Saturday, July 7, 2018

NEW WRINKLES: A man on the moon, brought down to earth

Nearly three decades of life in a retirement town have convinced me that there’s no age limit on romantic love — even the kind that can teleport you back to all the dizzying sensations of a seventh-grade crush.

I’ve seen couples settle down in their 80s with newly found soulmates, and live happily ever after. And I’ve seen formerly thoughtful and dignified elders lose their hearts and their fortunes to an engaging home health aide or ballroom dance instructor.

That’s love for you. And at first blush, if you’ll excuse the term, this seems to be what has happened in the case of the second human being ever to walk on the moon.

Unlike most of the elders I have met and written about who become ensnared in Florida’s guardianship system, former astronaut Buzz Aldrin, 88, appears to have received excellent legal advice on how to defend himself against two of his children who petitioned the state to declare him mentally incompetent. Not only did he obtain an independent cognitive assessment from a geriatric psychiatrist at the University of California Los Angeles — who described his abilities as “superior to normal” — but he also went on the offensive, filing a lawsuit in Brevard County against his own kin.

The younger Aldrins’ claim is that their father suffers from dementia, has fallen under the sway of false friends and is spending money at a ruinous rate. In return, he accuses two of his three offspring of seeking to control him “for their own self-dealing and enrichment.”

Under Florida law, adults deemed by a judge too frail or mentally compromised to make decisions for themselves can be stripped of their civil rights — unable to manage their own finances, to buy or sell property, to marry or divorce, even to vote.

Guardianship laws are necessary, especially in a state like Florida where elders can find themselves isolated and vulnerable in their later days. But the system that attempts to safeguard penniless wards is terribly underfunded, and the money to pay for attorneys and guardians has to come from somewhere. Often, as the Herald-Tribune showed in a series nearly four years ago, it comes from far wealthier wards whose life savings become a target of shiny new love interests, manipulative con artists or mercenary adult children.

The result is an adversarial courtroom drama where a judge has to decide, based on sadly skimpy evidence, who is telling the truth. The process is almost always demeaning and humiliating for the elder placed in the position of proving a negative — that he or she has not irretrievably lost his or her mind.

What’s so tough for the judge is that an elder such as Aldrin, even with a history of depression and divorces, is legally allowed to be a fool for love and act against his own best interests, regardless of how his family feels about it — as long as he can convince a court of his mental competence. We’re talking about the subtle but vital difference between illusion and delusion.

As we approach the 50th anniversary of the Apollo 11 lunar landing, it’s far too soon to rush to judgment regarding this particular moonwalker. But it’s hard not to be moved by a plea Aldrin’s attorney has already made in the court of public opinion:

He’s 88 years old, but he still has something to contribute to this country and the world. He doesn’t want to be a FabergĂ© egg stuck up on the shelf.”

Full Article & Source:
NEW WRINKLES: A man on the moon, brought down to earth

See Also:
Legendary astronaut Buzz Aldrin sues his family alleging fraud

Former guardian not eligible to bring DeBrodie lawsuit, judge rules

A Callaway County judge has dismissed a wrongful death suit filed by Carl DeBrodie's former guardian Mary Martin.

Judge Jeff Harris ruled July 2 that as Mary Martin and her husband, Bryan Martin, were not DeBrodie's birth or adoptive parents, they did not have standing to bring a wrongful death claim under Missouri statute, according to court documents.

"We already knew we were going to be denied, so it's not such a blow," Mary Martin said Friday. "We'll carry it as far as we can."

She said she, her husband and her lawyer are exploring legal options to continue pursuing the suit.

The Martins filed the wrongful death suit April 13, claiming as "psychological, 'de facto'" parents of DeBrodie, they should be among the beneficiaries entitled to participating in the wrongful death suit.

DeBrodie, the developmentally disabled man found dead in April 2017 after vanishing from a Fulton group home, lived with the Martins from ages 13-21. The Martins attempted to adopt DeBrodie when he was 25, but the petition was rejected by the Circuit Court of Cole County. The legal battle dragged from 2011-14.

Harris cited the failed adoption attempt in his July 2 decision.

"Plaintiffs' claims are barred in that their attempt at equitable adoption has already been adjudicated and rejected in other proceedings," he wrote.

Additionally, Harris noted, DeBrodie's mother, Carolyn Summers, already has filed a wrongful death lawsuit in the case.

"Only one action may be brought under the wrongful death statute for the death of Carl DeBrodie," he stated.

Summers and DeBrodie's aunt Carol Samson filed their own wrongful death suit in January and have opposed the Martins' involvement in it. The Martins' civil suit was filed April 9.

On April 13 the Martins filed to intervene as plaintiffs in the Summers/Samson civil suit. At the time, Mary Martin said she hoped to change legal precedent to allow non-adoptive and birth parents more legal recourse in cases like this. She also mentioned plans to use money won through the suit to start a foundation to help people like DeBrodie.

The motion to intervene was terminated April 16.

In May, Samson filed a motion to dismiss the Martins' lawsuit. She and Summers also filed a motion to support its dismissal before the July 2 hearing.

The Martin suit was dismissed with prejudice, court records show, meaning the Martins will have to pay for costs associated with the suit.

"It hurts that the laws do not see us as the psychological parents," Mary Martin said Friday.

Full Article & Source:
Former guardian not eligible to bring DeBrodie lawsuit, judge rules

See Also:
Carl DeBrodie was killed by injuries from forced fighting, court documents reveal graphic details

Carl DeBrodie case: Family attorney says the charges didn't surprise him

Judge Dismisses Restraining Order Protecting Stan Lee

UPDATED with details from legal memo: A judge dismissed a restraining order that sought to permanently bar a memorabilia collector from involvement in Stan Lee’s affairs, citing confusion over who legitimately represented the Marvel Comics icon.

Attorney Tom Lallas said he appeared in court today to argue for a permanent restraining order against Keya Morgan, who had inserted himself into Lee’s affairs. Lallas said he was confronted, in court, by other lawyers who also claimed to represent Lee.

“It was very unusual,” said Lallas, who was asked by the Los Angeles Police Department detective investigating claims of elder abuse to step in as legal guardian. “It has never happened to me in 40 years.”

Judge Pro Tem Ruth Kleman, citing the lack of clarity about Lee’s legal representation, dismissed the request for a permanent restraining order without prejudice — meaning it could be refiled at any time.

Lallas filed a voluminous 263-page document (read it here) in state Superior Court supporting Lee’s request for a permanent elder abuse restraining order against Morgan and for the attorney’s appointment as Lee’s legal guardian.

Linda Sanchez, Lee’s former nurse and in-home caregiver, said she witnessed verbal abuse and financial manipulation, both by Morgan as well as by Lee’s 68-year-old daughter, JC Lee, whom the father describes as “a vulnerable woman” who is “an easy target for predators.”

Sanchez says JC “screams terrible, abusive things at her father” and blames him for her problems. The nurse also says that, although she has not witnessed direct physical abuse, “I have noted numerous bruises to the right side of Mr. Lee’s body which were unexplained.”

“Mr. Lee has told me privately that he is giving up, after his daily harassment, and that he believes he has nothing left to live for but to ‘go to sleep’ and ‘die,’ ” Sanchez said in her testimony. “As a result of everything described above, Mr. Lee falls into very dark and depressed moods because he doesn’t have the strength or will to fight anymore.”

The legal documents claim Morgan took control of Lee’s business affairs and personal life in February and isolated him from the people Lee was closest to and trusted the most, including his executive assistant of 20 years Michael Kelly.

“I called Mr. Lee to arrange to meet with him but was told by Morgan that he would not come to his office at POW! and I would be required to come to his home,” Kelly said. “I went to his home to meet with him and Morgan and a bodyguard named Leo were present throughout my meeting with Mr. Lee … I was not allowed to meet with Mr. Lee privately.”

Lallas alleges Lee was held hostage in his own home. Morgan hired a security guard to block access to the Oriole Way residence, changed all of Lee’s phone numbers and tightly controlled his communications. “I was not permitted to meet or speak with Mr. Lee,” Lallas said. “The Morgan group also took control of all email communications.”

Morgan was arrested by LAPD on suspicion of filing a false police report, allegedly concerning a supposed break-in incident at Lee’s residence. Out on $20,000 bail, Morgan is due in court on the matter early next month.

At the time of Morgan’s arrest, Lee and his family were granted a 48-hour restraining order against the business manager. Among the various conditions of the order was that Morgan must stay at least 100 yards away from Lee and his home.

The paperwork also states that “Mr. Lee has a large estate worth over $50 million and therefore is vulnerable to financial predators.”

Full Article & Source:
Judge Dismisses Restraining Order Protecting Stan Lee

See Also:
Stan Lee Granted Restraining Order Against Business Manager, LAPD Investigating Claims of Elder Abuse

Friday, July 6, 2018

The Massachusetts Adult Guardianship System

Upstate NY Judge Admonished for Entering Resident's Home, Sharing Photos on Facebook

An Otsego County judge was publicly admonished by a state commission on Thursday for entering a local resident’s home without permission and posting photos of it on Facebook.

William Fisher, a justice of the Worcester Town Court, agreed to the admonition by the State Commission on Judicial Conduct and pledged to be more careful about his social media use in the future, according to the commission’s decision.

The home Fisher entered previously belonged to relatives of his wife, who was a co-executrix of the estate, the commission said.

The home was sold in 2012 to a person not named in the decision. The buyer was behind on mortgage payments when Fisher entered her home without giving notice in January 2015, the commission said.

He took several photos of the home, which the commission said was in a state of disorder. He posted seven of those photos using his wife’s Facebook account with a caption that said his wife’s relatives “are turning over in their graves.”

The post was visible to the public, including the buyer who took screenshots of it on her phone. 

In March 2017, the commission requested court records about three occasions when the buyer’s then-domestic partner was a defendant before the Worcester Town Court. The buyer was not mentioned in the letter.

Fisher replied to the commission’s request with the records along with several Facebook posts by the buyer, where she asked her friends to contact the commission about him, the commission said.

One month later, Fisher posted photos to his personal Facebook account from when he entered the buyer’s home without permission. He wrote in the post about how she had previously fallen behind on mortgage payments.

Fisher told the commission in July 2017 that he would immediately remove the post. He did not take the photos down until November 2017 and the post itself was public until February 2018.
“Judges carry with them the mantle of judicial office both on and off the bench,” said Robert Tembeckjian, administrator of the commission. “They must therefore always be mindful that inappropriate personal behavior may undermine public confidence in the judiciary and result in discipline, as it did here for Judge Fisher.”

Fisher has been a justice in Worcester Town Court since 1991. Michael Breen, an attorney with a practice in Middleburgh, New York, who represented Fisher, declined to comment on Thursday.

Full Article & Source:
Upstate NY Judge Admonished for Entering Resident's Home, Sharing Photos on Facebook

Bank restores stolen funds to 112-year-old Texas man

AUSTIN, Texas (AP) — Bank of America has credited the account of a Texas resident who is believed to be the oldest man in the U.S. after his family reported that thieves had stolen his identity and drained the account.

Richard Overton's family said Social Security and bank account numbers for the 112-year-old Austin man were used to make seven withdrawals over the past several months. The family filed a police report Friday .

Cousin Volma Overton said the family was shocked when the bank asked them to come in and sign for the restored funds. He declined to say how much money was stolen, but said it was a "significant amount."

"Man, I teared up," Volma Overton said. "I couldn't believe it. They made it happen. The executive of the company said he'd take care of this, and he took care of it."

Bank spokeswoman Colleen Haggerty said the bank is investigating and the family said Austin police and federal authorities are also looking into it.

"Everyone wants to get to the bottom of this. I don't think it's going to be long before we know," Volma Overton said.

The money was separate from a 2015 online campaign that raised more than $300,000 to provide for Richard Overton around-the-clock, in-home care. He is the nation's oldest World War II veteran and was at Pearl Harbor just after the Japanese attack.

Full Article & Source:
Bank restores stolen funds to 112-year-old Texas man

See Also:
Thieves empty bank account of 112-year-old Richard Overton, oldest living WWII vet

Thursday, July 5, 2018

Judges’ punishments should be public

By CJ Baker

A Cheyenne judge apparently did something she shouldn’t have.

The Wyoming Commission on Judicial Conduct and Ethics put out a news release last month announcing that Laramie County Circuit Court Judge Antoinette Healy had been disciplined with a “private censure.” That means the commission — which oversees discipline of Wyoming’s judges — issued Healy a confidential document expressing disapproval with something she did.

Whatever that something was, it was serious enough that the commission ordered Healy to take a legal class and to pay $15,990.28 to cover the expense of investigating and punishing her. The commission also apparently thought that, while the public didn’t need to know what Judge Healy did, it was important for the citizens of Wyoming to know she had been punished.

It’s hard to follow that logic.

We aren’t privy to any of the facts of this case, which makes it difficult for us to second-guess the judges, attorneys and private citizens who make up the Commission of Judicial Conduct and Ethics.

But we can say that the state and commission should do away with private censures: Our judges are some of the most powerful and highly compensated public officials in our state and if they engage in misconduct, they should be publicly disciplined.

As the Wyoming Tribune Eagle noted in a report last month, the commission’s rules give it the option of censuring, reprimanding or admonishing a judge privately.

Private discipline generally indicates that a judge’s misconduct was relatively minor. But the secret, confidential nature of the discipline leaves a whole lot to the imagination — especially as citizens consider whether they want to vote to keep that judge on the bench.

