Saturday, January 30, 2021

N.Y. Severely Undercounted Virus Deaths in Nursing Homes, Report Says

The state attorney general, Letitia James, said it’s likely that the Cuomo administration failed to report thousands of Covid-19 deaths of nursing home residents.

Credit...Dave Sanders for The New York Times

By Jesse McKinley and Luis Ferré-Sadurní

ALBANY, N.Y. — For most of the past year, Gov. Andrew M. Cuomo has tried to brush away a persistent criticism that undermined his national image as the man who led New York through the pandemic: that his policies had allowed thousands of nursing home residents to die of the virus.

But Mr. Cuomo was dealt a blow when the New York State attorney general, Letitia James, reported on Thursday morning that Mr. Cuomo’s administration had undercounted coronavirus-related deaths of state nursing home residents by the thousands.

Just hours later, Ms. James was proved correct, as Health Department officials made public new data that added more than 3,800 deaths to their tally, representing nursing home residents who had died in hospitals and had not previously been counted by the state as nursing home deaths.

The state’s acknowledgment increased the overall death toll related to those facilities by more than 40 percent. Ms. James’s report had suggested that the state’s previous tally could be off by as much as 50 percent.

The findings do not change the overall number of Covid-19 deaths in New York — more than 42,000, the most of any state — but the recalculation in the number of nursing home deaths illustrates how unprepared the nursing home industry was in the first and deadliest weeks of the pandemic.

Mr. Cuomo, a third-term Democrat, had long dismissed the critiques of his policies governing those facilities as partisan attacks from the Trump administration and other Republican adversaries.

But the report by Ms. James, a fellow Democrat, casts a renewed light on the state’s decision to send nursing home residents who had been hospitalized with the coronavirus back to the nursing homes, a policy that Mr. Cuomo has defended as following federal guidelines.

At the same time, Ms. James’s assertion of an undercount of deaths gave credence to theories that the state may have intentionally played down the number of those deaths to avoid blame.

“This is shocking and unconscionable,” said Assemblyman Richard N. Gottfried, the Democratic chairman of the Assembly Health Committee. “But not surprising.”

The 76-page report, which included critiques of other policies promulgated by the Department of Health and of the behavior of nursing home operators, led to a scramble by Mr. Cuomo’s administration to rebut its assertions, including a lengthy response late Thursday afternoon from the health commissioner, Dr. Howard Zucker.

Dr. Zucker said that the state website had always been clear that deaths it listed did “not include deaths outside of a facility.”

“The word ‘undercount’ implies there are more total fatalities than have been reported,” he said. “This is factually wrong.”

He also asserted that the lack of data on hospital deaths of nursing home residents was due to concern and caution about the accuracy of data that nursing homes supplied — an issue also raised by the attorney general. “D.O.H. does not disagree that the number of people transferred from a nursing home to a hospital is an important data point,” he said.

The new data released by Dr. Zucker puts the total number of deaths connected to nursing homes at 12,743.

Ms. James’s findings would seem to put her in rare conflict with Mr. Cuomo; she was the governor’s preferred candidate after Eric T. Schneiderman suddenly resigned as attorney general in 2018, and she readily embraced Mr. Cuomo’s political backing.

Her report seemed certain to inspire more questions about the handling, oversight and performance of the state’s nursing homes in the early stages of the pandemic. Indeed, on Thursday, Mr. Cuomo’s critics in Washington and Albany had already seized on the attorney general’s report as evidence of his dishonesty, amid calls for Dr. Zucker to resign.

“This is now more than a nursing home scandal,” said Representative Elise Stefanik, a conservative Republican from upstate New York. “This is a massive corruption and cover-up scandal.”

Deaths in nursing homes and other long-term care facilities have accounted for about a third of the nation’s some 430,000 Covid-19 deaths. Federal and state authorities have made vaccinating staff and residents at such facilities a top priority, though that effort has been slower than hoped.

But even as state officials in New York tackle vaccine shortages, the count of deaths in the state’s nursing homes remained a source of controversy. Mr. Cuomo had been accused of obscuring a more accurate estimate of nursing home deaths, because the state’s count only included the number of deaths at the facilities, rather than accounting for the residents who died at a hospital after being transferred there.

For its report, Ms. James’s office surveyed dozens of homes and found consistent discrepancies between deaths reported to the attorney general’s investigators and those reported to and officially released by the Health Department.

In one instance, an unnamed facility reported to the Health Department that it had 11 confirmed and presumed deaths on site through early August. The attorney general’s survey of that same facility, however, found 40 deaths, including 27 at the home and 13 in hospitals.

Another facility reported one confirmed and six presumed Covid-19 deaths to the Health Department, according to the report. The attorney general’s office, however, said the facility reported to its investigators that there were more than four times that number — 31 dead — by mid-April.

The attorney general’s report also scrutinized immunity provisions granted to health care providers codified by Mr. Cuomo in the state budget. The report said the protection of immunity may have prompted some nursing homes to make financially motivated decisions at the height of the pandemic, like admitting patients even when the facilities were facing staff shortages or were unequipped to care for them.

Indeed, Ms. James’s office is still investigating and weighing legal action stemming from complaints made to her office about shortcomings and neglect that may have placed residents at risk. Those include allegations of nursing homes that failed to isolate Covid-19 patients, maintain stockpiles of personal protective equipment, properly screen employees for the virus or ensure adequate staffing levels even before the pandemic.

The report also cast a critical eye on perhaps the governor’s most criticized decision since the beginning of the pandemic last year: a March 25 directive from the Health Department that ordered nursing homes to accept and readmit patients who had tested positive.

The Health Department responded in July with a report that sought to absolve the state from any blame resulting from the March directive. The report concluded that most of the patients sent back to nursing homes “were no longer contagious when admitted and therefore were not a source of infection.” The Health Department concluded that the virus was instead spread by employees who did not know they were contagious.

While acknowledging that Mr. Cuomo’s memo to nursing homes was consistent with federal guidance, the attorney general’s report said the governor’s policy “may have put residents at increased risk of harm in some facilities.” Under the policy, some nursing homes stopped testing residents for the coronavirus, a factor that might have obscured data reported by the facilities, the report found.

For its part, the Health Department also cited Ms. James’s findings on the March 25 memo, saying the report had found no evidence that the policy outlined in the directive “resulted in additional fatalities in nursing homes.”

