ORLANDO, Fla. — AdventHealth has stopped paying professional guardians for services and has put new guardianship procedures in place as part of a series of changes it's instituting amid growing scrutiny into the state's guardians system.

The changes were spelled out in a news release by the health care system Friday.

“They’re taking steps to ensure they’re not in the same situation as before,” said Dr. Sam Sugar, founder of the Americans Against Abusive Probate Guardianship.

In September, an Orange County Comptroller's investigative report revealed that AdventHealth had paid almost $4 million over a decade to former guardian Rebecca Fierle, who is now the subject of several state criminal investigations.

That included more than $1 million for patients who were never "wards," or seniors in a guardian's care.

"They have a problem they'd like to solve," Sugar said.

The problem, he says, is that hospitals are paid for a patient to stay a certain amount of days, but the hospital loses money for any time more than that. 

So if no family or friends can be found, the hospital petitions a judge for a guardian.

“They were paying somebody, namely a guardian, to empty their beds of patients who might cost them money or make them lose money,” Sugar said.

Now the hospital says they will not pay any guardian for services. 

“While our goal is always to help the patient, recent events clearly indicate we were too trusting of a flawed system. We are committed to reforming the guardianship system both inside our walls and in Florida,” said Advent Health CEO Daryl Tol in a statement Friday.

In May, Steven Stryker, a ward of Fierle, died at a Tampa hospital after Fierle filed a "do not resuscitate" order against his family's wishes. Stryker's daughter, Kimberly, who lives in Virginia, and a longtime family friend say AdventHealth petitioned the Ninth Circuit Court to appoint Fierle as his guardian without contacting them.

AdventHealth says at the time, it couldn't locate family members. But an investigative report by the state's Office of Public and Professional Guardians says "contact information was listed on the Advance Directive on file with the hospital, and our office found her contact information with a quick Google search."

"Whenever we petition the court to appoint a professional guardian, it’s always a last resort and to act in the best interests of the patient," said Daryl Tol, president and CEO of AdventHealth’s Central Florida Division in the news release.

Among the other procedural changes AdventHealth announced Friday:

  • It has appointed a guardianship review panel, which will include various leaders from care management, nursing, and legal counsel;
  • It has drawn up a mandatory guardianship review checklist that will require a determination by at least two physicians trained to evaluate patient capacity before a guardian is appointed;
  • New guardianship training and education for care managers.

Fierle has resigned from all of her cases statewide as local and state leaders vow to examine the faults of the state's guardianship system.

The health care system said it supports reforms to the state guardian system. Its new procedural changes were effective immediately.