Saturday, September 8, 2018

Avoidable Sepsis Infections Send Thousands Of Seniors To Gruesome Deaths

No one tracks sepsis cases closely enough to know how often these severe infections turn fatal. But the toll — both human and financial — is enormous, finds an investigation by KHN and the Chicago Tribune.


Willie Jackson ( Photo: Shana Dorsey)
Shana Dorsey first caught sight of the purplish wound on her father’s lower back as he lay in a suburban Chicago hospital bed a few weeks before his death.

Her father, Willie Jackson, had grimaced as nursing aides turned his frail body, exposing the deep skin ulcer, also known as a pressure sore or bedsore.

“That was truly the first time I saw how much pain my dad was in,” Dorsey said.

The staff at Lakeview Rehabilitation and Nursing Center, she said, never told her the seriousness of the pressure sore, which led to sepsis, a severe infection that can quickly turn deadly if not cared for properly. While a resident of Lakeview and another area nursing home, Jackson required several trips to hospitals for intravenous antibiotics and other sepsis care, including painful surgeries to cut away dead skin around the wound, court records show.

Dorsey is suing the nursing center for negligence and wrongful death in caring for her dad, who died at age 85 in March 2014. Citing medical privacy laws, Lakeview administrator Nichole Lockett declined to comment on Jackson’s care. In a court filing, the nursing home denied wrongdoing.

The case, pending in Cook County Circuit Court, is one of thousands across the country that allege enfeebled nursing home patients endured stressful, sometimes painful, hospital treatments for sepsis that many of the lawsuits claim never should have happened.
My father was like my best friend. Most people go to their mom to talk and tell all their secrets, and for me it was my dad.

Shana Dorsey
Year after year, nursing homes around the country have failed to prevent bedsores and other infections that can lead to sepsis, an investigation by Kaiser Health News and the Chicago Tribune has found.

No one tracks sepsis cases closely enough to know how many times these infections turn fatal.

However, a federal report has found that care related to sepsis was the most common reason given for transfers of nursing home residents to hospitals and noted that such cases ended in death “much more often” than hospitalizations for other conditions.

A special analysis conducted for KHN by Definitive Healthcare, a private health care data firm, also suggests that the toll — human and financial — from such cases is huge.

Examining data related to nursing home residents who were transferred to hospitals and later died, the firm found that 25,000 a year suffered from sepsis, among other conditions. Their treatment costs Medicare more than $2 billion annually, according to Medicare billings from 2012 through 2016 analyzed by Definitive Healthcare.

In Illinois, about 6,000 nursing home residents a year who were hospitalized had sepsis, and 1 in 5 didn’t survive, according to Definitive’s analysis.

“This is an enormous public health problem for the United States,” said Dr. Steven Simpson, a professor of medicine at the University of Kansas and a sepsis expert. “People don’t go to a nursing home so they can get sepsis and die. That is what is happening a lot.”

The costs of all that treatment are enormous. Court records show that Willie Jackson’s hospital stays toward the end of his life cost Medicare more than $414,000. Medicare pays Illinois hospitals more than $100 million a year for treatment of nursing home residents for sepsis, mostly from Chicago-area facilities, according to the Medicare claims analysis.

Sepsis is a bloodstream infection that can develop in bedridden patients with pneumonia, urinary tract infections and other conditions, such as pressure sores. Mindful of the dangers, patient safety groups consider late-stage pressure sores to be a “never” event because they largely can be prevented by turning immobile people every two hours and by taking other precautions. Federal regulations also require nursing homes to adopt strict infection-control standards to minimize harm.

Yet the failures that can produce sepsis persist and are widespread in America’s nursing homes, according to data on state inspections kept by the federal Centers for Medicare & Medicaid Services. Many of the lawsuits allege that bedsores and other common infections have caused serious harm or death. The outcome of these cases is not clear, because most are settled and the terms kept confidential.

Cook County, where the private legal community is known to take an aggressive approach to nursing homes, has more of these suits than any other metro area in the U.S., KHN and the Tribune found by reviewing court data.

State inspectors also cite thousands of homes nationally for shortcomings that have the potential to cause harm. Inspections data kept by CMS show that since 2015 94 percent of homes operating in Illinois have had at least one citation for conditions that increase the risk of infection. These citations include care related to bedsores, catheters, feeding tubes and the home’s overall infection-control program.

“Little infections turn to big infections and kill people in nursing homes,” said William Dean, a Miami lawyer with more than two decades of experience suing nursing homes on behalf of patients and their families.

Much of the blame, regulators and patient advocates say, lies in poor staffing levels. Too few nurses or medical aides raises the risks of a range of safety problems, from falls to bedsores and infections that may progress to sepsis or an even more serious condition, septic shock, which causes blood pressure to plummet and organs to shut down.

Staffing levels for nurses and aides in Illinois nursing homes are among the lowest in the country. In the six-county Chicago area, 78 percent of the facilities’ staffing levels fall below the national average, according to government data analyzed by KHN.

Matt Hartman, executive director of the Illinois Health Care Association, which represents more than 500 nursing homes, acknowledged low staffing is a problem that diminishes the quality of nursing care.

Hartman blamed the state’s Medicaid payment rates for nursing homes — about $151 a day per patient on average — which he said is lower than most other states. Medicaid makes up about 70 percent of the revenue at many homes, he said.

Last October, CC Care LLC, an Illinois nursing home group that specializes in treating mentally ill patients on Medicaid, filed for bankruptcy, arguing that the state’s “financial troubles have been disastrous for all nursing homes.”

In a July court filing, CC Care creditors’ committee argued that the company couldn’t stay afloat relying on Illinois Medicaid payments, which it called “slow, erratic and significantly less than what we are due.”

Pat Comstock, executive director of the Health Care Council of Illinois, said nursing homes she represents “are operating in an increasingly difficult environment in Illinois, yet they continue to prioritize delivering the best care possible to residents in a safe and secure setting.”

A Festering Complaint

Shana Dorsey remembers her father as a quiet but friendly man. He worked as a uniformed bank security guard and picked up extra cash fixing neighbors’ cars in an empty lot adjacent to his West Side apartment building. He was a stickler for detail, who relished teaching his granddaughter the state capitals and was always ready to lend a hand to help his daughter, who now works for a Chicago property management firm.

But age and declining health caught up with the Army veteran, who by his early 80s began to exhibit signs of dementia and moved into an assisted living apartment.

Dorsey knew her dad needed more specialized care when she found him sitting in his favorite peach recliner in his apartment, unable to get up and incontinent.

He required more intense medical and personal care as his kidney disease worsened and he became more confused, medical records show. In his last 18 months of life, he cycled in and out of hospitals eight times for treatment of septic bedsores and other infections, according to court records.

