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Home My WebLink About07-02-07 IN RE: WILLIAM HERSHEY, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : REGISTER OF WILLS, ORPHANS' COURT : NO. bH-Ol-lo~~ an alleged incapacitated person PETITION OF GOLDEN VENTURES d/b/a GOLDEN LIVING CENTER - WEST SHORE FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A PLENARY GUARDIAN OVER THE PERSON AND ESTATE OF WILLIAM HERSHEY AND NOW comes the Petitioner, Golden Ventures, d/b/a Golden Living Center- West Shore, by and through its counsel, Thomas, Thomas & Hafer, LLP, and respectfully petitions this Honorable Court pursuant to 20 Pa. C.S.A. ~ 5511 for an Order adjudicating William Hershey to be an incapacitated person and appointing a guardian over his person and estate and in support thereof states as follows: 1. Petitioner Golden Ventures ("Golden Ventures") is a corporation properly registered and qualified to do business in Pennsylvania. 2. Golden Ventures operates skilled nursing and rehabilitation facility for needy individuals known as Golden Living Center- West Shore (the "GLC-West Shore") at 770 Poplar Church Road, Camp Hill, Pennsylvania 17011. 3. William Hershey, the alleged incapacitated, is a resident ofGLC-West Shore; the ,.~ essential requirements for his health and safety are provided at the home. 8 0 ~ "~~ E As the residential care provider for William Hershey, GLC-West ~~as ~ ::-: ;:::s ~ N 1--)(")0 > C) C) 11 __ C) L -"" ~:o _ William Hershey is 70 years of age, with a date of birth of June 2~r937. .. 4. interest in his welfare given his status as an alleged incapacitated person. 5. 6. N .r:- William Hershey suffers from dementia, organic psychotic conditions, neurotic disorders, anxiety and depression. In addition to these mental conditions, Mr. Hershey suffers ,.. ~'-J!',:"l ['11 CJ C"i::-) ,"r, ;:-:0 .:--; C:.J n",n, :.nl..-:::J C> -.,.., r~~ (f) () -~r1 from cerebral palsy, hypertension, diseases of the esophagus, hypertrophy and Decubitus ulcer. (See a copy of the Certification of Thomas Kunkle, D.O., attached hereto at Exhibit A). 7. Mr. Hershey's condition is permanent and not expected to improve; it will continue to deteriorate over time. (See Exhibit A). 8. As a result, Mr. Hershey is unable to manage or take care of matters pertaining to his own health or well being including, but not limited to, making and communicating decisions regarding his health and medical treatment. (See Exhibit A). 9. Upon information available to the Petitioner, William Hershey has executed a living will declaration, regarding his wishes pertaining to his personal affairs and/or medical care in the event of his incapacity while a resident at GLC-West Shore (See a copy of the Living Will Declaration attached as Exhibit B). However, Mr. Hershey does not have a power of attorney, nor has he appointed anyone to make decisions on his behalf in the event of his incapacity (See a copy of the Certification of Beverly Fry, Executive Director at Golden Living Center- West Shore, attached hereto as Exhibit C). 10. Upon Petitioner's information and belief, William Hershey has a sister, Mary Kuhn, who resides at 1408 Fishburne Road, Hershey, Pennsylvania 17033 (See Exhibit C). 11. Ms. Kuhn does not wish to serve as Mr. Hershey's guardian nor does she oppose the appointment of an independent guardian to care for her brother (See a copy of the correspondence to Ms. Kuhn dated June 13,2007 attached hereto as Exhibit D). 12. The appointment of a guardian is necessary to provide consent for medical and surgical treatments, if necessary, and to ensure that Mr. Hershey's continued medical needs are met. 13. Further, a guardian is needed to handle Mr. Hershey's financial affairs. 2 14. To the best of Petitioner' s knowledge, Mr. Hershey receives social security benefits in the amount of $ 747 per month. Mr. Hershey does not receive a pension. 15. Mr. Hershey has an irrevocable cremation fund with the Cremation Society of Pennsylvania valued at $700. 16. Mr. Hershey does not own any real estate for he resided in an apartment located at 300 E. Poplar Avenue, Apt. # 217, Hummelstown, Pennsylvania 17036 prior to his admission at GLC - West Shore. His apartment was closed upon his admission to GLC - West Shore, thus the only items that Mr. Hershey continues to possess are basic personal items, such as clothing, shoes, and so forth. 