MD jury awards $1.85M to nursing home resident left outside in heat

Morningside House of Satyr Hill is shown in Parkville on Dec. 26, 2025. (Brian Compere/The Daily Recod)

by Ian Round

Earlier this month, jurors in Baltimore County awarded a $1.85 million judgment to a nursing home resident with dementia who suffered heat stroke after being left outside for several hours.

The award is connected to a June 2024 incident at Morningside House of Satyr Hill, a facility in Parkville that operates within the broader Morningside House network of elder care properties across the mid-Atlantic and Florida. There, staff took resident Ann McShane outside, then neglected to bring her back in for at least four hours. Later that afternoon, staffers couldn’t find her for dinnertime. They eventually located her “slumped over” in the courtyard, severely sunburned, covered in vomit and barely responsive, her lawsuit stated.

“I went outside to get some fresh air and I was yelling for hours for someone to let me in,” McShane, who is in her 70s, told first-responders and hospital staff, according to the incident report filed by the Baltimore County Fire Department.

She was hospitalized for a week and a half.

The incident was not a one-off for Morningside House of Satyr Hill. State regulators with the Office of Health Care Quality (OHCQ), a division of the Maryland Department of Health, have cited the nursing home for failing to not only properly administer and document resident medications, but also to provide mandatory incident reports after residents’ injuries and falls.

Maryland has also issued “deficiency notices” after the elopement of at least two memory-care residents, McShane’s complaint states. In one case, staff failed to account for a resident after a fire drill; the person was returned after a concerned neighbor called 911. In another case, staff didn’t know a resident got out because the alarm system was not working.

Beth Sinnott, executive director of Morningside House of Satyr Hill, said in a brief interview that the organization takes such incidents “very seriously” and has acted to make sure this doesn’t happen again. She declined to say what had changed.

“The safety and wellbeing of our residents is our highest priority,” Sinnott said.

Morningside House was represented by the law firm Kiernan Trebach; a lawyer declined to comment.

McShane, who was represented by Owings Mills attorneys Allen Honick and Dustin Furman, sued in December 2024, alleging negligence and breach of contract. She now lives in an assisted living facility in White Marsh, Honick said, and while she has recovered from her physical injuries, the heat stroke left “significant lasting effects on her overall wellbeing.”

The jury on Dec. 17 awarded her $1.85 million, all for noneconomic damages, Honick said. She is set to receive $965,000 due to the cap on such damages.

McShane was the named plaintiff; her sister served as a guardian ad litem during the proceedings after the defendant raised concerns about her competency.

“Had the Plaintiff and her family known that Morningside had a pattern of ignoring and failing to implement OHCQ corrective action plans,” her complaint stated, “especially those addressing safety, medication management, and incident reporting for memory care residents, the Plaintiff would never have become a resident at Morningside.” 

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MD jury awards $1.85M to nursing home resident left outside in heat 

Nursing home costs in the U.S. are rising even faster than health care

By Kate Gibson

• The cost of nursing homes in the U.S. can easily top $70,000 a year and has risen even faster than that of overall medical care in some states, a Georgetown University Medical Center study found.
• New York nursing homes were the most expensive, averaging more than $300 a day, while Texas had the most affordable facilities.

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Nursing home costs can cost upwards of $100,000 a year, a heavy financial burden even for Americans who have set money aside for their later years -- and a crushing one for those who haven't. And those costs are rising, even outstripping the rising cost of health care in the U.S.

"What is already expensive is only getting more so," said Dr. Sean Huang, lead author of a study by researchers at the Georgetown University Medical Center. 

The cost of nursing home care is a particular risk for people without long-term care insurance or Medicaid coverage, Huang said, noting the number of Americans who are already short on retirement savings. Annual out-of-pocket expenditures can easily exceed $70,000, found the analysis of prices from 2005 through 2010 across eight U.S. states.

"For someone who is not poor enough for Medicaid or who doesn't have long-term care insurance, this will be a huge financial burden," Huang told CBS MoneyWatch. 