The Chicago law firm representing Dorsey, Levin & Perconti, provided KHN and the Tribune with medical records and additional court filings that cover Jackson’s care.

Jackson had two pressure sores in late November 2012 when he was first admitted to Lakeview nursing center from the Jesse Brown VA Medical Center in Chicago, according to lawyers for his daughter.

These wounds healed, but in late September 2013, Jackson spiked a fever and had an infected sore in his lower back that exposed the bone, causing what Dorsey’s lawyers called “significant pain.”

The nursing home transferred Jackson to Presence St. Joseph Hospital in Chicago, where surgeons cut away the dead skin and administered antibiotics. At that time, the sore was as wide as a grapefruit and had “copious purulent drainage, foul smell and bleeding,” Dorsey’s lawyers argue. Tests confirmed sepsis, and the wound had grown so deep that it infected the sacral bone in his back, a condition known as osteomyelitis, the lawsuit said.

In November 2013, Dorsey moved her father to another nursing home. He required three more hospital visits before Dorsey made the difficult decision to place Jackson in hospice care. He died March 14, 2014, from “failure to thrive,” according to a death certificate.

In her suit, Dorsey, 39, argues that Lakeview nursing staff knew Jackson was at “high risk” for bedsores because of his declining health. Yet the home failed to take steps to prevent the injuries, such as turning and repositioning him every two hours, according to the suit. That didn’t happen about 140 times in August 2013 alone, Dorsey’s lawyers said.

“My father was like my best friend. Most people go to their mom to talk and tell all their secrets, and for me it was my dad,” Dorsey said in a November 2015 deposition.

While Lakeview declined to discuss Jackson’s treatment, it has denied negligence and argued in court filings that its actions were not to blame for Jackson’s death. Lockett, the home’s administrator, said the facility “strictly follows” all regulations to minimize the effects of skin breakdowns that can occur naturally with age.

“We are grateful for the daily opportunity to enhance the lives of seniors and other chronically ill populations in our community,” Lockett said in a statement.

Infection Control

Poor infection control ranks among the most common citations in nursing homes. Since 2015, inspectors have cited 72 percent of homes nationally for not having or following an infection-control program. In Illinois, that figure stands at 88 percent of homes.

Illinois falls below national norms for risks of pressure sores or failure to treat them properly in nursing homes. Inspectors have cited 37 percent of the nation’s nursing homes for this deficiency, compared with 60 percent in Illinois, according to CMS records. Only three states were cited more frequently.

Inspectors in November 2016 cited Alden Town Manor Rehabilitation and Health Care Center in Cicero, Ill., for neglect due to its care of an unnamed 83-year-old man with pressure ulcer sores that went untreated. Gangrene had set in by the time the staff sent him to the hospital, where surgeons ended up amputating his right leg above the knee, according to the inspectors’ report and citation. Alden Town Manor had no comment.

Dean, the Miami lawyer, said that nursing home staffs often miss early signs of infection, which can start with fever and elevated heart rate, altered mental status or not eating. When those symptoms occur, nurses should call a doctor and arrange to transfer the patient to a hospital, but that process often takes too long, he said.

“They don’t become septic on the ambulance ride over to the hospital,” Dean said.

There is little agreement over how much staff should be required in nursing homes. Federal regulations simply mandate that a registered nurse must be on duty eight hours per day, every day. In 2001, a federal government study recommended a daily minimum of 4.1 hours of total nursing time per resident, which includes registered nurses, licensed practical nurses and certified nursing assistants, often referred to as aides. That never became an industry standard or federal regulation, however.

Most states set requirements lower and face industry resistance to raising the bar. A California law requiring 3.5 hours per resident as of this July 1 is drawing intense criticism from the industry, for instance.

In addition, staffing can fluctuate, particularly over the weekends. A recent KHN investigation found that on some days, nursing home aides could be in charge of twice as many residents as normal.

At a minimum, Illinois requires 2.5 hours of direct care daily for residents. Yet federal nursing home payroll data show that at least 1 in 4 Chicago-area nursing home residents live in facilities that aren’t consistently providing that much care, KHN found.

Nationally, each aide is responsible for 10 residents on average; in the six-county Chicago area, the average is 13 residents per aide.

Federal officials have linked inadequate staffing to bedsores and other injuries, such as falls. If left unattended, even a small ulcer or sore can become septic, and once that happens, a patient’s life is in imminent danger.

In October 2014, Milwaukee-based Extendicare denied wrongdoing but paid $38 million to settle a federal False Claims Act lawsuit that accused it of not having enough staff on hand in 33 nursing homes in eight states, including Indiana, and failing to take steps to prevent bedsores or falls.

In other cases, federal officials have alleged that some nursing homes overmedicate residents — which can result in injuries such as falls from beds or wheelchairs and bedsores — rather than staff up to care for them properly.
Little infections turn to big infections and kill people in nursing homes.

William Dean, a lawyer who represents patients and their families
In May 2015, owners of two nursing homes in Watsonville, Calif., agreed to pay $3.8 million to settle a whistleblower lawsuit alleging the homes persistently drugged patients, contributing to infections and pressure sores.

The suit alleged that an 86-year-old man who could barely move after receiving a shot of an anti-psychotic medication lost his appetite and spent most of the day in bed, “was not turned or repositioned and developed additional pressure ulcers.” He ran a 102-degree fever, but the staff failed to notify his doctor for three days, according to the suit.

Hospital doctors later diagnosed the man with sepsis and an infected pressure ulcer. The home did not admit wrongdoing and had no comment.

Personal injury lawyers and medical experts say that poor infection control often sends nursing home residents to hospitals for emergency treatment — and that the stress can hasten death.

Elderly people often “don’t have the ability to bounce back from an infection,” said Dr. Karin Molander, a California emergency room physician and board member of the Sepsis Alliance advocacy group.

That odyssey of multiple, stressful trips to the hospital is a common thread in negligence and wrongful death lawsuits involving sepsis or bedsores. KHN identified more than 8,000 suits filed nationwide from January 2010 to March of this year that allege injuries from failing to prevent or treat pressure sores and other serious infections.

Molander said serious bedsores indicate “someone is being ignored for an extended time period.”

“When we see patients like that we file [patient neglect] complaints with adult protective services,” she said.

Some of these cases led to million-dollar jury verdicts. In 2017, a Kentucky jury awarded $1.1 million to the family of a woman who suffered from bedsores and sepsis in a nursing home. In a second case last year, a jury awarded $1.8 million to a widow who alleged a Utah nursing home failed to turn her husband often enough to prevent bedsores, which led to his death.

Lawyers filed more than 1,400 of the cases from January 2010 to March of this year in Cook County Circuit Court, which tops all metro areas across the country in the KHN sample.

Nursing homes complain that garish billboards to solicit clients are a fixture in Chicago, where many attorney websites also boast of recent million-dollar verdicts from bedsore cases alone.

