Saturday, November 30, 2019

Some nursing homes are illegally evicting elderly and disabled residents who can't afford to pay

“You’re just a piece of garbage,” one evicted nursing home resident said. “They’ll kick you right out on the curb.”
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By Katie Engelhart
BISHOP, Calif. — When Jamie Moore arrived home on a Thursday evening in March, she was surprised to find her mother-in-law in her living room. Glenda Moore, 67, had been sitting in her wheelchair for hours. Without anyone to help her to the bathroom, she’d had an accident. She was also having trouble breathing. “It was awful,” Jamie Moore recalled.

Glenda Moore told Jamie that she had been discharged from the Bishop Care Center nursing home, in Bishop, California. She had been living at the nursing home — a sprawling brick building on the side of a state highway — for several weeks, recovering from a back surgery that unexpectedly left her unable to walk much or take care of herself.

Several days earlier, nursing home administrators had shown Glenda Moore a letter from Medicare, explaining that her rehabilitation coverage was ending. She was unable to pay the nursing home’s more-than-$7,000 monthly fee, so, thinking she had no other options, she left. (A relative dropped her off at Jamie’s home, where Glenda Moore had lived previously, without telling Jamie.)

“They pushed her out and she was not ready,” Jamie Moore, who has worked as a nursing assistant, said. “She was not ready at all.”
Glenda Moore went to a nursing home to recover from a back surgery that unexpectedly left her unable to walk much or take care of herself.
Glenda Moore went to a nursing home to recover from a back surgery that unexpectedly left her unable to walk much or take care of herself.Valerie Bischoff / for NBC News
As the family later learned, Glenda Moore had the right to appeal the Medicare decision, or to apply for Medicaid — and, if she qualified (which she later did), to stay in the nursing home on Medicaid for as long as she needed nursing care. Instead, Moore’s family said, Moore became one of thousands of Americans discharged against their wishes or evicted from nursing homes each year. (The Bishop Care Center maintains that Moore's health had improved and that she voluntarily left the facility, and points out that they gave her a document noting her right to appeal the Medicare decision.)

Nationally, long-term care ombudsmen, who advocate for elderly and disabled residents of nursing homes and assisted living facilities, received 10,610 complaints about discharges and transfers in 2017, up from 9,192 in 2015. The ombudsmen, whose work is federally mandated and state-funded, receive more complaints about discharges and transfers than any other grievance.

The complaints likely expose just a small fraction of the problem, said Kelly Bagby, vice president at the AARP Foundation, a nonprofit that serves vulnerable people over 50.

“Most people don’t even know they have rights,” she said. And many complaints never result in a formal state investigation.

Advocates, experts and the federal government say that nursing homes tend to evict low-income, longer-term residents who receive Medicaid, to make room for shorter-term rehabilitation patients who are covered by Medicare. Medicare reimburses nursing homes at a higher rate than Medicaid, so it’s more lucrative for facilities to house Medicare patients who stay for short stints before recovering and moving elsewhere.

In California, for example, the average state Medicaid reimbursement for a nursing home is $219 per day, according to the California Association of Health Facilities, while Medicare may reimburse more than $1,000 per day, but only for up to 20 days, when patients must begin paying part of the fees. (Medicare coverage ends completely after 100 days.) Advocates say that eviction notices are often handed out around the 20-day mark.

“It is illegal to discriminate against residents based on payment source, but it happens all the time,” said Tony Chicotel, attorney at the California Advocates for Nursing Home Reform, a nonprofit that supports long-term care residents in the state. “It feels like there’s just a tidal wave of cases.”

Chicotel said he receives calls every day from panicked residents or family members being threatened with discharge from a long-term care facility.

Deborah Pacyna, director of public affairs at the California Association of Health Facilities, a trade association representing nursing homes, told NBC News that improper and illegal discharges are “a really rare thing,” and that the issue is exaggerated by media attention.

She added that California’s Medicaid program, Medical, does not provide “adequate funding” to care for many patients with complicated health issues and behavioral disorders. “Medicare pays more. Those people are rehab patients; they’re in and out,” she said. “That is how they break even,” she added of nursing homes. “Society’s problems are manifesting themselves on the doorsteps of nursing homes.”

‘You’re just a piece of garbage’

Nursing homes are legally permitted to evict residents under several conditions: if a resident’s health improves sufficiently; if his presence in a facility puts others in danger; if the resident’s needs cannot be met by the facility; if he stops paying and has not applied for Medicare or Medicaid; or if the facility closes. Facilities are obligated under federal law to give 30 days’ notice, in writing, and also to work with the resident on a transition plan.

Bagby, of the AARP, said that while some residents are issued formal discharge letters with advance notice, others are asked or pressured to leave with “no due process rights, no notice.”

In one case in Los Angeles, in April 2018, Ronald Anderson said he was woken at night by the nursing home staff at the Avalon Villa Care Center and told he was being evicted. Anderson, 51 at the time, had moved into the facility over a year earlier to recover from a partial foot amputation. He said he was loaded into a van and dropped off on a sidewalk in downtown Los Angeles, which has one of the largest homeless populations in the country, according to a report from the California Department of Public Health.

Anderson, who is diabetic, was left in a wheelchair without his insulin or testing supplies — on a street cluttered with tent encampments and broken glass. The Department of Public Health report noted that he could have slipped into a coma or died.

“You’re just a piece of garbage,” Anderson said, from the Union Rescue Mission homeless shelter in Los Angeles where he now lives. “They’ll kick you right out on the curb.”
Ronald Anderson now lives at the Union Rescue Mission homeless shelter in Los Angeles.
Ronald Anderson now lives at the Union Rescue Mission homeless shelter in Los Angeles.Valerie Bischoff / for NBC News
Avalon Villa Health Care, which runs the nursing home, later paid $450,000 to settle a civil complaint filed by the Los Angeles city attorney in response to Anderson’s case and other evictions of homeless residents, with the money going toward civil penalties, hiring and training Avalon Villa staff and finding temporary housing for the facility’s homeless residents. The city attorney set up an emergency hotline and invited members of the public to report cases of resident abandonment.