For-profit nursing home chains were the least expensive, while nonprofit chains were the most costly, according to the report. Independently operated for-profit and nonprofit facilities were similarly priced. Nursing homes in New York had the highest average cost in the U.S. at $302.30 per day, while Texas had the lowest at $121.90, according to the study, which drew on data from 2005 to 2010. Over that period, costs in the eights states rose faster than the roughly 20% increase in overall medical care prices.

Most Americans are eligible for Medicare at 65, with the government program covering some routine and emergency health care, but not long-term care, such as that provided by nursing homes. Although it's cheaper to buy long-term care insurance in your 40s and 50s, most people don't, focusing instead on other financial priorities like paying for a child's college expenses.

That can prove costly. Huang noted that three-quarters of Americans 65 and older will need to use a nursing home at some point, but only a small fraction had long-term care coverage.

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Nursing home costs in the U.S. are rising even faster than health care

Why Power of Attorney Can Be Key for Senior Health Care

To make sure all the documents are properly filed, it's usually best to work with an attorney you trust.

In the vast constellation of legal documents you could encounter over your lifetime, some are more critical than others. For older adults, a few legal instruments take on outsized importance, particularly in the context of ensuring adequate health care as we age. While some documents that older adults may need are focused on the financial side of your affairs, others concern how decisions will be made about your health care. The information that follows will focus on the documents related to health care that may come into play as you age.

As you navigate these legal waters for yourself or a loved one, some legal terms and documents you may encounter include:

• Living will
• Advance directive
• Do not resuscitate order
• Physician orders for life-sustaining treatment
• Health care proxy
• Power of attorney
• Guardianship or conservatorship

Living Will, Advance Directive, or Do Not Resuscitate Order

Living wills can go by a number of different names including advance directive, do not resuscitate order or POLST, which is short for physician orders for life-sustaining treatment. This document, which is often printed on brightly colored card stock and is signed by a physician, outlines which specific procedures and actions you do and don't want to receive from first responders in the event of an emergency or from end-of-life health care providers. It may include questions such as: Do you want a feeding tube placed? Do you want to be transported to the emergency room? Answers can help specify how you want to be treated if you can't communicate your wishes directly.

Stuart Furman, an elder law attorney and president of the Southern California Legal Center, Inc., in Valley Center, California, and author of "The ElderCare Ready Book," says the living will or advance directive is sometimes colloquially referred to as the "pull-the-plug" document, meaning that if someone is beyond the hope of resuscitation, then let the person go and don't take heroic efforts to revive them.

Health Care Proxy

Health care proxy is a term used in some states to designate the agent who can make health care decisions on your behalf, and may be a casual term or may reference the agent named in a formal health care power of attorney document.

Power of Attorney

There are many different types of power of attorney documents that can cover financial or health care matters. Furman says that while there are many permutations of these documents that should be tailored by an attorney for your specific situation, generally speaking all of these legal instruments are "giving authority to someone else to make medical decisions for you in the event that you're not able to make them on your own."

Pamela D. Wilson, a caregiving expert, advocate and speaker based in Golden, Colorado, says that a durable power of attorney is an important document that older adults should seek to organize sooner rather than later. "In very simple terms, power of attorney is either somebody to help you manage money or your health at a point when you either can't take care of yourself or at the point that you become incapacitated," Wilson says. Incapacitation, also sometimes called incompetency, is a legal term that generally refers to someone who "can't review information or logically think through things," such as may occur after a stroke or with later-stage dementia or Alzheimer's disease. When this occurs, the durable power of attorney would come into full force, meaning that a designated overseer or agent steps in to make decisions on behalf of the individual.

It's important to "get your ducks in a row" early, with regard to organizing your legal documents for health care, says Megan Carnarius, a registered nurse, founder of Memory Care Consulting and author of "A Deeper Perspective on Alzheimer's and Other Dementias: Practical Tools with Spiritual Insights." Particularly if there's a family history of Alzheimer's or dementia, you need to make arrangements before the diagnosis is made, because "you can't typically write a power of attorney if someone has this diagnosis." A dementia diagnosis often means the person is considered legally incapable of making those decisions. Therefore, "if families have a suspicion that the person is getting more confused and they feel like they need to go to the doctor to get a diagnosis, they should have already taken care of the financial and decision-making stuff. You don't want to wait until you've gotten a diagnosis, because then (attorneys) worry about competency."

