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Home My WebLink About07-13-091N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION In Re: Jacqueline Beaudry, an alleged incapacitated person s ~~ -= _ ~~u r c-~ ~`-" r ~ ~~ C~~ C_ i ~ c~- r:: "= o= o o U N O.C. No. OZ C.IJ/ - lp !~ PETITION UNDER § 5511 OF THE PROBATE, ESTATES AND FIDUCIARIES CODE TO ADJUDGE JACQUELINE BEAUDRY TO BE TOTALLY INCAPACITATED AND APPOINT A PERMANENT PLENARY GUARDIAN FOR HER ESTATE Filed on Behalf of Petitioner: Guazdian Elder Caze, LLC d/b/a Forest Pazk Health Center Counsel of Record for Plaintiff: Schutjer Bogar LLC Nicole M. Kems Attomey I.D. No. 206827 (412) 281-3511 nkerns@schutjerbogaz.com Marijane E. Treacy Attorney I.D. No. 84070 (412) 281-3535 mjtreacy@schutjerbogaz.com U.S. Steel Tower 600 Grant Street, Suite 3290 Pittsburgh, PA 15219 Fax (412)281-0530 Chadwick O. Bogaz Attorney I.D. No. 83755 (717)909-5920 417 Walnut Street, 4s' Floor Harrisburg, PA 17101 IN THE C()UIiT OF CdMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: JACQUELINE BEAUDRY, An Alleged Incapacitated Person O.C. No. o2czA'-~~5~ n o ~~ J n L '~ fT C.7 l r ~ W v:: __~ i ''iii ~ ~~ t c.~ ` s _~_ .,_ J ~~ W // i'_rl ~ +~'' ~~} F' PETITION UNDER $ 5511 OF THE PROBATE. ESTATES AND FIDUCIARIES CODE TO ADJUDGE JACOUELINE BEAUDRY TO BE TOTALLY INCAPACTTATED AND APPOINT A PERMANENT PLENARY GUARDIAN FOR HER ESTATE AND NOW, COMES, Petitioner, Guazdian Elder Caze, LLC d/b/a Forest Pazk Health Center ("Petitioner"), by and through its attorneys, SCHUTJER BOGAR LLC, and hereby petitions for adjudication of incapacity and appoinhnent of a permanent plenary guazdian of the estate of Jacqueline Beaudry and, in support thereof, represents as follows: The name of the alleged incapacitated person is Jacqueline Beaudry. 2. Jacqueline Beaudry, the alleged incapacitated person, is an 87 yeaz old married woman who currently resides at Petitioner's skilled nursing facility located at 700 Walnut Bottom Road, Carlisle, Pennsylvania 17013. 3. Petitioner is a domestic limited liability corporation, with its principle place of business located at 1217 Slate Hill Road, Camp Hill, Pennsylvania 17011. 4. Because the alleged incapacitated person resides in Cumberland County, this Court has Jurisdiction pursuant to § 711(10) of the Probate, Estates and Fiduciary Code and § 5512(a). Upon information and belief, the alleged incapacitated person has the following living heirs or next of kin who aze sui jurist Robert Beaudry (husband) c/o Forest Pazk Health Center 700 Walnut Bottom Road Cazlisle, Pennsylvania 17013 Paul Beaudry (son) 4055 West 166"' Street Cleveland, Ohio 44135 Catherine Beaudry (daughter) 118 W. South Street Cazlisle, Pennsylvania 17103 6. To the extent of Petitioner's knowledge, the alleged incapacitated person's estate is less than $10,000.00. 7. An application for Medical Assistance benefits has been filed on behalf of Jacqueline Beaudry and is currently pending before the Cumberland County Assistance Office. 8. Upon information and belief, and to the extent of Petitioner's knowledge, the alleged incapacitated person receives monthly income from Social Security in the amount of approximately $350.00. Petitioner has applied to become Representative Payee of the same. 9. The alleged incapacitated person's treating physician is: Dr. Jay Townsend Grahm Medical Clinic 110 S. High Street Newville, Pennsylvania 17241 10. Jacqueline Beaudry, the alleged incapacitated person, has been diagnosed by Dr. Townsend as suffering from, interalia, dementia. Said mental condition has caused her incapacity and requires that she receive 24-hour-a-day caze. 11. Because of the mental condition set forth in pazagraph 10, Jacqueline Beaudry, the alleged incapacitated person, is totally unable to manage or even appreciate the significance of her financial affairs and to make and communicate any decisions relating thereto, including the ability to communicate her need for assistance in this azea. 12. Presently, the alleged incapacitated person does not have an agent, guazdian, and/or available next of kin who has power of attorney to manage her financial affairs on her behalf. On Apri12, 2004, Jacqueline Beaudry executed a General Power of Attorney document naming her husband, Robert Mann Beaudry as her agent. See the Power of Attorney attached hereto as Exhibit "A." However, Mr. Robert Beaudry is currently a resident of Petitioner's skilled nursing facility and unable to perform his duties as agent under his wife's Power of Attorney. Mrs. Beaudry did not appoint any successor agents. 13. There aze no less restrictive alternatives to the appointment of a permanent plenary guazdian of the estate of the alleged incapacitated person. 14. The proposed guazdian of the alleged incapacitated person is PA Guazdianship Association, P.O. Box 7295, Lancaster, Pennsylvania 17604. PA Guazdianship Association does not have any adverse interest to the alleged incapacitated person and an acceptance to serve as guazdian of the estate is attached hereto as Exhibit "B." I5. PA Guardianship Association has been suggested as guazdian of the estate of Jacqueline Beaudry because of its experience in dealing with incapacitated persons such as her. 16. No Court within this Commonwealth, of which Petitioner has knowledge, has appointed a guazdian for Jacqueline Beaudry. 17. Upon information and belief, Jacqueline Beaudry was not a member of the Armed Services of the United States and, therefore, is not receiving any benefits from the United States Veterans' Administration. WHEREFORE, Petitioner prays that a citation be issued to Jacqueline Beaudry to show cause, if any there be, why she should not be declazed an incapacitated person and PA Guazdianship Association be appointed permanent plenary guazdian of her estate. Respectfully submitted, Dated: -?~ SCHUTJER BOGAR, LLC By: ~~ M /~ Nicole M. Kerns Attorney I.D. No. 206827 (412)281-3511 nkerns@schutjerbogaz.com Marijane E. Treacy Attorney I.D. No. 84070 (412) 281-3535 mjtreacy@schutjerbogaz.com U.S. Steel Tower 600 Grant Street, Suite 3290 Pittsburgh, PA 15219 Fax (412)281-0530 Chadwick O. Bogaz Attorney I.D. No. 83755 (717)909-5920 417 Walnut Street, 4"' Floor Harrisburg, PA 17101 VERIFICATION The undersigned hereby verifies that the statements of fact in the foregoing document aze true and correct to the best ofmy knowledge, information and belief. I understand that any false statements therein aze subject to the penalties contained in 18 Pa. C. S. § 4904, relating to unsworn falsification to authorities. Dated: ~~~4'wy Dawn Jordan, BillinRiSupervisor Guazdian Elder Care, LLC d/b/a Forest Park Health Center s~-rr-ao~ EXHIBIT "A" f.F20i-04 8205-04 GENERAL POWER OF ATTORNEY nth Durable Provision) NOTICE: 'THIS IS AN Il~IPORTANT DOCUMENT. BEFORE SIGNING THLS DOCU- MENT, YOU SHOULD KNOW TfIESE IMPORTANT FACTS. THE PURPOSE OF THIS POWER OF ATTORNEX IS TO GIVE THE PERSON WHOM X DESIGNATE (YOUR "AGENT'') BROAD POWERS TO HANDLE YOUR. PROP RTY, WHICH MAY INCLUDE POWERS TO PLEDGE, SELL OR OTHERWISE D POSE OF ANY REAL OR PERSONAL PROPERTX WITHOUT ADVANCE NOTICE T® YOU OR APPROVAL BX XOU. YOU MAY SPECIFX THAT THESE POWERS WILD EXIST EVEN AFTER YOU BECOME DISABLED, INCAPACITATED OR INCOMPETENT. THIS DOCUMENT DOES NOT AUTHORIZE ANYONE TO MAKE MEDICAL OR OCHER HEALTH CARE DECISIONS FOR YOU. IF THERE IS A.NY'THING ABOUT THIS (FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER TO EXPII,AIN IT TO YOU. YOU MAY REVOKE THIS POWER OF ATTORNEY IF YOU LATER VvISH TO DO SO. TO ALL PERSONS, be it known that I, .lr.. c$ut (rr-t C(~ev. r~t+gRti[ 3~~ , of /3 ~~*aiPCbrvelK ~[../ Sleva.b+resa+~/t, /ha.'a..c 04075' s ' the undetsig[led Grantor, do hereby make and grant a general power of attorney to J#e Deaf hT waw ~efe4d'r of ~ 3 trt/,r,c~+rskJfc.