“We see an incredible amount of lawsuits out there,” said Hartman, of the Illinois nursing home association. “We feel we have a target on our backs.”

Trial lawyers counter that nursing homes often try to duck responsibility for poor care by creating complex corporate structures to limit their liability. Yet Hartman derided these suits as “cash cows” for law firms that can rack up six-figure legal fees as cases drag on. The nursing home industry supports tort reforms that would compensate injured persons but also bring a quicker resolution of claims, he said.

“That is something that needs to be fixed in Illinois,” Hartman said.

Avoidable Hospital Transfers

In September 2013, the Centers for Medicare & Medicaid Services said it was working to reduce avoidable transfers from nursing homes to hospitals. CMS had previously called these trips “expensive, disruptive and disorienting for frail elders and people with disabilities.”

The plans came in the wake of a critical 2013 Department of Health and Human Services audit that found Medicare had paid about $14 billion in 2011 for these transfers. Care related to sepsis cost Medicare more than the next three costliest conditions combined, according to the audit.

The auditors have not checked in to see if Medicare has since reduced those costs and have no plans to do so, a spokesman for the HHS Office of Inspector General said.

However, Definitive Healthcare’s analysis of billing data, modeled after the HHS audit, shows little change between 2012 and 2016, both in terms of deaths and costs.

Wendy Meltzer, executive director of Illinois Citizens for Better Care, said that hospital trips caused by treatment for sepsis can be “emotionally devastating” for confused elderly patients.

“It’s not a choice anybody makes. It’s horrible for people with dementia,” Meltzer said. “Some never recover from that. It’s a very real phenomenon and it’s cruel.”

University of Maryland master’s student Chris Cioffi contributed to this report.

This story was jointly produced by Kaiser Health News and the Chicago Tribune by reporters based in Washington, D.C., and Chicago. Fred Schulte is a senior correspondent for KHN and Elizabeth Lucas is data editor. Joe Mahr is a Tribune reporter.

KHN’s coverage of these topics is supported by John A. Hartford Foundation, Gordon and Betty Moore Foundation and The SCAN Foundation
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Avoidable Sepsis Infections Send Thousands Of Seniors To Gruesome Deaths

The lawyer was charged with a $20M fraud, then took a drive 4 years ago. He’s been found

In the four years since Fort Lauderdale attorney Michael Casey rented a car in Tallahassee and drove off as a fugitive, three Broward County residents indicted along with him in a $20 million scam went to federal prison.

Casey? He went to Mexico. Now, he’s in Miami — at the Federal Detention Center.

The 71-year-old’s mail and wire fraud charges remain, legally, in doubt. But on Friday, Casey pleaded guilty to knowingly failing to appear in court after jumping bail before an April 2014 hearing in his fraud case. He will be sentenced in November.

In August 2012, Casey, Louis Gallo and James Howard of Parkland, Rita Balbirer of Coral Springs, and Patricia Saa of Tampa were indicted on stacks of fraud charges related to Commodities Online Management. Saa became a fugitive two months later.

Casey posted $50,000 bond and was confined to the Southern District of Florida federal court jurisdiction, except for trips to visit his mother in North Carolina.

Before a April 29, 2014, case status conference, Casey got permission to drive to North Carolina, visit his mother and drive back. Casey rented a car on April 21 in Tallahassee. He then drove to Laredo, Texas, where he dropped the car off on April 25. Casey was in Mexico by the time he officially was missing for the status conference.

Meanwhile, Howard already had pleaded guilty to one count of conspiracy to commit mail fraud and wire fraud. Gallo did the same six months after Casey disappeared. Gallo’s admission of guilt lays out a smorgasbord of lies used to sucker 700 investors out of about $20 million.

They lied about the usage of investor money. They lied about COL’s bottom line. They faked contracts. They hid Howard and Gallo’s criminal experience (each had a federal conviction on his rap sheet and Gallo was still on supervised release). When Howard was arrested on a state fraud charge, investor money was used for his bail. Among the $2.5 million Gallo used for his family and himself was $300,000 for cars, jet skis and a boat.

Howard was sentenced to 15 years, nine months in prison. Gallo got 14 years. Balbirer pleaded guilty to two counts of money laundering and got 17 months.

Casey came back over the border at some point and was arrested July 2 in the Southern District of Houston federal court district. He gave his income for the previous year as $2,000 from “odd jobs.”
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The lawyer was charged with a $20M fraud, then took a drive 4 years ago. He’s been found

Local man spending time with residents in nursing home

LAKE CHARLES, LA (KPLC) - Most people spend their days off relaxing, watching TV, or sleeping in, but Adam Goodwin spends his Sunday doing something a little different. He comes to the Rosepine nursing home to sit, listen and give back to the residents.

“I’m growing a relationship with them. I come every Sunday. These people are a part of me right now,” says Goodwin.

Goodwin says what inspires him to dedicate his time is the loss of his very own grandmother. He was trying to fill the void he felt when she passed on.

“I felt a void, you know, I came here with the intentions to find me a granny and a papa and next thing you know, I saw so many people that were in need. I said, ‘I got to adopt everybody.’”

Goodwin started a weekly routine of spending his days off visiting those residents, giving company to the often overlooked, bringing them items they may need like blankets and shampoo. He has grown close to one woman named Irene Brooks. She says having reliable company is a nice change.

“Sometimes I don’t have company during the week, but I can count on him, he’ll be there," Irene says.

Goodwin says, “Some of these people, they have no one to talk to and probably been in here for years. And they’re not as fortunate as others to have visitors. What I want to do is be that person. I mean, it’s really awesome, It’s a real good feeling. I’m not rich, I’m far from it man... I mean it costs you no money to have a heart. Hey, if I can make somebody’s day, I’m going for it.”

Brooks says, “I love it, being his grandma.”

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Local man spending time with residents in nursing home

Friday, September 7, 2018


From The Elder Abuse Reform Now's "The Silver Standard News"
The Systematic understaffing of America's nursing homes.

By Joan Hunt

Most Nursing Homes Have Overstated Staffing for Years
A recent analysis by the New York Times and Kaiser Health News confirms what many families of nursing home residents have long suspected—staffing is often inadequate to provide proper care for their loved ones. Records show the number of nursing aides fluctuates significantly from day to day, with particularly large deficits occurring on weekends. In fact, on the lowest-staffed days, personnel take care of twice as many residents as they do on the highest-staffed days.

The analysis is based on a newly implemented system of documenting staff numbers in nursing homes, which has been designed to provide greater accuracy. Thus, records for the first time reveal the extent and magnitude of personnel deficiencies in facilities across America. Approximately 70 percent of 14,000 nursing homes have lower staff numbers than the previous system reported. The average staffing decrease is 12 percent. Records also show that on weekends, 11 percent fewer nurses and 8 percent fewer aides are on duty.