In a perfect world, we'd all set up a durable power of attorney as soon as we turned 18, as that's when things can get dicey legally if you're incapacitated. Wilson shares the story of a young man who fell off a retaining wall and sustained injuries that rendered him incapacitated. A lengthy legal battle ensued over who would make medical decisions on his behalf because he didn't have any power of attorney documents drafted prior to the accident. For seniors, it becomes even more important to get these documents sorted out, as conditions can deteriorate quickly and catch everyone off guard. If the power of attorney assignation is left too late, the person will be forced into guardianship, Wilson says.

Guardianship or Conservatorship

Guardianship, which Furman says is called conservatorship in California, comes into play when someone is unable to make decisions for themselves and there is no power of attorney in place. Many power of attorney documents also include provisions for that same person to become guardian. But there is a distinction in the level of power each role has, Wilson says. "An example would be an older adult living at home who's burning food because they have poor memory. They're not showering, they're not taking medications and they refuse to move to assisted living." The power of attorney designee "can't put that person into a care community because that person could say, 'Hey I'm leaving,' and power of attorney can't stop them. But a guardian can. A guardian has absolute power of appointment through the court. It's a very serious appointment, because when you have a guardian, you give up all your rights to decide about health care and money." Therefore, "it has to be a very trusted person."

Who Should Be My Power of Attorney?

Typically, power of attorney and guardianship responsibilities are vested in a family member, such as the adult child of a senior. But there are lots of other relationships that can work, from close friends to hired professionals. Wilson is one such professional advocate who takes power of attorney assignments for people who don't have an appropriate agent in the family.

Choosing the right person to act on your behalf as your power of attorney is critical, Wilson says. "If a parent chooses a child who has been terrible at financial management to be their financial power of attorney, it's going to be a disaster. Same for health care. If they choose someone who can't advocate with doctors and the care community, it's not going to work out," and this is where professionals like Wilson can help. Appointing a professional can also be a savvy way of avoiding conflict if you anticipate such could occur in choosing one sibling over the other, for example. "You really have to plan for conflict if it exists in family members because all of this gets so very, very nasty," when wishes aren't clearly communicated.

It's also important to designate one or more successors, or backups, to your first-choice power of attorney. A successor would step into the role of power of attorney if your first choice can't or won't serve. "If you don't appoint a successor and the appointed person resigns, and you can't do another power of attorney, you're forced into guardianship. So, you always want to have backup successors in your documents," Wilson says.

Who Can Help Me with Power of Attorney?

To make sure all the documents are properly filed, it's usually best to work with an attorney you trust. "There's all sorts of forms you can pull off the internet," Wilson says, "but it's better to use an attorney in the state where you live because laws differ by states. Have an attorney draft them and look at them every 10 years to see what needs to be changed."

These variations from state to state can become problematic if your loved one moves, says Lindsay Perrin, co-founder of Ro & Steve, an independent online review site for senior living facilities and other businesses related to senior care that sprang out of her and her husband's challenges in finding the right care scenarios for their aging parents. "We drafted these documents for my dad years ago," when he was living in Massachusetts prior to his diagnosis with Lewy body dementia. But since then, he's moved in with Perrin's family in New Hampshire, and sometimes the personnel the family encounters at health care centers aren't familiar with the out-of-state documents. This can cause significant hassle, leading to "stressful situations in the hospital where I'm trying to sign for Medicare and the desk staffers aren't familiar with my Massachusetts documents." Sometimes they need to make calls to an attorney to clear up confusion.

Perrin says it's not possible now to have new documents drawn up in New Hampshire because her father's condition has progressed to the point where he's unable to sign new documents, so they soldier on with the out-of-state but still completely legal documents they have. Still, Perrin recommends thinking ahead about where you're likely to be living when the power of attorney will come into force and have the documents drawn up in that state. "Technically my Massachusetts documents should be well understood. They work here. It's just that not everybody has that education, so think about the next phase," and where you might be living when you'll need the assistance of a power of attorney.

