HomeMy WebLinkAbout03-0278IN RE: A. RICHARD GEISLER
An alleged incapacitated person
· IN THE COURT OF COMMON PLEAS
· OF CUMBERLAND COUNTY,
· PENNSYLVANIA
· ORPHANS' COURT DIVISION
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
PETITION FOR APPOINTMENT OF GUARDIAN OF THE
PERSON AND ESTATE OF AN ALLEGED INCAPENNSYLVANIACITATED PERSON
TO THE HONORABLE PRESIDENT JUDGE OF SAID COURT:
NOW COME, Petitioners, GINA M. ROBERTSON and MARK A. GEISLER, by and
through their attorney, Marielle F. Hazen, Esquire, and file the within Petition for the Appointment
of Guardian of the Person and Estate of an Alleged Incapacitated Person, and in support hereof, aver
as follows:
1. A. RICHARD GEISLER, the alleged incapacitated person, currently resides at 35
Beach Farm Road, Wormleysburg, Pennsylvania 17043. He is seventy one years old, his date of
birth being February 3, 1932·
2. A. RICHARD GEISLER is married, but has lived separately from his wife for
approximately 20 years. His wife is Betty R. Geisler, of 325 E. King Street, Littlestown,
Pennsylvania 17340· Betty R. Geisler joins in this request that petitioners be appointed plenary
guardians of the person and estate of A. RICHARD GEISLER.
3. A. RICHARD GEISLER is not a patient in a mental hospital.
4. The Petitioners are GINA M. ROBERTSON, daughter, of 293 Thomas Drive,
Gettysburg, Pennsylvania 17325, and MARK A. GEISLER, son, of 3 E. Miner Street, West Chester,
Pennsylvania 19382. They are the only two children of A. RICHARD GEISLER.
5. The names and addresses of those persons who would be the intestate heirs (or next of
kin) of A. RICHARD GEISLER are as follows: GINA M. ROBERTSON, daughter, of 293 Thomas
Drive, Gettysburg, Pennsylvania 17325, MARK A. GEISLER, son, of 3 E. Miner Street, West
Chester, Pennsylvania 19382, and BETTY R. GEISLER, spouse, of 325 E. King Street, Littlestown,
Pennsylvania 17340. Other interested parties include Martin Robertson, (son-in-law and beneficiary
of A. RICHARD GEISLER's Will), of 293 Thomas Drive, Gettysburg, Pennsylvania 17325, and
Joyce M. Gemberling (beneficiary of Will and long time companion of A. Richard Geisler), of 35
Beach Farm Road, Wormleysburg, Pennsylvania 17043.
6. The names and addresses of the person or institutions providing residential services to
A. RICHARD GEISLER are as follows: A. RICHARD GEISLER is receiving rehabilitation and
nursing care services at Masonic Homes, One Masonic Drive, Elizabethtown, Pennsylvania 17022.
7. The names and addresses of other service providers are as follows: None.
His primary physician is:
Glenda Cook, M.D.
One Masonic Drive
Elizabethtown, PA 17022
717/367-1121
8. A. RICHARD GEISLER was/is not a member of the Armed Services of the United
States and is not receiving benefits from the United States Veterans Administration.
9. The Petitioners ask that they, GINA M. ROBERTSON and MARK A. GEISLER, be
appointed as Co-Guardians, individually or jointly, of the person and estate of A. RICHARD
GEISLER. The proposed guardians are the children of A. RICHARD GEISLER. A. RICHARD
GEISLER's spouse joins in this request that GINA M. ROBERTSON and MARK A. GEISLER be
appointed plenary Co-Guardians of the person and estate of A. RICHARD GEISLER.
10. The proposed guardians have no interests that are adverse to the interests of A.
RICHARD GEISLER.
11. Petitioners believe, and therefore aver, that no Court has ever assumed jurisdiction in
a proceeding to determine whether A. RICHARD GEISLER is incapacitated.
12. Petitioners believe, and therefore aver, that A. RICHARD GEISLER has not
previously had a guardian appointed, nor is a guardianship hearing pending in any other jurisdiction.
13. The reasons why this guardianship is being sought are as follows: A. RICHARD
GEISLER is unable to manage his financial affairs or to make decisions regarding health
care/medical decisions, due to a stroke and the mental and physical impairments resulting from the
stroke.
14. The functional limitations and physical and mental condition of A. RICHARD
GEISLER are: A. RICHARD GEISLER is not able to manage his financial affairs, nor is he able to
make competent decisions as far as his welfare is concerned. A. RICHARD GEISLER is not able to
communicate and requires twenty-four hour care. He requires total assistance with all activities of
daily living. He is being fed with a feeding tube and is non-ambulatory.
15. The following steps have been taken, in order to find less restrictive alternative to the
appointment ora guardian: In the opinion of his medical providers, A. RICHARD GEISLER is not
competent to execute a power of attorney. No less restrictive alternatives are available to adequately
provide for the physical and financial care orA. RICHARD GEISLER. A. RICHARD GEISLER
signed a self-prepared financial Power of Attorney on April 12, 1992, designating Gina M.
Robertson, one of the petitioners herein, as his Agent. This document was witnessed, but was not
notarized. Because real estate may need to be sold, a co-agent is needed and healthcare decisions
need to be made, this document is inadequate to provide for A. RICHARD GEISLER's needs. A
copy of the Power of Attorney dated April 12, 1992 is attached hereto as Exhibit "A".
16. The Petitioners request that the guardians be granted powers to act for A. RICHARD
GEISLER in the following specific areas: financial management, including the ability to sell A.
RICHARD GEISLER' real estate, and medical and health care affairs including care and placement
decisions, access to all medical records, including psychiatric records, and the power to make all
decisions regarding medical treatment and life support.
17. The proposed guardians have the following qualifications: The proposed guardians
are the children of A. RICHARD GEISLER. The proposed guardians love and care for their father.
18. The gross value of the Estate of A. RICHARD GEISLER is unknown at this time.
Documentation is being gathered. A. RICHARD GEISLER' net income from all sources totals
approximately Five Thousand Dollars ($5,000) per month.
Petitioners respectfully request that the Court, under Section 5511 of the Probate, Estates and
Fiduciaries Code, issue a Citation to A. RICHARD GEISLER, A. RICHARD GEISLER's next of
kin, and to such other persons as the Court directs, to show cause why A. RICHARD GEISLER
should not be adjudged to be an incapacitated person and plenary guardian of his person and estate
be appointed.
Respectfully submitted,
y: arl~¥1e F. Hazen, Esquire
Attorney for Petitioners
Attorney ID No. 68003
2000 Linglestown Road, Suite 303
Harrisburg, Pennsylvania 17110
(717)540-4332
MAR--19-200~ 02:~5 PM MARIELLE_HAZEN~ATTORNE¥ ?17 540 4~I~
P.06
An alleged iflcapecitated person
: {3V' TILE COURT OF COMMON PLF. AS
: OF CUIViBERLAND COUNTY,
: PENNSYLVAI'qlA
: ORPHANS' COURT DI~*ISION
:
: NO.
CONSF, FF TO APPOtlVrMr. rr AS GUARD
1. Tho name of the proposed guardian of the person of A. RICHARD GEISLER is
Gl]VA M. ROBERTSON.
2. The name of the proposed guardi~m of the estate orA. RICHARD OEIRLER is OINA
M. ROBERTSON.
The propoe~! ~uerdisn does not bavc an intcrc~ edver~ to thc edleg~ incelmci~
Ol]'4',~vL ROBERTSON
MAR--19-280~ 02 :~4 PM MARIELLE--HA~EN~ATTORNE¥ 717 548 4~1~
P.04
COMMONWEALTH OF PENNSYLVANIA ·
COUNTY OF DAUPHIN ·
SS:
personaJly appem~ GINA M. ROBERTSON who, being duly sworn according to law, does dep0ae
and my that the facts set fm~h in the fomgo~ Petition are ~ue and ¢orte~ to th~ best of her
knowledge, information and belief.
IN wrrNESS WHEREOF, I hereunder set my hand and oifi¢ild seal.
M. ROBERTSON
l~otaty Public
Notarial g~d
Mariall¢ F. l-la.n. Notary Public
City of Harrisburg, Dauphin County
My Commission Expilw Sept. 23, 2006
MAR--19--288~ 02 :~4 PM MARIELLE--HAZEN~ATTORN£Y
717 548 4~1~
P.85
I v~fy that th~ stat~m~ts ma~ in this Petition are tru~ and ~rr~t. I uuck'mamt that fals~
sum~n~s lmx~n ar~ mad, subject to tl~ l~nalti~s of 18 PA.C.S. § 4904, relating to unsworn
fitbification to authorities.
OlN~d. ROBERTSON
IN RE: A. RICHARD GEISLER
An alleged incapacitated person
· IN THE COURT OF COMMON PLEAS
· OF CUMBERLAND COUNTY,
· PENNSYLVANIA
' ORPHANS' COURT DIVISION
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
1,4 2282003
REQUEST FOR ASSIGNMENT OF NON-JURY PROCEEDINC
We hereby request that this matter be assigned for judicial disposition. We certify that
thc following matter is ready for judicial disposition.
Captions of related cases and names of judges previously assigned: None
Respectfully Submitted,
Date
Attorney for Petitioners
PA I.D. No. 68003
2000 Linglestown Road, Suite 303
Harrisburg, PA 17110
(717) 540-4332
IN RE: A. RICHARD GEISLER
An alleged incapacitated person
· IN THE COURT OF COMMON PLEAS
· OF CUMBERLAND COUNTY,
· PENNSYLVANIA
· ORPHANS' COURT DIVISION
-NO.
On the Petition of GINA M. ROBERTSON AND MARK A. GEISLER
PRELIMINARY ORDER OF COURT
AND NOW, this day of ,2003, the foregoing Petitio!a having been
presemed in open Court, upon consideration thereof and on motion of Marielle F. Hazen, Esquire,
Counsel for the Petitioner, it is ORDERED and DECREED that a Citation be awarded, directed to
A. RICHARD GEISLER to show cause why he should not be adjudged an incapacitated person and
a plenary guardian of his estate and person be appointed, returnable __ .~t~ /~ , 2003 at
qD__0o'clock,/°c_M., prevailing time.
The time and place of hearing on the petition for appointment ora guardian of the estate and
person of the alleged incapacitaled person are fixed for ~ lq ~ 2003, at ~: 30 o'clock,pzM.'
prevmhng time, in the Orphans Court Division, CUMBERL(JAND County Courthouse, Carlisle,
Pennsylvania.
At least twenty days, written notice of the hearing shall be given to A. RICHARD GEISLER,
the alleged incapacitated person, by serving him personally with the Citation and this Order of Court
and a copy of the foregoing petition together with an explanation of the content and terms of the
petition; and at least ~ days' written notice of the petition and hearing shall also be given to the
next of kin and to the following Parties in interest: Masonic Homes, One Masonic Drive,
Elizabethtown, PA 17022; Betty R. Geisler (spouse), of 325 E. King Street, Littlestown, PA 17340;
Joyce M. Gembefling (beneficiary of Will), of 35 Beach Farm Road, Wormleysburg, PA 17043; and
Martin Robertson (beneficiary of Will), of 293 Thomas Drive, Gettysburg, PA 17325, either
personally or by registered or certified mall.
