84-year-old woman who lost life savings to scammer thought she was 'helping the government'

By Diane Wilson 

RALEIGH, N.C. -- A scammer used fear and intimidation to steal thousands of dollars from an 84-year-old North Carolina woman.

She says she gave up her savings to "help the government," and now she's using her voice to help you.

"The whole time I kept telling him, 'I know you're scamming me. I know you're scamming me,'" says Barbara, of Raleigh, who said despite the red flags going off, it wasn't enough for her to stop a scammer. She adds, "He had gotten so into my head and had me scared, had me so confused."

Barbara asked us not to use her last name or show her face because she fears scammers will target her again, got caught up in what's known as an imposter scam.

"He said he was with the Federal Trade Commission and the reason he was calling me was because they were trying to get these people who were money laundering, using older people," Barbara tells ABC11 Troubleshooter Diane Wilson.

She said the person got her to believe her money was in jeopardy.

"What we want to do is we want to take your money and wash it. We want to clean your money, right now. If you tried to use the money in your account, it's gonna pick up as being dirty money."

The man called her daily, gaining her trust.

"Always thought that scammers will go on to pitch fast and run. He didn't, he did not hit fast. He took his time with everything."

Over two weeks, she says he convinced her to take $7,500 from her bank account and transfer money to him daily.

"The way it was going to end was they had all my money they would run it through the cleaning process, and then there would be local undercover people who would come to my house and bring funds to replace my money."

Barbara said she heard from him only once after she sent all of the money to him.

"He called me when it was over and he said, 'I just want to thank you for all your hard work and helping me get this done.'"

She never heard from him again and her money was gone. She's so embarrassed and devastated she lost her life savings.

"I don't want that to happen to anybody else because it was so invasive."

Barbara is not alone.

Federal data shows in 2022 that imposter scams were the most commonly reported, with consumers losing $2.6 billion. Scammers often impersonate not only government officials, but also tech support, and well-known businesses. They're always after your money. The key is to not fall for either their scare tactics, or efforts to build your trust, like they did in Barbara's case.

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84-year-old woman who lost life savings to scammer thought she was 'helping the government'

Promised $2.5 million and a Mercedes, an Auburn senior wound up losing her life savings

Barbara Hinckley, 95, lost everything to a sweet-talking scam artist who told her she'd placed second in a sweepstakes for the Publisher's Clearing House. 

By Steve Collins

Barbara Hinckley sits in her Auburn home with paperwork from a monthslong scam that promised her millions of dollars and a new car, but instead drained her life’s savings. Andree Kehn/Staff Photographer

AUBURN — When the phone rang in her trailer at the Ja-Lynne Mobile Home Park off Turner Street on July 6, 95-year-old Barbara Hinckley quickly answered it.

A friendly voice on the other end told her that he was David Sawyer, prize director for Publishers Clearing House in New York, and he had some good news: She’d won second prize in its annual contest.

That meant, he told her, that she could expect $2.5 million and a new Mercedes-Benz.

Hinckley said she didn’t need a new car and wasn’t even too sure about the cash.

“What would I do with all that money?” she asked. “What would anybody do with all that money?”

Three days after hearing she had won $2.5 million in a Publisher’s Clearing House sweepstakes, Barbara Hinckley received a package that included a purported copy of the check she would receive for $2.5 million. Provided image

But she didn’t see any reason to be suspicious. After all, she said, she’d done business with the company off and on for three decades. She also knew from its television commercials over the years that it really does give away large sums.

Sawyer, who struck Hinckley as a well-spoken, well-educated fellow, told her she had two choices about how to handle her good fortune.

“You can do it publicly,” he said, with all the attendant publicity, “or you can do it privately. But if you do it privately, it is just between you and me. You can’t say anything about it to anyone.”

During the next six weeks, keeping it all mum from family and friends, Hinckley forked over more than $16,000 in a series of transfers that wiped out her life savings.

Right to the end, the man identifying himself as Sawyer, never dropped the pretense that Hinckley was a lucky winner.

In fact, though, she was just the latest — and, no doubt, not the last — to be conned by crooks who prey on vulnerable, often lonely seniors who are too trusting and naive. Publisher’s Clearing House, which has long warned about the fraud, had nothing to do with the crime.

The Federal Trade Commission says that if somebody claims you won something and then asks for a fee, it’s fake. “If you have to pay, it’s a scam,” the agency says.

U.S. Sen. Susan Collins, a Maine Republican who chairs the Senate Aging Committee, has long targeted scams aimed at the elderly.

