VCU says Times-Dispatch series on guardianship process is ‘out-of-context’

A person who attended an event at VCU's Larrick Center, which is located on MCV campus, has tested positive for COVID-19. CT file photo

Hannah Eason, News Editor

VCU Health System sent out a news release and email to employees Sunday on the recent Richmond Times-Dispatch series about the health system’s guardianship practice, saying the article lacks “context, balance, and journalistic ethics.”

The Richmond Times-Dispatch released the first of a series of articles on guardianship — the legal process of removing an adult’s right to make life decisions — and said the university and other health providers used the process to disadvantage poor patients.

A guardian is a person legally allowed to make medical and housing decisions on behalf of an incapacitated person. A conservator is in control of an incapacitated person’s finances. A person can be both a guardian and conservator.

The email was signed by Marsha Rappley, VCU Health Systems CEO and senior vice president for health sciences, and Interim CEO of VCU Hospitals and Clinics Ron Clark, and contains five points that VCU says were incomplete or inaccurate in the Times-Dispatch’s report.

“We especially regret that the Times-Dispatch included incomplete information or out-of-context stories and hearsay about health system employees and patients to make their case,” the email stated.

Richmond Times-Dispatch Executive Editor Paige Mudd said the publication “stands by our reporting on this story,” which was written by Bridget Balch.

The Times-Dispatch article says reporters analyzed more than 250 court cases and interviewed more than two dozen people, which they say showed VCU Health System took hundreds of low-income patients to court to “remove their rights to make decisions about their medical care.”

In the release, VCU Health Systems states they use the guardianship process for patients who are unable to make health decisions and don’t have a friend or family member who can serve as a decision-maker.

The article states there were 24 cases since 2013 in which patients had a family member or friend willing to serve as a guardian, but an attorney was appointed instead.

According to VCU’s statement, final decisions about guardianship and who will be the guardian are determined by the court. 

“VCU Health System has no role and has never participated in the process to determine who is appointed to be the patient’s guardian,” the release stated.

The series, which will have a second part released Sunday, uses the example of a Richmond man, William Lomax, whose wife, Ora Lomax, was willing to take care of him. According to the Times-Dispatch, VCU Health Systems said that because her husband had been to the hospital 12 times in 8 months — among other factors — she was unfit to care for him.

Her husband’s guardian and conservator was attorney R. Shawn Majette, which the Times-Dispatch says was at VCU Health System’s request through a petition.

The article also noted five VCU Health System cases in which a guardian ad litem —  an independent attorney appointed to represent children and incapacitated people — or psychiatrist believed a patient was mentally competent, but an attorney was appointed as the person’s guardian.

“In at least 13 cases, Majette or another attorney was appointed guardian for the stated purpose of having the patient discharged to a nursing home, signed up for Medicaid or to ensure a bill was paid,” the article says.

According to the article, Majette, who works for ThompsonMcMullan law firm, has more than 100 people under his guardianship. According to Virginia law, the “established ideal ratio” is 20 incapacitated persons per each full-time staff member.

Both parties noted that guardianship is rarely pursued; it accounted for less than 40 cases out of nearly 40,000 this year.

The statement said VCU Medical Center makes efforts to ensure patients are discharged into a safe environment by providing nursing facility contracts, home visits, transportation and medical equipment. VCU Health said the discharge process involves many medical experts including doctors, psychiatrists, therapists, social workers and others.


  1. when powerful institutions are confronted with uncomfortable allegations of wrongdoing so they typically deny deny deny .But eventually honest investigations take place, truth always wins out. This practice is widespread across the country and not at all unique to Virginia. It is simply a question cutting the hospital’s losses on patients who will overstay their welcome and the limits of Hospital reimbursement. Rather than his line the problem the hospital should look for ways to avoid the situations And do their best to avoid every guardianship that is not absolutely necessary

  2. When a guardianship is abusive in any way, the person in the guardianship who is suffering abuse, neglect and/or exploitation has nowhere to go for help. The system depends on loving family to bring the matter to court and litigate against the guardian. The irony is of course, the guardian’s fees to litigate and defend against the allegations are paid by the person in guardianship who is being abused. Family has to pay out of pocket. Family often goes broke or worse – goes into bankruptcy – and all too often family loses everything trying to protect their loved one.

    So, victims and their families turn to the media for help. Bridget Balch’s first article in the series has exposed serious problems involving VCU Health. It would be nice if VCU Health would not just own up to the problems but set about to fix them. People are suffering and VCU Health’s first concern should be to stop that suffering and then find ways to be sure it never happens again.

  3. It sounds like the court process is at fault, not the VCU. As a certified professional guardian in Washington State, we are the guardians of last resort. Attorneys are not typically appointed guardians and anyone who wants to be paid to be a guardian with more than two guardianships are required to be certified and then there is regulatory oversight. Hospitals end up housing incapacitated individuals if there isn’t someone who can make financial and medical decision to transition the individuals to more appropriate housing. The state of Virgina need to review and revise their laws pertaining to guardianship.

  4. My disappointment is the commentary of Marsha Rappley, VCU Health Systems CEO and senior vice president for health sciences, and Interim CEO of VCU Hospitals and Clinics Ron Clark and the writer VCU junior Heather Eason. VCU Health Systems, with the help of ThompsonMcMullan, intentionally leveraged the known dysfunction of the Virginia’s adult guardianship adjudication system to mitigate their obligations or liability. How can the only two choices be to dump a person on the street or involuntarily place them into guardianship, to remove all liability as well as protections, for a completely vulnerable convalescing adult?
    Shawn Majette admitted he has many medical system clients. VCU Medical is not the only system leveraging this inhumane option to deal with risk mitigation. Mr. Majette and most attorneys believe they are entitled to exploit the vulnerable with their special privileges and the leverage these courts provide.

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