New law aims to protect Ga. seniors from financial exploitation

By Harry Samler

ATLANTA, Ga. - A new law now on Georgia Gov. Brian Kemp’s desk would give banks and credit unions a tool to temporarily delay certain transactions when there is reasonable cause to suspect financial exploitation.

House Bill 945 applies to an “eligible adult,” defined in the bill as someone 65 or older or a disabled adult. Under the bill, a financial institution may place a hold on the execution of a financial transaction if it has reasonable cause to suspect the transaction may involve, facilitate, result in, or contribute to financial exploitation.

The bill allows holds on transactions involving:

• An account of an eligible adult.
• An account on which an eligible adult is a beneficiary.
• An account of a person suspected of perpetrating the exploitation.

If a hold is placed, the financial institution must notify in writing all parties authorized to transact business on the account and any “trusted contact” on the account within three business days, unless the institution reasonably believes those people may be involved in the suspected exploitation.

The institution must also initiate a review of the facts and circumstances that led to the hold.

A hold expires on the 15th business day after it is placed, but the financial institution may extend the hold for up to an additional 15 business days if its review continues to support a reasonable belief of financial exploitation.

The bill says the length of a hold may be shortened or extended by a court. It would allow an eligible adult to designate at least one trusted contact on an account. A financial institution could contact that person to address possible financial exploitation or other concerns related to account administration.

To add a trusted contact, account holders should speak directly with their bank or credit union.

HB 945 includes immunity provisions for financial institutions and their employees who act in good faith and exercise reasonable care under the bill.

The bill’s current version does not include a specific effective date clause. That typically means it would take effect upon the governor’s signature, unless another date is set in the final enrolled act.

Resources for seniors and families

To report suspected elder financial abuse to your bank or credit union, ask to speak with a fraud or compliance officer.

You should also file a police report with your local department if you believe you or a loved one is the victim of financial exploitation or fraud. Keep a copy of the report number; you may need it when contacting your bank, an attorney or a state agency.

You can also report it to these agencies:

• FBI Elder Fraud Hotline: Call 1-800-CALL-FBI (1-800-225-5324) or submit a tip at tips.fbi.gov.
• Federal Trade Commission: Report fraud at reportfraud.ftc.gov.
• Georgia Division of Aging Services/Adult Protective Services: Call 1-866-552-4464 to report suspected exploitation of a vulnerable adult in Georgia.

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New law aims to protect Ga. seniors from financial exploitation 

New law eases guardianship process for parents of disabled children

News. A recently signed New Jersey law allowing parents to seek guardianship before a child with developmental disabilities turns 18 was inspired in part by the experience of Sandyston resident Lee-Ellen Pisauro.

The calendar did not stop moving.

When Lee-Ellen Pisauro of Sandyston marked her son Sam’s 18th birthday on Dec. 22, 2021, it was not a celebration but the start of a legal struggle that left her unable to make medical and care decisions for her child with Down syndrome.

Under previous New Jersey law, parental authority ended when a child turned 18, even if the child required daily support and advocacy. Although Sam’s needs did not change overnight, Pisauro was required to navigate a lengthy guardianship process before she could resume decision-making on his behalf.

“Professionally, I had peripherally supported families through the guardianship process; however, it was not until I navigated it personally as a parent and presumptive guardian that I experienced the unintended consequences of the procedural timelines embedded in the prior law,” Pisauro said.

Pisauro, who works with special-needs students at Wallkill Valley High School, said the gap in guardianship created uncertainty and disrupted continuity of care.

“Sam was without a guardian until March 22, 2022,” she said. “During that period, my husband and I were unable to manage some of his health care needs, access his medical benefits, or obtain documentation for time-sensitive diagnostic testing.”

Concerned other families would face similar challenges, Pisauro met with former state Sen. Steven Oroho and his deputy chief of staff, Brett Conrads, now chief of staff to Assemblyman Michael Inganamort, to advocate for legislative change.

After Oroho left the Legislature, Inganamort sponsored legislation allowing parents of children with developmental disabilities to apply for guardianship up to 180 days before their child turns 18. The bill, was recently signed into law.

“Parents like Lee-Ellen who have children with medically complex needs or require everyday decision-making assistance are some of the most selfless and tireless advocates I have ever had the pleasure to serve,” said Inganamort, R-Morris. “They shouldn’t have to battle a legal system to ensure their child remains protected.”

Pisauro testified before the Senate Health Committee in early 2024, and the bill later advanced through both chambers of the Legislature. It passed Dec. 22, 2025, and was signed by Gov. Phil Murphy the following day.

“I’m proud to have played a role alongside Lee-Ellen in helping get this common-sense and compassionate law across the finish line,” Inganamort said. “It will make a big difference in the lives of New Jersey families.”

Pisauro said the law will help ensure smoother transitions for families who rely on guardianship protections.

“Pursuing guardianship is a personal decision. It’s not for everyone,” she said. “But for those needing this protection, the passage of this law will ensure a smoother transition for vulnerable young adults and their families.” 

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New law eases guardianship process for parents of disabled children 

Minnesota law meant to help prevent financial exploitation of vulnerable adults now in effect

The law creates an expedited process to prevent someone from financially exploiting a vulnerable adult. 

Author: Ian Russell

MINNESOTA, USA — With the new year comes new laws in Minnesota, ranging from the workplace to farmers.

There's also a new law centered around protecting vulnerable adults from financial exploitation.

"This is putting the power in the hands of the victim or trusted contacts that are close to them to help protect them," Jill Sauber, a certified elder law attorney, said.

The law creates an expedited process by petitioning the court for an injunction.

"The court can order either an order for protection, injunctive relief, they can freeze assets," she said. "They can do all of that very, very quickly, which is not really possible in those other ways that we approach these cases."

Sauber says that would normally take longer, potentially involving an emergency conservatorship or protective order.

"Things that take days, even though it's an emergency hearing, and in that amount of time, just a few days, is enough time for the transaction to take place, the money to go out the door, and then we have nothing to try to recover," she said.

Sauber helped push for the law, based on a law in Florida. She says it also comes from her own work experience.

"I'm seeing more and more scams and exploitation in my practice," she said. "I think at least anecdotally, we all have."

State data from the Vulnerable Adult Protection Dashboard shows the number of allegations involving financial exploitation, whether fiduciary or not, increasing over the last several years.

This is meant for vulnerable adults over the age of 18, a group defined under state statutes.

"They require some care, either in a care facility, institution, group home," Sauber said. "Or they have some sort of mental or physical infirmity that makes it hard for them to protect themselves, so they are vulnerable."

Documents to file that petition are currently available on the Minnesota Courts website, and can be accessed here, at the bottom of the webpage.

"I think this is going to be a really important tool for people to step in on behalf of somebody they love or the victim themselves, and be able to take immediate action." 

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Minnesota law meant to help prevent financial exploitation of vulnerable adults now in effect 

Petitions to review, modify, or terminate a guardianship: New law establishes protective timelines

When a guardianship is no longer needed or circumstances change, families and individuals may face delays while waiting for a court to review their request. A new Pennsylvania law is designed to address that problem.

On October 27, 2025, Governor Josh Shapiro signed Act No. 39 of 2025 (House Bill 18; P.L. 129) into law. The act, introduced by Representative Jeff Olsommer (R-House District 139), further amends Section 5512.2 (a.1) of Title 20 (the Decedents, Estates and Fiduciaries Code) of the Pennsylvania Consolidated Statutes.

It defines the timeframe within which the court must schedule a review hearing upon receipt of a petition to terminate or modify the guardianship of an incapacitated adult person. Specifically, the new law requires the court to schedule the review hearing within 30 days of filing the petition to terminate or modify a guardianship, and the review hearing must take place within 60 days of filing the petition.

Limited extensions

The statutory revisions permit the court to continue the review hearing beyond the 60-day mark if the court makes a written finding that rescheduling the hearing is necessary to:

1. Permit an interested party to participate;
2. Permit counsel for the incapacitated person to participate and to be prepared;
3. Allow for a capacity evaluation or a medical report to be completed or other medical procedure to occur; or
4. Otherwise allow for all interested parties to be prepared for the review hearing.

The use of the word “or” in the statutory language indicates that the court is permitted to extend the review hearing beyond the 60 days should it make a written finding that any of the above circumstances exist.

Restrictions on repetitive filings

Additionally, this act permits the court to decline to schedule a review hearing when that request has been filed by the same interested party and a hearing has been held upon the same request within the past 180 days, unless the new filing raises new issues or facts for the court to consider.

These new requirements will take effect on December 26, 2025.

Context within broader guardianship reform

Act 39 builds on the state’s recent efforts to strengthen oversight and accountability in guardianship cases.

The statutes and the Orphans’ Court Procedural Rules governing guardianships have undergone significant changes in the past two years. This new statutory amendment follows the earlier and much broader modifications implemented by Act 61, which took effect in June 2024.

Act 61 included increased checks in the guardianship review context, among other things. Those included:

• The requirement of an automatic review hearing where evidence presented at the original guardianship hearing indicates that the circumstances of the person’s incapacity may change.
• The requirement of counsel for the incapacitated person during both the initial guardianship and review hearing stages of the proceedings.

 

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Petitions to review, modify, or terminate a guardianship: New law establishes protective timelines

New law empowers Idaho financial institutions to intervene in suspicious activity

by IBR STAFF 

In an effort to help senior citizens and vulnerable individuals, a new law has been enacted by Idaho lawmakers to tackle financial fraud.

At a Glance:

• Idaho enacts House Bill 182, the “Report and Hold” law
• Financial institutions can freeze suspicious transactions
• Staff and reporting parties shielded from liability
• Law protects seniors and disabled adults from exploitation

House Bill 182, or the “Report and Hold” law, gives financial institutions the authority “to place temporary holds on suspicious transactions and report suspected exploitation,” while shielding those entities’ staff from liability.

According to the Idaho Department of Finance, the law allows financial institution staff to place temporary holds on transactions or disbursements from an account if fraud or exploitation is suspected, giving law enforcement, state agencies and family members time to investigate any situations that could lead to financial loss.

The law also empowers those financial institutions or reporting persons to identify and report suspicious activity. “This may include large or irregular withdrawals, sudden changes in account behavior, or shifts in a customer’s demeanor that may indicate undue influence or fraud,” a press release stated.

Reporting parties are also protected from civil or administrative liability when acting in good faith. “This provision encourages proactive intervention without fear of legal repercussions when fraud or exploitation is reasonably believed to have occurred, is occurring, or is likely to occur,” IDOF stated. The agency also said it and the Idaho Commission on Aging should be the recipients of such reported suspected activity, forms for which can be found on the IDOF website by clicking on the tab titled “Financial Exploitation of Certain Adults.”

