Elsie Jablonsky, 82, went to the hospital to heal after she fell and lay stranded on her kitchen floor for two days with no food or water.

To Jablonsky's horror, the hospital turned her over to a professional guardian -- who froze her bank accounts, used her charge card for shopping sprees and terrorized her, according to Jablonsky and public records.

"I had to change the locks on my house, I was so afraid of her," said Jablonsky, of Margate, a spirited retired bookkeeper who won a court fight to escape her guardian. "The hospital did the wrong thing by me."

South Florida hospitals each year hand over hundreds of unsuspecting elderly patients to professional guardians, who make a living having elderly people declared incompetent and running their lives for a fee of $30 to $75 per hour.

Eager to discharge patients quickly once they can no longer bill an insurer for their care -- but fearful of sending weak or confused people home alone -- hospitals turn to professional guardians to sign patients out, typically to nursing homes or boarding houses.

The practice is so common, especially in Broward, that elderly people without close relatives who land in the hospital are in danger of losing all their legal rights and never going home again.

Several hospitals in Broward and Dade actually pay guardians or lawyers at least $1,200 a head to initiate guardianship proceedings for their patients.

"That's amazing, to put it mildly," said Frank Repensek, executive director of the Guardianship Program of Dade County, a nonprofit corporation that provides guardianship services for poor people and never accepts payment from hospitals for its services. "In my view, there's an enormous conflict of interest in that."

Two public hospitals in north Broward have contracts with a large guardianship company. They pay the company up to $1,800 for taking on each poor patient and -- as an added incentive -- promise to refer patients who have money.

The patients who have cash or own homes that can be sold end up paying the guardian company $41.50 an hour -- indefinitely -- to visit, run errands, pay bills and oversee their care whether they want a guardian or not.

"I don't like to look at it in terms of the patient losing rights," said Lynn Futch Cooney, attorney for the North Broward Hospital District. "In our terms, it's more a patient gaining benefits. . . . We're trying to provide for that patient the best care possible when there is no one else to do it.

"I don't see a conflict at all."

To be sure, guardianship may be the best alternative for some patients, such as a comatose man or woman who has no relatives to consent to medical care or make life choices. And some hospitals resort to guardianship only in extreme cases.

"It's always been something we've avoided at all costs," said Jill Lenney, director of social work at Jackson Memorial Hospital in Miami, which never pays professional guardians to place patients and has a rigorous medical review process to ensure that no patient is plunged into an unneeded guardianship.

But the financial interests of some hospitals and guardians are being placed ahead of elderly patients' rights and well-being, according to a review of hundreds of court records and interviews with South Florida hospital officials and guardianship experts: