Mary Li Creasy, the administrative law judge, who is presiding over the Savitt hearing. (Damon Higgins / The Palm Beach Post)
With $190,000 and his wife’s job as a professional guardian on the line, former Circuit Judge Martin Colin
took the stand Wednesday and called it “nonsense” that his spouse
stands accused of receiving appointments by virtue of their marriage.
Instead,
Colin said his fellow judges — who he referred to as friends —
appointed his wife. He said all the judges who approved Savitt’s
appointment knew she was his wife.
He also said the families and their lawyers were the ones who
drafted Savitt as a guardian — lawyers who often had cases in front of
him and relied on Colin to approve tens of thousands of dollars in their
fees.
The accusations against Savitt arrived in the first ever administrative complaint filed by the Office of Public and Professional Guardians. Despite concerns against guardians voiced statewide, the office chose Savitt.
It accuses the former tennis instructor of failing to reveal a conflict of interest with her husband and failing to act in good faith, contrary to her wards’ best interests.
An
amended complaint filed last week added the fact that Savitt took a
vacation with Circuit Judge David French, who oversaw a majority of her
cases. The office claims that was an additional conflict of interest.
The guardianship office is asking an administrative
hearing judge to consider sanctions, including one that could
effectively keep Savitt from practicing in Palm Beach County and direct
her to repay $190,000 in fees.
Colin was asked on the stand by
Savitt’s attorney about the crux of the state’s case: that his wife was
appointed because she is married to a sitting judge in the guardianship
division.
“If that’s the wording of it, then the best way to answer that is, ‘That’s nonsense,’” Colin said.
“It
never happened that way. I had no role in the cases that she got
appointed on. That is not a process that would even take place if
someone has an understanding of how one gets guardianship cases.”
Colin’s
testimony came a day after Administrative Law Judge Mary Li Creasy
revealed that a confidential report on an investigation of Savitt by the
Palm Beach County Clerk of Court & Comptroller contains “allegations or suggestions of wrongdoing by sitting judges.”
The guardianship office told The Palm Beach Post on Thursday that
it would release the report no later than Friday after it has been
redacted.
Savitt’s attorney tried to keep the clerk’s
investigation out of the proceeding through a motion, saying it included
“statements and conclusions that are highly objectionable throughout.”
Morris
tried Thursday to steer any testimony away from judicial behavior,
especially whether Colin approached an attorney who practiced in front
of him to represent Savitt.
“I think we got away from the focus
here, which is whether Ms. Savitt did anything, not whether Judge Colin
or Judge French or any other judge did anything wrong, ” Morris said.
Creasy
allowed Sheri Hazeltine to testify about Colin asking her to represent
his wife. Morris had called the line of questioning irrelevant.
“I
don’t think it’s irrelevant. I think it goes to the heart of this
matter as to whether or not Ms. Savitt’s relationship with a sitting
probate judge as a professional guardian, whether or not that influenced
her appointments.”
Hazeltine, who appeared rattled on the stand,
testified that Savitt had not waived her attorney-client privilege.
Hazeltine contradicted previous statements made to The Post that she
felt “a natural measure of fear” when Colin approached her and that she
stopped working for Savitt because she took fees without prior approval
from a judge.
Hazeltine said Savitt — sitting about three yards
from her — was a good guardian and that she still represents her on
cases involving disabled individuals. Hazeltine said she willingly
represented Savitt.
Colin testified he did ask Hazeltine to
represent his wife and that as a duty judge he accidentally signed
orders in his wife’s cases. “I didn’t know at the time they were orders
involving her cases,” he said.
After The Palm Beach Post’s investigation, Guardians: A Broken Trust
in January 2016, Colin was moved out of the guardianship division and
announced his retirement. All of Savitt’s cases were moved to the North
County Courthouse and away from French.
The judicial circuit in
Palm Beach County then adopted new standards for guardians that
addressed many of the complaints about Savitt. It banned retainers.
After The Post started investigating, Colin recused himself of 115 cases that involved attorneys who represented his wife.
Savitt’s
attorney, Morris, tried to establish through questioning of witnesses
Thursday that judges approved Savitt taking fees — nearly $20,000 by The
Post’s accounting — before getting their permission.
An expert
witness testifying for Savitt also said that state law doesn’t
explicitly say guardians are prohibited from taking retainers.
Morris
through her questioning pleaded her case that the state’s guardianship
office didn’t get the authority to regulate guardians until March 2016
and that many of the issues in the hearing occurred before that date and
were not subject to its authority.
The guardianship’s office
amended its complaint last week to include Judge French, who appointed
Savitt to a case in January 2017 after south county judges were directed
to recuse themselves by then-Chief Judge Jeffrey Colbath. The
guardianship of senior Mavis Samms allowed Savitt to be included on a
new wheel for random appointments to guardianships under the judicial
circuit’s new rules that require a pro-bono case.
But like many of
Savitt’s cases, a family member complained. Samms’ daughter said Savitt
allowed the senior’s home to go into foreclosure, according to court documents.
Creasy has said at the hearing she is not completely familiar
with the intricacies of guardianship law but has been a quick learner.
The guardianship office, though, is staying clear of cases that occurred
before the state Legislature gave it regulatory powers.
So because of that timeline, Creasy hasn’t heard testimony by family members or loved ones of wards who have complained repeatedly about Savitt to no avail to the judges Colin calls his friends.
She never heard testimony on how Savitt attempted to draw fees from a stroke victim’s $640,000 trust.
She
never heard testimony on how she tabbed as a paid caretaker the
daughter of Albert Vassallo Sr., even though the woman admitted to
taking $130,000 from her father.
She never heard testimony on how Savitt took an $8,000 retainer in the guardianship of Robert Paul Wein and then tried to annul his marriage that would have cut his wife out of any of his benefits once he died.
She
never heard testimony about how the former lawyers of Savitt’s ward,
Frances Berkowitz, alleged that $400,000 went missing from her accounts
while Savitt became her guardian.
Still, the state put on its strongest testimony on Thursday with expert witness Twyla Sketchley, a veteran guardianship attorney in Tallahassee.
Sketchley
said Savitt didn’t pass muster when it came to disclosure when she
merely put her husband’s name on her guardianship applications since a
Google search found numerous Martin Colins.
She also said taking
money from a ward’s account didn’t constitute a retainer, as Savitt
called it, but a loan or a gift, which is prohibited by guardianship
laws. This also was a conflict of interest.