“I have heard numerous heartbreaking stories of Mainers being robbed of their hard-earned money, from amounts ranging from hundreds of dollars to their entire life savings,” Collins said Friday. “One of my top priorities as chairman of the Senate Aging Committee is to stop the ruthless scam artists who steal billions of dollars from seniors each year.”

“Last year, the bipartisan Senior $afe Act I authored was signed into law, which helps protect seniors by encouraging the trained employees of financial institutions to question suspicious transactions and report suspected senior financial exploitation,” Collins said. “I have also introduced legislation to prevent guardianship abuse and crack down on robocalls, but more work remains to be done. Protecting our nation’s seniors requires a coordinated response among all levels of government.”

This fall, her office said, staffers assisted an older Lewiston woman robbed of her life savings through a lottery scam that came to light after a teller noticed she was withdrawing large sums. The FBI is investigating it.

For Hinckley and other seniors, it’s an all-too-common tale, usually remaining under wraps because victims are too broken or ashamed to admit they fell for cons ranging from “your grandson is in prison and needs your help” to phone warnings that only immediate payments will stop the Internal Revenue Service from seizing your home, both schemes that often entrap unwary seniors.

Hinckley said she wanted to tell the story of this “sleazy business” that happened to her because the only good that can come of her odyssey is to let others know how it occurred so that they don’t fall victim as well.

“I hope it never happens to other people,” she said. “It was horrible to live through.”

That first call from Sawyer came on a Saturday.

By Tuesday, the supposed company executive was fast on his way to becoming a near-constant phone buddy, calling Hinckley “sweetheart” and “baby girl,” asking about her health, her meals, her family and all sorts of things.

“The conversation just kept going on and on and on,” Hinckley said. “We talked about everything, just about.”

Sawyer even mentioned President Donald Trump to her, calling him “that freak down in Washington” whose new rules and regulations were supposedly making it hard for his firm these days.

At first, Hinckley said, she wondered if it was some sort of flimflam operation. She asked the caller flat-out whether she could trust him.

He told her she was “perfectly safe, that it was all on the up-and-up,” Hinckley said.

Within a week, Sawyer said he was heading to Auburn, calling her before boarding a plane to Portland and then from the airport in Maine and then from a hotel there. He even gave her the name of the hotel and its phone number.

That was also when he first asked her to send money.

Sawyer provided some convoluted tale about why she had to send the cash — placed inside the pages of three magazines in an overnight package — so Publisher’s Clearing House could confirm her identity and ensure that she could get her prizes.

“Gee, that doesn’t sound right,” Hinckley said in response. “I said to him, ‘Asking me to send this is like scammers have done.’”

But Sawyer assured her she would get reimbursed soon. The fees she paid upfront, he said, were just a technicality.

They soon added up.

On July 10, she sent $3,490. Three days later, it was $500. On July 15, another $1,000. Three more days went by and then she sent $500 more.

On July 20, she mailed him $9,000. Then, after two more days passed, $2,000.

A teller at Mechanic Savings Bank asked her if she knew what she was doing — and even got a supervisor to come talk to her.

“That’s a lot of money,” Hinckley recalled the teller saying. “Are you sure?”

But Hinckley explained to the skeptical bankers that she would be getting it all back soon, nothing to worry about.

Somebody at the bank apparently didn’t buy it, since Hinckley’s children got a call warning them that something was amiss. She said she “sort of put off” subsequent questions from her family about the money.

“I was being loyal to the wrong people,” Hinckley said.

By early August, a month into the scam, Hinckley’s account was pretty much drained.

“Don’t worry about anything,” Sawyer told her. “You’re going to get this all back.”

Hinckley said that even though she enjoyed talking with Sawyer, the experience became an ever greater worry, so upsetting that she lost eight pounds fretting about it.

Hinckley, who retired at age 65, had built up her savings by working multiple jobs for 46 years and spending as little as she could. Typically, she said, she even added $200 a month from her pension and Social Security checks to the stash.

She said she has always lived on the money she gets from Social Security and a pension from her old job with the Auburn Housing Authority, never touching the cash she’d socked away for the future.

“I just knew I was never going to spend it,” Hinckley said, but having something set aside was a comfort — security for what could happen.

The scam began to unravel in August, when Sawyer claimed he had arrived at the Hilton Garden Inn in Auburn, preparing to get the car and cash to Hinckley at last.

He called her to say he was on the way over to her home — a trailer with a baby grand piano where the music-loving Hinckley had lived for 40 years. In the next call, though, just minutes later, he told her his GPS was acting up and instead of nearing her place, he was actually over by the post office on Rodman Road.

Before long, he was supposedly having his first lobster dinner in Maine at Mac’s Seafood in Auburn.

