TAMPA, Fla. — Hospitals across the Florida are paying lawyers to go to court to take away patients’ rights, a three-month I-Team investigation uncovered.
I-Team Investigator Adam Walser found hospitals in Orlando, Miami, West Palm Beach, Naples and other Florida cities paying private attorneys to file hundreds of court petitions to put patients into guardianship.
An I-Team review of state court records found:
- Tampa Bay area hospitals, including those owned by Baycare, AdventHealth and HCA, went to court to put more than 100 patients into guardianship since 2017 alone.
- Tampa General Hospital filed five nearly identical court documents seeking guardianship for patients, describing each as having “disorganized thinking and poor cognition.” A hospital spokeswoman said TGH spent $28,000 on guardianship cases so far in just 2019.
- An attorney for Florida Hospital Altamonte requested guardianship for a patient because her “Kia Soul that was almost paid off… may be repossessed.”
Tampa guardianship attorney Gerald Hemness questioned hospitals’ widespread use of guardianship.
“Certainly, missing a payment on a car doesn’t seem like it would be a financial emergency,” said Hemness.
Guardianship is supposed to protect people who have been declared incapacitated and are considered in immediate danger – something that doesn’t often fit the bill for people in the hospital, according to Hemness.
“How – if they’re in a hospital – is their physical well-being at imminent risk? They’re in the safest medical place a person in America can be,” said Hemness.
Hospital says it’s ‘over capacity’
Jay Wolfson, a medical ethicist at University of South Florida, said money can be a factor in the decision to take patients to court.
“It’s costing the hospital too much to keep the patient in that bed,” said Wolfson.
The I-Team found Regional Medical Center Bayonet Point – an HCA-owned hospital where a semi-private room costs $2,100 a day – requested guardianship for a patient on Social Security, stating in court papers, “The hospital is at risk of being over capacity and the ward’s use of a bed may deprive others.”
None of the hospitals contacted by the I-Team would say why they pay lawyers to go to court instead of letting state social workers at the Department of Children and Families handle the cases of patients potentially in need of a court-appointed guardian.
For those in the guardianship system, a judge hands complete control of their lives to court-appointed guardians. Those under the care of guardians also lose most of their rights, including the right to vote, drive, marry, make medical decisions, determine where to live and decide which friends and family members are allowed to visit.
A $4 million guardianship gig
The controversy over hospitals getting into the business of guardianship first gained public attention after a court investigation revealed AdventHealth paid nearly $4 million to disgraced former guardian Rebecca Fierle, who is accused of causing the death of a man under her care.
Invoices show AdventHealth paid Fierle the $4 million to serve as the guardian for 682 patients at its Orlando hospital – part of a secret arrangement hidden from the courts.
- Urns full of cremated human remains seized from professional guardian's office
- Florida guardians routinely issue “Do Not Resuscitate” orders without court oversight
- Judge removes professional guardian from nearly 100 cases for alleged violations
A court investigation report shows Fierle never disclosed to the judge she was being paid by the hospital – a violation of state statute, which bars guardians from receiving financial benefits other than those approved by the court.
An Orange County Comptroller’s report showed AdventHealth often turned to Fierle
Florida Hospital – now re-branded as AdventHealth – also asked Fierle to provide guardianship for Steven Stryker, the man whose death Fierle is accused of causing.
On Aug. 5, 2018, the judge approved placing Stryker under Fierle’s care in a hearing that lasted less than three minutes.
The I-Team obtained the official audio recording of the court proceedings. Laughter can be heard on the recording after the judge decides to push up the hearing date by three weeks and decide the case that day.
Stryker spent two months in the hospital prior to the hearing. After Fierle was appointed his guardian, she moved him from the hospital to multiple assisted living facilities, which investigators reported did not meet his medical needs.
Stryker died in May after Fierle had his feeding tube removed and ordered a “Do Not Resuscitate” order without permission.
- State report on guardian: 'Removal of necessary care directly resulted in ward's death'
- Embattled professional guardian accused of causing death resigns from 40 cases
- Head of state’s guardianship watchdog office resigns
“If it can be shown that the hospital was intentionally hiring Ms. Fierle in order to specifically get that patient out of the bed and didn’t care about the placement and didn’t care about the best interest of the ward, then I think it could potentially be improper patient dumping,” said Vanessa Albaum, a St. Petersburg attorney who specializes in federal health care law.
Fierle is currently under criminal investigation by the Florida Attorney General’s Office.
“Maybe this could be an eye-opener for both the court and for the hospital going forward to make sure this doesn’t happen again,” said Albaum.
Only one hospital goes on camera
AdventHealth West, which owns 11 hospitals in the Tampa Bay region, never pay guardians directly, said spokesperson Richelle Hoenes-Ahearn in interview with the I-Team.
“That’s not how we handle guardianship cases,” said Hoenes-Ahearn. “I can only speak for us, but I think every hospital probably feels the same. When it comes right down to brass tacks, it’s what’s best for the patient care.”
When asked whether AdventHealth patients should be concerned about being placed in guardianship, Hoenes-Ahearn said, “Oh, absolutely not. I can’t even imagine being somebody that had nobody.”
Other area hospitals contacted by the I-Team declined on-camera interviews to explain to the public why they take patients to court to seek guardianship and give a full accounting of how much these hospitals spend to put patients under the care of guardians.
Emailed statement from Regional Center Bayonet Point (HCA):
“Regional Medical Center Bayonet Point is committed to providing high quality, personalized care for our patients. We work with patients, families and caregivers, when appropriate, to develop a care plan to address the patient’s personal goals while in the hospital and after discharge. When a patient isn’t able to make medical decisions and doesn’t have a family member or friend to help, we may at times petition the court to appoint an independent guardian to make decisions on behalf of the patient.”
Emailed statement from Tampa General Hospital:
“At Tampa General Hospital, the care and safety of our patients is our number one priority. There are certain occasions where we must petition the courts to appoint a guardian for a patient. In 2019, Tampa General Hospital worked with five guardians for a total cost of $28,000. We do not pay guardians directly. This situation is rare but happens when a patient is unable to make medical decisions on their own and doesn’t have a family member or medical proxy to make decisions for them. DCF is rarely involved due to their significant case load. Tampa General Hospital works with local agencies to provide guardian services when needed for patients. In every instance, the care and safety of our patients is our number one priority.”
Emailed statement from BayCare:
“A few times each year, patients come to us who are not able to speak for themselves. In these situations, we work very hard to find the closest family member who is willing to serve as the patient’s decision maker. However, for a variety of reasons, some people have no one in their life who is willing to take on this responsibility.
When we are unable to find a legal health care decision maker, we make DCF aware of the situation if it falls in their purview. That agency would be better suited to answer questions about why they do not take certain cases. If all of our other efforts to find a health care surrogate fail, we then work through the court system to be sure that the patient is represented.
If the court determines that a court-appointed legal guardian is appropriate, then the appointed guardian becomes the legal decision maker. If a family member later decides to manage the patient’s care, the family member has the right to go to court and request a hearing to have decision-making responsibility.
This is a very complex process governed by laws designed to protect patients. We’re a not-for-profit hospital with a mission to serve through community-owned health services that set the standard for high-quality care, compassionate care. We take this responsibility seriously and will continue to work closely with the appropriate agencies and authorities to ensure the best possible patient care is provided to those we serve.”
“For patients who have no family willing or able to assume responsibility for them, from time-to-time we have had to petition the court to appoint an emergency guardian. Petitioning the court to appoint an emergency guardian is a last resort 100% of the time, only after exhaustive efforts to find family members or friends willing to fulfill this role.”
If you have a story you’d like the I-Team to investigate, email firstname.lastname@example.org.