A Tribune investigation into some Chicago-area hospitals’ questionable use of the state’s guardianship system has resurrected legislation that would exclude private entities from being appointed as guardians in such cases.

The newspaper reported in November that if a patient in need of guardianship had property or other assets, hospitals and their lawyers usually asked the court to appoint a certain private care management organization as guardian. That organization often charges more for its services than county public guardians, which along with fees billed by lawyers working on the cases can quickly drain a person’s savings, the Tribune found.

The bill, filed last week, would require the appointment of a state or county public guardian, if one is available, when hospitals, nursing homes or similar institutions file guardianship petitions in court.

State Rep. Marti Deuter, an Elmhurst Democrat in the second year of her first term, said she is working with AARP Illinois on the legislation. The Tribune’s two-part series underscores the need for reforms, she said.

“As I was reading the articles, it was clear to me that we can do better for our seniors,” Deuter told the Tribune. “My interest as a policymaker is really to make sure government works as well as it can for people, and affordability is a big issue. As your articles pointed out, this is draining (people’s) resources very quickly in some cases.”

Earlier versions of the bill failed to pass in 2024 and 2025 when introduced under former state Rep. Terra Costa Howard, who left the legislature last year when she became a judge. The earlier measure faced heavy opposition, including from the Illinois Health and Hospital Association, whose concerns included the possibility that the change could cause some patients to remain hospitalized beyond medical necessity.

Though advancing a hotly debated measure will likely be an uphill battle during an election year, Deuter said she hopes to work with all stakeholders on the issue and put forward “the best legislation we can.”

The Tribune’s investigation revealed that Chicago-area hospitals initiated hundreds of guardianship petitions in an 18-month period, a step they said is intended to protect patients who have lost the ability to make decisions and who have no friends or family willing and able to take charge. But in many cases, the Tribune found the arrangement facilitated patients’ discharge to subpar nursing homes, and it sometimes stripped families of control over their loved ones.

Lori Hendren, AARP Illinois’ senior associate state director of advocacy and outreach, said the Tribune “has shined a light on a troubling situation that may be impacting far too many of our most vulnerable residents — individuals who may be isolated, medically fragile, and without family or trusted support to help navigate critical decisions.”

Hendren added: “Guardianship is one of the most consequential legal interventions a person can face. It can remove fundamental rights and control over personal, medical and financial decisions. For that reason, it should be pursued only when truly necessary, used in the least restrictive way possible, and paired with strong due process protections, transparency, and meaningful court oversight.”

The vast majority of the hospitals’ guardianship petitions involved people with little money who were placed with the Office of State Guardian at the hospitals’ expense. But the Tribune reported that when patients did have assets, the law firm that Chicago-area hospitals commonly hire in such cases — Monahan Law Group — usually named a particular organization — Midwest Care Management — as the hospital’s preferred guardian. In many cases, both parties then benefited from providing months or years of services funded by the former patient.

Ben Topp, owner and managing director of Midwest Care Management, said in a statement Monday that although state and public guardians play a vital role in protecting vulnerable adults, “We also believe the system functions best when courts retain discretion and petitioners are able to thoughtfully evaluate all appropriate options — public, private, corporate, friends, or family members — based on the individual’s specific circumstances.”

“The focus should remain on identifying the right guardian for each individual, not limiting the court’s ability to make case-specific decisions,” Topp said in the statement.

The Illinois Health and Hospital Association is reviewing the new legislation and has reached out to the bill sponsor to learn more, spokesperson Paris Ervin said in a statement Monday.

The hospital association looks forward to working with the lawmaker and other stakeholders “on what additional improvements may be appropriate to strengthen existing protections in the guardianship statute; as well as thinking through with her the possible unintended consequences of the proposed legislation on vulnerable patients, such as delays in obtaining timely consent for treatment,” the statement said.

Joseph Monahan, founding partner of Monahan Law Group, did not provide comment on the new legislation, but he previously told the Tribune he opposed similar legislation in the past because it would have resulted in “limiting choice based solely on the petitioner and removing judicial discretion.”

Cook County Public Guardian Charles Golbert, whose office oversees the cases of more than 600 adults under guardianship, has spoken to the Tribune about his long-standing concerns regarding what he called the injection of a “profit motive” into guardianship services.

Still, in an interview this week, Golbert said he worries the proposed legislation is too restrictive. He said there may be cases where a private guardian is needed, such as when a public one is not available or there is a conflict of interest.

“The approach that we would like to take is to make sure that before a private guardianship corporation is appointed, that the court makes a finding that this is actually appropriate for this person and the facts of the case, taking into account whether any family members are available,” he said.

“In the Tribune’s series, there were examples where family members were willing and able to be the guardian but the hospital was apparently very eager to open up the bed and nonetheless made it a private guardianship corporation that was appointed instead of the family member.”

Before accepting an appointment, Golbert argued, the private corporation should be required to meet with the individual and complete an assessment to see if less-restrictive alternatives are more appropriate. He said his office does this in all cases.

Golbert said he is “thrilled” the Tribune’s reporting is stimulating legislative efforts and applauded Deuter for “taking the lead.” He said: “Hopefully now there is momentum to move needed reforms across the finish line.”

The House returns to Springfield next week. Deuter’s bill will likely end up in the Judiciary – Civil Committee, which Rep. Jennifer Gong-Gershowitz chairs.

“It is critical that we bring transparency and accountability to this process to ensure that the best interests of vulnerable people are protected at every stage,” Gong-Gershowitz, a Glenview Democrat, said in a statement.

cmgutowski@chicagotribune.com
lschencker@chicagotribune.com