The man had all the details down, but nothing he couldn’t have found easily on the internet. He talked as if he often came to Maine to see her, but somehow could never quite get to her.

“This kept happening, over and over and over,” Hinckley said, with Sawyer always friendly and solicitous, asking her about whether she’d taken her medication, worn her seat belt and kept herself safe.

Sawyer promised repeatedly to come to her. But “always something happened” that made it impossible or impractical, especially for a busy executive with a wide portfolio, Hinckley said

Sawyer had Hinckley change her phone number a couple of times, once knowing her new one even before she did. He kept switching his number, too.

“You don’t want scammers getting to you,” Sawyer told Hinckley.

Calls by the Sun Journal to the last number Sawyer used to phone Hinckley went straight to voicemail. Nobody responded to them.

Hinckley still speaks of Sawyer with more than a hint of fondness, despite everything.

“He was very considerate,” she said, and obviously bright. He spoke without an accent, only saying a few words oddly, but nothing that triggered any concern.

Collins’ office and the AARP say scams like this one are often run out of Jamaica.

Hinckley sent money to addresses in Connecticut, North Carolina, Rhode Island and elsewhere, always changing.

Early on, she got a packet of information from a fellow in New Britain, Connecticut — her address handwritten on a mailing label for a Priority Mail package from the post office — that included copies of prize letters, Internal Revenue Service documents, picture of other prize winners and such, clearly meant to bolster Sawyer’s tale but short on any solid information.

The language sometimes displayed fake formality and twisted legalese, but to someone unfamiliar with such things, it seemed to have a ring of authenticity.

But Hinckley grew suspicious as her savings dwindled.

On Aug. 6, she mailed a check for $4,300 to a man in Greenville, North Carolina — and then thought better of it. She made sure it bounced.

Out of money, worried and increasingly convinced she’d been tricked, Hinckley said she finally fessed up to a family member.

“I’m in something over my head,” she said. “I need help.”

Within a day, the bank, the police and others were told. But nobody had an answer for how to find Sawyer, how to get her money back or how to roll back the clock to July 5.

“My family was ready to lock me up” in an assisted-living facility, Hinckley said, but she refused to go.

“If you’re going to take away all of my independence,” she said she told them, then “you might as well shoot me.”

Instead, they all agreed to let someone else control her finances. By then, though, her savings had vanished.

“I gave it all away,” she said sadly. “I felt so stupid.”

The problem, Hinckley said, is that “I never think anybody would do anything to hurt me.”

The next time Sawyer phoned, she told him she’d talked to the police and knew she’d been the victim of a scam. She told him, as the police urged her to say, not to call ever again.

But he didn’t listen.

Hinckley said he kept calling, repeatedly, for days and weeks. She ignored him.

By mid-September, she’d had it.

She said she knew it was hopeless, that she’d been the victim of a thief.

And yet, when Sawyer called one day to tell her he was in town and had the $2.5 million, Hinckley didn’t just tell him to get lost.

She said she wanted to find out if there was any chance that maybe it wasn’t all just a fraud. She said she wanted to be sure, to be absolutely positive.

Sawyer insisted he just wanted “to prove my honesty to you once and for all.”

So Hinckley listened as Sawyer said he could refund all her money to her that very day.

All he needed, he said, was $285 to pay a police officer to escort him to her home.

So she sent him the $285.

Nobody showed up.

She had $8.75 left in her account.

“Now I know,” Hinckley said. “I want nothing to do with him again.”

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Promised $2.5 million and a Mercedes, an Auburn senior wound up losing her life savings

“I Thought They Were Going to Kill Me”: How an Elderly Woman Was Defrauded of Her Life Savings

By Harold Gagné

 

Photo: Edouard Plante-Fréchette/La Presse

The shocking fate of Veronika Piela, a Montreal woman defrauded of her life savings, is symptomatic of a larger problem. Many seniors are isolated, vulnerable and unlikely to be believed—even when they're telling the truth.

 

The case of Veronika Piela

Short of breath, her face tensed with fear, an elderly woman struggled with her walker on a snowy sidewalk in Montreal’s Côte-des-Neiges neighbourhood. It was February 14, 2014, and, despite the biting cold, she wore no scarf, gloves or coat.

“Help me,” she asked a passerby, who was surprised to see the frail woman so underdressed. The good Samaritan covered her with some of her own clothes and called emergency services.

When the police arrived, the older woman was shaking. She had no ID. With a thick Russian accent, she kept repeating how much she disliked her new apartment. She didn’t want to return because she wasn’t allowed to have visitors or use the telephone.

The officers escorted her back to her nursing home, where they were shown a court order for 89-year-old Veronika Piela to live at the residence.

