The URL can be used to link to this page

Home My WebLink About03-06-07 Louis J. Capozzi, Jr., Esquire* Daniel K. Natirboff, Esquire Donald R. Reavev. ESQuire Doreena C. Sloan, Esquire Brian K. Zellner, Esquire Bruce G. Baron, Esquire Andrew R. Eisemann, Esquire Timothy Ziegler, Reimb. Analyst Karen L. Fisher, Paralegal Jennifer Kain, Paralegal . (licensed in P A, NJ and MD) 2933 North Front Street Harrisburg, P A 17110 Telephone: (717) 233-4101 Fax: (717) 233-4103 www.capozziassociates.com Victor J. Bierman!, III Esq. Dennis A. Roth', Esq. Vincent E. Fishe~, Esq. Craig I. Adler, Esq. Of Counsel I Licensed in Ohio 2 Licensed in OH. P A. FL March 1, 2007 Orphan's Court Division Cumberland County Court of Common Pleas A TTN: Clerk of Court One Courthouse Square, 2nd Floor Carlisle, P A 17013 RE: Petition for the Appointment of a Permanent Plenary Guardian of the Person Reginald Waller Our Matter No. 737-06 Dear Clerk: Enclosed please find the original and a copy of the Petition, Notice with Citation, and Preliminary Order for the above-referenced matter, along with a check in the amount of $50.00 for the required filing fee. Upon filing the original, kindly return to us a date-stamped copy in the self- addressed, stamped envelope provided. Per the Courts request, also provided are two sets of self-addressed, stamped envelopes--one set in order to return the Notices with Citation and Hearing Order, and another set to return the Final Order--to all parties involved. Please contact me should you have any questions or concerns regarding this filing. Sincerely, ~~~ Robin Parker, Paralegal (2 ,':-; C") ~ =:J .,..} f"'-,j C=~::l ,= ...... Enclosures ~ :~ :..;;:) I 0-.. -0 N -.J ~, .~ ~ . MAR 011- 4' !J IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA INRE: ORPHANS' COURT DIVISION REGINALD WALLER c9oo1 - ;II~ No. AN ALLEGED INCAP ACIT A TED PERSON. PETITION FOR THE APPOINTMENT OF A PERMANENT PLENARY GUARDIAN OF THE PERSON Filed on Behalf of Petitioner: Golden Living Center-Camp Hill Our Matter No. C) , ~ (~~) - -:".~.-.1 ""'~...' I'"~ ::~.,! C.J .--.J I G) -a ". ) ; ---~ ; 1',) ~,-' ) i-\ 1 Counsel of Record for Petitioner: \D CAPOZZI AND ASSOCIATES, P.C. ';Uw.{ Doreena C Sloan, Esquire Attorney ID No. 44880 2933 North Front Street Harrisburg, P A 17110 (717) 233- 4101 (phone) (717) 233- 4103 (fax) Attorneys for Petitioner J 1//1 ~ J( "- IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA INRE: ) ORPHANS' COURT DIVISION ) ) ) ) ) ) ) ) No. dOOi ~ c::; IV REGINALD WALLER AN ALLEGED INCAPACITATED PERSON. PETITION FOR THE APPOINTMENT OF A PERMANENT GUARDIAN OF THE PERSON IMPORTANT NOTICE / CITATION WITH NOTICE A PETITION HAS BEEN FILED WITH THEIR COURT TO HAVE YOU DECLARED AN INCAPACITATED PERSON. IF THE COURT FINDS YOU TO BE AN INCAPACITATED PERSON, YOUR RIGHTS WILL BE AFFECTED, INCLUDING YOUR RIGHT TO MAKE PERSONAL DECISIONS. A COPY OF THE PETITION, WHICH HAS BEEN FILED BY ATTORNEY DOREENA CRAIG SLOAN, ESQUIRE, IS ATTACHED. YOU ARE HEREBY ORDERED TO APPEAR AT A HEARING TO BE HELD IN COURTROOM NO. , CUMBERLAND COUNTY COURTHOUSE, ONE COURTHOUSE SQUARE, CARLISLE, PENNSYLVANIA 17013-3387, ON AT O'CLOCK, .M. TO TELL THE COURT WHY IT SHOULD NOT FIND YOU TO BE AN INCAP ACIT A TED PERSON AND APPOINT A GUARDIAN TO ACT ON YOUR BEHALF. TO BE AN INCAPACITATED PERSON MEANS THAT YOU ARE NOT ABLE TO RECEIVE AND EFFECTIVELY EVALUATE INFORMATION AND COMMUNICATE DECISIONS AND THAT YOU ARE UNABLE TO MAKE NECESSARY DECISIONS ABOUT WHERE YOU WILL LIVE, WHAT MEDICAL CARE YOU WILL GET, OR HOW YOUR MONEY WILL BE SPENT. AT THE HEARING, YOU