Saturday, June 13, 2020

Heartbreak in nursing homes, dying from loneliness amid COVID-19 visiting restrictions

Chester Peske, a WWII veteran, died on June 2nd, four months short of reaching 100th birthday. (FOX 9)
The state of Minnesota is making plans to ease visitor restrictions in long-term care facilities after senior citizens spent the last three months in isolation, one of them dying in part to loneliness.

The FOX 9 Investigators found Chester Peske died on June 2nd, four months short of reaching his 100th birthday. His primary cause of death is Alzheimer's but the secondary cause is “social isolation, failure to thrive, related to COVID-19 restrictions”, meaning he died, in part, from loneliness.

Heartbreak in nursing homes, dying from loneliness amid COVID-19 visiting restrictions
The state of Minnesota is making plans to ease visitor restrictions in long-term care facilities after senior citizens spent the last three months in isolation, one of them dying in part to loneliness.

The WWII veteran was diagnosed with the coronavirus, but remained asymptomatic. He then spent two and a half weeks alone, isolated in his room at a Twin Cities memory care unit.

Allison Fiedler from Bluestone Physician Services was his nurse practitioner and the medical certifier, providing the cause of death on the death certificate. She told the FOX 9 Investigators she doesn’t use that cause of death often, but felt it was necessary in this case and wanted to create a historical record on why he died.

The FOX 9 Investigators found another individual with the cause of death labeled “COVID-19 social isolation”. His family declined to comment.

Isolated and lonely

Barbara Lokken’s aunt, survived COVID-19 at St. Therese in New Hope, where at least 60 other people died from the virus. However, 91-year old, Millie Harms might die of a broken heart. She hasn’t seen her family in three months. Her niece believes she is losing weight, and “the spark in her eyes.”

“It just breaks my heart that her kids can’t go see her,” she said. “We are robbing them of being with their loved ones before they pass away.”

Thousands of seniors in assisted living and nursing homes are going on their fourth month of lockdown: no visitors, no activities, and their friends are dying.

Studies show isolated seniors have higher rates of heart disease, stroke, and dementia. It’s a mortality rate comparable to those who smoke, are obese, or chronic alcoholics.

Testing necessary to get visitors back 

Minnesota Senator, Karin Housley, of St. Mary’s Point, has been urging the Minnesota Department of Health (MDH) to allow visitors back into the facilities. During the special session of the legislature, which starts on Friday, she will introduce a bill that would require long-term care centers to test all residents and staff and create comprehensive infection control programs.

“These people need some testing, who has it who doesn’t, so we can get these family members back together because that’s what we need right now,” she said.

The senator believes one way to ease the restrictions would be to require visitors to get COVID-19 tests, 48 hours prior to seeing their loved ones.

Visitors needed to help monitor the vulnerable

University of Minnesota adjunct professor and aging expert, Eilon Caspi said visitors are often the eyes and ears of vulnerable residents.

“We are allowing staff members to go in and out, there’s got to be ways to do it in a reasonably safe way,” he said. “We are starting to receive reports on residents who are severely harmed in different ways, through mistreatment as well as death.”

MDH making plans to ease restrictions

The Minnesota Department of Health is making plans to reunite visitors with their loved ones, at least from a safe distance from one another. MDH plans to release details soon on window and outdoor visits.

Officials are now allowing hair stylists back into long-term care facilities as long as they follow certain rules on protecting themselves and residents who choose to have beauty shop services.

"We know the importance of these social connections for health and well-being. The toll of the separation of families and loved ones has been one of the most heartbreaking parts of the COVID-19 outbreak," MDH officials wrote in a press release.

Full Article & Source:
Heartbreak in nursing homes, dying from loneliness amid COVID-19 visiting restrictions

Deputies: Woman exploited elderly man, allegedly embezzled more than $300K

The Pitt County Sheriff's Office says it was contacted by BB&T bank in August regarding possible elder exploitation. A detective worked the with victim's adult children and learned that the Heather Dawn Taylor (also known as Heather Dawn Russ, Heather Taylor Russ and Heather Dawn) had been in a business relationship with the victim running Double Barrel Stables. (Photo provided by Pitt County Sheriff's Office)
by Sydney Basden

A Pitt County woman has been arrested following a nine-month investigation into elder exploitation; deputies say she allegedly embezzled more than $300,000 from an elderly man.

The Pitt County Sheriff's Office says it was contacted by BB&T bank in August regarding possible elder exploitation. A detective worked the with victim's adult children and learned that the Heather Dawn Taylor (also known as Heather Dawn Russ, Heather Taylor Russ and Heather Dawn) had been in a business relationship with the victim running Double Barrel Stables.

Officials say the Farmville business - which no longer exists - offered a variety of equestrian-related services.

During the investigation, officials say they worked with fraud departments from multiple institutions, interview witnesses and examined financial records. So far, the sheriff's office says the detective has identified more than $300,000 in funds she allegedly embezzled from the victim - an elderly man with serious health conditions.

Over the course of a 9-month investigation, the detective worked with the fraud departments from multiple financial institutions as well as interviewed witnesses and examined financial records. So far, he has been able to identify well over $300,000 in funds that had allegedly been embezzled by the suspect from the victim, an elderly man with serious health conditions.

To conceal her crimes, officials say Taylor paid others to lie to the victim's children and pretend they were horse transporters bringing in money for the business. They add that all of this took place while she was on probation for a previous fraud conviction.

Also during the investigation, officials say a second elderly victim came forward with information that Heater had also approached her wanting to start a stable and horse transport business. They say the victim produced evidence that showed a similar pattern of behavior as the first case; Taylor had already obtained more than $1,000 before they say the victim became suspicious and cut ties.

The Pitt County Sheriff's Office says Taylor has already been indicted by a Grand Jury on the following charges:
  • Embezzlement over $100,000 (two counts)
  • Exploit elder trust (two counts)
  • Obtaining property by false pretense (one count)
Taylor was arrested on Thursday and booked into the Pitt County Detention Center where officials say she is being held under a $450,000 secured bond. They add that she has previous convictions of obtaining property by false pretenses and other fraud offenses.

Officials say there may be other victims; those who believe they could be victims should contact Detective Hines with the Pitt County Sheriff’s Office, Major Crimes Unit at 252-902-2149.

