Capitol Correspondence - 11.26.19

Investigative Series: Virginia Hospitals Suing Patients for Guardianship

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The Richmond Times-Dispatch issued the first installment in a three-part series on Virginia’s VCU Health System, which has been suing to obtain the guardianship of patients with low incomes, including people with disabilities. The Health System’s efforts represent a significant threat to the civil rights of people with disabilities, as the transfer of guardianship would stirp people of their rights to make their own decisions about their health care and treatment options.

As reported by the Richmond Times-Dispatch:

“A yearlong investigation by the Richmond Times-Dispatch, which involved analyzing more than 250 court cases and interviewing more than two dozen people, revealed that VCU Health System has taken hundreds of low-income patients to court over the past decade to remove their rights to make decisions about their medical care. This process, which frees up hospital beds at VCU Health System and saves thousands in uncompensated costs, often results in sick, elderly or disabled patients being placed in poorly rated nursing homes, sometimes against the wishes of their own family members.

In these cases, VCU Health asks the court to grant an attorney at the Thompson McMullan law firm the power to make critical medical and life decisions for its patients. The court orders the attorney to represent the best interests of those patients, but the law firm continues to look out for the hospital’s interests on dozens of guardianship cases each year. At the same time, the hospital is often losing thousands of dollars every day the patients it takes to court stay in the hospital. It’s an arrangement that calls into question the attorneys’ abilities to independently advocate for the best interests of the patient, according to 10 people who specialize in guardianship, medical ethics, law and disability rights.


Hospitals have a strong financial incentive to initiate guardianship proceedings, according to a 2018 report to the Virginia General Assembly by the Department for Aging and Rehabilitative Services on the state Public Guardian and Conservator Program.

‘Hospitals are trying to get folks under guardianship to get people discharged if they don’t have a close family member because they want to get them out,’ said David Hutt, managing attorney for community integration at the National Disability Rights Network, a group that advocates for people with disabilities.

Majette said the research he is aware of says that ‘it’s not a good use of resources and it’s not a safe place for the person to be,’ to keep someone in a hospital.”