BY THE COURT:
Jo
IN RE: A. RICHARD GEISLER
An alleged incapacitated person
· IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
· PENNSYLVANIA
· ORPHANS' COURT DIVISION
· NO.
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
CITATION
YOU ARE HEREBY NOTIFIED THAT THE ATTACHED PETITION FOR THE
APPOINTMENT OF A GUARDIAN HAS BEEN FILED WITH THE ORPHANS' COURT OF
CUMBERLAND COUNTY AND THAT A HEARING ON THE PETITION HAS BEEN
SCHEDULED BEFORE , IN COURTROOM NUMBER _, LOCATED IN
THE CUMBERLAND COUNTY COURTHOUSE, AT HANOVER AND HIGH STREETS,
CARLISLE, PENNSYLVANIA, ON THE DAY OF , 2003, AT
O'CLOCK _.M. (PREVAILING TIME).
THE PURPOSE OF THIS HEARING IS TO DETERMINE:
1. WHETHER YOU SUFFER FROM ANy MENTAL OR PHYSICAL
IMPAIRMENT WHICH WOULD AFFECT YOUR ABILITY TO RECEIVE AND
EVALUATE INFORMATION EFFECTIVELY AND COMMUNICATE
DECISIONS; AND
2. WHETHER SUCH IMPAIRMENT, IF ANY, IS SIGNIFICANT ENOUGH TO
RENDER YOU PARTIALLY OR TOTALLY UNABLE TO MANAGE YOUR
FINANCIAL RESOURCES OR TO MEET ESSENTIAL REQUIREMENTS FOR
YOUR PHYSICAL HEALTH AND SAFETY.
AT THE TIME OF THE HEARING, THE COURT WILL RECEIVE EVIDENCE ABOUT
YOUR ALLEGED INCAPACITIES OR FUNCTIONAL LIMITATIONS. IF THE COURT
DETERMINES THAT INCAPACITIES OR FUNCTIONAL LIMITATIONS EXIST, THE COURT
MAY APPOINT A GUARDIAN TO ACT ON YOUR BEHALF. THE APPOINTMENT OF A
GUARDIAN IS A MATTER OF GREAT IMPORTANCE SINCE IT WOULD RESTRICT AND
INFRINGE UPON YOUR LEGAL RIGHT TO PERFORM CERTAIN ACTIVITIES OR TO
MAKE CERTAIN DECISIONS, POSSIBLY INCLUDING THE RIGHT TO HANDLE YOUR
OWN MONEY AND TO DECiDE WHERE YOU LIVE.
DUE TO THE SERIOUSNESS OF THIS PROCEEDING, YOU HAVE THE RIGHT TO
REQUEST THE APPOINTMENT OF COUNSEL AND TO HAVE COUNSEL APPOINTED IF
THE COURT DEEMS IT APPROPRIATE. IF YOU CANNOT AFFORD COUNSEL, YOU HAVE
THE RIGHT TO HAVE SUCH COUNSEL PAID FOR BY THE COUNTY.
IF YOU DO NOT HAVE AN ATTORNEY, OR CANNOT AFFORD ONE, GO TO, OR
TELEPHONE THE OFFICE LISTED BELOW TO FIND OUT WHERE YOU CAN GET LEGAL
HELP.
CUMBERLAND COUNTY LAWYER REFERRAL SERVICE
2 LIBERTY AVENUE
CARLISLE, PENNSYLVANIA
(717) 249-3166
YOU ALSO HAVE THE RIGHT TO REQUEST THE COURT TO ORDER AN
INDEPENDENT EVALUATION OF YOUR ALLEGED INCAPACITIES. ADDITIONALLy,
YOU HAVE THE RIGHT TO A TRIAL BY JURY ON THE ISSUE OF YOUR ALLEGED
INCAPACITIES. YOU HAVE A RIGHT TO BE PRESENT AT THE COURT HEARINGS
UNLESS YOUR PHYSICAL OR MENTAL CONDITION WOULD BE HARMED BY YOUR
PRESENCE, OR IF YOU ARE OUT OF PENNSYLVANIA.
YOU HAVE THE RIGHT TO APPEAL THE COURT'S DECISION REGARDING
INCAPACITY OR FUNCTIONAL LIMITATIONS AND THE APPOINTMENT OF GUARDIANS
BY FILING NOTICE OF APPEAL TO THE SUPERIOR COURT OF PENNSYLVANIA WITHIN
'~ DAYS OF THE COURT'S DECISION. YOU ALSO HAVE THE RIGHT TO
PETITION THE ORPHANS' COURT OF CUMBERLAND COUNTY FOR A REVIEW HEARING
TO MODIFY OR TERMINATE THE GUARDIANSHIPS WITHIN 10 DAYS OF THE COURT'S
DECISION.
YOU MUST ACT PROMPTLY IF YOU HAVE REASONS WHy YOU THINK YOU ARE
NOT AN INCAPACITATED PERSON, AND IF YOU OBJECT TO HAVING A GUARDIAN
APPOINTED FOR YOUR PERSON AND/OR FOR YOUR PROPERTY. YOU MUST TELL THE
COURT YOUR REASONS, OR HAVE YOUR ATTORNEY TELL THE COURT THE REASONS
BEFORE OR AT THE TIME OF THE HEARING.
WITNESS MY HAND AND SEAL THIS ~ DAY OF
,2003.
By:
Jo
A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
CERTIFICATE OF SERVICE
I, Marielle F. Hazen, Esquire, certify that on April 7, 2003, I served a true and
correct copy of the within Petition for Appointment of Guardian of the Person and Estate
of an Alleged Incapacitated Person on the parties named below, by depositing same in the
United States mail, postage prepaid as follows:
Martin Robertson
293 Thomas Drive
Gettysburg, PA 17325
Joyce M. Gemberling
35 Beach Farm Road
Wormleysburg, PA 17043
Betty R. Geisler
325 E. King Street
Littlestown, PA 17340
I, Marielle F. Hazen, Esquire, certify that on April 24, 2003, I served a tree and
correct copy of the within Petition for Appointment of Guardian of the Person and Estate
of an Alleged Incapacitated Person on the party named below, by depositing same in the
United States mail, postage prepaid as follows:
Masonic Homes
One Masonic Drive
........,.", E1 .~. beth~, PA 17022
~ate r~O
Respectfully Submitted,
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
PROOF OF SERVICE OF CITATION
I, Marielle F. Hazen, Attorney for Petitioners, hereby certify that service of a copy
of the Citation and Petition, a copy of which is attached, was made on A. RICHARD
GEISLER, by reading a copy of it to him on April 23, 2003, at 11:00 a.m. at Masonic
Homes, One Masonic Drive, Elizabethtown, Pennsylvania 17022. I read the Petition and
Citation to the alleged incapacitated person, and then explained the documents to him, to
the maximum extent possible, in language and terms he was likely to understand.
Respectfully Submitted,
M'arielle F. Ha~en, Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
IN RE: A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
NOTICE REGARDING REPRESENTATION
OF ALLEGED INCAPACITATED PERSON
In conformity with statute 20 Pa. C.S. Section 5511(a), please take notice that
counsel has not been retained by or on behalf of the alleged incapacitated person, and that
the hearing to determine this matter is scheduled on May 19, 2003, at 9:30 a.m. in
Courtroom #1 in the Cumberland County Courthouse, Carlisle, Pennsylvania.
Respectfully Submitted,
M~[ri~lle F .l Hazen,' Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
IN RE: A. RICHARD
GEISLER
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-0278
ORDER OF COURT
AND NOW, this 19th day of May, 2003, it is ordered and directed that Daniel
Worley, Esq., is appointed to represent A. Richard Geisler, the alleged incapacitation
person, at a hearing scheduled for Monday, May 19, 2003, at 9:30 a.m., in Courtroom
No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania.
BY THE COURT,
Marielle F. Hazen, Esq.
Attorney for Petitioners
Daniel Worley, Esq.
Attorney for A. Richard Geisler
:rc
A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
F ,1NAL ORDER OF COURT APPOINTING PLENARY GUARDIAN
AND NOW, this _~ay of_~~__~, 2003, a hearing in this case having been
held on May 19, 2003 at ~ ~' _~ O a.m., and it appearing to the Court that A. RICHARD
GEISLER was served with a Citation and Notice of this hearing on April 23, 2003, and the Court
finds that the physical or mental condition of A. RICHARD GEISLER would be harmed by his
presence at hearing, and further finds from the testimony:
1. That A. RICHARD GEISLER suffers from brain damage due to a hemorrhagic stroke,
a condition which totally impairs his capacity to receive and evaluate information effectively and to
make and communicate decisions concerning his management of financial affairs or to meet essential
requirements for his physical health and safety.
2. That there are insufficient supports available to assist A. RICHARD GEISLER in
such decisions and that there exists no other less restrictive alternative mechanism for decision-
making.
3. That based on the incapacity of A. R/CHARD GEISLER to receive and evaluate
information and to make or communicate decisions, a plenary Guardian of the Person and a plenary
Guardian of the Estate are required on a permanent basis.
NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing
findings it is ORI)EREI), AD JUl)GED and DECREED that A. R/CHARD GEISLER be and is
hereby adjudged an incapacitated person, and GINA M. ROBERTSON and MARK A. GEISLER are
appointed Plenary Permanent Co-Guardians of the Person and Estate. As Plenary Permanent Co-
Guardians of the person, GINA M. ROBERTSON and MARK A. GEISLER have the authority to
access all A. RICHARD GEiSLER's medical records, including but not limited to psychiatric
records, and to request and/or terminate an out-of-hospital do-not-resuscitate order on behalf of A.
R/CHARD GEISLER, in accordance with Pennsylvania law. Further, as Co-Guardians of the
person, GINA M. ROBERTSON and MARK A. GEISLER shall have the power and authority to
serve as personal representatives for all purposes of the Health Insurance Portability and
Accountability Act of 1996, (Pub. L. 104-191), 45 CFR Sections 160 through 164. The Co-Guardians
shall be considered the personal representatives for A. R/CHARD GEiSLER's heath care disclosures
under the 2003 federal HIPAA regulations and shall have full authority to review A. R/CHARD
GEISLER's medical records and to execute releases of confidential information from medical
providers and insurers or other third party payors.
As co-guardians of the estate, GINA M. ROI~BERTSON and MARK A. GEISLER shall
have the authority to make distributions from principal for the payment of care expenses, all medical
needs and taxes and insurance for the real properties in which A. RICHARD GEISLER has an
interest. The Co-Guardians shall have the authority to sell real property owned by A. RICHARD
GIESLER, except for the real property located in Wormleysburg in which Joyce Gemberling
currently resides. The co-guardians must receive court approval after notice to all interested parties,
including Joyce Gemberling, before selling the Wormleysburg real property.
