Tonight we will be talking about the corruption of the Judiciary, and what we might do to regain control of our legal system.
At issue is the “self-policing” that the BAR Associations along with the Judiciary use to protect themselves and what many times is outright criminal activity. BAR oversight boards, Judicial oversight boards and other constructs are used to discredit and discard complaints of judicial abuses and sweep away the wrong doings of lawyers. Self-policing is obviously a disservice to the public and has facilitated the rampant corruption in what is now laughingly referred to as our judicial/legal system. The entire system is designed to act as a protection racket.
BUT~! what if we assembled citizens committees to take in complaints and review them? Then compare those reviews to the actions taken on the same complaints made to BAR oversight boards and judicial oversight boards? Did you send in a formal complaint? What was the response? Let our citizens committees review the same complaint and see if we would come up with same results. With a national average approaching nearly 99% of findings of no wrong-doing by judges or lawyers with the thousands of complaints lodged each year…..how honest do you believe these oversight boards are?
As a note: WE DO NOT need BAR union cards to access the law, nor to review complaints. Even though the citizens committees would have no force of law at this time, they could provide a counter to the obvious protection rackets running by those gaming the system for self benefit.
ST. LOUIS - Will your mom or dad get proper treatment in a nursing home or end up just another head in a bed?
Marion Thompson said she left Riverview Nursing Home on South Broadway because she was being neglected.
"I screamed for a good 10 to 15 minutes and they finally came in," she said.
Thompson called us from a hospital room where she was recovering.
"They can't keep help," she said, describing problems at the nursing home. "You're lucky to have two aids on a floor." Thompson's medical records state she was admitted to the hospital partly for "dehydration and disorientation."
Records also say, "Per EMS, the (patient) hasn't been taking her medications regularly from staff."
Thompson blames the staff. "You pull for help. They come in and unplug the call light, turn it off, and then you don't see them again, even if it's for water," she said. An inspection last year led to Riverview being denied government pay for new admits. The freeze lasted three months starting last July. Federal inspectors noted hot rooms, including one measuring 90.6 degrees.
An inspector wrote "the Certified Nursing Assistants said everyone was aware it was hot in the building, including administration" and that the "Director of Nurses ... Did not think anything of it."
The report states Riverview "immediately hired a new and competent maintenance director.
"You hear the term 'heads in the bed,' because that's how they get paid, and so most of these decisions start from the ownership and they work their way down," he said. Terry said most problems start with a lack of staff.
"They will often times cut staffing to save on their bottom line because every dollar you save on staffing increases the amount you have in your bank account," he said. Terry said regulators cannot cite a nursing home for staff problems.
"In Missouri and at the federal level, there is no staffing ratio. There are some states that do have ratios, but Missouri is not one of them," he said.
"A lot of them, not all of them, base their staffing just upon fire code, which means you have a minimal amount of staff members you're required to have in case there's a fire so you can get residents out."
Terry said poor staffing at St. Sophia in Florissant led to his client's mother being left alone in a bathtub for more than eight hours in July 2017. She died as a result.
"That shower room where the bathtub is is about 15 feet from the nurse's station and nobody seemed to check on it. So it was a systemic failure, I think, primarily caused because there just weren't enough staff members in the facility at the time."
Meanwhile, Marion Thompson is working with her family to find a new facility.
"I want to live," she said. "I've been fighting to live since last February."
It was a year ago when she was healthy enough to leave hospice while living in Riverview. She said she'll keep fighting.
"I have 25 grandchildren and six kids that I love deeply," she said. Riverview did not respond to requests for comment about Thompson's claims and the government payment freeze. Regarding the bathtub case, St. Sophia's parent company MGM Healthcare wrote, "Our relationship with the facility was in its infancy when the unfortunate situation took place."
MGM added that its investments have paid off and it has increased the nursing home's government quality measures rating to "five out of five stars."
The facility itself, St. Sophia also responded, saying it now has a "new administrator (and) director of nursing."
You can read the full statement from James Mason, Chief Operating Officer of MGM Healthcare, below:
"MGM Healthcare provides consulting and management services for skilled nursing facilities including St. Sophia Health and Rehabilitation Center in Florissant, MO. Our relationship with the facility was in its infancy when the unfortunate situation took place.
"When we were first engaged, the Center for Medicare and Medicaid Services (CMS) ratings for St. Sophia were lower. Today, the CMS Quality Measures Rating for St. Sophia is five out of five stars, with the facility exceeding Missouri and national averages on many measures. We immediately began investing to improve the facility, and over time are improving its performance.
"We help create a culture within skilled nursing facilities that is focused on continuous improvement, and by so doing are dedicated to empowering better living for residents who need rehabilitation, skilled and long-term care."
Denise Thordsen, director of St. Sophia Health and Rehabilitation Center, issued this statement:
"St. Sophia is deeply committed to providing high-quality care for all of our residents. We respect the privacy of all our residents and their families, and federal law prevents us from commenting further on any specific events or treatment.
"St. Sophia is on a continual journey to be a place that is safe, comfortable, and that provides a high quality of care. Our commitment is demonstrated by the improvement in the 'star' ratings by the U.S. Centers for Medicare and Medicaid Services (CMS), a staff that includes a new Administrator, Director of Nursing and an Assistant Director of Nursing, as well as the investments we have made in the facility over the past year. We look forward to continuing to serve the Florissant community for many more years."
Judge Jessica Arong O'Brien is accused of lying on loan documents to secure $1.4 million for investment properties.
CHICAGO — The federal trial of a Cook County judge indicted last year on two counts of fraud is set to begin this week in Chicago. Judge Jessica Arong O'Brien has been accused of a scheme to defraud banks by lying on mortgage paperwork. The Chicago Sun-Times reports jury selection started Monday and opening statements could begin as early as Tuesday at the Dirksen Federal Courthouse.
At the time the alleged fraud was taking place, O'Brien was working full-time for the Illinois Department of Revenue, working part time as a loan officer for Amronbanc Mortgage Corp. in Lincolnwood and the owner of a O'Brien Realty LLC, according to the feds.
Prosecutors said she met co-defendant Maria Bartko at the Lincolnwood firm and used her as a straw buyer to fraudulently obtain about $1.4 million worth of home loans for two properties on Chicago's South Side – to buy an investment property on the 600 block of West 46th Street and to refinance another in the 800 block of West 54th Street.
Bartko pleaded guilty last month to one count of mail fraud and is expected to testify in O'Brien's trial, according to the Sun-Times.
The alleged crimes took place before O'Brien, who is married to Cook County Circuit Court Judge Brendan O'Brien, was elected to her position as the first Filipino-American elected to judge.
O'Brien has been on administrative duty since her indictment in April 2017, the Sun-Times reported. She is up for retention in 2018 but has not yet filed paperwork.
Under state law, O'Brien would be automatically removed from office and lose her nearly $200,000 salary if convicted of a felony.
O'Brien's lawyer said the government's case relied on a "known liar" and someone who had a "sham marriage" in order to gain citizenship, according to the Sun-Times.
Ricardo Meza has claimed his client is being unfairly targeted because of her job and promised more details in future remarks to the jury.
