Showing posts with label AdventHealth. Show all posts
Showing posts with label AdventHealth. Show all posts

Monday, April 27, 2020

AdventHealth Orlando seeks dismissal of lawsuit from family of man whose death sparked state’s guardianship scandal

Steven Stryker, seen here during his time working for the Environmental Protection Agency, according to his daughter. Stryker died while under the care of Rebecca Fierle, who according to investigators filed a "do not resuscitate order against Stryker's wishes.(Courtesy of Kim Stryker)
By Monivette Cordeiro

AdventHealth Orlando asked a judge Tuesday to dismiss a negligence lawsuit filed against the hospital company and former guardian Rebecca Fierle by the family of an incapacitated client who died under a “do not resuscitate” order that Fierle signed against his wishes.

The Altamonte Springs-based company said there are “no allegations” that it played a role in Fierle’s decision to authorize a DNR order on 75-year-old Steven Stryker or that it exercised control over his care after he was discharged from the hospital.

Stryker’s death last May at St. Joseph’s Hospital in Tampa sparked a statewide scandal that led to reforms of Florida’s troubled guardianship system and landed Fierle behind bars on charges of aggravated abuse and neglect of an elderly person.

“The complaint contains no ultimate facts establishing AdventHealth’s liability for any of the alleged events after Steven Stryker’s discharge from AdventHealth Orlando,” wrote J. Charles Ingram, the hospital’s attorney, in an April 21 motion.

Stryker was a patient at AdventHealth Orlando in 2018 when the hospital petitioned a judge to declare him incapacitated and appoint Fierle to be his guardian. Although Stryker had made his friend Linda Lanier his health-care surrogate, an attorney for the hospital said he wasn’t capable of choosing his decision-maker.

Lanier has told the Orlando Sentinel that AdventHealth seemed determined to put Stryker into guardianship and get him discharged from the hospital, despite her efforts to find him a new place to live.

Without the required court approval, Fierle billed AdventHealth nearly $4 million over a decade for providing services to Stryker and nearly 700 other vulnerable patients, according to an audit by the office of Orange County Comptroller Phil Diamond.

“Rebecca Fierle’s negligence, neglect, abuse, and exploitation of Steven Stryker caused his death,” said the lawsuit filed by Kimberly Stryker, the man’s daughter who is in charge of his estate. “AdventHealth created, facilitated, and funded the guardianship relationship between Rebecca Fierle and Steven Stryker and is therefore responsible for the actions that led to Mr. Stryker’s death.”
After Stryker became her ward, Fierle disregarded the opinions of his daughter, health care surrogate and a St. Joseph’s psychiatrist in signing the DNR, according to an investigation by the Okaloosa County Clerk of Circuit Court and Comptroller.

Fierle opted to cap Stryker’s feeding tube on May 9, despite him stating “several times that he wanted to live,” the Florida Department of Law Enforcement said. Stryker, who was using a feeding tube because he had difficulty swallowing, aspirated and went into cardiac arrest.

He died May 13.

Ingram said AdventHealth could not predict Fierle would enter a DNR against Stryker’s wishes or that his daughter and St. Joseph’s would not intervene to overturn her decision.

“The events at St. Joseph’s Hospital completely fail to allege anything creating liability on the part of AdventHealth in terms of duty, breach, causation or vicarious liability,” Ingram said. “Instead, these allegations suggest that St. Joseph’s Hospital owed a duty to Mr. Stryker as its patient, that there was a failure to protect Mr. Stryker from his court-appointed guardian, and that St. Joseph’s Hospital felt obligated to follow the instructions of the court-appointed guardian.”

After Stryker’s death, the hospital company announced it would no longer pay private guardians to take on patients and would form a review panel to ensure at least two doctors determine whether patients can no longer make their own decisions before asking a judge to appoint a guardian.

In addition to misusing DNRs and ignoring her wards’ wishes, Fierle, who is still under investigation by multiple agencies, has also been accused of double-billing and conflicts of interest.