Ms. James’s report also found a number of homes that “failed to comply with critical infection-control policies,” including failing to isolate residents who had tested positive for the virus or screen employees for it.

The state’s reporting of nursing homes deaths has been the focus of a lawsuit by a conservative economic think tank, the Empire Center for Public Policy, which has sued, seeking to force the Health Department to release more complete data. 

Last year, the Democratic-controlled Legislature held hearings partly in an attempt to pry the data from the administration, to no avail.

Dr. Zucker was supposed to testify next week during a state budget hearing, where lawmakers were expected to press him on nursing home deaths, but his appearance was recently pushed back to late February.

The Democratic chairman of the investigations and government operations committee in the State Senate, James Skoufis, who has accused the Health Department of stonewalling investigators, suggested on Thursday that he would use a subpoena to compel the release of data from Dr. Zucker’s office.

“The D.O.H. commissioner’s unresponsiveness to the Legislature’s many questions and concerns is insulting and unacceptable,” the senator said in a statement.

The attorney general asked 62 nursing homes — about a tenth of the state’s total — for information about on-site and in-hospital deaths related to the virus; investigators then cross-referenced that information with public reports of deaths issued by the Health Department. The deaths reported to the attorney general’s office at most of those facilities totaled 1,914, compared to the state’s much lower count of 1,229.

Ms. James said that her office was investigating those circumstances “where the discrepancies cannot reasonably be accounted for by error or the difference in the question posed.”

The attorney general said she was continuing to conduct investigations of more than 20 nursing homes across the state that “presented particular concern,” noting that “other law enforcement agencies also have ongoing investigations relating to nursing homes.”

Under normal circumstances, the attorney general’s office “would issue a report with findings and recommendations after its investigations and enforcement activities are completed,” Ms. James said in her report. “However, circumstances are far from normal.”

Full Article & Source:

Disbarred attorney sentenced to probation on felony embezzlement charge

Barbara Harris
by: Jason Kotowski 

BAKERSFIELD, Calif. (KGET) — Former attorney Barbara McDaniel Harris was sentenced to five years’ probation after pleading no contest to a felony embezzlement charge, according to court records.

Harris, who also uses “Lynn” as her middle name, was disbarred last year after the State Bar found she misappropriated hundreds of thousands of dollars from a former client, records show. The state Supreme Court ordered her to pay restitution of more than $370,000 to a man and woman whose money she allegedly stole.

The allegations against Harris have their origins in 2004 when a Kern County couple entered into divorce proceedings in which Harris, who practiced family law, represented the wife. During the course of the proceedings, it was ordered the family house be sold and the proceeds of the sale be placed in Harris’ client trust account for stipulated disbursements.

In 2016, the couple filed a complaint with the State Bar after Harris failed to comply with court orders to produce an accounting of the money, according to State Bar documents. The Office of Chief Trial Counsel of the State Bar held a trial July 2, 2019, and found Harris culpable of multiple allegations, including failing to maintain records of client property and moral turpitude by intentionally misappropriating hundreds of thousands of dollars, the filings said.

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‘Skyrocketing’ level of elder financial abuse rising further during COVID-19

by Kira Vermond

There are several red flags advisors should look out for if they believe senior clients are being taken advantage of financially by those close to them.

jfmdesign/iStockPhoto / Getty Images

The COVID-19 pandemic has ushered in an era of mask-wearing, anxiety, and plenty of handwashing, but it has also brought an uptick in financial elder abuse.

One in five seniors will experience the abuse in which family members, caregivers or so-called friends take advantage of an elderly person’s finances, says Laura Tamblyn Watts, president and chief executive officer of CanAge, a national seniors’ advocacy group, who also teaches a course on law and aging at the University of Toronto. If online and phone phishing scams perpetrated by strangers are included, the number is even higher.

“Elder abuse and neglect is skyrocketing, and it appears during the time of COVID-19, it’s going to get worse, not better,” she says.

The reasons are double-barrelled. Adult children who have been supported by government dollars to ride out the pandemic will eventually lose that funding and may turn to parents for financial support – even if those parents need that money, too. And the pandemic’s physical distancing measures have also forced many seniors to become more isolated, making them especially vulnerable to abuse.

For financial advisors, touching base with senior clients is more important than ever, and they should use the opportunity to look for signs of financial exploitation, from the seemingly innocent – the daughter who buys groceries for her mother each week but pockets $50 in change – to the outright insidious: a new “friend” who tries to get a client to change her will.

“That’s where advisors can be very beneficial,” says Kathy Majowski, board chair for the Canadian Network for the Prevention of Elder Abuse. “It’s about developing that relationship with an older adult and saying, ‘Are you okay? Do you need some help?’”

The more blatant cases of financial abuse against clients with obvious signs of cognitive decline are easy to detect and mitigate. But not every situation is as clear cut, says Leanne Kaufman, president and CEO of RBC Royal Trust. In cases in which parents want to give money to adult children or other family members, it’s a grey area.

“‘A fine line’ is a great way to put it,” she says. “It’s very nuanced and there’s clearly a balance between agency and respecting the wishes and decisions of the client.”

To determine what’s happening with a senior client behind closed doors, it’s important to know what financial elder abuse actually looks like. Ms. Majowski says advisors should be on the lookout for coercion – an elderly client is feeling pressured to give money, or they’re being made to feel guilty if they don’t.

She says she’ll sometimes hear about adult children saying, “You have to help me because I get your groceries or drive you to the doctor’s office. I’m helping you deposit your cheques, so you owe me.”

There are other red flags advisors should consider. Keep an eye out for older clients who are financially responsible suddenly bouncing cheques, can’t pay their bills, or are getting their phone and utilities cut off. The, there are new, so-called friends, caregivers, or distant relatives who are taking an unusual interest in your client’s financial dealings or are asking about an early inheritance. They may suddenly want to be on all the phone calls or virtual meetings, ready to intercept if questions start to probe uncomfortable areas.

One of the key benefits of the client-advisor relationship is that it’s built over time, so asking pointed questions such as, “Is your son refusing to take you to the doctor unless you pay his mortgage this month?” or “Does somebody else have control over your bank account?” likely won’t feel as though they are coming out of the blue.

Nevertheless, Ms. Majowski says it can still take a bit of time to work up to direct questions, though. Advisors who have suspicions of financial elder abuse may have to start with more open-ended queries first.

