Names on paper
Ohio doesn’t require guardians to meet with their wards, and many don’t
Like some 4,000 other adults in Franklin County whose minds or bodies have failed them, Monica Morales was just a paper file on a courthouse shelf — Case No. 535890. So when a deadline came and went without a report from her guardian, court officials never checked on her.
In a system set up to watch out for the well-being of people who can’t do it themselves, little attention is actually paid to the person. What matters is the paper about them.
Everything about these adults, labeled “wards,” is reduced to paper — status reports and financial accounts that largely are unchecked and unchallenged.
When the state shut down a decrepit Fayette County nursing home this year, one resident walked out into the snowcovered world barefoot. He didn’t own a pair of shoes, and his probate courtappointed guardian had not made sure he had them.
“We reduce them to the legal status of a child. So we need protections.” — Julia R. Nack, amaster guardian “The court is not, nor was it ever intended to be, a social-service agency.” — Franklin County Judge Robert G. Montgomery “What you have to have is people who give a damn.” — Ohio Attorney General Mike DeWine
In Columbus, a prostitute has continued to turn tricks and face arrest — more than three dozen times since the court appointed a guardian to help her in 2008. Her guardian blames her — a woman declared mentally incompetent— and the state of the health-care system for her continued troubles.
Even when the guardian of an alcoholic woman begged a probate court for years to help get the woman into rehab, the pleas fell on deaf ears. The alcoholic eventually stopped drinking — after a heart attack last year.
A yearlong Dispatch investigation found that the paperdriven probate court process that Ohio employs sometimes subjects fragile adults to abandonment, neglect and mistreatment by the very people appointed to protect them.
Some have been neglected by their own family members, who become overwhelmed from tending to someone with profound needs.
Other wards have been ignored by lawyers who earn their livings as professional guardians with dozens — even hundreds — of adults in their care.
And still others are overlooked by probate judges, known by law as “superior guardians,” who ultimately are responsible but rarely have contact with wards.
The majority of probate courts across the state struggle to monitor their wards. They have antiquated computer systems and a limited pool of people willing to serve as guardians.
Many courts have investigators dedicated to guardianships, but by law their job is only to serve documents to potential wards and to document their appearance, living conditions and demeanor before a guardianship has been established.
In a review of more than 700 adult guardianship cases opened in Franklin County during a three-year span beginning in 2007, The Dispatch identified 67 cases that contained allegations of wrongdoing or neglect filed by family members, social-services agencies and the wards themselves.
Only 25 percent were investigated by the court. And the investigations typically were initiated by either the Franklin County Developmental Disabilities Board or the U.S. Department of Veterans Affairs. Few investigations are initiated by the court.
Complaints by family members and wards often are disregarded. Those declared inattorney competent are left voiceless because they have been stripped of their rights.
“We reduce them to the legal status of a child. So we need protections,” said Julia R. Nack, who runs the volunteer-guardian program through the Central Ohio Area Agency on Aging and is a former probate court investigator. “We need oversight. We need the superior guardians to be well aware of what guardianship best practice is and enforcing best practice.”
Franklin County Probate Judge Robert G. Montgomery acknowledges that the current approach needs reform largely because his court relies too much on lawyers, who are the de facto guardians of last resort.
But he defends his court, saying that it’s not a probate court’s job to buy shoes or keep a prostitute off street corners.
“The court is not, nor was it ever intended to be, a socialservice agency. They’re not the caregiver,” he said. “The court, for the record, is doing a very good job with the resources we have.”
But it is the probate court’s responsibility to make sure that guardians are clothing and caring for their wards.
Some have doubts about the effectiveness of the guardian system statewide. Among them is Ohio Attorney General Mike DeWine, whose office takes complaints about bad guardians as part of its mission to investigate wrongdoing in nursing homes.
“The idea would be if you were a guardian, you’d be an advocate for that person,” DeWine said. “The guardianship system is not providing that for many people.”
Shocking callousness
A hidden camera didn’t capture the whole scene, but it captured enough to make the general’s investigators suspect that an elderly nursinghome resident was being sexually assaulted.
They called the woman’s guardian to alert him to the probable danger so he could move her to a safer environment. But the guardian didn’t share the investigators’ concerns.
The guardian, an attorney, told the investigators, “When you get some evidence, call me back,” DeWine said.