The law pertains to adults who are 65 years and older or adults 18 and older who have a physical or mental disability that keeps them from protecting their own interests.

The department also stated that it will help facilitate collaboration for investigation.

“The law facilitates information sharing among financial institutions, reporting persons, law enforcement and state agencies. This collaboration is expected to strengthen investigations, enhance protections for vulnerable adults, and hold perpetrators accountable.”

It is not just banks, credit unions or their staff that are covered under the new law. According to IDOF, those included are “state or federally chartered banks, savings and loan associations, credit unions, credit union service organizations, regulated lenders, collection agencies, credit counselors, debt counselors, mortgage lenders and brokers, money transmitters, escrow agencies, broker-dealers, and investment advisers licensed or registered under Idaho or federal law.” 

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New law empowers Idaho financial institutions to intervene in suspicious activity 

New law and local resources help protect vulnerable adults from financial exploitation

According to AARP, financial exploitation costs older Americans $28.3 billion every year.

Source:
New law and local resources help protect vulnerable adults from financial exploitation

Floridians with disabilities applaud new law protecting their rights

by Sabrina Maggiore,Charles Frazier

Millions of Floridians with disabilities are celebrating a new law that protects their rights.

Those new protections are listed under a Florida law that took effect this week.

Under the law, courts are now required to consider what’s known as “supportive decision-making agreements” before they place someone in legal guardianship, allowing people with disabilities to appoint helpers for certain jobs.

Michael Lincoln-McCreight became the first person in Florida to end a guardianship in favor of a supported decision-making agreement. He spent four years lobbying for a change to the law after his rights were stripped from him.

Born with fetal alcohol syndrome, autism, and ADHD, Lincoln-McCreight today is living his dream life.

He’s accomplished a life-long goal of working for Universal Orlando and supports himself in his Orange County home. He says he does not take it for granted.

“I feel like I went from being a prisoner to being a free human being,” Lincoln-McCreight said.

Lincoln-McCreight says he remembers the moments he aged out of foster care, was declared incapacitated, and was placed under guardianship.

“They take all your rights away,” Lincoln-McCreight recalled. “The right to vote. The right to get married. The right to choose who your relationships are...everything is literally stripped for you.”

Lincoln-McCreight spent years in court fighting to restore those freedoms. In 2016, a doctor and judge found he could make his own decisions, and his guardianship ended in favor of supported decision-making.

“You get help with the support of family and friends that you trust,” Lincoln-McCreight said.

For the last four years, he lobbied for the new state law requiring judges to consider alternatives to guardianship, like a notirzed, supported decision-making agreement.

Matt Dietz of Nova Southeastern Law School says the informal agreements grant supporters privileges to help those with special needs.

“Think of it as a continuum between the most restrictive and the least restrictive,” Dietz explained. “Courts now have to say, ‘Okay, you’ve come here for a guardianship, what types of decisions can this person make by themselves,’ before they say ‘the person loses all of their rights.’”

For Lincoln-McCreight, the law was worth the fight.

“This is going to make not only a difference for one person but millions of Floridians with disabilities,” Lincoln McCreight said.

The law also requires third parties to recognize supported decision-making agreements.

For example, schools and hospitals must allow appointed supporters to access confidential records if the agreements are in place.

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Floridians with disabilities applaud new law protecting their rights

New Georgia law targets elder, incapacitated adult abuse

By Eric Mock

Gov. Brian Kemp has signed a new law that will help prosecutors crack down on people who harm the elderly or those who can't take care of themselves. The law is called HB 218.

The new law allows a "surrogate" to speak in court on behalf of the person who has been hurt if that person is unable to speak for themselves. Georgia has become the first state in the country to allow someone to stand in court on behalf of mentally incapacitated adults over the age of 17, provided the victim previously reported the abuse to them.

"This is just another tool that our prosecutors now have to go after the bad guys who are trying to abuse our state's most vulnerable people," said Rep. Scott Hilton. "There was one in Cobb where a school bus driver slapped in the face, a child with Down's syndrome. He then told a forensic interviewer, and that interview was not allowed or was not admissible into court."

"It's very significant. So somebody doesn't get to walk away scot-free," said Joe Gavalis, the law enforcement coordinator for the North Georgia Elder Abuse Task Force.

He said the law would have been especially helpful in a recent case in which a 91-year-old woman was interviewed by police after experiencing a case of alleged sexual abuse at the facility she was living in.

"And in two weeks, God bless her, she passed away," Gavalis said. "Well, that case goes nowhere under the old law. Now, there is a good possibility, using this law, that cases like this can be brought forward and have the investigator who took the record, who did the interview, can be put on the stand and be cross-examined."

Rep. Sharon Cooper expressed hope that this new law would convey a powerful warning that Georgia is determined to protect its elderly population and will harshly penalize those who exploit vulnerable individuals.

"It's very important that we make people in Georgia realize that you cannot take advantage of our elderly if you do. We're going to go after you and the punishment is going to be severe," she said.

Now that HB 218 is a real law, Gavalis says Georgia leaders are going to spread the word all over the state.

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New Georgia law targets elder, incapacitated adult abuse

New law makes it harder to exploit seniors with neurocognitive disorders

A Bexar County judge worked for years on a bill prevent senior citizen exploitation. Now it's becoming law.