“It’s both unfair to the voter and unfair to the judge, frankly,” attorney Bruce Moats, who often represents Wyoming newspapers in open government issues, told the Tribune Eagle. “Unfortunately for the judge … it allows speculation and suspicion. [And] if the public has to go up and vote on retention, and you don’t know what [the conduct] is, it can certainly significantly affect that.”

The Wyoming State Bar Association similarly can impose private punishments when it disciplines an attorney.

But it’s a mistake to put judges on the same scale as lawyers. As Moats noted to the Tribune Eagle, “There is a difference between the discipline of an attorney, who may be acting totally privately, as opposed to someone that is holding public office.”

Further, these are public officials who wield tremendous power.

A few words from a judge can bring a lifetime in prison or financial ruin; they decide who can see their children and for how long; they decide whether someone can present their case to a jury; and they review decisions made by lawmakers, county commissioners and city councils.

Judges also enjoy a lot of discretion and their decisions are given great deference; in some cases, an appellate court will overturn a decision only if the original judge’s ruling “exceeded the bounds of reason.”

It makes perfect sense that judges are given the ability to tailor their decisions to the wide range of cases and people that pass before them — and that the judge who actually hears a case is given the benefit of the doubt on appeal.

But it also means our judges can and should be held to extremely high standards. If a judge is found to have engaged in misconduct or acted unethically, the voting public should know. There is no reason for a judge who has effectively been “convicted” by the commission to be afforded special protections.

Part of the reason we believe misconduct should be made public is that the overwhelming majority of our judges take great pains to follow the rules.

As Wyoming’s dozens of judges handled hundreds of thousands of cases last year, the Commission of Judicial Conduct and Ethics dealt with a total of 23 verified complaints. According to the commission’s annual report, 20 of the 23 were dismissed or withdrawn, while the commission issued just one letter of caution, one letter of correction and one censure — which, in that 2017 case, the commission chose to make public.

In short, discipline is rare, and when it happens, we, the voting public, should know about it. Private or, in this case, quasi-private discipline serves no one well.
Full Article & Source:
Judges’ punishments should be public

Court upholds decision barring pastor/judge from death penalty cases

Judge Wendell Griffen
A three-judge panel of federal appeals court on Monday dismissed a lawsuit testing the boundary between religious liberty and judicial restraint.

The 8th U.S. Circuit Court of Appeals ruled 2-1 that Arkansas Judge Wendell Griffen’s lawsuit challenging his disqualification from hearing death-penalty cases must be dismissed. The ruling overturns a lower court decision that Griffen, who also serves as a Baptist pastor, can sue justices of the Arkansas Supreme Court for discipline based on the judge’s moral views on capital punishment.

Griffen, pastor of New Millennium Church in Little Rock, Ark., claims the Supreme Court justices violated his constitutional rights when they permanently barred him from presiding over death penalty cases after he joined fellow church members in an anti-death penalty demonstration on Good Friday in 2017.

Judge Griffen responded with a lawsuit claiming his religious views on the death penalty have nothing to do with his ability to rule impartially on matters of secular law. Griffen claims the disqualification was in retaliation for his exercise of free speech and religion rights as an African-American.

U.S. District Judge James Moody ruled April 12 that Griffen stated a plausible claim and the lawsuit could move forward. In an unusual procedural move, however, two appeals court judges said Monday the lower court judge got the case wrong and ordered the decision reversed.

U.S. Circuit Judges Steven M. Colloton of Des Moines, Iowa, and Duane Benton of Kansas City, Missouri, said the ban on death penalty cases applies only to Griffen’s role as a public employee and protects an interest by the state to ensure integrity of the courts. A third judge, Jane Kelly of Cedar Rapids, Iowa, filed a dissenting opinion saying the majority went too far in dismissing the case in its entirety.

Griffen’s lawyer, Mike Laux, said he and his client “are indeed disappointed” by the ruling and will seek reconsideration by the full 8th Circuit Court of Appeals.

“We have known since day one that this was going to be an uphill battle every step of the way,” Laux said on social media. “Cases like this are never cakewalks, but we are undaunted and prepared to continue this important fight for this great judge.”

New Millennium Church is an interracial congregation affiliated with the Cooperative Baptist Fellowship and Association of Welcoming and Affirming Baptists. The church has been affiliated with CBF since its formation in 2009 but this year for the first time boycotted the group’s annual national gathering to protest hiring practices that discriminate based on sexual orientation and gender identity.

“We refuse to engage in a charade whereby claims about professed devotion to the Great Commission of Jesus and buzz words such as ‘big tent’ and ‘denomi-network’ are used by CBF to justify excluding married LGBTQ Baptists from mission field and other employment opportunities,” Griffen explained in a recent blog.

Last year CBF officials including Executive Coordinator Suzii Paynter traveled to Little Rock to show support for Griffen’s right to serve simultaneously from the pulpit and the bench.

“Those who serve in government are not disqualified from having religious beliefs and exercising their religious beliefs in ways that are protected by law,” Paynter said at a rally organized by religious and civil rights leader in June 2017.

Full Article & Source:
Court upholds decision barring pastor/judge from death penalty cases

Rhode Island News: Rhode Island Governor Gina M. Raimondo signs 183 bills, including legislation expanding access to contraceptive care

PROVIDENCE, RI – Rhode Island Governor Gina M. Raimondo this evening signed and vetoed 188 bills.  She vetoed three laws (five bills), including the so-called Peter Falk bill, a bill requiring sellers of real estate disclose to potential buyers if the premises were used for marijuana cultivation and a bill related to surplus line insurance.

In vetoing the Peter Falk bill (H 8352 as amended/S 2421 as amended), Governor Raimondo acknowledged the good intentions of the bill which aimed to reduce elder abuse, but noted concerns raised by senior advocates. Maureen Maigret, Chair of the Aging in the Community Subcommittee of the Long Term Care Coordinating Council; Meg Underwood, Rhode Island Senior Center Directors’ Association; Kathy McKeon, Catholic Social Services; and Kathy Heren, Rhode Island’s Long-Term Care Ombudsman. Elder advocates and advocates for Rhode Islanders with disabilities along with the Rhode Island Division of Elderly Affairs and the Rhode Island Department of Behavioral Health, Developmental Disabilities, and Hospital are concerned that there was not sufficient engagement in crafting this legislation and cite many potential unintended consequences for Rhode Island. Governor Raimondo is committed to working with advocates and legislators next year to pass a version of the bill that better protects Rhode Island’s most vulnerable seniors. Her veto message is available here.

A full list of bills transmitted today will be released by the Governor’s Office tomorrow.  There is no additional legislation awaiting Governor Raimondo’s action.

Full Article & Source:
Rhode Island News: Rhode Island Governor Gina M. Raimondo signs 183 bills, including legislation expanding access to contraceptive care

Wednesday, July 4, 2018

’Til Death (or Lack of Profits) Do Us Part Healthcare: Humana’s Debut in Hospice

As nonprofits ceased to dominate the hospice field in recent years and for-profits became the majority players—according to the New York Times, for-profits controlled 63 percent of the sector as of 2013— quality of care has arguably decreased while fraud and overbilling has increased. NPQ has been following the changes to the hospice industry for years, and while it is possible these issues plaguing hospice can be chalked up to correlation, not causation, it seems more probable that the hospice industry’s lack of standards coupled with its high profit potential make it ripe for fraud by dishonest providers.

With profit margins as high as 16 percent, it comes as no surprise that for-profit companies want a piece of the pie and have eagerly joined the industry. The New York Times estimates that since the year 2000, the number of for-profit hospice providers has “more than quadrupled.” In this time, dozens of lawsuits have found for-profit outfits guilty of a wide variety of infractions ranging from inappropriately accepting patients into hospice, to substandard care, overbilling, and even causing untimely death. Throughout it all, hospice providers have received “slap on the wrist” penalties with no real changes to the industry occurring.

Part of the reason there are few changes being made to the industry is that the field itself is rather subjective. In the face of terminal illness, some physicians and patients opt for aggressive treatment, whereas others do not. In some cases, it seems to be as much a personal decision as it is a medical one. While the National Hospice and Palliative Care Organization has put out a tip sheet on compliance, even this indicates that “each patient and his or her symptoms will differ.” The subjective nature of the field does not lend itself to strict standards and, to reiterate previous NPQ conclusions, may be another reason that hospice should stay within the nonprofit sector. Without a profit motive, nonprofit organizations are better able to focus on quality care and keep the patients’ best interest front and center.

With Humana entering the game, now there’s a new player with added cause for concern. Humana is partnering with private investors to purchase two hospice providers, Kindred and Curo. Both providers have already faced steep penalties: Kindred for overbilling and Curo for providing kickbacks to physicians referring patients to its facilities. Humana’s foray into hospice represents one of the first insurers to do so and, as one of the largest private Medicare agencies, they stand to reap in huge profits as they work with patients from health through death.

What is particularly concerning about Humana’s involvement is that Humana would benefit from its customers opting for hospice over expensive end-of-life treatment. The New York Times article explains:
“An insurer that can steer patients towards its hospice has ‘better control,’ said Rob Smith, an analyst with Capital Alpha Partners. After giving consent, dying patients can be shifted to the hospice program, and while an insurer would lose out on money it received from Medicare to cover that person, a company like Humana could count on the revenue generated by its hospice business. ‘Your other pocket is filled by Medicare,’ he said.”
The same issues plaguing the hospice industry stand to be exacerbated in the case of Humana unless the company sets its own high standards for hospice eligibility. When hospice providers operate independently, they still need to convince patients to come to their facility. That would explain why providers such as Curo provided incentives for physician referrals. With Humana dominating private Medicare and owning its own hospice outfits, they can technically funnel patients into their facilities.

With Humana entering the hospice field, it’s only a matter of time before other insurers jump on board as well. This idea of ’til-death-do-us-part healthcare from for-profit entities smells incredibly fishy and opens up an already problematic industry to even more duplicitous behavior. Meanwhile, patients and families are in their most vulnerable position and need help that is not clouded by greed. While the hospice field seems to be moving away from nonprofit hospice providers, it stands that this is the best model for the industry.—Sheela Nimishakavi

Full Article & Source:
’Til Death (or Lack of Profits) Do Us Part Healthcare: Humana’s Debut in Hospice

MCSO: 92-year-old Fountain Hills woman shot, killed son over assisted living plans

Anna Mae Blessing
FOUNTAIN HILLS, AZ (3TV/CBS 5) - A 92-year-old woman shot and killed her 72-year-old son because he wanted to put her in an assisted living facility, according to the Maricopa County Sheriff’s Office.

In what MCSO described as a "bizarre turn of events," Anna Mae Blessing is facing one charge each of first-degree murder, aggravated assault with a deadly weapon and kidnapping.

Deputies were called out to the Fountain Hills home where Blessing had been staying with her son, Thomas, and his girlfriend at about 10 a.m. Monday.

"According to statements provided by suspect Blessing and received by the detectives, she had been contemplating for several days her son’s intentions to place her in an assisted living facility," explained a news release from MCSO. "Blessing retrieved two pistols and concealed them in the pockets of her robe then confronted her son in his bedroom."

MCSO said she shot her son twice before turning the gun on his 57-year-old girlfriend.

While struggling with that woman, whose name has not been released, Blessing lost her grip on the gun. But she still had the second one.

"Blessing retrieved the second handgun and attempted to point it at the girlfriend, who knocked it from Blessing’s possession," according to MCSO.

The girlfriend is the one who called MCSO.

She told deputies Thomas and Blessing had been living with her in her Fountain Hills home for several months.

When deputies arrived on the scene, they ordered Blessing to come outside but were met with silence.

"As deputies continued clearing the residence, they located the [Blessing] seated in a recliner inside her room [and she] continued to disobey commands," according to the arresting officer.

"As the suspect was being escorted from the residence, she made a spontaneous statement to the effect of 'You took my life, so I'm taking yours,'" court documents read. "(It was later determined during an interview with the suspect, she believed her life was being taken as a result of her son ... and his girlfriend ... attempting to place her into an assisted living facility.)"

According to the probable cause for arrest statement, Blessing "intended to kill herself, however she didn't possess any additional firearms."

In speaking with Blessing, investigators learned that she had had the two guns -- a revolver and a .25 caliber pistol -- since the 1970s. The first she said bought at a gun store; the second was given to her by her husband before he died. She also told deputies the last time she fired either of the weapons was in the '70s.

"The suspect stated she stored the two handguns on the floor, under a shelf in her bedroom," according to court documents.

"The suspect was asked what she thinks should happen to her, which she replied she should be 'put to sleep' as a result of her actions," the arresting deputy wrote in the probable cause statement.

"This is definitely an odd one," MCSO Sgt. Bryant Vanegas told Arizona's Family. "There's a lot of circumstances surrounding it, of course, but it's definitely something you don't see every day and it's very unfortunate that this took place."

[Blessing] made a spontaneous statement to the effect of 'You took my life, so I'm taking yours.'
~ Court documents for Anna Mae Blessing

"It is always concerning when domestic issues escalate to violence or tragic outcomes," Sheriff Paul Penzone said in a statement. "They are often isolated and neither predictable nor preventable."

According to court documents, there was a history of domestic violence between Blessing and Thomas, including at least one incident in which police responded.

"I don't know the incidents, but I know that we've responded there before," Vanegas said.

A  judge set a cash-only appearance bond for Blessing in the amount of $500,000 and scheduled a status conference and preliminary hearing for later this month.