The callousness shocked DeWine and his staff. There was not enough proof to pursue criminal charges, he said, “but boy, there was what I would call circumstantial evidence that would indicate to a reasonable person that ... there was sexual abuse going on.”
DeWine’s senior policy adviser, Ann O’Donnell, was so appalled by the guardian’s dismissal of the suspected abuse that she became a volunteer guardian.
“What you have to have is people who give a damn,” DeWine said.
About two-thirds of the adults under guardianship in Franklin County are indigent. They need someone to make decisions about housing, health care and other important needs. But the system isn’t set up to guarantee that, and some wards end up being neglected.
It happened to Monica Morales.
In 2009, the 79-year-old Columbus woman was found wandering outside a hotel, carrying $5,200 in cash in her purse. Morales was taken to a hospital, where doctors diagnosed mild-to-moderate dementia.
She agreed that she needed help but objected to having her son as her guardian. Doctors called her paranoid when she said her son was only after her money and possessions.
Five days later, her son became her guardian. Within months, he had liquidated her assets, including a house in California, and placed her in a nursing home. A year later, he reported in his annual financial accounting to the court that his mother was broke.
It was the last time court officials heard from him.
Three years later, after repeated attempts to reach the son through official court letters, a magistrate realized that the son was gone and that he didn’t even know where Morales was. He found her at the nursing home.
No one knows what happened to Morales during those three years or who made medical decisions for her.
Last summer, the court recruited Columbus lawyer Steven McGann to be her new guardian. By then, dementia had stolen her memory. She didn’t know what happened to her son or her money, McGann said.
“I’ve never heard from family,” he said. “I’ve never heard of anyone visiting her.”
In fact, he never heard from anyone when she died a few months ago, including the nursing home.
No response
Year after year, the daughter’s pleas to Franklin County court officials were met with silence.
“My mother needs ordered into treatment,” the woman wrote in 2008 of her alcoholic mother. “She’s killing herself.”
In 2011, she wrote that her mother weighed 97 pounds, that her hair was falling out and that she was having seizures. “If she does not get treatment soon, she will die.”
In 2013, the woman reported that her mother finally quit drinking because she had a heart attack. The court never responded. The woman, who didn’t want to be identified for fear of retribution by the court, had asked for help in the courtrequired reports of wards’ well-being.
The reports are the only state-mandated vehicle to communicate with probate judges about the adults under their jurisdiction. The reports generally provide bare-bones information about wards’ living arrangements and how often guardians interact with caretakers, medical professionals and the wards themselves.
It’s a paper trail that generally doesn’t give any real information about a ward’s quality of life or whether his or her needs are being met. It is not shared with family members or other interested parties unless they physically go to the court to review the case file.
And there’s nothing in state law or Ohio Supreme Court rules that spells out what courts should do with those
reports if there are signs of trouble.
Stark County Probate Judge Dixie Park has learned not to put too much stock in the reports. Park recruited a team of volunteers to visit wards under her jurisdiction.
One volunteer called on an elderly woman and found her living at home with two disabled sons. She was wearing diapers and crawling around the house on her hands and knees. Her daughter, who was her guardian, would leave food on the floor — as if for a family dog — because she sometimes would not see her mom for days. The woman weighed 84 pounds.
Park moved the frail woman to a nursing home and found her a new guardian.
“Even though the daughter said she made sure she got enough food, when she was at the nursing home for the first three days, she ate constantly because she was so hungry,” Park said. “It was just a horrific situation.”
If not for the court-appointed visitor, Park never would have found out about the woman’s condition, because the daughter faithfully filed her annual guardianship reports and said everything was fine.
Blaming others
Since entering guardianship in 2008 because she threatened to harm her unborn child, Joshlin Hill has seen little change for the better.
The 34-year-old still is turning tricks, living on the streets from time to time and spending lots of time in the Franklin County jail.
In fact, since lawyer Paul S. Kormanik became her guardian, Hill has been arrested more than three dozen times on prostitution- and drug-related charges.
Despite her dangerous lifestyle, a diagnosis of schizophrenia and a legal declaration of incompetency, the court has never investigated why someone under guardianship is sometimes homeless and often peddling sex for $20.
Kormanik blames Hill for her predicament because she leaves any treatment facility he puts her in. He also blames the health-care system for not making long-term care possible for her.