A lawyer for the Avalon Villa Care Center told NBC News that the facility “strongly disputes that it has inappropriately discharged any patients” and “rejects the allegations of the city attorney.”

The Rev. Andy Bales, director of the Union Rescue Mission, said “resident dumping” from nursing homes and hospitals is so common that the shelter set up a security camera outside — which Bales calls “the dump cam” — to capture evidence of it. He said he is aware of at least four instances from the last year in which people have been dropped off on nearby streets by hospitals or nursing homes — though he believes the number is higher. As a result of the security camera, he said, “They won’t dump them off in front of us anymore.”

California’s long-term care ombudsmen received 1,404 complaints about nursing home evictions in 2018, up from 1,022 in 2014. Several lawsuits concerning nursing home discharges have recently been filed in the state.

Molly Davies, a California long-term care ombudsman, said that in addition to receiving more complaints about evictions, “there has also been an uptick in the egregiousness of some of these cases.”

In some instances, she and other experts said, nursing homes drop residents off at a low-cost motel and pay for a night or two. “We’ve seen cases with residents who have dementia put into a van and dropped downtown onto the streets, without the ability to care for themselves,” she said.

The California Department of Public Health does not track where nursing homes discharge patients, according to a department spokesman, nor does the California long-term care ombudsman program. In some instances, however, routine state inspections and inspections following complaints uncover problems.

In a 2018 incident, described in a California Department of Health and Human Services report, a Rosemead nursing home discharged a resident to a hotel without any medical equipment and without ensuring that the hotel was “a safe environment.” The female resident still required assistance with activities such as using the toilet and bathing, and was found to lack “the capacity to make her needs known.” The nursing home received a federal “deficiency” citation.

In another case that resulted in a deficiency citation, a nursing home resident who “needed extensive assistance” to move between locations in his bedroom was discharged to a motel — and, a few days later, ended up in a hospital for emergency care.

These practices are not unique to California. In Maryland, one nursing home resident was dropped off in Baltimore, a city she had never been to, according to the state attorney general’s office. In another instance, a Washington County Sheriff’s deputy accused a nursing home of discharging a resident to a storage unit on a hot summer day.

Even when residents appeal eviction decisions through a state process and win the right to return to a nursing home, that nursing home sometimes refuses to readmit them, a group of plaintiffs told the Ninth Circuit Court of Appeals found in July. The case is still pending, but the appeals court agreed with the plaintiffs that federal law does not allow “meaningless show trials that allow nursing homes to persist in improper transfers and discharges.”

The California Department of Health Care Services, the California Department of Public Health and the federal Centers for Medicare & Medicaid Services all declined to comment, citing department policy not to comment on pending litigation.

A push for enforcement

In 2016, the Centers for Medicare & Medicaid Services strengthened regulatory requirements around nursing home discharges and transfers, specifying that residents cannot be evicted for nonpayment while they are in the process of applying for Medicaid or appealing a Medicaid denial. A year later, the agency announced an initiative to prevent illegal nursing home discharges, acknowledging that “some discharges are driven by payment concerns, such as when Medicare or private pay residents shift to Medicaid as the payment source.”

So far, the agency has approved $784,630 for a program in California that focuses on training nursing home staff on discharge regulations, a spokeswoman said in an email. The agency also provided $84,00 for a smaller project in Montana. Beyond that, the agency is not acting directly to address illegal evictions but is instead encouraging states “to propose projects that seek to address facility-initiated discharges that violate federal regulations,” the spokeswoman said by email.

Advocates for nursing home patients said more is needed. They want both federal and state agencies to do more to enforce existing rules on evictions.

“We haven’t seen any change in practice,” said Davies, the California long-term care ombudsman. “We haven’t seen a reduction in inappropriate transfers and discharges. There are certain enforcement tools that they have that they aren’t using consistently.” These tools, she said, include substantial fines.

But the federal government has made changes that reduced fines against nursing homes that harm or endanger residents. Nursing homes used to receive fines for each day a violation was observed, but after a change the Trump administration implemented in July 2017, nursing homes are now usually fined just once per retroactive violation.

Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care, an advocacy group, says this change can affect the way illegal evictions are punished. For instance, a nursing home that evicts a patient and refuses to readmit the person may be fined one time, instead of every day that the resident is denied access to a bed.

In the first 18 months following the change in guidelines, nursing homes across the country paid about $47 million less in fines for all violations compared to the previous 18-month period, said Dr. David Gifford, senior vice president of quality and regulatory affairs at the American Health Care Association, the nursing home industry’s main lobbying group.

Gifford told NBC News that the change was not about saving the industry money, but was meant to ensure consistent standards. He said the new fine structure incentivizes nursing homes to report violations and improve resident care.

‘I thought I was completely covered’

After she left the Bishop Care Center nursing home in March, Glenda Moore grew sicker. Over the following weeks, she cycled among her son and daughter-in-law’s home, several emergency rooms and another nursing home an hour away. According to her son and daughter-in-law, she was diagnosed with a bladder infection and pneumonia.

“I don’t want to be a burden on the kids,” Glenda Moore told NBC News in an interview in April. “I had retirement insurance, I had Medicare, I thought I was completely covered. That doesn’t count for anything … I had no idea.”

In May, her family appealed her discharge from the center. At a hearing conducted by the California Department of Health Care Services, the nursing home’s administrator said Glenda Moore had left willingly, according to the state’s summary report.

The state’s hearing officer ultimately found that the facility “failed to meet all of the regulatory-mandated discharge planning requirements.” However, the hearing officer ruled in favor of the nursing home, noting that Glenda Moore agreed to leave and was given paperwork notifying her of her right to appeal Medicare’s noncoverage decision.

By late July, her weight had dropped to about 80 pounds. She was hospitalized, and on Aug. 2 she died from acute renal failure and cardiopulmonary arrest.
Glenda Moore lived for a time with her son and daughter-in-law.
Glenda Moore lived for a time with her son and daughter-in-law. Valerie Bischoff / for NBC News
Her family believes she wouldn’t have become so sick if she had been able to stay in the Bishop Care Center for a few weeks longer, until she was more stable.