[PDF: Anna Mae Blessing's court documents]

Arizona's Family

Full Article & Source:
MCSO: 92-year-old Fountain Hills woman shot, killed son over assisted living plans

South Florida Judge Ordered to Immediately Step Down From Bench

Judge Dana Marie Santino
The Florida Supreme Court Monday ordered Palm Beach County Court Judge Dana Marie Santino off the bench, giving her hours to leave office. Its July 2 ruling removed the embattled judge from the bench, effective 5 p.m. that day.

The Palm Beach County judge has been battling to keep her seat, since the Florida Judicial Qualifications Commission panel filed a notice of formal charges against Santino in light of unsavory tactics employed against Gregg Lerman, her political opponent during the 2016 election.

In September 2017, the JQC recommended the judge’s removal, alleging Santino aimed “to win at all costs” and “pay the fine later.”

Santino was alleged to have paid consultants to create an array of campaign material for her, including a Facebook page titled “Taxpayers for Public Integrity.”

“Attorney Gregg Lerman has made a lot of money trying to free Palm Beach County’s worst criminals. Now he’s running for judge!” read one of the Facebook pages.

Accompanying text went on to link criminal defense lawyer Lerman with identity theft, rape, child pornography, drug trafficking and murder.

Santino was also featured in an October 2016 interview with Fred Hadley of the Village Sentry, where she said, “I find it hard to believe [Lerman] can go into the courtroom and be impartial and identify with the victim of a crime or the prosecution’s side of the case.”

Santino at the time admitted to “making mistakes” during the election, but denied that any of her actions violated Florida law, insisting she was fit to remain on the bench.

Neither the judge nor her attorney, Jeremy Kroll of Bogenschutz Dutko & Kroll, responded to requests for comment by deadline. But Kroll had asked the high court, which has the final word on judicial discipline, to reject the JQC’s recommendation.

“Judge Santino deeply regrets the campaign violations that underlie this proceeding and will take no steps in this pleading to justify or minimize them,” he wrote on the judge’s response to the high court’s Sept. 28 order to show cause. “Respondent, however, demonstrates good cause why the hearing panel’s legal conclusions and recommendations should not be approved by this court.”

A divided Supreme Court denied the judge’s request.

Justices Barbara Pariente, R. Fred Lewis, Peggy A. Quince and Jorge Labarga were in the majority, while Chief Justice Charles Canady and Justices Ricky Polston and C. Alan Lawson dissented.

The high court accepted the recommendation by Sumter Circuit Judge Michelle T. Morley, who wrote last September on behalf of the state judicial panel recommending Santino’s ouster.

“We do not make this recommendation of removal lightly, or without due consideration of its severity. We are mindful of — and heavy-hearted about — the testimony of Judge Santino’s witnesses that she is beloved by many, and a judge with a strong work ethic,” Morley wrote in the findings of fact, conclusions of law and recommendations of the hearing panel. “However, were we to countenance her studied and continued refusal to abide by Canon 7, we would ourselves be undermining the rules governing judicial elections.”

It is not known whether administrators received any warning of the decision, so the fate of Santino’s caseload was unclear at press  time.

Santino had practiced law for 16 years before running for office.

Full Article & Source:
South Florida Judge Ordered to Immediately Step Down From Bench

See Also:
Judge removed over campaign misconduct

Palm Beach County judge removed over campaign misconduct 

You can be old at 30 or young at 90 - it’s all up to you

T. Boone Pickens at his 90th birthday party in Dallas, Texas on May 19, 2018
I’ve always been in a hurry. I know I’m racing against time, and now more than ever. But I have not lost my competitive spirit, and, in some ways, it’s personal.

My father passed away at 90, peacefully, in his sleep. Last month I turned 90 myself, and I’m laser-focused on beating my dad in the longevity race. And I have reason to be optimistic. Not long ago my longtime physician told me he had good news and bad news. The good news: he thinks I’ll live to be 113. The bad news: he told me when I get there I wouldn’t be able to see or hear.

“Hell,” I joked with him. “I’m already there.”

This optimism comes despite one of the darkest years of my life, health wise. Last July, I wrote that I had suffered a Texas-sized fall that required hospitalization. That wasn’t all – I had suffered a series of ministrokes in December 2016. Right before the fall, I had recovered 85 percent of my speech and cognitive skills. The fall was a major setback. My speech was badly affected. The months afterward involved daily intensive speech therapy all week, every week.

The fall made me more determined than ever. I wrote then that I would never let age be an obstacle, and I’ve stuck by that. Several times in my life have I been the epitome of the “Old Man Makes a Comeback” story, and this year has been no different. It has been, in some ways, one of my strongest comebacks. Here’s a little update since my fall.

After intensive physical and speech therapy, I was beginning to feel more like myself. I was able to travel and maintain a level of activity that I enjoy. In February, the New York Stock Exchange launched a new exchange-traded fund (ETF) with the ticker symbol BOON, the first ETF named in honor of an individual. BOON allows investors the opportunity to invest in many of the America-first energy policies espoused in the Pickens Plan I unveiled 10 years ago next month. In May, I rang the NYSE closing bell on the trading floor. I dined at the 21 Club in New York, reliving the glory days when I would do power breakfasts in Dallas and lunch in New York on the same day.

Perhaps the most exciting event – in May, I celebrated my 90th birthday. Five hundred friends and family from both coasts and everywhere in between came to Dallas for a Texas-sized party. Some sent me videos wishing me well (with a few jokes at my expense). It was incredibly special and the meaningful event put my health challenges on the backburner, at least for a day.

At times I still struggle. It is often difficult to have my words drag behind my still crystal-clear thinking. Speech therapy is helping, but for someone who values communication, it could always be better. I continue to share my sharpest thoughts and opinions online and on social media, on LinkedIn and Twitter and elsewhere. Some find my age-old wisdom even more relevant in today’s current events.

I understand there are some things that I simply won’t be able to do again, including two of my favorite activities: quail hunting and golfing. I’m now a poor quail shot and I can’t hit a golf ball up my pant leg. But with frustration comes acceptance, and embracing the things I still am able to do. I’m convinced you can be old at 30 or young at 90, and it’s all up to you. Heck, it seems like just yesterday I scored an eagle on the 11th hole at Augusta National.

One thing about turning 90? It’s tough to find people your own age to hang out with. But that’s a rich man’s problem.

I still keep an active office and go there every day. Retirement isn’t an option for me. When you retire you have time to do what you love, and I love to work. I’ve got two brilliant young interns that remind me constantly of the incredible potential of our next generation. I enjoy giving them opportunities and embracing and empowering their ambitious and entrepreneurial spirit. It reminds me of when I was first striking out on my own, and I’m glad to help keep that spirit alive and well in America.

So, from getting back on my feet to celebrating a major milestone and getting back to doing what I enjoy and do best, it’s been a good year. My goal for the next year is simple: keep doing what I’m doing – just stay on two feet and don’t fall again.