According to an online biography, O'Brien has won an award from former President Barack Obama for performing more than 4,000 hours of volunteer service over a decade.
She also has been a contributing editor for the Chicago Daily Law Bulletin and the president of the Women's Bar Association of Illinois.
Nursing homes in the US are inappropriately medicating an estimated 179,000 residents with dementia each week, in what amounts to use of “chemical restraints”, according to a new Human Rights Watch report.
The 157-page report, titled ‘They Want Docile’ claims thousands of long-term nursing-home patients with dementia are inappropriately given antipsychotic drugs not designed for them. In many cases, the report states, antipsychotics are prescribed because of their sedating effects, making dementia patients easier for staff to handle.
Antipsychotic drugs carry a serious warning from the US Food and Drug Administration called a “black box” because the drugs increase dementia patients’ risk of death. The drugs were developed to treat psychiatric conditions such as schizophrenia.
Hannah Flamm, an NYU law school fellow at Human Rights Watch: “People with dementia are often sedated to make life easier for overworked nursing home staff, and the government does little to protect vulnerable residents from such abuse.
“All too often, staff justify using antipsychotic drugs on people with dementia because they interpret urgent expressions of pain or distress as disruptive behavior that needs to be suppressed.”
The report comes as lawmakers and researchers are warning of a wave of aging baby boomers. Currently, more than 5 million Americans have Alzheimer’s, and one in three seniors dies with Alzheimer’s or another dementia. The number of people with Alzheimer’s could triple by 2050.
Researchers with Human Rights Watch interviewed 323 people and visited 109 nursing homes in California, Florida, Illinois, Kansas, New York and Texas between October 2016 and March 2017. They used federal data to estimate the percentage of patients nationally who inappropriately receive such drugs.
Researchers found instances where patients or their proxies (such as family members) were not told of the risks of antipsychotic drugs, or felt their loved ones would be removed from a facility if they were taken off the drugs.
“[It] knocks you out,” a 62-year-old woman from a nursing facility in Texas told HRW. She said she was given Seroquel, an antipsychotic drug, without her knowledge. “It’s a powerful, powerful drug. I sleep all the time. I have to ask people what the day is.”
In another instance, the director of a nursing facility in Kansas told HRW that, “antipsychotics are a go-to thing”.
Rates of nursing home residents on antipsychotic drugs have declined in recent years, but government reports have said there is more work to do.
The HRW report chimes with others, including a recent government report, which found high rates of antipsychotic drug use in US nursing homes.
For example, a federal government report found that in 2012, 33% of older adults with dementia who lived in nursing homes were prescribed antipsychotics, versus 14% who lived outside nursing homes.
The most common antipsychotics address conditions such as schizophrenia and bipolar disorder. However, the FDA has found the drugs are commonly prescribed for “off-label” disorders.
“The trend now is to reduce the use of antipsychotic medication, and to monitor and to use them as appropriate,” said a spokeswoman for LeadingAge, a lobbying group for nursing facilities.
HRW called on the government to step up efforts against antipsychotics use in nursing homes.The federal government pays for the majority of nursing home residents’ care through the public health program Medicaid.
(CNN)Children complained about parents who were robbed of their personalities and turned into zombies. Residents remembered slurring their words and being unable to think or stay awake. Former administrators admitted doling out drugs without having appropriate diagnoses, securing informed consent or divulging risks.
The 157-page report, released Monday, estimates that each week more than 179,000 people living in US nursing facilities are given antipsychotic medications, even though they don't have the approved psychiatric diagnoses -- like schizophrenia -- to warrant use of the drugs. Most of these residents are older and have dementia, and researchers say the antipsychotic medications are administered as a cost-effective "chemical restraint" to suppress behaviors and ease the load on overwhelmed staff.
What's revealed in this report echoes the findings of a CNN investigation published in October. The CNN story described how one little red pill, Nuedexta, was being misused and overprescribed in nursing homes. What's more, CNN learned that this overuse benefited the drugmaker to a tune of hundreds of millions of dollars, largely at the expense of the US government. The CNN report prompted an investigation into a California-based pharmaceutical company.
The Human Rights Watch report shows that concerns about overmedicating nursing home residents with inappropriate drugs extends beyond this one pill.
Researchers visited 109 facilities in six states between October 2016 and March 2017. They interviewed 323 people, including residents, family members, nurses, social workers, pharmacists, long-term care experts and more.
What they found wasn't just disturbing, it was dangerous.
Some family members in dark over dangers
The Food and Drug Administration has not deemed antipsychotic drugs an effective or safe way to treat symptoms associated with dementia -- including dementia-related psychosis, for which there is no approved drug. In fact, the FDA cautions that these drugs pose dangers for elderly patients with dementia, even doubling the risk of death, the report shows. Other possible side effects outlined in the report include an onset of nervous system problems that may cause "severe muscular rigidity" or "jerking movements," as well as low blood pressure, high blood sugar, blood clots and other problems.
Researchers heard from family members who hadn't been informed of the dangers. Others felt they had no choice but to agree to the administration of drugs for fear that their loved ones would be otherwise evicted from their facilities.
When residents were taken off antipsychotic drugs, they and their family members often saw improvement. One daughter, who'd assumed her 90-year-old mother's decline was irreversible, said she saw her mom come back to life after the two years of being on antipsychotic drugs stopped.
"Lo and behold, she can talk again. She can read again ... It's not just that she can walk now ... it's her personality," the report quotes the daughter saying. "She had been sleeping all the time. She was totally incoherent. She had no memory at all. She recognized no one. On the meds, she couldn't remember if you were there while you were there."
Laurel Cline visits her mother, Lenora, in a Los Angeles nursing home. She said she had to persuade staff to stop giving her mother antipsychotic drugs.
There are plenty of ways to deal with dementia-related symptoms or behaviors that don't involve pharmaceuticals, the report lays out. Improvements can be achieved through providing activities, reducing loneliness, creating routines, encouraging relationships with familiar staff members, offering exercise and promoting programs like music therapy and pet therapy.
All of this is important to keep in mind as America ages. There are currently about 50 million Americans over age 65, and that number is expected to double by 2060, according to the US Census Bureau. And while today there are 5 million people with Alzheimer's disease or other forms of dementia, the Alzheimer's Association projects that there may be as many as 16 million people with Alzheimer's by 2050.
The industry that cares for the country's aging population, whether that be nursing homes, assisted living centers or other long-term care options, is largely funded by Medicare and Medicaid -- which raises the question: Who is responsible?
Recent improvements noted
Human Rights Watch points a finger at the government, which is required under the Nursing Home Reform Act of 1987 to protect the rights of residents. And what's raised in this report is not new. The government has long-recognized the problem of overusing antipsychotic medications and is required to monitor the use of such drugs, the report shows. In fact, in 2012, the Centers for Medicare & Medicaid Services established the National Partnership to Improve Dementia Care in Nursing Homes in acknowledgement of this issue.
That move made a difference, reducing the use of antipsychotic drugs by 35%, according to a statement emailed to CNN.
Human Rights Watch, too, acknowledged that there have been improvements in recent years, with some facilities slashing use of the drugs after studying the needs of residents. A director of one of these nursing homes in Kansas acknowledged to researchers that the facility "used to be like a death prison" in which "half our residents were on antipsychotics."