“As long as we stay appointed (her guardian), there’s things we can do to help,” Kormanik said. “Eventually, she’s probably going to have physical problems that will keep her (from the street) and then we’ll be able to get her in a nursing home.”
Once guardianship is established, most counties never again have face-to-face contact with wards. More than twothirds of counties do not randomly check on them.
“All too often, the consequences (of the mental illness) are that they are abandoned by their families,” said David Royer, executive director of the Alcohol, Drug and Mental Health Board of Franklin County.
Hill has no known next of kin. That leaves her, and others like her who need help, at the mercy of strangers — typically court-appointed lawyers.
At least a third of Franklin County’s guardians have no ties to their wards.
“Attorneys are good at the law, but I’m not sure they’re good at guardianship,” Royer said.
About three-quarters of adults in guardianship in Franklin County have been declared incompetent because of severe mental illness or mental disability. Providing care for them can be especially challenging if they are not receiving services that connect them with a caseworker.
Caseworkers, especially those with county developmental-disabilities boards, often serve as watchdogs over adults in guardianship.
Such was the case for Grant Richardson.
Born with Down syndrome, Richardson lived at his parents’ Hilliard home until they died, then moved in with a sister. His siblings disagreed about what was best for him. They argued over who should be guardian and where Richardson should live.
After Richardson endured years of family strife and being sheltered from the community, his caseworker wrote to the court that Richardson and his family had been evicted from their house and were living in a motel. He had been missing doctor’s appointments and wasn’t taking his medications properly.
The court appointed McGann as his new guardian, and the attorney immediately began apartment hunting for Richardson. The 44-year-old man now lives in a house with a roommate, has 24-hour care and works at one of the county’s sheltered workshops.
“We felt like he would thrive, and he has,” said McGann, who visits monthly. Developmental-disabilities-board caseworkers “are great. They’re like a pseudo staff because they do so much work.”
Extra eyes
Columbus lawyer Kormanik has nearly 400 wards to monitor. “And I could take another 1,000 if they were in nursing homes,” because the staff members serve as his eyes and ears, he said.
“That is an absurd statement. I find that shocking that anyone would think that,” DeWine said. “You couldn’t have that many people and do what you’re supposed to be doing.”
And nursing homes aren’t without problems. On any given day, DeWine’s office investigates as many as 300
One elderly woman whose daughter was her guardian was found wearing diapers, crawling on her hands and knees, eating food left on the floor for her.
nursing-home-related complaints.
About 900 of the county’s 4,500 adult wards assigned to lawyer-guardians live in nursing homes, according to a Dispatch analysis of Franklin County court records and Medicare data.
More than 80 percent of them are indigent and live in facilities that Medicare has reported as being its lowestrated, based on poor health inspections, staffing levels and quality-of-care measures.
“Professional guardians who have so many wards just aren’t in touch with them,” said Beverly Laubert, the state’s longterm-care ombudsman who advocates for patients and investigates complaints. “There’s this general perception that if you go to a nursing home, you’re safe. I think it requires a greater diligence.”
Montgomery said his court’s two investigators regularly visit nursing homes to check on wards, but he acknowledged that is not fail-safe.
He, too, doesn’t like that a handful of lawyers are guardians to hundreds of adults or that there isn’t regular contact with wards.
But “it’s the system that’s in place. We don’t do anticipatory care,” Montgomery said.
In the past year, three nursing homes that were home to at least four dozen Franklin County wards have been closed — or threatened with closing — because of failed inspections or unsafe environments.
Laubert headed up efforts to find new homes for the 130 residents of Carlton Manor in Washington Court House after the state closed it in February. More than three dozen Franklin County wards lived at the home, which had failed numerous health inspections.
Laubert called guardians to notify them about the upcoming closing and to ask their assistance in relocating their wards. Some of them responded, “OK, let us know where they end up,” she said. “There just wasn’t a great deal of involvement.”
The most shocking moment of all, however, was when Laubert saw the man leave without shoes.
And for DeWine, he was stunned by the guardian’s hohum attitude in the case of the suspected sexual assault. He said it reinforces his commitment to nursing-home safety.
“Everyone has to have an advocate,” he said. “I don’t know how anyone could not be shocked or appalled.”