HAVE THE RIGHT TO APPEAR, TO BE REPRESENTED BY AN ATTORNEY, AND TO REQUEST A WRY TRIAL. IF YOU DO NOT HAVE AN ATTORNEY, YOU HAVE THE RIGHT TO REQUEST THE COURT TO APPOINT AN ATTORNEY TO REPRESENT YOU AND TO HAVE THE ATTORNEY'S FEES PAID FOR YOU IF YOU CANNOT AFFORD TO PAY THEM YOURSELF. YOU ALSO HAVE THE RIGHT TO REQUEST THAT THE COURT ORDER THAT AN INDEPENDENT EVALUATION BE CONDUCTED AS TO YOUR ALLEGED INCAPACITY. IF THE COURT DECIDES THAT YOU ARE AN INCAPACITATED PERSON, THE COURT MAY APPOINT A GUARDIAN FOR YOU, BASED ON THE NATURE OF ANY CONDITION OR DISABILITY AND YOUR CAPACITY TO MAKE AND COMMUNICATE DECISIONS. THE GUARDIAN WILL BE OF YOUR PERSON AND WILL HAVE EITHER LIMITED OR FULL POWER TO ACT FOR YOU. IF THE COURT FINDS YOU ARE TOTALLY INCAPACITATED, YOUR LEGAL RIGHTS WILL BE AFFECTED AND YOU WILL NOT BE ABLE TO MAKE A CONTRACT OR GIFT OF YOUR MONEY OR OTHER PROPERTY. IF THE COURT FINDS THAT YOU ARE PARTIALLY INCAPAC~TATED, YOUR LEGAL RIGHTS WILL ALSO BE LIMITED AS DIRECTED BY THE COURT. IF YOU DO NOT APPEAR AT THE HEARING (EITHER IN PERSON OR BY AN ATTORNEY REPRESENTING YOU) THE COURT WILL STILL HOLD THE HEARING IN YOUR ABSENCE AND MAY APPOINT THE GUARDIAN REQUESTED. By: Clerk, Orphans' Court . IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA INRE: ) ORPHANS' COURT DIVISION ) ) ) ) ) ) ) No. doo1, ~/cj REGINALD WALLER, AN ALLEGED, INCAPACITATED PERSON. PETITION FOR THE APPOINTMENT OF A PERMANENT GU~]>IAN ~ THE PERSON>-~ 0 ==~ ~~_::::J --J ._._' --C) >u I C'l Petition For The Appointment Of A Permanent Guardian Of The Person Of An Allee;ed Incapacitated Person ij CJ --,.- --- r0 "-' co AND NOW comes Petitioner, Golden Living Center-Camp Hill, through their attorney, Doreena Craig Sloan, Esquire, and presenting their Petition to this Honorable Court for the Appointment of a Permanent Guardian of the Person of REGINALD WALLER an Alleged Incapacitated Person, representing as follows: I. Petitioner, Golden Living Center-Camp Hill is a nursing facility offering skilled care and long-term care and is located at 46 Erford Road, Camp Hill, Pennsylvania 17011. Petitioner is licensed to participate in the Medicaid and Medicare programs. 2. The Alleged Incapacitated Person is Reginald Waller, a 66-year-old male residing permanently at Golden Living Center-Camp Hill. His date of birth is January 29, 1940, and his Social Security Number is 346-30-4098. 3. Petitioner is an interested party because the Petitioner is currently providing long- term care and nursing services to the Alleged Incapacitated Person. Petitioner has a statutory and contractual obligation to act in the best interests of the Alleged Incapacitated Person. vf( 4. The Alleged Incapacitated Person was admitted to Golden Living Center-Camp Hill on December 28, 2004. His prior residence was 1909 South Front Street, Harrisburg, P A 17102. 5. The Alleged Incapacitated Person is diagnosed with Cognitive Disorder; Depressive Disorder; Chronic Airway Obstruction; Vascular disease, and unspecified disorder of the kidney and ureter. 6. To the best of our knowledge, information and belief, the Alleged Incapacitated Person has never served in the Armed Forces ofthe United States of America. 7. The Alleged Incapacitated Person does not generally comprehend his surroundings to such an extent that he requires consistent supervision in his activities of daily living. As a result of his condition, the Alleged Incapacitated Person requires specific one-on-one assistance with grooming, transferring, toileting and bathing. 