According to WCTI archives, Taylor was arrested in 2013 on charges of allegedly pretending to be pregnant to scam couples who wanted to adopt children. The story was featured on ABC's 20/20 in 2014. In 2015, Taylor was also charged after she allegedly pretended her mother was dying of cancer and tricked victims into sending money to her.

Full Article & Source:
Deputies: Woman exploited elderly man, allegedly embezzled more than $300K

Big Sky Senior Services to commemorate World Elder Abuse Awareness Day

Big Sky Senior Services Prevention of Elder Abuse program is commemorating World Elder Abuse Awareness Day on Monday, June 15, by creating awareness of elder abuse issues. Staff will be reaching out to the senior living facilities in Billings to present purple ribbons and brochures on the types and signs of elder abuse and how to report suspicions.

The International Network for the Prevention of Elder Abuse and the World Health Organization at the United Nations launched the first World Elder Abuse Awareness Day on June 15, 2006, in an effort to unite communities around the world in raising awareness about elder abuse.

Every year an estimated one in 10 older Americans are victims of elder abuse, neglect or exploitation. Experts believe that for every case of elder abuse or neglect reported; as many as 23.5 cases go unreported.

Montana is aging at a faster rate than most of the other states and ranks at fifth in the nation in the percentage of people over the age of 65.

In a press release, Big Sky Senior Services encouraged community members to help by volunteering to be a phone friend to an elderly person or donating to assist the organization’s elder abuse education efforts.

Organizations interested in a presentation on elder abuse may call 406-259-3111 or go to for more information.

Full Article & Source:
Big Sky Senior Services to commemorate World Elder Abuse Awareness Day

Friday, June 12, 2020

Nursing homes under scrutiny after warnings of seized stimulus checks

© iStock Nursing homes under scrutiny after warnings of seized stimulus checks
by Naomi Jagoda

Nursing homes are coming under more scrutiny during the coronavirus pandemic, this time for complaints about efforts to confiscate coronavirus stimulus checks.

Lawmakers on both sides of the aisle are calling on the Trump administration to ensure nursing homes and assisted living facilities aren't improperly seizing the checks from residents following alerts from the Federal Trade Commission (FTC) and state attorneys general.

State and federal authorities have recently notified the public about complaints of long-term care facilities demanding residents on Medicaid turn over their relief payments. Those alerts prompted prominent lawmakers to lean on various federal agencies, urging them to investigate the issue and make it clear to facilities that they aren't entitled to the checks.

"These economic impact payments were not designed to reimburse people," Rep. Gwen Moore (D-Wis.) told The Hill. "And we have provisions that protect the elderly."

Moore, a member of the House Ways and Means Committee, authored one of several letters to federal agencies on the nursing home issue this week. In her letter, she urged the Treasury Inspector General for Tax Administration to exercise its oversight authority to protect residents of nursing homes and assisted living facilities.

State attorneys general say they've gotten complaints about nursing homes and assisted living facilities attempting to take residents' payments.

The FTC in May issued alerts saying nursing homes and assisted living facilities can't seize residents' checks just because they are on Medicaid. Agency officials said they had heard about the issue from the Iowa attorney general's office and other states.

"The main message is that the money belongs to the resident," Lois Greisman, associate director for marketing practices at the FTC, told The Hill. "That's the word we wanted to get out loud and clear."

Nila Davis (L) deals cards to Becky Lewis of Texas at a blackjack table with plexiglass safety shield dividers at Excalibur Hotel & Casino after the Las Vegas Strip property opened for the first time since being closed in mid-March, on June 11, in Las Vegas. 
Lynn Hicks, a spokesman for the Iowa attorney general's office, said the FTC alert referred to a complaint about a long-term care facility that had told residents they should not spend their stimulus checks until the Iowa Department of Human Services makes determinations about the amount of income residents have to pay to the facility. The owner of the facility subsequently sent another letter to residents saying they could keep their payments.

The Iowa attorney general's office and other state attorneys general have also been warning their residents about attempts from nursing homes to take people's payments, particularly after the FTC issued its message.

"If you or a relative are a Medicaid recipient living in a nursing home or assisted living center and you qualify for a CARES Act payment, be wary of attempts to take CARES Act payments using the Medicaid system as a guise," Missouri Attorney General Eric Schmitt (R) said in a statement last month. The alert from Schmitt's office said the office had received several complaints concerning this issue.

"We have heard some Oregon nursing homes may have taken or are attempting to take stimulus checks from residents who are Medicaid recipients. This needs to stop," said Oregon Attorney General Ellen Rosenblum (D). "These stimulus checks are the property of the residents and must be returned."

Concerns about facilities' efforts to seize residents' payments have prompted lawmakers in recent days to urge several federal agencies to take actions to help protect residents.

House Ways and Means Committee Chairman Richard Neal (D-Mass.) and House Energy and Commerce Committee Chairman Frank Pallone Jr. (D-N.J.) on Monday sent a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verna, urging CMS to "issue guidance to nursing homes and residents on the status of these checks and their independence from residents' Medicaid status."

The lawmakers also asked CMS to provide information about what actions to take to ensure nursing homes don't seize people's payments and return any payments that may have already been taken.

Neal and Pallone said they have had reports of representative payees of Social Security and supplemental security income recipients - people who manage benefits for recipients that are incapable of doing so themselves - being confused about whether the relief payments should be given to long-term care facilities that demand payment.

Verna replied to Neal and Pallone on Twitter, saying CMS requirements prohibit nursing homes from seizing the coronavirus checks of residents on Medicaid.

"Nursing homes engaging in this behavior will be subject to enforcement action," she said.

One day after the House committee chairmen sent their letter, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and ranking member Sen. Ron Wyden (D-Ore.) urged the inspector general for the Department of Health and Human Services to "look into these practices targeting elderly Americans and individuals with disabilities and issue alerts to raise awareness that this practice is improper and contrary to congressional intent."

The direct payments are a key part of the record $2.2 trillion coronavirus relief package President Trump signed into law on March 27. Under the CARES Act, most Americans are entitled to a one-time payment of up to $1,200 per adult and $500 per child. The Treasury Department said last week that it has distributed about 159 million payments so far.

The legislation that established the direct payments prevents the checks from being reduced due to unpaid taxes or other debts owed to federal and state government agencies. Lawmakers say any seizures on the part of nursing homes go against the spirit of the law.