Jamie Moore said her mother-in-law’s experience has changed the way she thinks about her own retirement.

“I never thought about it much until now. It scares the crap out of me,” she said. “The system is the system. What are you doing to do?”

Full Article & Source:
Some nursing homes are illegally evicting elderly and disabled residents who can't afford to pay

Top 7 Celebrity Estates Impacted By Alzheimer’s Disease

In honor of Alzheimer’s Awareness Month - and the more than five million Americans living with the disease - we highlight our Top 7 Celebrity Estates impacted by Alzheimer’s disease:

1. Rosa Parks

The legendary civil rights icon died at age 92 in 2005, suffering from Alzheimer’s disease. Her death set off a series of legal battles over her estate that continue to this day, 14 years later.

Rosa Parks’s estate plan left her assets to a charitable institution she created. But her nieces and nephews challenged the validity of her will and trust, due to her mental deficiencies and allegations of undue influence.

That claim was eventually settled, giving the relatives a 20% share of her assets. But that settlement was far from the end. Since then, there have been ongoing fights over broken deals and leaked secrets, claimed mismanagement of her estate and assets, allegations of bribery and corruption, and a lengthy battle over requested sanctions based on Rosa Parks’s missing coat that she wore at the time of her famous arrest at the Alabama bus stop in 1955.

For an iconic lady whose life was marked by grace, dignity, and self-sacrifice for the greater good, it’s especially tragic that her estate and legacy have been tarnished in ways that she never could have imagined.

2. Gene Wilder

The family of the late actor – famed for movies such as Willa Wonka & the Chocolate Factory and Blazin’ Saddles – raised awareness about the terrible effects of Alzheimer’s disease after he died in 2016.

Luckily, his widow - his fourth wife, Karen - and his adopted daughter did not fight over Gene Wilder’s estate after he died, a testament to the importance of good estate planning. When someone has Alzheimer’s disease, proper wills, trusts, and powers of attorney are especially important.

Instead of a fight, Wilder makes our list because of how his widow used her husband’s struggle - which she kept private while Gene Wilder was alive - to bring attention to the terrible disease, including allowing his Willa Wonka character to be used in a video campaign to raise awareness.

3. Aaron Spelling

When famed Hollywood producer Aaron Spelling died in 2006, he left behind a reported fortune worth $500 million. His death certificate listed Alzheimer’s disease as a contributing factor.

Despite his mental struggles late in life, Aaron Spelling changed his estate plan just two months before he died, reducing the share to his daughter, actress Tori, and his son, Randy, to $800,000 each.

Tori’s economic struggles were well-publicized in the years that followed. Even though she felt that the reduction in her inheritance was improper, she did not challenge the estate plan in court.

4. Etta James

Legendary blues singer Etta James passed away in 2012, at 73 years of age. Her family reported that she had been struggling with Alzheimer’s disease for several years. Her illness sparked an ugly court fight between her husband of more than 40 years and her son from a prior relationship over the right to make her medical and financial decisions, including control of her $1 million account.

Etta James’s husband, Artis Mills, alleged that the power of attorney Etta had signed appointing her son, Donto James, as decision-maker was invalid because she was incompetent when she signed it. He sued for control of the money to pay for Etta’s care.

After repeated court hearings, Etta James’s leukemia was determined to be fatal, which led to a settlement. Mills was granted conservatorship and permitted to control sums up to $350,000 to pay for Etta’s care for the last few months of her life.

5. Peter Falk

The famous actor who was best known for his role as Lieutenant Columbo, died at age 83 in 2011, after living with Alzheimer’s disease for years. His wife, Shera, and his adopted daughter, Catherine, fought for conservatorship to make his decisions in a heated court battle.

Shera argued that she had power of attorney and could already legally make Peter Falk’s decisions for him, which included banning daughter Catherine from visits. The judge ultimately granted Shera conservatorship, but ordered a visitation schedule for Catherine. Sadly, a doctor who testified at the hearing said that Falk’s memory struggles were so great that he would likely not even remember the visits.

6. Tom Benson

The billionaire owner of the New Orleans Saints and Pelicans was the subject of a bitter and drawn-out court battle over control of his NFL and NBA franchises, and hundreds of millions of dollars of other assets.

Prior trusts established by he and his late wife left the sports franchises and other business interests to his daughter and two grandchildren. One of them, Rita LeBlanc, ran the Saints as lead owner until she was fired by her grandfather. Tom Benson opted to take the controlling stock of the teams out of the trust and substitute other assets in their place, taking over control of the teams.

His daughter and grandchildren fought the move, until a 2015 court ruling declared Benson to be competent, despite allegations he suffered from Alzheimer’s disease. Benson then changed his will and trust and left everything to his third wife, Gayle

The two sides settled their dispute in 2017, leaving other assets to Rita, her mother and brother, but ultimately leaving Gayle in control of the Saints and Pelicans after Benson’s death in 2018 at age 90.

7. Glenn Campbell

The renowned country singer publicly revealed that he suffered from Alzheimer’s disease in 2011, as he embarked on a final “Goodbye Tour.” He died at age 81 in 2017, leaving behind eight children from four marriages, and his widow, Kimberly.

Kimberly helped spearhead a critically-acclaimed documentary about Campbell’s struggle with Alzheimer’s and has openly talked about the details of her husband’s illness, not only the memory loss, but how it caused him to become paranoid and even violent.

Glenn Campbell’s 2007 estate planning documents cut out three of his adult children, who sued to challenge their disinheritance after he died. In late 2018, they dropped the case, without receiving a settlement. The fact that Campbell’s final will was done a few years before his Alzheimer’s diagnosis was an important factor in the outcome of the lawsuit.

As with the other celebrities on this list, Glenn Campbell’s estate shows how important proper estate planning is - before it’s too late. Wills and trusts that are created or changed after someone is diagnosed with Alzheimer’s disease, dementia or similar conditions are much more likely to be challenged in court, often successfully.