An Inventory must be filed within ninety (90) days. A report by the Co-Guardians shall be
filed within 12 months and annually thereafter.
o Bond in the amount of ' shall be posted by the Co-Guardians.
A. RICHARD GEISLER, an incapacitated person, has the fight to appeal this Order of Court
by filing exceptions within ten (10) days of this date or to petition this Court for a review hearing to
modify or terminate the guardianship herein established.
IfA. RICHARD GEISLER was not present at this heating on appointment of a guardian then
petitioner shall serve upon and read to A. RICHARD GEISLER the Statement of Rights, a copy of
which is attached to this Order as Exhibit "A", and file proof of such service with this Court within
ten days.
BY THE COURT'
IN RE: A. RICHARD GEISLER
An incapacitated person
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
STATEMENT OF RiG,firs UPON APPOINTMENT OF A G,,U, ARDIAN
AN ORDER HAS BEE~N ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED AN
INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE
YOUR PERSONAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE
COURTS DECISION WITHIN TEN (10) DAYS OF THE DATE OF THE COURT'S ORDER. IF
YOU FAIL TO FILE EXCEPTIONS, THE ORDER W~LL BECOME FINAL. IN THE EVENT
THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIGHT TO FILE
AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF
THE DENIAL OF THE EXCEPTIONS.
IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO
MODIFY OR TO TERMINATE THE GUARDIANSHIP IF THERE IS A CHANGE IN YOUR
CAPACITY OR IF YOUR GUARDIAN FAILS TO PERFORM HIS/HER DUTIES IN
ACCORDANCE WITH THE COURT'S ORDER.
IF YOU WISH TO APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY
OR TERMINATE THE GUARDIANSHIP, YOU HAVE THE RIGHT TO BE REPRESENTED BY
AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, THE COURT MAY APPOINT
ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES
OF AN ATTORNEY WHOM THE COURT MAY APPOINT FOR YOU MAY BE PROVIDED
AT NO COST TO YOU.
Exhibit A
IN RE: A. RICHARD GEISLER
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-0278
IMPORTANT NOTICE
CITATION WITH NOTICE
A petition has been filed with the 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 Gina M.
Robertson and Mark A. Geisler is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 1, Cumberland
County Courthouse, Carlisle, Pennsylvania, on May 19 ,2003, at 9:30 A.M. to tell the
Court why is 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 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 of 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 to 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 heating (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.
Clerk, 6rphans' Court Division ~ t .
Cumberland County, Carlisle, PA
· . · st da
My Commission Expires 1 Mon y,
January, 2006
IN RE: A. RICHARD GEISLER
An alleged incapacitated person
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-0278
PRAECIPE FOR APPEARANCE
TO THE CLERK:
Enter the appearance of Metzger, Wickersham, Knauss & Erb, P.C., on behalf of Joyce M.
Gemberling, party in interest.
Date: May 19, 2003
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
J~ Esquire
PA Court I.D. No. 19211
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorneys for Joyce M. Gemberl~g~:
281147-1
CERTIFICATE OF SERVICE
AND NOW, this 19th day of May, 2003, I, Jered L. Hock, ofMetzger, Wickersham, Knauss
& Erb, P.C., attorneys for Joyce M. Gemberling, hereby certify that I served the foregoing Praecipe
for Appearance this day by depositing the same in the United States mail, postage prepaid, in
Harrisburg, Pennsylvania, addressed to:
Marielle F. Hazen, Esquire
2000 Linglestown Road, Suite 303
Harrisburg, PA 17110
Jered L. Hock, Esquire
281147-1
ORIGIM
IN RE: A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
PROOF OF SERVICE OF CITATION
I, Marielle F. Hazen, Attorney for Petitioners, hereby certify that service of a copy
of the Final Order and Statement of Rights, a copy of which is attached, was made on A.
RICHARD GEISLER, by reading a copy of it to him on May ~ I
Pennsylvania 17022.
and then explained the documents to him, to the maximum extent possible, in language
and terms he was likely to understand.
,2003, at
a.m. at Masonic Homes, One Masonic Drive, Elizabethtown,
I read the Petition and Citation to the alleged incapacitated person,
Respectfully Submitted,
l~iaffel I e- F .-~I-faz'en, Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
P 4-'131(8-01)
COMMONWEALTH OF PENNSYLVANIA
NOTIFICATION OF MENTAL HEALTH,COMMITMENT
The Uniform Firearms Act, 18 PA. C.S. 6105(c)(4) specifies that it shall be unlawful for any person adjudicated as an incompetent or who has been
involuntarily committed to a mental institution for inpatient care and treatment under Section 302, 303, or 304 of the Mental Health Procedures Act of
July 9, 1979 (P.L.817, No. 143) to possess, use, manufacture, control, sell or transfer firearms. This would include adjudication of incapacity pursuant to
20 Pa.C.S.A. 5501. Pursuant to the Pennsylvania Mental Health Procedures Act, Section 109, notification shall be transmitted to the Pennsylvania
State Police by the judge, mental health review officer or county mental health and mental retardation administrator within SEVEN days of the
adjudication, commitment or treatment by first class mail to the Pennsylvania State Police, Attention: Firearm Unit, 1800 Elmerton Avenue,
Harrisburg, PA 17110. NOTE: The envelope shall be marked "CONFIDENTIAL."
Place an "X" on either Involuntary Commitment and indicate 302, 303, 304, or Adjudicated Incompetent
PRINT CLEARLY OR TYPE 302 303 304 OTHER:
INVOLUNTARY COMMITMENTr---] r-~
DATE OF COMMITMENT OR ADJUDICATED INCOMPETENT
COUNTY OF COMMITMENT
[-'-] ADJUDICATED INCOMPETENT /
INDIVIDUAL INFORMATION - INDIVIDUAL INVOLUNTARILY COMMI'i-FED OR ADJUDICATED INCOMPETENT
LAST NAME ~
JR., ETC. MAIDEN NAME
SEX ./~ RACE ~...HEIGHT
ADDRESS
ALIAS
SOCIAL SECURITY NUMBER ¢~0~"- ~O=,(3 -- Z//--,.~"-_.~-/--/
.¢"?" WEIGHT Z/.¢_ HAiR EVES
302 Commitment Requires Physician's Certification
Physician Certifying Necessity of Involuntary Commitment
(Required in accordance with Section 6105(c)(4) of the Uniform Firearms Act) Please Print Name and Provide Signature
Hospital / Facility Providing Treatment / Address
NOTIFICATION BY (Please print name, address~ area code, and phone number of agency or county court.)
MH/MR AdministratodReview Officer Phone
303 and 304 Commitment requires the Judge's name authorizing the commitment, case number & order date
Judge
Coud Case NUmber
NOTIFICATION OF PHYSICIAN'S DETERMINATION THAT NO SEVERE MENTAL DISABILITY EXISTS
The physician shall provide signed confirmation of the lack of severe mental disability following the initial examination under Section 302(b) of the
Mental Health Procedures Act and pursuant to the Uniform Firearms Act, Section 6111.1 (g)(3). Notice shall be transmitted by physician to the
Pennsylvania State Police through the county mental health and mental retardation administrator or mental health review officer.
Name of Physician (Please print.)
Signature of Physician Date
9V:gd 6-N1T £0.
4- ~ 2.,..J,6-98)
COMMONWF_.AI-'TH OF PENNSYLVANIA
NOTIFICATION OF MENTAL HEALTH COMMITMENT
The Unifom3 Firearms Act, 18 PA. C.S. 6105 (c)(4) spedl~es Ihat it shall be unlawful I~ any pe~3on adjudicated as an ir,=3mpet~nt or who has been involuntarily Committed to a mental
institution t'or inpatient care and treatment under Section 302, 303, or 304 of Ihe Mental Health Procedures Act of July 9, 1978 (P.L. 817, No. 143) to possess, use, manufacture,
conl~ol; sell or freest'er ~rearrns. This would include adjudication of incapadty pursuant to 20 Pa.C.S.A. §5501. Pursuant to the Pennsylvania Mental Health Procedures Act, SeclJon
109, no~flcalion shall be transm~cl to the Pennsylvania State Police by the judge, mental health review olficer or County mental health and mental retardation administrator within
SEVEN days of the adjudication, commitrnent or treatment by tirst daas mail to the Pennsylvanta State Police, AttentJon: Firearm Unit, t800 Elmerton Avenue, Harrtsbu~,
PA 17110. NOTE: The envelope shall be marl(ed 'CONFIDENTIAL"
Place an 'X' on either InvolUntary Commitment or Adjudicated Incompetent
INVOLUNTARY COMMITMENT ADJUDICATED INCOMPETENT
Date of Involuntary Commitment or Adjudicated Incompetent ~_ ~,.~ ! ~ c~OO__~ "
I
INDIVIDUAL INFORMATION (INDIVIDUAL INVOLUNTARILY COMMITI'ED OR AD~,~_DICATED INCOMPETENT)
JFL, ETC. ~ MAIDEN NAME ""
ALIAS '"'"'
NOTIFICATION BY (Please print name, address, area code, and phone number of agency or county court.)
County Submitting Notification
County Mental Health and Mental Retardation Administrator
Cou~]ty Menial Health Review Officer
Physician Certifying Necessity of Involuntary Commitment
( Required in accordance with Section 6105(c)(4) of the Uniform Firearms Act )
Hospital / Facility Providing Treatment /Address
Judge
SIGNATURE OF NOTIFYING OFFICIAL __ DATE
Court Case Number Date of Court Order
NOTIFICATION OF PHYSICIAN'S DETERMINATION'THAT NO SEVERE MENTAL DISABILITY EXISTS
The physician shall provide signed conl~rmation of the determination of the lack of severe mental disability i'ollowing the iniUal examination under Section 302(b) of the Mental Health
~rocedums Act and pursuant to the Uniform Firearms Act, Sec/Jun 6111.1 (g)(3). Notice shall be b'ansmitted by the physician to the Pennsylvania State Police through the county
mental health and mental retardation administrator or mental health review officer.
Nature of Physician (Please print.)
Signature of Physician Date
AUTHORITY TO PAY COURT APPOINTED COUNSEL JUL 1 1 2003
1. COURT 2. VOUCHER - .
[] District Justice [] Common Pleas [] Appellate [] Other N ; 7 9 4 0
5. BUDGET CODE
. ,c.a,~ Geisler B FELONY Q MISDEM~NOR
9. PROCEEDINGS (Describe briefly) 1 1. PERSON REPRESENTED 12, CIVIL DOCKET NO.
I ~ Defendant-Adult 21-203-0278
3 D Ao¢e~nt 13. CRIMINAL DOCKET NO.
5 D Habea~ P~litioner
8 B Material W~lne~l
~ C Parol~ Charged Wilh Violation
10. PERSON~E~ENT~uI~ N~me) 80 Probationer Charged With Violation 14. APPEALS DOCKET NO.
A~ot Date MAILING ADDRESS
Daniel D. Worley, Esquire
Wesley Oler, Jr. TURO LAW OFFICES
NAME OF COMMON PLEAS JUDGE ASSIGNED TO CASE 20 South Piff Street
Carlisle, ~A ~ 70~ 3
CLAIM FOR SERVICES OR EXPENSES
19. SERVICE HOURS DATES AMOUNTS CLAIMED
a. Arraignment ~n~or Plea Multiply rate ~r hour times total
hour] to oblain "In Coud" com-
b. Prelimina~ Headng ~n~ation. Enter Iotal below.
