GREENWOOD, Ind. – Can a sole professional guardian handle hundreds of cases at a time? That’s happening in Indiana, where Debra Woods typically earns $35 a month for each of the 200-plus clients under her watch.
Woods used to work for a guardianship company and set off on her own in 2010. Her caseload has ballooned since, in a state that doesn’t limit a guardian’s number of cases.
Since 2016, Woods has taken on at least 420 clients, Indiana court records show. She often represents nursing home residents, many of whom die in the ensuing months or years. In an interview in January, she confirmed her current client list exceeded 200.
Woods’ experience speaks to the absence of meaningful oversight in the guardianship industry, Bloomberg Law found in a six-month examination. The limitless caseloads and lack of rigorous vetting of guardians are cornerstones of a system in which adults lose nearly all their rights to another person, sometimes a family member, other times a professional guardian or lawyer. It’s the same system pop star Britney Spears escaped.
To be clear, Woods, 58, is breaking no rules by taking on so many clients. Indiana allows her to do so, nursing homes continue turning to her, and judges routinely approve her petitions. She is nationally certified, which she said in court filings shows her commitment to the work, though Indiana doesn’t require certification.
Woods said she must maintain that caseload to earn a good living. The reason: In Indiana, she earns $35 a month per client, a cap in place for nursing home residents on Medicaid. If her client has financial means, she charges $35 an hour.
“If there was a bigger guardian fee, I would be able to hire individuals who would assist with that much-needed service,” Woods said. “I have to have a caseload like this to make it work.”
A caseload that high is rare but not unprecedented. Legal experts say they’ve seen caseloads of 200 in California, Florida, and Michigan. In Indiana, one company lists a roster of 230-plus cases since 2016, though all aren’t active and they are divided among two guardians.
“How can a guardian effectively carry out its obligations for 200 people?” asked Julie Kegley, senior staff attorney for the Georgia Advocacy Office. “It’s a disservice to the ward.”
Bloomberg Law asked a half-dozen industry veterans, including disability rights lawyers, a guardianship reformer, and American Bar Association specialist, what they consider the maximum number of cases a guardian could ably handle.
One said 20, another 25, and a third 30. A fourth said anything over 10 cases at a time “would raise some flags.” None had a cap anywhere near 200.
“We probably don’t have a real great system for professional guardians in Indiana,” said Kevin Barton, a Johnson County Superior Court judge who questioned Woods’ handling of one case. “Professional guardians don’t have to be licensed. There really is no training qualification for them.”
He adds, “How much time can you really spend effectively for pay of $35 a month?”
Even at that miniscule monthly rate, a guardian with huge caseloads could make a decent living. A guardian with, say, 215 active cases at $35 a month would earn $90,300 a year; more if the guardian also billed some clients at a higher hourly rate.
In Indiana, a guardian’s duties include being responsible for an incapacitated person’s care, custody, and property. The guardians are to become “sufficiently acquainted” with their capabilities, limitations, and needs, state law says, and are to report to the court on their physical or mental well-being. “The guardian shall encourage self-reliance and independence of the protected person.”
In recent years, Woods has served as a guardian for residents in at least 50 nursing homes in Indiana, court filings show. Many times, she’ll be the guardian for several residents in one home at once. “Let’s say I have five people in that building,” she said in an earlier interview. “I’ll go and visit everybody in that building. Or if I have a care plan over the phone, I’ll go ahead and get an update on everybody.”
One Indianapolis nursing home that often turns to Woods is American Village. Another, North Woods Village, is in Kokomo, an hour north. A third, Southwood Healthcare Center, is in Terre Haute, some 75 miles west of Indianapolis. Bloomberg Law sought comment from all three on the guardianships in their nursing homes. None responded.
Nationwide, some lawyers who serve as guardians charge hundreds of dollars an hour for their services, but guardianships typically make up just a portion of their legal dockets. For Woods, it’s her livelihood.