While some places like this one in Kansas are taking heed, the human rights group contends that the problem is persistent. Between 2014 and mid-2017, inspectors issued more than 7,000 citations to facilities for violations tied to the use of antipsychotic medications, the report shows. But without meaningful penalties, researchers say, little has changed.
The Centers for Medicare & Medicaid Services agree that more can be done -- and insist it will be.
"CMS appreciates the work done by the Human Rights Watch on this vital issue and is working towards a goal that ensures America's nursing home residents receive safe, high-quality care that is clinically appropriate," the division said in its statement.
The previous administration under President Barack Obama planned to beef up regulations, but the human rights group points out that the Centers for Medicare & Medicaid Services placed a moratorium on strengthened regulations in November 2017.
"The US government pays nursing homes tens of billions of dollars per year to provide safe and appropriate care for residents," said Hannah Flamm, a New York University Law fellow at Human Rights Watch. "Officials have a duty to ensure that these often vulnerable people are protected rather than abused."
The government can do its part in a number of ways, the report suggests. It can end the inappropriate administration of antipsychotic medications by enforcing regulations and penalties, improving inspections, requiring informed consent, and ensuring adequate staffing and training in care facilities.
The Centers for Medicare & Medicaid Services said it's already hard at work to make further improvements, having instituted new goals as of the end of 2017. Among the goals is an expectation that nursing facilities which still overuse antipsychotic medications will decrease their use by 15% by the end of 2019.
As for a moratorium on such efforts, the division says there's no change in requirements "that residents must be free from unnecessary medications and must not be chemically restrained." Rather, there is now an 18-month "transition period" wherein those that fall short are not being fined and instead are being asked to invest in education and compliance.
This is all part of an effort "to reduce [the] burden on providers while still protecting the health, safety, welfare, and rights of residents," the statement said.
GAO finds gaps in reporting
A separate government-issued report released Monday, completed at the request of a bipartisan group of US senators, looked at oversight of care in assisted living facilities.
The Government Accountability Office investigation examined the care provided to Medicaid enrollees and found significant gaps in the reporting of safety and serious health incidents including physical and sexual abuse, medication errors, inappropriate discharge and unexplained death.
More than 20,000 incidents were reported for 2014 in the 22 states that tracked such information. But 26 other states had not tracked "critical incidents," and therefore could not report the relevant statistics to the accountability office.
"Our nation's seniors, who depend on Medicaid for long-term care services and support, must be safe and protected wherever they call home," said Sen. Orrin Hatch, a Utah Republican. "Given that each year the Medicaid program spends billions on assisted living facilities to ensure beneficiaries receive the high-quality care that they deserve, we must be vigilant that these programs are working as intended."
The accountability office outlined recommendations to the Centers for Medicare & Medicaid Services, including clarifying state reporting requirements, the report states. HHS agreed with that recommendation and stated that it would consider annual reporting requirements for critical incidents after completing an ongoing review.
Former Ninth Circuit Appeals Court Judge Alex Kozinski
(CNN) - Nearly eight weeks after a federal judicial council received a sexual harassment complaint against California-based US Appeals Court Judge Alex Kozinski, the council said Monday that it was dismissing the grievance because Kozinski had stepped down in December.
The council said it conducted no investigation and was not reaching a ruling the merits of the complaint.
But it maintains the charges are serious.
"We recognize that the complaint references grave allegations of inappropriate misconduct, which the federal judiciary cannot tolerate," the judicial council of the 2nd Circuit wrote.
However, since Kozinski has retired, the council has dropped the matter.
The Washington Post reported in December that six former clerks or junior staffers claimed that Kozinski subjected them to inappropriate sexual conduct or comments. Other women subsequently came forward.
The 67-year-old Kozinski is eligible for a $217,600 annual pension, a figure based on the standard appellate judge salary, according to David Sellers, spokesman for the Administrative Office of the US Courts.
Susan Estrich, Kozinski's lawyer, declined to comment.
When he announced his retirement on December 18, Kozinski said in a statement, "I've always had a broad sense of humor and a candid way of speaking to both male and female law clerks alike. In doing so, I may not have been mindful enough of the special challenges and pressures that women face in the workplace. It grieves me to learn that I caused any of my clerks to feel uncomfortable; this was never my intent."
A recent CNN investigation found that judges who are subject to a serious complaint often leave the bench, immediately halting any investigation.
The CNN report also found that, overall, very few of the more than one thousand complaints filed each year against federal judges are deeply investigated. Seldom are judges reprimanded, suspended or subject to other disciplinary action.
University of Pittsburgh law professor Arthur Hellman, who has studied the judiciary's complaint system, said, "By resigning before the investigation even began, Kozinski avoided any kind of inquiry."
It is unlikely any congressional committee would take up the Kozinski case, Hellman added, questioning why members of Congress would take the time to look specifically into the conduct of an individual who has left the bench. However, he said, lawmakers may want to look more broadly at judicial sexual harassment and other misconduct.
Sending copy of four-page report to Congress
The council said that "given the seriousness of the conduct alleged," it was asking the Committee on Judicial Conduct and Disability of the US Judicial Conference to forward a copy of the order "to any relevant Congressional committees for their information." It was not clear what the judicial council hoped would come of that action, particularly because Kozinski has already stepped down.
Congress may forcibly remove a judge from office through the process of impeachment and conviction. The House of Representatives, which is responsible for any impeachment, typically begins a proceeding only on a recommendation of the Judicial Conference.
Only three times in the past 30 years have federal judges been impeached by the House and convicted by the Senate, for issues related to bribery and perjury.
Previous complaints against Kozinski
After the Kozinski harassment claims emerged, Chief Justice John Roberts established a working group to examine the judiciary's procedures for protecting court employees from misconduct. The group is scheduled to report back to Roberts in May.
Kozinski underwent a separate disciplinary process in 2009 after the Los Angeles Times reported that Kozinski was maintaining a publicly accessible website of sexually explicit images. He publicly apologized and took the server offline. A judicial council admonished Kozinski but concluded no further discipline was warranted.
The Philadelphia-based 3rd Circuit judicial council that pursued the 2009 claim noted that, "The judge recognizes that some members of the public, upon learning he possessed the material, may have the misimpression that he has demeaning or disdainful attitudes toward women, creating in the minds of some people what he called 'a highly distorted picture' of him. The judge testified, 'It is especially unfortunate that this happened on account of images and videos that I care absolutely nothing about.'"
Chicago police are investigating allegations that Dennis Edwards, a Grammy-winning singer with the Motown group the Temptations, was abused shortly before his death.
The Rock & Roll Hall of Fame inductee died at a Chicago hospital Thursday from complications of meningitis, according to his wife, Brenda Edwards. He was 74 and had lived in the St. Louis area for more than 30 years.
Court documents filed by an adult protective services investigator allege that weeks before the singer’s death, Brenda Edwards abused her husband.
An investigator with the Healthcare Consortium of Illinois filed the protection order request on behalf of Dennis Edwards Jan. 12 in Chicago, where the couple lived together before Edwards’ death.
The documents allege that Brenda Edwards had attempted to suffocate the 74-year-old by holding his head facedown on a bed. The investigator also accused Brenda Edwards of taking her husband’s hearing aids from him, according to a petition for an order of protection. The documents say Edwards was “bed bound and immobile.”
Dennis Edwards was removed from the home because of medical issues, according to the Jan. 12 document.
An emergency protective order against Brenda Edwards was granted Jan. 18, barring her from contact with Dennis Edwards. A hearing that would have allowed Brenda Edwards to respond to the allegations was scheduled for Friday, but was canceled after her husband’s death the day before.
The protective order was vacated on Friday, after Dennis Edwards’ death.
Brenda Edwards disputed the allegations in a brief statement released Monday night. “I loved Dennis, and we were married for 18 years,” she said. “I would have never done anything to harm him. These allegations are false and defamatory and will be proven as such. Until this is all over, I have no further comment.”
The Chicago Police Department confirmed Monday that there is an open criminal investigation into the matter.
Until recently, Dennis and Brenda Edwards lived in north St. Louis County, and property records show the house remains listed in Dennis Edwards’ name.
The couple recently moved to Chicago to seek better health care, according to Dennis Edwards’ daughter Denise Edwards.
Dennis Edwards lived in the St. Louis area for more than 30 years. He was born in Alabama and moved to Detroit as a young boy, but moved to the St. Louis area in the 1980s to be closer to his mother. By that time, Edwards had already sung lead vocals on some of the Temptations’ biggest hits
Edwards wasn’t an original singer with the classic Temptations lineup, but became the official sixth member in 1968.
He sang lead on hits including “Ball of Confusion (That’s What the World is Today),” “I Can’t Get Next to You,” and the Grammy-winning tracks “Papa Was a Rollin’ Stone” and “Cloud Nine.” The Temptations were inducted into the Rock & Roll Hall of Fame in 1989.
In his later years, Dennis Edwards was often seen in St. Louis at the Fox Theatre and Peabody Opera House when classic soul artists passed through.
The family is working to make arrangements for a memorial service for the singer, Denise Edwards said.
Survivors of Dennis Edwards include five daughters, a son and several grandchildren.
Elderly or incapacitated adults no longer able to look after their own finances will soon have advocates to look after them.
An agreement to initially create 35 volunteer advocates to oversee the financial interests of incapacitated individuals was signed Monday by the Bartholomew County commissioners.
According to the agreement, which expires Dec. 31, the Indiana Office of Court Services agrees to pay up to $50,000 to Thrive Alliance, a combination of the Aging and Community Services of South Central Indiana, Inc. and Housing Partnerships, Inc.
In exchange, the Columbus-based agency will be responsible for vetting, screening, training and supervising volunteer financial guardians, as well as for maintaining court-required progress and accounting reports.
Persons incapable of caring for themselves financially includes those with a neuro-developmental disorder, mental illness, dementia or stroke, the agreement states.
The program is structurally comparable to Court-Appointed Special Advocates (CASA), trained individuals who speak up for the best interests of children within the judicial system, Bartholomew Superior Court 1 Judge Jim Worton said.
All tasks performed by Thrive Alliance will be overseen by Bartholomew County Adult Court Services. If a problem arises from a decision or action taken by a volunteer advocate, the court can remove their financial guardianship, Worton said.
With a staff of five, Adult Court Services also provides services to Bartholomew, Brown, Jennings, Decatur and Jackson counties.
When Worton first spoke on this proposal to the commissioners in December, he was joined by Lori Bland, Thrive Alliance Guardian Program manager.
Now that baby boomers are increasingly retiring, the number of incapacitated adults is expected to grow larger than it ever has been in the past, Bland told the commissioners.
There are already as many as 400 incapacitated adults within the region that have no one else able or willing to assist them with their finances, Bland said.
Until now, only one couple — Bartholomew County Adult Protective Services employees John and Brenda Defler — have been available to advocate for those hundreds of incapacitated adults, the judge said.
“There’s no doubt in my mind we’ve needed this program for years,” John Defler said during a follow-up interview.
Besides retiring baby boomers, there has also been a noticeable increase in the number of adults with Alzheimer’s Disease and other forms of dementia, he said.
Since it’s been more than 40 years since Indiana moved away from institutionalization, there are also many incapacitated adults cared for by the parents their entire lives who now suddenly find themselves alone, Defler said.
His department works with other organizations, such as Centerstone Behavioral Health, to place those persons into extended-care facilities, supportive living quarters or group homes, Defler said.
Based on his own experiences, Defler anticipates most volunteers recruited by Thrive Alliance will be recent retirees.
Not only does that group have more time and expertise, but they also have empathy for people in need, he said.
“They know they could be that person tomorrow,” Defler said. “Whether it’s a stroke or an accident, we are all vulnerable and there are no guarantees.”
The agreement can be terminated by mutual consent, or if funding is no longer available.
The commissioners are serving as a pass-through entity for the exchange of funds, as no local tax dollars will be spent for these services, commissioner Rick Flohr said.
The FBI has charged a South Texas judge with accepting bribes after a lawyer working as a confidential informant helped agents record the jurist allegedly accepting $6,000 in cash in exchange for favorable rulings.
Federal agents arrested 93rd State District Judge Rodolfo “Rudy” Delgado of Edinburg on Feb. 2. Delgado was charged with “bribery concerning programs receiving federal funds,” and released on $100,000 bond. The criminal complaint filed against Delgado alleges the FBI worked with an unnamed lawyer, who confessed he had a history dating back to 2008 of bribing Delgado.
The lawyer-turned-informant, listed in the complaint under the initials CHS, worked with the FBI for over a year and participated in numerous recorded phone calls and meetings with Delgado.
The attorney provided Delgado with pre-recorded government funds on two occasions, according to the complaint. In each instance, Delgado allegedly accepted a bribe to place the attorney’s clients on bond.
The attorney wore a recording device as he met with Delgado at a restaurant to hand off an envelope containing the bribery money on Jan. 17, according to the complaint. Delgado allegedly accepted the bribe and then asked for the client and case number. Delgado placed the attorney’s client on bond the next day.
However, on Jan. 29, Delgado sent a text message to the attorney, which stated, “Good evening, please call me. The campaign contribution needs to be by check. I need to return that to you so you can write a check. Sorry about the confusion, I though you knew and I did not open the envelope till today.”
The complaint alleges the text message was an attempt by Delgado to cover up the bribe.
“Delgado had solicited contributions from CHS in the past, but when CHS offered Delgado the bribe, he did not say that it was a campaign donation. Furthermore, CHS offered and Delgado accepted a thick white envelope full of prerecorded government funds,” the complaint alleges. Delgado did not return a call for comment. Neither did his attorney, Adolfo “Al” Alvarez.
Eric Vinson, executive director of the State Commission on Judicial Conduct, said Delgado will automatically be suspended from the bench upon indictment.
The commission normally suspends judges without pay automatically if they are indicted for a felony or a misdemeanor involving official misconduct. Judges are allowed to petition the commission to resume their pay or to return to the bench after an indictment, Vinson said, but the commission has historically not allowed indicted judges to sit in Texas.