¢ Moflon~ and Reque~t~
Sentence
O f. Trial .vv v~ ~ v~ v~
Z
g. Rev~ation Hearings
h. Juvenile Hearings
i. Appeals Cou~ lg~ TOTAL IN COURT COMP.
~ Other (S,.ci~ on additional .beet.) .60 ~¢ 27.00
TOTAL HOURS = ~R H~R = $
20. & Inte~iews and conierence~ Multiry rate ~er hour times total
hour~. Enter total "Out of Cou~"
b. Obtaining and reviewing r~ord~ ¢om~n~ation ~low.
~ ~ L~al research and ~ief writing
~ ~ d. In~s~gafi~ ~d o~er w~k (S~ ~ addi~n~ ~ee~) 20~ TOTAL OUT OF COURT
COMP.
TOTAL HOURS = X ~ PER H~R ~ $
21. I~MIZATION OF REIMBURSABLE EXPENSES AMI PER I~M
Mileage $.25 ~r mile x
~ 21~ TOTAL ITEMIZED EXP.
O
=$
22. CERTIFICATION OF A~ORNEY/PAYEE X 23. GRAND ~~I~ED
Has compensation ancot reimbumement for ~ In this ~e pmvlousN ~en a~lled fo~ ~ YES ~ NO = $
Ifyes, were you paid? ~ YES ~ NO Ifye&by~wereyou~l~ Howmuch?.
Has the person represent~ paid any money to you, or to y~r kn~le~e anyone else, in connection with the maker for 24. DEDUCT. PRIOR PYMTS.
which you were appoint~ to provide repr~e~tlOq?l .~ YES ~ NO ~ ye& give details on additional sheets = $
I swear or affirm the truth or co.~.e. ~~' ~~ 7r-lo-q ~ 25. N~ AMO~T~IMED
of lhe above ~talements - S~nilure of A~/Payee~M Dite = $ ~.~
.,...,, ure ol 27. AMT. APP"OVED
Mail to Court Administrator at completion of service
IN RE: A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
PETITION FOR AMENDMENT TO GUARDIANSHIP ORDER
AND NOW come Petitioners, Mark A. Geisler and Gina M. Robertson, by and
through their Attorney, Marielle F. Hazen, Esquire, and submits this Petition for
Amendment to Guardianship Order and in support hereof aver as follows:
1. On May 19, 2003, A. RICHARD GEISLER was adjudicated a totally
incapacitated person and Mark A. Geisler and Gina M. Robertson were appointed as
plenary co-guardians of the person and estate of A. RICHARD GEISLER. (A copy of
said Final Order dated May 19, 2003, attached hereto as Exhibit "A").
2. Since that time, the co-guardians have been serving in their capacity as co-
guardians and have been handling all financial and healthcare decisions on behalf of A.
RICHARD GEISLER.
3. Several issues have arisen requiting timely action on behalf of the
guardians. It has been difficult for the guardians to act jointly. These issues have
included phone conversations with the state retirement system and access to bank
accounts. In addition, medical decision-making has needed to be made on a more
expedited basis. The requirement of joint action by the co-guardians has hindered
effective actions on the part of the co-guardians.
WHEREFORE, Petitioners request an amended Final Order providing for the
joint and/or individual action of each of the co-guardians on behalf of A. RICHARD
GEISLER.
Respectfully Submitted,
Manelle F. P~en, Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
VERIFICATION
I verify that the statements made in this Petition are tree and correct. I understand
that false statements herein are made subject to the penalties of 18 PA.C.S. § 4904,
relating to unsworn falsification to authorities.
Date
A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
CERTIFICATE OF SERVICE
I, Marielle F. ,azen, Esquire, certify that on ~0'~U/ti/ c.~ , 2003, I served
a tree and correct copy of the within Petition for Appointment of Guardian of the Person
and Estate of an Alleged Incapacitated Person on the parties named below, by depositing
same in the United States mail, postage prepaid as follows:
Martin Robertson
293 Thomas Drive
Gettysburg, PA 17325
Masonic Homes
One Masonic Drive
Elizabethtown, PA 17022
Betty R. Geisler
325 E. King Street
Littlestown, PA 17340
Joyce M. Gemberling
c/o Jared Hock, Esq.
Metzger Wickersham
3211 North Front St.
Harrisburg, PA 17110
Respectfully Submitted,
Date
-FfH~azen, Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
IN RE: A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
· NO. 21-03-0278
On the Petition ofGINA M. ROBERTSON and MARK A. GEISLER
FINAL ORDER OF COURT APPOINTING PLENARY GUARD~
AND NOW, this _~lay of___~_~~, 2003, a hearing in this case having been
held on May 19, 2003 at . ~ ~' ~ O a.m., and it appearing to the Court that A. RICHARD
GEISLER was served with a Citation and Notice of this hearing on April 23, 2003, and the Court
finds that the physical or mental condition of A. RICHARD GEISLER would be harmed by his
presence at hearing, and further finds from the testimony:
1. That A. RICHARD GEISLER suffers from brain damage due to a hemorrhagic stroke,
a condition which totally impairs his capacity to receive and evaluate information effectively and to
make and communicate decisions concerning his management of financial affairs or to meet essential
requirements for his physical health and safety.
2. That there are insufficient supports available to assist A. RICHARD GEISLER in
such decisions and that there exists no other less restrictive alternative mechanism for decision-
making.
EXHIBIT "A"
3. That based on the incapacity of A. RICHARD GEISLER to receive and evaluate
information and to make or communicate decisions, a plenary Guardian of the Person and a plenary
Guardian of the Estate are required on a permanent basis.
NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing
findings it is ORDERED, ADJUDGED and DECREED that A. RICHARD GEISLER be and is
hereby adjudged an incapacitated person, and GINA M. ROBERTSON and MARK A. GEISLER are
appointed Plenary Permanent Co-Guardians of the Person and Estate. As Plenary Permanent Co-
Guardians of the person, GINA M. ROBERTSON and MARK A. GEISLER have the authority to
access all A. RICHARD GEISLER's medical records, including but not limited to psychiatric
records, and to request and/or terminate an out-of-hospital do-not-resuscitate order on behalf orA.
RICHARD GEISLER, in accordance with Pennsylvania law. Further, as Co-Guardians of the
person, GINA M. ROBERTSON and MARK A. GEISLER shall have the power and authority to
serve as personal representatives for all purposes of the Health insurance Portability and
Accountability Act of 1996, (Pub. L. 104-191), 45 CFR Sections 160 through 164. The Co-Guardians
shall be considered the personal representatives for A. RICHARD GEISLER's heath care disclosures
under the 2003 federal HIPAA regulations and shall have full authority to review A. RICHARD
GEISLER's medical records and to execute releases of confidential information from medical
providers and insurers or other third party payors.
As co-guardians of the estate, G1NA M. RO~BERTSON and MARK A. GEISLER shall
have the authority to make distributions fi'om principal for the payment of care expenses, all medical
needs and taxes and insurance for the real properties in which A. RICHARD GEISLER has an
interest. The Co-Guardians shall have the authority to sell real property owned by A. RICHARD
GIESLER, except for the real property located in Wormleysburg in which Joyee Gemberling
currently resides. The co-guardians must receive court approval after notice to all interested parties,
including Joyce Gemberling, before selling the Wormleysburg real property.
An Inventory must be filed within ninety (90) days. A report by the Co-Guardians shall be
filed within 12 months and annually thereafter.
~' Bondin the mount of
shall be posted by the Co-Guardians.
A. RICHARD GEISLER, an incapacitated person, has the right to appeal this Order of Court
by filing exceptions within ten (10) days of this date or to petition this Court for a review hearing to
modify or terminate the guardianship herein established.
IfA. RICHARD GEISLER was not present at this hearing on appointment of a guardian then
petitioner shall serve upon and read to A. RICHARD GEISLER the Statement of Rights, a copy of
which is attached to this Order as Exhibit "A", and file proof of such service with this Court within
ten days.
BY THE COURT:
IN RE: A. RICHARD GEISLER
An incapacitated person
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
PENNSYLVANIA
ORPHANS' COURT DIVISION
NO.
STATEMENT OF RIGHTS UPON APPOINTMENT OF A G,U, ARDIAN
AN ORDER HAS BE]~2N ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED AN
INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE
YOUR PERSONAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE
COURTS DECISION WITHIN TEN (10) DAYS OF THE DATE OF THE COURTS ORDER. IF
YOU FAIL TO FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT
THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIGHT TO FILE
AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF
THE DENIAL OF THE EXC. EPTIONS.
IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO
MODIFY OR TO TERMINATE THE GUARDIANSHIP IF THERE IS A CHANGE IN YOUR
CAPACITY OR IF YOUR GUARDIAN FAILS TO PERFORM HIS/HER DUTIES IN
ACCORDANCE WITH TH]2. COURTS ORDER.
IF YOU WISH TO APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY
OR TERMINATE THE GUARDIANSHIP, YO~J HAVE THE RIGHT TO BE REPRESENTED BY
AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, THE COURT MAY APPOINT
ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES
OF AN ATTORNEY WHOM THE COURT MAY APPOINT FOR YOU MAY BE pRO~/1DED
AT NO COST TO YOU.
Exhibit A
A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
AMENDED FINAL ORDER OF COURT
APPOINTING PLENARY GUARDIAN
ANDNOW, this~dayof ~l~o i .~ ,2003, upon Petitioner by the co-guardians
in this matter and a finding that the co-guardians need the ability to act jointly or individually on
behalfofA. RICHARD GEISLER, it is hereby ordered, adjudged and degreed that the co-guardians
are authorized to act individually or jointly as plenary co-guardians of the person and estate of A.
RICHARD GEISLER.
The co-guardians shall have all of the authorities outlined in the original Order dated May 19,
2003. Said Order is attached hereto and made a part hereof as if set forth in full.
L~
y/_[/~/~BY THE COURT~A~.~../~~,~
IN RE: A. RICHARD GEISLER
an incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY,
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
: NO. 21-03-0278
On the Petition ofGINA M. ROBERTSON and MARK A. GEISLER
FINAL ORDER OF COURT APPOINTING PLENARY GUARDLt~
AND NOW, this _~ay of~~_~~, 2003, a hearing in this ease having
been
held on May 19, 2003 at ~ ,' ~ O a.m., and it appearing to the Court that A. RICHARD
GEISLER was served with a Citation and Notice of this hearing on April 23, 2003, and the Court
fmds that the physical or mental condition of A. RICHARD GEISLER would be harmed by his
presence at hearing, and further finds from the testimony:
1. That A. RICHARD GEISLER suffers from brain damage due to a hemorrhagic stroke,
a condition which totally impairs his capacity to receive and evaluate information effectively and to
make and communicate decisions concerning his management of financial affairs or to meet essential
requirements for his physical health and safety.