Power of Attorney and Assisted Living

Matt Perrin, Lindsay's husband and co-founder of Ro & Steve, has also had to navigate these legal waters in caring for his mother who's currently in an assisted living facility. He says it's very important to have all of your legal documents in order before making the move to an assisted living community.

Some facilities may require that such documents be in place before they will admit your loved one, particularly if that person is incompetent. "There's no authority for that person to sign the contract," Furman says. "That's a cardinal rule across the country – incompetent people have no authority to sign contracts. It's like a child." Even if you're entering a facility while you're still considered competent, it's wise to have a power of attorney in place so that if your situation changes rapidly, as can happen with a stroke, for example, the community will know whom to contact when decisions need to be made. Having the appropriate type of power of attorney in place "gives us the tools in our toolbox," to be able to act in the best interest of the individual, Furman says.

Matt says drafting a power of attorney was easy and straightforward – the hardest part was having the conversation with his mom about initiating the process. On the advice of a friend, he approached that difficult conversation delicately, seeking consensus with his mother rather than being prescriptive. "It did make it easier to cut through what's not the easiest of discussions," he says of taking a collaborative approach. His mother's 40-year career as a nurse also meant she was open to talking about end-of-life and what arrangements needed to be made for her care. "She sees the value in these sorts of things, but even then, when it comes time to have the discussion about you, it's hard. It's just a tricky discussion, but you're doing it hopefully at the right time and not when you're in dire straits." As with most anything related to aging and health care, getting ahead of any coming crisis is best.

To draft the documents, the family worked with an attorney they'd known for years, though Matt says if he were to do it again, he'd probably opt for an attorney with specialized expertise in estate planning. "We're not wealthy. My mom has very few assets, but thinking we didn't need an estate plan was sort of a naive mistake. And from what I can tell it's a common misconception." Rather, estate planning is an important aspect of the whole picture no matter how much money you have. "I would tackle (estate planning and power of attorney) in tandem. It's one less thing for you to do later," when perhaps your loved one's condition has deteriorated, making even a small task like seeking a notary's signature seem like a much bigger chore. "It adds up, and you need to save your mental space for the real stuff," he says.

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Why Power of Attorney Can Be Key for Senior Health Care

Semel Son, Wife, Say They Will Mediate Conservatorship Dispute

The wife and the oldest child of former Yahoo! and Warner Bros. executive Terry Semel, who has Alzheimer’s disease, told a Los Angeles judge Thursday they will try to resolve their differences over his health care and living conditions without the need of a conservator.

Lawyers for Jane and Eric Semel said attorney Andrew Wallet’s temporary conservatorship over the person of Terry Semel, which Los Angeles Superior Court Judge Daniel Juarez imposed on Friday, will terminate Thursday as scheduled. The former studio chief’s son had filed the first volley in the legal dispute and picked Wallet as the temporary conservator for his father.

Eric Semel, 39, was born during his father’s first marriage, which ended in divorce in 1974. The 75-year-old Semel married his wife, Jane, three years later. They have three daughters.

The lawyers told the judge that between now and a June 20 status conference, both sides will discuss whether Semel should continue to live at his current home at the Motion Picture & Television Fund-operated retirement community in Woodland Hills. Eric Semel had contended that his father preferred the environment he had at his Bel-Air mansion.

No restrictions will be put on family members who want to visit Semel, he will continue to have his medical appointments and none of his current caregivers will be fired, according to the agreement.

The parties will appear before Juarez on June 20 to let him know if mediation was successful, or whether a temporary conservatorship should be put back in place. An Aug. 3 hearing was scheduled in case a permanent conservatorship is needed.

Jane Semel filed court papers several days after her stepson asked that a judge appoint a conservator to manage his father’s finances. He says in his May 10 petition that his stepmother currently has sole control over her husband’s finances and there is dissension between her and some of his four children.