Even if there doesn’t seem to be any abuse going on, it’s still important to walk through any large fund transfers with the clients and explain exactly what letting go of that money would mean to them in the long term. That’s especially true of requests that appear to be urgent. Ms. Majowski says hasty decision-making is another hallmark of financial abuse, so she advises people to take a day or two as a cooling-off period before moving funds or assets to a friend or relative.

“After a few days, there can be a feeling of, ‘Oh my god, I can’t believe I almost fell for it,’” she says.

So, what should advisors do if they suspect an elderly client is being abused? Don’t be afraid to get a second opinion or call in for support from your firm’s compliance department or legal department, Ms. Kaufman says.

Advisors can also visit the Investment Funds Institute of Canada’s Vulnerable Investors Resource Centre to learn how to report wrongdoing, and keep a file that documents all the steps they have taken with the client in question. Also, advisors should contact the client’s power of attorney or trusted contact, if they exist, unless, of course, that’s the person there are concerns about.

Ultimately, it’s vital advisors remember who their client is. No matter how sticky or fraught things may get within a family, it’s the senior who originally hired them, Ms. Tamblyn Watts says.

“That’s not to say that advisors shouldn’t listen to everyone and be compassionate,” she says. “But they must know their client – and their client is not the adult child.”

Full Article & Source:

Friday, January 29, 2021

Podcast: Families ripped apart by guardianship disputes

by Bob Sullivan

Former Florida guardian Rebecca Fierle was arrested last year and charged with aggravated abuse of an elderly person after she signed a do not resuscitate order on behalf of a 75-year-old man in her care — against his will — and he died when his feeding tube was capped.

That’s just one of the dark stories you’ll find if you start researching guardianship disputes around the nation.

I’ve spent the past couple of months working on a podcast about guardianship cases for AARP’s The Perfect Scam podcast. It’s a heartbreaking topic, full of raw emotion, and attacks on vulnerable people, families torn apart by this difficult phase of life. It’s also a complex tale, but I hope we’ve told it well, and I hope you’ll give this week’s episode a listen. Click on the image below to reach AARP’s podcast page, or find The Perfect Scam wherever you listen to podcasts. A brief transcript excerpt follows the link.


It’s one of the most heartbreaking realities of life; people get to a point when they can’t make decisions for themselves about their money, about their own health, and about where they live. Legal authority is granted to someone else. A court-appointed guardian is named to make these decisions. About 1.3 million people in the US are currently guardianship: 85% of them over 65. Guardianship is a process that involves families, lawyers, guardians, healthcare providers, and state courts. It’s an awesome responsibility with the goal of looking after the person’s best interests. It’s not always easy for a judge to decide what’s in the best interest of a vulnerable adult or who is best to make decisions for them. More often than not, a judge will appoint a family member, however, sometimes a judge may appoint a professional guardian, especially if there is family conflict or no family or friends are available or willing to serve as the guardian.

As you can imagine, these cases can be complicated and extremely emotional, and they have sometimes served as an unfortunate way for bad actors to take advantage of vulnerable adults.

00:04:39] (news clip) “Now to a news alert out of Marion County. A former Florida guardian at the center of a statewide scandal faces aggravated abuse and elderly neglect charges. Investigators say Rebecca Fierle signed a “Do No Resuscitate” order for a 75-year-old. His name’s Stephen Stryker, against his own wishes. Stryker died…”

“Susan and William Harris were caught in Oklahoma after fleeing New Mexico and failing to show up for sentencing in what’s known as the Ayudando Guardian’s case. The two stole 11 million dollars from those under the guardianship’s care. Susan Harris…”

“Four people are facing more than 250 felony charges for crimes against the elderly. Well they’re taking plea deals. And their conviction’s bringing to an end what Chief Investigator Darcy Spears started nearly four years ago. The most significant guardianship exploitation case in Nevada…”

“Lawyers with the District Attorney’s Office spelled out what they could prove if this case did go to trial, including multiple billing scams, charging for unneeded services, and…”

“Paul Donesdorf ran the nonprofit trust for 10 years. In February, he pleaded guilty to stealing nearly 7 million dollars from DSLM accounts. He was sentenced to…”

(Click here to listen to the podcast)

Full Article & Source:

Nursing Home Critics Say COVID-19 Immunity Laws Are A Free Pass For Neglect

Lisa Howze, Gia Howze and Palestine Howze. Palestine Howze died last year. Now her family is suing Treyburn Rehabilitation Center, where she lived.

Lisa Howze

Palestine Howze died April 14, 2020, in a North Carolina nursing home.

She had developed a pressure ulcer — or bed sore as they're commonly known. It flared up in December 2018 and just grew worse, says her daughter Lisa Howze. Infection set in.

"We begged them to take her to the emergency room, but they assured us that they could handle it," Howze says.

Howze and her three sisters contend that the nursing home could not. In their experience, Treyburn Rehabilitation Center in Durham didn't seem to be able to handle much. On a scale of one to five stars, the federal government gives Treyburn just one. It also gets below-average ratings on the ratio of nurses to residents. The government has fined Treyburn almost $190,000 in the past three years.

Lisa Howze and her sisters have filed a lawsuit against Treyburn Rehabilitation Center. But it's unclear whether it can proceed.

Like nearly 30 other states, North Carolina granted legal immunity to nursing homes to shield them from COVID-19 lawsuits. Nursing homes argued that they needed protection as the coronavirus raged through their facilities and the recommended safety guidance from the Centers for Disease Control and Prevention fluctuated.

But that immunity raises questions for families like the Howzes, who contend that because their mother's death had nothing to do with the coronavirus, they should be able to legally hold Treyburn Rehabilitation Center accountable.

"Palestine Howze did not have to die in that way or at that time," says Elizabeth Todd, the family's attorney. Their lawsuit is believed to be the first of its kind to challenge nursing home immunity.

The Howze sisters hadn't had a lot of luck with nursing homes in general. Treyburn was the third one they'd tried. But it was close to where they lived, so the sisters could visit often to keep an eye on things. They needed to, says Lisa Howze.

"We were there a lot and we found ourselves having to bathe her, just general things they were supposed to do," Howze says. "We'd come in several times when she hadn't been fed her tray; [it was] just sitting there."

Then COVID-19 exploded across the country, taking an especially deadly toll in nursing homes — which have accounted for more than a third of all coronavirus-related deaths. Nursing homes closed their doors in March, locking families out as the industry tried to control the outbreaks. Everything got harder. And took longer.