Author: Andrew Moore

SAN ANTONIO — Senior citizens and mentality disabled individuals with neurodegenerative diseases can be easily exploited by supposed friends and caretakers who are looking for cash. 

Thanks to a loophole in state law, those individuals sometimes get away with it. That's why Bexar County Probate Judge Veronica Vasquez worked with Senator José Menéndez and other lawmakers this session to end that loophole with S.B. 576.

Judge Vasquez began her position in Bexar County Probate Court 2 in 2018. She told KENS 5 she sees elements of senior exploitation routinely in her cases. 

"Elder abuse and exploitation is a huge problem," Vasquez said. "We preside over hearing emergency removals and hearing of adult protective services....When it's an allegation of abuse and they need to remove them from the home, they have to go through the probate court to try and do that." 

Vasquez said during those cases, they sometimes find that family members or caregivers convinced a senior with dementia or Alzheimer's disease to write them a check or withdraw money for personal reasons. 

"They get them to write a check, get their bank account information, or take them to the bank and have them remove cash. That's typically what we see," Vasquez said. 

Vasquez told KENS 5 the senior's family sometimes tries to get the money back, but there was previously no laws preventing caretakers from getting a loan from an elderly individual they are friendly with. This is still the case if the person has a neurocognitive disorder. Even if the caretaker didn't intend to give the money back, claiming that they would repay the money would still help them avoid criminal charges. 

"When it became a criminal offense, this was their scapegoat to say, "they let me borrow it and I intended to pay them back and I still intend to pay them back," Vasquez said. "How can you prove it one way or the other, especially when your victim now has dementia and they can't remember?" 

Fortunately, lawmakers passed S.B. 576 and the Governor signed the law in June. The bill states that if the offender "knew or should have known" that the  elderly individual "had been diagnosed with dementia, Alzheimer ’s disease, or a related disorder," then the transfer of money or other property is automatically presumed to be "wrongful" in that situation. Vasquez said the offender can then be charged with financial abuse of an elderly individual. This means the offender can no longer protect themselves by claiming the the money or property was loaned. 

Vasquez said she worked with the Elder Abuse and Exploitation Task-Force for three years to get the legislation passed. It failed in 2021 but passed in the last session. The bill passed with a unanimous vote in the Texas Senate this year. 

"We're finally able to do it and it is an exciting day," Vasquez said. "It's amazing to see that this made it through."

The bill will go into effect on September 1, 2023, though it also states it will also apply to still apply to any offense committed previous to that date.

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New law makes it harder to exploit seniors with neurocognitive disorders

New law heightens penalties for elder abuse in Alabama

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New law heightens penalties for elder abuse in Alabama

Son of victim of elder abuse applauds new Ohio law

by: Brandon Jaces

(WKBN) – Governor Mike DeWine signed a law Wednesday that allows cameras to be installed in nursing homes.

Senate Bill 58 known as Esther’s Law is named after Steve Piskor’s mother who was a victim of elder abuse.

“My mother was abused. It’s been over 10 years now, and we got the letters, I got the legislation that was used in 2019,” Piskor said. 

Then the pandemic happened and the legislation failed, but it was reintroduced earlier this year and has since passed.

“It’s amazing after so long of trying. I mean, I pushed so many people to the max. I probably got so many people mad at me, but in the end, I think a lot of people realized how much this was needed,” Piskor said.  

The cameras aren’t a requirement, and if a resident has a roommate, the roommate has to agree to it being installed.

“Maybe just pointing the camera at the person that wants it and maybe setting the sound off or whatever agreement they want to come to,” Piskor said.

This law is geared to the most vulnerable, but during a pandemic, it might make it easier for families to see their loved ones.

“Residents in nursing homes with dementia or Alzheimer’s, residents who can’t tell us what’s happening, and that was the same with my mother, she couldn’t tell me what was happening,” Piskor said.

Following the signing of the bill, AARP released a statement congratulating Piskor. The agency said, “On behalf of our more than 1.5 million members statewide, we thank Governor DeWine for his signature to enact Esther’s law. This law provides additional peace of mind, a gift for family caregivers and long-term care residents this season.”

Continuing Healthcare of Lisbon released the following statement:

“We understand that cameras may offer families some measure of comfort, however, they aren’t the answer to ensuring quality care in nursing homes. We have extensive policies and procedures in place to protect our residents and pride ourselves on the quality of care we provide. We have always encouraged residents and families to bring any concerns to us so they can be addressed immediately. Having a camera in a room will change very little for us.”

Continuing Healthcare of Lisbon

“So I just asked people to use it, you know, and we have to get the word out to let people know that this law is there,” Piskor said.

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Son of victim of elder abuse applauds new Ohio law

Nursing homes will have to boost staffing or shrink capacity thanks to new law

Nursing homes have a staffing problem and they are scrambling for answers. When 2021 concludes, state law will mandate that nursing homes provide 3.5 hours of direct care to each resident.

What does that mean? More staff or fewer residents.

“Studies over the last 50 years show that staffing levels lead to better care and poor staffing levels lead to poor care,” Mary Wypych, a volunteer with Elder Justice recently told 13WHAM-TV. She advocated for the state law that will now require nursing home residents to receive 3.5 hours of direct care.

Nursing home administrators say coming out of the pandemic, the new state law presents facilities with a major challenge.