Full Article & Source:
Top 7 Celebrity Estates Impacted By Alzheimer’s Disease

Determining incapacity requires assessing executive function

Adult Protective Services (APS) investigator Darlene B., summoned by a call from a concerned neighbor to Ellen P.’s residence, discovered a pile of trash outside the front door. Inside the home, Darlene noted disconnected electricity, no running water and the overwhelming smell of urine and feces.

Ellen denied she lacked power and insisted the mess was temporary because she was hunting for a lost bill. Asked what APS could do to help her, Ellen claimed the only thing she needed was a limb removed from a tree in her yard. Despite these illogical disclosures, Ellen’s memory and orientation seemed to be intact. How can both family and professionals determine whether Ellen is incapacitated? How can they determine the services needed?

Under Texas law, an incapacitated person is an adult who, because of a physical or mental condition, is substantially unable to provide food, clothing, or shelter for himself or herself, to care for the individual’s own physical health, or to manage the individual’s own financial affairs.

Fortunately for Darlene, her APS contracts with the University of Texas Health Science Center of San Antonio Psychiatric Services division, to make assessments of individuals exhibiting impairments similar to Ellen’s. Darlene requested a comprehensive evaluation of Ellen’s mental capacity. Central to that evaluation is what mental health professionals call “executive function.”

Although an individual may be able to recite what they need to do for themselves regarding hygiene, nutrition, medications, and safety, more important is whether they retain the “executive capacity” to follow through with the tasks required for each.

Texas law requires that before a person can be declared incompetent and a guardian appointed, a licensed physician must declare person to be incompetent through a Certificate of Medical Examination (CME). Unfortunately, the CME by the physician is often completed following a far less comprehensive evaluation than the twelve-hour plus battery of testing Darlene was able to secure. Families faced with a situation like Ellen’s should insist upon an evaluation by a psychiatrist trained in assessing geriatric capacity to adequately determine the mental capacity, care and services appropriate for their loved one.

Full Article & Source:
Determining incapacity requires assessing executive function

Friday, November 29, 2019

Holidays for Nursing Home Residents

The holidays are almost here! Most of us will soon begin to feel a spirit of giving and may think about how to make someone’s Christmas a little merrier. Please don’t forget, there are many nursing home residents who receive very few visitors if any at all.

In fact, statistics prove that 60% of nursing home residents never have a personal visitor. So why not take an hour during this holiday season and go visit your local nursing home. Visitors do not have to know a resident to be able to brighten someone’s day and the joy you will receive, by getting to know some of the most amazing people, will bless you for years to come.

A visit from you is all the gift necessary. However, if you want to provide a physical gift some suggestions for residents might include, house shoes, slipper socks, large print books, lap blankets, puzzles, pictures for their walls, sweat suits, robes, gowns or pajamas, night lights, large calendars, clocks or stuffed animals. Residents may also enjoy a prepaid shopping card to the local discount store, or an invitation to a meal at a restaurant or the visitor’s home. Just giving a little bit of your time, could be the greatest Christmas gift that residents will receive. So as you are marking your calendars for family events, please don’t forget there are approximately two million residents living in nursing homes and the holiday season is often the loneliest time for them.

Full Article and Source:
Holidays for Nursing Home Residents

Six Seniors Move In Together To Avoid Nursing Homes

By Rozzette Cabrera

For most people, retirement is one of those topics that are hard to talk about. The ideas of growing old, being unemployed, and living alone aren’t just uncomfortable to think about, but they’re quite scary, too.

Six adults had a different idea about retirement.
A group of friends who call themselves as The Shedders decided to go with a co-living arrangement. It’s a strange setup that makes everyone who hears about it feel awkward.

Some of their family members even raised an eyebrow on them. They’ve been asked if they were a group of swingers or if they are doing strange things while living in a single home.

Contrary to what others think, these people planned their retirement arrangements early.
All of them weren’t interested in spending the rest of their lives in a nursing home. With that in mind, they figured that living close to each other and sharing everything that comes with growing old would be better.

To make sure that they’ll be able to carry out their plan, they did a trial and lived together in Sydney. Unfortunately, living in the area wasn’t for them. Sydney wasn’t just too fast-paced for them, but it was also costly.

That’s when they decided to pool all their savings and purchase a piece of land. It made the cost of retiring a lot cheaper. The area also made it easier for the 6 adults to establish a really strong community.

They were able to join the local choir and help raise money for different charitable causes. This includes palliative care and other causes that are close to their hearts.

The Shedders’ living arrangement is breaking stereotypes and misconceptions.
Living with other adults is way too different when you compare it with living with people who are in their 20s or 30s. At their age, the friends are able to properly divide housework. They share the bills, too.

Full Article and Source:
Six Seniors Move In Together To Avoid Nursing Homes

Thursday, November 28, 2019

Comedians are being hired by the hour to help dementia patients. Their goal? ‘A full belly laugh.’

About a year after Dani Klein Modisett moved her mother from Manhattan to an Alzheimer’s care center near her Los Angeles home in 2016, she noticed that her mom, then 84, was sad and withdrawn.

Muriel Klein, once the life of the party (even with her memory loss), was no longer talkative or interested in food. She kept her head down and slept a lot.

“I was really upset, thinking, ‘What have I done? Why did I take her from everything she loved in Manhattan?’ ” Modisett said.

During a dental exam one afternoon, Modisett, an author and former stand-up comedian, tearfully told her dentist about her mother, saying she wished she could hire a comedian for her.

“Why don’t you?” her dentist replied.

Modisett went home and made a few calls, and soon she had hired a stand-up comedian to visit her mom eight hours a week.

The very first day, the comedian told Klein: “Some days, I don’t want to talk either, Muriel. When someone gets in my face, I think, ‘[expletive], do I look like I want to talk?’ ”

Klein repeated the expletive — a Yiddish word — laughing. Then she repeated it again. She lit up.

“After that visit, my mom became more engaged and started eating and laughing again,” said Modisett, who has taught comedy classes at the University of California at Los Angeles. “She felt that she was being seen.”