“By taking those
retainers, she created a financial interest in her ward,” Sketchley
said. “Particularly, a financial interest in making sure her fees
approved, because if her fees weren’t approved she would have to return
that money.”
And the state’s expert witness said Savitt simply
shouldn’t have been practicing in front of Colin or probably his fellow
judges.
“Simply because of appearance of the conflict of
interest,” Sketchley said. “If it appears to the people in the case that
you can go home and tell your husband to tell his friend to enter your
order.”
In 1991, Montana Gov. Stan Stephens issued a statement trumpeting the good done by the state lottery system:
“The
Montana Lottery generated a lot of excitement for the state in Fiscal
Year 1991. Mindy Bowman and Karin Brier demonstrated to Montanans that
the dreams of young people really can come true with their good fortune
in winning the $7.36 million Lotto Jackpot last year.''
Mindy
Bowman’s mother had also hit the jackpot two years earlier. Rose-Marie
Bowman, divorced then, had fallen for a Federal Aviation Administration
employee, successful investor and avid square dancer.
Fast
forward to Aug. 27, when a Missoula judge dismissed an elder
exploitation case, the kind with a frail millionaire whose health is
failing, the kind that decimates family ties. But in this case, it’s
also the kind that may force lawmakers to rewrite the state's criminal
statute.
The suspect: Rose-Marie Bowman, a dainty woman— now 80 years old — with an appetite for travel and finer things.
The
charges: police and prosecutors believed Bowman had been
inappropriately spending the fortune of 80-year-old Lanny Franzen, the
investor who became her partner of 30 years and whose memory was
decaying.
While she’s
been living under pre-trial conditions since she was charged about a
year ago, Bowman hasn’t been able to leave the Missoula and Ravalli
counties, or be with Franzen without supervision. She said in that time,
they’ve lost the last year they could be together, intellectually.
“We’ve
been deprived of time where he would have known and enjoyed us doing
things together. And now he’s progressed to the point where he’s… you
can’t carry on a conversation,” she said. “He doesn’t understand what
you say to him.”
Her attorneys say, with Franzen's affairs finalized nearly six years ago, Bowman never should have been charged.
***
They had first met
square dancing. Franzen had long been single, and never had any
children of his own. He asked her to dinner, and things took off like a
dynamite fuse.
Within a
few years, they were living in condos just across the walkway from each
other. While they grew inseparable, they would never live in the same
home. And although they became engaged after just a couple of years
together, they never married, either.
Bowman said they both liked it that way.
“We
truly never argued, because we weren’t a married couple,” she said.
“Literally, positively because there wasn’t anything to argue about… We
had a wonderful life.”
Before
he met Bowman, she said he lived modestly, never having traveled
farther than Spokane, Washington. But in their life together, the next
20 years consisted of traveling the world: New Zealand, Australia,
Canada, the San Juan Islands of Washington state and more.
She brought him into a broader world, she said, and he gave her compassion.
“Love,
unconditional love,” she said. “Total freedom, for the first time in my
life, to be the person that I am. To just be me. And he was extremely
generous and kind.”
Franzen
also grew to love Mindy Bowman like a daughter. In 2004 he added
Rose-Marie and Mindy to his bank account, creating joint ownership.
On
November 27, 2012, Franzen signed a living will that made Rose-Marie
his sole beneficiary. In the event Rose-Marie did not survive him, Mindy
would become his heir. On the same day, Franzen signed a document
giving Rose-Marie power over his finances, which again would go to Mindy
if Rose-Marie were “unable or unwilling” to execute the power of
attorney document. In a third document, he signed his condo over to
Rose-Marie in the event of his death.
This
was approximately four months after Franzen was diagnosed with
Alzheimer’s disease. The attorney who prepared the legal documents would
later tell investigators it’s not uncommon for people to create these
documents in such a time frame after this type of diagnosis. It was a neighbor,
who Rose-Marie Bowman's attorneys describe as “disgruntled,” in the
condo complex where she and Franzen lived that sparked the
investigation. A report to Adult Protective Services with the Montana
Department of Public Health and Human Services turned into a suspicion
of financial exploitation, according to the final report in 2016.
The
allegations stemmed from Bowman’s purchase of a home about a year
earlier. She sold her condo to put the down payment on a new home, which
she said doctors told her to look for for Franzen's weakening state.
When she purchased the new home, she put his name on the deed, but the
neighbor reportedly questioned Franzen's mental capacity to understand
the transaction.
When
Adult Protective Services visited his condo in April 2016, investigators
reported Franzen "does not know where his money goes" and said he
didn’t have a mortgage, according to the DPHHS report. He did say he
knew Rose-Marie Bowman, and that she took him on errands, but he denied
that they were in a relationship, according to the report forwarded to
local law enforcement.
Deputy
Missoula County Attorney Karla Painter, a specialist in financial
crimes, said she was aware of the documents granting Bowman the power
over Franzen's finances, as well as their longstanding relationship. But
the criminal statute, and the state definition of the power of
attorney’s related duties, required Bowman to spend Franzen's money for
his benefit, not hers, Painter said. So they sat on the case, and
watched the money in the account.
“If
you look at where the money was going in conjunction with the timeline,
you see that Lanny Franzen’s mental capacities tend to decline when
spending for Rose-Marie Bowman’s benefit alone tends to increase,”
Painter said.
A
detective’s spreadsheet tracking the spending from the account shows
Bowman issuing several thousand dollars to herself, including one check
for $25,000. Franzen told a Missoula police detective that she likely
took $6,000 from the account in one instance to “travel the world,”
although he also said he wrote her such checks all the time.
“Money is nothing to me,” he said, according to court records.
Painter
said this case may not have been charged if Franzen was able to give
explicit consent for Bowman spending the money as she did, but that’s
not what detectives got with his condition.
“Lanny had no idea he had a mortgage or who was controlling his money,” Painter said.
But
Bowman’s attorneys contend that’s not the case. Those two documents
— the will and the power of attorney — handing the control of Franzen’s
estate to Rose-Marie Bowman should have squashed this investigation from
the beginning, they said. Bowman was only obligated to make sure
Franzen had enough money to cover his care, said Rob Bell, one of
Bowman's attorneys. Franzen had more than $2 million in his investment
account, which was growing faster than it could be spent, Bell said.