2. That there are insufficient supports available to assist A. RICHARD GEISLER in
such decisions and that there exists no other less restrictive alternative mechanism for decision-
making.
EXHIBIT "A"
3. That based on the incapacity of A. RICHARD GEISLER to receive and evaluate
information and to make or communicate decisions, a plenary Guardian of the Person and a plenary
Guardian of the Estate are required on a permanent basis.
NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing
findings it is ORDERED, ADJUDGED and DECREED that A. RICHARD GEISLER be and is
hereby adjudged an incapacitated person, and GlNA M. ROBERTSON and MARK A. GEISLER are
appointed Plenary Permanent Co-Guardians of the Person and Estate. As Plenary Permanent Co-
Guardians of the person, GINA M. ROBERTSON and MARK A. GEISLER have the authority to
access all A. R/CHARD GEISLER's medical records, including but not limited to psychiatric
records, and to request and/or terminate an out-of-hospital do-not-resuscitate order on behalfofA.
RICHARD GEISLER, in accordance with Pennsylvania law. Further, as Co-Guardians of the
person, GINA M. ROBERTSON and MARK A. GEISLER shall have the power and authority to
serve as personal representatives for all purposes of the Health Insurance Portability and
Accountability Act of 1996, (Pub. L. 104-191), 45 CFR Sections 160 through 164. The Co-Guardians
shall be considered the personal representatives ~for A. RICHARD GEISLER's heath care disclosures
under the 2003 federal HIPAA regulations and shall have full authority to review A. RICHARD
GEISLER's medical records and to execute releases of confidential information from medical
providers and insurers or other third party payors.
As co-guardians of the estate, GINA M. RO~BERTSON and MARK A. GEISLER shall
have the authority to make distributions fi.om principal for the paymem of care expenses, all medical
2
needs and taxes and insurance for the real properties in which A. RICHARD GEISLER has an
interest. The Co-Guardians shall have the authority to sell real property owned by A. RICHARD
GIESLER, except for the real property located in Wormleysburg in which Joyce Gemberling
currently resides. The co-guardians must receive court approval after notice to all interested parties,
including Joyce Gemberling, before selling the Wormleysburg real property.
An Invemory must be filed within ninety (90) days. A report by the Co-Guardians shall be
filedwithin 12monthsandannuallythereafier. t'~xi S o.c~,.~r cc,oo~-,a~5 ~ ~o~.,a~," o'(
"' Bondin the mount of ' shall be posted by the Co-Guardians.
A. RICHARD GEISLER, an incapacitated person, has the right to appeal this Order of Court
by filing exceptions within ten (10) days of this date or to petition this Court for a review hearing to
modify or terminate the guardianship herein established.
IfA. RICHARD GEISLER was not present at this hearing on appointment of a guardian then
petitioner shall serve upon and read to A. RICHARD GEISLER the Statement of Rights, a copy of
which is attached to this Order as Exhibit "A", and file proof of such service with this Court within
ten days.
BY THE COURT:
J.
IN RE: A. RICHARD GEISLER
An incapacitated person
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
: PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO.
STATEMF, NT OF RIGHTS UPON APPOINt, MENT OF A G,UARI)IAN
AN ORDER HAS BE]~L-~N ENTERED WHEREBY YOU HAVE BEEN ADJUDICATED AN
INCAPACITATED PERSON AND UNABLE TO CARE FOR YOURSELF AND/OR MANAGE
YOUR PERSONAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO THE
COURTS DECISION WITHIN TEN (I0) DAYS OF THE DATE OF THE COURTS ORDER. IF
YOU FAIL TO FILE EXCEPTIONS, THE ORDER WILL BECOME FINAL. IN THE EVENT
THAT YOU FILE EXCEPTIONS AND THEY ARE DENIED, YOU HAVE A RIOHT TO FILE
AN APPEAL TO THE SUPERIOR COURT WITHIN THIRTY (30) DAYS OF THE DATE OF
THE DENIAL OF THE EXCEPTIONS.
IN ADDITION, YOU MAY PETITION THE COURT AT ANY FUTURE TIME TO
MODIFY OR TO TERMINATE THE GUARDIANSHIP IF THERE IS A CHANGE IN YOUR
CAPACITY OR IF YOUR GUARDIAN FAILS TO PERFORM HIS/HER DUTIES IN
ACCORDANCE WITH THE COURT'S ORDER.
IF YOU WISH TO APPEAL THE ORDER OR TO PETITION THE COURT TO MODIFY
OR TERMINATE THE GUARDIANSHIP, Y0~J HAVE THE RIOHT TO BE REPRESENTED BY
AN ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, THE COURT MAY APPOINT
ONE TO REPRESENT YOU. IF YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES
OF AN ATTORNEY WHOM THE COURT MAY APPOINT FOR YOU MAY BE PR(~VIDED
AT NO COST TO YOU.
Exhibit A
IN RE: A. RICHARD GEISLER
an incapacitated person
· IN THE COURT OF COMMON PLEAS
· OF CUMBERLAND COUNTY,
· PENNSYLVANIA
· ORPHANS' COURT DIVISION
· NO. 21-03-0278
On the Petition of GINA M. ROBERTSON and MARK A. GEISLER
CERTIFICATE OF SERVICF
I, Marielle F. Hazen, Esquire, certify that on ~'~~/ ~.~ ,2003, I served
a true and correct copy of the within Petition for Appointme~lt of Guardian of the Person
and Estate of an Alleged Incapacitated Person on the parties named below, by depositing
same in the United States mail, postage prepaid as follows:
Martin Robertson
293 Thomas Drive
Gettysburg, PA 17325
Masonic Homes
One Masonic Drive
Elizabethtown, PA 17022
Joyce M. Gemberling
35 Beach Farm Road
Wormleysburg, PA 17043
Betty R. Geisler
325 E. King Street
Littlestown, PA 17340
The original return receipts are affixed hereto as Exhibit "A."
Respectfully Submitted,
~Vlafieil~. ffazen,-Esq.
PA I.D. No. 68003
2000 Linglestown Road
Suite 303
Harrisburg, PA 17110
(717) 540-4332
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
· Print your name and address on the reverse
so that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
A. Signature
B~ved b,~ Pdnted Name) C. Date of Delive~
D. Is delive~ addm~ d~emnt ~om item 17 ~ Yes
If YES, enter delive~ address below: ~ No
3..Service Type
,l~:~ertified Mail p__.~xpress Mail
[] Registered ~Return Receipt for Merchandise
[] Insured Mail [] C.O.D.
4. Restricted Delivery? (Extra Fee) [] Yes
2. Article Number
(Transfer from service label)
7003 0500 0000 7382 5891
PS Form 3811, August 2001
Domestic Return Receipt
102595-01-M-0381
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
· Print your name and address on the reverse
so that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the front if space permits.
B. Received I
[] Agent
[] Addressee
Date of Delivery
1. Article Addressed to:
Li+ l sb on,
2. Article Number
D. Is delivery address different from item 1 ? [] Yes
If YES, enter delivery address below: [] No
3. i~_ice Type
.,"r,-J.~-;ertified Mail [] Express Mail
[] Registered ~eturn Receipt for Merchandise
[] insured Mail /'O C.O.D.
i4. Restricted Delivery? (Extra Fee) [] Yes
(Transfer from service label)
PS Form 3811, August 2001
7003 0500 0000 7382 5860
Domestic Return Receipt
102595-01-M-0381
EXHIBIT "A"
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
· Print your name and address on the
so that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
[] Agent
[] Addressee
C. Date of Delivery
niteml? []Yes
If YES, enter delivery address below: [] No
3. Service Type
~ertified Mail
[] Registered
[] Insured Mail
[] Express Mail
c etUrn Receipt for Merchandise
.O.D.
4. Restricted Delivery? (Extra Fee) [] Yes
2.Article Number 7003 0500 0000 7382 5877
(Transfer from service/abe.
PS Form 3811, August 2001 Domestic Return Receipt 102595-01-M-0381
· Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
· Print your name and address on the reverse
so that we can return the card to you.
· Attach this card to the back of the mailpiece,
or on the front if space permits.
[] Agent
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.B. Name) I C. Date of Delivery
1. Article Addressed to:
2. Article Number
(Transfer from service label)
PS Fo~m 3811, August 2001
r If YES, enter delivery address below:
7003
0500
D. Is delivery address different from item 17 [] Yes
[] No
3., )~G'ice Type
"J~LCertified Mail [] Express Mail
[] Registered ~eturn Receipt for Merchandise
[] Insured Mail [] C.O.D.