“If I stay, I’ll kill myself,” Piela told the police. She had run away by sneaking out an emergency exit.

Reliving traumas

Piela knew what it was like to be held against her will. During the Second World War, as an 18-year-old orphan, she was interned with thousands of other Ukrainians at a labour camp in Germany, unsure if she would make it out alive. There she met a Polish man named Joseph Piela. Together they survived imprisonment and, in August 1945, married in the camp before being released at the end of the war.

In 1948, the couple emigrated to Quebec’s Mauricie region and then on to Montreal, where Joseph worked as a cook and Veronika as a maid and labourer. They had no children. With their savings, they eventually purchased two homes. When Joseph died in 1987, Piela was alone. She lived on a small retirement pension and, later, on the money from their properties, which she sold in 2007.

Now, once again, Piela was trapped. But providence intervened, as it had during the war. Back at the station, the officers submitted their statement to Elizabeth Kraska, an elder-abuse case investigator for the city’s police department.

“I immediately connected it to another incident that had occurred two weeks earlier,” she said.

On January 28, Alissa Kerner, a social worker in private practice, had called the police to report an Alzheimer’s patient named Veronika Piela. Kerner claimed that Piela was living in squalid conditions and the social worker was seeking urgent help from the police to remove her from her apartment.

The call was transferred to Kraska. Kerner explained that she had been hired by Anita Obodzinski, described as Piela’s niece and legal representative, to conduct a psychosocial assessment of the elderly woman. Her conclusion was that Piela could no longer manage on her own and needed to be sent to a care facility.

“I told her to come down to the station with the protection mandate and evaluation reports,” said Kraska. But when Kerner showed up, she didn’t have any of the documents to prove the subject’s incapacity or Obodzinski’s legal authority to make decisions on her behalf. Without them, the police could only transfer Piela to hospital if they felt she needed help. Yet Kerner insisted that Piela should not be sent to a hospital.

For Kraska, something felt off. At that time, she was moving her own 91-year-old father to a care centre for Alzheimer’s patients, so she was familiar with the process. “He went through several medical assessments, and I was there every step of the way. It was clear to me that Ms. Kerner was trying to hide something,” she said.

On February 5, Kraska raised the alert with Quebec’s human rights commission and public curator. Then she set to work on the investigation. Kraska turned her attention to Piela’s police file, where she found evidence of more suspicious incidents.

On February 2, less than a week after Kerner’s call to the station, police had been summoned to Piela’s apartment. According to the report, Kerner and Obodzinski had knocked on the door, but Piela had refused to let them in. The women soon returned with Obodzinski’s husband, Arthur Trzciakowski, and forced their way in to the apartment.

“I thought they were going to kill me,” Piela had told the officers, in tears. She had alerted the police to the intrusion before her phone was unplugged. Kerner, Obodzinski and Trzciakowski were arrested but released without charges when they showed a protection mandate and claimed the incident was a misunderstanding.

Kraska also found a report from February 12, two days before Piela was discovered in the street, when officers had been called to help a bailiff with a Superior Court order to evict Piela from her apartment and bring her to a nursing home.

The court order had been granted in December 2013. Piela—described as an Alzheimer’s patient incapable of living alone—was not present during these proceedings. The judge ruled in favour of eviction, and Piela was sent by ambulance to a nursing home. The lawyer representing Obodzinski for the hearing was Charles Gelber, Kerner’s husband.

“Help me.”

Kraska had seen enough. On February 17, she and four officers went to Piela’s nursing home. There they discovered that the elderly woman had been placed in a small, stark basement room. Her only possessions were the clothes on her back.

Kraska walked toward Piela slowly, as she did with her own father, and spoke to her in Polish, a language she had learned from her parents. “Her face lit up,” said Kraska.

During their exchange, Piela appeared mentally sound and exhibited no signs of Alzheimer’s disease. The only medication Kraska found in the room was a prescription to treat Piela’s rheumatism.

“Help me,” said Piela, “or I’ll commit suicide.” Kraska put her arm around the elderly woman and promised to get her out.

“She’s only interested in the money from the two homes I sold,” Piela said of Anita Obodzinski.

Defrauded

Thanks to Kraska’s intervention, Piela was quickly placed in another care centre, the location of which was kept secret for her own safety. But she had another urgent problem: she’d been stripped of all her money. When Piela checked her bank accounts, she discovered that $474,000 had been transferred to a trust registered to Charles Gelber, on behalf of Obodzinski. In order to get her money back, she had to regain her legal autonomy. Piela hired a lawyer.