Palestine Howze needed specialists in wound care and IV antibiotics. Lisa Howze had her mother's power of attorney. Again, she says she begged Treyburn Rehabilitation Center to send her mother to a hospital emergency room where they could find the specialists she needed. Again, she was turned down.

"Their excuses were, 'Well, you know, the emergency room at the hospital is not taking new patients because of COVID. And she would be safer here if she stayed here. And the facility is equipped to take care of your mother.'"

None of those things turned out to be true, Lisa Howze says.

In May, a month after Palestine Howze died, North Carolina passed a sweeping liability shield for long-term-care facilities, meaning that nursing homes — with rare exceptions — were immune from lawsuits. The measure was made retroactive to March 10, a few weeks before her mother's death.

Lisa Howze and her sisters decided to sue Treyburn anyway.

"For the legislature to say that the nursing homes need protection in the middle of a pandemic, not the nursing home patients, is outrageous and it's unjust," says Todd, their attorney.

North Carolina's immunity law lasts until the pandemic is over. Todd is especially worried that the law gives a free pass to nursing homes with low staffing, like Treyburn.

"Literally, the nursing homes can take their own understaffing, their chronic understaffing, and use it as a shield to prevent any liability at all during the COVID pandemic," Todd says.

Through its attorneys, Treyburn Rehabilitation Center declined to comment.

But for many in the long-term-care industry, these immunity measures are a welcome relief, says Dave Voepel, CEO of the Arizona Health Care Association. Arizona Gov. Doug Ducey was among the first to sign an executive order granting nursing and assisted living facilities legal immunity.

"And for that we applaud him, because that just takes a little bit of pressure off," Voepel says, adding that it allows facilities to focus on what's most important. "We need to worry about keeping COVID out of the building."

Sometimes, he says, that cuts into the bottom line.

"Take, for instance, a 100-bed building and they really have 50 rooms, two beds per room," Voepel says. But to keep infection from spreading, those rooms may have to be converted to private rooms. So revenue is cut in half.

"It really takes its toll on the business side of the ledger," says Voepel.

Long-term-care facilities are facing a crisis of existential proportions, says Mark Reagan, the attorney for the California Association of Health Facilities.
That's because liability insurers are excluding all things COVID-19 when they renew policies.

That "would mean that any claims made regarding COVID infection, regardless of when that infection occurred in the past, would be subject to exclusion and no insurance coverage," says Reagan.

California does not have a liability shield, but the state has waivers, relaxing standards for personnel and bed space, for example. Congressional Republicans wanted a national immunity law but dropped it as part of the deal for the latest coronavirus relief package. Reagan still has hopes.

"What we are merely asking for is that caregivers and their employers don't get punished for doing the best that they could under the circumstances," he says.

But attorney Elizabeth Todd says Treyburn Rehabilitation Center wasn't doing the best it could for Palestine Howze. And she says that one of North Carolina's immunity criteria is that a facility must be acting in good faith, though that's not defined in the law.

"And so we argue the pretty shoddy state of Treyburn nursing home as COVID approached, and then as Mrs. Howze became very ill, that that was not providing health care in good faith," she says.

A Superior Court judge will decide whether to dismiss the case because of the immunity statute or allow it to continue, potentially giving Lisa Howze and her sisters their day in court.

Full Article & Source:

NY data show nursing home deaths undercounted by thousands

Click for Video


ALBANY, N.Y. (AP) — New York Gov. Andrew Cuomo's administration confirmed Thursday that thousands more nursing home residents died of COVID-19 than the state's official tallies had previously acknowledged, dealing a potential blow to his image as a pandemic hero.

The surprise development, after months of the state refusing to divulge its true numbers, showed that at least 12,743 long-term care residents died of the virus as of Jan. 19, far greater than the official tally of 8,505 on that day, cementing New York's toll as one of the highest in the nation.

Those numbers are consistent with a report released just hours earlier by Attorney General Letitia James charging that the nursing home death count could be off by about 50%, largely because New York is one of the only states to count just those who died on facility grounds, not those who later died in the hospital.

“While we cannot bring back the individuals we lost to this crisis, this report seeks to offer transparency that the public deserves,” James said in a statement.

The 76-page report from a fellow Democratic official undercut Cuomo's frequent argument that the criticism of his handling of the virus in nursing homes was part of a political “blame game," and it was a vindication for thousands of families who believed their loved ones were being omitted from counts to advance the governor's image as a pandemic hero.

“It’s important to me that my mom was counted,” said Vivian Zayas, whose 78-year-old mother died in April after contracting COVID-19 at a nursing home in West Islip, New York. “Families like mine knew these numbers were not correct.”

Cuomo’s office referred all questions to the state health department. Several hours after the report, State Department of Health Commissioner Howard Zucker released a lengthy statement attempting to refute James' report but which essentially confirmed its central finding.

Zucker's figure of 12,743 nursing home resident deaths included for the first time 3,829 confirmed COVID-19 fatalities of those residents who had been transported to hospitals.

Those figures could be even higher, but the health department said its audit was ongoing, didn't break out deaths presumed but not confirmed to be caused by the virus, and omitted those in assisted living or other types of long-term care facilities.

Zucker, however, still took issue with James' characterization of his department's official tally as an “undercount.” He said “DOH was always clear that the data on its website pertains to in-facility fatalities."

James has for months been examining discrepancies between the number of deaths being reported by the state's Department of Health, and the number of deaths reported by the homes themselves.

Her investigators looked at a sample of 62 of the state’s roughly 600 nursing homes. They reported 1,914 deaths of residents from COVID-19, while the state Department of Health logged only 1,229 deaths at those same facilities.

Thursday's release backed up the findings of an Associated Press investigation last year that concluded that the state could be understating deaths by as much as 65%.

State Sen. Gustavo Rivera, a Democrat who has blasted the Cuomo administration for its incomplete death count, said he was “sadly unsurprised” by the report.

“Families who lost loved ones deserve honest answers,” Rivera said. “For their sake, I hope that this report will help us unveil the truth and put policies in place to prevent such tragedies in the future.”

Cuomo, who last fall released a book touting his leadership in dealing with the virus, has not been shy about using New York's lower nursing home death count to make the argument that his state is doing better than others in caring for those in such facilities.