Federal law doesn’t mandate a minimum staff-to-patient ratio. The only requirement is that a registered nurse be on site eight hours a day and that a licensed nurse be on site at all times in certified nursing homes. Data from the last quarter of 2017 disclose that one fourth of the facilities had no registered nurse at work.

Previous Nursing Home Rating System Misled Consumers

Since 2009, Medicare had used a nursing home rating system that assigned from one to five stars to each facility based largely on three criteria. Two of the criteria were derived from unverified self-reported data. Because no procedure was in place to validate the data, it could paint an inaccurate picture of staffing levels.

While the remaining criterion came from annual health inspections conducted by independent reviewers, this assessment could be manipulated. It was possible for nursing homes to anticipate the inspection and temporarily schedule more staff during that time, thus enabling them to inflate their staffing numbers. After the inspection was finished, the staffing would return to its inadequate level. Consequently, the ratings failed to reflect reality, and consumers were misled.

New Nursing Home Rating System Has Greater Accuracy

Now, due to the Affordable Care Act of 2010, which has only recently been implemented, data on nursing home staffing is more accurate. Instead of coming from self-reports, it’s based on daily payroll records. The discrepancies between earlier staffing records and the new records provide evidence that staffing levels reported over the last ten years have been exaggerated. The data shows that even facilities with good Medicare ratings for staffing have shortages in nurses and aides on some days.

Despite the more reliable method of determining staff numbers, the new rating system still has some drawbacks. Medicare assigns stars to facilities by comparing one nursing home to another, which is, in effect, grading on a curve. Therefore, many facilities have kept their ratings, even though payroll records show they have lower staffing levels than previously reported. Although the ratings can be found on Medicare’s Nursing Home Compare website, they aren’t dependable indicators that a facility has enough staff to provide quality care.

Patient Advocacy Group Calls for Congressional Hearings

After the recent report in the New York Times, an advocacy group known as the Elder Justice Coalition (EJC) called for immediate congressional hearings on chronic nursing home staff shortages. Group members are specifically concerned that the shortages have gone unnoticed up until now.

“We’re asking Congress to take a good hard look at staff shortages,” said the coalition’s national coordinator, Bob Blancato, in an interview with the Silver Standard News. “The new system may not be living up to expectations. Perhaps after clarification there could be legislation that would come forward.

“Several things need to be considered: number, quality, and training of staff. If part of the problem in attracting and keeping staff is due to wages that aren’t competitive with other types of medical facilities, this needs to be addressed. There has to be an incentive for people to want to go to work. The lack of workforce required to care for the aging population is a crisis that will be in front of us for years.”

Consequences of Understaffing

Understaffing is one of the causes that underlie elder abuse and neglect in nursing homes: reports Research shows that when staff are overworked and stressed, patients have a higher risk of bedsores, dehydration, malnutrition, weight loss, pneumonia, and infections. The exhaustion that accompanies working in short-staffed conditions can result in mistakes and failures to notice adverse changes in patients’ health. Moreover, frustration that comes from overwork can lead to intentional or unintentional mistreatment.

Tips for Choosing a Nursing Home

Because the current rating system doesn’t guarantee a nursing home is adequately staffed, families of the elderly should investigate candidate facilities thoroughly when the need for placement of a loved one becomes apparent. Assistive Living Today provides the following tips in choosing a home:

⋅    Instead of scheduling a visit, make a surprise visit to get an idea of cleanliness and quality of care. If the facility looks promising, make at least two additional trips to observe meals and activity sessions.
⋅    Check the public record for violations of state code. Note the type of complaints to see if they are related to serious issues.
⋅    Conduct research to see what licenses are required in your state, and ask the facility to show you its credentials.
⋅    Observe the residents to see if they appear happy, well-groomed, and actively engaged.
⋅    Pick a facility that doesn’t have a strong odor. Don’t be fooled by a strong deodorizer scent that may be masking the smell of urine and excrement.
⋅    Ask the facility if it has dieticians and if they can accommodate special dietary needs.
⋅    Since activities are important, inquire whether an activities director is on staff, and find out whether outdoor activities are included.
⋅    If your loved one has a condition requiring special care, such as Alzheimer’s disease or diabetes, ask if the staff has experience in these areas.

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WATCH The Elder Abuse Reform Now's Documentary, THE UNFORGIVABLE TRUTH

The EARN Project website

Verbal abuse complaint against Muskegon County judge dismissed

Judge Kathy Hoogstra
MUSKEGON COUNTY, MI - A judicial commission recently dismissed a complaint filed against Muskegon County Circuit Judge Kathy L. Hoogstra, clearing her of allegations that she verbally abused a county employee.

The complaint was originally filed in March with the state's Judicial Tenure Commission by Muskegon County Deputy Clerk Marcia Wilkes. The commission dismissed the claims as being without merit.

Hoogstra declined to comment on the dismissal. She is a judge in the 14th Circuit Court's Family Court division which hears cases on domestic relations, neglect and abuse and delinquency matters. She was appointed in 2013 and retained the seat in the 2014 election.

Wilkes claimed that Hoogstra verbally abused her in private and within earshot of her co-workers in response to a request from the clerk's office about a missing circuit court file.

"I was frightened and (Hoogstra) was wildly mad and kept going on like a crazy person," Wilkes wrote.

Neither Wilkes nor Hoogstra would comment on the complaint. However, in an email to the clerk's office provided to MLive, Hoogstra claimed Wilkes' request for the document was "unprofessional and offensive."

The Judicial Tenure Commission is an independent state agency responsible for investigating complaints of misconduct among state judges. The 11-person panel made up of lawyers and judges recommends discipline for judges to the Michigan Supreme Court, which rules on whether misconduct had occurred.

A representative from the commission declined to disclose when the body decided Hoogstra's case, saying it was considered internal information.

Sandra Vanderhyde, the 14th Circuit Court administrator, said she was notified about the decision on Aug. 7. The same day, Vanderhyde sent a memo to the county's judges, court staff and the Muskegon County Board of Commissioners announcing the dismissal.

"Judge Hoogstra has always maintained the highest professional standards of conduct in the workplace and wanted her colleagues to know the outcome of this case," Vandrhyde wrote in the memo that was read at the Aug. 7 county board meeting. "She is also very proud of the 14th Circuit Court's administrative staff and their colleagues in the 60th District Court and thankful for their hard work serving the people of Muskegon County."

The incident follows several workplace harassment allegations made against current and former Circuit Court employees. The county recently completed several workplace harassment seminars and training sessions for all county and court employees following the complaints of sexual harassment.