Full Article & Source:
AdventHealth Orlando seeks dismissal of lawsuit from family of man whose death sparked state’s guardianship scandal 

See Also:
AdventHealth outlines guardianship changes after paying disgraced guardian nearly $4 million | Exclusive

Attorney General Ashley Moody fires back at embattled former Florida guardian

Ex-guardian Rebecca Fierle charged Altamonte Springs facility $100K, illegally pocketed refunds, investigation finds

Florida Elder Affairs chief announces ‘immediate’ changes as embattled Orlando guardian Rebecca Fierle resigns from all cases

Florida professional guardian Rebecca Fierle: Devoted or dangerous? | Exclusive

Cremated remains of 9 people found at Orlando office of disgraced former guardian Rebecca Fierle

Expert’s complaint against Florida guardian Rebecca Fierle was ignored for years before scandal erupted | Exclusive

Orlando guardian accused of filing unauthorized ‘do not resuscitate’ orders resigns from Seminole cases

Watchdog: In Short Hearing, Fierle Given Guardianship Over Patient

Judge releases confidential information to authorities investigating former Orlando guardian Rebecca Fierle

Sunday, February 9, 2020

AdventHealth outlines guardianship changes after paying disgraced guardian nearly $4 million | Exclusive

AdventHealth Orlando CEO Daryl Tol in his office. Thursday, Nov. 21, 2019. Tol revealed changes the hospital is making to its guardianship practices in the wake of the Rebecca Fierle scandal. (Sarah Espedido / Orlando Sentinel)
AdventHealth Orlando will make sweeping changes to how it handles court-appointed guardianships for vulnerable patients after a probe found the hospital paid disgraced guardian Rebecca Fierle nearly $4 million to care for hundreds of its incapacitated patients.

The hospital will no longer pay private guardians to take on cases, will form a review panel to ensure at least two doctors determine whether patients can no longer make their own decisions before asking a judge to appoint a guardian, and will provide more training to care managers, said Daryl Tol, president and CEO for AdventHealth’s Central Florida Division, in an exclusive interview with the Orlando Sentinel.

The changes come after the hospital hired an outside law firm to conduct an audit of its campuses in Orange, Seminole and Osceola counties. Tol said the hospital will also put its political heft behind statewide reforms for the troubled guardianship program, advocating for lawmakers to increase funding, add more oversight for guardians and clarify the legal definition of incapacity.

“We have put too much trust in a flawed system,” Tol said. “And that is not something we want to continue doing or want to do again.”

Tol, who did not provide the Sentinel with a copy of the audit during an interview Thursday, said no wrongdoing was found on the part of hospital staff. He said the Sentinel’s reporting about flaws in the guardianship system served as a “positive catalyst” for some of the changes.

Fierle first came under scrutiny when one of her incapacitated clients, 75-year-old Steven Stryker, died at a Tampa hospital in May after staff were unable to perform life-saving measures because of a “do not resuscitate” order Fierle filed against his wishes and refused to remove, according to state reports. Less than a year before his death, AdventHealth Orlando had petitioned a judge to appoint Fierle as Stryker’s guardian when he was a patient there, despite him having a health-care surrogate.

The embattled guardian later admitted to routinely filing DNRs on her wards.

An audit by the office of Orange County Comptroller Phil Diamond later found Fierle improperly billed AdventHealth close to $3.96 million over a decade for services she provided to 682 of its patients, either as a court-appointed guardian, durable power of attorney, heath care surrogate or proxy. The hospital system paid at least $3.7 million, according to Diamond’s office.

Tol said the hospital spends about $30 million a year on care management for patients, which until now has included payments to guardians along with other costs, such as helping patients transition to group homes or other facilities.

As an example of the how challenging it can be to find long-term care for patients, he said employees once made more than 1,000 phone calls to find a group home for a man who was able to make his own decisions, but couldn’t live alone and didn’t have any money or family. AdventHealth Orlando is now paying for the man to live in a group home in California, he said.

About 70 patients a year are admitted to one of the hospital’s Orlando campuses who end up needing a court-appointed guardian because they can no longer make decisions and do not have family or friends who can do so for them, he said.