Additionally, the checks are advance payments of refundable tax credits. Under federal law, advance payments of refundable credits are not considered income for purposes of determining eligibility for which amount of assistance from programs such as Medicaid and are not considered resources for eligibility and assistance amount purposes for a period of 12 months after they are received.

It's unclear how many nursing homes have tried to take the residents' checks.

The American Health Care Association and National Center for Assisted Living said in a statement they "are not aware of widespread issues with resident stimulus funds" and that "stimulus checks are handled in the same manner as other resident benefit payments."

The groups have sent a question-and-answer document to their members that specifies that the checks don't immediately impact Medicaid eligibility.

Hicks said his office is also concerned in general about the rights of nursing home residents during the coronavirus pandemic.

Even if complaints about nursing homes seizing coronavirus relief payments aren't highly common, policymakers and advocates for seniors want to make sure that confiscations don't happen at all. They note that residents of long-term care facilities make up a significant portion of coronavirus cases and deaths in the U.S.

At least 32,000 residents of nursing homes have died due to COVID-19, according to CMS.

Advocates said they appreciate the efforts of lawmakers and federal agencies in wanting to protect seniors from having their relief payments confiscated.

"We welcome their attention to this issue so that facilities are not taking the stimulus checks of nursing home residents," said Rhonda Richards, senior legislative representative at the AARP.

Full Article & Source:
Nursing homes under scrutiny after warnings of seized stimulus checks

Lawyer stole from clients to renovate home

A Melbourne lawyer has been jailed for stealing more than $260,000 from clients
by Karen Sweeney

While suburban lawyer John James Kotsifas was living the high life with money he stole from his clients, they were getting deeper and deeper into debt.

He bought and renovated a million-dollar property, installed a swimming pool and paid golf club green fees with money entrusted to him by clients and friends.

Then it all came undone.

Already bankrupt, disbarred and living back home with his mother, his life hit a new low on Thursday when he was jailed for six years for his crimes.

Kotsifas was convicted of 23 charges, including the theft of $267,000 from clients and another $1.49 million he was supposed to have held on trust for them.

He is not to be confused with another Melbourne solicitor named John Andrew Kotsifas

Kotsifas helped himself to more than $400,000 he held on trust for one client.

She identified 27 transactions by him that she hadn't authorised, including the payment of his golf club green fees and settlement fees for properties she didn't own.

He stole $20,000 from another client to install a swimming pool and pay a real estate agent.

Kotsifas held more than $200,000 for stamp duty fees he never paid, costing the client another $167,000 out of pocket for the tax.

He has a history of disciplinary proceedings dating back to 2006, including VCAT proceedings that were underway for trust account offences during this offending.

A forensic accountant had to be brought in to sort through the mess he left.

When the $450,000 he had left on trust was paid out after his practice shut down, clients received just 47 cents on the dollar back.

One woman said she felt preyed on by Kotsifas, who destroyed her financially and left her on the brink of homelessness because of his greed.

Another said Kotsifas was a solicitor for her gravely ill, and now deceased, husband for 20 years.

He trusted Kotsifas as a friend and would have been gutted by the betrayal, she said.

Kotsifas, a twice married father of four, said he was under financial pressure when he committed his crimes, blaming pressure from his second wife to sustain a certain lifestyle.

He bought a $1.2 million Balwyn North property with a substantial mortgage and had a second large loan to cover renovations so he could then sell that home to buy a $2.4 million English Tudor-style home in Balwyn.

Kotsifas spent clients' money to rent the second Balwyn home during the purchase process.

But he defaulted on the first two mortgages rendering him unable to buy the other property, costing him his $247,000 deposit.

Supreme Court Justice John Champion said Kotsifas' offending was calculated, repeated, significant and a sustained betrayal of trust.

He posed as a solicitor and confidante to people he was meant to be on friendly terms with, but manipulated them and stole their money, he said.

Kotsifas must serve at least four years before he's eligible for parole.

Full Article & Source:
Lawyer stole from clients to renovate home

Medical Decision-Making for Incapacitated Adult Patients Under Utah Law

Healthcare providers generally are required to have an adult patient’s consent before they can administer any type of medical care, which raises the question: Who has the authority under Utah state law to make medical decisions on behalf of an unconscious (or otherwise incapacitated) adult patient. In treating patients with COVID-19, this concern is particularly relevant, as an intubated patient will be sedated and unable to participate in their own medical decision-making. Therefore, it is critical that healthcare providers determine who holds such authority under the applicable state laws.

Under Utah law, an adult with the capacity to make healthcare decisions (“Capacity”) retains the right to make healthcare decisions on their behalf.1 Their decisions, however expressed or indicated, will always supersede any prior decisions or healthcare directives they may have made.2 Also under Utah law, an adult is presumed to have Capacity, which means the ability to make an informed decision about receiving or refusing healthcare, when they have (i) the ability to understand the nature, extent, or probable consequences of health status and healthcare alternatives; (ii) the ability to make a rational evaluation of the burdens, risks, benefits, and alternatives of accepting or rejecting healthcare; and (iii) the ability to communicate a decision.3

To overcome the presumption that a particular patient has Capacity, a physician, APRN, or physician assistant4 who has personally examined the adult patient must perform each of the following:
  • find that the patient lacks Capacity;
  • record the finding in the patient’s medical chart and indicate whether the patient is likely to regain Capacity; and
  • make a reasonable effort to communicate the determination to the patient, other healthcare providers, or healthcare facilities that the medical provider would routinely inform of such a finding, and any known surrogate decision maker (e.g., an appointed agent, guardian or a Default Surrogate Decision-Maker (defined below)).5
Once the determination is made that an adult patient lacks Capacity (an “Incapacitated Patient”), the question then arises:

Who has the authority to make medical decisions on behalf of the Incapacitated Patient?