8. The Alleged Incapacitated Person is incapable of handling his personal affairs, however minor, and if called upon to grant informed consent to any medical procedure he would be unable to grant it because of his inability to comprehend the nature of the procedure. Additional information is set forth in the competency affidavit, prepared by his treating physician Dr. Thomas Young, 890 Poplar Church Road, Camp Hill, Cumberland County, Pennsylvania 170 II and incorporated by reference attached hereto, and marked Exhibit "A." 9. The Alleged Incapacitated Person is not expected to recover from his current condition to become sufficiently independent to return to the community. 10. After reasonable investigation Petitioner has determined that the Alleged Incapacitated Person has no next of kin or interested parties. 11. After reasonable investigation, Petitioner can find no other individual willing to act as Guardian for the Alleged Incapacitated Person. 12. The Alleged Incapacitated Person has no known assets. 13. Petitioner requests the Guardian be assigned the following powers below described: Making Medical decisions, which would include but not be limited to: 1. medication, antibiotics, hydration, tube feeding, respirator use; 11. situations related to the active dying process; 111. hospice selections; IV. selecting or replacing the attending physician; v. skilled care and acute care placement; 14. Petitioner knows of no available less restrictive alternative to the establishment of a Permanent Guardian of the Person of the Alleged Incapacitated Person. 15. The Proposed Guardian is Faith, Hope and Love Guardianship Services, Inc., located at P.O. Box 183, Harrisburg, Pennsylvania 17108-0183, a guardianship agency which for a fee provides Guardianship services to persons in need of such services. 16. Faith, Hope and Love Guardianship Services, Inc., having no interest adverse to the Alleged Incapacitated Person, has agreed to act as Guardian of his Person if this Honorable Court shall so appoint. The executed Consent of the Proposed Guardian is attached to this Petition and marked Exhibit "B." 17. Neither Petitioner, nor Proposed Guardian, is related to the Alleged Incapacitated Person nor does either have an interest in the estate of same. 18. If appointed by this Honorable Court, the Guardian will act in compliance with regulations promulgated under Court Order in Pennsylvania Bulletin 931, et seq., April 19, 1975. 19. As a Medical Assistance recipient, the Alleged Incapacitated Person is permitted to maintain assets totaling no more than $2,500.00. 20. As a Medical Assistance recipient, the Alleged Incapacitated Person receives a personal allowance of $40.00 a month. 21. 20 Pa.C.S.A. ~55l5 states "... provisions relating to a guardian of an incapacitated person and her surety shall be the same as are set forth in the following provisions of this title relating to a personal representative or a guardian of a minor and their sureties:..." Section 5122 (relating to when bond not required). 22.20 Pa.C.S.A. ~5l22 (d) states "in all other cases, the court may dispense with the requirement of a bond when, for cause shown, it finds that no bond is necessary." WHEREFORE, Petitioner respectfully requests this Honorable Court to: 1. Award a Citation directed to REGINALD WALLER and others as the Court sees fit to show cause why REGINALD WALLER should not be declared an incapacitated person and why a Permanent Guardian of his Person should not be appointed; 2. Appoint Faith, Hope and Love Guardianship Services, Inc., as Permanent Guardian of the Person of REGINALD WALLER. 