HomeMy WebLinkAbout08-04-09IN RE: THEODORE SYPHAX, 1N THE COURT OF COMMON PLEAS
An Alleged Incapacitated Person OF CUMBERLAND COUNTY, PENNSYLVANIA
:ORPHANS' COURT DIVISION
PETITION OF GOLDEN LIVINGCENTER-CAMP HILL
FOR THE ADJUDICATION OF INCAPACITY AND APPOINTMENT OF A
GUARDIAN OVER THE PERSON AND ESTATE OF THEODORE SYPHAX
AND NOW, comes the Petitioner, Golden LivingCenter -Camp Hill ("GLC-Camp
Hill"), by and through its counsel, Thomas, Thomas & Hafer LLP, and respectfully petitions this
Honorable Court pursuant to 20 Pa. C.S. § 5511 for an Order adjudicating Theodore Syphax to
be an incapacitated person and appointing a guardian over his Person and Estate and, in support
thereof, avers as follows:
1. Petitioner GLC -Camp Hill is licensed as a long-term care nursing facility in
Pennsylvania. ~
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2. GLC -Camp Hill is a long term care nursing facility located at 46rd Ro . •_ ~
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Camp Hill, Pennsylvania 17011. ~:.`.~' ~ ~ ~ r
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3. Theodore Syphax is 77 years of age, with a date of birth of May 3~ ~3~L. ~` -~ , '_,
4. Mr. Syphax. was admitted to GLC -Camp Hill on Apri122, 2009, and is curr~tly ~ ~~~
a resident at that facility. The essential requirements for Mr. Syphax's health and safety are
provided at GLC -Camp Hill.
5. As the residential care provider for Mr. Syphax, GLC-Camp Hill has an interest in
his welfare given his status as an alleged incapacitated person.
6. Mr. Syphax suffers from Anoxic Encephalopathy, and other serious medical
conditions. These conditions impair his ability to make any decisions regarding his physical
condition, health, well-being, and other matters, including financial matters. (See Verification of
James Harty, M.D., attached hereto as Exhibit "A").
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7. According to his attending physician, James Harty, M.D., Mr. Syphax is
incapable of making competent decisions regarding his medical treatment or financial and
personal affairs. (See Exhibit "A").
8. Theodore Syphax's mental and physical status is not expected to improve. The
progression of his mental condition is irreversible. (See Exhibit "A").
9. Theodore Syphax is unable to competently manage or take care of matters
pertaining to his own health and well-being or financial matters without the existence of another
individual who will act as his guardian. He is unable to resist fraud or undue influence without
the assistance of a guardian. (See Exhibit "A")
10. Upon Petitioner's information and belief, Theodore Syphax has no living will,
advance directive for health care, power of attorney, or other document regarding his wishes
pertaining to his personal affairs and/or medical care in the event of his incapacity while a
resident at GLC -Camp Hill. (See Certification of Jacquelyn Lovejoy, Social Services Director,
Golden LivingCenter -Camp Hill, attached hereto as Exhibit "B").
11. Upon Petitioner's information and belief, no other guardian over the Person or
Estate of Theodore Syphax has been appointed, and no other Court has assumed jurisdiction in
any proceedings to determine the capacity of Theodore Syphax.
12. Upon Petitioner's information and belief, Theodore Syphax has a daughter,
Dorothy Atkins, who currently resides at 508 Carver Court, Lawnside, NJ 08045, (856) 430-
3476. (See Exhibit "B").
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13. Petitioner's counsel has contacted Dorothy Atkins to discuss the proposed
guardianship over the Person and Estate of Theodore Syphax. Dorothy Atkins indicated that she
does not oppose the appointment of The Pennsylvania Guardianship Association as guardian
over the Person and Estate of Theodore Syphax. (See July 6, 2009 correspondence, Exhibit
«C„
)•
14. Upon Petitioner's information and belief, Theodore Syphax has a daughter,
Jacqueline Harris, who currently resides at 214 Ellis Street, Haddonfield, NJ 08033, (856) 795-
0285. (See Exhibit "B").
15. Upon information and belief, Jacqueline Harris does not oppose the appointment
of The Pennsylvania Guardianship Association as guardian over the Person and Estate of
Theodore Syphax. (See July 6, 2009 correspondence, Exhibit "C").
16. Upon information and belief, Theodore Syphax maintains a checking and savings
account with Members lst Federal Credit Union in the aggregate amount of $2,989.55.
17. Upon information and belief, Theodore Syphax receives approximately $643.00
in Social Security Income per month.
18. Upon information and belief, Theodore Syphax owns real property located at 73
Partridge Circle, Carlisle, PA 17013.
19. Upon information and belief, the real property is being occupied by Theodore
Syphax's girlfriend and former caregiver.
20. Upon information and belief, Theodore Syphax was a member of the United
States Armed Forces, and receives a Veteran's Administration pension of approximately
$2,647.00 per month.
