HomeMy WebLinkAbout11-02-09Steven M. Montresor
Attorney I.D. No. 74244
LATSHA DAMS YORE & McKENNA, P.C.
1700 Bent Creek Boulevazd, Suite 140
Mechanicsburg, PA 17050
Tele: (717) 620-2424
Fax: (717)620-2444
smontres@ldylaw.com
i
6 r
p
W
Z
[~'
O Ci'S
CC~~ c ~;
N
~ r
Cl~
N r~ r
_:., r.
CQ
~
S~
-i=i -'T'+
r „~
C
~ S
.
~ ~ e.';,,..,1
~ 'J~
Attorneys for Petitioner,
Sarah A. Todd Memorial Home
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN THE MATTER OF
MIMI BLAZER, ~ /+
An Alleged Incapacitated Person No cr?/- 09- ~V°~7
PETITION FOR ADJUDICATION OF INCAPACITY
AND APPOINTMENT OF GUARDIAN
AND NOW COMES, Petitioner, United Church of Christ Homes, Inc. d/b/a Sazah A.
Todd Memorial Home, by and through its attorneys, Latsha Davis Yohe & McKenna, P.C., and
hereby petitions for an adjudication of incapacity and appointment of a guazdian under 20
Pa.C.S. § 5511, and in support thereof represents as follows:
The name of the alleged incapacitated person is Mimi Blazer, hereinafter referred
to as "Ms. Blazer".
132690
2. Petitioner is United Church of Christ Homes, Inc. d/b/a Sarah A. Todd Memorial
Home located at 1000 West South Street, Cazlisle, Cumberland County, Pennsylvania 17013,
hereinafter referred to as "Facility" or "Petitioner"
3. Ms. Blazer is single, 86 years of age, and currently resides at the Facility.
4. Ms. Blazer has been a resident of Facility since October 30, 2008, where she
currently receives skilled nursing caze.
The name and address of Ms. Blazer's family and presumptive heir known to
Petitioner is as follows:
John Blosser
49 Thrale Road
London SW16 1NT, UK
6. The name and address of Ms. Blazer's attending physician is as follows:
George P. Branscum, M.D.
75 Nelson Drive
Carlisle, Pennsylvania 17015
7. Ms. Blazer suffers from Alzheimer's disease, aphasia and depressive disorder.
Due to Ms. Blazer suffering from Alzheimer's disease, aphasia and depressive
disorder, she is no longer capable of making medical or financial decisions.
9. The attending physician named above will be available to testify in person during
a hearing scheduled by the Court.
10. Due to her condition, Ms. Blazer is:
a. Unable to manage her financial affairs;
b. Unable to make and communicate responsible decisions relating to her
financial affairs;
132640
c. Unable to make responsible decisions concerning her person, health,
welfare, and safety;
d. Unable to communicate her needs conceming her health, welfaze, and
safety;
e. Unable to reside alone;
f. Unable to provide for her personal safety;
g. Unable to keep herself properly nourished and hydrated;
h. Unable to tend to her personal hygiene;
Unable to clothe herself;
Unable to medicate herself; and
k. Unable to make responsible decisions with regard to her medical Gaze,
including, but not limited to, obtaining health care services and entering
herself into a hospital, convalescent home, skilled Gaze facility, residential
care facility or similaz institution.
11. Ms. Blazer has appointed Alan Berlin as her agent pursuant to a General Power of
Attorney dated September 30, 1998. Mr. Berlin's last known address is 1 Bellaire Avenue #3,
Cazlisle, Pennsylvania 17013.
12. Upon information and belief, Ms. Blazer has not executed a Last Will and
Testament or an Advance Directive.
13. Upon information and belief, Ms. Blazer's sole asset is a checking account with
Wachovia Bank. As of October 30, 2008, the account balance was $2,866.27.
132640
14. Ms. Blazer receives a monthly pension check in the amount of $26.53, a monthly
Social Security check in the amount of $852.00, and a quarterly annuity check in the amount of
$662.58.
15. Ms. Blazer is a recipient of Medical Assistance benefits.
16. The Medical Assistance program calculated Ms. Blazer's monthly contribution
toward her cost of caze based upon her annuity, pension and Social Security income.
17. Ms. Blazer's pension and annuity checks are not being fumed over to the Facility
on a consistent basis.
18. Facility serves as representative payee for Ms. Blazer's Social Security checks.
19. Alan Berlin executed a Nursing Home Admission Agreement dated October 29,
2008, hereinafter referred to as "Admission Agreement", on behalf of Ms. Blazer, and is
designated as "Responsible Person" under the Admission Agreement.