3. Dispense with the requirement that the Proposed Guardian obtain a bond. Date: ,-5 II /07 / I VERIFICATION I, Doreena Craig Sloan, Esquire, hereby verify that I am an attorney for the Petitioner. I have sufficient knowledge or information based upon investigation into this matter by my client, to make this verification. In addition, my client is currently unavailable which hinders the timely filing of this petition. I hereby verify that the statements in the foregoing Petitioner are true and correct to the best of my knowledge, information, and belief. I understand that false statements contained herein are made subject to the penalties of 18 Pa. C.S.A. 94904 relative to unsworn falsification to authorities. Date: "3/1/01 By: Doreena Crai an, Esquire Attorney ID No. 44880 2933 North Front Street Harrisburg, PAl 711 0 (717) 233-4101 Capozzi & Assoc. Fax:111-233-4103 Feb 1 2001 01:30pm P002/006 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHAN'S COURT DIVISION IN THE MATTER OF REGINALD WALLER, an Alleged Incapacitated Person ~ No. ;;067 - dlt/ : Petition for the Appointment of a Permanent ; Guardian of the Person Affidavit of Dr. Thomas YounG in SUPpOrt of Petition to Adiudicate REGINALD WALLER. an AlleQed Incapac~ted Person 1. 2. My name is Dr. Thomas Young. My occupation is as a physician. 3. My business address is 890 Poplar Church Road, Camp Hill, PA, 17011. 4. My educalional background is as follows: 5. a. State Medicall Graduate School " S~( &-R-- M-e~ H JJH N f. MAN Iv /"UJ1UfAt.S I~ 6f'~ +-V)N~ ~ q="~II~~ tP.4- Iq/t)2- b. State Undergraduate F144--NK.A_/N ANO (YJfl~AlL Co tl~1c l-A-NC-,,-,>'r'UL PAr- 13'A- sllK'l,g <p n~cnr I am licensed by the State of Pennsylvania as M.D. M 0 6-- I - "7 tI 6. I specialize in :tNTE/2/V'AL- /J'l.E/>/C/rV (. 7. I am affiliated with Golden liVing Center~Camp Hill 8. I have been affiliated with Golden Living Center-Camp Hill since ,~~~ 9. I first met REGINALD WALLER in ~ In , '2,...'1, ~o -.1 ~ 10. I last met with REGINALD WALLER on J ~ ^ t.. ~ I 1.. o.~ 1-- 11. I last reviewed REGINALD WALLER'S chart on J "''"'. '\..... D 1.- !) 0 l , I - EXHIBIT I A t. Capozzi' Assoc. FaK;111-233-&103 Feb 1 2001 01;30PI P003/006 12. REGINALD WALLER'S pertil)ent diagnoses are: U. t'*'V?rfO V"' J \. v1 #--,.. ~ I)~ "/~ 13. ~XI'/"f/lJ vt..- (;'l/~I-J"~ J:-f. vr...-t... '- <) /' J..} REGINALD WALLER currently takes the medications on the list attached to this Affidavit. REGINALD WALLER'S prognosis is: good @ poor The extent of REGINALD WALLER'S ability to communicate is as follows: a. Verbally good fair ~ b. In Writing good fair c. Other Means good fair oar 14. 15. 16. The extent of REGINALD w.~ S ability to receive information is as follows: a. Reading: good air poor b. Hearing: good Ir poor 17. REGINALD WALLER is capable of indeoendentlv performing ONLY the following activities of daily IMng. ~Eatinv b, Grooming c. Toileting d. Transferring e. Taking medications 18. REGINALD WALLER has emotionallimitalions in the form of: ..p)( /HJ.IJ Itt G.,/J~ A,I'~ I , 19. REGINALD WALLER i~BL~LE to interact socially on any meaningful level. If ABLE, then please describe: 20. REGINALD WALLER does Dot generally comprehend his surroundings to such an extent that he requires consistent supervision in her activities of daily living. As a result ofms condition, he requires specific one- on- one assistance with grooming) transfcming, ambulatioo, toileting and bathing. He absolutely could not manage any of his own activities of daily living without supervision or ~ance_ ,,' Capozz i & Assoc. Fa~;717-233-d103 Feb 7 2007 01;30pm POOd/006 L 21. REGINALD WALLER ISIIS NOT capable of handling his personal affairs, however mi~e requires total assistance in these areas. C!!J 22. REGINALD WALLER, if called upon to grant informed consent to any medical procedure, however minor or straightforward, would be unable grant it because of his ina~ to comprehend the nature of the procedure. 