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Verbal abuse complaint against Muskegon County judge dismissed

KC woman posed as relative, exploited elderly veteran. But now she’s paying the price

A Kansas City woman found guilty of exploiting an elderly veteran for money and falsifying medical records has been ordered to serve probation and pay thousands in restitution, according to a news release from the Missouri Attorney General’s Office.

Cheryl Kelly, 52, was charged with one count of financial exploitation of an elderly person and two counts of Medicaid fraud. The incidents happened while Kelly worked as an in-home personal care attendant in 2013.

Prosecutors accused Kelly of abusing her position by depositing the victim’s money from his veteran benefits and Social Security into an account she created under her name and the victim’s name.

She promised the victim she would use the money to take care of his finances but instead used the money to gamble and pay her mortgage and car insurance, the attorney general’s office said.

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Kelly also allegedly pretended to be the victim’s relative — his niece or sometimes his daughter — to hospital staff, social workers and the U.S. Department of Veterans Affairs.

Prosecutors said the misuse of the victim’s money caused him to incur “numerous” overdraft fees and get evicted from his home.

Kelly was also accused of falsifying medical records of the victim as well as another Medicaid recipient.

The attorney general’s office also said Kelly had “falsely represented to Medicaid” that she was providing the victims with in-home health services, including bathing, dressing, grooming and help with administering medication.

The attorney general’s office Fraud Control Unit led an investigation into Kelly’s conduct with help from the Missouri Medicaid Audit and Compliance Unit, the Missouri Department of Health and Senior Services and the United States Department of Veterans Affairs.

A jury found Kelly guilty of the charges in June.

On Tuesday, Kelly was sentenced to five years of probation and ordered to pay $15,000 in restitution and $10,000 in civil penalties, the attorney general’s office said.

“The abuse of elderly Missourians will not be tolerated,” Missouri Attorney General Josh Hawley said in a statement. “And those who abuse our elderly residents, veteran residents, and the Medicaid program will be prosecuted to the fullest extent of the law.”

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KC woman posed as relative, exploited elderly veteran. But now she’s paying the price

Thursday, September 6, 2018

Tonight on Marti's T. S. Radio Network: Whistleblowers With Guest Caroline Douglas

5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST

Caroline Douglas, author of "The Dark Side: A Treatise on Law and Judging", joins us this evening to discuss the generating of fees for favored attorneys, which she describes as the "currency of judging". Nowhere is this more apparent than in the probate system. This includes, but is not limited to excessive hourly rates, unnecessary work, unsupervised and questionable billing and approving bills with cursory or no review or audit. This favoritism for specific attorneys also extends to specific and routinely appointed predatory guardians who work with probate hearing examiners, who appear repeatedly together so often in public records on case after case, that no one could look at this information and conclude that some kind of working relationship has been formed that is predicated on profiting from the estates of the targeted victims.

Quote: Page 311, The Dark Side
"Make no mistake--all kinds of attorney appointment/fees are a significant unregulated industry, which routinely is operated to deplete savings and assets of incapacitated people--who cannot avoid or even get rid of the scam of court appointed experts. In any other forum, this insider appointment would be called an insider scheme, and, a crime."

LISTEN to the show live or listen to the archive later

Florida hospices accused of defrauding taxpayers get ‘slap on the wrist'

The federal government says hospice fraud costs taxpayers hundreds of millions of dollars. An Action News Jax Investigation has uncovered hospices accused of fraud are only getting a slap on the wrist.

“My signature was on paperwork that I didn’t sign,” said Jacksonville hospice whistleblower Dr. John Simons.

That was one of the first red flags for Simons. He’s a former medical director at Haven Hospice and Hospice of the Treasure Coast.

Hospice is where people go for end of life care, but Simons said he saw a pattern of hospices taking on patients with plenty of life left to live, billing Medicare hundreds of dollars a day.

“There was a CEO down at one point who basically just told us to just do it and shut up. We didn’t have an option,” said Simons. Simons became a whistleblower for the federal government.

The U.S. Attorney’s Office hit both Haven Hospice and Treasure Coast with False Claims Act Lawsuits.

Both hospices settled last year.

That’s not the end of the story. “The penalties don’t meet the crime, if you will,” said Simons.

The government accused Haven Hospice of defrauding taxpayers out of “hundreds of millions,” but Haven only had to pay up about $5 million.

The government accused Treasure Coast – now known as Treasure Health – of defrauding taxpayers out of $72 million. They settled for $2.5 million.

Action News Jax kept digging through federal court records, and found every Florida hospice hit with a False Claims Act lawsuit settled for a fraction of the amount they’re accused of taking fraudulently.

Assistant Special Agent in Charge Brian Martens supervises the Jacksonville and Orlando offices of the U.S. Department of Health and Human Services Office of Inspector General. It’s the federal agency that investigates hospice fraud.

Martens said every Medicare dollar taken fraudulently is a dollar that can’t be used by a dying patient who actually needs it.

He said the money could run out within a decade.

“If your parents are dying or my parents are dying, how do they get the treatment if others have taken that cash?” said Martens.

Action News Jax asked Martens what incentive there is for a hospice to be honest if it could potentially get away with defrauding taxpayers out of hundreds of millions of dollars.

“There is a potential risk that people could be investigated and go to jail,” said Martens. “In a corporate environment, breaking the corporate veil to get to prove something beyond a civil related matter is a difficult thing.”

An Office of Inspector General report last month identified vulnerabilities in the Centers for Medicare & Medicaid Services’ oversight that are putting patients and taxpayers at risk.

The report said the OIG found CMS has no way of penalizing hospices behaving badly, other than cutting off the hospice from the Medicare program.

Action News Jax called every Florida hospice that settled with the government.

None of them wanted to talk, but they asked Florida Hospice & Palliative Care Association President Paul Ledford to do an interview instead.

Action News Jax asked Ledford why the hospices did not want to talk.

“Well, I think most of them view it as sort of a private matter now. They’ve reached a corporate integrity agreement,” said Ledford.

Ledford said False Claims Act lawsuits against hospices more often stem from differences in medical opinions and poor record-keeping than intentional fraud.

“The whistleblowers, invariably, tell a story that’s more dramatic than the facts will bear out,” said Ledford.

Dr. Simons no longer works in hospice care. He was awarded about $1 million as part of the settlements.

Simons said he has little hope that the hospices will change their ways. “The small slap on the wrist -- you know, I think, unfortunately some hospices may continue that behavior,” said Simons.

If you suspect a company is committing health care fraud, you have the power to report it.

Contact U.S. Department of Health and Human Services Office of Inspector General at 1-800-HHS-TIPS (447-8477) or online here

Full Article & Source:
Florida hospices accused of defrauding taxpayers get ‘slap on the wrist'

Federal judge refuses to acquit Cook County judge as she clings to the bench

For months, a Cook County judge found guilty of fraud has refused to step down from the bench, insisting that the federal judge overseeing her criminal case could still overturn the jury’s verdict.