4. Restricted Delivery? (Extra Fee) [] Yes
0000 7382 5884
102595-01-M-0381
Domestic Return Receipt
EXHIBIT "A"
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: A. RICHARD GEISLER, an incapacitated person FILE NO. 21-03-0278
GUARDIAN OF THE ESTATE 90-DAY REPORT
[20 Pa.C.S.A. 5521 (c)]
FROM May 19 ,2003_ TO _August 7 ,2003
1)
2)
I am the __ Limited X Plenary Guardian of the Estate of my ward, named
above. I was appointed Guardian by Order of Court dated May 19, 2003, which X
was __ __ was not modified by Court Order(s) dated July 31, 2003
Is the incapacitated person still living? Yes
If no, answer the following:
(a) Date of Death
(b) Place of Death
(c) Name of Administrator/trix or Executor/trix
(d) Date Guardian of the Person filed the last Annual Report
PLEASE ANSWER THE FOLLOWING QUESTIONS WHETHER THE INCAPACITATED
PERSON IS LIVING OR DECEASED:
3)
My initial Inventory was filed on ~August 7, 2003__ and listed a total estate value of
$_2,306,184
The Inventory listed a total monthly income of $
the following: Social Security $1,489
salary from Commonwealth of PA $2,543
4,032 comprised of
4)
At the beginning date of this reporting period, my initial balance on hand was
$2,247,856
5)
During this reporting period, the following reflects all sources of income (other than
social security) received by me for my ward: (Add additional pages if needed)
Date Received
5-30, 6-13, 6-27,
7-11, 7-25
Source of Income
salary - Comm. of PA
Amount
$6,344
2. 6-1 stock dividend $28
3. 6-13 stock dividend
$126
4. 7-24 stock dividend $412
o
o
6)
During this reporting period, the following reflects all payments I have made for my
ward: (Add additional pages if needed)
Date To Whom Paid
Reason for Payment
Amount
1. * Please see attached sheet
Date Paid Payee Reason Amount
05/19/03 PP&L Wormleysburg residence electric payment 65.01
05/22/03 Sadler Oil Wormleysburg residence heating oil payment 131.02
05/23/03 Comcast Cable Wormleysburg residence cable payment 39.64
05/26/03 PA American Water Wormleysburg residence water payment 19.17
05/30/03 Masonic Homes Elizabethtown A. Richard Geisler medical expense/charges 74.14
06/03/03 Columbia Gas 327 & 325 E. King St., Littlestown residence gas payment 58.18
06/03/03 First Energy Opco 327 E. King St., Littlestown residence Electric payment 20.26
06/03/03 First Energy Opco 325 E. King St., Littlestown residence Electric payment 13.75
06/09/03 Marielle F. Hazen A. Richard Geisler legal fees 3321.50
06/12/03 Adalphia Cable 327 E. King St., Littlestown residence TV cable payment 35.06
06/12/03 Nationwide Insurance Auto Grand Marq A. Richard Geisler auto Insurance Mercury Grand Marquis 225.10
06/12/03 Regional Gastrc Assoc of Lancaster A. Richard Geisler medical expense 165.00
06/16/03 PP&L Wormleysburg residence electric payment 48.76
06/19/03 Register of Wills Cumberland Co Court 4 Certified copies of A. Richard Geisler Guardianship 10.00
06/23/03 Adelphia Cable 327 E. King St., Littlestown residence TV cable payment 35.06
06/23/03 Comcast Cable Wormleysburg residence cable payment 39.64
06/30/03 Bank Card Services Visa A. Richard Geisler credit report fee 15.70
06/30/03 Broadmoor Landscaping Wormleysburg residence lawn care payment 222.60
06/30/03 Masonic Homes Elizabethtown A. Richard Geisler/charges 27.62
07/02/03 PA American Water Wormleysburg residence water payment 19.71
07/03/03 Columbia Gas 327 & 325 E. King St., Littlestown residence gas payment 37.62
07/05/03 Joyce Gemberling Prescription WD cat food for Jesse 21.55
07/07/03 First Energy Opco ,327 E. King St., Littlestown residence Electric payment 21.36
07/07~03 First Energy Opco 325 E. King St., Littlestown residence Electric payment 14.61
07/12/03 Lancaster Emergency Assoc. A. Richard Geisler medical expense 68.46
07/12/03 PA Dept of Revenue A. Richard Geisler 2003 2nd Qtr Form PA40 ES F-~fimated Income TaxPayment 750.0(
07/12/03 Regional Gastro Assoc of Lancaster A. Richard Geisler medical expense 4/29/03 Office Visit 55.00
07/12/03 United States Treasury A. Richard Geisler 2003 2nd Qtr Form 1040 ES Estimated Income Tax Payment 7000.00
07/14/03 Adelphia Cable 327 E. King St., Littlestown residence TV cable payment 35.06
07/15/03 PP&L Wormleysburg residence electric payment 62.42
07/16/03 Broadmoor Landscaping Wormleysburg residence lawn care payment 74.20
07/16/03 Marielle F. Hazen A. Richard Geisler legal fees 564.00
07/21/03 Boro of Littlestown Water & Sewer 327 & 325 E. King St., Littlestown residence water & sewer payment 140.00
07/21/03 Bom of W-Burg Sewer & Refuse Wormleysburg residence sewer & refuse payment 112.00
07/21/03 Broadmoor Landscaping Wormleysburg residence lawn care payment 74.20
07/21/03 Norlanco Medical A, Richard Geisler medical expense service from 4/8/03 to 6/5/03 480.00
07/21/03 Protection Mutual Insurance Co. 327 & 325 E. King St., _Littlestown residence property insurance C-12655 121.00
07/23/03 Register of Wills Cumberland Co Court 10 Certified copies of A. Richard Geisler Guardianship 25.00
07/29/03 Masonic Homes Elizabethtown A. Richard Geisler/Room & Board 11280.54
07/29/03 PA American Water Wormleysburg residence water payment 19.74
I07/31/03 Comcast Cable
08/01/03 Columbia Gas
Wormleysburg residence cable payment
1327 & 325 E. King St., Liffie_~!own residence gas payment
39.64I
20.961
7) The present principal assets of my ward are:
Description of Asset(s)
Present Value
1. Certificates of Deposit
$1,019,970
2. Savings, Money Market
$19,299
3. Bonds, Stocks
$717,915
4. Real Es~te
$549,000
TOTAL:
$2,306,184
8)
The present amount and sources of income for my ward are:
Source of Income
Paycheck- Comm. of PA
Amount of Income
(indicate whether monthly,
quarterly, annually)
$1,271.50 biweekly
2. Social Security
$1,489 monthly
Farm Land Rental
Stock Dividends
$3,500 biannually
$893 quarterly
9)
10)
The regular monthly expenses of my ward which I pay are:
To Whom Paid
Amount
Littlestown Residence(includes monthly utilities.
spouse's personal expenses; and monthly bndget
average of utilities, .taxes, insurance, and maintenance
with quarter, biannual, and annual billin~ cycles)
Wormleysburg Residence (includes monthly utilities;
and monthly budget average of utilities, taxes, insurance,
and maintenance with quarter, biannual, and annual
billing cycles)
Farm Property_ (budget average for real est_ale taxes)
Income Tax (monthly budget average for)
Masonic Home (room & board for ward)
$930
$621
$108
$2368
$7,750
ILl, have not (circle one) petitioned the Court for permission to invade principal to
meet the needs of my ward.
(If applicable) The following expenses of my ward have been paid from principal:
To Whom Paid Purpose Amount
Masonic Home
Room and Board 6-16 to 7-31
$11,281
4
o
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11)
I
have~,~ no~(circle one) paid myself compensation for services I rendered as
guardian.
The amount I paid myself totaled $ 0 and was calculated at the
following rate: $ per week/month (circle one).
12) Check the correct response and complete, if appropriate.
There will be no need for extraordinary expenditures on behalf of my ward
in the next twelve (12) months.
X There will be a need for extraordinary expenditures on behalf of my ward
in the next twelve (12) months because:
Blue Cross / Maior Medical / Medicare no longer covers his stay at the Masonic Home
13)
Check the correct response and complete, if appropriate.
X A. My ward receives monthly social security benefits directly.
~B. I am the designated payee to receive my ward's social security benefits.
__C. The designated payee of my ward's social security benefits is:
Whose address is
And is/is not (circle one) related to my ward as (insert relationship:)
14) Please note any concerns about the incapacitated person's physical or mental well-being
He has shown no significant progress
or the finances that the Court should know.
with return of right-side movement, communication skills, and cognitive ability
since the stroke.
15) I X am~
attached.
am not guardian of the incapacitated person's person. If yes, report is
I CERTIFY under the penalties of perjury that the information contained in this report is true and
correct to the best of my knowledge, information and belief.
Telephone
(home)
(work)
Gina R~tson, Co-Guardian Date
Mark A. Geisler, Co-Guardian Date
6
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE:
A. Richard Geisler, an incapacitated person
FROM
FILE NO. 21-03-0278
GUARDIAN OF THE PERSON 90-DAY REPORT
[20 Pa.C.S.A. 5521 (c)]
May 19 ,2003_ TO ~August 7 ., 2003
1)
2)
3)
4)
I am the Limited X
above.
Plenary Guardian of the Estate of my ward, named
I was appointed Guardian by Order of Court dated May 19, 2003, which
was not modified by Court Order(s) dated July 31, 2003
X was
Is the incapacitated person still living? Yes
If no, answer the following:
(a) Date of Death
(b) Place of Death
(c) Name of Administrator/trix or Executor/tflx
(d) Date Guardian of the Person filed the last Annual Report
(b)
(c)
If the incapacitated person is still living, answer the following questions:
(a) Date Guardian of the Person filed the last Annual Report? This is the initial one.
Current address of the incapacitated person: Renaissance Unit, Health Care
Center, Masonic Home, One Masonic Dr., Elizabethtown, PA 17022
Current age: 71 Date of birth of incapacitated person: 2-3-32
(d)
The incapacitated person's residence is:
__ Ward's own residence
X Nursing Home
__ Hospital or Medical Facility
The incapacitated person has been living there since
__ My home/apartment
__ Relative's Home
__ Boarding Home
2-23-03
If moved within the past year, state from where and the reason for the change:
Dad's stroke was 1-6-03. From 1-6-03 to 2-3-03 he was in Holy Spirit ICU
From 2-3-03 to 2-23-03 he was in Select Specialty Hospital. From 2-23-03 to the
present he has been at the Masonic Home.
I rate his/her living arrangement as:
X Excellent Average Below Average
Explain: Excellent, caring, professional, well staffed facility.
5)
(e)
I believe he/she is:
X Content with the living situation
Unhappy with the living situation
Unaware with the living situation
Physical Health
(a) Current physical condition of the incapacitated person is:
Excellent Good X Fair Poor
(c)
(d)
His/her major physical health problems are as follows: fight side paralysis due to
stroke, history of post-polio syndrome weakness, impaired coLmitive function
(During the 90 day reporting period)
During the past year, his/her physical condition has:
X Remained about the same.
Improved. Explain
Worsened. Explain
(During the 90 day reporting period)
During the past year, he/she received the following medical treatment (include
check-ups and dental work):
Date Ailment
Type of treatment
Doctor's name
5-20, 5-27, 6-5,
6-10,6-19, 7-11
7-18 cough & fever
6-19
receives routine visits/
check-up by staff MD
antibiotic
routine foot exam
Dr. Glenda Cook
Dr. Glenda Cook
staff podiatrist
2
8-5
removal of peg tube
Dr. Edward Wilson
6)
Mental Health
(a)
The incapacitated person's condition is:
Excellent Good X Fair Poor
His/her major mental health problems are as follows: depression was noted due
to stroke, improved with daily antidepressant medication.
(c)
(During the 90 day reporting period)
During the past year, his/her mental condition has:
X Remained about the same.
Improved. Explain
Worsened. Explain
(e) During the past year, treatment or evaluation by a psychiatrist, psychologist or
social worker X was was not provided. Such mental health services are
briefly described as:
Seen as needed on 5-30, 6-16, 7-1 for assessment of level of depression and
coping skills.
Social Activities/Services
(a) His/her current social condition is:
Excellent Good
(During the 90 day reporting period)
(b) During the past year, his/her social condition has:
X Remained about the same.
Improved. Explain
Worsened. Explain
X Fair Poor
3
8)
(c)
(During the 90 day reporting period)
during the past year he/she has participated in the following activities:
X Recreational therapist visits a few times a week for 1 on 1 sessions
Educational
X Social receives regular visits from family and friends, attends
some activities provided by the Masonic Home as entertainment
X Occupational receives RNP (restorative nursing l~ro~am) a few times a
week for swallowing and range of motion.
__ No activities available.
~ He/she refuses to participate in any activities.
~ He/she is unable to participate in any activities.
Visitation
(a)
(During the 90 day reporting period)
During the last year, I visited him/her as follows:
times a week.
Combined we visit 3 to 4
9)
(b) The average amount of time I spent on each visit was 2 to 3 hours
(c) The last time I visited was on August 7, 2003 (date)
(During the 90 day reporting period)
During the last year I have performed the following activities on behalf of the
incapacitated person: We maintained accounts and records, paid bills, and
managed personal affairs and business for Dad_ We participated in team care meeting::
with staff at the Masonic Home, made medical decisions, and provided clothing and
personal items for Dad. We visit regularly, ~et updates on hi~ condition from the nursing
staff, and spend quality time with him.