17. Upon information and belief, William Hershey was never a member of the United States Armed Forces. 18. Upon information and belief, no other guardians of the person or estate of William Hershey have been appointed, and no other court has assumed jurisdiction in any proceedings to determine the capacity of William Hershey, the alleged incapacitated person. 19. Petitioner believes there are no less restrictive appropriate alternatives to seeking a guardianship over the person and estate of William Hershey. 20. The proposed guardian over William Hershey is Pennsylvania Guardianship Association, Inc., a nonprofit corporation, located at P.O. Box 7295, Lancaster, Pennsylvania 17604. (See a copy ofthe Consent of Proposed Guardian attached as Exhibit E). 21. Pennsylvania Guardianship Association, Inc. has agreed to serve as William Hershey's guardian. (See Exhibit E). 22. Upon information and belief, the proposed guardian has no interest adverse to the alleged incapacitated person. (See Exhibit E). 3 23. The proposed guardian is a qualified guardian pursuant to 20 Pa. C.S.A. ~ 5511(f). 24. Petitioner respectfully requests that the proposed guardian be appointed guardian over the person and estate of William Hershey. 25. William Hershey's mental and physical condition mandates that a guardian be appointed to make decisions concerning his person and estate, including, but not limited to his living arrangements, his medical and psychiatric care, the administration of medications, surgical interventions, the employment and discharge of physicians, dentists, nurses, etc. for his physical care, and to make decisions concerning his fmances. WHEREFORE, Petitioner respectfully requests that this Honorable Court issue a citation directed to William Hershey, the alleged incapacitated person, with notice to such persons as this Court may direct, to show cause why William Hershey should not be adjudged a totally incapacitated person, and why Pennsylvania Guardianship Association, Inc., should not be appointed guardian over his person and estate. Respectfully submitted, Date: June 29, 2007 ~. Bahl, Esqwre Atto y I.D. No. 87803 THOMAS, THOMAS & HAFER, LLP 305 North Front Street Harrisburg, P A 1710 1 (717) 237-7100 Attorney for Petitioner Golden Ventures, d/b/a Golden Living Center - West Shore 4 Jljjj-2'3-2007 10: 48 FRDf'l: 11-'. l,l. I VERIFICATION 1, Beverly Fry, Executive Director at Golden Ventures, d/b/a Golden Living Center- West Shore, hereby state that 1 have read the Petition for Adjudication ofIncapacity and Appointment of a Plenary Guardian over the Person and Estate of William Hershey, which has been drafted by counsel. The factual statements contained therein are true and correct to the best of my information, knowledge, and belief, although the language is that of counsel and, to the extent that the content of the foregoing document is that of counsel, J have relied upon counsel in making this Verification. This statement is made subject to the penalties of 18 Pa. C.S.A. S 4904 relating to unsworn falsification to authorities, which provides that ifI make knowingly false statements, I may be subject to criminal penalties. U~bl Date ,/ eetor at den Living Center - ':\ h ,I " i I CE;RTIFlCAT10N ,P-F THOMAS KUNKI..E. M,~ ,!. true on:'c~,' (::~;:;.::~::::::~~ pen~ty ofpeijury ~t me fullo~ing ~ 1. 1;1 ~ ~ a physician licensed in good standing to practi~e medicine in 111e , , Commonwe ' of PennsylvaDlB_ rJ' , , ,I 2. i,i am the .phYSlicisn who acts in t.he capacity as attending physician for William Hershey at + FOlden Living - West Shore facility in Camp HillPennsylvani. where Mr.. Hershey has ~I tided since November 18,2006. 3. ': r. Hershey is 70 years of age, with a dote of birth "fJlJJlC 21, 1937. 4. :: 1. have examined Mr. Hershey and find him to be i"".ompetent and incap.ble of making any d' 's~ons regarding his medical treatment and persona:' or financial affairs. Mr. I' Hershey suff~ from dementia, organic psychotic conditions, neurotic disorders, anxiety and !,t !,,, depr0ssion. fti ddition to these mental oonditions~ Mr. Hershey suffers from cerebral palsy) ,jt '1' hypem:msion1~ seases of the esophagus, hypertrophy and decubitur; ulcer. 'l 5. !'