Full Article & Source:
You can be old at 30 or young at 90 - it’s all up to you

Tuesday, July 3, 2018

Barratry and Personage : How the BAR Associations and Professional Predatory Guardians Traffic the Elderly and Disabled.

Declaring the living individual dead to enable the theft of the estate.


Barratry, a term that is now referred to as archaic, rarely, if ever, appears in the legal lexicon. It is the act of knowingly bringing false claims and charges against a targeted individual by members of the BAR Associations. And, it is the result of “the frequent incitement of lawsuits and quarrels that is a punishable offense.” 


Every such individual ever forced into one of these pseudo “courts” that are in reality, tribunals, has suffered barratry and been subjected to a foreign jurisdiction and form of “pseudo law”, within which they were specifically disabled and unable to defend themselves. These unconstitutional tribunals were specifically created for this purpose: to leave the individual totally unable to defend themselves against a system devised to render them without any rights or protections. The Constitutional authority for these tribunals has been argued under the 1st, 3rd and 4th Articles of the Constitution, the sheer number of these treatises being a clear indication that they are not Constitutional.

Next, is the use of personage ( a term redefined for obvious reasons). Both barratry and personage are crimes against the individual by members of the BAR. Both of these criminal acts are used to enact foreign statutory law against living people. Foreign to the people, as statutory law circumvents the natural rights and liberties guaranteed in the Constitution and erects a legal fiction contradicting and adverse to the Constitution Bill of Rights, to directly benefit its creators. Which is exactly the only purpose of statutes.


The term “personage” has now been redefined to mean a person of importance or rank. Originally, it meant to assume another individuals’ identity with the intent of accessing their property; an act criminally prosecutable.
Today we recognize personage as identity theft. Of course its only a crime if you do it…if a member of the BAR Association does it in collusion with a for-profit guardian intent on availing themselves of your identity with the intent of fraudulently accessing your assets, it is not a problem; just all in a day’s work. Once the identity theft has been secured, testamentary powers are gifted to the predators who now present themselves as the civilly dead person so that the liquidation of the estate assets can begin in earnest.

Personage was known to be the act of knowingly mis-characterizing the living man or woman as deceased in the law, and then assuming their identity and by extension, access to all their assets. The purpose of knowingly misrepresenting the living human being as deceased (statutory civil death), is exactly what occurs in probate tribunals across the country. This is the ultimate in identity theft. It is also human trafficking with the intent to profit and precisely what happens every day of the week in these administrative tribunals across the country.

These criminal acts defraud and deprive individuals of their life, liberty and property. The collateral consequences and damages that result from the many times exaggerated and fabricated claims of eminent danger to, or from, the victim seldom have any validity. But none is needed in these kangaroo tribunals and rarely is any ever produced or required.

As a result, the ensuing collateral damages to the victim and the intended heirs are civil and regulatory (statutes) and so are not subject to, or applicable to, criminal punishment under actual law.

But the real perk in all of this criminal activity is the clever arrangement that forces the targeted victim to pay all expenses of any kind associated with the unwarranted actions against them by the very predators who bring those actions.

In fact, probate determinations, including the ensuing identity theft and theft of property and the individual’s freedom have been carefully constructed to avoid the Constitution and any rights or protections contained therein. And successful identity theft in these tribunals is totally dependent upon the hearing examiner, around whom all activities and proclamations pivot.

Probate Administrative Tribunals: How the living human being is declared dead, while still breathing

Probate administrative tribunals are to become active only upon presentation of the death certificate. The only supposed intent of the tribunal is to determine if the death is testate, or intestate; meaning with a will or without a will and to make sure that the estate is distributed in the manner the deceased intended.

So how does the living human being become subject to a tribunal that is supposed to become active only upon presentation of a certificate of death?

And how does this fictional death allow for the theft of estates, the disinheriting of families and designated heirs? The discarding of pre-standing legal instruments and instructions is pivotal in the theft of the assets and this is routinely done by hearing examiners, (euphemistically “judges”) working in tandem with predatory guardians and unethical attorney’s and law firms.

An individual subject to probate suffers a statutory civil death. This civil death is equal in its legal consequences to an actual physical death. The victim cannot speak, defend or otherwise refute the claims of the predators. Rarely are they even allowed into one of these kangaroo tribunals and, when they are, they are they are often intentionally drugged with any number of psychotropic drugs to make them appear delusional and dysfunctional. The hearing examiner is fully aware of what is taking place, but since they they receive an annual percentage of the value of the estate just for operating this kangaroo tribunal, they aren’t about to say a word. In fact, this whole operation pivots around the collusion of the hearing examiner, with the predators.

Supposedly, an adult ward of the state is protected by law once he/she is deemed incapacitated ( formerly, incompetent). But the guardian now has control over all monetary and property decisions. As such, they now present themselves as the lawful owners of the property in question including access to all bank accounts or investments and property.

The loss of legal status that is the result of guardianizing the living individual and declaring them dead in the law, is an inherent element of criminal—not civil, punishment. This “civil death” is usually the result of conviction of a crime. But, what crime did the newly declared dead person who is still alive and breathing, commit? Where is the injured party? What damages resulted from the victims actions? Apparently, aging with assets that someone else has decided they want, is now a crime.

It is precisely because no crime has been committed that the targeted victim is subjected to the probate tribunal. There has been no crime, no injury to another, no damages that could be addressed in an actual court of law. No state or federal laws have been violated that would have come into play and which would have required they be brought into an actual court of law.

It would seem to me that if you are intent on depriving a targeted victim of their identity, this should be done in a civil court, where evidence would have to be provided under oath attesting to the charges being levied. Let a jury decide if your personal identity should be taken from you and gifted to a professional predator that most likely has a long and sordid history of preying on those they perceive to be vulnerable.

Once the living individual is subjected to probate, now having suffered a civil death, they are not allowed to speak. After all, dead people can’t talk…can they? And while many friends or family members are willing to care for the individual, they are not allowed to speak either. Then the transcripts from the hearings read as if no one stepped forward willing to care for the individual. That is, if you can even obtain a transcript. In virtually every probate tribunal across the country, all video, audio and court transcriptionists have been done away with. In many cases, even the individuals present in these tribunals are prohibited from hiring their own transcriptionists or recording or taping the proceedings. And of course now, with all of the growing outrage over this trafficking of the elderly through this predatory system, the public is not allowed in to view first hand the overwhelming corruption, violations of rights and dehumanizing activity facilitated by these tribunals and are prevented from being present in the tribunal to witness the corruption first hand.

The generally unfounded claim of “incompetence” has been replaced with the word “incapacitated”. Incompetence required some form of evidence if enough pressure could be applied to the predators to prove their claims. That evidence was usually obtained by obtaining a written diagnosis of mental impairment from an on-board psychiatrist who rarely ever interviews the victim, but claims upon hearsay evidence from others involved that XYZ mental illness is present and therefor the victim was incompetent.