“I think it would have been hard under normal circumstances. When you throw in the vaccine mandate, it will be nearly impossible,” VP for Long Term Care at Thompson Health Amy Daly said. “What other Nursing Homes already doing is closing down wings, not admitting, so you’re essentially closing down beds, you’re not decertifying beds but you’re not admitting to your full compliment beds so you can reploy the staff and care for the residents you do have.”

The new state law takes effect January 1, 2022. Some nursing homes say they have already experienced significant loss of residents due to visitation rules during the pandemic.

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Nursing homes will have to boost staffing or shrink capacity thanks to new law

New Texas law tightens requirements for Harris Co. boarding homes housing elderly, disabled people

HARRIS COUNTY, Texas (KTRK) -- Thanks to a new Texas law, there are now more protections for vulnerable Harris County residents living in boarding homes in unincorporated areas of the county.

Harris County Sheriff Ed Gonzalez, Fire Marshal Laurie Christensen and others spoke at a press conference Thursday morning after a new state law was passed that creates criminal sanctions for people who operate unlicensed boarding homes outside of city jurisdictions. 

 

Senate Bill 500, which takes effect on Wednesday, Sept. 1, also creates criminal penalties for people who fail to report abuse or neglect in boarding homes.

"Because they serve such a vulnerable population, boarding homes can also be susceptible to abuse," Gonzalez explained

The county defines a boarding home as a residential facility that provides housing and personal care services to three or more unrelated persons with disabilities, or elderly people.

Gonzalez said for many residents, boarding homes are a lifeline to avoid homelessness.

The sheriff explained that, up until the passing of SB 500, some boarding home owners were operating in a loophole that avoided basic oversights.

"Until recently, however, many boarding homes managed to escape basic oversight by operating in unincorporated areas (of the county) where law enforcement had little authority to intervene on behalf of residents," Gonzalez said.

He said these homes are often overpacked with deplorable conditions. The residents are too often victims of exploitation, abuse, neglect and Medicare and Medicaid fraud.

Gonzalez said that he suspects many boarding home operators moved to unincorporated areas of Harris County after the City of Houston adopted a tough ordinance years ago when he was a city council member.

"We see people living in facilities and being brought out of facilities that do not have an evacuation plan, they do not have a fire alarm system. They do not have the basic needs for the kitchen, and those things that are needed to keep them safe," Christensen said.

She said the fire marshal's office is also focused on making sure the homes are clean and in good repair, have working carbon monoxide detectors, access to phones and more.

SB 500 was authored by state Sen. Borris Miles.

 

"You know, for a divided legislative session, a great thing happened. Sen. Miles carried a bill that serves our Harris County residents, especially our most vulnerable elderly and disabled individuals living at a lower socioeconomic level," District Attorney Kim Ogg said." They're forced, many times, to choose between homelessness and some kind of boarding home"

Ogg said her office has seen abuse out of boarding homes in the past that has shocked even law enforcement.

"We need other individuals in the boarding homes or visiting the boarding homes to report victimization," Ogg said. "We as a society have a responsibility to protect one another."

The new law means that individuals operating a boarding home without a permit can face a Class B misdemeanor, which could include a $2,000 fine and a 180-day jail sentence.

Similarly, individuals who fail to report abuse at boarding homes can face a $4,000 fine and one year in jail.

Boarding homes will have to renew their permits every year to insure they stay up to code. Officials will be visiting homes for inspections any time concerns are raised.

Officials with the newly-formed Sheriff's Office Boarding Home Detail work with identified boarding homes in Harris County to make sure they are up to standards and licensed.

The Boarding Home Detail consists of one sergeant and two deputy investigators who work to proactively identify and permit all boarding houses outside of the city.

So far, the team has visited over 100 homes and completed over a dozen inspections. As a result, about 60 facilities in Harris County are working to get their permits.

 

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New Texas law tightens requirements for Harris Co. boarding homes housing elderly, disabled people

'Lives will be saved': New protections for Minnesota seniors in assisted living go into effect

Nearly 55,000 seniors in assisted living gain sweeping protections. 

 

By Chris Serres

 

David Joles - Star Tribune

Residents at the Jones-Harrison Senior Living complex participated in Chaplain Chat, a three-times-a month gathering with Chaplain Monica Powers where Powers leads group members on discussions about religious as well as other topics. Here, Jones-Harrison Senior Living complex residents Colleen Jackson, right to left, and Anne Klein, were eager to get started in July.

Tracy Lussier and Shelly Gelhar had a modest wish list when they moved their 68-year-old mother, who suffered from a degenerative brain disease, into an assisted-living home in Apple Valley. They expected staff to keep her clean, comfortable and safe, so loved ones could focus on her emotional well-being.

Yet within weeks, the sisters noticed alarming signs of neglect. On regular visits, they found their mother was left unbathed and lying in soiled sheets for days at a time. When she fell from her bedroom chair, the sisters had to plead with facility staff to call for medical help. The next day, X-rays showed she had fractured her hip — an injury that would leave her bedridden and in agony for the last few months of her life.

"From day one, it was apparent they didn't care about our mother," said Gelhar, of Rosemount. "She was just another body to fill a bed."

Their experience highlights the extreme lack of oversight of Minnesota's assisted-living industry, a shortfall that has potentially endangered thousands of seniors who entrusted their care with these supportive housing communities.

But now, years of grassroots lobbying by victims of abuse and neglect in these facilities have resulted in the broadest expansion of state supervision of long-term care in generations. A sweeping new state law goes into effect Sunday that establishes minimum levels of care and basic consumer protections for the fast-growing assisted-living industry, which is home to nearly 55,000 Minnesotans.

