HomeMy WebLinkAbout01-0278
WILLIAM BARcr.AY
an alleged incapar.i tated
person
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NCt'" ~ ~ - 278 ORPHANS' COURT 2001
IN RE:
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with this Court to have you declared an Incapacitated Person. If the Court
finds you to be an Incapacitated Person, your rights will be affected, including our right to manage money
and property and to make decisions. A copy of the petition which has been filed by
MICHAEL A. BYNUM, ESO. is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 3 , Cumberland
County Courthouse, Carlisle, Pennsylvania, on MARCH 23 ,200'~, at 10: 30 A .M. to
tell the Court why it should not find you to be an Incapacitated 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 manage your
money and/or other property, or 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 jury 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
~}..-
.. _ .-. _..~i _~...._~..;
---...-_......._.....~
make and communicate decisions. The Guardian will be of your person and/or your money
and other property and will have either limited or full powers 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 incapacitated, 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:
~~jJ .
Clerk, rphans' Court Division
Cumberland County, Carlisle, PA
My Commission Expires 1 st Monday I
January, 2002
DATED:
MAOCH 15,2001
Guardianship Petition
IN THE MATTER OF William
Barclay, an alleged incapacitated
person.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION No
GUARDIANSHIP-INCAPACITATED PERSON
~
NOW, this ~ day of ,2001, on motion of
Michael Hynum, squIre, and ElIzabeth A toun, EsquIre, upon consIderatIon of the attached
petition and after a hearing held following due notice, it is ordered and decreed that William
Barclay, 121 Walnut Bottom Road, Shippensburg, Pennsylvania 17257-9005, is adjudged an
incapacitated person. Larry Cottle is appointed guardian of the person and of the estate of
William Barclay. No bond shall be required of petitioner.
By the Court,
prelim decree
MAR 1 4 ?a~~
~
IN THE MATTER OF William
Barclay, an alleged incapacitated
person.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION No
GUARDIANSHIP-INCAP ACIT A TED PERSON
c21 - 01 - ~ 1'1
.1 (~ SRYDECREE
NOW, this ~ day of ",2001, upon consideration of
the annexed petition, it is hereby decre that a citation is awarded directed to William Barclay
to show cause why he should not be adjudged an incapacitated person and a guardian of his
person and estate be appointed; the hearing thereon to be held in Courtroom 3
, Cumberland County Courthouse, Carlisle, P A on /J1~ :1-3 2001 at /0 .-3D 0' clock
at ffM. I
At least 48 hours' notice of the hearing shall be given to William Barclay, the alleged
incapacitated person by personal service of a copy of said petition and citation and by service of
notice upon his attending physician or the superintendent or other official of the institution
having custody of him who are sui juris personally or by registered mail
By the Court,
Guardianship Petition
IN THE MATTER OF William
Barclay, an alleged incapacitated
person.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION No
GUARDIANSHIP-INCAPACITATED PERSON
Petition For The Appointment Of Guardian For An Incapacitated Person
NOW comes Larry Cottle, petitioner, by Attorneys Michael A. Hynum, Esquire and Elizabeth
Antoun, Esquire, and presents this petition for the appointment of a guardian by this Honorable
Court upon William Barclay, an alleged incapacitated person, representing as follows:
1. Petitioner is the Administrator at Shippensburg Health Care Center, a skilled nursing
facility located at 121 Walnut Bottom Road, Shippensburg, Pennsylvania 17257-9005.
2. Petitioner is not related to the alleged incapacitated person nor does he have an interest in
the estate of same.
3. The alleged incapacitated person resides at 121 Walnut Bottom Road, Shippensburg,
Pennsylvania 17257-9005.
4. The alleged incapacitated person's diagnosis is Dementia with agitation.
5. 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, William Barclay requires specific one on one assistance with
grooming, eating, ambulation, toileting and bathing.
6. The alleged incapacitated person is incapable of handling his financial and personal
affairs, however minor, and if called upon to grant informed consent to any medical
procedure would be unable grant same because of his inability to comprehend the nature
of the procedure. Additional information related to William Barclay's capacity is set forth
Guardianship Petition
in a letter dated December 20,2000, prepared by his treating physician and incorporated
by reference and attached hereto as Exhibit "A".
7. After reasonable investigation it has been determined that the alleged incapacitated
person's next of kin are either unwilling or unable to serve as his guardian.
8. Upon investigation, Petitioner can find no other individuals willing to act as guardian for
the alleged incapacitated person.
9. The Facility has requested the Cumberland County Area Agency on Aging to provide
guardianship services for the alleged incapacitated person.
10. The Cumberland County Area Agency on Aging has declined the Facility requests to
provide guardianship services.
11. Petitioner has no knowledge of any other court within this Commonwealth that has
appointed a guardian for the alleged incapacitated person.
12. Upon information and belief, the alleged incapacitated person has no assets.
13. Petitioner, having no interest adverse to the alleged incapacitated person, has agreed to
act as guardian of his person and estate if this Honorable Court shall so appoint. The
consent of the proposed guardian is incorporated herein by reference and attached hereto
as Exhibit "B".
14. If appointed as guardian, petitioner will act in compliance with regulations promulgated
under Court Order in Pennsylvania Bulletin 931, et seq., April 19, 1975.
Guardianship Petition
Wherefore, petitioner respectfully requests this Honorable Court issue a rule and citation
upon William Barclay, the alleged incapacitated person, with notice thereof to be given to
such other persons as this Court may direct, to be appointed guardian of his person and
estate.
Respectfully submitted,
Q \t'1 )rd
Date:~
M HAEL A. HYNUM
Identification No. 85692
ELIZABETH S. ANTOUN,
Identification No. 72592
CAPOZZI AND ASSOCIATES, P.C.
2933 North Front Street
Harrisburg, PAl 711 0
(717) 233- 4101
Attorneys for Petitioner
FEB-Z7-ZDOl lllZ1AM FRD~POZZI AND ASSOCIATES
'*'717-233-4103
r-259 P,OPS/DID '-7DB
Guatclianship Petition
IN THE MAnER OF William.
Barclay. an al)esed incapacitated
person.
IN mE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PBNNSYL VANIA
ORPHANS COURT DIVISION No 57 of2001
aUARDtANSHtp.INCAPACITATED PERSON
JlS1l1FlCATION
La,rry Cottle J petitioner in this matter, does hereby depose and b'tate that the facta
eontained in the foregoins petition are ttuc and correct to the 'best of my knDwledge, informari= and belief. I
underslaIld that false statements made herein are subject to the penalties of 18 PI.C.S.A. Section 4Q94, relating
to unswom fal8ltlQariol1 to authorid.~.
Date: ~ ? I lPloJ
I I
{/11; r/Jf( 2
2.d
Wd9S:E0 10, 90 ~~W
EXIlIBlrr A
HEALTH CARE CENTER
121 Walnut Bottom Road
Shippensburg, Pennsylvania
17257-9005
(717) 530-8300
FAX (717) 530-8304
TTY 1-800-654-5984
December 20, 2000
Elizabeth S. Antoun
Capozzi and Associates
3109 North Front Street
Harrisburg, PA 17110
Dear Mrs. Antoun:
As per the capability form completed at the time of Mr.William Barclay's
admission (August 31,1999), I continue to feel that he is not capable of
making decisions about his care.
A Mini-Mental Status Assessment, completed during 1999, reflects
significantly impaired orientation, short term and long term memory. No
improvement is noted and prognosis related to mental status is poor.
Diagnosis related to mental status is Dementia with agitation.
Sincerely,
1!~.
Yogindra Balhara, M.D. / at! 2.- 'J.-fL-
EXIlIBlrr B
---------------
I N THE MATTER OF Willian1
IN THE COURT OF COMMON PLEAS OF
Barclay, an alleged incapacitated
CUMBERLAND COUNTY, PENNSYLVANIA
person.
ORPHANS COURT DIVISION No
GUARDIANSHIP-INCAPACITATED PERSON
CONSENT OF PROPOSED GUARDIAN
L LaiTY Cottle, hereby consent to act as guardian of the estate and person of William
Barclay, if appointed by the Com1.
I reside al~1 \tJ~~tLwJJ~~f'i.and I am i~~~y
I am a citizen of the United States of America and can sp~k, read and write the English
language.
I have no interest adverse to William Barclay, the a
S worn to and subscribed
before me this f~
, 2001.
Notary Public
"'~~"-"'._"-'~."~,~~
I NOTARIAL SEAL --;
, MARLEN~ A. MOYER, Notary Public'
j Harnsburg, Dauphin County ,
My CommiSSion expires July 5, 2004
COURT COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
TO
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with this 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 manage money and
property and to make decisions. A copy of the petition which has been filed
by CAPOZZI AND ASSOCIATES, ATTORNEY FOR THE PETITIONER.
You are hereby ordered to appear at a hearing to be held in Courtroom No.
_' Cumberland County Courthouse, Carlisle, Pennsylvania, on
, at . To tell the Court why it should
not find you to be an Incapacitated 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 your money and/or other property, or 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 your have the right to appear, to be
represented by an attorney, and to request a jury 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/or your money and
other property and will have either limited or full powers 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 incapacitated, 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, Orphan's Court
.-
I
Guardianship Petition
IN THE MATTER OF William
Barclay~ an alleged incapacitated
person.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS COURT DIVISION No cQ.l-OI-c2 '7 t
GUARDIANSHIP-INCAPACITATED PERSON
Addendum to Petition For The Appointment Of Guardian For An Incapacitated Person
NOW comes Larry Cottle, petitioner, by Attorneys Michael A. Hynum, Esquire and Elizabeth
Antoun, Esquire, and presents this addendum to petition for the appointment of a guardian by
this Honorable Court upon William Barclay, an alleged incapacitated person, representing as
follows:
1. William Barclay is a nursing home resident whose stay is paid for by Medicaid.
2. As a Medicaid resident, Mr. Barclay is required to maintain total funds of not more than
$2,000.00.
3. As a Medicaid resident, Mr. Barclay receives a personal needs allowance of $30.00 per
month.
4. Mr. Barclay's funds are maintained in a resident fund at Shippensburg Healthcare Center.
5. The Business Office at Shippensburg Healthcare Center supervises the resident fund,
which includes Mr. Barclay's funds. The business office employs persons who are
bonded for the purpose of handling resident funds.
6. Nursing Home resident funds are monitored by the P A Department of Health and/or the
PA Department of Public Welfare.
7. 20 Pa.C.S. S55l5 states"... provisions relating to a guardian of an incapacitated person
and his surety shall be the same as are set forth in the following provisions of this title
.
Guardianship Petition
relating to a personal representative or a guardian of a minor and their sureties:.. . Section
5122 (relating to when bond not required).
8. 20 Pa.C.S. S5122 (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 dispense with the
requirement of the Petitioner to obtain a bond.
Respectfully submitted,
CAPOZZI AND ASSOCIATES, P.C.
Date: --412k
M CHAEL A. HYNU
Identification No. 85692
ELIZABETH S. ANTOUN,
Identification No. 72592
CAPOZZI AND ASSOCIATES, P.C.
2933 North Front Street
Harrisburg, PAl 711 0
(717) 233- 4101
Attorneys for Petitioner