Elizabeth "Betsy" Savitt

A Florida woman who the state has charged with abusing her role as a professional guardian received an early boost into the lucrative field from her then-circuit court judge husband, a report said.

A report by the Palm Beach County Clerk & Comptroller’s Office prompted the Florida Office of Public and Professional Guardians to take action against Elizabeth “Betsy” Savitt, according to a Sept. 1 article in the Palm Beach Post.

The state is seeking sanctions on Savitt which include suspending or revoking her guardianship registration and ordering her to pay restitution.

“The action against Savitt is the first of its kind against any guardian by the guardianship office, which was bestowed new regulatory powers by the Florida Legislature in 2016 after an avalanche of complaints about predatory guardians statewide,” the Palm Beach Post report said.

In 2009, the report said, Savitt launched her guardianship career with the help of her husband, Circuit Court Judge Martin Colin, who had presided over guardianship cases.

“Court records indicate that his was an invisible hand establishing his wife” as a professional guardian,” the report said.

At the time he was boosting his wife’s entry into professional guardianship, “the judge’s finances were marked by foreclosures, liens and unpaid debt,” the report said.

The guardianship office alleges Savitt violated state guardianship statutes regarding conflicts of interest as she failed to disclose she was married to Colin. Savitt is also accused of failing to act in good faith and behaving in a manner contrary to her wards’ best interests, the Palm Beach Post report said.

Savitt also continues to serve on cases in which she should have been disqualified, according to the guardianship office’s complaint, which notes that Savitt has earned $190,000 in fees in at least 13 cases in Palm Beach County.

The guardian office cited two of Savitt’s earliest cases in which then-Judge Colin appointed lawyer Sheri Hazeltine as an attorney for another party and Hazeltine’s actions led to Savitt becoming a guardian or guardian advocate for a disabled adult, the report noted. The state accuses Colin of improperly transferring cases to fellow jurists, avoiding random assignments by the clerk’s office.

“In the case of a developmentally disabled woman, Carol Dobrzynski, now 75, Colin never entered an order of transfer and therefore was presiding when his wife was appointed,” the report states, citing the guardianship office’s complaint. “The clerk formally reassigned the case, involving a $290,000 trust, nearly four years later.”

The Post found another judge’s signature “appeared on key orders in one of Savitt’s cases over the printed name of Judge Colin. Savitt tapped the joint account of the senior ward and his wife for $18,000 and overdrew it, leaving his widow complaining to the court to no avail, court documents show.”

In another case, “Colin appointed Hazeltine, positioning Savitt to take over a guardianship attached to a trust worth about $680,000,” the report said.

Hazeltine said she stopped representing Savitt after The Post reported that Savitt “was taking fees from the life savings of her elderly wards without prior court approval.”

Hazeltine told The Post: “I regret it (representing Savitt) insofar as my name and my law firm’s name was being repeatedly associated with her and Judge Colin’s and their actions.”

In 2015, Colin told the Palm Beach Post he never presided over cases involving his wife. “He also denied any conflict of interest in granting fee requests for attorneys who represented his wife and appeared in front of him in other cases,” the Post’s report said.

Colin recused himself from 115 cases that involved his wife’s lawyers in the last six months of 2015 “after The Post started asking questions in its investigation,” the report said.

The guardianship office’s complaint uses the term “conflict of interest” more than 30 times.

After the publication of The Post’s initial investigation, Colin was moved out of the guardianship division. He later announced his retirement.

Full Article & Source:
Florida complaint says judge’s ‘invisible hand’ helped wife, a professional guardian for seniors 

See Also:
Judge Martin Colin had a hand in his wife’s guardianship cases, state says 

Judge in Post series moved from guardianship cases

Chief judge keeps public waiting on details of guardianship shakeup

Guardianships: A Broken Trust: Attorney: "Courts Have Allowed This Culture"

Guardianships: A Broken Trust, 115 Recusals in Six Months

Guardianships: A Broken Trust: Judges Socialized, Planned Trips Together  

Gov. Bruce Rauner recently signed the Kasem-Baksys Visitation Law to help adult children unreasonably being denied visitation with their elderly parent by another family member.