“The Feds have 30 days to indict and we’re going to kind of watch and see what happens and go from there,” Vinson said.
Delgado has a history with the commission. He was suspended from the bench in 2005 after a grand jury indicted him in connection with a driving while intoxicated incident. That suspension was later lifted by the commission in 2007 after the criminal charges against Delgado were dismissed by a visiting judge—a decision that was later upheld by Corpus Christi’s 13th Court of Appeals.
Jack Burton, an attorney from Santa Fe, Sen. Jim White, R-Albuquerque, and Sen. Daniel Ivey-Soto, D-Albuquerque
The New Mexico Senate on Wednesday approved a two-pronged measure to provide “immediate relief” to those who have struggled for years with the abuses of a closed legal guardianship/conservator system, while creating the framework for a comprehensive system overhaul by 2020.
The unanimous vote, which sends the legislation to the House of Representatives, comes after what one senator called a “Herculean” effort to address failings of the current system – as evidenced by the recent embezzlement of millions of dollars from guardian or conservator clients of two now-defunct Albuquerque firms.
Under the measure approved Wednesday, court hearings that are now closed would be open to the public as of July 1. Family members would have more access to guardianship records and visitation wouldn’t be as easily thwarted by commercial guardians, who also have been accused in some cases of profligate spending and excessive fees. Nonfamily conservators would have to post bonds in case financial impropriety occurred.
Sen. Daniel Ivey-Soto, D-Albuquerque, one of the bill’s sponsors, said the phased-in measure would give “immediate relief and to make sure we make good on a promise (for more comprehensive changes). We will keep legislating on it.”
Sen. Jim White, R-Albuquerque, who led the reform effort, told his colleagues before Wednesday’s vote that the state’s courts need more time and money to enact the more costly aspects of the measure, such as bringing all existing cases up to compliance.
Judges approve petitions for guardianship and rely on annual reports to ensure their guardian or conservator appointees are doing their jobs.
Sen. Jerry Ortiz y Pino, D-Albuquerque, a longtime advocate of reform, recounted his experience on the Supreme Court commission appointed last year after publication of a Journal series, “Who Guards the Guardians?” The commission heard testimony from the public about the issue last year.
“It was painful to hear how dysfunctional our system has become … because we as legislators haven’t been giving the judiciary the tools to make the system work better.”
Over the months of study by the commission and several legislators, a consensus emerged: Reporting requirements to allow judges to assess a protected person’s welfare and assets aren’t stringent enough. Families are sometimes shut out of their incapacitated loved ones’ lives by guardians. And judges should improve oversight. There was also the recognition that the judiciary is financially strapped and needs additional time and resources to implement more reform.
The judiciary, for instance, identified 24,000 existing cases in its computer system as being “sequestered” – meaning closed to the public. But it isn’t clear how many of those are adult guardianship cases, and there’s no way to easily tell in each case whether the protected person or the guardian is still alive.
“We don’t have that information, and that’s part of the issue before us,” White said. ” There’s not a database that keeps track of all those cases. There may be abuse out there that we don’t know about.” A provision of the bill, he said, would entail building a database of guardianship cases.
The bill, which Sen. Sander Rue, R-Albuquerque, described Wednesday as a “Herculean effort,” incorporates but delays the more expensive requirements of a new model guardianship reform law unveiled nationwide last fall.
In essence, more time and work would be required from attorneys who file petitions, from guardians and conservators, and from judges who hear the cases.
For example, guardians and conservators would have to devise plans detailing their care of a protected person and file them with the judge. Judges would have to give specific authorization for conservators to deviate from a protected person’s will, including considering the incapacitated person’s prior directives and financial needs.
“This bill is the result of a lot of work, both nationally and locally,” said Sen. Cisco McSorley, D-Albuquerque. “There is a huge need to protect elders. This is a reflection of a new American society where older people move to the Southwest to retire … without close family members, and there’s really nobody to look after them if they have some catastrophic event. Once you are incapacitated and in front of a judge, the judge literally gives somebody else total and complete control not only over your physical being, but your money, your future financial dealings, your legal dealings.”
Ortiz y Pino said that if the measure is signed into law, “We can feel very good about plugging some of the holes, such as families getting more notification (of when hearings will occur).”
But he said that if lawmakers don’t give the courts enough money for improved oversight, such as staff to review guardian and conservator reports and for field visits to check on protected people, “we’ve just hamstrung the new law and created no better situation.”
CHARLESTON, W.Va. (AP) — West Virginia's House has voted to let nursing aides give various prescription medications to patients at nursing homes.
Supporters of the bill, approved 55-44 on Tuesday, say the certified nurse aides would have to be trained every two years, work under the direction of a registered nurse, couldn't give opioids and other drugs listed as having high potential for abuse and could give injections only with pre-filled insulin.
Aides would have to record every medication they give. They couldn't calculate dosages or work from verbal doctor's orders.
Opponents say their concerns are patient safety as well as the potential diversion of allowable medications, which include barbiturates that are potentially addictive.
Lawmakers on both sides note that 25 states allow the practice and 25 don't.
The estate of a woman whose special needs trust was drained under questionable circumstances prevailed Wednesday before the 7th Circuit Court of Appeals. The founder of the organization that took the money is a suspended Indiana attorney facing charges that he stole from other clients’ trusts. The organization must now repay the estate more than $200,000.
The court reversed Southern District Judge Tanya Walton Pratt and ordered the National Foundation for Special Needs Integrity Inc. to pay the estate of Missouri woman Theresa Givens $234,181.23 plus prejudgment interest.
Further, Hamilton wrote, “We must note that the Foundation’s (former) counsel, (Kenneth) Shane Service, testified that he intentionally drafted (a section of Special Needs Integrity’s agreement dealing with distributions upon the death of a beneficiary) to confuse Missouri government officials.”
Givens had set up a special needs trust with about $255,000 in settlement proceeds from a lawsuit related to injuries she received from dialysis treatments. She died shortly after the trust was established, and her children were told by Special Needs Integrity that there would be no money left in Givens’ account. Hamilton, though, noted in the opinion that Service also had testified that Givens’ “main concern was always about her children.”
While the children received none of the roughly $234,000 that remained in Givens’ trust when she died in 2011, the foundation claimed the money after initially informing Givens’ children there would be no money because the proceeds most likely would be consumed by Medicaid refunds. After the children questioned distributions to the foundation, Special Needs Integrity filed a declaratory judgment action against the estate in April 2015, which Pratt awarded.
But the 7th Circuit found the contract Givens signed to be ambiguous and found no reason to believe Givens intended her money to go to the foundation rather than to her children. “The Foundation provided Givens with a service by managing her assets for what turned out to be just a few weeks before she died — a service for which Givens paid the Foundation” Hamilton wrote. “There is no plausible reason she would have intended to give it all the money that might be left upon her death.
“… We thus conclude that the agreement is best construed as providing that the remainder funds go to the Estate of Theresa Givens,” the panel held in reversing and ordering the foundation to pay the estate $234,181.23 plus prejudgment interest.
During oral arguments in September, Lewis & Kappes attorney David Gray, who represented Special Needs Integrity, faced tough questioning from Hamilton.