But Jane Semel said in her court papers filed Wednesday that in August 2012, her husband executed an advanced health care directive in which he named her and one of her daughters as his agents to make his health care decisions. She said she and her daughter, Lily, were suited to become co-conservators of her husband, who she says was diagnosed with Alzheimer’s disease five years ago.

Semel was the chairman and CEO of Yahoo! from 2001 to 2007. Before that, he spent 24 years at Warner Bros., where he served as chairman and co-CEO, resigning amid shareholders’ dissatisfaction over his compensation package.

In 2004, the UCLA Neuropsychiatric Institute was renamed the Jane and Terry Semel Institute for Neuroscience and Human Behavior. At the time, the university said the couple’s $25 million gift was one of the nation’s largest to be dedicated exclusively to the better understanding of the brain.

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Semel Son, Wife, Say They Will Mediate Conservatorship Dispute

See Also:
Terry Semel’s Wife Files Competing Conservatorship Petition

Owner of N.J. healthcare agency admits to $7 million fraud, bribery and tax evasion

NEWARK — The owner of a Linden home healthcare agency pleaded guilty to carrying out a multimillion dollar Medicaid fraud, bribery and other offenses that could lead to decades in prison, the office of U.S. Attorney for New Jersey Paul Fishman announced Monday.

Irina Krutoyarsky, 61, of Springfield, owner of HHCH Health Care, is scheduled to be sentenced in September after admitting she told the state's Board of Nursing that the aides she employed had completed required training and testing when in reality she charged the aides hundreds each for obtaining fraudulent credentials.

Krutoyarsky also billed Medicaid for aide visits that never occurred, in some instances charging for visits by aides who were on overseas vacations, working at other jobs or who were not in the area at the time. As part of the scheme, patients were also paid to back up claims of visits that never happened. All told, authorities estimate Krutoyarsky bilked Medicaid of $7 million.

Krutoyarsky also bribed a state Department of Labor employee who was working undercover with federal agents after the department received complaints in 2010 that employees were not getting paid overtime. The $10,000 bribe attempt was recorded, authorities said. A second bribe, for $15,000, was also caught on video the following year in an unrelated Department of Labor investigation.

Krutoyarsky has also pleaded guilty to tax evasion for failing to pay more than $907,000 in taxes on income she received between 2007 and 2011 from clients who were not eligible for Medicaid and paid cash for the company's services.

She faces up to 10 years in prison each for conspiracy to commit health care fraud, bribery and money laundering. She also faces five years on the tax evasion charge and must forfeit $7 million.

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Owner of N.J. healthcare agency admits to $7 million fraud, bribery and tax evasion

Two Herald-Tribune staffers honored for health care reporting

Herald-Tribune reporters Barbara Peters Smith, left, and Justine Griffin.

Two Herald-Tribune journalists were honored by the Association of Health Care Journalists with national awards for their work on elder guardianship and the medical egg donation industry. 

Barbara Peters Smith won first place in the health policy category for small publications for her series “The Kindness of Strangers: Inside Elder Guardianship in Florida.”

Herald-Tribune reporter Justine Griffin won second place for her “Cost of Life” project in the consumer category for small publications.

The awards, which recognize the best health reporting in 11 categories, received more than 420 entries.

“These pieces show that excellent journalism is alive and well,” said contest chair and AHCJ board member Julie Appleby, a senior correspondent for the nonprofit Kaiser Health News.

AHCJ started the recognition amid growing concern that too many journalism awards are sponsored by special interest groups that seek to sway coverage. No health care companies or agencies fund this program.

Peters Smith's series has inspired a move in the Florida Legislature this year to address the issue of elder guardianship, including a bill that would create a state agency to provide more oversight for a growing group of professional guardians who exercise tremendous control over the finances and everyday lives of elderly and vulnerable Floridians.

Sen. Nancy Detert, a Venice Republican, said her legislation was prompted by the Herald-Tribune's December series, which highlighted the potential for conflicts of interest among judges, attorneys, guardians, health care providers and other business people who work closely together within the system.  (Continue Reading)

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Two Herald-Tribune staffers honored for health care reporting