AdventHealth Orlando announces changes to its patient guardianship procedures, advocates for statewide reform


ORLANDO, Fla., Nov. 22, 2019 — AdventHealth Orlando announced changes to its procedures in guardianship situations, as well as its advocacy for significant reforms to the entire guardianship program statewide. The changes are the result of a sweeping independent audit AdventHealth has undertaken using outside counsel to identify improvements and develop an action plan moving forward.

The changes take effect immediately and include:

  • The appointment of a new guardianship review panel
  • A mandatory guardianship review checklist
  • New guardianship education and training for care managers

The new guardianship panel will include leaders from care management, nursing leadership and legal counsel. Guardianship will only be considered after the completion of the mandatory review checklist, which includes a determination made by at least two physicians trained to evaluate patient capacity, as well the exhaustive search we do for family and friends willing to take on the guardianship role.

Additionally, AdventHealth will no longer pay any guardian for services. As part of an ongoing investigation, it was revealed that AdventHealth was double-billed and paid $4 million to former guardian Rebecca Fierle over the past decade for care management and guardian services. AdventHealth spends nearly $30 million on its care management program annually, which includes guardianships.

“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. “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, as nothing is more important than ensuring the safety and care of our most vulnerable patients.”

During the upcoming legislative session in Tallahassee, AdventHealth will also be aggressively supporting several statewide reforms, including:

  • Strengthening the statutory obligation of the Florida Department of Children and Families (DCF) to care for these patients, which has shifted to hospitals.
  • An intensive, statewide review of cases where DCF refused to assist patients.
  • Increased funding and an expansion of the public guardianship program to increase the number of available guardians.
  • Additional oversight by the courts, the Florida Department of Elder Affairs and other state agencies. Currently, guardians are only required to make one court report each year, sharing only the patient’s location and medical condition.