“You don’t even have records of a decision” by Service or by other foundation representatives to take the money, Hamilton said. “You just have money shifted from one account to another in 2013 and then again in 2014.
“… Why should we simply not decide it’s an ambiguous document that needs to be construed against the drafter and order distribution?” he asked Gray near the end of his presentation.
“If laches doesn’t work, nothing prevents you from doing it,” Gray responded.
Meanwhile, Service is awaiting trial on theft charges in Lawrence County, where he is accused of stealing more than $85,000 from two former clients’ special needs trusts. Authorities believe Service may have other victims in different states. An Indiana State Police investigator said in September officials were looking into the possibility of “numerous victims in multiple states.”
Service’s next court date on the Lawrence County charges is set for March 21.
LANSING, Mich. (WXYZ) - A 7 Action News investigation has now changed the law in Michigan. Earlier this week, Gov. Rick Snyder signed the legislation that will increase protections in the law for heirs after a loved one dies.
Since Nov. 2016, 7 Investigator Heather Catallo has been exposing several loopholes in the law that allowed real estate brokers and Attorney General-appointed lawyers called Public Administrators to open probate estates after a loved one dies. Catallo’s relentless reporting showed that Macomb County real estate broker Ralph Roberts and his company, Probate Asset Recovery, used that power from the courts to sell the homes and take thousands of dollars from the probate estates.
After the 7 Investigators exposed this, Attorney General Bill Schuette shut the practice down, and supported the changes to the law.
“Actions that came to light last year made it clear that now is the time to make changes to the public administration system,” said Schuette in a statement Tuesday. “What has happened in the system is unacceptable and these changes to an almost 40-year-old law will help ensure this never happens again. By creating a clear, current and direct path for public administrators to follow in the probate process we can better protect Michigan citizens and weed out any bad actors.”
“Establishing a more transparent process for the appointment of a personal representative when no heir can be located will prevent future fraud schemes and prevent these fraudsters from praying on innocent heirs,” said Jim Runestad, R-White Lake. “Public administrators do good work to help our citizens and these reforms provide further safeguards when families are grieving.”
Oakland County Sheriff’s detectives are also now conducting a criminal investigation into these practices.
In May 2017, Oakland County Treasurer Andy Meisner and Oakland County Clerk Lisa Brown connected with a bi-partisan group of lawmakers to close the loopholes. Two bills sponsored by Rep. Runestad and Rep. Jim Ellison (D-Royal Oak) were signed into law Tuesday.
Meisner is pleased the bills passed, especially since several probate judges and lawyers opposed the changes to the law.
“We reached out to the probate bench and to the bar, and solicited their input about it,” said Meisner.
“Despite our reaching out, they didn’t connect with us, they didn’t provide any feedback – and then they submitted a letter before the committee hearing opposing the legislation… It reflects poorly on the probate bar and the judges that they came out against the legislation, and I hope in the future when they’re confronted with this sort of obvious wrong doing that they take the stand of the people.”
Here are more details from Public Act 13 of 2018:
-Heirs will now have 63 days instead of 42 days to open a probate estate, before a Public Administrator can open the estate;
-A formal hearing is now required for a Public Administrator to be appointed;
-If an estate includes a piece of property in tax or mortgage foreclosure, PA’s must post a notice of the court hearing on the property at stake and prove that that they diligently searched for heirs.
Any Public Administrator who intentionally fails to give proper notice can now be found guilty of a 90-day misdemeanor.
Here are more details of Public Act 14 of 2018:
-Public Administrators must give a written notice to a county treasurer’s office if there is property in the estate that’s delinquent on property taxes; then the treasurer can make sure heirs who are on tax payment plans receive notice of the opening of the estate;
-Public Administrators must now give the courts copies of the settlement statements from the sale of real estate;
-Public Administrators will now have to get court approval before selling a property that they represent, and if an heir is living in the property, the State Public Administrator must be notified.
The changes to the law also cap real estate fees and the fees related to identifying estates to only 10% of the net proceeds from the property sales.
The 7 Investigators first exposed that Roberts and PAR were often taking 33% of the total value of the estate, plus 4% in real estate commissions, as well as other charges invoiced by Roberts various companies.
The bills passed the House and Senate very quickly, and the law will take effect in 90 days.
“It is an example of democracy working the way that it’s supposed to work. The interplay between the government sector and the media -- this a great example of how it’s supposed to work. The media providing some transparency, and then the government working to act to address the issues the media brings to bear. And so in this time where the media is under such vicious attack, I think it’s a good reminder to people across the state and the country that the media is trying to help us tell the important stories like this one,” said Meisner.
When Oregon became the first state in the nation to legalize the practice of assisted suicide, pro-life advocates argued this would be a slippery slope that would lead to euthanasia. Apparently assisted suicide is not enough for the death peddlers in this Pacific Northwest State. Now they are pushing legislation in the Oregon State Legislature that would allow starving mentally ill patients to death.
A similar bill was defeated last year but the euthanasia promoters are back with a new one, Oregon Right to Life tells LifeNews. House Bill 4135 is scheduled for a hearing and possible work session in the House Health Care Committee at 3:00 pm on February 7th. It is believed this bill will move quickly because there are only 35 days in the 2018 regular session.
Last session a similar bill (SB 494) was introduced in the Senate by Senator Floyd Prozanski . It died in the House. The new bill, HB 4135, is chief sponsored by Speaker of the House, Tina Kotek.
“Supporters of this bill are touting it as a ‘fix,’ but the only fixing that is happening is fixing it so vulnerable Oregonians are left without protections and their right to basic care like food and water,” said ORTL Executive Director Lois Anderson. “One wonders what the true motivations are for this legislation.”
Anderson says HB 4135 is purported to just be a bill that makes technical changes to the current statutory advance directive form found in ORS 127.531. However, over the last 25 years Oregonians at the end-of-life stage have been protected by the current advance directive and removing it from statute has legal consequences.
“The advance directive was put into Oregon statute back in 1993. I was then a state senator when a very well vetted bill was thoroughly discussed and passed. I worked hard to ensure the advance directive was in statute. If it were to be removed from statute, I fear the legal protections we carefully placed there could be jeopardized, potentially harming end of life decisions for vulnerable patients,” stated Representative Bill Kennemer (R- HD 39). Under current Oregon law, a healthcare representative does not have the authority to make a life ending decision for an incapable person unless the representative has been given authority to do so, or the incapable person is in one of four end of life situations defined in statute.
Anderson said that if HB 4135 is passed a person who appoints a healthcare representative, but makes no decisions regarding end of life care, would be granting his or her healthcare representative the power to make a life ending decision for the principal even when the principal is not in one of the four statutorily defined end of life situations, and even if this is not the will of the principal.
HARTFORD CITY, Ind. — A state panel has recommended that an Indiana judge be suspended for six days without pay following charges filed by the Indiana Judicial Qualifications Commission.
The commission filed the four misconduct charges against Blackford Circuit Court Judge Dean Young in June over a dispute with his county’s clerk.
The commission alleged Young barred then-Blackford County Clerk Derinda Shady from the courthouse while she was hospitalized in August 2015 with chest pains she suffered after refusing to attend a meeting with Young and Superior Court Judge John N. Barry without a witness. The charges also allege that Young’s conduct didn’t promote public confidence in the impartiality of the judiciary.