Starting Jan. 1, close family members will be able to petition a court to visit their elder outside of a guardianship proceeding. This last detail is important, because many physically frail elders may still not qualify for guardianship. In other cases, the custodian of an elder who has lost competency may simply not want court interference with de facto powers the custodian has already been exercising.

Picture a blind or wheelchair-bound elder who, while mentally competent, might not physically be able to open the door. Imagine that elder’s reluctance to even try if it would mean angering the sole person providing his care and who owns the home in which the elder has been isolated for weeks or even years.

I couldn’t have asked for a more dedicated and caring lead sponsor for this long-overdue law than Rep. Sara Wojcicki Jimenez, R-Leland Grove. She and her staffer Ryan Melchin marshaled key bipartisan support, resulting in overwhelming bipartisan support in both houses. I also thank Sen. Melinda Bush, D-Grayslake, who carried the bill in the Senate, and Rep. Laura Fine, D-Glenview, the co-lead sponsor in the House.

Sandy Baksys
Leland Grove

Full Article & Source:
Good Deed: Thankful to Rep. Wojcicki for help in passing elder visitation law

For months, a Cook County judge found guilty of fraud has refused to step down from the bench, insisting that the federal judge overseeing her criminal case could still overturn the jury’s verdict.

On Tuesday, U.S. District Judge Thomas M. Durkin shut the door on that possibility, denying several motions made by defense lawyers for Jessica Arong O’Brien, including her request for an acquittal or a new trial.

O’Brien now faces sentencing Oct. 9. A jury found her guilty Feb. 15. And though she has been doing little judicial work, she has been paid $148,900 so far this year, according to a state comptroller database.

Steve Greenberg, O’Brien’s attorney, said he was disappointed by Durkin’s 45-page ruling and insisted the government overreached in its case against O’Brien.

He also said, “I think it’s too soon for her to do anything today.”

“Let her have a minute to absorb the ruling,” Greenberg said. “But obviously, if the conviction stands, she’s not going to be able to continue as a judge.”

Federal jurors found O’Brien guilty after prosecutors said she pocketed $325,000 during a mortgage fraud scheme that took place more than a decade ago, before she became a judge.

Despite becoming the rare sitting judge to be found guilty in federal court, O’Brien has fought on multiple fronts to keep her job — and even filed paperwork to seek retention in November’s election.

The Illinois Supreme Court suspended O’Brien’s law license back in April. Then, in July, retired Cook County Judge George Scully pointed to the suspension and asked the Illinois Supreme Court to remove O’Brien from the November ballot.

The state constitution requires a judge to be “a licensed attorney-at-law of this state.” O’Brien is “not authorized to practice law due to discipline,” according to the Attorney Registration & Disciplinary Commission.

The high court has yet to rule.

The Illinois Courts Commission is also set to consider at a Sept. 24 hearing whether to suspend O’Brien from her position without pay. O’Brien’s lawyers have argued the Courts Commission — the body authorized to discipline judges — does not have the authority to “discipline a judge for conduct which occurs prior to the judge’s election to the bench.”

After her indictment in April 2017, O’Brien began to perform administrative duties. Typically that includes presiding over marriages. However, a spokesman for Cook County Chief Judge Timothy C. Evans has said she is no longer even doing that.

Full Article & Source:
Federal judge refuses to acquit Cook County judge as she clings to the bench

The federal government says hospice fraud costs taxpayers hundreds of millions of dollars. An Action News Jax Investigation has uncovered hospices accused of fraud are only getting a slap on the wrist.

“My signature was on paperwork that I didn’t sign,” said Jacksonville hospice whistleblower Dr. John Simons.

That was one of the first red flags for Simons. He’s a former medical director at Haven Hospice and Hospice of the Treasure Coast.

Hospice is where people go for end of life care, but Simons said he saw a pattern of hospices taking on patients with plenty of life left to live, billing Medicare hundreds of dollars a day.

“There was a CEO down at one point who basically just told us to just do it and shut up. We didn’t have an option,” said Simons. Simons became a whistleblower for the federal government.

The U.S. Attorney’s Office hit both Haven Hospice and Treasure Coast with False Claims Act Lawsuits.

Both hospices settled last year.

That’s not the end of the story. “The penalties don’t meet the crime, if you will,” said Simons.

The government accused Haven Hospice of defrauding taxpayers out of “hundreds of millions,” but Haven only had to pay up about $5 million.

The government accused Treasure Coast – now known as Treasure Health – of defrauding taxpayers out of $72 million. They settled for $2.5 million.

Action News Jax kept digging through federal court records, and found every Florida hospice hit with a False Claims Act lawsuit settled for a fraction of the amount they’re accused of taking fraudulently.

Assistant Special Agent in Charge Brian Martens supervises the Jacksonville and Orlando offices of the U.S. Department of Health and Human Services Office of Inspector General. It’s the federal agency that investigates hospice fraud.

Martens said every Medicare dollar taken fraudulently is a dollar that can’t be used by a dying patient who actually needs it.

He said the money could run out within a decade.

“If your parents are dying or my parents are dying, how do they get the treatment if others have taken that cash?” said Martens.

Action News Jax asked Martens what incentive there is for a hospice to be honest if it could potentially get away with defrauding taxpayers out of hundreds of millions of dollars.

“There is a potential risk that people could be investigated and go to jail,” said Martens. “In a corporate environment, breaking the corporate veil to get to prove something beyond a civil related matter is a difficult thing.”

An Office of Inspector General report last month identified vulnerabilities in the Centers for Medicare & Medicaid Services’ oversight that are putting patients and taxpayers at risk.

The report said the OIG found CMS has no way of penalizing hospices behaving badly, other than cutting off the hospice from the Medicare program.

Action News Jax called every Florida hospice that settled with the government.

None of them wanted to talk, but they asked Florida Hospice & Palliative Care Association President Paul Ledford to do an interview instead.

Action News Jax asked Ledford why the hospices did not want to talk.

“Well, I think most of them view it as sort of a private matter now. They’ve reached a corporate integrity agreement,” said Ledford.

Ledford said False Claims Act lawsuits against hospices more often stem from differences in medical opinions and poor record-keeping than intentional fraud.

“The whistleblowers, invariably, tell a story that’s more dramatic than the facts will bear out,” said Ledford.

Dr. Simons no longer works in hospice care. He was awarded about $1 million as part of the settlements.

Simons said he has little hope that the hospices will change their ways. “The small slap on the wrist -- you know, I think, unfortunately some hospices may continue that behavior,” said Simons.

If you suspect a company is committing health care fraud, you have the power to report it.

Contact U.S. Department of Health and Human Services Office of Inspector General at 1-800-HHS-TIPS (447-8477) or online here. 

Full Article & Source:
Florida hospices accused of defrauding taxpayers get ‘slap on the wrist'

5:00 pm PST … 6:00 pm MST … 7:00 pm CST … 8:00 pm EST


Caroline Douglas, author of "The Dark Side: A Treatise on Law and Judging", joins us this evening to discuss the generating of fees for favored attorneys, which she describes as the "currency of judging". Nowhere is this more apparent than in the probate system. This includes, but is not limited to excessive hourly rates, unnecessary work, unsupervised and questionable billing and approving bills with cursory or no review or audit. This favoritism for specific attorneys also extends to specific and routinely appointed predatory guardians who work with probate hearing examiners, who appear repeatedly together so often in public records on case after case, that no one could look at this information and conclude that some kind of working relationship has been formed that is predicated on profiting from the estates of the targeted victims.

Quote: Page 311, The Dark Side
"Make no mistake--all kinds of attorney appointment/fees are a significant unregulated industry, which routinely is operated to deplete savings and assets of incapacitated people--who cannot avoid or even get rid of the scam of court appointed experts. In any other forum, this insider appointment would be called an insider scheme, and, a crime."