First, to determine who can make medical decisions on behalf of an Incapacitated Patient (a “Surrogate Decision-Maker”), one should determine if the Incapacitated Patient formerly designated an individual to act on their behalf in such situation6 (an “Agent”) or, alternatively, if the Incapacitated Patient has a court-appointed legal guardian.7 Either an Agent or legal guardian would be the proper Surrogate Decision-Maker, with an Agent having priority over a legal guardian.8

In the absence of an Agent or legal guardian (including an Agent that is unavailable or unwilling to act on the Incapacitated Patient’s behalf), Utah law designates who can act as a “Default Surrogate Decision-Maker.”9 The following family members (as long as they are over 18 years of age, have Capacity themselves, are available, and have not been disqualified by the Incapacitated Patient10 or a court) can act as a Surrogate Decision-Maker, according to the following hierarchy, in descending order of priority:
  • the patient’s spouse, unless the patient is divorced or legally separated;
  • a child;
  • a parent;
  • a sibling;
  • a grandchild; or
  • a grandparent.11
A person listed above may not act as the Surrogate Decision-Maker if a person of a higher priority class is able and willing to act as the Surrogate Decision-Maker.

If no family member listed above is available or willing to act as the Surrogate Decision-Maker, a non-family member can act as the Surrogate Decision-Maker if they: (i) are at least 18 years of age, (ii) have Capacity, (iii) have exhibited special care and concern for the patient; (iv) know the patient and the patient's personal values; and (v) are reasonably available to act as a Surrogate Decision-Maker.12

In those cases where there is more than one individual of the highest priority class that has assumed the role as a Surrogate Decision-Maker (e.g., three adult children) and there is a disagreement between them about healthcare decisions, the provider must following the majority decision.13

If an Incapacitated Patient does not have any family or friends available to act as their Surrogate Decision-Maker, Utah law is silent on who would then become the most appropriate decision-maker. However, it can be helpful to look to other state laws as guidance for this determination. For example, a few states allow clergy or other religious members to act as a Surrogate Decision-Maker.14 Other states allow a treating or attending physician, provided there is consultation with and concurrence by a second physician.15 Alternatively, some states allow healthcare decisions to be made following a consultation with the hospital’s ethics committee.16 Regardless of the approach taken, hospitals should create a uniform policy to be followed in such a situation and take care to follow and document that process. This is especially important when making decisions on behalf of critically ill or terminally ill Incapacitated Patients.

Last, Surrogate Decision-Makers must make healthcare decisions in accordance with the Incapacitated Patient’s current preferences (if known), their written or oral healthcare directions (e.g., Living Will, statements previously made by patient prior to losing Capacity, or other advanced healthcare directive), or by using the substituted judgment standard.17 The substituted judgment standard essentially requires a Surrogate Decision-Maker to consider the preferences of any adult patient who previously had Capacity to make their own decisions.18 Moreover, Utah law provides that a court-appointed legal guardian of an adult Incapacitated Patient must comply with the patient’s advanced healthcare directive and may not revoke the Incapacitated Patient’s advanced healthcare directive, without court involvement.19

Healthcare providers should cooperate with Surrogate Decision-Makers and ordinarily also must comply with decisions made by the highest-ranking Surrogate Decision-Maker.20 However, when the decision of a Surrogate Decision-Maker contravenes the known wishes of the Incapacitated Patient (e.g., Living Will, other written documents or statements made by patient prior to losing Capacity), the provider should carefully weigh the facts and evidence. Generally, the patient’s wishes should be honored.21 Utah law specifies that a healthcare provider does not have to comply with the decisions of the Surrogate Decision-Maker if, in the opinion of the healthcare provider, they have evidence that the Surrogate Decision-Maker’s instructions are inconsistent with the Incapacitated Patient’s healthcare instructions.22

Healthcare providers also can refuse to follow the decisions of Surrogate Decision-Makers when, in the opinion of the healthcare provider, (i) the Surrogate Decision-Maker lacks Capacity themselves (e.g., mental illness, dementia, disability), or (ii) for a patient that has always lacked Capacity, the Surrogate Decision-Maker’s instructions are inconsistent with the best interest of the adult.23 Additionally, a healthcare provider can decline to follow the decisions of the Surrogate Decision-Maker for reasons of conscience.24 In cases where a healthcare provider refuses to follow the wishes of the Surrogate Decision-Maker, among other things, the healthcare provider must communicate their decisions, attempt to resolve the conflict (where possible), and provide continuing care until the issue is resolved or the patient can be transferred.25

While it can be difficult for healthcare providers and facilities to wade through complicated scenarios involving Incapacitated Patients and decisions of Surrogate Decision-Makers, Utah law offers significant protections. A healthcare provider or facility that acts in good faith, consistent with generally accepted healthcare standards, and in accordance with the provisions contained in the Advance Health Care Directive Act will not be subject to civil or criminal liability or professional disciplinary action for providing or refusing to provide care to Incapacitated Patients.26

Protecting patients’ rights to direct their own healthcare treatment requires that providers thoughtfully approach situations where a patient’s Capacity is at issue. Healthcare facilities should establish processes to (i) evaluate and document the Capacity of patients; (ii) determine the valid Surrogate Decision-Makers for Incapacitated Patients; (iii) verify that decisions by Surrogate Decision-Makers do not contravene any prior patient healthcare directives; and (iv) give providers an effective avenue for raising concerns that may arise related to Surrogate Decision-Makers and their treatment decisions.