The proceedings to invalidate the protection mandate—which provides someone control of another person’s physical and financial care in case of their incapacity—began at the end of February 2014 and continued for two years. During that time, Piela had to go to court 20 times. The anxiety she experienced caused her to develop heart problems and high blood pressure, for which she was hospitalized. Despite her poor health, Piela was determined to provide her testimony.

“I met Anita Obodzinski in 2007,” she explained to Superior Court judge Hélène Langlois in November 2015. “She showed up at my house with her mother, an acquaintance of mine, and wanted to buy one of my duplexes.”

The sale fell through, but Obodzinski offered to take Piela to her medical appointments and help her with chores for $100 a week. Their arrangement came to an end in June 2013, when Piela said she accused Obodzinski of stealing from her purse.

In her defence, Obodzinski claimed she was officially mandated to care for Piela and manage her property. But the protection mandate, dating from March 2013, when Piela had undergone knee surgery, was shown to have been forged. An expert witness from the forensic-science laboratory testified that the signature on the document wasn’t Piela’s.

Under Quebec law, the protection mandate requires both a medical assessment and a psychosocial report to be put into effect. Kerner had supplied the latter. And she had asked Dr. Lindsay Goldsmith, a Montreal family doctor, to conduct the medical evaluation. Goldsmith claimed that she had carried out her evaluation in November 2013, in Piela’s kitchen, with Obodzinski translating the questions and answers to and from Russian. Goldsmith concluded that Piela wasn’t able to take care of herself or her property and that she suffered from Alzheimer’s disease. Piela, however, maintained that she had never met with a doctor.

In court, geriatric physician Dr. Catherine Ferrier disputed Goldsmith’s findings. After completing her own medical tests, she found that Piela was capable of making decisions and administering her affairs. Ferrier told the court that it was unlikely that Piela was suffering from Alzheimer’s in November 2013, since the disease may stabilize, but it doesn’t improve.

The court ruled that the reports by Goldsmith and Kerner were unreliable. The mandate was revoked in November 2015, and Piela was declared able to take care of herself and her property and exercise her civil rights. She was free, and her money was returned to her.

Not an isolated incident

Meanwhile, Piela’s attorney contacted Quebec’s order of social work, urging them to investigate Alissa Kerner. In September 2014, they suspended her. Given the allegations, the order initiated a review of the social worker’s assessments of other seniors. Thanks to that inquiry, three more stories were brought to their attention and investigated.

One of those cases involved Rose Stein Brownstein. In 2011, when the Montrealer was 76, her son had encouraged her to sign a protection mandate in case of incapacity. The following year, social worker Alissa Kerner had performed an assessment that determined Brownstein had trouble managing her finances and making rational decisions. In October 2012, despite inconclusive medical reports, the protection mandate was put into effect, with her son as mandatary.

But just two months later, Brownstein’s son died of cancer. The replacement named on his mother’s protection mandate was his close friend: Charles Gelber. Over the course of the following year, Brownstein stopped receiving her financial statements, which had been rerouted to Gelber. When she requested copies, she noticed that money was disappearing from her accounts. In December 2013, Gelber had paid himself $17,000 for “administrative services rendered.” Additionally, regular payments, amounting to thousands of dollars, were being transferred to an account belonging to Alissa Kerner.

Brownstein reported the incident to the police and took legal action to prove she wasn’t suffering from Alzheimer’s. She hired a lawyer to demonstrate that the protection mandate should be nullified, and a new medical assessment proved that her cognition was just fine. In March 2015, over Gelber’s objections, a judge found in Brownstein’s favour and she regained her autonomy. The court has yet to rule on the amounts in dispute, but no criminal charges were brought.

Justice is served

For her misconduct, Alissa Kerner faced 11 ethical violations before her professional order—six of them for her involvement in Piela’s case. Another seven disciplinary charges were filed against her in July 2015, and in August 2016, Kerner was suspended for three years and ordered to pay $2,000. She has admitted fault on most counts but expressed no remorse.

“This is the first time we’ve seen collusion and such serious transgressions against seniors by one of our own members,” said Marcel Bonneau, trustee of Quebec’s order of social workers.

In criminal court in September 2017, Kerner pleaded guilty to mischief and breaking and entering into Piela’s home. She was given six months’ probation and ordered to pay $2,000 to the Crime Victims Assistance Centre.

In January 2018, Obodzinski pleaded guilty to a number of charges, including mischief and obstruction of justice. Her husband, Arthur Trzciakowski, also pleaded guilty to one count of unlawful entry and mischief. Obodzinski was sentenced to two years’ house arrest, three years’ probation and 240 hours of community service. Trzciakowski received a conditional discharge and 170 hours of community service.