“She’s
the sole beneficiary. That means she can give gifts to herself,” he
said. “There’s no question that he had the ability to provide for his
future care.”
And that
was important, because Franzen never moved into the home Bowman bought.
She had moved in with plans for him to follow, but she said he couldn’t
do it. Instead, he moved into The Springs at Missoula senior living
community.
“He said, ‘I just don’t know if I could live in a house with somebody else. I just need my own space,'” she recalls him saying.
*** In December 2017,
more than 18 months after Adult Protective Services first visited
Franzen, the Missoula County Attorney's Office charged Bowman with elder
exploitation, a felony.
The
affidavit mentions the neighbor, the house, the mortgage. It also
mentions Bowman's power of attorney, the joint bank account and
Franzen's “money is nothing to me” comment regarding Bowman’s use of his
funds.
Ultimately,
Judge Robert “Dusty” Deschamps allowed prosecutors to proceed with the
case based on the information authorities brought in charging
documents.
But
Deschamps ruled on Aug. 21 that the criminal statute for exploitation of
the elderly was unconstitutionally vague. Primarily, Deschamps wrote in
his order, the statute fails to require criminal intent.
As
a result, the judge said, a family member could face criminal charges
under the statute just for accepting a gift of china or jewelry from a
grandmother.
Deschamps’ ruling
on the state’s criminal statute is only in play in this district, a
Montana Department of Justice spokesman told the Missoulian. But Painter
has advised law enforcement to consider a theft charge instead of elder
exploitation if such a case arises. She expects lawmakers will address
the vague nature of the law's language in the legislative session next
year.
In Bowman's
case, the county attorney’s office told Deschamps they would not appeal
his decision, which would have required the assistance of the state
Attorney General’s office. Painter also told the judge she did not
believe they could continue to prosecute Bowman on a theft charge, and
asked he dismiss the case.
Deschamps
obliged, but issued an eerie warning to Rose-Marie. “You’re a lucky
lady, Ms. Bowman,” he said, elaborating no further.
About a dozen of Bowman's friends applauded the dismissal and filed out of the courthouse to encircle her with support.
“It should have never went this far,” said Wanda Freyholtz, a friend.
***
Bowman, Franzen
In the face of
all the evidence of Franzen's willingness to finance Bowman's life, she
and her attorneys believe it was her daughter, Mindy, who pushed for
prosecution.
The money
Mindy Bowman had won in the lottery is gone, they say. If Rose-Marie
Bowman had been convicted, Mindy could have challenged Rose-Marie’s
right to the inheritance, the same way the state may challenge a widow’s
inheritance if she killed her husband, said Lance Jasper, Rose-Marie's
other attorney.
Mindy Bowman declined to comment for this story, although she did say the case had ruined her relationship with her mother.
Painter
called the belief that Mindy sought to influence the case “comical,”
and said there was nothing in this case that challenges Rose-Marie’s
position in the will.
“She
was reluctant to go against her mother,” Painter said. “Can you imagine
being in that situation? She saw what was going on was wrong.”
Rose-Marie
Bowman believes differently, and since the case has concluded, has no
interest in maintaining a relationship with her daughter, who was listed
as a witness for the state and would have likely testified about her
spending patterns had the matter gone to trial.
“She
stabbed me in the back,” Rose-Marie Bowman said. “It’s all about the
money. How strange it was, the first time in court. She was there with
me for support.”
Rose-Marie
Bowman now must go through the legal process to regain control of
Franzen's accounts, including the account of which she is a co-owner.
Mindy Bowman is also still listed as a co-owner.
The
mother's attorneys say they are also preparing to pursue claims against
the daughter, Painter and a handful of others involved in Rose-Marie
Bowman's criminal case.
In
the meantime, she is looking forward to spending time with Franzen
again without supervision. Bowman called it "an incredible relief" to
have the charges against her dismissed after a year of turmoil.
According
to the National Center on Elder Abuse, part of the Administration on
Aging, financial mistreatment is the most commonly reported form of
elder abuse. A 2009 study found that close to 50 percent of people with
dementia experience some kind of abuse, according to the agency.
Larry
Riley, vice chair of Missoula Aging Services and director of the
agency's Elder Justice Program, said each year billions of dollars are
fraudulently obtained from the elderly, and family is culpable about 90
percent of the time.
No
family is immune from the process of dealing with estate issues after
the impairment or death of an aged relative, a process that can easily
lead to feelings of mistreatment or betrayal, real or perceived, he
said.
"It's
enormously sad, and it will just rip a family apart," he said. "What a
horrible thing to be going through, at any point in your life,
particularly at the end of your life, driving the family apart."
Full Article & Source: Elderly exploitation case upends family ties, criminal statute
Santa Rosa neighborhood damaged by Tubbs Fire in October 2017.
SOURCE: CHP Golden Gate Division
Staff at two senior care centers abandoned residents during an
evacuation as wildfires swept through Northern California last October,
state officials said Thursday as they moved to revoke licenses from the
Santa Rosa facilities and their top administrators. Nobody in either
facility died.
A Department of Social Services complaint says more
than 20 people would have died when a dementia facility burned to the
ground if family members and emergency responders hadn't evacuated them
after all staff left. The investigation says night staff members at
Villa Capri were not trained in emergency procedures and had never
practiced a fire drill. They could not find keys to a bus that could
have sped evacuations.
At least three residents were never evacuated from another facility,
Varenna, and workers who found them the next morning lied about it, the
investigation found.
Both care centers are owned by Oakmont Senior Living, which called the allegations unfounded.
The
night of the fire, "we voluntarily began evacuating residents after we
were repeatedly unable to reach emergency authorities on clogged 911
phone lines. We never received an official evacuation order from
emergency authorities," the owner said in a statement.
"All 418 residents were safely evacuated," Oakmont added.
Oakmont
owns 25 senior centers in California and one in Las Vegas. The company
has 15 days to appeal and request a hearing before an administrative law
judge, said Michael Weston, a spokesman for the state Department of
Social Services.
The state's complaint conveys a chaotic scene as
flames swept into Santa Rosa overnight on Oct. 8 and 9. The blaze, known
as the Tubbs Fire, ultimately destroyed thousands of homes in Santa
Rosa and killed dozens of people, part of a firestorm that left a trail
of destruction across Northern California wine country.