For the first time, facilities will be licensed and subject to more regular inspections, and residents will have statutory protections against arbitrary evictions and retaliation for reporting maltreatment.

"People's lives will be saved by this law — and hopefully the conditions of those lives will be improved," said Kristine Sundberg, executive director of Elder Voice Family Advocates, a coalition of relatives of elder abuse victims that pushed for changes.

Those families say the dozens of new regulations are long overdue and needed to keep up with the evolving nature of senior care.

When assisted living first gained popularity in the 1980s, the facilities were thought to need less regulation because their residents typically were younger and required less care than people in federally regulated nursing homes. Over the years, however, the distinctions have blurred.

Assisted-living communities have mushroomed in size and have begun catering to older residents and those with more acute health needs. Many have opened specialized "memory care" units for people with dementia and buildings that resemble skilled nursing homes. Nationally, nearly 60% of people living in these homes are older than 85 and about 40% suffer from dementia.

But until now, Minnesota stood alone as the only state that did not license assisted-living facilities, which meant it was hamstrung in enforcing basic standards of care.

Major change for Minnesota

The new law marks a significant shift by expressly recognizing the vulnerability and complex medical needs of assisted-living's changing population.

For the first time, facilities will be required to evaluate the physical and cognitive needs of every newly admitted resident and provide access to a registered nurse 24 hours a day, seven days a week. On-site inspections will be every two years, compared with the previous three-year cycle. And training requirements have been strengthened for staff who care for people with dementia.

The law also effectively bans the practice of sudden and arbitrary evictions in assisted living.

For decades, these homes faced almost no repercussions for forcing out residents who became difficult to manage. Now, if a provider wants to terminate a resident's contract, they must first ensure the resident has a safe place to go and provide them with at least 30 days' written notice before they are discharged — similar to protections that already exist for nursing home residents.

"This should have happened years ago," said Eilon Caspi, a gerontologist and health researcher who is on the board of Elder Voice.

Were it not for a relentless effort to call attention to unsafe conditions in these homes, the new consumer safeguards might never have arisen.

Starting in 2016, the daughters, sons, spouses and other relatives of maltreatment victims began coming forward with harrowing stories of their loved ones suffering from preventable deaths and abuse in assisted-living homes.

The family members, organized as Elder Voice Family Advocates, inundated lawmakers with stories of loss and anguish, including incidents in which loved ones had died, been maimed or traumatized as a result of maltreatment.

In emotional testimony and research reports, they described incidents in which elders were left for hours on the floor after falling, or suffered painful deaths because facilities failed to treat routine health problems, such as hernias, dehydration and diarrhea. Others died because wellness checks were not completed as prescribed and medications were not given or were given incorrectly, they found.

These were far from rare incidents.

A 2017 Star Tribune investigation found the state was receiving more than 20,000 allegations a year of neglect, physical abuse, unexplained serious injuries, and thefts in homes for seniors and people with disabilities. Only a fraction of those complaints — approximately 3% — were investigated on-site by the state.

What's more, some family members who spoke out about the maltreatment, or who attempted to install cameras in their loved ones' rooms to monitor care, were harassed or threatened with eviction, the investigation found.

Uncovering abuse

Sisters Jean Peters and Kay Bromelkamp were among the first to call for changes after uncovering verbal abuse and neglect of their 85-year-old mother on video at an Edina assisted-living home.

Using a tiny camera, they caught aides repeatedly chastising their mother as well as sleeping in chairs without providing daily care, regular safety checks or taking their mother to meals. After their mother died, the sisters helped dozens of families install cameras in senior homes — a right that in 2019 became enshrined in state law.

"We got this done for the sake of humanity," said Peters, a registered nurse and president of Elder Voice. "For decades, the industry and the regulators had let things slide, and they needed to be woken up."

Some wondered if licensing would ever become a reality.

In 2018, a broad-based effort to reform Minnesota's system for protecting seniors foundered amid partisan divisions and opposition from the senior care industry.

Then last spring, the Minnesota Department of Health, the state agency that oversees long-term care, became swept up in efforts to combat the worsening coronavirus pandemic. As a result, agency officials pushed back licensing a year later than planned, asserting that senior homes needed to stay focused on preventing the spread of the fast-moving virus, which had already killed hundreds of Minnesotans in long-term care facilities.

The delay frustrated elder care advocates who pointed to the staggering death toll in senior homes as further evidence of why more regulatory oversight was needed.

Yet, despite a winter surge in COVID-19 cases, the Department of Health forged ahead and this spring completed the monumental task of drawing up the new rules with public input and educating providers on the new licensing system.

The response was stronger than many expected. By June, the agency had received more than 2,000 license applications from assisted-living and dementia care providers across the state. To enforce the new regulations, the agency expects it will need another 56 staff.

"I am really proud of the work we have done to stand this up at a time that we also had a COVID-19 pandemic," said Lindsey Krueger, director of the Department of Health's Office of Health Facility Complaints.

Connie Billmeier of Minnetonka is among those who wishes the new law had been enacted years earlier.

In fall 2018, her 58-year-old brother with cognitive disabilities was found slouched in his wheelchair with unusually high blood pressure at an assisted-living home in northern Minnesota. Instead of calling for medical help, unlicensed staff gave him aspirin and put him back to bed. Later, he was airlifted to a hospital where doctors discovered internal brain bleeding that likely caused his death, she said.