“There's also no doubt that we’re in this hyper-political environment so everybody wants to point fingers,” Cuomo told CBS “This Morning” in October. “New York, actually, we’re number 46 out of 50 in terms of percentage of deaths in nursing homes ... it’s not a predominantly New York problem.”

The attorney general’s report also took aim at New York's controversial March 25 policy that sought to create more space in hospitals by releasing recovering COVID-19 patients into nursing homes, which critics contended was a driving factor in causing nursing home outbreaks.

James’ report said those admissions “may have contributed to increased risk of nursing home resident infection and subsequent fatalities,” noting that at least 4,000 nursing home residents with COVID-19 died after that guidance. But James’ report said the issue would require further study to conclusively prove such a link.

New York’s health department released a much-criticized report last summer that claimed the March 25 policy, which was reversed in May, was “not a significant factor” in deaths.

James’ review also found that a lack of infection controls at nursing homes put residents at increased risk of harm, that homes with lower federal scores for staffing had higher fatality rates, and that a broad measure Cuomo signed in April shielding nursing homes and other health care providers from lawsuits may have actually encouraged homes to hold back on hiring and training.

“As the pandemic and our investigations continue," she wrote, “it is imperative that we understand why the residents of nursing homes in New York unnecessarily suffered at such an alarming rate.”

Full Article & Source:

Thursday, January 28, 2021

Former East Prairie funeral home owner charged with financial exploitation of elderly

By David Jenkins

Ricky Penrod
A former Mississippi County funeral homeowner has been charged with financial exploitation of the elderly after selling pre-need funerals without a proper license.

Charles R. “Ricky” Penrod, of East Prairie, was charged Friday with financial exploitation of an elderly person or person with a disability. He was taken into custody Monday and bonded out on a $25,000 cash or surety bond.

According to a probable cause statement, Penrod, the former owner of Shelby Funeral Home in East Prairie, was not licensed to sell pre-need contracts or provide services for pre-need contracts after Oct. 31, 2009. On April 19, 2016, Penrod’s funeral director license was revoked, and Shelby Funeral Home's ownership was assumed by new owner Lonnie Ponder on April 4, 2016.

Court documents from Mississippi County Circuit Court between the State Board of Embalmers and Funeral Directors v. Shelby Funeral Home, Inc., states Shelby Funeral Home was administratively dissolved as of Feb. 13, 2004. The court document also states Penrod engaged in pre-need services from Dec. 31, 2009, through the date of the order, which was dated July 24, 2014.

According to the probable cause statement, there was an interview with Ponder on March 26, 2020. Ponder confirmed he took possession of the funeral home in 2016 after assuming the debt incurred by Penrod.

Ponder told officers over time that he located at least 100 pre-need contracts, sold by Penrod, that had not been funded. Ponder also said there could be more unfunded contracts but would not know until he is contacted by the purchaser's family of the pre-need contract following a death.

Ponder also told officers he serviced 18 funerals in which families had provided a copy of a pre-need contract sold by Penrod. According to Ponder, he received no money from Penrod for the contracts, and he only asked the families to pay the inflationary costs of the funeral.

Ponder said he was trying to do the right thing by paying the funeral costs, stating his costs for those funerals was about $140,000.

Some of the pre-need contracts written by Penrod were after the sale of Shelby Funeral Home in April of 2016. Ponder told officers there was no money available to fund the pre-need accounts Penrod had written, providing 68 unfunded pre-need accounts.

The total dollar amount not transferred to Ponder by Penrod when taking ownership of Shelby Funeral Home was $268,040.10, with potentially more funds identified upon a death and the families coming forward.

According to the probable cause statement, Penrod stated the money from the pre-need accounts was garnished by the IRS because he didn’t put the money in the right place.

Sergeant J.S. Stoelting, a Missouri State Highway Patrol investigator, asked Penrod if he was ever licensed to sell pre-need contracts, to which Penrod replied, “yeah, at one time.”

Stoelting then asked Penrod if he continued to sell pre-need contracts after losing his license, and Penrod replied, “probably,” stating he couldn’t put the money into an account or the IRS would garnish it. Penrod told Stoelting everyone knew about the missing money, even the state.

Stoelting explained to Penrod that he sold numerous people a pre-need funeral without a proper license, to which Penrod replied, “I know.”

Stoelting also confronted Penrod that people wrote him a check that he cashed at McDonald’s Grocery Store, and the money is gone. Penrod asked, “for how much money?”

The investigator told Penrod they were still totaling it up, and Penrod replied, “They won’t cash a check that big.” Stoelting then informed Penrod he had copies of the cashed checks, with one for around $9,000.

Penrod was asked about one specific pre-need account for $9,532.25 that was purchased from him on July 7, 2014. The check was cashed by Penrod, and the family later learned of the missing pre-need money from Ponder.

A complaint was filed with the Missouri Attorney General’s Office on Jan. 19, 2020, after learning of the missing money. A letter, dated Feb. 11, 2020, was also written to the Attorney General requesting Penrod repay the money, $397 per month for two years. As of Sept. 23, 2020, there was no money returned to the family.

Stoelting asked Penrod when the last time was he sold a pre-need contract, to which he replied, “2014 or 2015.” Penrod told investigators when he received the money, he would cash the checks to keep the IRS from getting it so he could pay his bills, such as his electric and mortgage.

Penrod told officers that no one else was at fault for the mess but him, and “if the files are wrong, I’m responsible.”

Penrod will be arraigned at 10 a.m. Friday in Mississippi County.

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Lawyer is arrested and disbarred after alleged threats and accusations of judicial witchcraft

By Debra Cassens Weiss

A Florida lawyer accused of making outrageous and threatening online remarks was arrested earlier this month and disbarred last week.

The Florida Supreme Court disbarred lawyer Edward Juan Lynum in a Jan. 21 order, about two weeks after his arrest on charges that included threatening harm to a public servant, Law360 reports.

Satan, witchcraft and racism were themes in Lynum’s online posts, according to an uncontested disciplinary referee’s report and an arrest report cited by the Daily Commercial.

Lynum’s online posts describe himself as the victim of a conspiracy in which judges and political figures conspired to kill him and destroy his life due to their bigotry and worship of satanic spiritual forces, according to the arrest report.

In one post cited in the arrest affidavit, Lynum allegedly wrote, “God strengthens us to kill … It is time to kill.”