1U.C.A. § 75-2a-109(1).
2U.C.A. § 75-2a-109(2).
3U.C.A. §§ 75-2a-104, 75-2a-103(13).
4The physician assistant must be permitted to make determinations of Capacity under their delegation of services agreement with their supervising physician. U.C.A. § 75-2a-104(6).
5U.C.A. §§ 75-2a-104(2), 75-2a-103(23). It should also be noted that under Utah law, a patient can challenge the determination that they lack Capacity by submitting written notice or orally informing the healthcare provider that the patient disagrees with the finding. In such case, the healthcare provider must treat the patient as having Capacity unless a court deems otherwise. U.C.A. § 75-2a-104(3).
6Designation of an agent can occur via a written document executed by the adult patient (e.g., Living Will, Medical Power of Attorney) or a witnessed oral statement. See U.C.A. § 75-2a-103(2).
7U.C.A. §§ 75-2a-111(1), 75-2a-112(2).
8U.C.A. § 75-2a-108
9An adult patient, even if found to lack Capacity, can disqualify a family member or friend from acting as their Surrogate Decision-Maker by personally informing a witness of the disqualification (e.g., telling a nurse or provider), providing a signed writing, or informing the individual trying to act as a Surrogate Decision-Maker. U.C.A. § 75-2a-108(5).
10U.C.A. § 75-2a-108(1).
11U.C.A. § 75-2a-108(2). However, if the provider has reasonable doubts about an individual’s right to act as a Surrogate Decision-Maker (e.g., someone claiming to be the spouse of an individual and the provider doubts such statement), the healthcare provider may require the person to provide a sworn statement giving facts and circumstances reasonably sufficient to establish the claimed authority, or seek a ruling from the court. U.C.A. § 75-2a-108(6).
12U.C.A. § 75-2a-108(4).
13See, e.g., TX Health & Safety Code § 313.001.
14See, e.g., A.R.S. § 36-3231. Note, however, that some states disqualify the patient’s healthcare providers. Tenn. Code Ann. § 68-11-1806.
15See, e.g., A.R.S. § 36-3231.
16U.C.A. § 75-2a-110(1).
17"Substituted judgment" requires the surrogate to consider: (a) specific preferences expressed by the adult when the adult had the capacity to make healthcare decisions; and at the time the decision is being made; (b) the surrogate's understanding of the adult's healthcare preferences; (c) the surrogate's understanding of what the adult would have wanted under the circumstances; and (d) to the extent that the preferences described in (a) through (c) are unknown, the best interest of the adult. U.C.A. § 75-2a-103(22).
18U.C.A. § 75-2a-112(1).
19U.C.A. § 75-2a-115(4)(a).
20U.C.A. § 75-2a-115(4)(a)(ii).
21U.C.A. § 75-2a-115(4)(b)(i)(C). A healthcare provider may seek a ruling from a court if they have evidence that a surrogate is making decisions that are inconsistent with an adult patient's wishes or preferences. U.C.A. § 75-2a-108(1)(d).
22U.C.A. § 75-2a-115(4)(b).
24U.C.A. § 75-2a-115(4)(c)–(e).
25U.C.A. § 75-2a-115(3).

Full Article & Source:
Medical Decision-Making for Incapacitated Adult Patients Under Utah Law

Thursday, June 11, 2020

Former judge accused of defrauding estates resigns from bar

by Dave Stafford

A one-time northern Indiana trial court judge who is accused in lawsuits of taking money from two estates in cases he represented has resigned from the Indiana bar rather than face disciplinary proceedings related to his misconduct.

The Indiana Supreme Court on Thursday accepted the resignation of Monon lawyer Robert V. Monfort. In resigning, Monfort acknowledged that there was a Indiana Supreme Court Disciplinary Commission proceeding alleging misconduct and that he could not successfully defend himself if prosecuted.

Montfort, who once presided as a Jasper Superior Court judge, has not been criminally charged, but lawsuits filed on behalf of charities in Rensselaer allegt he and/or his law office misappropriated hundreds of thousands of dollars that a deceased widow bequeathed to community charities.The commission filed a disciplinary complaint April 27 accusing Monfort of criminal acts and “conduct involving dishonesty, fraud, deceit or misrepresentation,” among a litany of other ethical charges.

The discipline case against Monfort arises from two estate matters he handled that resulted in litigation in Jasper Superior Court against him and his law firm.

In one case, charities that stood to benefit from an elderly widow’s estate accuse Monfort of undue influence over Rose Jennette Nagel that “resulted in more than $600,000 in damages” to a Catholic school and the Jasper Newton Foundation, which the suit says stood to benefit from her bequests. The suit also makes claims of negligence and improper estate administration, and contests Nagel’s probated will that would have instead left her estate to an employee in Monfort’s office who also had served as personal representative for Nagel’s estate.

Monfort also is accused of attorney misconduct in handling the estate of Anthony Kaczorowski, who died intestate in 2014. Among other things, the commission says as recently as 2019, Monfort swore an affidavit that Kaczorowski had no known heirs, which he knew to be false. The commission likewise levels allegations of criminal conduct and fraud in Monfort’s handling of that case.

The commission alleged Monfort consumed nearly all of the $114,000 in Kaczorowski’s liquid estate assets through estate administration expenses, inappropriate fees and“unjustified payments to respondent and his office staff,” and more.

Meanwhile, Monfort faces one other civil lawsuit alleging professional negligence in his office’s handling of a third estate case, that of John Garling. Garling’s estate alleges, among other things, that the case dragged on for more than five years while a personal representative appointed at Monfort’s request caused assets to be dissipated and “may have taken certain assets for his own personal use.”

The suit also alleges a house belonging to Garling’s estate was sold for an amount significantly below fair market value.

Monfort was judge of Jasper Superior Court 2 from 1994-2000. The Indiana General Assembly dissolved the court, a decision affirmed by the Indiana Supreme Court in 2000.

Monfort, who was admitted to the bar in 1988, was previously suspended for 30 days with automatic reinstatement for helping a client in 2009 who previously had been a defendant in a drunken-driving case in which Monfort had presided as judge.

The disciplinary case is In the Matter of: Robert V. Monfort, 20S-DI-284.

Full Article & Source:
Former judge accused of defrauding estates resigns from bar

SUNDAY TALK: Grassley on Older Americans Month

Q: What policies are you pursuing to help older Americans, especially during the pandemic?

A: Since COVID-19 first was identified in February at a nursing home in Kirkland, Washington, the novel coronavirus has impacted older citizens in communities across the country. According to the Centers for Disease Control and Prevention (CDC), the infectious disease poses greater risk to older populations, especially those with underlying health conditions. The unprecedented effort to slow the spread of the virus and curb transmissions and infections is particularly acute for older residents in the nation’s nursing homes, memory care facilities and other residential care communities and for the health professionals who provide their around-the-clock care. The number of COVID-19 deaths linked to long-term care facilities, including residents and workers, accounts for a disproportionate share of coronavirus fatalities in the United States. As chairman of the Senate Finance Committee, which has legislative and oversight jurisdiction of Medicare and Medicaid, I work to ensure these public health care programs effectively serve older Americans. Medicaid pays for the lion’s share of nursing home care in the United States. During the pandemic, I’ve worked closely with the Trump administration to prioritize nursing homes and ensure they have the emergency medical equipment they need to protect staff and residents. Following my request for more transparency, the Centers for Medicare & Medicaid Services (CMS) required nursing homes to report COVID-19 cases in nursing homes directly to the CDC and to post testing data online. In addition, Congress swiftly approved a series of laws to respond to the coronavirus pandemic that support the health and well-being of older Americans, including $1,200 direct financial assistance payments, expanded Medicare telehealth coverage, and enhanced funding and flexibility for nutrition assistance and community-based programs delivered under the umbrella of the Older Americans Act, such as home delivered meals. Earlier this year, I helped secure a five-year renewal of the Older Americans Act that makes critical resources available to the nation’s network of Area Agencies on Aging to provide community-based services for older residents and individuals with disabilities so they may live independently and enjoy a higher quality of life. I’m glad President Trump directed the Federal Emergency Management Administration (FEMA) to deliver emergency supplies of personal protective equipment to more than 15,000 nursing homes in local communities across the country. The health care professionals caring for loved ones in the nation’s nursing homes are on the front lines of the pandemic. They need proper protective equipment as they care for patients from one room to the next. That’s also why I’ve called upon CMS to step up enforcement of infection control to protect our nation’s most vulnerable citizens throughout the pandemic and beyond.