She believes the monthly pay should be $100, but, even without that boost, said she strives to give her clients a voice and not restrict their rights.
“I treat my individuals as if they were paying $100 a month,” Woods said. “I try to do the best regardless of what the fee is and that’s because I love what I do.”
Her wish for higher pay is surely a long shot.
“I mean basically there’s no money,” Barton said. Probate courts in general are “fairly low in terms of priority because really nothing is out there where it catches the public’s attention.”
Problem Case
In Barton’s courtroom, the case of Woods’ client Patricia Persinger drew his judicial rebuke.
Woods didn’t take Persinger to her cancer doctor appointments during the Covid-19 pandemic, court records show. Adult Protective Services filed a complaint, and a local prosecutor got involved.
“I was pretty disturbed with that,” Barton said. “I basically blew a fuse.”
Persinger is a nursing home resident at Greenwood Healthcare Center, some 30 minutes south of the Indianapolis airport. In 2020, Woods had petitioned to put Persinger under guardianship. As in other cases involving nursing home residents, she cited a doctor’s report, often just one page, saying Persinger was incapacitated and needed a guardian.
Persinger received a pharmacy degree from Butler University in 1962, the school confirmed, and she said she was a pharmacist by trade.
In an interview at Greenwood last fall, Persinger said she never wanted a guardian, whether it was Woods or anyone else.
“I didn’t like it,” Persinger said. “I didn’t need it.” She felt she had “no voice” in the process.
Persinger scoffed at professionals saying she couldn’t handle her affairs. “I can’t take care of myself. I can’t take care of my bills,” she said, dismissing those views. “I can be a little bold when I’m upset.”
Woods said she didn’t take Persinger for her cancer treatments because she refused to see the doctor. “She was adamant that she didn’t need treatment,” Woods said. “Just because somebody has a guardian, that doesn’t mean you can make them do anything.”
That explanation didn’t sit well with Barton, who wrote in court papers: “It is unclear how an incapacitated person can block medical services from being provided.”
Woods stepped aside in 2021 and a county senior volunteer group became Persinger’s guardian. Within a week group members took her to her oncologist, where she received radiation and oral chemotherapy, court records show.
Bloomberg Law asked legal professionals to analyze topics including the role guardianship plays in states and what reforms would serve vulnerable populations.
Persinger ultimately petitioned the court to end the guardianship. She remembers the day nursing home personnel came to whisk her to the court and an in-person meeting with the judge. “We’re taking you to the courthouse,” she recalled. “Get ready.”
Once there, she told the judge she was in the dark about the decisions affecting her. “I told him, ‘I don’t know about this. I don’t know about that. I don’t know about anything.’”
Barton granted her request and terminated the guardianship in February 2022. “She wanted to make her own decisions,” he said. “Essentially we got out of the picture.”
In a follow-up call this February, Persinger said she now hopes to move out on her own. “I’m out of the guardianship,” she said, “and I’m still in the nursing home.”
Legal Support
Oftentimes, Woods works with the law firm Havrilla & Nolin, which specializes in elder law and nursing home issues. When they collaborate, its legal fees, which run into a few thousand dollars in complex cases, are paid through clients’ accounts.
“She does have a high caseload, but I’ve never had a situation where something has not been done or fallen through the cracks,” partner Felicity Havrilla said. “I wish I could clone Debra Woods.”
Woods is a “phenomenal” guardian, Havrilla said, “who always answers her phone, who always responds to email.”
As Woods’ caseload grew, court records show, items sometimes did slip through the cracks. Woods failed to file a required status report in one case and faced a possible contempt citation. The judge in another case said a client’s final accounting was unacceptable. In a third, Woods hadn’t notified all kin their relative was under guardianship.
Woods said she addressed those issues but acknowledged she must improve her report filing. And, she knows her high caseload has been a topic of courthouse conversation.
“If I start to feel overwhelmed or if I can’t keep up,” she said, “I will probably stop taking cases.”
To contact the reporter on this story:
To contact the editors responsible for this story: