ORLANDO, Fla. -- A former Florida guardian accused of filing "do not resuscitate" orders without her clients' permission had authority over hundreds of wards without court supervision, according to an audit released Thursday.
The audit by the Orange County Comptroller's office said Rebecca Fierle billed $3.9 million to the AdventHealth medical system in the past decade for acting as a guardian for 682 incapacitated patients in legal and health care matters.
Less than a third of those clients were in Florida's guardianship system, while the rest weren't and had no court oversight. AdventHealth paid Fierle $2.8 million for clients under court supervision and another $1.1 million on behalf of those clients without court supervision, according to the audit, which refers to the unsupervised wards as "Group 2" patients.
Florida law prohibits a guardian from having business relationships with a ward without court approval or notification.
"It is clear how guardianship is established under Florida law," the audit said. "However, it is not entirely clear how Ms. Fierle obtained the authority to act and exercise discretion over the Group 2 patients."
Fierle had 450 guardianships when she resigned amid a criminal investigation this summer. Authorities began probing her work after the death of a 75-year-old man in a Tampa hospital whose doctors were barred from trying to save his life because Fierle had filed a "do not resuscitate" order. Investigators said that order went against his family's wishes.
The controversy prompted the resignation of Florida's director Office of Public and Private Guardians, Carol Berkowitz, at the request of Florida Elder Affairs Secretary Richard Prudom this summer.
Gov. Ron DeSantis also called for a vigorous investigation into the state's guardianship program.
According to the audit, in one case, Fierle was paid almost $289 for paying bills and discussing with the ward about a storage unit whose contents were about to be auctioned off because a $299 bill wasn't paid. The storage unit bill was never paid to stop the auction, despite Fierle being paid, the audit said.
The audit identified other cases where Fierle double-billed AdventHealth or billed the health care system for cases that belonged to other guardians.
The audit also uncovered instances where "do not resuscitate" directives had been obtained for Fierle's wards not under court supervision. The audit recommended a review of those decisions.
Fierle's attorney, Harry Hackney, didn't immediately respond to an email seeking comment on Thursday.
AdventHealth spokesman Bryan Malenius said in an email that officials at the hospital system were "surprised and dismayed" by the audit findings that Fierle improperly billed them and withheld information from the court.
"We are committed to lending our voice to reforming the guardianship system because it is core to our mission to ensure those who need this kind of help are cared for and protected," Malenius said.
This story has corrected the spelling of AdventHealth. It is AdventHealth, not Advent Health.
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