LISTEN to the show live or listen to the archive later

A Kansas City woman found guilty of exploiting an elderly veteran for money and falsifying medical records has been ordered to serve probation and pay thousands in restitution, according to a news release from the Missouri Attorney General’s Office.

Cheryl Kelly, 52, was charged with one count of financial exploitation of an elderly person and two counts of Medicaid fraud. The incidents happened while Kelly worked as an in-home personal care attendant in 2013.

Prosecutors accused Kelly of abusing her position by depositing the victim’s money from his veteran benefits and Social Security into an account she created under her name and the victim’s name.

She promised the victim she would use the money to take care of his finances but instead used the money to gamble and pay her mortgage and car insurance, the attorney general’s office said.

Kelly also allegedly pretended to be the victim’s relative — his niece or sometimes his daughter — to hospital staff, social workers and the U.S. Department of Veterans Affairs.

Prosecutors said the misuse of the victim’s money caused him to incur “numerous” overdraft fees and get evicted from his home.

Kelly was also accused of falsifying medical records of the victim as well as another Medicaid recipient.

The attorney general’s office also said Kelly had “falsely represented to Medicaid” that she was providing the victims with in-home health services, including bathing, dressing, grooming and help with administering medication.

The attorney general’s office Fraud Control Unit led an investigation into Kelly’s conduct with help from the Missouri Medicaid Audit and Compliance Unit, the Missouri Department of Health and Senior Services and the United States Department of Veterans Affairs.

A jury found Kelly guilty of the charges in June.

On Tuesday, Kelly was sentenced to five years of probation and ordered to pay $15,000 in restitution and $10,000 in civil penalties, the attorney general’s office said.

“The abuse of elderly Missourians will not be tolerated,” Missouri Attorney General Josh Hawley said in a statement. “And those who abuse our elderly residents, veteran residents, and the Medicaid program will be prosecuted to the fullest extent of the law.”

Full Article & Source:
KC woman posed as relative, exploited elderly veteran. But now she’s paying the price

Judge Kathy Hoogstra

MUSKEGON COUNTY, MI - A judicial commission recently dismissed a complaint filed against Muskegon County Circuit Judge Kathy L. Hoogstra, clearing her of allegations that she verbally abused a county employee.

The complaint was originally filed in March with the state's Judicial Tenure Commission by Muskegon County Deputy Clerk Marcia Wilkes. The commission dismissed the claims as being without merit.

Hoogstra declined to comment on the dismissal. She is a judge in the 14th Circuit Court's Family Court division which hears cases on domestic relations, neglect and abuse and delinquency matters. She was appointed in 2013 and retained the seat in the 2014 election.

Wilkes claimed that Hoogstra verbally abused her in private and within earshot of her co-workers in response to a request from the clerk's office about a missing circuit court file.

"I was frightened and (Hoogstra) was wildly mad and kept going on like a crazy person," Wilkes wrote.

Neither Wilkes nor Hoogstra would comment on the complaint. However, in an email to the clerk's office provided to MLive, Hoogstra claimed Wilkes' request for the document was "unprofessional and offensive."

The Judicial Tenure Commission is an independent state agency responsible for investigating complaints of misconduct among state judges. The 11-person panel made up of lawyers and judges recommends discipline for judges to the Michigan Supreme Court, which rules on whether misconduct had occurred.

A representative from the commission declined to disclose when the body decided Hoogstra's case, saying it was considered internal information.

Sandra Vanderhyde, the 14^th Circuit Court administrator, said she was notified about the decision on Aug. 7. The same day, Vanderhyde sent a memo to the county's judges, court staff and the Muskegon County Board of Commissioners announcing the dismissal.

"Judge Hoogstra has always maintained the highest professional standards of conduct in the workplace and wanted her colleagues to know the outcome of this case," Vandrhyde wrote in the memo that was read at the Aug. 7 county board meeting. "She is also very proud of the 14th Circuit Court's administrative staff and their colleagues in the 60th District Court and thankful for their hard work serving the people of Muskegon County."