I believe he/she has the following unmet needs: none known to date
The guardianship X should ~ should not be continued without
modification because: Dad continues to be non-ambulatory and is right side paralyzed__
from the stroke. He is unable to communicate verbally and has severely impaired
· cognitive abilities. Since the stroke he has exhibited long term and short term memory_
!0ss/lapses of unknown magni_n~de.
4
12)
Please note any concerns about the incapacitated person's physical or mental well-being
or the finances that the Court should know: He has shown no significant progress
with return of right-side movement, communication skills, and cognitive ability since the
stroke.
13)
v
I
/x~ am am not the guardian of the incapacitated person's estate. If yes,
my report is attached.
I CERTIFY under the penalties of perjury that the information contained in this report is tree and
correct to the best of my knowledge, information and belief.
Name: C3-"t~x~ f~obe~+~ch, i Telephone No.
'717-_~3~/-(.o~'70 (home)
?/7- ZZ~- Co:LSd/ (work)
I~K 710~2_.
Telephone No. [-~C5- %"t~4' O~'~.~ (home)
qg q ' "/32.-~g ~ ~-- (work)
Gina~obertson, Co-Guardian
Mark A. Geisler, Co-Guardian
Date
Date
READING AND SIGNING OF DEPOSITION
Deposition of Glenda Cook, M.D.
Taken on 4/24/03 Reporter Lorraine Troutman
Caption In Re: A. Richard Geisler
PAGE LINE
CHANGE AND REASON
I have read and inspected my deposition as captioned
above and have listed all changes and corrections
above along with the reasons therefore.
Return transcript and sheet to:
Archive Reporting Service
2336 North Second Street
Harrisburg, PA 17110
ORIGINAL
IN RE:
A. RICHARD GEISLER
IN THE COURT OF CON94ON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-0278
DEPOSITION OF:
GLENDA COOK, M.D.
BEFORE:
DATE:
PLACE:
LORRAINE K. TROUTM3kN, RPR
REPORTER/NOTARY PUBLIC
APRIL 24, 2003
MASONIC HOMES
ONE MASONIC DRIVE
ELIZABETHTOWN, PA
APPEARA_NCES:
BY: MA_RIELLE F. HAZEN, ESQUIRE
FOR - PETITIONER
LORRAINE K. TROUTMAN, RPR
REPORTER - NOTARY
ARCHIVE REPORTING SERVICE
2336 N. Second Street (717) 234-5922
Harrisburg, PA 17110 FAX (717) 234-6190
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STIPULATION
It is hereby stipulated by and between
counsel for the respective parties that sealing,
certification, and filing are waived and that
all objections except as to the form of the
question are reserved to the time of trial.
GLENDA COOK, called as a witness, being
duly sworn, testified as follows:
EXAMINATION
BY MS. HAZEN:
Q This is the deposition of Glenda Cook,
who is the physician for Richard Geisler.
I have some questions for you. If you
don't hear me, please let me know so I can
repeat the question; and if you don't understand
the question, just let me know so I can rephrase
it.
A Okay.
Q Will
you state
address
professional for
A Glenda Cook, One
Elizabethtown, Pennsylvania
your full name and
the record.
Masonic Drive,
17022.
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Q Please describe your education,
training and background, with particular
emphasis on your experience in evaluating
individuals with incapacities.
A Okay. I did medical school at the
Medical College of Virginia in Richmond. I did
my residency in internal medicine at the Hershey
Medical Center.
I worked for seven years with a group
in Lancaster and have been working with Norlanco
and Masonic Homes here since August of this
year. I do a lot of geriatric care both here,
and I also did a lot when I was at Lancaster.
Q Okay. And when did you first examine
Richard Geisler?
A I first saw him February 28th of this
year -- sorry, February 24th of this year.
Q And was that because he was admitted
into the Masonic Home?
A Yeah.
Q Did you receive his history from any
other physician?
A We got his history from the hospital he
was at before.
Q Which was Holy Spirit?
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A Yeah.
Q Since that first visit, how
have you examined him?
A I have seen him
a week, if not more often.
Q When did you most recently
A I last saw him -- it was
which would have been the 22nd.
Q What is Richard Geisler's diagnosis?
A His primary diagnose is -- he had a
hemorrhagic stroke, and had to undergo a
craniotomy, and has had brain damage from that,
and that's his primary cause of his disability
at this point.
Q Can you
impairment?
A He has
unable to eat.
Q Can you
the record?
frequently
see him?
this Tuesday,
please describe his physical
some expressive aphasia. He is
explain expressive aphasia for
A Expressive aphasia means that he really
has trouble communicating with us. He is not
consistent with nodding yes or no.
I have never actually been able to get
him to speak to me. Basically he has
probably at least once
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trouble -- we are not sure if he has receptive
aphasia also, which means he would have trouble
understanding what we are saying, but he
definitely has trouble getting what he is
thinking across to us.
Q Okay. So he is not communicating.
A He will sometimes use some hand signs
or grab at things, but he is not communicating
to the point where we consistently know what he
is trying to tell us.
And often when he grabs our hands, we
cannot really understand what he is meaning by
that. So no, there is no real useful
communication from him.
Q And when he does respond, is it always
accurate, his responses?
A No. In fact, sometimes when we ask him
to do things, he won't do them. For example,
when I listen to him and try to ask him to take
a deep breath, he is not always consistent in
being able to do that.
Q Okay. And I interrupted you. Do you
want to continue describing his physical
impairments?
A
He is unable to eat so he has what we
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call a PEG tube, which is a tube into his
stomach to feed him. He is pretty much
paralyzed on the right side.
We have been having some trouble with
him intermittently not even being able to
tolerate the tube feeds, although that seems to
have resolved.
He has had some trouble with
intermittent infections, both pneumonia
pneumonia and also related to his feeding tube.
Q At this time you don't know of any
active infections?
A No.
antibiotics
standpoint.
Actually, at this time he's off
and seems to be doing well from that
Q Can you describe what assistance he
needs with his activities of daily living?
A He needs total assistance.
Q With everything?
A With everything.
Q And he is not ambulatory?
A No.
Q Can you describe his mental condition?
A It's hard because of this aphasia.
It's hard to really assess that. He
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seems -- especially over the last month -- much
more brighter, much more willing to try to
interact with us and try to do things we are
requesting him. Although, again, he is not very
consistent with that either. He is alert. He
is awake.
Q Okay. Do you believe his ability to
receive and evaluate information is impaired to
such a significant extent that he is totally
unable to manage his financial resources?
A Absolutely.
Q And do you believe he is impaired to
such a significant extent that he is totally
unable to make decisions to safeguard his
physical well-being?
A Yes.
Q What recommendations would you make
concerning services necessary to meet his
physical safety and care needs?
A He is going to need 24-hour nursing
care both for the tube feeding he is getting;
but also, I mean, he can't help with bathing
himself. He can't brush his teeth. He
basically needs around-the clock skilled care.
What recommendations would you make
Q
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concerning
resources?
A
that for
Q
management of his
He is going to
him.
So you believe
appropriate?
A Yes, I do.
Q What is the
regaining any physical
A His prognosis for
financial
need somebody else to do
guardianship is
expectation
or mental
at this point. He may gain
had his stroke in January,
months now, and he really has
significant improvement.
Q Do you know of any
alternatives to guardianship
in terms of his
abilities?
that is pretty poor
a little bit, but he
so it's been four
not made any
less restrictive
to be able to
for him at this point?
A No.
Q And I also need to ask you whether
believe his physical or mental condition
be harmed by his presence in open court?
A I think with the care he needs, it
would not be appropriate for him to go into
court.
Q And that he would be harmed?
care
you
would
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him,
A
yes.
Q Physically he
A I believe there
of that happening, yes.
Q Okay. Is there
think the Court should hear
A No, I don't think
Q Okay. Then I have
I thank you for your time.
A Thank you.
Q Do you want
signature?
A Yes.
(Concluded at 10:11 a.m.)
I think that would be
dangerous for
would be harmed.
would be a possibility
anything else that you
in this matter?
so.
no
other questions.
to read it or waive
10
COUNTY OF DAUPHIN
COMMONWEALTH OF PENNSYLVANIA
: SS
I, Lorraine K. Troutman, RPR, Notary Public,
authorized to administer oaths within and for the
Commonwealth of Pennsylvania and take depositions in
the trial of causes, do hereby certify that the foregoing
is the testimony of
GLENDA COOK, M.D.,
I further certify that before the taking of
said deposition, the witness was duly sworn; that the
questions and answers were taken down by said Reporter,
approved and agreed to, and afterwards reduced to
typewriting under the direction of the said Reporter.
I further certify that the proceedings and evidenc~
are contained fully and accurately in the notes
taken by me on the within deposition and that this is a
correct transcription of the same.
In testimony whereof, I have hereunto
subscribed my hand this 30th day of April, 2003.
my commission expires
July 24, 2006
~/Lo ~raine K: routman, RPR
Reporter/Notary Public
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1,1,1
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2006 Ambulatozy [1] 8:11 [2] 1:3 10:1
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
IN RE: A. RICHARD GEISLER, an incapacitated person FILE NO. 21-03-0278
GUARDIAN OF THE ESTATE FINAL REPORT
[20 Pa.C.S.A. 5521 (c)]
FROM: August 7, 2003 TO: Date of Death April 13, 2004
1)
above.
I am the __ Limited X Plenary Guardian of the Estate of my ward, named
I was appointed Guardian by Order of Court dated May 19, 2003, which was modified by
Court Order(s) dated July 31, 2003.
2) Is the incapacitated person still living? No
If no, answer the following:
Date of Death: April 13, 2004
Place of Death: Lancaster Regional Hospital, Lancaster PA
Name of Administrator/trix or Executor/trix: Gina M. Robertson and Mark A. Geisler
Date Guardian of the Person filed the last Annual Report: August 7, 2003
PLEASE ANSWER THE FOLLOWING QUESTIONS WHETHER THE INCAPACITATED
PERSON IS LIVING OR DECEASED:
3) My initial Inventory was filed on August 7, 2003 and listed a total estate value of
$2,306,184.
The Inventory listed a total monthly income of $ 4,032 comprised of the following:
Social Security $1,489
Salary Commonwealth of PA $2,543
4) At the beginning date of this reporting period, my initial balance on hand was
$2,306,184.