The panel, which was composed of three judges, said Young’s “misconduct adversely affected the integrity of and respect for the judiciary.” However, the panel also said Young’s “misconduct” wasn’t motivated “by a desire for financial personal or material gain.”
The state Supreme Court will decide what action, if any, will be taken against Young, The Star Press reported.
Attorneys for Young and the commission said they believe the recommended suspension is appropriate.
Young, a Republican, served 12 years in the Indiana House of Representatives before being elected as the circuit court judge in 2006.
A report provides the most detailed look to date at the role of assisted living in Medicaid, one of the nation’s largest health care programs.Credit Nam Y. Huh/Associated Press
WASHINGTON — Federal investigators say they have found huge gaps in the regulation of assisted living facilities, a shortfall that they say has potentially jeopardized the care of hundreds of thousands of people served by the booming industry.
The federal government lacks even basic information about the quality of assisted living services provided to low-income people on Medicaid, the Government Accountability Office, a nonpartisan investigative arm of Congress, says in a report to be issued on Sunday.
Billions of dollars in government spending is flowing to the industry even as it operates under a patchwork of vague standards and limited supervision by federal and state authorities. States reported spending more than $10 billion a year in federal and state funds for assisted living services for more than 330,000 Medicaid beneficiaries, an average of more than $30,000 a person, the Government Accountability Office found in a survey of states.
States are supposed to keep track of cases involving the abuse, neglect, exploitation or unexplained death of Medicaid beneficiaries in assisted living facilities. But, the report said, more than half of the states were unable to provide information on the number or nature of such cases.
Just 22 states were able to provide data on “critical incidents — cases of potential or actual harm.” In one year, those states reported a total of more than 22,900 incidents, including the physical, emotional or sexual abuse of residents.
Many of those people are “particularly vulnerable,” the report said, like older adults and people with physical or intellectual disabilities. More than a third of residents are believed to have Alzheimer’s or other forms of dementia.
The report provides the most detailed look to date at the role of assisted living in Medicaid, one of the nation’s largest health care programs. Titled “Improved Federal Oversight of Beneficiary Health and Welfare Is Needed,” it grew out of a two-year study requested by a bipartisan group of four senators.
Assisted living communities are intended to be a bridge between living at home and living in a nursing home. Residents can live in apartments or houses, with a high degree of independence, but can still receive help managing their medications and performing daily activities like bathing, dressing and eating.
Nothing in the report disputes the fact that some assisted living facilities provide high-quality, compassionate care.
The National Center for Assisted Living, a trade group for providers, said states already had “a robust oversight system” to ensure proper care for residents. In the last two years, it said, several states, including California, Oregon, Rhode Island and Virginia, have adopted laws to enhance licensing requirements and penalties for poor performance.
But the new report casts a harsh light on federal oversight, concluding that the Centers for Medicare and Medicaid Services has provided “unclear guidance” to states and done little to monitor their use of federal money for assisted living.
As a result, it said, the federal health care agency “cannot ensure states are meeting their commitments to protect the health and welfare of Medicaid beneficiaries receiving assisted living services, potentially jeopardizing their care.”
Congress has not established standards for assisted living facilities comparable to those for nursing homes. In 1987, Congress adopted a law that strengthened the protection of nursing home residents’ rights, imposed dozens of new requirements on homes and specified the services they must provide.
But assisted living facilities have largely escaped such scrutiny even though the Government Accountability Office says the demand for their services is likely to increase because of the aging of the population and increased life expectancy.
That potential has attracted investors. “Don’t miss out on the largest market growth in a generation!” says the website of an Arizona company, which adds that “residential assisted living is the explosive investment opportunity for the next 25 years.”
Carolyn Matthews, a spokeswoman for the company, the Residential Assisted Living Academy, said: “Unfortunately, there has been elderly abuse in this business. We are trying to change the industry so the elderly have better quality care and we are not warehousing them.”
The government report was requested by Senator Susan Collins of Maine, a Republican who is the chairwoman of the Special Committee on Aging; Senator Orrin G. Hatch of Utah, a Republican who is the chairman of the Finance Committee; and two Democratic senators, Claire McCaskill of Missouri and Elizabeth Warren of Massachusetts.
The Trump administration agreed with the auditors’ recommendation that federal officials should clarify the requirement for states to report on the abuse or neglect of people in assisted living facilities. The administration said it was studying whether additional reporting requirements might be needed.
“Although the federal government has comprehensive information on nursing homes providing Medicaid services, not much is known about Medicaid beneficiaries in assisted living facilities,” the report said.
Assisted living was not part of the original Medicaid program, but many states now cover it under waivers intended to encourage “home and community-based services” as an alternative to nursing homes and other institutions.
The report said that assisted living could potentially save money for Medicaid because it generally cost less than nursing home care. Under the most common type of waiver, Medicaid covers assisted living only for people who would be eligible for “an institutional level of care,” in a nursing home or hospital.
A week before Valentine’s Day last year, an Orlando nursing home sent nine of its residents on an outing to a local super store with a single assistant to supervise. All the residents needed round-the-clock care, five were in wheelchairs and three used walkers.
One elderly resident desperately needed to use the bathroom but couldn’t find the assistant, so he tried to go on his own — ultimately losing his balance and control of his bowels, falling in his own feces and breaking his hip. A stranger had to help him while the store paged the nursing home staffer, who then neglected the other eight residents to tend to the emergency.
For that and other actions posing “immediate jeopardy” to residents — including failing to provide kidney dialysis to another resident — federal regulators fined the nursing home, Avante at Orlando on North Semoran Boulevard, nearly $1 million in 2017. They cited 20 health violations and placed it on a national watch list for its failure to correct repeated problems.
But advocates for residents say it’s not enough.
Because of facilities like Avante with track records of putting their patients in danger, some want to change the Florida Constitution, adding a nursing home and assisted-living facility residents’ bill of rights. Doing so, they say, would not only add more protections, but it also would shield residents from state legislators and presidential administrations that might roll back existing regulations under pressure from the nursing home industry.
“The public is completely in the dark about what happens in some of these facilities,” said Brian Lee, a former nursing-home watchdog for the state who now heads the national advocacy group Families for Better Care. “Even the tragedy of 12 nursing home residents dying from neglect after Hurricane Irma — deaths that were categorized as homicides — has not been enough to shame the industry into making changes.”
The Rehabilitation Center at Hollywood Hills in South Florida was evacuated Sept. 13 after power was knocked out by the storm and temperatures inside soared. A dozen elderly residents ultimately succumbed to heat exposure; one had a body temperature of 109.9 degrees.
That facility is still fighting to keep its license.
The tragedy led Florida Gov. Rick Scott to call for all nursing homes and assisted-living facilities in the state to install sufficient backup generators and have 96 hours of fuel on site to keep temperatures safe in case of power failure — a proposal that prompted four months of lawsuits and negotiations by the industry before reaching an agreement this month. The result is Proposal 88, which is now being aired in public hearings throughout the state. If approved by the commission, it would go before voters in November.