In early 2017, realizing that other seniors with memory loss could also benefit from some slapstick and one-liners, Modisett launched Laughter on Call, an organization that pairs comedians with dementia and Alzheimer’s patients. The group also puts on laughter workshops and live comedy shows at care centers.

Full Article and Source:
Comedians are being hired by the hour to help dementia patients. Their goal? A full belly laugh

See Also:
Laughter on Call

A Great Idea: Nightclubs for the Elderly to Fight Loneliness

Knitting, owning fifteen cats, reading the newspaper on a rocking chair, staying indoors — these are just some of the many things associated with being old. But for the Posh Club, the word “old” doesn’t even exist.

The group started with siblings Simon Casson and Annie Bowden, who wanted to do something for their mother who constantly felt lonely. They organized a tea party and invited some of their mother’s friends who were also in their 80s to 90s.

Seeing the positive effect of this gathering to their mother, Simon and Annie decided to take it to the next level — they hired and decorated the local church hall and opened the invitation to all senior citizens in their neighborhood.

The community continually grew, and now the Posh Club established five major clubs all over London and the South East.

Full Article and Source:
This Nightclub for the Elderly is Fighting Loneliness With Tea Party Disco

Wednesday, November 27, 2019

Hundreds of Richmond hospital patients lost their right to make medical decisions

Times-Dispatch investigation finds potential conflicts of interest between Richmond law firm and VCU Health.

By Sean Galvin

VCU Health System has taken hundreds of low-income patients to court since 2009 to strip them of their right to make medical decisions, the Richmond Times-Dispatch found in the first of a three-part series on guardianship. That led to sick, elderly, and disabled patients getting transferred out of the hospital and into poorly-rated nursing homes, often at the objection of family members.

In hundreds of cases, VCU Health asked the court to grant the patient’s guardianship rights to an attorney from ThompsonMcMullan, a Richmond law firm. When granted, the attorney is ordered to make decisions in the patients’ best interests.

But medical ethicists say those decisions have a conflict of interest if the lawyer’s law firm has a long-term arrangement with the hospital, as ThompsonMcMullan had with VCU Health. The Richmond Times-Dispatch reports that VCU paid the law firm $1.1 million since 2007. This is a contrast to other hospitals in the Richmond area, which petition courts to have attorneys take over patients’ guardianships, but forbid the same attorney from bringing the case to court and then representing the patient.

“If [the law firm is] repeatedly representing the hospital, the concern is that they’re going to be more likely to make decisions that the hospital is happy with because it will ensure they get this continuous ability to represent the hospital in other cases,” George Cohen, a professor who teaches professional responsibility at UVA Law School, told the Richmond Times-Dispatch.

Three lawyers at ThompsonMcMullan have been involved in over 90% of the guardianship cases filed by health care providers in Richmond since 2014. One of those lawyers, R. Shawn Majette, has served as guardian for 120 people at the same time— six times the caseload allowed for the state’s public guardians.

A report from the Virginia Department for Aging and Rehabilitative Services found that hospitals are financially incentivized to initiate guardianship proceedings and get poorer patients discharged. Of the cases reviewed by Times-Dispatch, over 87% of the patients appointed a guardian by a healthcare provider were deemed “very poor” by the courts.

VCU Health System officials said finances do not play any role in their decision making process. Pam Lepley, a spokesperson for VCU, said the number of patients put into guardianship is so low, it doesn’t affect the hospital’s “financials in any regard.”

Full Article & Source:
Hundreds of Richmond hospital patients lost their right to make medical decisions

Buyer Beware: Are wholesalers taking advantage of elderly home sellers?

By: Justin Gray , Terah Boyd

ATLANTA - A booming Atlanta real estate market may make some elderly homeowners a target.

Homeowners are selling their houses for tens and even hundreds of thousands of dollars less than they are worth, a Channel 2 Action News/Atlanta Journal-Constitution investigation learned.

One elderly woman contacted Channel 2 Action News after she sold her southwest Atlanta home for more than $140,000 less than real estate site Zillow estimated it was worth.

The woman did not want to be interviewed by the news organizations, and her name is not being used in this story.

Channel 2 investigative reporter Justin Gray spoke with the real estate broker who found the elderly woman on the side of the road with her belongings while the wholesalers who bought her home cleared it out.

“The wholesaler would come to her house every single day and beg her to sell,” said Robin Andrade, who runs Sell Atlanta. “She would say no. Then they started bringing her dinner, they started asking her if she needed her medication picked up from the pharmacy, they befriended her.”

Andrade got a call about a woman who had just sold her home who needed help buying a condo.

“She didn’t have enough money for a condo, and she was almost 80 years old.” Andrade said she knew why wholesalers would want the home. “It’s in the west end by the (Atlanta) Beltline. It’s the hottest, juiciest neighborhood right now in Atlanta."

The woman’s southwest Atlanta home was purchased by Green Sky Properties LLC on July 30 of this year for $95,000. The same day, Green Sky Properties sold the home to Njeri Warfield for $130,000. Zillow estimated the home was worth more than $240,000.

Atlanta Legal Aid attorney Sarah Stein told Gray wholesalers typically shop for houses that aren’t for sale. Stein said wholesalers buying homes for less than market value and reselling them to investors the same day is a calculated technique.

“They’re literally doing nothing to the property … and selling it the same day to somebody else for significantly more,” Stein said.

The wholesaler group that was involved in the purchase of the elderly woman’s home holds weekly training sessions called “Wholesale Live” in southwest Atlanta. A Channel 2 producer attended the event undercover.

The producer paid $35 to attend the session, where the “Wholesale Live” crew had her cold-call owners of off-market homes around the metro.

Their technique was not to take no for an answer and try to get homeowners to sign a contract to sell the same day. The wholesalers even provided a script for cold callers.

If an attendee's lead resulted in a signed contract, they would get a cut from the sale.

“It’s like a boiler-room atmosphere. Everybody is here in one room making phone calls,” a member of the “Wholesale Live” crew said during the session.

When Gray went to a “Wholesale Live” session to ask about the elderly woman’s home, organizer Monique Williams said the woman approached their team about selling her home.