At Villa
Capri, home to 62 elderly and disabled residents including 25 in the
dementia unit, the night supervisor did not know evacuation plans or
where to find flashlights and batteries, the report said. One on-duty
staff member spent an hour unsuccessfully searching for vehicle keys,
according to the complaint.
When the power went out at about 11:30
p.m., disabling electronic locks that keep patients with dementia from
leaving, the facility administrator, who was not there, instructed staff
to guard the exit doors, preventing them from caring for residents, the
state alleges. But the administrator, Deborah Smith, did not go to the
facility, according to the state's complaint.
Between 3 and 3:30
a.m., the night supervisor left as a passenger in a vehicle taking
residents to an evacuation center, followed by the two remaining staff
members who evacuated about six residents, according to the complaint.
After
staff left, relatives of residents arrived and helped non-mobile
residents "who were left stranded on the second floor." Emergency
responders eventually arrived to help.
At Varenna, which houses
228 residents, administrator Nathan Condie directed staff members who
had been evacuating residents to return them to their rooms, the
complaint alleges.
"Nathan Condie stated that he did not want to cause issues or make trouble for (Oakmont)," the complaint says.
He
left with "a small number of residents in his personal car" at about
3:30 a.m., the complaint alleges, followed later by remaining staff
members, leaving about 70 residents behind.
The grandson of one resident arrived at 4 a.m. and found his grandfather had left.
"He
was besieged by questions about what to do and became aware that there
were many residents in the darkened, smoky building who needed help,"
the complaint says. He ran door to door to awaken residents, help them
into the lobby, and started a list of names as he stayed for three hours
to help people evacuate.
Smith and Condie could not be reached
for comment. The state is seeking to ban them for life from owning or
working in licensed care facilities.
The former administrator for Franklin County Common Pleas Court
testified Tuesday that Judge Tim Horton’s bailiff didn’t tell him that
she had been sexually harassed by the judge before she resigned and
filed a formal complaint in October 2014.
The
testimony, at a disciplinary hearing for Horton at the Ohio Judicial
Center, was challenged during cross-examination by Casey Russo, an
assistant disciplinary counsel.
She produced a text message that then-bailiff, Elise Wyant, sent to the administrator, Atiba Jones.
Wyant
wrote in the text that she had to “ditch” the judge during a night of
drinking because he was making her “uncomfortable with comments and
touching.”
Jones testified that, after
speaking with Wyant, he attributed the incident to the close friendship
she shared with the judge, with whom she often went to bars for happy
hour.
“I followed up and I said, ‘What
specifically is happening?’ and she said, ‘Oh, it’s just him being him
... You know how he is. He’s just annoying’ ... I didn’t go farther than
that because I had witnessed him being annoying and obnoxious” when he
was drinking, Jones said.
Wyant’s
complaint alleged that Jones, with whom she had a brief romantic
relationship, failed to act on her complaints about the judge.
Jones,
who resigned two days after Wyant submitted her resignation and
complaint, was among the witnesses called by Horton’s lawyers as part of
their defense of the judge. The hearing before a three-member panel of
the Ohio Supreme Court’s Board of Professional Conduct began with three
days of testimony in July and is expected to conclude with Horton taking
the stand Thursday.
Horton, 48, was a Franklin County Common Pleas
judge from 2006 until 2014, when he won election to the county’s Court
of Appeals, a judgeship he still holds.
Wyant’s
complaint — in which she also accused Horton of requiring her to do
campaign work on county time and on county equipment — triggered a
series of investigations. In January, the Supreme Court disciplinary
counsel filed a complaint containing three charges of professional
misconduct against Horton.
Pat Sheeran,
the former administrative judge for Common Pleas Court, testified that
he passed along information to the disciplinary counsel after leading an
internal investigation of Wyant’s complaint.
“If I didn’t think there was a strong potential for a violation,” Sheeran said, “I wouldn’t have made the referral.”
If
the panel finds that Horton engaged in misconduct, it will recommend
discipline, which could include a suspension or disbarment. The Supreme
Court will make the final decision.
This is an actual letter that was sent to a bank by an 86-year-old
woman. It was so amusing that the bank’s manager decided to have it
published in the New York Times. Dear Sir: I am writing to thank
you for
bouncing my check with which I endeavored to pay my plumber last month.
By my calculations, 3 nanoseconds must have elapsed between his
presenting the check and the arrival in my account of the funds needed
to honor it.. I refer, of course, to the automatic monthly deposit of my
entire pension, an arrangement which, I admit, has been in place for
only 8 years. You are to be commended for seizing that brief window of
opportunity, and also for debiting my account $30 by way of penalty for
the inconvenience caused to your bank. My thankfulness springs from the
manner in which this incident has caused me to rethink my errant
financial ways. I noticed that whereas I personally answer your
telephone calls and letters, — when I try to contact you, I am
confronted by the impersonal, overcharging, pre-recorded, faceless
entity which your bank has become.
From now on, I, like you, choose only to deal with a flesh-and-blood
person. My mortgage and loan repayments will therefore and hereafter no
longer be automatic, but will arrive at your bank, by check, addressed
personally and confidentially to an employee at your bank whom you must
nominate. Be aware that it is an OFFENSE under the Postal Act for any
other person to open such an envelope. Please find attached an
Application Contact which I require your chosen employee to complete. I
am sorry it runs to eight pages, but in order that I know as much about
him or her as your bank knows about me, there is no alternative. Please
note that all copies of his or her medical history must be countersigned
by a Notary Public, and the mandatory details of his/her financial
situation (income, debts, assets and liabilities) must be accompanied by
documented proof. In due course, at MY convenience, I will issue your
employee with a PIN number which he/she must quote in dealings with me. I
regret that it cannot be shorter than 28 digits but, again, I have
modeled it on the number of button presses required of me to access my
account balance on your phone bank service. As they say, imitation is
the sincerest form of flattery. Let me level the playing field even
further. When you call me, press buttons as follows. IMMEDIATELY AFTER
DIALING, PRESS THE STAR BUTTON FOR ENGLISH.
1. To make an appointment to see me. 2. To query a missing payment.
3. To transfer the call to my living room in case I am there. 4 To
transfer the call to my bedroom in case I am sleeping. 5. To transfer
the call to my toilet in case I am attending to nature. 6. To transfer
the call to my mobile phone if I am not at home. 7. To leave a message
on my computer, a password to access my computer is required. Password
will be communicated to you at a later date to that Authorized Contact
mentioned earlier. 8. To return to the main menu and to listen to
options 1 through. 9. To make a general complaint or inquiry. The
contact will then be put on hold, pending the attention of my automated
answering service. 10. This is a second reminder to press for English.
