Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.
Oklahoma Watch | J.C. Hallman
In 2021, Vietnam veteran Leroy Theodore, Sr., of New Orleans, suffered two catastrophic strokes that left him quadriplegic, unable to communicate apart from answering questions with eye movements.
Theodore’s life became a nightmarish tour through health systems in Louisiana and Oklahoma, bouncing from hospital to hospital for several years, until 2024 when one of his daughters, Valerie Parks, having completed training in order to care for her father, was able to provide a bedroom in her Sapulpa home that had been transformed into a fully outfitted hospital room.
In early April, the trach tube that Theodore needed in order to breathe properly became blocked and his breathing became strained; Parks called an ambulance to take him to St. Francis Hospital in Tulsa.
The nightmare got worse.
Without warning, St. Francis seized control of Theodore, 76, initiating an effort to obtain legal guardianship over his finances and health decisions, a legally murky practice that in the last decade has come to be associated with fraud.
Parks said she and her siblings were denied access to Theodore, even though Parks had been granted power of attorney over her father. The family called the police, but no report was made because Adult Protective Services had been called. The family was told they had to leave the hospital property.
They would not set eyes on Theodore again for one and a half months.
In that time, a saga would unspool involving St. Francis, the judicial system, APS and the Oklahoma Department of Human Services that would raise the specter of a horrifying proposition.
In recent years, elder guardianship scams have become common across the country. Hospitals and nursing homes have sought and obtained legal guardianship over thousands of poor and elderly adults for financial gain. A survey of recent literature on the subject reveals that millions of dollars are at stake, in what may be bilked of patients and the government in Medicaid fraud and what may be awarded when fraud is exposed and punished.
The case of Leroy Theodore suggests that a nationwide plague of guardianship abuse may have arrived in Oklahoma.
Charges of Neglect Were Unsubstantiated
St. Francis Health System has refused all requests for comment on this story.
St. Francis had a history with Theodore; he had been in and out of St. Francis facilities, most recently in January.
At that time, St. Francis initiated an investigation with APS based on a claim of caretaker neglect; Parks was incapable of caring for her father, it was said.
On March 10, APS Specialist Abby Walden issued a report after visiting Parks and Theodore in Sapulpa: the allegations of neglect were unsubstantiated, Walden’s report concluded.
After that, Parks and her siblings said, St. Francis began to quash the flow of supplies that Parks needed to properly care for her father, including products intended to keep his trach tube clean.
In April, the trach tube began to crust over, resulting in difficulty breathing; trained in trach tube care, Parks removed Theodore’s tube before calling an ambulance.
Since then, family members said, the hospital and APS have offered conflicting explanations for the effort to seize guardianship of Theodore: the removal of the trach tube and long-standing bedsore problems.
It wouldn’t be that easy to win guardianship.
On April 25, Parks and her siblings initiated their own action; Creek County District Court Judge Pam Hammons awarded a 30-day guardianship to Parks and a sister and brother, Larissa Dudkiewicz and Leroy Theodore, Jr.
Four days later, on April 29, Tulsa County District Court Judge Loretta Radford awarded a 30-day guardianship to the APS division of DHS.
It was a standoff.
By that point, Theodore’s family didn’t even know where he was.
Down to the Bone
Leroy Theodore served in Vietnam when he was very young, so long ago that his family wasn’t sure what he’d done during the war. It had to do with supplies, and it was sometimes dangerous.
“He made it through Agent Orange and all that,” Parks said.
He returned home to New Orleans and fathered three girls and a boy; a marriage didn’t survive, but the family did, even as a move first took all of them to New York. Eventually, Theodore returned to Louisiana and the children spread out across the country.
One daughter, now deceased, settled in Moore.
After Theodore’s first stroke in 2021, a stent surgery at Tulane Hospital intended to prevent future strokes caused his second stroke by mistake, which resulted in his entire body locking up, his family said.
His children descended on New Orleans to care for him.
“Every day I would teach him the word,” Parks said.
Theodore was moved to a nursing home, but it was a disaster; within weeks, he developed bedsores that cut down to the bone.
The family decided to take him to Oklahoma, inventing a makeshift ambulance for the 10-hour drive.