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21. A guardian over Mr. Syphax's Person and Estate is required to provide consent
for medical and surgical care and treatment, and to ensure that Theodore Syphax's continued
personal needs and financial obligations are satisfied.
22. Petitioner believes there are no less restrictive alternatives to seeking a
guardianship over the Person and Estate of Theodore Syphax.
23. The proposed guardian over Theodore Syphax is The Pennsylvania Guardianship
Association ("PAGA"), anon-profit corporation, located at P.O. Box 7295, Lancaster, PA
17604.
24. PAGA has agreed to serve as guardian over Theodore Syphax's Person and
Estate. (See Consent of Proposed Guardian attached hereto as Exhibit "D").
25. Upon information and belief, PAGA has no interest adverse to the alleged
incapacitated person.
26. PAGA is a qualified guardian pursuant to 20 Pa. C.S. § 5511(f).
27. Petitioner respectfully requests that the proposed guardian be given powers over
the Person and Estate of Theodore Syphax.
28. Theodore Syphax's mental and physical condition mandates that a guardian be
appointed to make decisions concerning his Person and his Estate, including, but not limited to
his living arrangements, 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 regarding his finances and to manage his assets.
WHEREFORE, Petitioner, Golden LivingCenter -Camp Hill, respectfully requests that
this Honorable Court issue a citation directed to Theodore Syphax, the alleged incapacitated
person, with notice to such persons as this Court may direct, to show cause why Theodore
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Syphax should not be adjudged a totally incapacitated person, and why 'The Pennsylvania
Guardianship Association should not be appointed guardian over his Person and Estate.
Respectfully submitted:
THOMAS, THOMAS & HAFER, LLP
Dated: ~ ~ ~- ~ 9
1)/iarc A. M er, Esquire
Attorney . No. 76434
305 No Front Street, 6th Floor
P.O. ox 999
Harrisburg, PA 17108
(717) 441-3960
mmoyer@tthlaw.com
Counsel for Petitioner Golden LivingCenter-
Camp Hill
711803.1
S
EXHIBIT A
VERIFICATION OF JAMES HARTY, M.D.
I, James Harty, M.D., do hereby state that the following is true and correct based upon
my personal knowledge, information and belief:
1. I am a physician licensed in good standing to practice medicine in the
Commonwealth of Pennsylvania.
2. I am the attending physician for Theodore Syphax. I attend to Theodore on a
regular basis at Golden LivingCenter -Camp Hill located at 46 Erford Road, Camp Hill,
Pennsylvania, 17011 where Theodore Syphax has resided since Apri122, 2009.
3. Theodore Syphax is 77 years of age, with a date of birth of May 30, 1932.
4. Mr. Syphax suffers from Anoxic Encephalopathy, and other serious medical
conditions.
5. Mr. Syphax's Anoxic Encerphalopathy is not curable or reversible.
6. I have determined to a reasonable degree of medical certainty that Theodore
Syphax is unable to receive and evaluate informatio ~ effectively and communicate decisions,
and that his abilities are impaired to such a degree as to render his totally unable to meet the
requirements for his physical health and safety without the assistance of another
individual/organization who will act as a guardian over his Person.
7. I have determined to a reasonable degree of medical certainty that Theodore
Syphax is unable to receive and evaluate information effectively and communicate decisions,
and that his abilities are impaired to such a degree as to render his totally unable to manage his
financial resources without the assistance of another individual/organization who will act as a
guardian over his Estate.
It is my opinion that Mr. Syphaa is unable to resist fraud or undue influence
without the assistance of a guardian to make decisions regarding his health care.
9. It is m}~ opinion that the failure to appoint a guardian with authority to provide
consent for Mr. Syphaa to receive appropriate psychiatric care and treatment will result in
irreparable harm to his Person
I declare that the above statements are true subject to the penalties of 18 Pa. C.S. X4904
relating to unsworn falsification to authorities.
Date
711837.1
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James Harty, .D.
2
EXHIBIT B
VERIFICATION OF JACQUELYN LOVEJOY DIRECTOR OF SOCIAL
SERVICES, GOLDEN LIVINGCENTER-CAMP HILL
I, Jacquelyn Lovejoy, do hereby state under penalt~~ of perjury that the following
is true and correct based upon my personal knowledge:
I am the Director of Social Services for Golden LivingCenter -Camp Hill
which provides skilled nursing and rehabilitation services at 46 Erford Road, Camp Hill,
Pennsylvania 17011.
2. Theodore Syphax is currently a resident of Golden LivingCenter -Camp
Hill and has been a resident since his admission on Apri122, 2009.
3. To the best of my knowledge, Theodore Syphax has not executed a living
will, advance directive for health care, power of attorney, or other document evidencing
his wishes regarding his medical treatment in the event of his incapacity.
4. Upon information and belief, Theodore Syphax maintains a checking and
savings account with Members 1 S` Federal Credit Union in the aggregate amount of
$2,989.55.