~ r. Hershey's mental status is not expected to imprf)Ve. 1 ill 6. ;:~ ha,ve found that Mr. Hershey is unable to manage or take care of matters ,I pertaining to ': ~ own health and well~bejng without the assistance of another individl.13.1 who will act as guardi~ l f this person. He is unable to resist fraud or undue influeoce without the -1 r assistance of ~I dian. I:J Ii' 7, I't, am unaware of any living will, advance du'ectivc for health care, power of 'J ' attorney or 0 ','fdocument rogarding Mr. Hershey's wishes pertaining to his personal affairs and/or m0dio~l e in the event ofl)is incapacity. q i \ Il :;\ "I I'" i,J I Ii} , 11 J ;. 8. t i~ my opinion that William HerSlhey's social, pbyr.ical, medical and hygiene I needs are be' et in a skilled care facility. ",! . Und~~ enalty ofperjut'Y, I declare that the above statements are true. :~ D.ted: t,';' .?f7 ~l~ ,J I Tfi6fnas Kunitle, M:f.r.-- '; ; AO". I' , :ill ':J I :;j , . I .,' . I: 'I' I : i :. ! 'I ::1 , , I .~ ,'f I I ,oj' "I ::1 ,I .'1 :t I ..\ . .1 f"t "~I , 1 ',I , 'i ~ : j ,J:I "1 : " ::. I I ~ ::i , ~ I' I;' I '.j: !.,:~ j "" 1'\ .' ~ '\ -~ LIVING 'H..L DECLARATION .._.,,1"" '.._/ I, W', III /lYfI )1 \-krsf-.. t ,underS13fl(l th" if I beCllme unllblelO participate in decisions regarding my medicol e..... my anorney-in-fact lthe erson I haye autho,iw1 by a power of anorney), legal guardian, or f.mily mUst nuke decisions about my medicol care consistent with my best interests. I understand thai I may. make a w,inen statement of my .,isbes regarding life-prolonging or Iife-sustaining "..,ment. I underswulth" a judicial proceeding "ill may be necessary 10 dl!lermioe what is in my best interest, and thai a Court may consider my ..,lier ""emenu and beliefs about such tr..tment, including a .,rinen statement such as this. Therefore, I make this written s",emenl " to ..sist in any decision-making about my medical core. I undctStand that I may change my mind at any time..d mal reyoke this document by desrrnying it, by signing another Liying Will Declar,nion or by telling my rep,esentatiye 0 my physician to disregard it. ". If..y of the following paragraphs expresses my wishes, I haye placed my signature en the line immediate! following the paragraph. 1. If I am in a state of permanent uneonsciousness (including, but not limited to, a coma or perSl"e yegetatiY. state) which my mending physician has reasonably concluded is irreyersible,l direct my attending physici to withhold or withdraw unduly burdensome or futile Iif......aining or life-prolonging treatment. I further direct tI' "eatm.nt b. Iimil<d to measures 10 keep m. ",,!."fortable and to r.li...e pain. By placing my signature on the Ii immediately b.low, I eonfirm thatthVlf1tes(:; WiS~;: e- N ~ Y Signature By my signawte placed immediately aboY., I haY< confirmed my directions thus far regarding pennanent unconsciousness. If I am in a ""e of permanent unconsciousness as described above, I further direct that unduly burdensome or futile artitici:ally supplied feeding antI fluid (including. but not limited to, tube f~edin~s and intravenous fluids) b: wilhcJr:.lwO or withhdo. By placing my s;gnature on lhe line immWi~ h~~)don~mi ')J~i, srWi'hCS: Signature Holy Spirit Hospital Camp Hill, PA 17011 Living Will Declaration MRfI R.;vsd: --../' .-/" '.-/' i ... If 1 bave an incurable or lerminal condition or illness which my attending physician has rC2Sooat concluded will cause my death in a short time, J direct my atlending phy~ici:an to withhold or withdraw undL burdensome or futile life-sustaining or life-prolonging treatment. I further direct that treatment be limited 10 mea.sUI to keep me comfortable and to relieve pain. By placing my SiG(lillUre on the line immediately below. 1 confirm tl this paragraph states my wishes: pI! llf-~'ltrgr Signature ' By my signature placed immediately above. 1 have confirmed my directions thus far regarding an incurable or terminal condition of illness. If I have an incurable or terminal condition or illness as described above, 1 further direct that unduly burdensome or futile anificially supplied feeding and fluid (including, but not limited to, tube feedings and intravenous fluids) be withdrawn or withheld. By placing my signatUre on the line immediately below, I confirm )'13tthis paragraph Slates my wishes: . re4J jf1)~ f--;) - Jtt:j-J . .,. Signarore 3. Other directions: N C tep- \ I iJ c 'iU\'b la...'tor [AdJ}f~ Wk\~ Signature Subject to the order of any Court of competent jurisdiction. 