“If you call a smaller hospital, it could literally be years in between these situations because of the volume,” Tol said. “Because of the 140,000 admissions a year, it just so happens that a rare thing happens more frequently here.”

Typically, private and public guardians are paid through the ward’s assets or by the state to make all legal, financial and medical decisions for incapacitated people. But the multimillion-dollar arrangement, which is not allowed under Florida law without a judge’s approval, has been described by experts as virtually unheard of in the industry. It is problematic, they say, because the hospital’s wishes could conflict with the best interests of the ward.

“I would say, with regret, that it was a misunderstanding and the payments were made in good faith for the services as deemed appropriate by our care management team,” Tol said.

At times, Fierle submitted identical invoices to the hospital and the court to get paid twice for the same service and net three times the court-approved maximum fee, according to the comptroller’s probe. The probe only reviewed AdventHealth hospitals in Orange, Seminole and Osceola counties but did not look at the company’s other entities, which likely also paid Fierle.

“We were unaware that there was double billing happening, and we were an unwitting victim of that,” Tol said.

Tol said AdventHealth’s relationship with Fierle developed over 20 years. The hospital company used other guardians but primarily relied on Fierle because she was “responsive” and would take cases quickly.

“She would take on cases very easily, was easy to work with from the perspective of the team’s ability to get in touch with her,” he said. “And yet, of course, the team didn’t realize the things that have been brought to light. … Sometimes there are bad actors in the middle of a lot of good people trying to do good work.”

AdventHealth spokesman Bryan Malenius previously told the Sentinel the hospital petitions a judge to appoint a guardian as a “last resort” because it can’t discharge patients unless they have a safe place to go. AdventHealth asks the Florida Department of Children and Families to step in when those situations arise, but the state agency regularly declines, Tol said.

“We have faced over the years a very challenging dynamic in which DCF will reject the responsibility for the situation, and frankly, just leave it in our hands,” he said. “That leaves our team of advocates dealing directly with the courts and with guardians.”

DCF spokeswoman Kristi Gray has previously said guardianship is “not a DCF process.”

“When the agency identifies a need for guardianship on an open case, our attorneys navigate that judicial process,” Gray said in a statement in October.

Tol said AdventHealth has petitioned the courts for professional guardians in order to expedite safe discharges to a “better and healthier location” because the wait for a public guardian to be appointed can be lengthy.

“The hospital is not intended to be a long-term safe residential facility,” Tol said. “If the public guardian is not readily available, it is not in the interest of the individual when they’re not in an acute health care episode to remain in the hospital setting surrounded by other very sick people. They are much better off in the appropriate care setting.”

The hospital CEO and president said AdventHealth believes Florida should clarify and strengthen the responsibility of DCF to care for incapacitated people.

“We think there needs to be an intensive review of cases where DCF has refused to assist patients so that at least it’s understood why that was the case,” Tol said. “... We’re not looking to point fingers or identify bad guys, other than perhaps the guardian in question, but aside from that, we just think it’s got to be a better team effort.”

The AdventHealth Orlando CEO said the hospital is cooperating with law enforcement in criminal investigations into Fierle but the company is not pursuing independent legal action against the former guardian.

“We want to be a partner with all those trying to get to the bottom of it in this specific case,” Tol said.

Fierle, who has resigned as a guardian, is not currently facing any charges.

Full Article & Source:
AdventHealth outlines guardianship changes after paying disgraced guardian nearly $4 million | Exclusive

See Also:
Attorney General Ashley Moody fires back at embattled former Florida guardian

Ex-guardian Rebecca Fierle charged Altamonte Springs facility $100K, illegally pocketed refunds, investigation finds

Florida Elder Affairs chief announces ‘immediate’ changes as embattled Orlando guardian Rebecca Fierle resigns from all cases

Florida professional guardian Rebecca Fierle: Devoted or dangerous? | Exclusive

Cremated remains of 9 people found at Orlando office of disgraced former guardian Rebecca Fierle

Expert’s complaint against Florida guardian Rebecca Fierle was ignored for years before scandal erupted | Exclusive

Orlando guardian accused of filing unauthorized ‘do not resuscitate’ orders resigns from Seminole cases

Watchdog: In Short Hearing, Fierle Given Guardianship Over Patient

Judge releases confidential information to authorities investigating former Orlando guardian Rebecca Fierle

Saturday, November 2, 2019

AdventHealth to turn over more records regarding relationship with ex-guardian Rebecca Fierle


Rebecca Fierle improperly billed AdventHealth nearly $4 million over a decade for services she provided to their patients, according to an investigation.
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AdventHealth will turn over more records regarding its financial relationship with Rebecca Fierle, the former Orlando guardian who was paid nearly $4 million by the hospital company over a decade to provide services to vulnerable patients, according to its attorney.

