What happens to elderly poor people who need to reside in a facility long term or to recuperate after an illness irrespective of their capacity status?
They are often subject to the actions of predators who gain entry to the facilities in their role as a known guardian for some other resident. In this racket, they do not even need to go to the trouble of becoming this person’s guardian but still can garner a sizable monthly income and more with no supervision or risk while robbing the resident blind.
A racket without any court involvement, oversight or monitoring and there for the taking.
Anatomy of the Racket
Often there is no family or other appropriate individual to take responsibility for the patient/resident. The facilities themselves must then appoint an individual as a Health Care Proxy (HCP)when the admitted elderly resident seems not capable of making informed decisions. These are not Wards or even alleged incapacitated individuals. These new residents may or may not be able to make simple needs known. They may be able to say “Yes, I want chocolate ice cream”, but cannot make an informed decision. When such a patient is admitted into a facility like a SNF, usually after being in the hospital, the facility must possess a signed consent to treat as well as admission paperwork from the hospital.
But facilities can skirt this paperwork deterrent to their benefit when they appoint a Health Care Proxy of their own (based on FL Statue Chapter 765.401), typically through a recommendation from an in house bioethics committee, populated with bought in predatory collaborators. Or, the facilities can deem residents incapable and in need of a HCP by having two collaborating medical physicians evaluate them and sign a statement. They are not deemed incapable or incapacitated by any court. This racket takes place with no court intervention. DCF does not view this as elder abuse even when it is reported!!
Follow the Money
Once appointed, the HCP sends a private bill to facility for each resident that he is HCP for to be paid from the miniscule $105 these residents get monthly for personal items in the State funded Resident Fund Management system (RFMS) accounts. These funds are intended strictly for resident’s personal use. Whatever is left of them on death, goes to funeral home to bury them.
But typically in these cases, there is nothing left—not because the resident spent these funds, but because they every dollar was diverted in to the pockets of the HCP.
How does this happen? The newly appointed HCP produces a bill to the Facility’s RFMS accounts payable manager, and as such he is suddenly listed as Responsible Party on the resident’s face sheet so any and all money from the State is automatically distributed to him. No questions asked. When he illegally signs more paperwork, he declares himself Beneficiary of resident, so any money in resident’s account goes to him. He immediately spends down any money, when they are close to $2000 limit Medicaid allows a recipient to possess to continue ripping off the resident and the State.
Once HCP and Beneficiary, he can easily fabricate Durable Power of Attorney (POA) paperwork and get financial information about any assets, and when he finds them, he will also make himself DPOA illegally, since the resident is not of sound mind to appoint anyone to be their DPOA.
The facilities require a DPOA to sign for the resident’s expenses and bills in order to get paid themselves, so they overlook or don’t care about this overt exploitation and criminality.
So the progression is HCP>Responsible Party>Beneficiary>Power of Attorney and in a matter of days, voila. A monthly income from a destitute elderly person with no court protection whatsoever.
Now multiply that times many residents in many facilities. It adds up fast. The income is not reported, no taxes are paid and no one is the wiser—till now.
No court is involved at any step in the process. All that is needed is a Notary and a witness—easy to find willing and predatory collaborators.
And when the money is gone and resident dies what happens? As one HCP has been quoted as saying “let them be buried in a pauper’s grave, the state will bury them. I want my bill to be paid”.
The facilities are getting paid by the HCP as well as Medicaid or Medicare, as long as they have a three-night stay. Also the newly appointed HCP is paid a fee from the facility for performing this role for the facility.
This arrangement completes all the paperwork hurdles needed to get paid from government programs. Even if it is a sham process, it is efficient for the facility.
The doctors usually sign whatever the facilities ask them to sign. Of course they bill Medicaid or Medicare Part B for that signature as a “consult”. Doctors may well be collaborators and fully aware of the power they are giving HCP. Or the doctors are not thinking in terms of how the HCP is abusing his appointment. Either way, their actions are illegitimate.
The doctors are also complicit when the resident complains or makes noise. With the blessing of HCP orders are written to prescribe psychotropic drugs to these elderly patients as handler drugs to shut them up. The all too familiar chain of events that follow this overmedication are familiar: stupor, feeding tubes, pressure ulcers, UTI’s, sepsis and death. Death appears to be only way out of this disgusting predation. There is no one to report this to who cares or is not part of the criminality.
Predators. Greed. Corruption. Exploitation. Danger for seniors. Easy prey. Defenseless.