1 expect my family, physici:ans, institutional t care providers and everyone concerned with my care to act in accord with my desires,. and in so doing to be fl any legal liability for h3ving acted in accord with my directions as expr~sed in this Living Will De~lua~ion:( _._ /r!'^HtlJtR, O"e: D.:J/3,!L Sign.d: ilL' ) . Time: Cj;5D 6~. ~. WimeS$:~""'.t~../P)~~ Witness: c -- ~ { ~ ' '11.QU-<- ~-Jc)J{ :~!Y;t He sf,j,..J CERTIFICATION OF BEVERLY FRY EXECUTIVE DIRECTOR AT GOLDEN LIVING - WEST SHORE I, Beverly Fry, do hereby state under penalty of perjury that the following is true and correct based upon my personal knowledge: 1. I am the Executive Director at Golden Living - West Shore, located at 770 Poplar Church Road, Camp Hill, Pennsylvania, which provides skilled nursing and rehabilitation services for elderly persons. 2. William Hershey is currently a resident of Golden Living - West Shore and has been a resident since his admission on November 18, 2006. 3. Upon information available to me, William Hershey has an executed Living Will Declaration with regard to his wishes pertaining to his personal affairs and/or medical care in the event of his incapacity while a resident at Golden Living - West Shore. 4. William Hershey has a sister, Mary Kuhn, who resides at 1408 Fishburne Road, Hershey, Pennsylvania 17033 and her telephone number is 717-534-1810. 5. To the best of my knowledge and belief, Mary Kuhn does not wish to serve as his guardian. Under penalty of perjury, I declare that the above statements are true. Dated:~ erly Executive Director Golden Living - West Shore THOMAS. THOMAS & HAFER LLP ATTORNEYS AT LAW www.tthlaw.com Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Street Address: 305 North Front Street, Harrisburg, P A 17101 Phone: (717) 237-7100 Fax: (717) 237-7105 Begene A. Bahl (717) 441-3959 bbahl@tthlaw.com June 13, 2007 Ms. Mary Kuhn 1408 Fishburne Road Hershey, P A 17033 Re: Guardianship of William Hershey Dear Ms. Kuhn: This letter is to memorialize the substance of a conversation you had with a paralegal from our office, Dana Thompson, on Tuesday, June 12,2007, regarding the appointment of a guardian over the person and estate of your brother, William Hershey. It is my understanding that you do not oppose the appointment of Pennsylvania Guardian Association, Inc., to act as William Hershey's guardian. If appointed guardian, Pennsylvania Guardian Association, Inc., will have the power to make medical and personal decisions on behalf of William Hershey. If my understanding is in any way incorrect, please contact me as soon as possible at the above number. Very truly yours, ~-- ~ ~ahl BAB/dyt cc: Laura Plank - Golden Living - West Shore Bethlehem Office · 3400 Bath Pike, Suite 302, Bethiehem, PA 18017 . Phone: (610) 868-1675. Fax: (610) 868-1702 Pittsburgh Office · 301 Grant Street, Suite 1150, Pittsburgh, PA 15219 . Phone: (412) 697-7403. Fax: (412) 697-7407 f; I, :' '1; I, I! CONSENT OF PRO~OSED GUARDIAN 1. I' Permsylvania Guardianship Associalion. inc., Ilnd through its President, Brian D. B~ok~, hereby COnsCllts to act as Plenary Guardian over the Person and EIIlt3tt !i of WiUiarnltIershey, an alleged incapacitated per3On. I. 2. r; PeMsylvania. Guardianship Association. Illc., Is a corporation organized under the i,\\IS oftbe Commonwealth of PerulSyl vW111l. Pennsylvania OuardiaDship II Assoc1lstioi Inc., is doing business at P.O. Box 7295. Lil:llC&5ttr, PA 17604. Telephone I, Nwnber 71~-299.4568. ., " 3. ::, Pennsylvania Guardianahip Association, Inc., provides QU8.1diau!lbip $e('\'ices IlI~in8 for the highest quality of care available in tbe leut restrictive settine ,I ~ : available. P~nnsylvaniQ Guardianllhlp Association. Inc.. will provide a full range of , , human se+es, including laking responsibilil}' for medical and personal care dC(:isions, Ii handling fi~cial affairs. providing one-on-one contact and monilorin~. W1d other I: S~tvioes. as,necessary. 1,' I" I' 4. :.' Pennsylvania Guardianship AiSociation. Inc., and its a8lm~ have no interest,. ~Ci.J or otherwise, advtrse to those of'the alleged incapacitated pe.r:8on. In !;, addition. n9;llienLIj of Pennsylvania Guardianship Association. Inc.. reside in the 9ame I household ~r facility with the inc.apacitated perSOJl, Dote: 6i~/"p? _ ~/~LL&~ ;' B~:\rooks . , President i! P<mn8yJvania Guardia.n3hip Association, Inc. "1 I. I:' " 1;, I:: ! : r I'