HomeMy WebLinkAbout01-22-08 (3)
ANNUAL REPORT OF
GUARDIAN OF THE PERSON
COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY PENNSYL VANIA
,
ORPHANS' COURT DIVISION
Estate of Mark A. Mower
, an Incapacitated Person
No. 21-06-0972
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I. INTRODUCTION
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Peter D. Mower
, was appointed
III Plenary DLimited Guardian of the Person by Decree of M. L. Ebert, Jr.
dated November 27,2006
, J.,
III A. This is the Annual Report for the period from November 27 2006
to December 3 2007 (the "Report Period"); or
o B. This is the Final Report for the period from
to
(the "Report Period"), and is filed
for the following reason:
1. The death of the Incapacitated Person. Date of death:
2. The Guardianship was terminated by the Court by Decree of
J., dated
For a Final Report, omit Sections II through IV.
~
Form G-03 rev. 10.13.06
Page 1 of 4
Estate of Mark A. Mower
, an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person: 48
Date of Birth: May 31, 1959
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
Holy Spirit Hospital
Behavioral Health Services
503 North 21st Street, Camp Hill, PA 17011
B. The Incapacitated Person's residence is:
o own home / apartment
o nursing home
o boarding home / personal care home
o Guardian's home / apartment
IZI hospital or medical facility
o relative's home (name, relationship and address)
o other:
C. The Incapacitated Person has been in the present residence since December 23,2007
. If the Incapacitated Person has moved within the
past year, state prior residence and reason(s) for move:
Adams Hanover Counseling, 270 S. Main St. Apt 10, Chambersburg, PA. Gold N
Gray Retirement Home, 18801 Main St. Dry Run, PA. Unable to care for himself.
Form G-03 rev. 10.13.06
Page 2 of 4
Estate of Mark A. Mower
, an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
Franklin County Mental Health
Intensive Case Management
425 Franklin Farms Lane
Chambersburg, P A 17201
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
Schizophrenia, chronic paranoid type
OCD
Traumatic brain injury
Suicide attempts
Chronic mental illness
B. Specify what, if any, social, medical, psychological and support services the
Incapacitated Person is receiving:
Mark is under the care of the Franklin County Mental Health Department which has
assigned an Intensive Case Manager (ICM) to work with him. The ICM takes him to
medical appointments, finds appropriate housing, insures that he has regular visits
with a psychiatrist.
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
III continue
o be modified
o be terminated
Form G-03 rev. 10.13.06
Page 3 of 4
Estate of Mark A. Mower
, an Incapacitated Person
The reasons for the foregoing opinion are:
Even with medication, Mark is not able to care for his estate. If left to his own
devices, he does not take his medication, which results in erratic, potentially
dangerous behavior.
B. During the past year, the Guardian of the Person has visited the Incapacitated Person
20
times with the average visit lasting I
hours, 0
minutes.
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the Incapacitated Person for the period covered by this Report may be
attached to supplement this Report.
I verify that the foregoing information is correct to the best of my knowledge,
information and belief; and that this Verification is SUb~~ect t the penalties of 18 Pa. C.S.A. ~ 4904
relative to unsworn falsification to anthorities. / A~.._
January 13, 2008 l ~
Date Signdture of Guardian of the Person
Peter D. Mower
Name of Guardian of the Person (type or print)
514 Mark Drive
Address
Elizabethtown, P A 17022
City, State, Zip
(717) 367-7006
Telephone
Form G-03 rev. /0.13.06
Page 4 of 4