At a Thursday hearing in the Orange County Courthouse, AdventHealth attorney Chuck Ingram said the hospital system agreed to produce emails between Fierle or her employees at Geriatric Management and certain hospital employees regarding the care of two incapacitated patients.

The patients were Fierle’s wards until she resigned as a guardian after one of her clients, 75-year-old Steven Stryker, died at a Tampa hospital. Staff were unable to perform life-saving measures due to a “do not resuscitate” order she filed against Stryker’s wishes and refused to remove.

David A. Yergey III, a lawyer representing the two patients’ new guardian, asked Circuit Judge Janet C. Thorpe to compel AdventHealth and Fierle to produce documents regarding their multimillion-dollar relationship, which industry experts have described as virtually unheard of.

An investigation by the office of Orange County Comptroller Phil Diamond found AdventHealth paid the embattled guardian at least $3.7 million over a decade for services she provided to 682 patients.

Close to a third of those patients were placed under guardianship, but for the majority, Fierle acted as a durable power of attorney, health care surrogate or health care proxy without court oversight and under questionable legal authority, the comptroller’s review found.

Third-party financial arrangements like the one between the guardian and AdventHealth are not allowed under Florida law without court approval. A second probe also found Fierle was profiting from her work by billing an Altamonte Springs assisted living facility almost $100,000 to handle the affairs of their vulnerable patients while pocketing refunds the facility issued to her incapacitated clients.

Thorpe previously ordered the hospital company to produce a trove of billings from Fierle’s companies, and Ingram said at the hearing AdventHealth would voluntarily provide Yergey with all invoices related to the two incapacitated patients whose new guardian he represents.

Fierle is under criminal investigation, but she is not currently facing any charges.

Full Article & Source:
AdventHealth to turn over more records regarding relationship with ex-guardian Rebecca Fierle

Tuesday, October 1, 2019

Watchdog: In Short Hearing, Fierle Given Guardianship Over Patient

By Greg Angel

ORLANDO, Fla. — In less than three minutes, Steven Stryker was stripped of all legal authority to make decisions for himself.
Newly-obtained court audio from September 2018 shows when now-embattled professional guardian Rebecca Fierle was given full authority over Stryker, 75, of Brevard County, in a court hearing that at times included laughter. Stryker hadn't even met Fierle yet.

The hearing's audio is a stark contrast from the sharply-worded petition issued by Ninth Circuit Judge Janet Thorpe, this summer. She was the same judge who presided over that September 2018 hearing. It is not clear what records Thorpe may have reviewed before granting guardianship.

The petition began to reveal what many had tried for years to show: Florida’s guardianship system is in crisis.

State investigators blame Stryker’s death on Fierle, saying she ordered his feeding tube capped, and because Fierle placed a Do Not Resuscitate order against Stryker’s wishes, doctors could not provide lifesaving support.

Stryker’s death sparked multiple ongoing criminal investigations, as well as Fierle’s resignation from hundreds of guardianship cases statewide, and growing scrutiny on the system.

"We had no time to prepare"


“Steve was very capable of making his own decisions,” said Linda Lanier, a close friend of Steven Stryker’s for nearly a decade.

In 2014, Stryker appointed Lanier his durable power of attorney and health care surrogate.

“That only ever came up because of medical issues,” Lanier said. “Steve was having a lot of issues with his esophagus.”

In June 2018 Stryker was Baker Acted to AdventHealth in Orlando, which Lanier said he then self-admitted for treatment.

