AdventHealth's arrangement with guardian called conflict of interest

Rebecca Fierle, a former Orlando, Fla.-based professional guardian under criminal investigation, had an unheard-of billing relationship with AdventHealth, industry experts told the Orlando Sentinel.

Ms. Fierle has been in the spotlight recently after an investigative report released by the Orange County comptroller found that she improperly billed Altamonte Springs, Fla.-based AdventHealth nearly $4 million between January 2009 and June 2019 for services provided to 682 patients. The comptroller accused Ms. Fierle of failing to report the payments to the court, as required under state law, and sending bills to both AdventHealth and the court, among other findings.

"I've never seen that," David Strachman, a Rhode Island family and elder law attorney, told the Orlando Sentinel of the arrangement between AdventHealth and Ms. Fierle. "Even when hospitals identify somebody who needs a guardian, they're making a referral — they're not hiring them. That would be a conflict of interest."

The newspaper asked other Florida hospitals about their use of guardians, who make legal, financial and medical decisions for elderly or disabled patients. The Orlando Sentinel did not get a complete picture of other Florida hospitals' use of guardians since eight of the state's 16 biggest hospitals didn't respond to questions.

AdventHealth spokesperson Bryan Malenius told the newspaper that the organization contracted with other people besides Ms. Fierle to serve as patient guardians, healthcare proxies or surrogates and that "whenever we have paid a professional guardian, it's always been to act in the best interests of the patient to ensure their needs are met."

Still, the Orlando Sentinel reported that experts said the direct financial relationship between Ms. Fierle and AdventHealth is uncommon and concerning.

Ms. Fiere did not return the newspaper's request for comment.


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