Satan was also a theme of online posts cited by the referee in the disciplinary case. The referee found Lynum wrote Facebook posts that disparaged the judiciary in Sumter County and opposing counsel in his divorce, as well as the bar counsel, The Florida Bar and the Florida Supreme Court.

Lynum’s posts “have grown more frequent, threatening and outrageous” as the ethics case progressed, the referee found.

Lynum said in a July 2019 Facebook post that the first judge who presided in his divorce “fabricates evidence” and is “a dirty stain in our clean SUMTER COUNTY,” according to the referee’s report.

On his blog, Lynum said the judge has a reputation as “a judge who fabricates evidence and fabricates the evidence in red font, so it screams pagan witchcraft. Her decision to fabricate evidence in red-font screams, ‘I am Satan’ in white people’s words.”

In another Facebook post, Lynum accused the judge who took over the divorce case of sodomizing Lynum’s daughter, the referee said. On his blog, Lynum said the judge issued “a satanic order” and said judges like him “have weaponized their judicial power for evil that appear racist to minorities. I don’t and won’t call it racism because it trivializes and distracts from his objective criminal behavior and practice of witchcraft.”

The referee also pointed to a post in which Lynum allegedly said the two judges “can’t hide from my almighty God’s vengeance; like David, I will kill Goliath and hold up his bloodied and severed head with a smile on my face.”

He also called the first judge “a dumb, satanic slut” and referred to bar counsel as a worthless and inept “satanic slut,” the referee said. And he allegedly said the chief justice of the Florida Supreme Court should be executed for tolerating hate crimes and witchcraft.

Lynum told Law360 that disbarment was an attempt to silence him. He told the publication he had a “moral obligation to complain that Sumter County, Florida, judges openly commit hate crimes on the public record.”

He once ran for for a Sumter judgeship and the Orlando City Council, according to the Daily Commercial.

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Financial advisers could put transactions on hold if they suspect exploiting of vulnerable adult

LINCOLN — It’s too easy for a caregiver of an elderly relative to stumble across a financial record, get online and say, “I’d like to withdraw $10,000 out of this account,” a legislative committee was told Tuesday.

That was part of the rationale given by State Sen. Brett Lindstrom of Omaha, who works as a financial adviser, for adopting a law that allows such investment advisers and brokers to put a “hold” on transactions they suspect might involve the exploiting of a vulnerable adult.

Legislative Bill 297, the Nebraska Protection of Vulnerable Adults from Financial Exploitation Act, would expand protections passed into law last year that allow bankers to pause a transaction they reasonably suspect is taking advantage of a vulnerable adult or senior citizen.

The issue is a major problem, according to officials with the AARP and Nebraska division of Adult Protective Services, which investigates allegations of elder abuse.

An estimated one in five Americans over age 65 is a victim of financial exploitation, with the average loss in such cases estimated at $125,000, said Jina Raglin of the AARP Nebraska. In the past two years, between 23% and 25% of reports of elder abuse have involved financial exploitation, said Andrea Lowe of the Nebraska Department of Health and Human Services.

The committee advanced the bill for debate by the full Legislature after its hearings were over on Tuesday.

Lindstrom told members of the Legislature’s Banking, Commerce and Insurance Committee that family members are most often involved in such exploitation. Under LB 297, a financial adviser or broker could put a hold of up to 30 days on a transaction to determine whether an elderly client really wanted to make it. Information could also be shared with Adult Protective Services and law enforcement, if necessary.

At least 28 other states have adopted similar bills or statutes, and a very similar proposal is being introduced in Iowa this year, according to State Banking Director Kelly Lammers.

Last year, state lawmakers heard stories of bankers concerned about large withdrawals by seniors who were convinced that they had won the Publishers Clearinghouse sweepstakes or a lottery in Jamaica, said Gothenburg Sen. Matt Williams, chairman of the banking committee.

LB 297 would be the next step in thwarting such fraud, he and other advocates for the bill said, by granting the same authority to financial advisers and brokers/dealers.

No one testified against the bill on Tuesday.

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Wednesday, January 27, 2021

Thousands died at a nursing home chain. Its CEO got a $5 million bonus

By Kate Gibson

Click to Watch Video

As COVID-19 took a deadly toll among residents of Genesis Healthcare facilities, the financially troubled company gave CEO George Hager Jr. a $5.2 million "retention payment." 
At the helm of the large U.S. nursing home chain during a pandemic that has killed more than 1,500 of its residents and threatens to push it into bankruptcy, Hager received the bonus in late October. He then resigned from the for-profit company, where he had served as chief executive for 17 years, less than three months later, earlier this month.

Nursing homes account for a sizable portion of the more than 419,000 U.S. COVID-19 deaths, and outbreaks at Genesis facilities caught the attention of lawmakers over the summer. "More than 1,500 Americans have died and many more have been infected at facilities owned by your company, with at least 187 of your facilities reporting cases of the coronavirus," members of a House panel looking into the impact of COVID wrote Hager in June.

The toll at Genesis reportedly nearly doubled in the second half of 2020, with 14,352 confirmed cases among its residents and 2,812 deaths as of December 20, according to the Washington Post. An analysis of Medicare data by the news outlet found almost all of Genesis' nursing homes running short on personal protective equipment up until late November, after the company's board had signed off on Hager's bonus. 

Genesis did not respond to requests for comment from CBS MoneyWatch. 

In a regulatory filing in November, the company said its first report of a positive case of COVID-19 in one of its facilities occurred on March 16, 2020. Since then, 266 of its 360 nursing facilities and assisted living communities had reported positive cases among patients and residents, the filing stated. More than 70% of those cases occurred in five states — Connecticut, Maryland, Massachusetts, New Jersey and Pennsylvania — with those facilities representing 45% of its beds. Genesis operates in 24 states.

Hager was also running the Kennett Square, Pa.-based chain when it agreed in 2017 to pay the federal government nearly $54 million, partly for providing "grossly substandard nursing home care" at multiple facilities. Genesis denied the allegations, some of them involving events that occurred at nursing homes before they'd been acquired by the company.

In financial distress for years, Genesis has cautioned its investors since the summer that the pandemic had worsened matters to the point where it might have to file bankruptcy. 

"The virus continues to have a significant adverse impact on the company's revenues and expenses," Hager stated in a November 9 earnings release in which the company reported a net loss of $62.8 million for the third quarter of 2020. Government stimulus in the third quarter fell almost $60 million short of the company's COVID-19 costs and lost revenue, he said.