The incident follows several workplace harassment allegations made against current and former Circuit Court employees. The county recently completed several workplace harassment seminars and training sessions for all county and court employees following the complaints of sexual harassment.

Full Article & Source:
Verbal abuse complaint against Muskegon County judge dismissed

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.

Full Article & Source:
THOSE ARE OUR PARENTS YOU ARE IGNORING

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.”

Brooks says, “I love it, being his grandma.”

Full Article & Source:
Local man spending time with residents in nursing home

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.”

Full Article & Source:
The lawyer was charged with a $20M fraud, then took a drive 4 years ago. He’s been found

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.

---

By Fred Schulte and Elizabeth Lucas and Joe Mahr

Willie Jackson ( Photo: Shana Dorsey)

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

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.

 
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Avoidable Sepsis Infections Send Thousands Of Seniors To Gruesome Deaths

 
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The bank let her check bounce, so the grandma wrote this letter. Her answer is brilliant

Judge Tim Horton

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.

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.

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Text message contradicts ex-court administrator’s testimony in Judge Tim Horton’s defense

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.

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State: Seniors were abandoned during Santa Rosa wildfire

Franzen (left) and Bowman

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

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.”

Full Article & Source:
Judge Colin says it’s ‘nonsense’ that he funneled work to wife

California Atty. Gen. Xavier Becerra on Friday announced human trafficking charges against four owners of several child and senior care centers. (California attorney general's office)

A family of four running several senior and child care centers in San Mateo County has been charged with human trafficking and other labor-related charges, California Atty. Gen. Xavier Becerra said Friday.

The defendants — Joshua Gamos, 42; Noel Gamos, 40; Gerlen Gamos, 38; and Carlina Gamos, 67 — are accused of holding employees of the Rainbow Bright day-care centers against their will, failing to pay them minimum wage and overtime pay, and abusing them verbally, physically and psychologically.

The alleged abuse took place between 2008 and 2017, according to the complaint.

The charges are the result of a yearlong investigation by the attorney general’s office’s Tax Recovery and Criminal Enforcement Task Force, which involved the collaboration of multiple agencies including the U.S. Department of Labor and law enforcement departments in Daly City, South San Francisco and Pacifica.

While serving the arrest warrants, officials seized 14 illegal assault weapons, three of which were “ghost gun” rifles without serial numbers, according to a statement released by Becerra’s office.

The Gamoses are charged with 59 criminal counts, including human trafficking, rape and grand theft.

The four family members allegedly targeted Filipinos who were living in the U.S. illegally or otherwise vulnerable by posting ads in a local Filipino newspaper. According to the complaint, employees at multiple Rainbow Bright facilities were promised food and a room to sleep in for their work as live-in caregivers for developmentally delayed adults. They were told they would work eight hours a day for five days a week and receive a monthly salary of between $1,000 and $1,200.

But according to the complaint, employees were made to work 24 hours a day, seven days a week with no increase in pay, sometimes with only a few hours of sleep a night. At times, they were not allowed to communicate with one another.

If the employees didn’t behave properly in the eyes of the owners, according to the complaint, they would be punished, sometimes with a decrease in pay or threats that they would be deported.

The owners also withheld employees’ passports on the pretext that they would help employees with their immigration status, the complaint said. In some cases they kept the passports until the employees were fired or quit.

The complaint also alleges that Joshua and Noel Gamos offered female employees gifts in exchange for sex acts. Joshua Gamos is also accused of raping employees on multiple occasions, according to the complaint.

“No worker in the United States should live in fear or be subjected to violence, abuse or exploitation at the hands of their employer,” Becerra said in a statement. “We must not turn a blind eye to abusive labor practices. Report it, and we will investigate and prosecute.”

Full Article & Source:
Owners of senior and child care centers charged with human trafficking

Full Article & Source:
WALKING ON THE MOON DOES NOT KEEP YOU FROM AGING

Former Judge Martin Colin and his Elizabeth “Betsy” Savitt.