“All of a sudden a sudden within a week of that treatment, I’m getting phone calls from Florida Hospital saying he’s got to go, he’s ready for discharge, but we can’t find a place for him unless there’s a guardian in place,” Lanier said.

Perplexed as to why a guardian was necessary, Lanier said the ultimate plan was for Stryker to live with her and her husband at their Brevard County home while Stryker received additional treatment at the VA Center.

It was on August 29, 2018 that Lanier says she was suddenly served with a notice of a hearing set for the following week: September 5, 2018.

“We had absolutely no time to prepare, Steven’s daughter Kimberly who lives in Virginia, and I were going nuts,” Lanier said.

The September 5, 2018 hearing was in response to AdventHealth’s petition to the court asking specifically for Rebecca Fierle to be appointed as Steven Stryker’s guardian.

A Spectrum News investigation found AdventHealth had made multiple petitions previously seeking Fierle be appointed guardian for various patients. In multiple cases seeking Fierle appointments, AdventHealth relied on attorney Philip Wallace as outside counsel.

Stryker’s family disputes AdventHealth’s claims in their petition that family could not be reached, and Steven Stryker was unable to make his own health care decisions.

“The decision was made for Rebecca to be assigned. She never contacted me, she never reached out, never asked for any information from me,” Steven’s daughter Kimberly told Spectrum News in July.

With days until the September 5, 2018 hearing, Lanier said she begged AdventHealth’s attorney Philip Wallace and Stryker’s court-appointed attorney Lori Loftis to delay the hearing.

“Both of them told me, quote unquote, Judge Thorpe would not allow this to happen,” Lanier said.

What Happened at the Hearing


Audio reveals those attending the September 5, 2018 hearing included Rebecca Fierle, AdventHealth representatives Philip Wallace and Melixa Carbonell, as well as Lori Loftis, Stryker’s then court-appointed attorney, who waived Steven Stryker’s right to appear at the hearing.

Wallace, Loftis, and Fierle are all heard identifying themselves at the beginning of the recording.

The hearing is supposed to set the status of Stryker’s temporary guardianship, but that quickly changes after Judge Thorpe announces she has possession of three reports from members of the court’s examining committee.
Judge Thorpe: “Ok, one, two, three…we’ve got three reports already in.”
Unknown: (Chuckling)
Attorney Wallace: “Yes ma’am.”
Judge Thorpe: “So much for emergency.”
Attorney Wallace: “Right” (chuckle)
Judge Thorpe: “We’ve got the final list later this month.”
Attorney Wallace: “Is the 26th, I believe.”
Judge Thorpe: “Well not anymore.”
(Collective laughter)
Unknown: “It’s right now. First and final.”
Judge Thorpe: “We just changed that. Alright. The recommendation of the three examining committee members, are they in consensus?”
Attorney Wallace: “They are your honor.”
The audio transcript shows in full how the decision was made at that point to give Fierle permanent control over Stryker’s affairs, assets, and life.

“To hear it now, to hear the voices and the laughing, it’s horrifying,” Lanier said.
The audio continues:
Judge Thorpe (to attorney Loftis): “You’ve seen the client?”
Attorney Loftis: “Yes”
Judge Thorpe: Are you (interrupted)
Attorney Loftis: “I’m in agreement your honor. There was a friend out there that was serving, we’re not sure if POA (interrupted)”
Attorney Wallace: “There is a reported Power of Attorney, signed in February. We don’t believe he had capacity to execute it. I’ve been in close contact. I spoke with her for a long time yesterday, she’s in agreement with having a professional guardian appointed.”
Attorney Loftis: “She conveyed that to me as well.”
This is a notion that Lanier fiercely denies, saying she was never in an agreement for a permanent guardian to be appointed to oversee Stryker.

“Philip Wallace left me a voicemail the day of the hearing saying 'I told the judge quote unquote your wishes, or your position', he didn’t tell the position,” Lanier said. “My position was he [Stryker] needs to go to the VA.”

Lanier is adamant that Stryker’s court-appointed attorney, Lori Loftis, acted against his wishes by not allowing him to appear in court.