23. REGINALD WALLER absolutely cannot actively and effectively participate in monitoring and managing his own medical care and medication. He requires supervision in this area. (Jff 24. REGINALD WALLER's limitations relevant to this guardianship proceeding are not likely to improve neither in the immediate future nor over time. To the extent relevant change is likely, it will be, in my opinion, expressed with reasonable medical certainty, for m= worse. 25. I have been made aware of the statutory definition of .incapacitated person~ under pe~lvania law. 26. My opinion, based on my examinations of REGINALD WALLER and my review of his medical records, expressed with reasonable medical certainty, is that REGINALD W~R is totally incapacitated as to matters affecting his person. CJJY 27. Based On the opinions that I have expressed, my opinion, expressed with reasonable medical certainty, is that REGINALD WALLER requires the appointment of a guardian of his person, CVF 28. My opinion is that REGINALD WALLER could possibly be harmed if he were required to attend his guardianship hearing, however, I feel this point is moot because REGINALD WALLER would not be able to contribute in any way to the hearing. (j)F ~ Capozzi & Assoc. FaK;717-233-d103 Feb 7 2007 01:31pl POOS/006 .. 29. My opinion is that REGINALD WALLER would not understand nor benefit from participation in a court hearing regarding a determination of his capacity to handle his ow~rsonal and financial affairs. I, Dr. Thomas Young, being duly sworn according to law deposes and says that I make this Affidavit on behalf of REGINALD WALLER and that the facts set forth in the foregoing Affidavit are true and correct to the best of my knowledge, information, and belief. I verify that the statements in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. ~ 4904 relating to unsworn falsification to authorities. Date: F t. brv..,'J r ~ ~ 1- ~~. PAr Dr. Thomas Young Sworn to and subscribed before me this 7 it... day of ~ 200.1..... ~~(~& ~ L ;:A4U~/ JI).L/E 4/J/J l-c~ Notary Public My Commission Expires: a II g / ..? 01 f , . IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA INRE: ) ORPHANS' COURT DIVISION ) ) ) ) ) ) ) No. ~06'l- die; REGINALD WALLER, AN ALLEGED INCAPACITATED PERSON. PETITION FOR THE APPOINTMENT OF A PERMANENT GUARDIAN OF THE PERSON CONSENT OF THE PROPOSED GUARDIAN I, .sheJ \~~ , am an authorized representative of Faith, Hope and Love Guardianship S ices, Inc., and do hereby certify that we are willing to act as the Permanent Guardian ofthe Person of REGINALD WALLER, ifthe Court shall so appoint us. Further, I do hereby certify that I am not a fiduciary of any estate in which the alleged incapacitated person has an interest, nor have I any interest adverse to the alleged incapacitated person. The facts and opinions contained herein are true and correct to the best of my knowledge, information and belief. ~i'/ D1 Sworn to and suhs..cri~en hefore me this COMMONWE/\LTH Of p~mV~NW- NOTARIAL SLAl JENNIFER KAIN, Notary Public East Pemsboro Twp., Cllilberland CotIlty My Commisalon Ex~ire~ Qet. 7. 2009 fj-f day of /rI (Jrch U~ ,2007. My Commission Expires: ()i. 1/ 2JJJl EXHIBIT I~ 15