Friday, October 11, 2019

Hospitals Cause or Facilitate Abusive Guardianships

When planning to Age in Place, folks must be aware of the causes of guardianship if they hope to have any chance of preventing abusive guardianships.  Hospitals are increasingly the source of guardianship referrals, and many are compromised or abusive guardianships The ABA Journal recently published an article, Cases Raise Questions about Adult Guardianship and Lawyer-Hospital Relationships reporting two recent sets of cases in which lawyers received guardianship appointments as a result of their relationships with hospitals. 

In one case, a Michigan judge removed a lawyer from several cases in which she served as a guardian or conservator after raising questions about a conflict of interest.  The case was originally reported in the Lansing State Journal. The presiding Judge  also referred the attorney to the state bar for a possible ethics investigation.

The lawyer was removed  for failing to disclose an agreement with a hospital in which she was paid to petition for guardianship of certain patients. In at least two of the cases, the hospital paid the attorney for time spent with the patients after she was appointed guardian.  The guardianship turned abusive, though, because the lawyer allowed his granddaughter and her boyfriend  to reside in the home of a ward for which the lawyer was guardian.

In South Carolina, the hospital's general counsel served as a patient’s guardian and conservator. The lawyer, received a public reprimand in an agreement for discipline by consent. The Legal Profession Blog noted the case.  The attorney billed more than $8,600 for her time as conservator and paid her son $700 to do repair and cleaning work at the patient’s home. At some point, the lawyer's son moved into the home without her knowledge; she had meningitis and was hospitalized for three months during the time period. The son also vandalized the patient’s home and sold the patient’s car after forging her name on a car title, the reprimand says. The attorney reported her son to police when she discovered his theft.

The New Yorker, too, is raising questions about the guardianship system in Clark County, Nevada, in which elderly people were removed from their homes without notice and without a lawyer to represent them.  In Nevada, hospitals also play a role in guardianships.

“Hundreds of cases followed the same pattern,” the article reported. “It had become routine for guardians in Clark County to petition for temporary guardianship on an ex-parte basis [meaning without a court hearing or notice to family, friends, or the public]. They [lawyers] told the court that they had to intervene immediately because the ward faced a medical emergency that was only vaguely described: he or she was demented or disoriented, and at risk of exploitation or abuse. The guardians attached a brief physician’s certificate that contained minimal details and often stated that the ward was too incapacitated to attend a court hearing.”

The article focused on one guardian, who was awarded a guardianship once a week, on average, and had up to a hundred wards at a time. There was evidence that the guardian visited hospitals and lawyers to build relationships and generate leads for potential clients.

Debra Bookout, an attorney at the Legal Aid Center of Southern Nevada, told the New Yorker that some hospitals were eager for a guardianship appointment:
 “When a hospital or rehab facility needs to free up a bed, or when the patient is not paying his bills, some doctors get sloppy, and they will sign anything.”
The "anything" is often the physicians’ certificate used to obtain ex parte guardianships.

The lawyer subject of the New Yorker article was indicted for perjury and theft in a case that focused on alleged double billings and sloppy accounting.

The New Yorker article notes that Nevada is reforming its guardianship system; a new law will entitle all wards to be represented by lawyers in court. The New Yorker questions whether that is enough. The guardianship commissioner who approved Parks’ appointments was transferred to dependency court but didn’t lose his job. And another guardian who is considered “the godfather of guardians” in Nevada is still listed as a trustee and administrator in several cases.

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