On Tuesday, U.S. District Judge Thomas M. Durkin shut the door on that possibility, denying several motions made by defense lawyers for Jessica Arong O’Brien, including her request for an acquittal or a new trial.

O’Brien now faces sentencing Oct. 9. A jury found her guilty Feb. 15. And though she has been doing little judicial work, she has been paid $148,900 so far this year, according to a state comptroller database.

Steve Greenberg, O’Brien’s attorney, said he was disappointed by Durkin’s 45-page ruling and insisted the government overreached in its case against O’Brien.

He also said, “I think it’s too soon for her to do anything today.”

“Let her have a minute to absorb the ruling,” Greenberg said. “But obviously, if the conviction stands, she’s not going to be able to continue as a judge.”

Federal jurors found O’Brien guilty after prosecutors said she pocketed $325,000 during a mortgage fraud scheme that took place more than a decade ago, before she became a judge.

Despite becoming the rare sitting judge to be found guilty in federal court, O’Brien has fought on multiple fronts to keep her job — and even filed paperwork to seek retention in November’s election.

The Illinois Supreme Court suspended O’Brien’s law license back in April. Then, in July, retired Cook County Judge George Scully pointed to the suspension and asked the Illinois Supreme Court to remove O’Brien from the November ballot.

The state constitution requires a judge to be “a licensed attorney-at-law of this state.” O’Brien is “not authorized to practice law due to discipline,” according to the Attorney Registration & Disciplinary Commission.

The high court has yet to rule.

The Illinois Courts Commission is also set to consider at a Sept. 24 hearing whether to suspend O’Brien from her position without pay. O’Brien’s lawyers have argued the Courts Commission — the body authorized to discipline judges — does not have the authority to “discipline a judge for conduct which occurs prior to the judge’s election to the bench.”

After her indictment in April 2017, O’Brien began to perform administrative duties. Typically that includes presiding over marriages. However, a spokesman for Cook County Chief Judge Timothy C. Evans has said she is no longer even doing that.

Full Article & Source:
Federal judge refuses to acquit Cook County judge as she clings to the bench

Good Deed: Thankful to Rep. Wojcicki for help in passing elder visitation law

Gov. Bruce Rauner recently signed the Kasem-Baksys Visitation Law to help adult children unreasonably being denied visitation with their elderly parent by another family member.

Starting Jan. 1, close family members will be able to petition a court to visit their elder outside of a guardianship proceeding. This last detail is important, because many physically frail elders may still not qualify for guardianship. In other cases, the custodian of an elder who has lost competency may simply not want court interference with de facto powers the custodian has already been exercising.

Picture a blind or wheelchair-bound elder who, while mentally competent, might not physically be able to open the door. Imagine that elder’s reluctance to even try if it would mean angering the sole person providing his care and who owns the home in which the elder has been isolated for weeks or even years.

I couldn’t have asked for a more dedicated and caring lead sponsor for this long-overdue law than Rep. Sara Wojcicki Jimenez, R-Leland Grove. She and her staffer Ryan Melchin marshaled key bipartisan support, resulting in overwhelming bipartisan support in both houses. I also thank Sen. Melinda Bush, D-Grayslake, who carried the bill in the Senate, and Rep. Laura Fine, D-Glenview, the co-lead sponsor in the House.

Sandy Baksys
Leland Grove

Full Article & Source:
Good Deed: Thankful to Rep. Wojcicki for help in passing elder visitation law

Wednesday, September 5, 2018

Florida complaint says judge’s ‘invisible hand’ helped wife, a professional guardian for seniors

Elizabeth "Betsy" Savitt
A Florida woman who the state has charged with abusing her role as a professional guardian received an early boost into the lucrative field from her then-circuit court judge husband, a report said.

A report by the Palm Beach County Clerk & Comptroller’s Office prompted the Florida Office of Public and Professional Guardians to take action against Elizabeth “Betsy” Savitt, according to a Sept. 1 article in the Palm Beach Post.

The state is seeking sanctions on Savitt which include suspending or revoking her guardianship registration and ordering her to pay restitution.

“The action against Savitt is the first of its kind against any guardian by the guardianship office, which was bestowed new regulatory powers by the Florida Legislature in 2016 after an avalanche of complaints about predatory guardians statewide,” the Palm Beach Post report said.

In 2009, the report said, Savitt launched her guardianship career with the help of her husband, Circuit Court Judge Martin Colin, who had presided over guardianship cases.

“Court records indicate that his was an invisible hand establishing his wife” as a professional guardian,” the report said.

At the time he was boosting his wife’s entry into professional guardianship, “the judge’s finances were marked by foreclosures, liens and unpaid debt,” the report said.

The guardianship office alleges Savitt violated state guardianship statutes regarding conflicts of interest as she failed to disclose she was married to Colin. Savitt is also accused of failing to act in good faith and behaving in a manner contrary to her wards’ best interests, the Palm Beach Post report said.

Savitt also continues to serve on cases in which she should have been disqualified, according to the guardianship office’s complaint, which notes that Savitt has earned $190,000 in fees in at least 13 cases in Palm Beach County.

The guardian office cited two of Savitt’s earliest cases in which then-Judge Colin appointed lawyer Sheri Hazeltine as an attorney for another party and Hazeltine’s actions led to Savitt becoming a guardian or guardian advocate for a disabled adult, the report noted. The state accuses Colin of improperly transferring cases to fellow jurists, avoiding random assignments by the clerk’s office.

“In the case of a developmentally disabled woman, Carol Dobrzynski, now 75, Colin never entered an order of transfer and therefore was presiding when his wife was appointed,” the report states, citing the guardianship office’s complaint. “The clerk formally reassigned the case, involving a $290,000 trust, nearly four years later.”

The Post found another judge’s signature “appeared on key orders in one of Savitt’s cases over the printed name of Judge Colin. Savitt tapped the joint account of the senior ward and his wife for $18,000 and overdrew it, leaving his widow complaining to the court to no avail, court documents show.”

In another case, “Colin appointed Hazeltine, positioning Savitt to take over a guardianship attached to a trust worth about $680,000,” the report said.

Hazeltine said she stopped representing Savitt after The Post reported that Savitt “was taking fees from the life savings of her elderly wards without prior court approval.”

Hazeltine told The Post: “I regret it (representing Savitt) insofar as my name and my law firm’s name was being repeatedly associated with her and Judge Colin’s and their actions.”

In 2015, Colin told the Palm Beach Post he never presided over cases involving his wife. “He also denied any conflict of interest in granting fee requests for attorneys who represented his wife and appeared in front of him in other cases,” the Post’s report said.

Colin recused himself from 115 cases that involved his wife’s lawyers in the last six months of 2015 “after The Post started asking questions in its investigation,” the report said.