The proposal establishes the right for residents to be treated “courteously, fairly and with the fullest measure of dignity,” given “adequate and appropriate health care” and live in “a safe, clean, comfortable and homelike environment” with “reasonable precautions” against natural disasters and extreme climatic conditions.
It also says residents have the right to access courts, have speedy trials and sue without limitations for damages, that they can’t be asked to waive those rights, and that the facilities must carry liability insurance sufficient to ensure that residents and their families are “justly compensated.”
Avante did not respond to several requests for comment on Proposal 88, nor did it respond to the federal fines and citations. But the industry as a whole is adamantly opposed to any such language in the state’s Constitution — even though some of the rights are already part of laws previously enacted by the Florida Legislature and the proposal doesn’t spell out the consequences for nursing homes that don’t comply.
“We don’t believe it’s really focused on residents’ rights. We think it’s focused on expanding lawsuits,” said Kristen Knapp, spokeswoman for the Florida Health Care Association, which represents the state’s nursing home industry. “There’s nothing in this proposal that would have prevented what happened in Hollywood Hills. They’re just capitalizing on a tragedy — on an egregious case — for which there are criminal charges. There are already 32 lawsuits filed against that building, so clearly there is already an ability to sue.”
The proposal was filed by Constitution Revision Commission member Brecht Heuchan, one of the governor’s appointees to the commission. Heuchan, a lobbyist who owns a political data company, has come under fire because of his clients — including the Florida Justice Association, a group that represents trial lawyers, and a law firm that has sued nursing homes. He dismisses those criticisms.
“In this state, someone living outside a nursing home has more rights than someone living inside of one,” he said. “All I’m doing is trying to restore the balance of power for these facilities that care for 70,000 Floridians who indisputably are the most frail, most vulnerable, possibly the biggest targets for exploitation.”
State law, for instance, requires the facilities to carry liability insurance or be self-insured, but not at specific levels, and critics have accused the facilities of routinely attempting to get residents to sign away their rights.
Knapp counters that nursing homes can no longer find insurers to write the liability policies after most carriers pulled out of the market.
Many now self-insure; Lee points to evidence that facilities should have the means to do so.
“Record-setting bed valuations, billions in guaranteed revenues and robust profit margins have pushed the senior care market to become one of the fastest growing, most highly profitable health care sectors,” he said.
At the same time, the Trump administration has pushed to soften fines against the industry — making the nearly $1 million penalty against Avante likely a thing of the past. New guidelines even discourage regulators from levying fines in certain situations.
And the state began redacting inspection reports of the facilities last year so severely that it made them virtually unintelligible to the public.
“This underscores why Proposal 88 is needed — to ensure residents’ rights and protections are not watered down or ridden roughshod over by politicians,” Lee said.
Nursing homes across the United States routinely give antipsychotic drugs to residents with dementia to control their behavior, despite regulatory prohibitions on this misuse of drugs as “chemical restraints.” This abusive practice remains widespread even though the use of antipsychotics is associated with a nearly doubled risk of death in older people with dementia.
About every week in US nursing facilities, more than 179,000 people, mostly older and living with dementia, are given antipsychotic drugs without a diagnosis for which their use is approved. Often, nursing facilities use these drugs without obtaining or even seeking informed consent. Using antipsychotic medications as a “chemical restraint”—for the convenience of staff or to discipline residents— violates federal regulations and may amount to cruel, inhuman, or degrading treatment under international human rights law.
Failing to plan is planning to fail.Failing to plan is planning to fail. There are numerous considerations that confront us at each stage of our lives that make it important to update your estate plan as you age.
A young family typically has a small net worth and is more focused on getting enough life insurance to sustain their children in the event of an untimely death, naming a guardian for their children and having a will that can create a trust to hold the monies and instruct how the monies should be spent for their underage children.
It is important that the monies are kept separate from the guardian's accounts so that they do not become commingled and exposed to the guardian's own personal adverse circumstances. You should always name the children as the beneficiary of a life insurance policy, retirement account or annuity, and never the guardian directly.
A mature client, between the ages of 40 and 60, is typically focused on how assets are passed onto their beneficiaries, those who receive some part of their estate. Typically, a will is effective in handling the distributions, but there are individual considerations that may require a higher level of planning. These include estate and inheritance tax issues, beneficiaries with disabilities, beneficiaries with unstable marriages, beneficiaries with addictions, beneficiaries who can't manage money or have creditors and their own second or third marriage with children from previous marriages.
Children from previous marriages involves issues of making sure assets are available to the surviving stepparent spouse for the remainder of their lives or until the stepparent marries, but ultimately the assets should go to the children of the deceased spouse.
Many times, assets are left to the surviving stepparent spouse under a verbal agreement to leave the remainder to the decedent spouse's children. This simple strategy rarely works because of the typically weak relationship between stepchild and stepparent. This leads to the stepparent legally leaving the monies to their blood relatives and not to the individuals who are supposed to get it. This happens frequently with respect to individual retirement accounts.
All of these issues can be managed with trusts. Trusts are agreements between three parties: grantors, trustees and beneficiaries. The grantors are the creators of the trust and owners of the assets going into the trust. The trustee manages the trust assets according the specific trust instructions.
Trustees often are family members and not expensive trust companies. The beneficiaries are the individuals who receive the trust assets at specific times. Trusts are flexible and highly customizable.
The senior client, typically between the ages of 60 and 80, still is concerned with all of the issues of the mature client but also should be concerned with their post-retirement income and financial resources supporting their cost of living for the remainder of their lives.
Questions about Social Security and Medicare are at the forefront of concerns. A good plan should involve a discussion of the pressing issue of how to prepare for the potential of long-term care expenses.
The statistics are staggering. It is estimated that 79 percent of women and 58 percent of men over the age of 65 will need some form of long-term care, which may involve home health care, assisted living or skilled nursing, ranging in cost from several hundred dollars to $12,000 per month. Topics include long-term care insurance, veterans benefits and Medicaid asset-protection planning.
While important at all stages, it is extremely important in the senior and elder, more than 80-years-old, stages of life to have a well-drafted financial power of attorney and health care power of attorney, documents that authorize others to act on your behalf, drafted by an elder law attorney.
In the event that an individual becomes incapacitated and cannot take care of themselves, a good financial power of attorney can save thousands of dollars and provide a continuous management of the individual's affairs. If there is no power of attorney or even a deficient one, family members must obtain an expensive guardianship order from the court, which involves medically proving incapacity. That can sometimes be disputed between family members and can take between four and six weeks to obtain.
If this issue is revealed at the time the individual needs to go into the nursing home, and the individual has too many assets to qualify for Medicaid, the delay can easily cost well in excess of $12,000 because they must pay for private nursing care during the delay in qualification. In almost all circumstances, assets can be preserved even if the individual is already in the nursing home, whether married or single, despite the common perception that the only option is to pay for nursing care until your assets are reduced to a level of financial qualification.
It is important that the power-of-attorney document gives the authority to the agent to protect assets in the Medicaid qualification process, which may involve several different legal rights.
Sean D. Curran, Curran Estate Law, focuses his practice, 222 N. Kenhorst Blvd., exclusively on estate and elder law, at www.curraneelaw.com.