“Steve wanted to go to the hearing, he was ready," Lanier said. "And the hospital said no.”

Spectrum News made multiple efforts to seek comment from attorneys Philip Wallace and Lori Loftis, but messages were not returned.

A spokesperson for the Ninth Judicial Circuit, on behalf of Judge Thorpe, told Spectrum News, “…hearings vary in length depending on their scope, purpose, and many other factors. The Court cannot comment further while there is an ongoing court case and law enforcement investigation.”

The Need for Oversight


Stryker’s case has put much attention on the state’s guardianship program and what critics say are large voids of oversight.

Lanier points to the September 5 hearing’s audio transcript as evidence.

“Not too truthful, you know, I want to give the judge at least the benefit of the doubt, a little bit. She can only go by who comes in front of her bench,” Lanier said. “You’re counting on these individuals to bring you the right information, but how much due diligence are these judges doing, to make sure all of this is correct?”

Judge Thorpe first called out Fierle ahead of a July 11, 2019 emergency hearing. Judge Thorpe wrote in a petition that there was sufficient evidence to see Fierle’s “abuse of power” and a series of “conflicts of interest”.

Judge Thorpe ordered reporters to leave that July 11 hearing at the request of attorneys, and sealed the proceeding. However, a transcript of the hearing put into focus a series of actions that Judge Thorpe said Fierle took without court knowledge.

The hearing also raised questions about the judge’s oversight of local guardians when the July 11 hearing revealed the number of cases Fierle was assigned.

“She had 97,” Thorpe said according to the July 11, 2019 hearing transcript. “We overloaded her. We overloaded her. So it probably won’t be a situation if she comes back in to take a look at it.”

A judge can appoint a guardian to oversee the welfare of an individual, extending the legal right to make decisions on behalf of the person’s affairs, health care, and finances, with control of various bank accounts and other assets.

Judge Thorpe also revealed that same day that she found Fierle had not been bonded and insured since 2013, so should have been disqualified as a guardian in the past six years.

Additionally, Fierle had employees working for her at her Geriatric Management company, without reporting those employees to the state and ensuring they were going through required criminal and financial background checks.

On September 13, 2019, Judge Thorpe also filed an order permanently removing Rebecca Fierle from any appointment in Orange County as a professional guardian, based on the findings of a second investigation by the Orange County Comptroller’s Office, which again raised questions about Fierle’s handling of financial assets of her wards.

“At no time during this Judge’s tenure in the Probate Division for Orange County did Ms. Fierle bring an issue dealing with a “Do Not Resuscitate Order” to the Court’s attention, much less in the specific case which brought this issue to light,” Judge Thorpe wrote in the September 13, 2019 order. “This appears to be a direct violation of the Administrative Code and her duty to ensure a Ward’s best interests are paramount. This Court finds probable cause that Ms. Fierle violated the Florida Administrative Code and her general duty to perform in a Ward’s best interests.”

Judge Thorpe wrote in the above order that Fierle failed to disclose her financial relationship with AdventHealth.

A September 2019 investigation by the Orange County Comptroller’s Office found Fierle charged AdventHealth at least $3.7 million for services; invoices Advent Health paid to Fierle without court approval nor knowledge.

Florida Administrative code states: “A professional guardian is specifically prohibited from soliciting or accepting incentives from service providers.”

“It is clear from the AdventHealth documents and the Comptroller’s Report that Ms. Fierle substantially benefited from her association with the facility, a service provider,” Judge Thorpe wrote in her September 13, 2019 order. “This Court finds probable cause that Ms. Fierle had a fiduciary duty to, at the very least, disclose her relationship with AdventHealth to the Court and the monies she was receiving prior to her appointment as guardian of any wards coming from AdventHealth. This information would have been extremely helpful to the Court in ensuring there was no conflict of interest in Ms. Fierle acting as either a temporary or permanent guardian of AdventHealth’s patients.”

“We were very troubled to see that there were duplicated bills sent to the hospital and to the court, and I think that is wrong,” Orange County Comptroller Phil Diamond told Spectrum News on September 12, after his office released their latest report.