The guardianship office’s complaint uses the term “conflict of interest” more than 30 times.

After the publication of The Post’s initial investigation, Colin was moved out of the guardianship division. He later announced his retirement.

Full Article & Source:
Florida complaint says judge’s ‘invisible hand’ helped wife, a professional guardian for seniors 

See Also:
Judge Martin Colin had a hand in his wife’s guardianship cases, state says 

Judge in Post series moved from guardianship cases

Chief judge keeps public waiting on details of guardianship shakeup

Guardianships: A Broken Trust: Attorney: "Courts Have Allowed This Culture"

Guardianships: A Broken Trust, 115 Recusals in Six Months

Guardianships: A Broken Trust: Judges Socialized, Planned Trips Together  

Bedsores, neglect, alleged abuse: Inside low-rated VA nursing homes

Helga and Charles Amidon
BEDFORD, Mass. – The nurse’s aide was busy getting a patient ready for bed when she noticed a commotion behind a privacy curtain on the other side of the room. She heard Russ Bonanno, a 94-year-old veteran, shout, “Ow, ow, ow.”

“It sounded like fighting,” said Julee, who asked that her last name not be used out of fear of retaliation. When she went to check what was happening, she saw another aide trying to hoist Bonanno from his wheelchair to his bed, normally a two-person job.

Julee said she watched the other aide simply toss the elderly dementia patient onto the bed.
“Let me tell you how brutal that guy was with the veteran,” Julee wrote to her supervisor two days after the alleged incident May 18. “After he was done, (we) went and checked Mr. Bonanno. The guy was wet. Everything needed to be changed.”

The aide accused of roughly handling Bonanno quietly resigned, but Julee, the aide who blew the whistle, was fired two weeks later. She said her supervisor told her she had attendance problems.

Welcome to one of the lowest-rated nursing homes for veterans in the nation run by the U.S. Department of Veterans Affairs. The facility, at the VA hospital in Bedford, Massachusetts, is among 11 nationwide to earn the lowest-possible one-star rating from the agency based on both overall quality and the results of surprise inspections. The ratings are on a scale of one to five, with one being the lowest.

The others are scattered from Lyons, New Jersey, to Prescott, Arizona, and from Dayton and Chillicothe, Ohio, to Tampa, Florida. 

Full Article & Source:
Bedsores, neglect, alleged abuse: Inside low-rated VA nursing homes

Elder abuse reports, substantiations up in Pennsylvania

A decade ago, investigators substantiated 159 elder abuse cases reported to the Pennsylvania Department of Health. Last year, the number was 1,018, more than a six-fold increase.

The number of abuse reports is up, too. More than 4,200 suspected cases were reported in 2017, a nearly 45 percent rise since 2008.

But agency regulations that shield caregivers from providing even basic information to the public mean little is known about the kind of elder abuse that is prevalent, who is reporting it and what type is more likely to be substantiated.

State officials were at a loss to explain the surge in reports.

"The Wolf administration and the department are committed to ensuring safety for seniors, which includes residents of nursing homes," Nate Wardle, a Health Department spokesman, said in an email. "There is no way of knowing what has caused the increase in reported abuse cases over the last 10 years."

Advocates, however, saw a silver lining.

Diane Menio, executive director of the Center for Advocacy for the Rights and Interests of the Elderly, or CARIE, credited greater awareness for the nearly 60 percent increase in reporting from 2,689 in 2016 to 4,236 last year.

"It's in the news; people are watching and seeing they can make complaints," Menio said.

That wasn't always the case. The Health Department had halted anonymous complaints - even though federal law required the department accept them - for nearly three years. Since reinstituting anonymous complaints in 2015, reporting has steadily climbed.

Still, elder abuse is widely believed to be underreported.

An oft-referenced study out of Boston by the National Research Council touted by advocates as evidence of underreporting estimated only 1 in 14 incidents of elder abuse is reported, and even fewer for financial exploitation, 1 in every 25.

Even though Menio and others - including an industry association and lawmakers - interpreted the increased reporting as a good sign, she also expressed concern that the percentage of substantiated abuse cases - while increasing - remains stubbornly low, only 1 in 4.

"As ombudsmen we struggle with this, that things aren't getting substantiated," Menio said. "It's my sense that they don't get reported unless it's pretty serious."

And what frustrates Menio is that Health Department investigators, she said, do not trust CARIE's ombudsman.

When conducting a performance review released two years ago, state Auditor General Eugene A. DePasquale found staffing cuts and revised policies had negatively impacted the agency's ability to prioritize and respond to complaints.

Full Article & Source:
Elder abuse reports, substantiations up in Pennsylvania

Tuesday, September 4, 2018

Tonight on Marti Oakley's T. S. Radio Network: Abolishing Probate with Teresa Kay-Aba Kennedy

5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST

In 2012, Dr. Lillie Sykes White, was entrapped in an involuntary guardianship by a "family friend" in Florida in order to control her Trust. The estranged granddaughter joined forces with him and waged a multi-year campaign to strip away her grandmother's rights. Dr. White called her only living sibling, Janie Sykes-Kennedy, for help and they have been fighting back the granddaughter and a team of attorneys ever since. In Orange County, where the case started, Ms. Sykes-Kennedy was named Limited Guardian and Trustee per her sister's request. Exploitation escalated when the case was moved to Flagler County where Dr. White lived. Judge Margaret Hudson suspended and then removed Ms. Sykes-Kennedy and unnecessarily appointed three court agents--a Guardian, Attorney ad Litem and Guardian ad Litem--all paid out of Dr. White's assets. On August 30, 2016, Dr. White was abducted by the Guardian and Attorney ad Litem and the family has not seen her since--for over two years. The team of attorneys, including the court agents, are billing large sums against her estate. Dr. White's 90th birthday is on September 6, 2018 and the family wants to celebrate with her but they don't know where she is being sequestered. The family is seeking federal intervention.

Bio: Teresa Kay-Aba Kennedy, or Terri, is a Harvard Business School-trained strategist, entrepreneur, award-winning author and former Vice President at MTV Networks. As President of Power Living Enterprises, Inc., she offers strategy consulting, executive training and motivational content. In 2009, she was named a Young Global Leader by the World Economic Forum recognizing her “professional accomplishments, commitment to society and potential for shaping the future of the world.” You can learn more at she is an Elder Justice advocate and launched in 2016.

LISTEN to the show live or listen to the archive later

Elder abuse in R.I.: Gaming the system is easy for fiscal guardians

Part 7: Judges and advocates for the elderly say that it’s not difficult for court-appointed guardians like Janet Mastronardi to steal from the cognitively impaired clients whose interests they are supposed to be protecting. Mastronardi’s embezzlement came to light, but experts say misappropriation of funds is not always detected.