“Corruption and collusion of judges and lawyers in Delray Beach for financial gain” centered around dubious professional guardian Elizabeth “Betsy” Savitt and her husband, former Circuit Judge Martin Colin, according to a report never before made public by Palm Beach County’s guardianship watchdog.

Once again, a major institution in what is known nationwide as “Corruption County” stands accused of betraying the public trust.

Judge David French

Colin signed orders in Savitt’s cases. The couple’s friend — Circuit Judge David French — oversaw the majority of her cases. And lawyers appointed by Colin steered lucrative guardianships to Savitt while asking Colin to approve tens of thousands of dollars in fees in other cases before him. Other judges approved questionable fees or appointed Savitt under “unusual” circumstances.

These allegations are detailed in a25-page report by the Inspector General of the Clerk & Comptroller’s Office and obtained by The Palm Beach Post on Friday. The State Attorney’s Office investigated but found no evidence of a crime.

Families of Savitt’s incapacitated wards — often seniors — complained in vain for years that a group of lawyers and judges were against them at every turn as they watched their loved ones suffer and lose their life savings.

The IG report stands as vindication for families who watched slack-jawed as numerous judges dismissed their concerns about retainers, over-billing and bogus litigation to generate fees. Remarkably, Savitt continues as a guardian.


“Given the pervasive involvement of so many judges over such a long period of time, it is unrealistic to expect that the system will police itself. It is beyond high time for federal prosecutors to finally mount a full-scale comprehensive and legitimate investigation of the now well-documented guardianship abuses.”

At least one chief judge was informed — verbally, not in writing — that the IG had found “major violations of Florida guardianship law” by Savitt as early as 2012. He told Colin to be sure not to preside over his wife’s cases.

Another investigation detailed in the report began in 2014 again found “major violations of guardianship law” by Savitt.

Despite years of investigation by authorities, none took public action until The Post exposed Savitt and Colin in its January 2016 investigation, Guardianships: A Broken Trust.

The report, delivered to the state Office of Public and Professional Guardians in December, is the basis for the first action by any authority to take Savitt out of the guardianship field, which poured thousands of dollars into hers and the judge’s household.

The guardianship office is seeking, in effect, to prohibit her from being a professional guardian in this county. It also seeks to require her to pay back the nearly $200,000 she earned from fees in 13 cases involving at least one of the judges or lawyers.

Chief Judge Jeffrey Colbath, in the wake of The Post investigation in 2016, made sweeping changes to the county guardianship system but didn’t stop Savitt from practicing. He ordered mass recusals from south county judges, transferred Colin to another division and sent Savitt’s cases to the North County Courthouse.

Colin announced he would not run for re-election and retired at the end of 2016. French is retiring at the end of this year but not before he appointed Savitt to another case, thumbing his nose at Colbath’s efforts.

Colin and Savitt did not respond to an email request for comment. French’s office said the judge declined to comment. And a spokeswoman for Chief Judge Krista Marx said she was unavailable for comment.

All of this might have been nipped in the bud if the state Judicial Qualifications Commission acted on complaints about Colin in 2008 that claimed he was favoring divorce attorneys who represented Savitt. The JQC failed to seek even a reprimand and within two years, Savitt was a professional guardian with power over the finances, the medical care, and the housing of incapacitated seniors and disabled adults.

The system works

Palm Beach County Clerk & Comptroller Sharon R. Bock.

Sharon Bock, the county’s Clerk & Comptroller, said the IG report shows the process worked because of the independence of her office to investigate guardianship complaints.

The initial Savitt investigation was kick-started by a call to the clerk’s fraud hotline in 2012. Another investigation commenced in 2014 with several more hotline tips and finally coalesced with a complaint to the state’s revamped guardianship office in 2016, within days of it getting the authority to police professional guardians.

“We believe the work product we are turning out is making a difference and has made a difference already in Palm Beach County,” Bock said. “We have been doing these reports since 2011.”

Carol Berkowitz, executive director of the Office of Public and Professional Guardians, said that there is enormous respect for many professional guardians across Florida who work tirelessly to support vulnerable adults, but added:

“It is extremely important that we act when a complaint investigation finds that a guardian has violated their statutory responsibilities or is not acting in the best interest of their ward.”