While this may, on occasion, involve a lengthy wait, uplifting music
will play for the duration of the call. Regrettably, but again following
your example, I must also levy an establishment fee to cover the
setting up of this new arrangement. May I wish you a happy, if ever so
slightly less prosperous New Year. Your Humble Client And remember.
Don’t make old people mad. We don’t like being old in the first place,
so it doesn’t take much to piss us off.
No one tracks sepsis cases closely enough to know how
often these severe infections turn fatal. But the toll — both human and
financial — is enormous, finds an investigation by KHN and the Chicago
Tribune.
Shana Dorsey first caught sight of the purplish wound on her father’s
lower back as he lay in a suburban Chicago hospital bed a few weeks
before his death.
Her father, Willie Jackson, had grimaced as nursing aides turned his
frail body, exposing the deep skin ulcer, also known as a pressure sore
or bedsore.
“That was truly the first time I saw how much pain my dad was in,” Dorsey said.
The staff at Lakeview Rehabilitation and Nursing Center, she said,
never told her the seriousness of the pressure sore, which led to
sepsis, a severe infection that can quickly turn deadly if not cared for
properly. While a resident of Lakeview and another area nursing home,
Jackson required several trips to hospitals for intravenous antibiotics
and other sepsis care, including painful surgeries to cut away dead skin
around the wound, court records show.
Dorsey is suing the nursing center for negligence and wrongful death
in caring for her dad, who died at age 85 in March 2014. Citing medical
privacy laws, Lakeview administrator Nichole Lockett declined to comment
on Jackson’s care. In a court filing, the nursing home denied
wrongdoing.
The case, pending in Cook County Circuit Court, is one of thousands
across the country that allege enfeebled nursing home patients endured
stressful, sometimes painful, hospital treatments for sepsis that many
of the lawsuits claim never should have happened.
My father was like my best friend. Most people go to their mom to talk and tell all their secrets, and for me it was my dad.
Year after year, nursing homes around the country have failed to
prevent bedsores and other infections that can lead to sepsis, an
investigation by Kaiser Health News and the Chicago Tribune has found.
No one tracks sepsis cases closely enough to know how many times these infections turn fatal.
However, a federal report has found that care related to sepsis was
the most common reason given for transfers of nursing home residents to
hospitals and noted that such cases ended in death “much more often”
than hospitalizations for other conditions.
A special analysis conducted for KHN by Definitive Healthcare, a private health care data firm, also suggests that the toll — human and financial — from such cases is huge.
Examining data related to nursing home residents who were transferred
to hospitals and later died, the firm found that 25,000 a year suffered
from sepsis, among other conditions. Their treatment costs Medicare
more than $2 billion annually, according to Medicare billings from 2012
through 2016 analyzed by Definitive Healthcare.
In Illinois, about 6,000 nursing home residents a year who were
hospitalized had sepsis, and 1 in 5 didn’t survive, according to
Definitive’s analysis.
“This is an enormous public health problem for the United States,”
said Dr. Steven Simpson, a professor of medicine at the University of
Kansas and a sepsis expert. “People don’t go to a nursing home so they
can get sepsis and die. That is what is happening a lot.”
The costs of all that treatment are enormous. Court records show that
Willie Jackson’s hospital stays toward the end of his life cost
Medicare more than $414,000. Medicare pays Illinois hospitals more than
$100 million a year for treatment of nursing home residents for sepsis,
mostly from Chicago-area facilities, according to the Medicare claims
analysis.
Sepsis is a bloodstream infection that can develop in bedridden
patients with pneumonia, urinary tract infections and other conditions,
such as pressure sores. Mindful of the dangers, patient safety groups
consider late-stage pressure sores to be a “never” event because they
largely can be prevented by turning immobile people every two hours and
by taking other precautions. Federal regulations also require nursing
homes to adopt strict infection-control standards to minimize harm.
Yet the failures that can produce sepsis persist and are widespread
in America’s nursing homes, according to data on state inspections kept
by the federal Centers for Medicare & Medicaid Services. Many of the
lawsuits allege that bedsores and other common infections have caused
serious harm or death. The outcome of these cases is not clear, because
most are settled and the terms kept confidential.
Cook County, where the private legal community is known to take an
aggressive approach to nursing homes, has more of these suits than any
other metro area in the U.S., KHN and the Tribune found by reviewing
court data.
State inspectors also cite thousands of homes nationally for
shortcomings that have the potential to cause harm. Inspections data
kept by CMS show that since 2015 94 percent of homes operating in
Illinois have had at least one citation for conditions that increase the
risk of infection. These citations include care related to bedsores,
catheters, feeding tubes and the home’s overall infection-control
program.
“Little infections turn to big infections and kill people in nursing
homes,” said William Dean, a Miami lawyer with more than two decades of
experience suing nursing homes on behalf of patients and their families.
Much of the blame, regulators and patient advocates say, lies in poor
staffing levels. Too few nurses or medical aides raises the risks of a
range of safety problems, from falls to bedsores and infections that may
progress to sepsis or an even more serious condition, septic shock,
which causes blood pressure to plummet and organs to shut down.
Staffing levels for nurses and aides in Illinois nursing homes are
among the lowest in the country. In the six-county Chicago area, 78
percent of the facilities’ staffing levels fall below the national
average, according to government data analyzed by KHN.
Matt Hartman, executive director of the Illinois Health Care
Association, which represents more than 500 nursing homes, acknowledged
low staffing is a problem that diminishes the quality of nursing care.
Hartman blamed the state’s Medicaid payment rates for nursing homes —
about $151 a day per patient on average — which he said is lower than
most other states. Medicaid makes up about 70 percent of the revenue at
many homes, he said.
Last October, CC Care LLC, an Illinois nursing home group that
specializes in treating mentally ill patients on Medicaid, filed for
bankruptcy, arguing that the state’s “financial troubles have been
disastrous for all nursing homes.”
In a July court filing, CC Care creditors’ committee argued that the
company couldn’t stay afloat relying on Illinois Medicaid payments,
which it called “slow, erratic and significantly less than what we are
due.”
Pat Comstock, executive director of the Health Care Council of
Illinois, said nursing homes she represents “are operating in an
increasingly difficult environment in Illinois, yet they continue to
prioritize delivering the best care possible to residents in a safe and
secure setting.”