Attorney Janet Mastronardi admitted to stealing nearly $130,000 while serving as court-appointed guardian for Jane Jacques, an elderly and cognitively impaired stroke victim, and she made full restitution.

But other allegations regarding her billing practices emerged at Mastronardi’s 2014 sentencing hearing. State prosecutor Maureen Keough, now a Superior Court judge, pointed out that civil complaints had been filed against Mastronardi for fee gouging.

Mastronardi, who had pleaded no contest to charges of embezzlement and exploitation of an elder in the Jacques case, was sentenced to seven years in prison, with 30 months to serve on home confinement and the remaining 54 months suspended with probation.

After her sentencing, David Curtin, the state Supreme Court’s chief disciplinary counsel, said that several people called him to complain that Mastronardi had charged them exorbitant fees.

Full Article & Source:
Elder abuse in R.I.: Gaming the system is easy for fiscal guardians

See Also:
Elder abuse in R.I.: Police training is a crucial part of solution

Judge Defers Ruling on Tim Conway Conservatorship Amid Dispute Over Care

A Los Angeles judge issued an order Friday preventing ailing actor/comedian Tim Conway from being moved to a different medical facility amid a growing dispute between his wife and daughter over his care.

Los Angeles Superior Court Judge Robert Wada did not immediately rule on a request by Conway’s daughter, Kelly, to be appointed as her father’s conservator. She has argued in court papers that the actor best known for his work on “The Carol Burnett Show” suffers from dementia and is completely unresponsive.

She expressed concern in court papers obtained by the website The Blast that Conway’s wife, Charlene, was planning to move him out of his existing care facility, where he has a private room and receives around-the-clock care. She argued that such a move would be “harmful to his health and life,” according to the court papers.

But Charlene Conway — who married Tim Conway in 1984 — denied in court papers that she has any plans to move her husband. She claims Kelly Conway’s request to be named conservator was based on a shoddy medical report based on “conjecture” and fabrications.

Attorney Michael Harris, who was appointed to protect Conway’s interests in the dispute, wrote in a court filing that he spoke to Charlene Conway, who also told him she had no intention of moving the 84-year-old actor, according to papers cited by The Blast and People magazine.

“Her concern now is for Mr. Conway to receive proper physical therapy so that he can better improve neurologically,” Harris wrote in his court papers. “It is my present belief that Mrs. Conway, my client’s wife, is an adequate and appropriate steward of her husband’s well-being and that her motives regarding Mr. Conway are in his best interest.”

Harris wrote that Conway suffers from “fluid on the brain” and is unable to communicate.

Wada scheduled another hearing in the matter for Sept. 7. But he ordered that “Mr. Conway’s residence shall not change pending the next hearing.”

Kelly Conway issued a statement after the hearing praising the decision.

“We are grateful to the judge for taking this matter seriously by considering all the evidence before making a decision,” she said. “We appreciate the overwhelming support and love we have received from my dad’s friends and fans.”

Questions about Conway’s health and his care prompted comedian and television legend Bob Newhart and his wife, Ginnie, to issue a statement on social media last week, saying, “We have been friends with Charlene and Tim for many years and want to assure you that he (Conway) is receiving the most devoted care.”

Conway was a performer on “The Steve Allen Plymouth Hour” in the 1950s before landing a role on the comedy series “McHale’s Navy.” But he shot to fame with his work on “The Carol Burnett Show,” with his comic antics often causing on-screen bouts of laughter by co-star Harvey Korman.

In addition to Kelly, Conway and his first wife Mary Anne Dalton had five other children. They divorced in 1978.

Full Article & Source:
Judge Defers Ruling on Tim Conway Conservatorship Amid Dispute Over Care

See Also:
Tim Conway, 84, Suffering from Dementia: He's 'Almost Entirely Unresponsive,' Says Daughter

Tim Conway's daughter gets temporary restraining order against his wife over star's care

Assembly passes Stern’s bill aimed at helping ‘the most vulnerable’

An effort to help Californians most in need, authored by Sen. Henry Stern, D-Canoga Park, passed the Legislature on Thursday, and is now headed to Gov. Jerry Brown for a signature.

Senate Bill 1045 would establish a five-year pilot program authorizing San Francisco, Los Angeles and San Diego counties to create a conservatorship focused on providing critical services and housing to the most vulnerable, who suffer from mental health and substance abuse issues, and who cannot care for themselves.

“Currently, local governments’ hands are tied when gravely disabled Californians experiencing homelessness refuse services,” Stern said. “The old model of conservatorship doesn’t give us the flexibility we need to address the crisis.”

A conservatorship is a court case where a judge appoints a responsible person or organization, called the “conservator,” to care for another adult, called the “conservatee,” who can’t care for himself or herself or manage his or her own finances, according to the Judicial Council of California’s website.
The bill, which was also supported by Scott Wiener, D-San Francisco, essentially expands and strengthens existing California conservatorship laws. 

“People who can’t help themselves are dying on the streets, and our communities suffer with them,” Stern’s office said in a news release. “This law will give our local leaders the power to update and modernize our antiquated and inhumane conservatorship system.”

The five-year pilot program would focus on housing with wraparound services to care for those who are mentally ill or otherwise unable to care for themselves. Under the bill, a county’s Board of Supervisors would have to opt in to the program by a vote via resolution, as is the case under Laura’s Law, and ensure that no resources dedicated to voluntary services and programs are curtailed or diverted in order to support this conservatorship.

Once a county votes to establish such a program, in order for an individual to be considered for conservatorship, an individual must be suffering from serious mental illness and substance use disorder, such that those co-occurring conditions have resulted in frequent detentions under a 5150 hold, or frequently being held for psychiatric evaluation and treatment.  

Los Angeles County officials, through 5th District Supervisor Kathryn Barger’s office, said Thursday they brought forth competing legislation, AB 1791, which was held on the Assembly floor due to concerns over amendments that were added to the bill in the Judiciary Committee, according to Eric Matos, Barger’s deputy in charge of health and legislative affairs.

Matos said both bills work to address issues surrounding conservatorship that have been brought to officials, “particularly, around (the term) grave disability, the concern where individuals who are in need of treatment and they’re having chronic issues, they’re not qualifying for a conservatorship because the current definition lacks the clarity needed.”

The current law is subject to interpretation, Matos said, noting the qualifications for someone to need a conservatorship state an inability to provide one’s self with food, clothing and shelter, however, the definition of shelter, i.e. a home and a lean-to under a freeway underpass could both be considered shelter, as an example.

The bill by Stern and Wiener also requires San Francisco, Los Angeles and San Diego counties to form working groups to assess the effectiveness of this new conservatorship, including collecting data that would be used to determine the effectiveness of the five-year pilot program. 

Full Article & Source:
Assembly passes Stern’s bill aimed at helping ‘the most vulnerable’