20. Alan Berlin executed a sepazate Responsible Person Agreement dated October 30,
2008.
21. As Responsible Person, Alan Berlin is obligated to fulfill the duties on behalf of
Ms. Blazer imposed by the Admission Agreement and the Responsible Person Agreement.
22. Alan Berlin continues to breach his contractual obligation to use Ms. Blazer's
financial resources to pay Facility for the services and supplies it provides to Ms. Blazer.
23. Upon information and belief, Alan Berlin was arrested on May 28, 2009 and
chazged with one count each of unlawful contact with a minor related to involuntary deviate
sexual intercourse, unlawful contact with a minor, criminal attempted sexual exploitation of
children, and criminal solicitation to commit sexual abuse of children.
]32690
24. Ms. Blazer's medical condition currently necessitates the appointment of a
plenary guardian of her person and estate.
25. The Admission Agreement provides that the Facility may petition a court to
appoint a guardian if the Facility reasonably believes that Ms. Blazer's needs aze not being met
by Ms. Blazer's Responsible Person.
26. Alan Berlin is not an appropriate guardian for Ms. Blazer for the reasons set forth
in this Petition.
27. Keystone Guardianship Services, located at P.O. Box 804, Elizabethville,
Pennsylvania 17023 consents to serve as guardian of the person and estate of Ms. Blazer. A
Consent of Proposed Guardian fonn signed and executed by Keystone Guazdianship Services is
attached hereto as Exhibit "A."
28. Keystone Guardianship Services is qualified to act as guardian of the person and
estate of Ms. Blazer by virtue of its familiarity and experience in acting as guazdian of the person
and estate for individuals such as Ms. Blazer.
29. To the extent Ms. Blazer is eligible for Medical Assistance benefits, Keystone
Guazdianship Services will serve as guardian of Ms. Blazer's person and estate for a fee of
$100.00 per month.
30. No other court within this Commonwealth has appointed a guazdian of the person
or estate of Ms. Blazer.
31. This proposed guazdianship is in the best interests of Ms. Blazer for the proper
medical decisions and management of her financial resources.
32. Due to Ms. Blazer's medical condition, no less restrictive alternative is feasible.
132640
33. Upon information and belief, Ms. Blazer was neither a member of the armed
forces nor a recipient of Veterans Administration benefits.
34. The type of guazdianship sought is plenary of Ms. Blazer's person and estate.
35. The proposed guardian has no interest adverse to Ms. Blazer.
WHEREFORE, Petitioner, United Church of Christ Homes, Inc. d/b/a Sazah A. Todd
Memorial Home respectfully requests that this Honorable Court issue a Citation directed to Ms.
Blazer or her counsel, if so appointed, to show cause why Ms. Blazer should not be adjudicated
an incapacitated person, and Keystone Guardianship Services not be appointed plenary guardian
of the person and estate of Ms. Blazer.
Respectfully submitted,
LATSHA DAMS YOHE & MCKENNA, P.C.
Date: l 0 • 3 U • aoO~ By: `~ l•.~
Steven M. Montresor
Attorney LD. No.: 74244
1700 Bent Creek Boulevazd, Suite 140
Mechanicsburg, PA 17050
(717) 620-2424
Attorneys for Petitioner, United Church of
Christ Homes, Inc. d/b/a Sazah A. Todd
Memorial Home
132690 6
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN THE MATTER OF
MIIVII BLAZER,
An Alleged Incapacitated Person No.
VERIFICATION
I, Mary Jane Walker, hereby verify that I am the Administrator and am duly authorized
on behalf of Sarah A. Todd Memorial Home, the Petitioner named in the foregoing Petition for
Adjudication of Incapacity and Appointment of Guardian, to verify that the statements made
therein are true and con•ect to the best of my knowledge, information and belief and that these
statements are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unswom
falsification to authorities.
Sarah A Todd Memorial Home
Date: Jo ~ a (• O `( By: q l ~
Mary ne al , NHA
132640
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN THE MATTER OF
MIMI BLAZER,
An Alleged Incapacitated Person No.
CONSENT OF PROPOSED GUARDIAN
Keystone Guardianship Services does hereby certify that it is willing to act as guazdian of
the person of Mimi Blazer, an alleged incapacitated person, if the Court shall so appoint.
Further, Keystone Guazdianship Services hereby certifies that it is not a fiduciary or
surety of any estate in which Mimi Blazer has an interest, nor leas it any interest currently
adverse to the alleged incapacitated person.
Date: ~ ~ a i D 9 By: Lr~~ __~~~
Constance E. toneroad
Keystone Guardianship Services
132640