“My name is not on any documents,” Williams said.

Williams is not on any of the home sale documents Channel 2 reviewed, but her Instagram account, @Mohustle_810, follows every step of the purchase and renovation of the elderly woman’s home.

Williams and a fellow “Wholesale Live” instructor appear in a posted testimonial video at the closing attorney’s office on the day of the sale about the elderly woman’s experience “working with the team.”

“They’re like my children,” the elderly woman said in the video.

In other videos, Williams documents the flipping process, including inviting Instagram followers to a “demo party” to educate them on the renovation process.

“Of course, guys, when you acquire properties, especially directly from the seller, and they’ve been in their house a long time, it’s possible you may run into these types of situations,” Williams said in a video recorded in the basement of the elderly woman’s home, explaining that they would have to remove 47 years' worth of furniture and other belongings.

David Blake, with Georgia’s Department of Human Services Division of Aging Services, trains police across the state to investigate elder abuse cases. Blake told Gray deceiving an elder to buy their home at bargain could be a crime.

“You're not really telling that victim the facts. You're hiding the facts, you're misstating the facts to make that sale, to make that transition,” Blake said.

“And that’s against the law?” Gray asked.

“Yes,” Blake said. “That would be considered financial exploitation.”

Channel 2 has not found evidence that the wholesalers have committed a crime, but an Atlanta police fraud investigator did contact the news station with questions about the case.

The news station passed the investigator’s information on to the elderly woman's attorney.

Whether it was a crime or not, Andrade said the situation the elderly woman was put in was wrong.

“There is absolutely no doubt in my mind that they took advantage of her,” Andrade said.

Full Article & Source:
Buyer Beware: Are wholesalers taking advantage of elderly home sellers?

‘Trust nobody’: Cyber crime warning directed at retirees

A lawyer has warned Australians of the ease with which hackers can drain an individual’s life savings online and the risks associated with cyber crime.

Nicole Murdoch, a principal lawyer at Brisbane’s Eaglegate Lawyers, said the latest figures show that cyber criminals are preying on individuals and businesses every 10 minutes, “trying to drain victims’ bank accounts”.

She said the rising prevalence of cyber crime is seeing Australians lose millions of dollars a year to thieves and online scammers.

There have been more than 13,500 reports of cyber crime to the Australian Cyber Security Centre (ACSC) in the past three months, the lawyer noted.

While romance and bank scams are the frontrunners in the cyber theft world, Ms Murdoch said “email scams have become so sophisticated, honest people can easily be hoodwinked by a scammer”.

The lawyer cited the case where a 65-year-old retiree reportedly lost $66,000 when he transferred money to what he thought was a legitimate bank account after buying a car from a dealership.

“He received an email with an invoice and bank details, so he paid, only to later discover either a cyber criminal had got into the dealership’s computer network and sent the email, or his email account could have been hacked,” Ms Murdoch said.

“Sadly, stories like this are becoming commonplace.

“Retirees especially are being targeted by cyber criminals who claim to be from banks or internet service providers, claiming your computer has a virus they can remove if you give them control of your system.”

Types of scams

Ms Murdoch highlighted that romance scams involve a criminal cultivating an online relationship with a person over several months before persuading them to transfer money for medical treatment or essential goods.

Bank scams involve a person being sent a text or email that appears to be from their bank, requesting log-in details to fix a problem with their credit card or online banking. If the person supplies the details, it allows the cyber criminal access to the bank account.

The lawyer also indicated that compromised emails “are one of the top issues being reported to the ACSC by businesses”.

“For example, a criminal hacks into a business email account and pretends to be a legitimate employee and sends an email to another employee who might be the person who makes online payments and tricks them into making an online payment to the criminal,” she explained.

Ransomware is also prolific, with Ms Murdoch commenting that criminals can take control of your computer system and make you pay a ransom to get your computer system back under your control again.

Protecting yourself

The lawyer has advised that “the safe option is: never supply your log-in details or passwords or bank account details to a caller or in response to an email unless you have initiated the contact with that institution”.

She urges Australians to regularly change their banking passwords or financial apps and create passwords that cannot easily be guessed.

Ms Murdoch also advises against using the same password across all apps and accounts.

Full Article & Source:
‘Trust nobody’: Cyber crime warning directed at retirees

Tuesday, November 26, 2019

Court appointed guardianship could cost Macomb County family $376,000

MACOMB COUNTY, Mich. (WXYZ) — The six-month guardianship of a Macomb County couple has racked up a total cost of $376,000. Now the couple's family members want the court to deny those fees because they say the guardianship never should have happened in the first place.

If a judge appoints a guardian and conservator, that person has the power to make all medical and financial decisions for a person. Now the bills from Caring Hearts Michigan have been revealed in the case of Barb and Bob.

They charged them for everything from $275 to research a Do Not Resuscitate order, to $13,000 to pay for the fence around their house.

The fence still stands around Barbara Delbridge and Bob Mitchell’s Utica home – a fence family members say blocked them from being with their loved ones. Lawyers for Caring Hearts said the fence was to keep Bob from running away

On the inside of the house, relatives say they found ripped furniture and what appears to be blood stains on the wall after six months of a court-appointed guardianship for the couple.

“It makes me so angry that time that we lost, we’ll never get back," said Gretchen Sommer, Delbridge’s niece. "The damage that was done is permanent.”

This all started in November 2018 when Marcie Mitchell petitioned the Macomb County Probate Court for guardianship of her dad and stepmom because they were becoming mentally incapacitated. However, Judge Kathryn George said she had “grave concerns” about the couple’s safety, and instead appointed Caring Hearts Michigan Inc. as guardian and conservator.

Caring Hearts is owned by Catherine Kirk. After the 7 Investigators exposed how Kirk then hired her own home-care company and her husband’s law firm to bill Barb and Bob for the guardianship, the Macomb County chief judge stepped in and returned the couple to their family.

The attorney general also intervened in the case, saying in court records that “there appears to be a clear violation of the statutes” about the guardian and conservator engaging in “self-dealing.”

