that own the corporation and made the decision to run the corporation without the necessary insurance.”

That case has been on hold since February, awaiting a decision from the S.C. Supreme Court on some questions about state law. Watkins’ legal counsel didn’t have an estimate of when a decision might be reached. 

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‘Egregious case’ of elder abuse: Companies ordered to pay $30M after SC woman’s 2011 death