Before rendering his decision, Justice Pierre Labelle read from a statement: “You latched on to an elderly victim and altered her life. You falsely used the court’s authority to have the victim declared incapable of taking care of herself. You took her life savings, and then you had her forcibly thrown out of her own home. I have no words to express the disgust I feel.”

In October 2018, Charles Gelber was suspended for 18 months by the Quebec bar after he pleaded guilty to seven infractions. The disciplinary committee ruled that his actions “were a direct infringement of Mrs. Piela’s fundamental rights.” Gelber did not appeal the decision.

In March 2014, Piela’s lawyer submitted a complaint against Dr. Lindsay Goldsmith to the province’s order of physicians. No charges were laid. However, Goldsmith, Kerner, Gelber, Obodzinski and Trzciakowski are all named in a civil suit that has been filed by Piela’s estate. The court documents indicate that each party will defend the claims against them. The case is scheduled for November 2019.

With her until the very end

Unfortunately, Veronika Piela can no longer testify.

Exhausted by the proceedings, she died following a stroke in December 2016, at the age of 92. She spent her final months in a Montreal residence for Ukrainian seniors. But she couldn’t shake her suspicion of others.

“She was afraid of becoming a victim of fraud again,” explained Kraska. “When she had to renew her lease or sign documents, she’d call me to make sure everything was in order.”

Piela would tell the officer that she had saved her life.

“I just did my duty,” said Kraska. She was with Piela until the very end.

 

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“I Thought They Were Going to Kill Me”: How an Elderly Woman Was Defrauded of Her Life Savings

How Medicare Stole My Mother’s Health and Life Savings

My very independent mom was aging right. Until she checked into the hospital

Marion Geoghegan Campbell

By Cat Stone

Some days it’s impossible to believe mommy’s gone.

But every day, it’s impossible to believe that she went the way she did: penniless and in pain—on every level. She spent her final years beating herself up for making the biggest mistake of her life. She wanted to support herself with the money she’d taken a lifetime to save. Instead, mom died embarrassed and heartbroken knowing the government had stolen her entire life savings and more because of a Medicare loophole.

Mom was puttering around her Florida apartment late in the spring of 2012 when without warning, she heard, then felt, a loud crack. Her hip fractured and sent her flailing backward onto the floor. In agony, she called out to her dear friend next door who dialed 911. She was rushed to the hospital.

My brother and I both lived out of state and mom didn’t want to worry us. So intelligent and capable (she had graduated from both high school and business school by age 16), she “took care of everything,” then called to tell us that she was already checked in.

Concerned about our mother’s health,  neither of us thought to ask how she had been admitted to the hospital.

In fact, we had no idea that there was a right or wrong way to be admitted.

Her American Dream

Born in 1924, my mother, Marion Geoghegan Campbell, began work in 1940 in the typing pool for Grace Shipping and quickly made her way up through the ranks, eventually leaving and becoming a paralegal. Marion helped set landmark cases in computer law.

She was also a Catholic who wrote her Pope annually. She trusted in the honor of our country, her fellow Americans, and the agencies that were meant to serve and protect her.

At 86 she was healthy and sharp and could sign her name with assistance (her eyesight was failing); she had all documents—from grocery lists to greeting cards—read to her. And she wasn’t shy about asking people to jump in to help.

Long before her vision deteriorated, Marion read everything she could about Medicare. She went into her senior years understanding how it worked. She even researched the skilled nursing facilities in town so she’d have a plan in case anything unexpected happened. She understood that with a three-day hospital stay, Medicare would pay for 100 days of skilled nursing or rehabilitation.

So when a doctor at the hospital told her that she had to sign the paperwork or leave, she signed. She told us that she was doing so well after the fracture that the hospital was just keeping her “under observation” and that she was relieved not to be “admitted.”

We all thought that was a good sign. Even though she was in pain, we assumed it meant she hadn’t been seriously injured.

The problem was that she was in no shape to understand or comprehend the hospital document she was signing. She was legally blind and a bit doped up, and it remains unclear whether or not anyone read her the fine print.

So my mother accidentally signed away her future because the papers she initialed said she understood Medicare’s special rule: that patients “under observation” do not qualify for skilled nursing care.

A Fateful Mistake

Six weeks later my fiancé and I sat in mom’s room at the rehabilitation facility to which she had been transferred. She had done her physical therapy daily and every afternoon we did  EFT (Emotional Freedom Techniques, a form of acupressure) together over the phone.

The doctors were impressed with her progress. She worked hard because she wanted to walk down the aisle at her daughter’s wedding! We were finally going to take her home.