Criminal investigation

The IG report states Savitt’s case was referred to the public corruption unit in State Attorney Dave Aronberg’s office, which also issued a subpoena to ascertain whether a senior’s money was used to satisfy Savitt’s outstanding $308,000 mortgage. Both the state attorney and IG said it was not.

“This investigation focused on whether the relationship between Judge Colin and Elizabeth Savitt resulted in Savitt receiving an unfair financial advantage assigned to her or if she or her associated attorneys received unfair favorable rulings from Judge Colin,” according to a memorandum issued by the state attorney’s office on Nov. 21, 2016, and quoted in the report.

The state attorney found “no evidence to support any of the allegations.”

The IG commented that even though the state attorney’s standard of proof was higher, there was circumstantial and anecdotal information of criminal corruption and collusion. He said it was unclear whether the state attorney’s standard was “beyond a reasonable doubt” or a “probability of obtaining a conviction” yet it concurred with the state attorney’s conclusion.

Anthony Palmieri, the deputy inspector general for the clerk who authored the IG report, said, “My sole focus was on Betsy Savitt as a professional guardian and her conflicts and what her duties were and what her responsibilities were. And yet that did kind of leach into Judge Colin and maybe into Judge French. My focus was not on the judiciary.”

More than a dozen judges

More than a dozen judges are part of the report.

French oversaw 16 of Savitt’s cases. He appointed her to cases, approved her fees as well as the fees of her attorneys — sometimes over the vigorous objections from families of the ward.

The IG was especially interested in a vacation trip French and his wife took with Savitt and Colin to the Bahamas.

The blockbuster report found Circuit Judges Charles Burton,James Martz, Rosemarie Scher, and Leonard Hanser all appointed Savitt to guardianships in some fashion.

Judge Scher also approved an improperly filed petition by Savitt’s lawyer, the report states.

Circuit Judges Jack Cook and Diana Lewis — now off the bench — were involved in cases where the IG found Colin paved the way for his wife’s appointment.

And Judge Edward Garrison approved a fee request from one of Savitt’s lawyers that was $5,000 more than requested. Fees for attorneys are taken from the ward’s money.

Marx, French and Scher, along with Circuit Judges Howard Coates and Jessica Ticktin approved $21,500 in retainers taken by Savitt from her wards’ banking accounts that the report said violates Florida guardianship law.

Circuit Judge Peter Blanc, the chief judge in 2012, received the initial verbal report finding a conflict of interest.

Blanc told The Post he spoke with Colin and told him not to preside over any of his wife’s cases. Colin testified at an administrative hearing on Thursday it was he who initiated contact with Blanc. It didn’t matter. Colin admitted on the stand that he signed several orders in his wife’s cases, claiming it was an accident.

Judge Marx, who was sitting in the Probate Division at the time, is quoted in the report admonishing Savitt in court for taking a retainer, saying: “It seems you are asking for forgiveness rather than permission.” Marx, however, approved the $8,000 retainer anyway.

Colbath, as part of his guardianship reforms, prohibited taking of fees from wards prior to judicial approval. Palmieri said that in the 2,000 guardianship cases he’s investigated statewide, only Savitt took fees before prior judicial approval.

‘Unusual circumstances’

Judge Jeffrey Dana Gillen appointed Savitt under “unusual” circumstances when no parties had asked for her to be a guardian for senior Frances Berkowitz.

Savitt’s name seemed to come out of nowhere. The two lawyers hadn’t recommended her and one even said, “I don’t think Judge Gillen did (recommend Savitt) either.”

The clerk noted, however, that the day before Savitt was appointed,an email had gone out that gave Judge Colin and his judicial assistant “an opportunity to discuss the case with Judge Gillen or Judge Gillen’s JA.” The IG has not substantiated whether Colin or his JA read the email.

Former attorneys for Berkowitz then tried to remove Savitt as guardian, arguing that her appointment was improper. They also claimed that $400,000 was missing from Berkowitz’s bank accounts.