A Festering Complaint
Shana Dorsey remembers her father as a quiet but friendly man. He
worked as a uniformed bank security guard and picked up extra cash
fixing neighbors’ cars in an empty lot adjacent to his West Side
apartment building. He was a stickler for detail, who relished teaching
his granddaughter the state capitals and was always ready to lend a hand
to help his daughter, who now works for a Chicago property management
firm.
But age and declining health caught up with the Army veteran, who by
his early 80s began to exhibit signs of dementia and moved into an
assisted living apartment.
Dorsey knew her dad needed more specialized care when she found him
sitting in his favorite peach recliner in his apartment, unable to get
up and incontinent.
He required more intense medical and personal care as his kidney
disease worsened and he became more confused, medical records show. In
his last 18 months of life, he cycled in and out of hospitals eight
times for treatment of septic bedsores and other infections, according
to court records.
The Chicago law firm representing Dorsey, Levin & Perconti,
provided KHN and the Tribune with medical records and additional court
filings that cover Jackson’s care.
Jackson had two pressure sores in late November 2012 when he was
first admitted to Lakeview nursing center from the Jesse Brown VA
Medical Center in Chicago, according to lawyers for his daughter.
These wounds healed, but in late September 2013, Jackson spiked a
fever and had an infected sore in his lower back that exposed the bone,
causing what Dorsey’s lawyers called “significant pain.”
The nursing home transferred Jackson to Presence St. Joseph Hospital
in Chicago, where surgeons cut away the dead skin and administered
antibiotics. At that time, the sore was as wide as a grapefruit and had
“copious purulent drainage, foul smell and bleeding,” Dorsey’s lawyers
argue. Tests confirmed sepsis, and the wound had grown so deep that it
infected the sacral bone in his back, a condition known as
osteomyelitis, the lawsuit said.
In November 2013, Dorsey moved her father to another nursing home. He
required three more hospital visits before Dorsey made the difficult
decision to place Jackson in hospice care. He died March 14, 2014, from
“failure to thrive,” according to a death certificate.
In her suit, Dorsey, 39, argues that Lakeview nursing staff knew
Jackson was at “high risk” for bedsores because of his declining health.
Yet the home failed to take steps to prevent the injuries, such as
turning and repositioning him every two hours, according to the suit.
That didn’t happen about 140 times in August 2013 alone, Dorsey’s
lawyers said.
“My father was like my best friend. Most people go to their mom to
talk and tell all their secrets, and for me it was my dad,” Dorsey said
in a November 2015 deposition.
While Lakeview declined to discuss Jackson’s treatment, it has denied
negligence and argued in court filings that its actions were not to
blame for Jackson’s death. Lockett, the home’s administrator, said the
facility “strictly follows” all regulations to minimize the effects of
skin breakdowns that can occur naturally with age.
“We are grateful for the daily opportunity to enhance the lives of
seniors and other chronically ill populations in our community,” Lockett
said in a statement.
Infection Control
Poor infection control ranks among the most common citations in
nursing homes. Since 2015, inspectors have cited 72 percent of homes
nationally for not having or following an infection-control program. In
Illinois, that figure stands at 88 percent of homes.
Illinois falls below national norms for risks of pressure sores or
failure to treat them properly in nursing homes. Inspectors have cited
37 percent of the nation’s nursing homes for this deficiency, compared
with 60 percent in Illinois, according to CMS records. Only three states
were cited more frequently.
Inspectors in November 2016 cited Alden Town Manor Rehabilitation and
Health Care Center in Cicero, Ill., for neglect due to its care of an
unnamed 83-year-old man with pressure ulcer sores that went untreated.
Gangrene had set in by the time the staff sent him to the hospital,
where surgeons ended up amputating his right leg above the knee,
according to the inspectors’ report and citation. Alden Town Manor had
no comment.
Dean, the Miami lawyer, said that nursing home staffs often miss
early signs of infection, which can start with fever and elevated heart
rate, altered mental status or not eating. When those symptoms occur,
nurses should call a doctor and arrange to transfer the patient to a
hospital, but that process often takes too long, he said.
“They don’t become septic on the ambulance ride over to the hospital,” Dean said.
There is little agreement over how much staff should be required in
nursing homes. Federal regulations simply mandate that a registered
nurse must be on duty eight hours per day, every day. In 2001, a federal
government study recommended a daily minimum of 4.1 hours of total
nursing time per resident, which includes registered nurses, licensed
practical nurses and certified nursing assistants, often referred to as
aides. That never became an industry standard or federal regulation,
however.
Most states set requirements lower and face industry resistance to
raising the bar. A California law requiring 3.5 hours per resident as of
this July 1 is drawing intense criticism from the industry, for
instance.
In addition, staffing can fluctuate, particularly over the weekends. A recent KHN investigation found that on some days, nursing home aides could be in charge of twice as many residents as normal.
At a minimum, Illinois requires 2.5 hours of direct care daily for
residents. Yet federal nursing home payroll data show that at least 1 in
4 Chicago-area nursing home residents live in facilities that aren’t
consistently providing that much care, KHN found.
Nationally, each aide is responsible for 10 residents on average; in
the six-county Chicago area, the average is 13 residents per aide.
Federal officials have linked inadequate staffing to bedsores and
other injuries, such as falls. If left unattended, even a small ulcer or
sore can become septic, and once that happens, a patient’s life is in
imminent danger.
In October 2014, Milwaukee-based Extendicare denied wrongdoing but
paid $38 million to settle a federal False Claims Act lawsuit that
accused it of not having enough staff on hand in 33 nursing homes in
eight states, including Indiana, and failing to take steps to prevent
bedsores or falls.
In other cases, federal officials have alleged that some nursing
homes overmedicate residents — which can result in injuries such as
falls from beds or wheelchairs and bedsores — rather than staff up to
care for them properly.
Little infections turn to big infections and kill people in nursing homes.
In May 2015, owners of two nursing homes in Watsonville, Calif.,
agreed to pay $3.8 million to settle a whistleblower lawsuit alleging
the homes persistently drugged patients, contributing to infections and
pressure sores.
The suit alleged that an 86-year-old man who could barely move after
receiving a shot of an anti-psychotic medication lost his appetite and
spent most of the day in bed, “was not turned or repositioned and
developed additional pressure ulcers.” He ran a 102-degree fever, but
the staff failed to notify his doctor for three days, according to the
suit.