My mother held my hand and joked that my new engagement ring was so shiny she could now see clearly. She called each of her nurses and the rehabilitation staff into the room to show off the ring and her handsome future son-in-law.

Reports of my engagement spread like wildfire. Which is, apparently, how the billing manager discovered I was in the building. She barged into the room waving a wad of papers and demanded to see “the checkbook.” She said she’d “hate to put mom in collections…”

Cat and her mother, Marion

“My mother is fully insured,” I shot back. “We’ll take care of the paperwork at a more appropriate time.”

Suddenly, my mother was crying.

The woman who’d survived a world war cowered behind me, whispering that she didn’t know what she was going to do because the billing manager had been mean to her about the money for months. Assuming that there had been a mix-up, I ordered the billing manager to leave the room. Just then I turned and saw that my mother’s roommate was crying, too.

When I asked to see the executive director, I was told she wasn’t available. I went to her office anyway.

Apologizing for being so pushy, I explained that the billing manager had terrorized not only my mother but also her roommate. The director replied very politely that she would look into the behavior and assured me it was not their policy to harass patients.

I then turned my attention to the billing error. The director explained that since my mother had not been fully admitted to the hospital, Medicare’s 100 days of skilled nursing care had not been activated.

“Clearly there is some mistake,” I insisted. “Why would your staff admit my mother if she didn’t have Medicare coverage?”

“Your mother knew what she was doing when she signed our admission forms,” the director said. “She told us she has a savings account. She will be billed for our services.”

The walk back to mom’s room took a century. How was I going to tell her she’d made such a huge mistake? By the time I got to the room, I had resolved that we’d fight the system and do all we could to correct this terrible injustice. Mom was horrified to learn she’d signed away her rights and possibly her life savings but she too was confident we’d win in court.

The Dream is Broken

A week later we sat in the office of the best elder care attorney in town. Shaking his head in dismay, he told us that he hears stories like this several times a week. He was compassionate and gentle but advised us that there was indeed no mistake and there was nothing we could do except negotiate a better payment schedule.

I worked out a $100-a-month payment plan for my mother to cover the five-figure bill. The accounting department continued to send her phone calls and threatening letters. Unbeknownst to me, her spirit broken, mom finally wrote out a check to the nursing home for everything she had in savings, except for $1,000. But even paying the nursing home in a bulk didn’t begin to cover the total she owed for all the extra equipment and therapies they had offered her–and she had accepted–thinking she was covered.

So, for four years, instead of using her Social Security check to buy food, she spent it on her debt to the nursing home

When we visited, her house looked spotless, her clothes clean; she did appear thinner and weaker, but we chalked it up to age. Mom never let on to us that she was starving herself and isolating herself to pay her bills.

She grew apart from her church community because she couldn’t afford the cab fare to services. She became frail due to malnutrition and had trouble caring for herself.

Finally, a visiting nurse found my 91-year old mother collapsed on her tile floor unable to get herself up. When the nurse phoned me after calling for the ambulance, I insisted mom be rushed to a hospital that I had researched ahead of time that had a history of caring for the elderly. Then I called her primary care doctor and insisted he have her fully admitted. He took over her case and signed the papers himself. Mom was going to require permanent, long-term care.

Next, I called the executive director of the nursing home that had treated her for the fractured hip four years earlier. It was still the best in town. I politely, but firmly, told her that mom wouldn’t be returning in her current condition had the system not failed her and stolen her money. Placing the blame on the system and not the nursing home, I concluded by telling her that it was the facility’s ethical duty to help mom now in her time of great need.

This time the executive director offered compassion and care: Mom was admitted that same day.

Her Last Wish: to Help Others

Mom spent two years in the nursing home, often joking that this or that was hers, because after all, she’d paid for it with her savings. The truth was she was horrified to be on Medicaid—the federal and state program for those with low or no income or assets. But it was the only way we could get her care. She’d worked for decades, saved, voted, fought and prayed but she ended up living “on the dole”—a burden to society—despite all her best efforts.

My mother was a fighter but this is how it ended for her.

One day mom began to talk about how this situation had impacted her emotionally. She apologized for her mistake and what it had cost her and what it had cost us—the tens of thousands of dollars we pitched in for housekeepers and nurses so she could remain at home. Mom lamented that she was too old and frail to do anything about it, so she made me promise I’d tell everyone I could about this horrible Medicare rule and help others avoid her fate. At least a dozen times before she died I called her to say, “Mom! You saved another one!” and gave her the details of some friend or family member who had used her knowledge, her mistake to protect themselves. And she would say, “Well then, dear, my prayers have been answered and my pain has meaning.”