As each of the surviving children arranged to relocate to Oklahoma, St. Francis performed a surgery on Theodore for his bedsores; Parks lived in a hotel while she was searching for a home and training in trach care.
Theodore bounced from St. Francis to swing beds and long-term acute care hospitals, known as LTACHs.
At one of the LTACHs, the family said, they found maggots in Theodore’s bed.
The family was left with the sense that the hospitals wanted to put Theodore on hospice care and let him die; that’s not what their father wanted.
“He’s fighting to live,” Parks said.
When Parks was seeking power of attorney, a lawyer was brought in to bear witness to Theodore’s wishes; Theodore signaled yes by looking up, no by looking down.
When Theodore was asked if he wanted Parks to make his decisions for him, his eyes went up; when he was asked if he wanted to be on hospice, his eyes went down.
“Oh, yeah, that’s clear as day,” the family recalled the lawyer saying.
This is Probably New to Oklahoma
In May, the family said, the Tulsa judge, Radford, called them on the phone with an APS lawyer on the line to ask them to drop their guardianship status.
They refused.
Radford told the family she would call the Creek County judge, Hammons. A short time later, Hammons vacated the family’s guardianship, and Radford awarded temporary guardianship to APS, pending a hearing scheduled for July 1.
Radford, Hammons, the APS, DHS, and a public defender assigned to Theodore in Tulsa all refused comment for this story.
In recent years, guardianship schemes ranging from defrauding Medicaid to the outright looting of individual estates in New York, Nevada, and Virginia have received extensive coverage from ProPublica, The New Yorker and the Richmond Times-Dispatch. A common refrain in the coverage is the scarcity of reliable data on the breadth of the problem.
Experts estimate that 1.5 million individuals are under some form of guardianship in the United States, but that’s a guess. A 2015 New York Times piece, “To Collect Debts, Nursing Homes are Seizing Control Over Patients,” lamented the dearth of information.
“Throughout the country, data is lacking on the most basic facts about guardianships, even how many there are,” the Times said.
“The Use and Misuse of Guardianship by Hospitals and Nursing Homes,” by Michigan Elder Justice Initiative Director Alison Hirschel and National Consumer Voice for Quality Long-Term Care Executive Director Lori Smetanka, list numerous financial incentives for hospitals seeking dubious guardianships.
Ensuring hospital bill payment, avoiding penalties for excess readmissions and fear of negative media coverage for discharging incapacitated patients may motivate an institution to seize control of a patient, regardless of the wishes of the patient or the patient’s family.
“Petitions for guardianship filed by hospitals or nursing homes should be viewed cautiously—especially because of the extraordinary imbalance of power between the healthcare institution and the individual,” Hirschel and Smetanka wrote. “Great care should be taken to avoid conflicts of interest when health care facilities are involved in the litigation.”
The Richmond Times-Dispatch came to very similar conclusions after a year-long investigation of hundreds of guardianship cases involving low-income patients and the Virginia Commonwealth University Health System. Veronica Williams, a Newport News elder law attorney heavily consulted for the Times-Dispatch story, said that hospitals may pursue inappropriate guardianship petitions even when a suitable caregiver is available, either because a hospital wishes to move a patient out of an acute care bed or because of disagreement over the family’s treatment preferences.
The cases described in the Times-Dispatch’s comprehensive three-part series bear an uncanny similarity to the case of Leroy Theodore.
A decade ago, Rick Black was inspired by an attempt to seize guardianship of his own father-in-law to found an organization dedicated to exposing guardianship fraud, the Center for Estate Administration Reform. Black warned that many attorneys make money from fraudulent guardianships and are therefore incentivized to hide the scope of the problem.
“The legal community has been very good at making sure the number of guardianships remains unknown,” Black said.
Presented with documents related to Theodore’s case, Black speculated that Oklahoma may have remained free of guardianship fraud until now because it’s off the beaten path and because Oklahomans may be more trusting of health institutions.
“This is probably new to Oklahoma,” Black said.
In a 2021 article for the Oklahoma Bar Journal, Edmond elder law attorney Sarah C. Stewart praised laws that were passed to protect vulnerable adults. Those measures may not have been enough.