Incapacitated, on the other hand, can mean simply that you have a bad cold that is causing you to spend your time in bed recovering. It can mean virtually anything, or more than likely means nothing at all, and usually does. And of course, that attorney and potential guardian can make any number of false and exaggerated claims in a probate tribunal without ever producing any evidence that what they say is true or valid. And don’t even think about attempting to present any countering evidence to refute the claims of these predators. The hearing examiner will not allow or accept any evidence that refutes the allegations made by those who are anticipating profiting from the estate.

As the number of retirees grows, so does the number of sociopathic predators who make their living preying on the public. This is a dangerous time to be an elderly or disabled individual in this country.

  Powers of testamentary guardian  
28. Where a guardian has been appointed by will or other instrument, his power to mortgage or charge, or transfer by sale, gift, exchange or otherwise, immovable property belonging to his ward is subject to any restriction which may be imposed by the instrument, unless he has under this Act been declared guardian and the Court which made the declaration permits him by an order in writing, notwithstanding the restriction, to dispose of any immoveable property specified in the order in a manner permitted by the order.

Also found in: Dictionary, Thesaurus, Medical, Financial, Wikipedia.


In Criminal Law, the frequent incitement of lawsuits and quarrels that is a punishable offense.

Barratry is most commonly applied to an attorney who attempts to bring about a lawsuit that will be profitable to her or him. Barratry is an offense both at Common Law and under some state statutes. The broader common-law crime has been limited by certain statutes. An attorney who is overly officious in instigating or encouraging prosecution of groundless litigation might be guilty of common barratry under a particular statute. The requirement for the crime of barratry is that repeated or persistent acts of litigation are performed by the accused. Barratry is generally a misdemeanor punishable by fine or imprisonment. In the case of an attorney, disbarment is the usual punishment. Since few cases have been prosecuted, barratry is considered by the legal community at large to be an archaic crime. This is particularly true today due to a highly litigious atmosphere. West’s Encyclopedia of American Law, edition 2. Copyright 2008 The Gale Group, Inc. All rights reserved.

“It is a crime known as “personage”. By arbitrarily creating an Estate trust named after you and claiming to own this thing they created, they have falsely claimed to own you and your assets and to literally buy and sell “you” on stock exchanges, ship “you” out of ports, and tax “you”…

“Hand in hand with personage comes “barratry” — the crime of knowingly bringing false claims into court. So what happens every day all across America, when charges are brought against the ESTATES of “dead men” who are standing right in front of the judge and jury? Barratry — a crime that is appropriately named after the “Bar Association”.

Full Article & Source:
Barratry and Personage : How the BAR Associations and Professional Predatory Guardians Traffic the Elderly and Disabled.

New law bars trafficking of vulnerable adults

As they pored over the laws that go into effect Sunday to further protect vulnerable adults, Rickey Coates and William Loomer of the local personal care home task force found themselves nodding along in acknowledgement and agreement.

The big asset is the new law prohibiting the trafficking of a disabled or elderly adult.

“It’s going to be awesome,” said Loomer, an investigator with the Augusta Judicial Circuit’s district attorney’s office. District Attorney Natalie Paine chose to lead the Crimes Against the Vulnerable and Elderly unit that she created last year, which has made a number of local arrests.

The Georgia Legislature followed Paine’s and a few other prosecutors’ lead when it wrote a bill, now law, calling for the formation of multidisciplinary teams to investigate suspected abuse, neglect and exploitation of elderly and disabled adults. It requires that all reports to Adult Protective Services also be copied to the district attorney, something that didn’t necessary happen before now.

The new law waives any repercussions for sharing information about a possible victim with members of the investigative teams, such as CAVE in Richmond, Columbia and Burke counties, Loomer said. It also enables employees of banks and other financial institutions to share information if they suspect someone is exploiting a vulnerable adult.

The new law also allows someone who reports suspicions of abuse, neglect or exploitation to ask whether the report was received, if an investigation was opened and if the investigation is still open or closed. The new law doesn’t allow for much sharing, but before, a reporter couldn’t learn if anything was done with a report.

What Loomer and Coates, a prosecutor and CAVE team member, are really looking forward to is the new law prohibiting the trafficking of vulnerable adults. For example, the new law spells out what coercion means – not only causing or threatening physical harm, but also restraining, threatening to or actually exposing embarrassing or personal information, or threatening to or actually destroying or confiscating personal identity, medical and public assistance documents.

CAVE members have seen victims afraid to leave a bad personal care home because the owner has taken their driver’s licenses and benefit cards, Coates said. If the owners took those documents and kept them in a file with all the other information about patients, that’s fine, Loomer said. But every time they have gone in to investigate a bad home they have had to chase down all of the patients’ personal identity documents, which is time-consuming and difficult enough when you know what to do, he said. For some patients, it is overwhelming, Loomer said.

The new law also contains the element of “deception” and spells out what it means.

Someone cannot promise to provide care when they have no intention of providing any services, Coates said. That is now criminal. The law also spells out “isolation,” another tactic CAVE members have seen employed to control victims. It means preventing a vulnerable adult from having contact with family, friends, a welfare agency, police or health provider.

“The law isn’t asking (personal care owners or caregivers) to do anything they shouldn’t already be doing,” Coates aid.

The basic elements of the new trafficking law involve promising to care for a vulnerable adult with no intention of doing so for the purpose of collecting their asset for personal use while controlling the victim through exploitation, deception or isolation.

If there are two or more victims, it is a crime punishable by five to 20 years. If there are three to 10 victims, the punishment range is 10 to 20 years, and if there are 10 or more victims, the punishment is 15 to 25 years with a mandatory 15 years in prison without parole. Each violation is also punishable by a fine of up to $100,000.

Full Article & Source:
New law bars trafficking of vulnerable adults

OIG Puts the Pressure On as Hospice Fraud Cases Pile Up

In March 2018, Health and Palliative Services of the Treasure Coast and two of its businesses paid $2.5 million to settle a False Claims Act (FCA) case related to hospice billing.

A month later, Horizons Hospice agreed to pay more than $1.2 million to resolve allegations that the company fraudulently billed Medicare and Medicaid for services to patients who did not have a life expectancy prognosis of six months of less.

Both settlements came more than a year after Chemed Corporation (NYSE: CHE) and various wholly-owned subsidiaries—including Vitas Hospice Services and Vitas Healthcare, the biggest for-profit hospice chain in the country—agreed to pay a whopping $75 million to resolve a government lawsuit with similar allegations.

As utilization has increased and companies have more widely shifted toward high-margin profit models, claims of fraud, waste and abuse in the hospice industry have become increasingly common.  So much so that, in fact, the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) has made hospice investigation a substantial portion of its active work plan.
Since the end of 2016, OIG has announced or revised plans for at least seven different hospice-related audits, evaluations and inspections, a Home Health Care News review found.

“The Medicare hospice program is an important benefit for beneficiaries and their families at the end of life,” the watchdog organization stated. “OIG and others have identified vulnerabilities in payment, compliance and oversight, as well as quality-of-care concerns, which can have significant consequences both for beneficiaries and for the program.”

Patients and taxpayers are at the front lines of those affected by the rise in fraud and improper billing, but scrupulous hospice providers are also being hurt.

For the many businesses that are free of red flags, it’s becoming more difficult to go up against competitors who aren’t exactly playing by the rules, an executive from a West Coast family-owned home health and hospice company with nearly 3,000 patients told HHCN.

“Some of the companies out there kind of just want to come in, see an opportunity to maybe generate a little bit more capital for themselves, and they’re really just rendering services that aren’t within the benefits of hospice,” the exec, who asked for anonymity to avoid backlash, said. “It gives the whole industry a black eye.”

The ‘cost of doing business’

The list of U.S. Department of Justice FCA cases against hospice companies in recent years is long and rapidly growing. Other prominent examples include Genesis HealthCare’s $53.6 million settlement in 2017, Evercare Hospice and Palliative Care’s $18 million settlement in 2016 and Guardian Hospice of Georgia’s $3 million settlement in 2015.

The number of civil cases against hospice providers also appears to be steadily trending upward.

“Right now, as we speak, I’m working on about five hospice fraud cases,” Mark Schlein, an attorney with Los Angeles-based law firm Baum, Hedlund, Aristei & Goldman, told HHCN. “In the past—even just six or seven years ago—that was only one case, at most, at a time. From my perspective, my hospice and fraud practice has grown dramatically, which reflects the problem in the health care fraud arena and is a small example of what’s going on nationwide.”

Mike Bothwell, attorney and founder of Georgia-based Bothwell Law Group, also has a hefty load of FCA cases targeting hospice providers, he told HHCN. Sometimes, identifying a suspect hospice company seems as easy as throwing a dart toward a map of  providers, he said.

“I think that I have filed something along the order of 15 different hospice fraud cases,” Bothwell, who represented whistleblowers in the 2015 Guardian Hospice case, said. “I think that I did my first hospice case in the late 90s or early 2000s—they didn’t really used to come up on my radar.”

The most widespread type of hospice-related fraud or improper billing is providers wrongfully admitting patients who are ineligible for care, according to the attorneys. Currently, to meet Medicare eligibility requirements, patients need to have their hospice doctor and primary care physician certify that they have six months or fewer to live. Patients also need to choose palliative care over curative care, except in certain demonstration programs.

Closely related to improperly admitting patients is improperly retaining patients when they are clearly not actively dying, though hospice rules do require hospices to regularly assess patient conditions.

“By improperly admitting and improperly retaining, the corrupt hospice company increases its patient census, which, of course, means more money to the hospice company,” Schlein said. “The more patients you have on hospice, the more that the government pays you.”

Besides accepting and keeping ineligible patients, other common types of hospice wrongdoing include the use of kickbacks to bolster referrals and the tactic of unnecessarily or fraudulently categorizing patients in more intensive care levels with higher reimbursement rates, such as for general inpatient care, typically referred to as GIP.

Routine home care services during a patient’s first 60 days of being on hospice were reimbursed at a rate of $190.55 per day last year, according to the National Hospice and Palliative Care Organization (NHPCO). GIP, meant for pain control and symptom management that can’t be handled in other non-facility settings, was reimbursed at $734.94 per day.

“Sometimes, you see GIP stays that are really extraordinary for certain diagnoses,” the West Coast hospice executive said. “There are certainly individuals who play that game.”

Fraud is inherently deceptive, meaning the total cost of all hospice fraud is almost impossible to calculate and largely unknown at this point.

What is known: Just the act of fraudulently placing patients in higher care categories costs Medicare hundreds of millions of dollars each year. Hospice providers billed about one-third of all GIP stays inappropriately in 2012, costing Medicare $268 million, the most recent OIG report on the issue found.

Overall, the Department of Justice opened 967 new criminal and 948 new civil health care fraud investigations during its 2017 fiscal year, according to a joint annual report with HHS.

“It’s fair to say that most companies engaging in fraud or cheating the government recognize that getting caught and paying a fine has become a cost of doing business,” Schlein said.

NHPCO response, OIG recommendations 

As a demographic group, baby boomers have helped drive attention paid to hospice, seeing value in being able to better control how, where and when they die. The market has seen that value as well, reflected by a string of recent hospice acquisition deals with sky-high valuations.

Fraud and improper billing may exist in the industry, but it isn’t “rampant,” Edo Banach—president and CEO of NHPCO, a not-for-profit hospice and palliative care organization—told HHCN.

“The fact is there are bad players in hospice, as there are in home care and nursing homes, certainly, and hospitals,” Banach said. “Rampant implies it exists across the board, and my experience is [that’s] not the case.

Any instance of improper billing is one instance too many, he said. With that in mind, NHPCO works diligently with Congress, the Centers for Medicare & Medicaid Services (CMS) and its members to make sure hospice providers are providing appropriate care and unlikely to make compliance mistakes.

“A lot of times when I see someone in the news being called out for … defrauding of Medicare, I am both chagrined and somewhat relieved to find out they are not a member of ours, to be honest,” Banach said. “Folks who join associations and take part in educational sessions are less likely to be out and flouting the rules. Where we do see some of our members getting into trouble is because of a difference of opinion about what is medically necessary and what’s not.”

OIG has made several recommendations to CMS to improve hospice oversight.

CMS should reform hospice payments to reduce the incentive for hospices to target beneficiaries with certain diagnoses and those likely to have long stays, OIG recommended. Medicare should also adopt a hospital transfer payment policy to lower hospital reimbursement for beneficiaries who are discharged early to hospice care and seek regulatory changes to establish more specific requirements for the frequency of hospice certification, according to the watchdog.

The FCA is often cited as the most effective means for holding fraudulent providers accountable, Schlein said. Even so, penalties recovered from FCA cases are often far less than the payments improperly received by a hospice, he said.

Treasure Coast hospice, for instance, was accused of defrauding Medicare by up to $72 million, but settled for only $2.5 million without admission of liability, TC Palm reported.

“[Whistleblowers play an incredibly important role in holding providers and companies accountable for committing fraud against the government,” Schlein said. “Still, when fraud is caught, in many cases, they get back only pennies on the dollar.”

How rampant fraud actually is—and what the most effective ways of combating it are—may be up for debate. Nonetheless, it’s safe to say that hospice providers should plan ahead for increased oversight and new policies in the coming months and years.

Full Article & Source:
OIG Puts the Pressure On as Hospice Fraud Cases Pile Up