Q: What reforms are you seeking to curb elder abuse and exploitation?

A: As former chairman of the Senate Aging and Judiciary Committees and now from the helm of the Senate Finance Committee, I leverage my leadership platforms to improve the quality of life for older Americans, such as my efforts to reduce prescription drug prices, curb age-related work discrimination and protect seniors from fraud and abuse. Within the next decade, all of the nation’s baby boomers will reach age 65 and older. Many older Americans depend on prescription medications to manage chronic health conditions and treat and cure disease. Iowans regularly share stories of financial hardship to pay for life-saving medicines, such as insulin. For two years I’ve built a bipartisan coalition with Sen. Ron Wyden to address the soaring costs of prescription drugs in America. Now more than ever, the pandemic underscores why Americans need affordable, innovative pharmaceutical treatments. Our Prescription Drug Pricing Reduction Act (PDPRA) would reduce out-of-pocket costs for seniors, bring stability and transparency to drug prices and save taxpayer dollars without hampering innovation and investment in pharmaceutical research and cures.
Unfortunately, criminals and wrongdoers are taking advantage of the pandemic to target older citizens with financial schemes and scams. Advocates say one in 10 Americans age 60 or older has experienced exploitation or abuse. As author of the Elder Abuse Prevention and Prosecution Act of 2017, I’m working to further strengthen tools to help prevent these crimes. My legislation established an elder justice coordinator in the Federal Trade Commission and the Department of Justice. This month I introduced bipartisan legislation with Senators Susan Collins and Bob Menendez that would enhance training resources to more effectively serve Americans with Alzheimer’s disease who fall prey to exploitation and abuse. The FTC is tracking a surge in COVID-19 fraud complaints, including travel offers, online shopping, bogus text messages and imposters posing as government representatives. Americans have reported losing nearly $37 million to fraud since January, with a median loss of $470. To report fraud, go to For personalized attention free-of-charge, contact the Department of Justice Elder Fraud Hotline at (833) FRAUD-11. A case manager will walk you through the reporting process and connect you with additional resources and agencies. Reporting financial fraud within the first 2-3 days increases the chances for recovering losses. The DOJ hotline is open 7 days a week.

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Letter to the editor: Legislation would curb elder abuse

As executive director for the Alzheimer’s Association’s Greater Pennsylvania Chapter, I understand personally and professionally the impact this disease has on families across Pennsylvania and our country. Alzheimer’s and all dementia are often emotionally and financially devastating.

As the number of people living with dementia rises, so, too, will their interactions with health care, social services and criminal justice services professionals. Unfortunately, those professionals receive little or no training in the unique needs of individuals living with dementia.

The Promoting Alzheimer’s Awareness to Prevent Elder Abuse Act would require the Department of Justice to develop training materials to assist law enforcement officers, prosecutors, judges, medical personnel, victims services personnel and others who encounter and support individuals living with Alzheimer’s and related dementias.

Dementia-specific training materials for these professionals will improve the quality of their interactions with individuals living with Alzheimer’s and other dementias, and also will help protect them from elder abuse.

On behalf of our staff, volunteers and the millions of families impacted by Alzheimer’s disease, we are thankful for Rep. Guy Reschenthaler’s leadership in introducing the bipartisan, bicameral Elder Justice Improvement Act.

As we look ahead, we are hopeful that additional legislators will sponsor this legislation, making it possible for us to protect people living with Alzheimer’s and other dementias from elder abuse and for Pennsylvania to lead on this important issue.

Clay Jacobs

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Letter to the editor: Legislation would curb elder abuse

Wednesday, June 10, 2020

Judge mulls conservator for so-called Hawaiian princess

By Jennifer Sinco Kelleher

HONOLULU — A long, bitter legal battle over control of a 94-year-old Native Hawaiian heiress' $215-million fortune raged on Tuesday, with a judge saying her conservatorship should be unlimited but not ruling on who the conservator will be.

It's not clear when Judge R. Mark Browning will rule on who will serve as conservator for Abigail Kawananakoa, considered a princess by some because she's related to the family that ruled the islands before the overthrow of the Hawaiian kingdom in 1893.

Browning "finds that an unlimited conservatorship is appropriate," he said in a written order after hearing arguments Tuesday. His order also directs a court-appointed helper, known as a Kokua Kanawai, to do a "brief investigation into the four proposed conservators," including Kawananakoa's wife.

The Kokua Kanawai must interview the nominated conservators and file a report by the end of the month. Browning set a July 21 hearing.

Kawananakoa inherited her wealth as the great-granddaughter of James Campbell, an Irish businessman who made his fortune as a sugar plantation owner and one of Hawaii's largest landowners.

The legal wrangling dates to 2017, when her longtime lawyer, Jim Wright, argued a stroke left her impaired. Kawananakoa said she's fine and fired Wright. She then married her partner of 20 years, Veronica Gail Worth, who later took her last name.

Native Hawaiians have been closely watching what happens because they are concerned about the fate of a foundation she set up to benefit Hawaiian causes.

"It is our kuleana to ensure Abigail Kawānanakoa's resources — which she intended for the Hawaiian community — aren't hijacked for personal or corporate gain," Oz Stender, interim director of her foundation, said in a statement, using the Hawaiian word for responsibility.

Another judge ruled in March that Kawananakoa needs a conservator because she's unable to manage her property and business affairs. She testified that she doesn't need anyone to handle her estate because she isn't dead yet.

Kawananakoa, who turned 94 in April, listened to Tuesday's hearing by telephone. She didn't speak during the proceeding. Because of the coronavirus pandemic, the judge allowed only a few attorneys to be in the courtroom to avoid a crowded space. Other attorneys, including those representing her foundation, participated by telephone.

She wants a limited conservatorship, said her attorney, Bruce Voss. He said she wants the conservator to be either be her wife, or Stacey Wong, who was trustee of the Eric A. Knudsen Trust, one of Hawaii's largest family estates.

"Fundamentally ... what Ms. Kawananakoa wants is to maintain some control, at least some control, over the things that are most important to her and her life: her people, her care and her horses."

She can make decisions, he said. "She doesn't want anyone ... to take complete control of her life," he said. "She's a proud, smart woman."

She needs is an independent conservator with full control over her finances who can work with a trustee who replaces Wright, said Wright's attorney, Edmund Saffery.

"The issue before the court is simple, should Ms. Kawananakoa be allowed to continue to run her financial affairs over a cliff or should the slate finally be wiped clean with the appointment of a neutral third party conservator beholden to seeing that Ms. Kawananakoa's finances are managed to her best interests," Saffery said.

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Judge mulls conservator for so-called Hawaiian princess

AG's Elder Abuse Team uncovers financially exploited victim in Weston

Ramona Bartell, 64, and Melissa Bublitz, 42
WAUSAU, Wis. (WSAW) -- The Wisconsin Attorney General’s Elder Abuse Team has identified two suspects in the financial exploitation of an elderly Marathon County resident.

Ramona Bartell, 64, and Melissa Bublitz, 42, are accused of stealing hundreds of thousands of dollars from a woman during a span of three years.

An exact dollar amount was not identified as some receipts and documents were missing from investigative reports, however, court documents said during a 21-month span the woman’s expenses exceeded $571,000. Prior to that period, her expenses had been under $50,000.

An investigation began after corporate guardians appointed to legally protect the woman believed the victim’s previous power of attorney was misusing funds.

A special agent combed through thousands of pages of transactions. While some were for the woman’s legitimate expenses, such as power lift chair and home improvements, many other items purchased were questioned that they would be for an elderly woman.

Court documents state Bubliz was the woman’s power of attorney from October 2014 to June 2017. She was then removed by a judge. Investigators said Bartell and Bublitz lived together at one point in Ozaukee County.

Investigators said suspect purchases included Disney timeshares, Coach purses and a subscription to a dating website for Disney lovers called ‘Mouse Mingle’.

When questioned, the women said the extravagant purchases were from the woman for her family and caregivers. However, a special agent said previously the woman would write $25 checks for birthdays as gifts and it was unlikely her spending habits would have changed that drastically.

Both women are charged with two counts of theft related to the allegations. They are both free on $10,000 signature bonds and will return to court June 25. That’s when a judge will rule if there is enough evidence for their cases to head to trial.

The victim died earlier this year.

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AG's Elder Abuse Team uncovers financially exploited victim in Weston

It feels impossible to protect residents in our care home if we loosen lockdown

‘We have watched the devastating consequences of the virus in other homes with horror.’ Robin Hall at the Home of Comfort nursing home in Southsea, Hampshire. Photograph: Simon Czapp/Solent News & Photo Agency/Solent News
As the lockdown rules loosen, friends and family members of our nursing home residents, who have been so supportive through this crisis, are nurturing hopes of a relaxation in our visiting policy.

It was on 17 March – only 11 weeks ago, though it feels like a lifetime – that we decided with the heaviest of hearts to close our doors to almost all visitors. When the country went into lockdown that decision seemed a prudent, if painful one; the home is normally full of the laughter and joy of up to 30 residents and their visitors, who are usually such an important presence. Deprived of their company, many of our residents have become more anxious, confused or both, in spite of our best efforts to maintain connections using technology.

By the end of March, 16 out of 58 staff members were isolating because they or a family member was sick, or shielding, meaning it has also been a day-by-day struggle to make sure we have had enough people on duty, not to mention supplies of food and personal protective equipment (PPE). Thankfully our local authority has provided support on all fronts, which helped us through the most turbulent initial weeks, and we’ve since managed to find new suppliers and recruit new staff alongside those who have been able to come back to work.

We have watched the devastating consequences of the virus in other homes with horror. Our own numbers make painful reading, with 11 deaths in as many weeks, but we think we have actually been lucky; most of those have been the culmination of a long illness, or new admissions to us from our local hospital for end-of-life care. Initially only three residents were tested so we won’t know for sure – and we try not to drive ourselves crazy wondering – but, although one of those three positive patients has sadly died, the other two, including a lady in her 90s, appear to have made a full recovery.
The rollout of the promised weekly testing of all care home residents and employees is painfully slow. Our first full set of tests arrived on Sunday 17 May, with a 30-hour window of opportunity to carry out tests before the prearranged collection; miraculously we managed to test 72 people, including all but three of the staff who weren’t on duty over those two days. When the results arrived two days later, a resident and a member of staff – neither of whom had experienced any symptoms – had tested positive. By chance, that staff member hadn’t been at work for a few weeks, but it brought home how important testing is, and how badly we need to repeat it regularly. Disturbingly, we still have no idea when that will be possible.

Current guidance states that the PPE that staff wear will protect them from transmitting the virus, and we can only hope this is the case, because our converted premises, which give us a lovely homely atmosphere, make social distancing impossible – even if two people washing and dressing the same resident could keep two metres apart. The guidance at least means we won’t lose half the staff team as the result of a single positive test – as the PPE is supposed to protect us – but given how Covid-19 has spread in other homes, all the PPE and infection-control processes in the world don’t give us confidence that if we have another case, we will be able to contain it.

And that is why, despite the easing of restrictions, and the government’s seemingly spontaneous last-minute decision to allow the “extremely vulnerable” to leave their houses, we are not yet comfortable with even the most socially distanced of visits. The only piece of official guidance, issued to care homes on 15 May, advises that face-to-face visits should only take place at the very end of a resident’s life, and under strict conditions (no more than two visitors, no kissing, PPE to be worn). It hasn’t been updated, leaving homes to navigate this minefield for themselves.