Gillen’s judicial assistant said Friday that he was reviewing the report and would have a comment next week.

In one of the more remarkable sections of the IG report, Savitt is said to have been “the driving factor” for guardianship reform by the Florida Legislature in 2015.

The new state guardianship office selected Savitt, though, as the first guardian against whom it is seeking sanctions. It accused her of conflict of interest and failing to act in good faith, contrary to her wards’ best interest. After the hearing last week, Administrative Law Judge Mary Li Creasy said she will issue a recommendation on sanctions in about a month.

Savitt’s attorney, Ellen Morris, tried without success to keep the report from being entered as evidence at the hearing, saying in a motion that it contained “statements and conclusions that are highly objectionable throughout.”

Creasy denied that motion and by accepting the report into evidence paved the way for its release by the guardianship office on Friday.

Savitt invoked spousal privilege at the hearing so she wouldn’t have to disclose conversations she had with her husband about her cases.

Twyla Sketchley, a veteran guardianship attorney in Tallahassee, testified that the spousal privilege went to the heart of the conflict of interest.

“If I’m a guardian and I’m married to the judge, I can go home at night and over the dinner table, I can discuss my cases and what I need and how horrible these parties are, and none of that can be disclosed to any other parties in a proceeding,” Sketchley said. “You have a special relationship with that judge that no one else in that courtroom can or could have.”

Colin testified that the crux of the state’s conflict of interest case against his wife was “nonsense.”

“I had no role in the cases that she got appointed on,” Colin said. “That is not a process that would even take place if someone has an understanding of how one gets guardianship cases.”

Colin, though, said he was friends with all the other probate judges who oversaw his wife’s cases. He also said lawyers and families chose Savitt as guardian, though many times those very lawyers appeared in front of him in other cases and relied upon Colin to approve their fees.

One of those attorneys was Clifford Hark, who was hired by families seeking guardianships and would recommend Savitt.

The IG investigated but couldn’t prove or disprove that Savitt’s appointments and the fact that she didn’t object to his legal fees was “quid pro quo.”

Hark was also accused of steering cases to Savitt. The Boca Raton attorney has denied assisting Savitt in establishing herself as a guardian.

Judge Garrison signed an order of fees for Hark of senior Helen O’Grady’s case for $14,689 when the amount sought was $5,000 less. Colin had transferred the guardianship directly to Garrison because Garrison was presiding over the probate case.

Garrison also ordered Savitt to return $30,000 she took from O’Grady’s estate to be “held in trust” by her and her attorney.

Attorney Sheri Hazeltine

That attorney, Sheri Hazeltine, told The Post that Colin asked her to represent his wife in 2010 and that she felt “there was a natural measure of fear involved” in complying with the request. The report said Colin appointed Hazeltine to two cases in which the lawyer paved the way for Savitt to be appointed guardian.

Savitt’s attorney has argued that the guardianship office does not have jurisdiction over any case prior to the Legislature endowing it with regulatory powers in March 2016.

French, however, gave the office a perfect opening. In January 2017, after Colbath had transferred all of Savitt’s cases from him to the North County Courthouse, French appointed her to a pro bono case involving senior Mavis Samms. Savitt was required to take a pro bono case to be included on the new wheel for random appointments of guardians.

Samms’ daughter said Savitt allowed the senior’s home to go into foreclosure, according to court documents.

Thomas Mayes, who fought Savitt in the guardianship of his mother, Helen O’Grady, said he felt the attorneys were complicit in generating bogus litigation in order to soak the life savings of the incapacitated seniors “until there is nothing left.”

“I am wondering if Betsy and her cronies would have to pay back the families?” said Mayes of Boynton Beach. “Hopefully they will see that she was out for herself and her cronies.”

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Full Article & Source:
Report: Savitt involved with ‘corruption, collusion of judges’

See Also:
Judge Martin Colin had a hand in his wife’s guardianship cases, state says 

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Stiehl restores elderly woman’s desire to live independently, dissolving guardianship move by daughter