Hospital doctors later diagnosed the man with sepsis and an infected
pressure ulcer. The home did not admit wrongdoing and had no comment.
Personal injury lawyers and medical experts say that poor infection
control often sends nursing home residents to hospitals for emergency
treatment — and that the stress can hasten death.
Elderly people often “don’t have the ability to bounce back from an
infection,” said Dr. Karin Molander, a California emergency room
physician and board member of the Sepsis Alliance advocacy group.
That odyssey of multiple, stressful trips to the hospital is a common
thread in negligence and wrongful death lawsuits involving sepsis or
bedsores. KHN identified more than 8,000 suits filed nationwide from
January 2010 to March of this year that allege injuries from failing to
prevent or treat pressure sores and other serious infections.
Molander said serious bedsores indicate “someone is being ignored for an extended time period.”
“When we see patients like that we file [patient neglect] complaints with adult protective services,” she said.
Some of these cases led to million-dollar jury verdicts. In 2017, a
Kentucky jury awarded $1.1 million to the family of a woman who suffered
from bedsores and sepsis in a nursing home. In a second case last year,
a jury awarded $1.8 million to a widow who alleged a Utah nursing home
failed to turn her husband often enough to prevent bedsores, which led
to his death.
Lawyers filed more than 1,400 of the cases from January 2010 to March
of this year in Cook County Circuit Court, which tops all metro areas
across the country in the KHN sample.
Nursing homes complain that garish billboards to solicit clients are a
fixture in Chicago, where many attorney websites also boast of recent
million-dollar verdicts from bedsore cases alone.
“We see an incredible amount of lawsuits out there,” said Hartman, of
the Illinois nursing home association. “We feel we have a target on our
backs.”
Trial lawyers counter that nursing homes often try to duck
responsibility for poor care by creating complex corporate structures to
limit their liability. Yet Hartman derided these suits as “cash cows”
for law firms that can rack up six-figure legal fees as cases drag on.
The nursing home industry supports tort reforms that would compensate
injured persons but also bring a quicker resolution of claims, he said.
“That is something that needs to be fixed in Illinois,” Hartman said.
Avoidable Hospital Transfers
In September 2013, the Centers for Medicare & Medicaid Services
said it was working to reduce avoidable transfers from nursing homes to
hospitals. CMS had previously called these trips “expensive, disruptive
and disorienting for frail elders and people with disabilities.”
The plans came in the wake of a critical 2013 Department of Health
and Human Services audit that found Medicare had paid about $14 billion
in 2011 for these transfers. Care related to sepsis cost Medicare more
than the next three costliest conditions combined, according to the
audit.
The auditors have not checked in to see if Medicare has since reduced
those costs and have no plans to do so, a spokesman for the HHS Office
of Inspector General said.
However, Definitive Healthcare’s analysis of billing data, modeled
after the HHS audit, shows little change between 2012 and 2016, both in
terms of deaths and costs.
Wendy Meltzer, executive director of Illinois Citizens for Better
Care, said that hospital trips caused by treatment for sepsis can be
“emotionally devastating” for confused elderly patients.
“It’s not a choice anybody makes. It’s horrible for people with
dementia,” Meltzer said. “Some never recover from that. It’s a very real
phenomenon and it’s cruel.”
University of Maryland master’s student Chris Cioffi contributed to this report.
This story was jointly produced by Kaiser Health News and the
Chicago Tribune by reporters based in Washington, D.C., and Chicago.
Fred Schulte is a senior correspondent for KHN and Elizabeth Lucas is
data editor. Joe Mahr is a Tribune reporter.
In the four years since Fort Lauderdale attorney Michael Casey rented
a car in Tallahassee and drove off as a fugitive, three Broward County
residents indicted along with him in a $20 million scam went to federal
prison.
Casey? He went to Mexico. Now, he’s in Miami — at the Federal Detention Center.
The 71-year-old’s mail
and wire fraud charges remain, legally, in doubt. But on Friday, Casey
pleaded guilty to knowingly failing to appear in court after jumping
bail before an April 2014 hearing in his fraud case. He will be
sentenced in November.
In August 2012, Casey, Louis
Gallo and James Howard of Parkland, Rita Balbirer of Coral Springs, and
Patricia Saa of Tampa were indicted on stacks of fraud charges related
to Commodities Online Management. Saa became a fugitive two months
later.
Casey posted $50,000 bond and was confined to the Southern District
of Florida federal court jurisdiction, except for trips to visit his
mother in North Carolina.
Before a April 29, 2014, case
status conference, Casey got permission to drive to North Carolina,
visit his mother and drive back. Casey rented a car on April 21 in
Tallahassee. He then drove to Laredo, Texas, where he dropped the car
off on April 25. Casey was in Mexico by the time he officially was
missing for the status conference.
Meanwhile, Howard already had
pleaded guilty to one count of conspiracy to commit mail fraud and wire
fraud. Gallo did the same six months after Casey disappeared. Gallo’s
admission of guilt lays out a smorgasbord of lies used to sucker 700
investors out of about $20 million.
They lied about the usage of
investor money. They lied about COL’s bottom line. They faked contracts.
They hid Howard and Gallo’s criminal experience (each had a federal
conviction on his rap sheet and Gallo was still on supervised release).
When Howard was arrested on a state fraud charge, investor money was
used for his bail. Among the $2.5 million Gallo used for his family and
himself was $300,000 for cars, jet skis and a boat.
Howard was sentenced to 15 years,
nine months in prison. Gallo got 14 years. Balbirer pleaded guilty to
two counts of money laundering and got 17 months.
Casey came back over the border
at some point and was arrested July 2 in the Southern District of
Houston federal court district. He gave his income for the previous year
as $2,000 from “odd jobs.”
more here: https://www.miamiherald.com/news/local/crime/article217841655.html#storylink=cpy
Read more here: https://www.miamiherald.com/news/local/crime/article217841655.html#storylink=cpy
LAKE
CHARLES, LA (KPLC) - Most people spend their days off relaxing,
watching TV, or sleeping in, but Adam Goodwin spends his Sunday doing
something a little different. He comes to the Rosepine nursing home to
sit, listen and give back to the residents.
“I’m growing a relationship with them. I come every Sunday. These people are a part of me right now,” says Goodwin.