“The circumstances surrounding guardianships have always been ripe for abuse,” Stewart said. “Those who wish to harm the vulnerable have used these laws to embezzle assets and take away the rights of those who cannot protect themselves.”
The State of Tulsa
Oklahoma Watch met with an individual who has intimate knowledge of the inner workings of the St. Francis Health Care System. The individual described a sudden and recent uptick in the number of instances in which the hospital has sought legal guardianship of low-income individuals.
The guardianships were a closely guarded secret, the person said. The individual said that as many as 15 people under guardianship were being hidden at the Laureate Psychiatric Clinic and Hospital, attached to the St. Francis campus in South Tulsa.
To repeat, St. Francis refused all comment for this story.
Esther Houser served as the Oklahoma Long-Term Care Ombudsman for many years before retiring a decade ago, though she has remained in close contact with her successor and with APS staff.
Houser recalled attending conferences and learning of bad practices that might make their way to Oklahoma; she attempted to install best practices to head off abuses, but said that times seem to have changed.
Provided with the details of Theodore’s predicament, Houser was incredulous.
“That’s the most bizarre story I think I’ve ever heard,” Houser said. “There are times when hospitals and families are in conflict about who is abusing who, but in a creepy way, it’s human trafficking.”
Houser offered praise for APS, but acknowledged that the service varied county to county; she recalled Tulsa as a wholly different breed of cat.
“We used to refer to Tulsa DHS as the State of Tulsa, because they would just do things their own way and say they were using a different model,” Houser said.
Models aside, there was no explanation for why Theodore’s family had been denied access to him.
“Even a guardian cannot restrict access unless there is special permission from a judge,” Houser said.
When Houser became aware of Theodore’s predicament, she contacted the head of APS and her successor at the ombudsman’s office, William Whited, triggering an inquiry into the case.
The ongoing investigation may take weeks to complete, Whited said in an email.
You Know Why
It’s unclear whether the July 1 hearing specified in Judge Radford’s order awarding guardianship to APS will be affected by the investigation from the ombudsman’s office.
Regardless, the order revealed Theodore’s location: Cross Timbers Nursing and Rehabilitation in Midwest City.
On June 4, Oklahoma Watch accompanied Parks, her sister Larissa Dudkiewicz, and Theodore’s former wife, Deborah Theodore-Hill, to Cross Timbers to visit Theodore for the first time in six weeks.
When the family indicated a desire to visit Theodore, the nursing home staff responded with hostility.
“You must leave our property immediately,” a staff member who refused to identify herself said. “We’ll call the police.”
“Why?” Dudkiewicz said.
“You know why,” the staff member said.
The family didn’t know why; they refused to leave. Two police cruisers arrived.
After the two-hour drive from Tulsa, the family was compelled to endure a second standoff in the nursing home parking lot, a two-hour delay as police officers examined court documents on smartphones and communicated with staff, APS officials, and Whited from the ombudsman’s office.
A 2015 order from then-Attorney General Scott Pruitt tipped the scale: Title 30 does not provide a guardian with the power to restrict visitation with a nursing home resident without a court order.
APS had not been given a court order to deny visitation.
Despite the clear order from the AG’s office, the beleaguered police officers opted for compromise. Parks, the daughter who knew best how to communicate with Theodore, was denied access. Dudkiewicz and Theodore-Hill were granted a brief, supervised visit.
Theodore was heavily medicated, but he was very excited to see his family, Dudkiewicz said.
“He immediately opened his eyes, especially when he saw my momma,” Dudkiewicz said. “They were dating when she was 16, so he loves to see her.”
Theodore-Hill chuckled. She recounted reading various psalms and Bible passages to Theodore, including Jeremiah 30.
“Those who plunder you will be plundered; all who make spoil of you I will despoil. But I will restore you to health, and heal your wounds,” the verse reads.
Editor’s Note: Individuals with knowledge of persons under inappropriate guardianship in Oklahoma are encouraged to contact Oklahoma Watch at JCHallman@OklahomaWatch.org.
Oklahoma Watch, at oklahomawatch.org, is a nonprofit, nonpartisan news organization that covers public-policy issues facing the state.
JC Hallman covers general assignments for Oklahoma Watch.
Get Local News!