~ '° Loros,a/c~ ,d~i0.rR~6 04s7~ and do thereupon constitute and appoint said individual as my auomey-in-fact/agent. My attorney-in-facVagent shall act in my name, place and stead is any waK which I myself could do, if I were pmonally present, with respect to the following matters, to the extent thaz I am ~ieermitted by taw to eee through an agent: l (lYt7IICE: The granror must write his or her initials [n the corresponding blank spade Of a boz below with rcspec[ to each of the subdivisions (A) through (O) below for which the Cttantor wants to give the agent authority. If the blank space within a box for any particular subdivision is NOT initialed, NO AUTFIORI~SY WII-L BE GRANTED for matters that are included in that subdivision. Cross out each power withheld) [ ~ j (A) Real estate transactions [ tjf j (B) Tangible personal propetry Iratasactions [ s ) (C) Bond, share and commodity transactions [ J' ) (D) Banking transactions [ j (E) Business operating transactions [ ~ J (~ Insurance transactions [ ,(~ j (G) Gifts to charities and individuals other than Attorney-ia-FacuA.gent r ,r (If trust distn'butiaus are involved or tax consequences are a~dpated, coawlt an attorney.) 01992-2001 atade E-Z PmducK, ac per` t acv. INtl1 TTis pradue[ dace swr coaaimte We rendering of legd advice or services. T'ais prOduet is intended for infmmstiooa~ sse wIY +ad a nor a sulMidu for legal advice. Suu laws vuy, 9ocoesult an attorney on >n legal 0raaefi-TMs product was npt aeeryyYlly pcepsred try • pelwn Ikeavd to pxrice law in your sue. AZP.K .9 [ LM~° i t 7 (II) Claims and ]idgation J 1 (I) Personal niatiooships and affairs I (n Benefits from military service ) I (IQ (L) Records, reports and statemenu Full and un ualified autboriry ro m att i f V q y orney- a- ac agetu foregoing powers to any person or persons whom my attome• ~ I (M) Access to safe deposit box(es) 1 (N) To authorize rnedreal and surgical procedures (Pennsylvania t } ] (O) All other maners Durable Provision: d ) (P) Xf the blank space fo the Dlock to the left is initialed by the G /' shall not be aRected by the subsequent dissbliky or income Other Terms: My attorney-iut-fact/agent hereby accepts this appointment subject to it and perform in said fiduciary capacity consistent with my best interest: discretion deems advisable, and 1 affirm and ratify all acts so undertake TO INDUCE ANY T'fiLltD PARTY TO ACT HEREUNDER, I HEREBY A~ PARTY RECEIVING A DULY EXECUTED COPX OR FACSIIvLQ-E OF T ACT HEREUNDER, AND THAT REVOCATION OR TERMINATIO: INEFFECTIVE AS TO SUCK THIRD PARTX UNLESS AND UNTII KNOWLEDGE OF SUCH REVOCATION OR TERMINATION SHALL HA SUCH TH]1LD PARTY, AND I FOR MXSELF AND FOR MY HEIR: REPRESENTATIVES AND ASSIGNS, HEREBY AGREE TO INDEMNIFY ANX SUCH THIItD PARTY FROM AND AGAINST ANY AND ALL CL.. AGAINST SUCH THIRD PARTX BY REASON OF SUCH THIILD PARTY I PROVISIONS OF THIS INSTRUMENT. any or all of the r shall select this power of attorney of the Grantor. terms and agrees to act ~ he/she in his/her best EtEE THAT ANY T'FIIRD IS INSTRUMENT MAY HEREOF SHALL BE ACTUAL NOTICE OR E BEEN RECEIVED BY EXECUTORS, LEGAL ,ND HOLD i~ttMi.RCS avlS THAT MAY ARISE WING RELIED ON THE Signed ands seal this day of , 20 ; . Signe in the presence of: Witness ~~ ImC3~ 5 -~ Attorney-in- ac Agent F~4o State of /U.Q ~ ne County of ~{~Y7~Pl~~a'+~/ On I~YT ~ c2 t aDr7~ before me. ~aQ~UGI %r-e C . Bet u~ I` / • appeared personally mown to me (or proved w me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/ate subscribed to the within instrtment and aclmowledged to me that 6e/she/thry executed the same in his/her/their authorized eapac- ity(ies), and tha[ by his/herftheir signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument ' WITNESS~.my hand and offi~i~l,sQeal. L Signature 11,G~ f~ _ PF-~~.~' i Af6ant _~ICUOwn Produced lA Yype of lIJ (Seal) P's° ~ KA?HRYN R. S'1'EVENS AZAK ~y My Cnmt~lubn s, 2009 EXHIBIT "B" ACCEPTANCE OF PROPOSED PERMANENT PLENARY GUARDIAN PA Guardianship Association, the guardian of the estate proposed in the foregoing petition for appointment of a permanent plenary guardian of the estate of Jacqueline Beaudry, the alleged incapacitated person, agrees to accept the appointment as guardian of the estate and avers that it is not a fiduciary of an estate in which the alleged incapacitated person has an interest, and the proposed permanent guardian of the estate of Jacqueline Besudry has no interests adverse to her. Dated: O so-tr-ao~ rian Brooks, President PA Guardianship Association ,A~ ~