"Perhaps if a [registered nurse] had been on duty, he or she would have recognized that my brother was failing sooner," she said. "It makes you wonder how many lives were lost because we didn't have these protections sooner."

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'Lives will be saved': New protections for Minnesota seniors in assisted living go into effect

Connecticut Enacts New Law On Use of Technology for Virtual Visitation and Monitoring in Nursing Homes

On June 16, 2021, Governor Ned Lamont signed into law Public Act No. 21-55, An Act Strengthening the Bills of Rights for Long-Term Care Residents and Authorizing the Use of Resident Technology for Virtual Visitation and Virtual Monitoring (“PA 21-55”). Connecticut now joins certain states across the county that have enacted statutes or regulations on the use of video monitoring in nursing homes. Unlike many other state laws, however, Connecticut’s new law addresses rights and obligations concerning resident use of technology in general, for communication and virtual visitation as well as for monitoring.

PA 21-55 draws on lessons learned during the COVID-19 pandemic when in-person visitation in nursing homes was significantly limited. Connecticut’s Nursing Home and Assisted Living Oversight Working Group, which was established in response to COVID-19’s impact on the long-term care setting, recommended that the Connecticut General Assembly enact legislation addressing visitation in the long-term care setting as well as resident access to the technology of their choosing, with provisions in place for roommates and privacy. At the same time, the growing prevalence and capabilities of communication technology devices raised concerns among nursing home providers that technology used for virtual communication and visitation could be deployed to secretly monitor resident care, capturing images and sounds of other residents and staff without sufficient dignity, privacy and consent protections.

PA 21-55 responds to these recommendations and concerns. It affords nursing home residents the right to install and use technology as they would in their own homes, but also sets out rules for how the technology is used. The law prohibits use of technology for covert monitoring. Use of technology for monitoring is permitted only if the resident provides prior notice to the facility, obtains consent where required and complies with other specific requirements.

In this Advisory, we first summarize PA 21-55’s provisions addressing the use of technology for virtual visitation and monitoring in the nursing home. These provisions take effect on October 1, 2021. Next, we summarize sections of PA 21-55 that contain related amendments to the statutory bill of rights for residents of nursing homes, as well as residential care homes, chronic disease hospitals and managed residential communities.

Use of Technology for Virtual Visitation and Virtual Monitoring in Nursing Homes

Use of technology for virtual visitation and monitoring is addressed in Section 3 of PA 21-55. That section applies only in the nursing home setting. It does not apply in other settings such as assisted living because assisted living services in Connecticut are provided in the managed residential community, which is considered a private residence under Connecticut law. As such, these residents are free to install and use technology in their private residences.

Rights and Rules for Residents and their Representatives

The law states that the nursing home resident has the “right to use technology of the resident’s choice that facilitates virtual monitoring or virtual visitation” subject to certain requirements. If the resident is not capable of exercising this right, a “resident representative” may do so on the resident’s behalf. PA 21-55 defines a “resident representative” as a court appointed conservator of the person or guardian or an appointed health care representative; if there is no conservator of the person or health care representative, then a person whom the resident has designated in a written document signed by the resident and included in the resident’s records on file at the facility may serve as the resident’s representative, and if there is no such written document, a legally liable relative or other responsible party can act on the resident’s behalf.

If a resident or resident’s representative wishes to install and use technology for virtual visitation or monitoring, the following requirements apply:

• Resident Responsible for Expenses. The resident is responsible for expenses involved in the purchase, activation, installation, maintenance, repair, operation, deactivation and removal of the technology and

• No Privacy Right Violations. The technology and any recordings or images obtained from it may be used by the resident and the person communicating with the resident only in a manner that does not violate any individual’s right to privacy under state or federal law and that complies with requirements set out in PA 21-55.

If a resident or the resident’s representative wishes to use technology for virtual monitoring, including situations where technology is already being used to enable virtual visits but the resident or representative later decides to put it to use for monitoring, the following additional requirements apply:

• Posted Notice of Monitoring. A “clear and conspicuous notice” must be placed on the door of the resident’s room, indicating that technology intended for and enabling virtual monitoring may be in use.

• Detailed Notice to Roommate(s). If technology will be used for virtual monitoring in a shared living situation, advance notice must be provided to the roommate or representative of the roommate specifying the type of technology, the proposed location of the device, its intended use, intended hours of operation and whether the device can record audio or visual or be activated remotely.

• Written Consent from Roommate(s). The resident or representative wishing to install a device for virtual monitoring must then obtain written consent of all roommates or their representatives for use of the technology for virtual monitoring; if any roommate withdraws consent, use of the technology must cease until consent is obtained and the resident or representative must notify the facility, in writing, no later than seven days after the roommate withdraws consent.

• Written Notice to Nursing Home. The resident or representative must file a signed, written notice with the nursing home along with a copy of the roommate’s consent not less than seven days before installing or using technology for virtual monitoring. The notice must:

(A) identify the type of technology, its intended use, intended hours of operation and location in the resident’s room,

(B) state whether the technology is capable of recording audio or video or being activated or controlled remotely,

(C) acknowledge that the resident is responsible for the purchase, activation, installation, maintenance, repair, operation, deactivation and removal of the technology, and

(D) include a waiver of all civil, criminal and administrative liability for the nursing home (PA 21-55 contains a separate provision, discussed below, providing that the nursing home is immune from liability in connection with use of the technology).

PA 21-55 specifically exempts cellular mobile phones used primarily for telephonic communication and tablets not used for virtual monitoring from these requirements, but these devices cannot be used in any way that will violate an individual’s right to privacy.

Nursing Home Responsibilities

• Internet Access. Under PA 21-55, the nursing home must provide Internet access, electricity and a power source for technology used for virtual visitation or virtual monitoring at no cost to the resident. However, the obligation to provide Internet access is based on certain conditions:

(A)  the nursing home must include the cost of providing Internet access in cost reports filed with the Department of Social Services for purposes of Medicaid reimbursement,

(B)  the cost is reimbursable to the facility if the Department of Social Services determines it is eligible for reimbursement,

(C)  the Department of Social services may use any available COVID-19 provider relief funding provided by the federal government to the State to provide grants-in-aid for nursing homes for Internet upgrades (provided this use of funds is approved by the federal government), and

(D)  the nursing home may assess a prorated portion of any unreimbursed cost of Internet upgrades to a privately paying resident using the technology.

A resident is also permitted to procure his or her own Internet connectivity. In that case, the nursing home may not charge the resident for any cost of facility Internet infrastructure upgrades necessary for resident use of technology.

• Facility Notice. The nursing home must place a conspicuous notice (i) at the entrance to the facility indicating that technology enabling virtual monitoring or virtual visitation may be in use in some residents’ rooms and (ii) on the door of any resident’s room where technology will be used for virtual monitoring.

• Roommate Refusal of Consent. If a resident’s roommate refuses to consent to use of technology for virtual monitoring that may capture video or audio of the roommate, the nursing home must work with both the resident and the roommate to seek an appropriate accommodation with the roommate’s consent. If the roommate continues to refuse consent, then the facility must work with the resident wishing to use the technology for virtual monitoring to develop an alternative, which may include transfer to another room with a roommate who is willing to consent, provided an appropriate room is available and the resident pays the difference in price if the new room is more costly than the resident’s current room.

Facility Policies and Procedures

PA 21-55 permits a nursing home to establish policies and procedures on use of technology for virtual monitoring.  Those policies and procedures may address the following six areas:

• Placement of the technology. Facility policy and procedures may require that any technology device be placed in a conspicuously visible, stationary location in the resident’s room (but such a requirement does not apply to cellular mobile telephones used primarily for telephone communications or tablets not used for virtual monitoring).

• Restrictions on location of video/audit recordings. Policies and procedures may place restrictions on use of technology to record video or audio outside the resident’s room or in any shared common space.

• Compliance with life safety code/fire protection requirements. The policies may also require that the installation, placement and use of technology comply with applicable life safety code and fire protection requirements.

• Privacy. The nursing home may address limitations on use of technology for virtual monitoring in its policies and procedures when such use will interfere with resident care or privacy, unless the resident, roommate or his or her resident representative consents to such use.

• Internet service disruption. The policies and procedures may provide that the facility can limit the use of technology in the event of a disruption to the facility’s Internet service.

• Facility actions for noncompliance. The nursing home may include in its policies and procedures the actions that it will take for failure to comply with applicable federal, state and local laws or facility policy on use of technology. These policies and procedures must set out the process by which a resident may appeal any facility actions.

Nursing Home Immunity Protections

PA 21-55 explicitly immunizes a nursing home from any civil, criminal or administrative liability for the following:

• Privacy Right Violations. The facility is immune from such liability for violations of privacy rights of any individual under state or federal law that is caused by a resident’s use of technology.

• Damages to Resident’s Technology. The facility is also immune from liability for damage to the resident’s technology, including but not limited to any malfunction not caused by the nursing home’s negligence.

• Use, Interception or Disclosure. The immunity protection also extends to situations in which audio or video produced by the resident’s technology is inadvertently or intentionally disclosed to, intercepted or used by an unauthorized third party.

Regulatory Implementation

The new law provides that the Office of the Long-Term Care Ombudsman may provide standard forms on its Internet web site for (1) resident notice to the facility of the resident’s plan to install and use technology for virtual monitoring;  (2) roommate consent forms and (3) forms addressing withdrawal of roommate consent. The Office of Long-Term Care Ombudsman must develop the standard forms in consultation with nursing home facility representatives and the Department of Public Health.

Finally, PA 21-55 authorizes the Commissioner of Public Health to adopt regulations to implement the PA 21-55’s provisions addressing use of technology for virtual visitation or virtual monitoring.

Bill of Rights Amendments

Section 1 and 2 of PA 21-55 amend statutes setting forth the bill of rights for residents of nursing homes, residential care homes, chronic disease hospitals and managed residential communities. The amendment establishes the resident’s right to treat his or her living quarters in these settings as his or her home, including the right to purchase and use technology of the resident’s choice such as technology to facilitate virtual visitation, so long as operation and use of the technology does not violate any individual’s right to privacy under state or federal law. In addition, PA 21-55 has added a separate provision to the bill of rights for nursing homes, residential care homes and chronic disease hospitals addressing the resident’s right to present grievances. These sections take effect on July 1, 2021. As a result, the long-term care providers covered by these requirements (nursing homes, residential care homes, chronic disease hospitals and managed residential communities) should make sure they have amended their resident bill of rights to incorporate the new requirements.

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Connecticut Enacts New Law On Use of Technology for Virtual Visitation and Monitoring in Nursing Homes