Portsmouth has had lower infection and death rates than many parts of the country, but as people start to mix we know that the local infection rate is likely to go up, making it more likely that any visitor brings more than they intend with them. It is a short step from there to another outbreak in the home, and we can’t count on being so lucky next time.

So for the time being, we are keeping our doors closed and trialling meetings between a resident inside the conservatory and a visitor outside who will be able to see and speak to each other through the glass double doors. We are also puzzling over how to provide chiropody, and when hairdressing and worship can resume in the home.

In spite of the severe symptoms some of our colleagues suffered, we have for the most part stopped worrying about becoming ill ourselves. Protecting our residents feels like our most important task. It also feels like an impossible one.

Robin Hall is administration manager at the Home of Comfort in Southsea, a charitable nursing home, and secretary of the Hampshire Care Association

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It feels impossible to protect residents in our care home if we loosen lockdown

Tuesday, June 9, 2020

Man in N.J. nursing home was buried before his family even knew he was dead

Thomas E. Comer and his granddaughter, BriannaCourtesy of Brianna Comer
By Ted Sherman

Thomas E. Comer’s final hours are a mystery to his family.

In fact, they never even knew the 88-year-old retired machinist — who lived out the last four years of his life at the Bayshore Health Care Center in Holmdel — had died from COVID-19 on April 13th until long after he was buried.

“Somebody could have told me something,” said his son, David. “He was my dad.”

His father, who suffered from dementia, was under state guardianship because of financial necessity, Comer said. But neither the state nor the nursing home reached out to contact his family after the Irish expatriate succumbed to the coronavirus.

“I understand what’s going on,” he said of the crisis in the state’s nursing homes that has killed more than 6,200 people in an outbreak that has taken 1 in 12 residents. “But they couldn’t spare me five minutes?”

Bayshore Health Care has reported the deaths of 21 of its residents in the outbreak. Another 119 residents tested positive for COVID-19.

Comer first learned of his father’s death after his daughter called the nursing facility to find out how he was doing.

“We had not heard anything. We knew they were overwhelmed, but I had this false sense nothing would ever happen to him,” Brianna Comer recalled. “The woman who answered the phone said she could not find him.”

Then she was told he had expired.

“I went, ‘what? When did he die?’”

“Oh, I can’t tell you that,” a staff member told her. “You’re not on the list.”

“Who is on the list?” she asked.

“I can’t tell you that either,” the staffer said.

It was not until she Googled her grandfather’s name that she discovered he had been sent to Laurel Funeral Home in West Keansburg following his death.

“We were told by the funeral home that he was already buried, against his wishes of being cremated, and they also attempted to contact my father, but they were only given an outdated phone number by the nursing home,” Comer remarked.

Funeral home officials said they tried calling the number given by Bayshore, but got only a click and no answer when they reached out. “That was the only phone number we had,” explained Kathleen Sperling, whose family owns the funeral home.

Brianna Comer said her father updated his phone number four times with Bayshore Health Care, giving it to nurses who directly cared for her grandfather, the nursing director, and the front desk.

“We visited frequently, always bringing a small black coffee, jelly donuts and occasionally a bottle of Guinness,” she said. “There was no reason for anyone in the facility to assume he was not wanted or loved.”

She said it was clear that no one bothered to update his file.

Hackensack Meridian Health, which operates Bayshore Health Care, said in a statement they followed state laws governing how notifications are to be made.

“Our thoughts and prayers go out to the Comer family. This is undoubtedly a sad situation and it’s understandable the process would be questioned. When an individual passes at a nursing or health care facility, a guardian or next of kin is notified,” the statement said. “If the individual is under the supervision of the Office of Public Guardian, this would be the entity that would receive appropriate notifications related to private health information — including death. Privacy laws prohibit the sharing of health protected information unless designated otherwise.”

The Office of the Public Guardian is administratively located in the Department of Human Services, but not part of it. Acting Public Guardian Helen Dodick said they do not discuss specific cases. But when an individual protected by her office passes away, she said the assigned care manager — or depending on the hour, the on-call care manager — notifies the family.

“If the staff cannot reach the family through the notification numbers provided by the family, staff will then try multiple means of finding the family, including working with the nursing home, funeral director and doing Internet searches,” she said. “The office — as part of its mission to aid, empower and protect New Jersey’s older adults who need assistance — does everything it can to contact families.”

Comer, a retired Passaic County Sheriff’s Officer, said it would not have been hard to find him.

“They could have called the Holmdel police and given my name and they would have found me in minutes,” he said.

Born on September 2, 1931 in County Mayo on Ireland’s west coast in the town of Westport, Thomas Comer was a proud Irishman who never lost his brogue, said his granddaughter.

“He never got sick. He always said he had Irish immunity,” Brianna Comer remembered. “When we got sick, he said we weren’t Irish enough.”

She said he loved math and loved chess and for some reason, dogs always seemed to love him.

He was a veteran of the Royal Air Force, where he was an air traffic controller. He followed his parents and siblings to the United States, arriving here in 1958, but never became a naturalized citizen. While he talked about returning one day to Ireland, he never did. He was afraid to fly, Comer said. He settled in Orange, and lived for 40 years in Passaic, working as a machinist before his retirement. He later moved to Union Beach.

In recent years, however, it became clear he would need nursing care.

“My grandfather suffered from dementia and would frequently leave the house and disappear on walks, no matter the weather,” said Comer. “Due to overwhelming costs of nursing homes, we sought help from the state by making him a ward of the state with a social worker to place him in a home where he thought he would be safe and monitored.”

The family is now trying to obtain his medical records in order to find answers regarding what happened to him and locate his belongings.

“I would have just appreciated his few effects,” said David Comer. “Some pictures. The wristwatch my son gave him. It’s just a $10 watch, but it was his.”

Survived by his older son John, of North Carolina, and youngest son David, of Keyport, he left behind 7 grandchildren and 3 great- grandchildren. He was predeceased by his wife, Eileen, and a son, Steven. He is buried at Bay View Cemetery in Leonardo.

“It was a direct burial,” said Sperling. “Our funeral director did say prayers there, which is normal if there is no family there.”

For now, the pandemic has prevented David Comer from going to his father’s grave.

“No one’s allowed to visit,” he said. “They said you have to wait.”

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Man in N.J. nursing home was buried before his family even knew he was dead