Goodwin
says what inspires him to dedicate his time is the loss of his very own
grandmother. He was trying to fill the void he felt when she passed on.
“I
felt a void, you know, I came here with the intentions to find me a
granny and a papa and next thing you know, I saw so many people that
were in need. I said, ‘I got to adopt everybody.’”
Goodwin
started a weekly routine of spending his days off visiting those
residents, giving company to the often overlooked, bringing them items
they may need like blankets and shampoo. He has grown close to one woman
named Irene Brooks. She says having reliable company is a nice change.
“Sometimes I don’t have company during the week, but I can count on him, he’ll be there," Irene says.
Goodwin
says, “Some of these people, they have no one to talk to and probably
been in here for years. And they’re not as fortunate as others to have
visitors. What I want to do is be that person. I mean, it’s really
awesome, It’s a real good feeling. I’m not rich, I’m far from it man... I
mean it costs you no money to have a heart. Hey, if I can make
somebody’s day, I’m going for it.”
From The Elder Abuse Reform Now's "The Silver Standard News" The Systematic understaffing of America's nursing homes.
By Joan Hunt
Most Nursing Homes Have Overstated Staffing for Years
A recent analysis by the New York Times and Kaiser Health News
confirms what many families of nursing home residents have long
suspected—staffing is often inadequate to provide proper care for their
loved ones. Records show the number of nursing aides fluctuates
significantly from day to day, with particularly large deficits
occurring on weekends. In fact, on the lowest-staffed days, personnel
take care of twice as many residents as they do on the highest-staffed
days.
The analysis is based on a newly implemented system of documenting
staff numbers in nursing homes, which has been designed to provide
greater accuracy. Thus, records for the first time reveal the extent and
magnitude of personnel deficiencies in facilities across America.
Approximately 70 percent of 14,000 nursing homes have lower staff
numbers than the previous system reported. The average staffing decrease
is 12 percent. Records also show that on weekends, 11 percent fewer
nurses and 8 percent fewer aides are on duty.
Federal law doesn’t mandate a minimum staff-to-patient ratio. The
only requirement is that a registered nurse be on site eight hours a day
and that a licensed nurse be on site at all times in certified nursing
homes. Data from the last quarter of 2017 disclose that one fourth of
the facilities had no registered nurse at work.
Previous Nursing Home Rating System Misled Consumers
Since 2009, Medicare had used a nursing home rating system that
assigned from one to five stars to each facility based largely on three
criteria. Two of the criteria were derived from unverified self-reported
data. Because no procedure was in place to validate the data, it could
paint an inaccurate picture of staffing levels.
While the remaining criterion came from annual health inspections
conducted by independent reviewers, this assessment could be
manipulated. It was possible for nursing homes to anticipate the
inspection and temporarily schedule more staff during that time, thus
enabling them to inflate their staffing numbers. After the inspection
was finished, the staffing would return to its inadequate level.
Consequently, the ratings failed to reflect reality, and consumers were
misled.
New Nursing Home Rating System Has Greater Accuracy
Now, due to the Affordable Care Act of 2010, which has only recently
been implemented, data on nursing home staffing is more accurate.
Instead of coming from self-reports, it’s based on daily payroll
records. The discrepancies between earlier staffing records and the new
records provide evidence that staffing levels reported over the last ten
years have been exaggerated. The data shows that even facilities with
good Medicare ratings for staffing have shortages in nurses and aides on
some days.
Despite the more reliable method of determining staff numbers, the
new rating system still has some drawbacks. Medicare assigns stars to
facilities by comparing one nursing home to another, which is, in
effect, grading on a curve. Therefore, many facilities have kept their
ratings, even though payroll records show they have lower staffing
levels than previously reported. Although the ratings can be found on
Medicare’s Nursing Home Compare website, they aren’t dependable
indicators that a facility has enough staff to provide quality care.
Patient Advocacy Group Calls for Congressional Hearings
After the recent report in the New York Times, an advocacy
group known as the Elder Justice Coalition (EJC) called for immediate
congressional hearings on chronic nursing home staff shortages. Group
members are specifically concerned that the shortages have gone
unnoticed up until now.
“We’re asking Congress to take a good hard look at staff shortages,”
said the coalition’s national coordinator, Bob Blancato, in an interview
with the Silver Standard News. “The new system may not be
living up to expectations. Perhaps after clarification there could be
legislation that would come forward.
“Several things need to be considered: number, quality, and training
of staff. If part of the problem in attracting and keeping staff is due
to wages that aren’t competitive with other types of medical facilities,
this needs to be addressed. There has to be an incentive for people to
want to go to work. The lack of workforce required to care for the aging
population is a crisis that will be in front of us for years.”
Consequences of Understaffing
Understaffing is one of the causes that underlie elder abuse and
neglect in nursing homes: reports NursingHomeAbuseGuide.org. Research
shows that when staff are overworked and stressed, patients have a
higher risk of bedsores, dehydration, malnutrition, weight loss,
pneumonia, and infections. The exhaustion that accompanies working in
short-staffed conditions can result in mistakes and failures to notice
adverse changes in patients’ health. Moreover, frustration that comes
from overwork can lead to intentional or unintentional mistreatment.
Tips for Choosing a Nursing Home
Because the current rating system doesn’t guarantee a nursing home is
adequately staffed, families of the elderly should investigate
candidate facilities thoroughly when the need for placement of a loved
one becomes apparent. Assistive Living Today provides the following tips
in choosing a home:
⋅ Instead of scheduling a visit, make a surprise visit to get an
idea of cleanliness and quality of care. If the facility looks
promising, make at least two additional trips to observe meals and
activity sessions.
⋅ Check the public record for violations of state code. Note the
type of complaints to see if they are related to serious issues.
⋅ Conduct research to see what licenses are required in your state, and ask the facility to show you its credentials.
⋅ Observe the residents to see if they appear happy, well-groomed, and actively engaged.
⋅ Pick a facility that doesn’t have a strong odor. Don’t be fooled
by a strong deodorizer scent that may be masking the smell of urine and
excrement.
⋅ Ask the facility if it has dieticians and if they can accommodate special dietary needs.
⋅ Since activities are important, inquire whether an activities
director is on staff, and find out whether outdoor activities are
included.
⋅ If your loved one has a condition requiring special care, such
as Alzheimer’s disease or diabetes, ask if the staff has experience in
these areas.