”You’re being enriched through your work as the guardian in a way the law didn’t intend for you to be enriched,” said Nicole Shannon, Systemic Advocacy Attorney for the Michigan Elder Justice Initiative.

And now the 7 Investigators have obtained the bills for that alleged self-dealing:

Court records show Caring Hearts is asking for $46,123.41 for guardianship services.

Robert Kirk’s law firm billed $67,149.14 in legal fees.

And Cathy Kirk’s employee wrote in their accounting to the court, the total for Barb and Bob’s 24/7 home-care from Executive Care was $263,478.91.

That’s a total $376,751.46.

“There’s no way they stood by their fiduciary duty doing that because what they were doing was just draining their estate,” Sommer said.

Within days of getting the appointment as conservator, Kirk and her employees had the power to start writing checks, and they wrote check after check from Barb and Bob’s account to Kirk’s two companies and the law firm.

Kirk also used at least four attorneys, including her husband, all of them billing at $275 an hour.

Marcie says the toughest thing to see was a lawyer fee of one hour of research on a guardian’s power to execute a Do Not Resuscitate Order.

“The hardest was when I read 'Do Not Resuscitate' order – and my parents have to pay for that? I’m sorry but it’s not fair,” said Marcie through tears.

When Sterling Heights Mayor Michael Taylor, who works for Robert Kirk’s law firm, showed up during our interview with family members last May, he charged Barb and Bob’s estate $1100 for his work that day.

In fact, Taylor’s fees on the case total $36,850, according to court records, and that doesn’t include the $542.50 just for others in the office to make copies for Taylor.

“These are humans that we’re doing this to," Sommer said. "But they don’t see them that way, they’re wards. They see the end game, the dollar sign, that’s it."

Caring Hearts has new lawyers now. They declined to talk to 7 Investigators on camera, but they argue in court filings that Caring Hearts “is entitled to every penny it seeks” because they performed “a multitude of good deeds.” They call Barb and Bob’s home a “house of horrors” and say family members were “taking advantage” of the couple’s $2 million estate. They argue Bob was physically and verbally abusive to the home-care aides.

Relatives deny that and say instead the so-called “house of horrors” was created by Caring Hearts, where Bob and Barb were over-medicated and mistreated.

“They were very harsh," Sommer said. "They would antagonize Bob. They would get in his face. They would tell him to hit them because if he did they would call the police and he’d go away to jail forever. We’re told they were forced to take cold showers, I don’t know why and it’s just heartbreaking. They were totally held hostage against their will."

After Bob and Barb were returned to their family members in June, they moved them to nursing homes where relatives say they improved dramatically.

Sadly, Barbara suffered a stroke and passed away earlier in November.

The family is continuing their legal fight, hoping to set some precedents in the courts in order to help other families fighting guardianships in Michigan.

Full Article & Source:
Court appointed guardianship could cost Macomb County family $376,000

See Also:
Family awarded guardianship of Macomb Co. couple after 7 Action News Investigation

Caring Hearts Michigan backs out of disputed guardianship case in wake of 7 Action News report

Michigan AG opens investigation into Macomb Co. probate case following 7 Action News report

Why did a Macomb Co. judge put strangers in charge of an elderly couple instead of family?

'I just want my parents back.' Woman says company imprisoned her parents in their own home

Michigan AG 'looking into' concerns about state's adult guardianship system

Former Caregivers Plead Guilty to Violating Rights of Resident with Developmental Disability

The United States Department of Justice 
Department of Justice
Office of Public Affairs

Friday, November 22, 2019

Former Caregivers Plead Guilty to Violating Rights of Resident with Developmental Disability

Sherry K. Paulo, 54, and Anthony R. Flores, 59, husband and wife, and former employees of a Missouri residential treatment facility, pleaded guilty today in federal court in the Western District of Missouri to criminal civil rights charges arising from the death of C.D., a Missouri ward of the state with developmental disabilities. Paulo and Flores each pleaded guilty to one count of willfully failing to provide necessary medical care to C.D., resulting in injury to and the death of C.D. Paulo also pleaded guilty to one count of health care fraud arising from her efforts to hide the fact of C.D.’s death.

“The defendants were entrusted with caring for some of our society’s most vulnerable individuals, who cannot advocate or care for themselves,” said Assistant Attorney General Eric Dreiband of the Civil Rights Division. “They abused that trust by depriving the victim of obvious and necessary medical care and then taking extraordinary measures to cover up their wrongdoing. The Department of Justice will continue to hold accountable those who commit such violations.”

“They were responsible to provide care to a vulnerable victim, but today admitted they ignored obvious signs of medical distress and failed to even call 911. Instead, they hid him away in their unfinished basement until he died,” said U.S. Attorney Tim Garrison of the Western District of Missouri. “They may have thought they could hide the body in a concrete-filled crate and get away with it. But when the civil rights of a vulnerable victim are violated, we will hold them accountable for their inhumane and criminal conduct.”

“The FBI is the primary federal agency responsible for investigating allegations regarding violations of federal civil rights, and we continue to hold that responsibility as a top priority,” said Timothy R. Langan, Special Agent in Charge of the FBI in Kansas City, Missouri. “When individuals, such as the defendants, abuse their power and neglect their responsibility to care for some of our most susceptible and defenseless members of society, it is not only wrong, it is criminal. Today's guilty plea emphasizes the continued commitment to hold all perpetrators accountable.”

“Flores and Paulo not only let C.D. die, they then compounded their crime by hiding the body in a storage unit,” said Curt L. Muller, Special Agent in Charge of the Office of Inspector General. “We will continue working with our law enforcement partners to fight for such vulnerable people and the government health programs upon which they depend.”

According to the plea agreements, Paulo and Flores worked as caregivers at Second Chance Homes, an organization that provided housing and care for developmentally disabled persons through a Missouri Department of Mental Health initiative. Victim C.D. had been a resident at Second Chance Homes since 2008.

Paulo and Flores admitted in their pleas that they observed C.D.’s health decline beginning in 2014. C.D. became unhealthily underweight and pale, and he grew more obviously ill over a period of several months. During this time, Paulo occasionally took C.D. out of his designated residence and put him in the basement of the personal home she shared with Flores.

C.D. suffered an acute medical emergency while in the basement of Flores’s and Paulo’s personal home. Despite observing C.D.’s physical distress and obvious medical need at that time, Paulo and Flores admitted that they purposefully did not seek medical care for C.D. C.D. died while in Flores’s and Paulo’s personal home.

In the plea agreement, Paulo admitted that she subsequently placed C.D.’s body in a trashcan and transported it to C.D.’s assigned residence, where she and Flores put it in a wooden crate and filled the wooden crate with cement. Paulo and Flores then transported the crate to Paulo’s storage unit.

Medicaid provided funding for C.D.’s care at Second Chance Homes. Paulo admitted that after C.D. died, she submitted, or caused to be submitted, claims to Medicaid for services that she purportedly rendered to C.D. Paulo admitted that at the time she submitted, or caused to be submitted, those claims, she knew that C.D. was dead and that the claims were thus false. The amount wrongfully paid by Medicaid, between approximately September 2016 and April 2017, was $106,795.00.

Paulo also admitted that on April 17, 2017, she reported C.D. missing to the Fulton, Missouri Police Department. Paulo and Flores both admitted that they falsely told the police that they had seen C.D. alive and well, even after they knew C.D. was deceased.

Under Paulo’s plea agreement, she faces a maximum of 210 months incarceration. Under Flores’s plea agreement, he faces a maximum of 188 months incarceration. A sentencing hearing will be scheduled after the completion of a presentence investigation by the United States Probation Office.

This case was investigated by the Jefferson City Resident Agency of the FBI Kansas City Division and the St. Louis Field Office of the Department of Health and Human Services Office of the Inspector General Kansas City Region. The case is being prosecuted by Assistant United States Attorneys Cindi Woolery and Gregg Coonrod of the U.S. Attorney’s Office, Special Litigation Counsel Julia Gegenheimer and Trial Attorney Janea Lamar of the Department of Justice Civil Rights Division Criminal Section. The Fulton, Missouri Police Department and Callaway County Prosecutor Christopher Wilson contributed significantly to the successful investigation and prosecution of this matter.

Civil Rights
Press Release Number: 

Full Article & Source:
Former Caregivers Plead Guilty to Violating Rights of Resident with Developmental Disability

Britney Spears‘ father officially gives up his role as her conservator after 11 years

After a difficult year in which she‘s had to cancel a major tour and fight wild online conspiracy theories about her family, things don‘t look likely to settle down for beloved pop star Britney Spears.

Britney‘s father, Jamie Spears, has temporarily stepped down as her legal conservator, after spending 11 years with wide-ranging legal powers over the pop star‘s life and career.

The move came after Jamie was accused of physically assaulting one of Britney‘s teenage sons, Sean. According to reports, after the incident, Britney‘s two sons sought restraining orders against Jamie, reports.

In another shocking twist, Britney‘s psychiatrist and doctor, Dr Timothy Benson, recently died after reportedly suffering a brain aneurysm. Dr Benson was due to present evidence to the court regarding Britney‘s care while under Jamie‘s conservatorship.

Britney‘s newly appointed temporary conservator, Jodi Montgomery, has been granted similar, wide reaching powers to look after the 37-year-old singer, and her affairs, until January 31, 2020, according to ET.

The conservatorship was put in place after Britney was involved in a string of high profile and highly publicised incidents from 2006 to 2008.

These included her shaving her head, being photographed in unflattering circumstances at a patrol station and, attacking a car with an umbrella.

At the same time, Britney was hotly pursued by paparazzi, and was a new mother. At the beginning of 2008, she entered into a custody battle with the father of her children, ex-husband Kevin Federline.

That same month, Britney was involuntary put into psychiatric care. By February, after almost two years of highly publicised public meltdowns, Britney‘s father Jamie was granted the temporary conservatorship of his daughter. Six months later, this conservatorship was made permanent, according to Fox Business.

A conservatorship is a status used in the US legal system, where an individual is considered to be legally under the care of another person, who is sometimes referred to as their “guardian”.

It is put in place where a person is suffering from conditions that place limitations on their ability to care for themselves. The person might be suffering from a mental condition that in some way makes them unable to make decisions over some, or all parts of their lives.

While Britney‘s conservatorship has been in place since 2008, in May of this year, Britney met with a judge to discuss issues to do with the conservatorship. The judge ruled the conservatorship needed to be evaluated.


While the evaluation continues, Ms Montgomery, who has worked with Britney for the past 12 months as her care manager, has been granted the role of Britney‘s new conservator.

According to court documents obtained by Billboard, Ms Montgomery is “an experienced professional fiduciary with ability, experience, and support resources, to take on these obligations during this time and has been the care manager for Spears for approximately a year”.

A Los Angeles judge approved the change on Monday.

If the court does find that Jamie‘s care of Britney was wanting, it‘s likely Lynne Spears, Britney‘s mother, or Kevin Federline, her ex-husband, will challenge the conservatorship that lasted more than a decade.

The issue has become so heated it has recently been at the centre of an online conspiracy, buffeted by the hashtag #freebritney.

In that case, it‘s likely Britney‘s father will be permanently removed from his role as the pop star‘s guardian.

It‘s worth remembering, before Britney sensationally cancelled her Britney: Domination Vegas residency in January, her conservatorship had largely been viewed as a handshake agreement between her and her father.

Despite being under the binding agreement, Britney had continued to tour, release music and make perfumes.

But Britney‘s Instagram post in January, announcing the cancellation of her upcoming residency in Vegas shocked many, and started a wave of fan‘s theorising wildly about Britney‘s personal freedom.

“I‘ve been looking forward to this show and seeing all of you this year, so doing this breaks my heart,” she wrote on Instagram. “However, it‘s important to always put your family first … and that‘s the decision I had to make.”

Full Article & Source:
Britney Spears‘ father officially gives up his role as her conservator after 11 years