A spokesman for AdventHealth responded to the Comptroller’s Report by saying they too were unaware of Fierle’s non-disclosure.

“We are both surprised and dismayed with the Orange County Comptroller’s findings that a professional guardian withheld information from the court and improperly billed the hospital and the court for resources to care for the most vulnerable in our community,” AdventHealth spokesman Bryan Malenius said. “The report from the Orange County Comptroller’s Office clearly highlights the importance of the state taking action. We are committed to lending our voice to reforming the guardianship system because it is core to our mission to ensure those who need this kind of help are cared for and protected.”

Florida Department of Law Enforcement and the Office of Florida Attorney General both have ongoing criminal investigations open, focused on Fierle.
Private Investigator Angela Woodhull told Spectrum News she tried to alert state and federal investigators years ago to Fierle’s alleged fraud and wrongdoing, to no avail.

Groups like Americans Against Abusive Probate Guardianship say Florida’s guardianship program has been fractured for years, like other states. They say much of the blame should be on judges who appoint guardianship with little actual oversight.

AAPG is hosting a community Town Hall on the issue of guardianships. The rescheduled town hall will be held November 4 from 3:00 p.m. to 7:30 p.m. at Marriott Orlando Airport Lakeside, located at 7499 August National Drive in Orlando. The town hall will begin with a screening of the documentary “The Guardians” followed by a Q & A session.

Full Article & Source:
Watchdog: In Short Hearing, Fierle Given Guardianship Over Patient

Wednesday, September 25, 2019

Audit: Florida guardian had wards with no court supervision

by Mike Schneider

ORLANDO, Fla. (AP) — A former Florida guardian accused of filing "do not resuscitate" orders without her clients' permission had authority over hundreds of wards without court supervision, according to an audit released Thursday.

The audit by the Orange County Comptroller's office said Rebecca Fierle billed $3.9 million to the AdventHealth medical system in the past decade for acting as a guardian for 682 incapacitated patients in legal and health care matters.

Less than a third of those clients were in Florida's guardianship system, while the rest weren't and had no court oversight. AdventHealth paid Fierle $2.8 million for clients under court supervision and another $1.1 million on behalf of those clients without court supervision, according to the audit, which refers to the unsupervised wards as "Group 2" patients.

Florida law prohibits a guardian from having business relationships with a ward without court approval or notification.

"It is clear how guardianship is established under Florida law," the audit said. "However, it is not entirely clear how Ms. Fierle obtained the authority to act and exercise discretion over the Group 2 patients."

Fierle had 450 guardianships when she resigned amid a criminal investigation this summer. Authorities began probing her work after the death of a 75-year-old man in a Tampa hospital whose doctors were barred from trying to save his life because Fierle had filed a "do not resuscitate" order. Investigators said that order went against his family's wishes.

The controversy prompted the resignation of Florida's director Office of Public and Private Guardians, Carol Berkowitz, at the request of Florida Elder Affairs Secretary Richard Prudom this summer.

Gov. Ron DeSantis also called for a vigorous investigation into the state's guardianship program.

According to the audit, in one case, Fierle was paid almost $289 for paying bills and discussing with the ward about a storage unit whose contents were about to be auctioned off because a $299 bill wasn't paid. The storage unit bill was never paid to stop the auction, despite Fierle being paid, the audit said.

The audit identified other cases where Fierle double-billed AdventHealth or billed the health care system for cases that belonged to other guardians.

The audit also uncovered instances where "do not resuscitate" directives had been obtained for Fierle's wards not under court supervision. The audit recommended a review of those decisions.

Fierle's attorney, Harry Hackney, didn't immediately respond to an email seeking comment on Thursday.

AdventHealth spokesman Bryan Malenius said in an email that officials at the hospital system were "surprised and dismayed" by the audit findings that Fierle improperly billed them and withheld information from the court.

"We are committed to lending our voice to reforming the guardianship system because it is core to our mission to ensure those who need this kind of help are cared for and protected," Malenius said.
___

This story has corrected the spelling of AdventHealth. It is AdventHealth, not Advent Health.

Full Article & Source:
Audit: Florida guardian had wards with no court supervision