"There is no question Genesis will need ongoing support from the federal government and our capital partners to sustaining operations," Hager told an earnings call that day. 

For the first nine months of last year, Genesis reported a loss of $96 million, a period in which it was given $254 million in federal aid related to COVID-19, as well as commitments of $85 million from some of the states where it does business. 

With Hager continuing as a consultant, board chairman Robert Fish has taken over as Genesis CEO. 

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'They just did it wrong': How COVID-19 ravaged Pennsylvania's long-term care facilities

by Jasmine Brooks

Nearly 20,000 Pennsylvanians have died from COVID-19 in less than a year, with seniors accounting for half of those deaths.

We're getting a firsthand account of what happened inside some of the nursing and personal care facilities from a nurse who says, she witnessed it.

"No one should ever die alone," says Margaret Barajas of the Pa Department of Aging.

Pennsylvania's nursing and personal care facilities; ground zero for COVID-19.

"The amount of overall death and destruction I’ve seen has been tremendous."

The deadly virus has already taken the lives of more than 10,000 seniors.

"By the time they found maybe one or two people who had positive tests, within a day or two those numbers doubled, tripled sometimes quadrupled."

A candid conversation with a nurse who has asked us to conceal her identity to protect her job. She's worked the floors of nearly ten-facilities in Pennsylvania, witnessing hundreds of patients trying to survive the quick and aggressive virus.

"Describe the worst situation that you've witnessed," asks CBS 21’s Jasmine Brooks.

"Honestly, there were some days where in a 12-hour shift there would be 10 to 15 people that would die. That was just hard as a nurse to watch day in and day out.”

"When COVID broke out around March in these nursing homes, were the nursing facilities prepared, Brooks asks.

"No," says Barajas.

"There are fingers to be pointed at systems that have failed our elders over and over again," she adds.

Margaret Barajas says, this pandemic has revealed the challenges that have existed in long term care facilities for years.

"Everything from facility design and structural limitations to maximize profits. Many homes still have four residents to a room," she explains.

"What were they lacking the most," Brooks asks our undercover nurse.

"I would say the knowledge of what to do. There would be no direction for anybody. You would show up at a facility and the director of nursing or anybody that probably should've been more prepared and have the knowledge really didn't know what to do, didn't know where to start, didn't know where to direct people where to go," she replies.

"What was the biggest complaint you were getting from family members on the outside?"

"That their family members were unfortunately isolated, which was absolutely true."

"Many of them are in rooms with no television, no telephone, no way to connect to the outside world," Barajas adds.

"If you had Dr. Levine in front of you what would you ask of her? Or tell her," asks Brooks.

"That they just did it wrong," the nurse says.

We went to the Department of Health to get some answers.

"What went wrong? Again, I understand it was a pandemic, unpresented times, but what went wrong," asks Brooks.

"How could anyone have truly been prepared for something of this magnitude and duration?" replies Keara Klinepeter with the Pa Department of Health.

Pennsylvania has now surpassed 60,000 resident cases.

"I am hoping that as we now move towards a brighter day with the vaccine on the horizon that we don't miss this opportunity to get better at this and to redesign and to bulldoze where necessary and start afresh," says Barajas.

"I personally was infected with COVID. It wasn't fun. I was pretty sick for a while. Emotionally I will say this has taken a greater toll. Emotionally, mentally, psychologically," she explains.

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Gov. DeSantis: All nursing home residents, staff members will have been offered vaccine by end of month

Gov. Ron DeSantis delivered an update on Monday regarding COVID-19 vaccine distribution.

He said the state is close to giving one million senior citizens their first dose of the COVID-19 vaccine.

About 22% of senior citizens in Florida have been vaccinated so far, officials said.

Florida has partnered with CVS and Walgreens to set up vaccine clinics at the state’s long-term care facilities. DeSantis said most nursing home residents were offered their first dose, and those at assisted living facilities will have been offered their first shot by the end of the month.

DeSantis also discussed the state’s extremely limited vaccine supply, saying they had administered between 300,000 and 450,000 doses in the first three weeks of January, but will only receive 226,100 doses between Monday and Tuesday.

“You’re going to see that there’s been shortages,” he said.

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Tuesday, January 26, 2021

San Luis Obispo man loses manslaughter conviction appeal

Christopher Skiff
The California Court of Appeal rejected an attempt by the former owner of the Manse on Marsh to overturns his convictions for manslaughter and elder dependent abuse over the 2014 death of a dementia patient who walked away from the assisted living facility and was struck by a car.

A few days before Christmas 2014, Mauricio Edgar Cardenas, 65, was hit and killed as he wandered across Los Osos Valley Road. Because of the darkness, the 26-year-old driver of the vehicle was unable to stop.

Shortly afterwards, a whistleblower accused Manse on Marsh owner Christopher Skiff and Executive Director Gary Potts of fraud and elder abuse because they admitted Cardenas, who was diagnosed with dementia, even though the facility was not licensed to house patients with memory issues. Employees accused Skiff and Potts of violating laws for financial reasons.

Former employees then testified that Skiff and Potts held regular meetings in which they discussed a “hot list” of prospective residents who had medical and other barriers to admission and created action plans on how to get the individuals admitted. Employees testified that they expressed concern to Skiff over Cardenas being on the hot list, but shortly afterwards, he was admitted to the Manse on Marsh anyway.

Skiff, who was permitted to stay out of jail during the appeal process, is facing up to eight years in jail.

In addition, Skiff is battling a civil suit. James McKiernan, the attorney for Mauricio Cardenas’ son Paul Cardenas, filed a wrongful death lawsuit against Skiff, Potts and the Manse on March.
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Santa Barbara Man Arrested on Elder Sex Abuse Charges

Three Reported Incidents Occurred at Nursing Homes  


Santa Barbara County Jail | Credit: Daniel Dreifuss (file)

By Indy Staff

Santa Barbara Sheriff’s detectives on Wednesday arrested 32-year-old Jared Ekola for allegedly sexually molesting three disabled patients at elder care homes. Two of the reported offenses occurred at the Goleta care facility where he worked, officials said. Another took place at a Santa Barbara nursing home. 

“Ekola allegedly engaged in sex acts with the victims who were unable to consent, protect themselves, or report the abuse due to their physical and mental status,” a statement from the Sheriff’s Office says.