WHAT YOU CAN DO TO HELP YOUR LOVED ONES

1. Understand the loophole Tell everyone. Shout it from the rooftops. Make sure your parents, siblings, friends, colleagues, and neighbors understand about the Medicare “Observation” loophole. Remind them to insist on being fully admitted should they or anyone they love be hospitalized. The rule: Medicare only covers skilled nursing facility care with a “qualifying” inpatient hospital stay. A qualifying inpatient hospital stay means your loved one has been a hospital inpatient, formally admitted to the hospital after their doctor writes an inpatient admission order, for at least 3 days in a row (counting the day of admittance as an inpatient, but not counting the day of discharge).

2. Protect your rights You have time to understand what you’re being asked to sign. You always have the right to have your attorney review any paperwork before you sign. Tests, medications, and assessments can, and often must, be administered before the doctor can choose the correct designation, that is, whether your status is “under observation” or “admitted.” Advocate for yourself or your loved one.

3. Understand your signature is permanent Changing the hospital stay designation after the fact is nearly completely impossible. The time to get it right is at the beginning, so understanding the process and taking the right actions up front is your best protection.

4. Make decisions from a place of calm Emotions are painful and powerful in the midst of a parent’s illness or injury. The worst decisions are made in overly emotional states. Learn processing skills like EFT, a self-applied acupressure technique, to help process stress and painful emotions like fear so you can make decisions from a calm, secure position.

5. Be prepared Engage an elder care attorney early. You will need one to create your power of attorney document when you need to take over the decision-making process for an impaired parent, but also so you have someone in place to handle a legal challenge if one arises. The phrase “my attorney will need to review” can be amazingly effective in securing the cooperation of medical and billing personnel.

6. Involve your parent’s primary care doctor Discuss the Medicare loophole with your parent’s primary care doctor ahead of time and make sure they will help obtain the proper designation if the need arises. The physician of record can sway things and if they have hospital privileges they have even more power. Have the same conversation with any specialists such as your parent’s cardiologist, surgeon or oncologist. At the time of hospitalization, call in all the troops and reference whatever issues or list of symptoms you can to secure the proper designation.

7. Review your hospitals Research local hospitals to determine how cooperative they are with admitting. Hospitals and doctors have quotas to meet and guidelines to follow if the doctor or hospital wants to get Medicare reimbursement. They are penalized for not obeying the rules. But different hospitals have different concerns about the rules. Same for doctors–who might be wealthy enough to forgo the reimbursement. Ask friends, your physician and even contact hospitals directly. Some will advise you about their policies up front. Write down the name of your designated emergency hospital on a card your parent can keep in his or her wallet. Make sure your parents know that if you are not there to advocate for them, they should insist on being brought to the designated hospital.

8. Confirm, confirm, confirm Check your loved one’s patient status daily until s/he is discharged. Sometimes doctors change the status, but sometimes hospital administrators press the issue forcing doctors to downgrade a patient during the stay. Remember, patients need to be fully admitted into the hospital for three days in order for Medicare to kick in. If that admission status changes at any time, the clock restarts.

9. Learn the lingo By law since March 2017, hospitals must advise you what the patient’s designation is and exactly what that means in terms of financial obligations and how that designation affects the patient’s insurance. But remember: the hospital isn’t there to protect your parent’s rights; it’s there to protect their requirements under the law and their own management. Terms like “downgraded to observation” could make it seem like the patient is getting better when in fact it simply means the patient has been switched to a lower status under Medicare. If they need to go to skilled nursing, they’ll have to pay out of their own pocket.

10. Work the system If you don’t get the proper designation, try again by checking out of the hospital and then in again a day or so later. A new hospital, another doctor or a new administrator might make all the difference. Or, sadly, a few more days might mean the condition has progressed enough to truly require more care.

11. Try again Even if your loved one does end up in a nursing home after an “observation status” hospital stay, voiding Medicare coverage, you can try to have them sent back to the hospital for a new stay and insist they be fully admitted. Once they are fully admitted for a three-day stay, the clock begins again and they can access their full 100 days of coverage.

12. What to do if all else fails Realize that skilled nursing care isn’t a stay at the spa and often it’s nothing you can’t do at home yourself. Exercises for the elderly are very simple; it’s the repetition that counts. Provided your loved ones can make bathroom visits themselves you might find taking them to your home or getting them in-home nursing is a better answer. Plus, many people find they heal better in their own home environment. If your loved one has no assets, many home-care services will be completely covered by Medicare or even Medicaid. Services such as bathing, wound care, meal prep and housekeeping can be obtained with just a few phone calls.
 
Full Article & Source:
How Medicare Stole My Mother’s Health and Life Savings