5. Upon information and belief, Theodore Syphax owns real property located
73 Partridge Circle, Carlisle, PA 17013.
6. Upon information and belief, Theodore Syphax receives approximately
$643.00 in Social Security Income per month.
7. Upon information and belief, Theodore Syphax was a member of the
United States Armed Forces, and receives a Veteran's Administration pension of
approximately $2,647.00 per month.
8. Upon Petitioner's information and belief, Theodore Syphax has a
daughter, Dorothy Atkin, who currently resides at 508 Carver Court, Lawnside, NJ
08045. (856) 430-3476.
9. Upon Petitioner's information and belief, Theodore Syphax has a
daughter, Jacqueline Harris, who currently resides at 214 Ellis Street, Haddonfield, NJ
08033, (856) 795-0285.
I declare that the above statements are true subject to the penalties of 18 Pa. C.S.
X4904 relating to unsworn falsification to authorities.
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Date Jacqu n L vejo , ~-e"'°f
Director of Social Services
Golden LivingCenter -Camp Hill
:711844.1
2
EXHIBIT C
HAI2RIS$U12G
BETHLEHEM
PITTSI3ITR(;H
BALTIMORE
PHILADELPHIA
THOMAS, THOMAS
& HAFER LT p
A`T'TORNEYS AT I,.AW
„~~~ .ttlila~-. com
Marc A. Moyer
(717) 441-3960
mmoyer~a)tthlati~. com
July 6, 2009
VIA CERTIFIED MAIL/REGULAR MAIL
7008 3230 0000 3420 6004
Jacqueline Harris
214 Ellis Street
Haddonfield, NJ 08033
Dear Ms. Harris:
I am writing this letter to you after several unsuccessful attempts to contact you by telephone
regarding the appointment of a guardian over the Person and Estate of your father, Theodore
Sypha~, who currently resides at Golden LivingCenter -Camp Hill. I have spoken with your sister,
Dorothy Atkins, who has informed me that you have spoken to her regarding the appointment of
Pennsylvania Guardianship Association as the designated guardian, and that you do not oppose such
an appointment.
Would you please be so kind as to contact me immediately in the event my understanding of
my conversation with your sister was incorrect in any manner, or if you have any questions. Thank
you for your time and attention to this matter.
MAM/jld:n2s9o.I
V ery t y yours
ar y r
305 North Front Street, Sixth Floor, Harrisburg, PA 17101 Phone: (717) 237-7100
Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Fax: (717} 237-7105
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Dorothy Atkins
508 Carver Court
Lawnside, NJ 08045
Re: Theodore Syphax Guardianship
Dear Ms. Atkins:
A'!'TORnF;YS AT I.Al~'
„~~~.t~tlilativ. com
Marc A. Mover
(717) 441-3960
mmoyer@tthla~~. com
It was a pleasure speaking with you on July 2, 2009, regarding the appointment of a
guardian over the Person and Estate of your father, Theodore Syphax, who currently resides at
Golden LivingCenter -Camp Hill. Pursuant to our conversation, this letter is to confirm that you
do not oppose the appointment of Pennsylvania Guardianship Association as the designated
guardian.
I also understand from our conversation that you have spoken with your sister, Jacquelyn
Harris, regarding the appointment of a guardian; and that she too does not oppose the appointment
of Pennsylvania Guardianship Association as guardian. Once again, thank you for your continuing
courtesy in that regard. Please do not hesitate to contact me if my understanding of our telephone
conversation was incorrect, or if you have any questions.
Very t yours,
Marc over
MAM/j 1d:712588.1
305 North Front Street, Sixth Floor, Harrisburg, PA 17101 Phone: (717) 237-7100
Mailing Address: P.O. Box 999, Harrisburg, PA 17108 Fax: (717) 237-7105
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EXHIBIT D
CONSENT OF PROPOSED GUARDIAN
1. I. Brian D. Brooks, President of Pennsylvania Guardianship Association
("PAGA") hereby consent on behalf of PAGA to act as Guardian over the Person and.
Estate of Theodore Syphax, an alleged incapacitated person.
2. PAGA is doing business at 117 South West End Avenue, P.O. Box 7295,
Lancaster. PA 17604 and is a qualified guardian pursuant to 20 Pa. C.S. ~ 5511(f).
3. PAGA provides guardianship services allowing for the highest quality of
care available in the least restrictive setting available. PAGA will provide a full range of
human services, including taking responsibility for medical and personal care decisions,
handling financial affairs, providing one-on-one contact and monitoring, and other
services, as necessary.
4. PAGA maintains liability insurance. (See Certificate of Liability
Insurance attached to this Consent).
5. PAGA and its agents have no interests, financial or otherwise; adverse to
those of Mr. Syphax. In addition, no agents of PAGA reside in the same household or
facility with the incapacitated person.
~/~ /~~
Date Brian D. Brooks
President, PAGA
:7l 1957.1