Detectives started investigating Ekola on January 5 after receiving information that the alleged abuse happened between 2013 and 2020, with additional incidents suspected. 

“This investigation remains ongoing and anyone with information is encouraged to contact Sheriff’s detectives at (805) 681-4150,” the Sheriff’s Office said. “If you prefer to remain anonymous, you can provide information by calling our tip line at (805) 681-4171 or online at”

Ekola has been booked in the main County Jail on felony charges of elder abuse, rape, and other unlawful sexual acts. He is being held without bail. 

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Son charged with elder abuse after assault on sick father at Nashville home

by: Josh Breslow

NASHVILLE, Tenn. (WKRN) — A 60-year-old man already jailed in Nashville has been charged with elder abuse after investigators said he assaulted and injured his father who was suffering from cancer and several other health issues.

Online jail records show James Venus was charged with elder abuse Wednesday, though an arrest warrant states the assault happened the morning after Christmas at a home in Nashville.

Metro police said Venus’ 79-year-old father, who has lung cancer, congestive heart failure and requires a walker to get around, was in his room, when Venus entered, “causing a disturbance.”

James Venus (Courtesy: Metro Nashville Police Department)
A warrant states Venus’ father got out of bed to get his son out of his room and Venus pushed him, causing him to fall and suffer “visible injuries.”

When the elder abuse charge was added Wednesday, Venus was already jailed on a charge of aggravated assault with a deadly weapon for an incident from the same day.

Venus has an extensive criminal history, including charges of assault and various drug charges.

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Monday, January 25, 2021

Britney Spears' father speaks out as she requests to remove him as conservator of her estate

By Chloe Melas

Britney Spears, shown here at an event in 2019, has requested her father be removed as co-conservator of her estate. (Photo by VALERIE MACON / AFP)

(CNN)Legal proceedings in Britney Spears' conservatorship battle had remained relatively private over the past year, but that changed during a dramatic hearing last month in which Spears' attorney, Samuel D. Ingham III, stated that his client was "afraid" of her father, Jamie Spears​, and accused him of making business decisions without her knowledge. According to court documents obtained by CNN, Ingham said the pop star would not perform again as long as her father remains in control of her estimated $60 million estate.

Spears defended his actions​ to CNN as protecting his daughter from "those with self-serving interests." He was first court-appointed, along with attorney Andrew Wallet, to serve as co-conservator of Britney's estate in 2008, following a series of personal issues that played out publicly for the singer​, and he remains in that role. ​For most of that period, he also oversaw her health and medical decisions.
In January of 2019, the singer announced an indefinite work hiatus from her Las Vegas concert residency and entered a 30-day voluntary residential treatment facility. Wallet resigned shortly after, in March.
Jodi Montgomery was ​appointed by the court to oversee Britney's medical care temporarily in September 2019, following a series of health issues for Jamie Spears. 
According to Jamie Spears, he was in touch with his daughter and on "good terms" with her up until August of this year, when Ingham filed to officially remove him as conservator. In November, the judge overseeing the case ruled in favor of keeping Spears as conservator and appointed Bessemer Trust to act as co-conservator. 
At that hearing, Britney Spears' attorney accused the elder Spears of a lack of transparency, citing his decision to hire a new business manager after the singer's previous manager resigned without notifying her in advance, according to court documents.
Jamie Spears' attorney, Vivian Lee Thoreen, disputed that in court documents obtained by CNN, arguing it "would have been a dereliction of Mr. Spears' responsibility" as conservator of the estate not to replace her manager and offered to introduce Ingham to the new hire. 
Spears told CNN that he has not spoken to his daughter since August and said he believes that it is by her attorney's design. 
"I love my daughter and I miss her very much," Jamie Spears said of his daughter. "When a family member needs special care and protection, families need to step up, as I have done for the last 12-plus years, to safeguard, protect and continue to love Britney unconditionally. I have and will continue to provide unwavering love and fierce protection against those with self-serving interests and those who seek to harm her or my family."
Thoreen also claims Ingham is trying to prevent her client from communicating with his daughter.
"Jamie's relationship with Britney is not that different than your average father-daughter relationship insofar as there has always been a mutual love and respect for each other. Until Britney's court-appointed attorney Sam Ingham abruptly instructed Jamie not to contact Britney a few months ago, Jamie and Britney had spoken often and regularly throughout the entire conservatorship.  In fact, they had spoken just the day before and had had a pleasant and collaborative conversation." 
When reached by CNN, Ingham declined to comment, citing ongoing litigation.
A source close to Britney, who interacts with her on a weekly basis, told CNN she faces ongoing challenges with her mental health.
In October, Ingham stated that Britney did not have "the capacity to execute a verified declaration for any purpose in this case," according to court documents obtained by CNN.
A representative for the singer had no comment. 
In a hearing scheduled for Wednesday, Jamie Spears' handling of Britney's assets will be reviewed.
CNN spoke to Sabino Biondi, a partner at Wilk Auslander LLP in New York about ​Britney Spears' conservatorship. He does not work with her but handles conservatorships regularly. Biondi said while it's not typical for someone to have a conservatorship last as long as Spears', it's "telling" that the courts have kept it in place.
"A conservatorship basically means you need someone to take care of your financial affairs and or possibly your personal affairs," Biondi said. "The court denied her petition because they must have found a good reason to maintain the conservatorship ... if a judge determines it's still for your own good, you aren't going to undo it."
Biondi said this week's hearing should reveal if Spears' father has mishandled his fiduciary responsibilities in any way.
Through her attorney, Gladstone N. Jones III, Spears' mother, Lynne Spears, said at last month's hearing that she agreed with her daughter's decision to have her father removed as her conservator.
Jones had "no comment" when reached by CNN.
"It has broken Lynne's heart that things have come to this point," Jones said at the November hearing. It's "time to start fresh," He said, before adding that Lynne Spears feels the relationship between her daughter and her ex-husband has become "toxic."
In response to Lynne's attorney's comments on Jamie Spears and Britney Spears' relationship, Thoreen told CNN, "Jamie strongly disagrees with Lynne's false statements and highly misleading statements and characterizations."
The global interest into Spears' conservatorship has prompted some of her long-time friends like Paris Hilton to speak out, calling the conservatorship "not fair."
In a podcast discussion in July, Spears' brother, Bryan Spears, called the conservatorship "frustrating" for his sister to not be able to freely make decisions but also said it had "been a great thing for our family, to this point."
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