5) During this reporting period, the following reflects all sources of income (other than
social security) received by me for my ward: (Add additional pages if needed)
6)
Date Received Source of Income
SEE ATTACHED SOURCE OF INCOME EXltlBIT A
Amount
During this reporting period, the following reflects all payments I have made for my
Reason for Payment
ward: (Add additional pages if needed)
Date To Whom Paid
SEE ATTACHED EXPENSE EXHIBIT B
7) The present principal assets of my ward are:
Description of Asset(s)
1. Certificates of Deposit
2. Savings, Money Market
3. Bonds, Stocks
4. Real Estate
5. Checking Account (on 4-13-04)
TOTAL:
The present amount and sources of income for my ward are:
Source of Income
1. Retirement Paycheck - Comm. of PA
2. Social Security
3. Farm Land Rental
4. Stock Dividends
The regular monthly expenses of my ward which I pay are:
To Whom Paid
8)
9)
Littlestown Residence (includes monthly utilities,
spouse's personal expenses; and monthly budget
average of utilities, taxes, insurance, and maintenance
with quarter, biannual, and annual billing cycles)
Amount
Present Value
$769,955
$18,875
$1,244,139
$549,000
$50,037
$2,632,006
Amount of Income
$2,738 monthly
$1,464 monthly
$3,500 biannually
$893 quarterly
Amount
$930
2
10)
2. Wormleysburg Residence (includes monthly utilities;
and monthly budget average of utilities, taxes, insurance,
and maintenance with quarter, biannual, and annual
billing cycles) $621
3. Farm Property (budget average for real estate taxes) $108
4. Income Tax (monthly budget average for) $2,368
5. Masonic Home (room & board for ward) $7,750
I have petitioned the Court for permission to invade principal to meet the needs of my
ward.
(If applicable) The following expenses of my ward have been paid from principal:
To Whom Paid Purpose
1. Masonic Home Room and Board (from 8-03 to 4-04)
2. Medical Providers Medical Costs
Amount
$57,440
$3,285
13)
12) Check the correct response and complete, if appropriate. N/A - Deceased
There will be no need for extraordinary expenditures on behalf of my ward in the next
twelve (12) months.
There will be a need for extraordinary expenditures on behalf of my ward in the
next twelve (12) months because:
A. Richard Geisler passed away 4-13-04
Check the correct response and complete, if appropriate. N/A - Deceased
A. My ward receives monthly social security benefits directly.
B. I am the designated payee to receive my ward's social security benefits.
C. The designated payee of my ward's social security benefits is:
Whose address is
And is/is not (circle one) related to my ward as (insert relationship:)
11) I have not paid myself compensation for services I rendered as guardian. The amount I
paid myself totaled $0 and was calculated at the following rate: $ per week/month (circle
one).
14) Please note any concerns about the incapacitated person's physical or mental well-being
or the finances that the Court should know. He had shown no significant progress with return of
right-side movement, communication skills, and cognitive ability since the stroke.
15) I x
is attached.
am
~ am not guardian of the incapacitated person's person. If yes, report
I CERTIFY under the penalties of perjury that the information contained in this report is true and
correct to the best of my knowledge, information and belief.
Name: Gina Maria Robertson
Address: 293 Thomas Drive
Gettysburg, PA 17325
Telephone No. (717) 334-6370
(717) 334-6254 ex.7102
(home)
(work)
Name: Mark A. Geisler
Address: 3 East Miner Street
Telephone No. (484) 432-0855
(home)
(work)
West Chester, PA 19382
Gina Robe~t~on, Co-Guardian Date
Mark A. Geisler, Co-Guardian Date
A. Richard Geisler Income from 0810812003 throu;Ih 04/1312004
Date
Received Source of Income Amount
08/01/03 Social Security Deposit ' I 1,489.001
08/08/03 Commonwealth of PA Payroll Deposit 1,271.73
08/18/03 Checking Account Interest 2.99
08/18/03 Dividends, Farm Rent, BC Payments 4,620.11
08/23/03 Commonwealth of PA Payroll Deposit 1,271.73
09/03/03 Social Security Deposit 1,430.00
09/05/03 Commonwealth of PA Payroll Deposit 1,271.73
09/13/03 PEBTF 263.15
09/15/03 Adams Co. Clerk of Courts 30.00
09/17/03 Checking Account Interest 2.12
09/19/03 Commonwealth of PA Payroll Deposit 1,271.73
10/03/03 Social Security Deposit 1,430.00
10/20/03 Checking Account Interest 3.20
11/03/03 Social Security Deposit 1,430.00
11/08/03 Dividends, Tax Refund, 25,895.95
11/14/03 Checking Account Interest 2.03
12/03/03 Social Security Deposit 1,540.00
12/16/03 Checking Account Interest 4.90
01/02/04 Social Security Deposit 1,464.00
01/16/04 Checking Account Interest I 4.71
01/20/04 PETBF, Dividends, PSECU Retirement, Dividends, Farm Rent 125,336.45
02/03/04 Social Security Deposit 1,464.00
02/13/04 Checking Account Interest 12.14
02/27/04 PSERS Retirement Deposit 2,738.68
03/01/04 PEBTF, Adams Co. Clerk of Courts, PSERS 2,774.27
03/03/04 Social Security Deposit 1,464.00
03/15/04 Dividends 800.00
03/17/04 Checking Account Interest 7.88
03/31/04 PSERS Retirement Deposit 2,738.88
04/02/04 Social Security Deposit 1,464.00
EXHIBIT A
-. Page 1 of 1
A. Richard Geisler Ex~enaea 08/08/2003 t~rou~lh 04113/2004
Date Paid Payee Reason Amount
08/08/03 First Energy Opco Littlestown residence electric 16.47
08/08/03 First Energy Opco Littlestown residence electric 22.52
08/10/03 Broadmoor Landscaping Wormleysburg residence lawn care 74.20
08/10103 Cumberland Co. Courthouse Guardianship report filing fee 10.00
08/14/03 PP&L Wormleysburg Wormleysburg residence electric 90.26
08/16/03 Law Office of Marlelle Hazen A. Richard Geisler legal expense 765.92
08/18/03 Carol A. Schreckengaust CPA A. Richard & Betty R. Geisler 2002 1040 and PA40 Tax Return Filing 250.00
08/18/03 Sadler Oil Wormleysburg residence heating oll 952.00
08/26/03 Broadmoor Landscaping Wormleysburg residence lawn care 37.10
08/26/03 Dennis P. Freistak - Collector Wormleysburg residence 2003 Real Estate Tax 2,023.85
08/26103 Marilyn Basehour - Collector Betty R. Geisler Per Capita Tax 9.80
08~26/03 Marilyn Basehour - Collector Littlestown residence real estate tax 1,533.84
08/26/03 Mildred A. Weaver - Collector Farm 2003 Real Estate Tax 985.65
08/26~03 West Shore EMS A. Richard Geisler medical expense - transportation 155.90
09~02~03 Columbia Gas Littlestown residence gas 17.80
09/03/03 First Energy Opco Littlestown residence electric 14.95
09/03~03 First Energy Opco Littlestown residence electric 20.77
09/05/03 Masonic Homes Elizabethtown A. Richard Geisler medical expense - Mesonic Home 8,202.05
09/08/03 Adelphis Cable Littlestown residence electric 35.06=
09/08/03 Betty R. Geisler Spouse monthly living expenses March-Sept 2003 1,800.00
09/08/03 Broadmoor Landscaping Wormleysburg residence lawn care 74.20
09/08/03 i Norlanco Medical A. Richard Geisler medical expense 297.00
09108/03 PA American Water - Wormleysburg Wormleysburg residence water 22.43
09/08/03 Susquehanna EMS A. Richard Geisler medical expense - transportation 816.00
09/12/03 Adelphia Cable Littlestown residence electric 35.06
09/15/03 Law Office of Marielle Hazen A. Richard Geisler legal expense 1,229.00
09/15/03 PP&L Wormleysburg Wormleysburg residence electric 91.50
09/22~03 Broadmoor Landscaping Wormleysburg residence lawn care 74,20
09/22/03 Lancaster Emergency Assoc. A. Richard Geisler medical expense 56.54
10/01/03 Columbia Gas Littlestown residence gas 19.36
10/04/03 AAA Transfer title & registration Mercury Marquis to Joyce Gemberiing 20.00
10104/03 Commonwealth of PA Transfer title & registration Mercury Marquis to Joyce Gemberling = 58.50
10/04/03 Joyce Gemberling Veterinary expense Jesse - insulin 31.00
10/05/03 Broadmoor Landscaping Wormleysburg residence lawn care 74.20
10/05/03 PA American Water - Wormleysburg Wormleysburg residence water 21.89
10/06/03 First Energy Opco Littlestown residence electric 21.09
10/06/03 First Energy Opco Littlestown residence electric 14.53
10/13/03 Masonic Homes Elizabethtown A. Richard Geisler medical expense - Masonic Home 7,819.52
10/14103 PP&L Wormleysbur~l Wormleysburl[I residence electric 73.03
-. Page 1 of 3
A. Richard Geisler J ExDensee 08/08/2003 thr°uah 04/1~1/2Q04
I
Date Paid Payee Reason Amount
10/21/03 Joyce Gemberling Veterinary expense Jesse - cat food 21.55
10/21/03 Law Office of Marlelle Hazen A. Richard Geisler legal expense 541,00
10/22/03 Comcast Cable Wormleysburg residence cable TV 124.15
10/26/03 Boro of Littlestown Ware & Sewer Littlestown residence water & sewer 140.00
10/26/03 Bom of W-Burg Sewer & Refuse Wormleysburg residence sewer & refuse 112.00
10/26/03 Broedmoor Landscaping Wormleysburg residence lawn care 74.20
10/26/03 Broadmoor Landscaping Wormteysburg residence lawn care 74.20
10/26/03 Masonic Homes Etizabethtown A. Richard Geisler medical expense - Masonic Home 6,163.65
10126/03 Norlanco Medical A. Richard Geisler medical expense 1,014.00
10/26/03 PA American Water - Wormleysburg Wormleysburg residence water 21.98
10/26/03 Susquehanna EMS A. Richard Geisler medical expense - transportation 484.42
10/30/03 Columbia Gas Littleatown residence gas 39.36
11/03/03 First Energy Opco Llttlestown residence electric 19.74
11/03103 First Energy Opco Littlestown residence electric 12.58
11/11/03 Adelphia Cable Littlestown residence electric 35.06
11/11/03 Law Office of Marielle Hazen A. Richard Geisler legal expense 171.50
11/12/03 Adelphia Cable Littlestown residence electric 35.06
11/13/03 PP&L Wormleysburg Wormleysburg residence electric 55.95
11/28/03 PA American Water - Wormleysburg Wormleysburg residence water 25.90
12/02103 Columbia Gas Littlestown residence gas 120.44
12/02/03 First Energy Opco Littlestown residence electric 23.12
12/02/03 First Energy Opco Littlestown residence electric 12.84
12/05/03 Comcast Cable Wormleysburg residence cable TV 39.64
12/05/03 Masonic Homes Elizabethtown A. Richard Geisler medical expense - Masonic Home 5,928.48
12/15/03 PP&L Wormleysburg Wormleysburg residence electric 64.00
12/27103 Comcast Cable Wormleysburg residence cable TV 39.64
12/30/03 American Express Balance of consultation fee 375.00
12/30/03 Betty R. Geisler Spouse home & automobile expenses 1,299.31
12/30/03 Betty R. Geisler Spouse medical expenses 563.28
12130/03 Betty R. Geisler Spouse weekly expenses Oct - Dec 2003 780.00
12/30/03 Masonic Homes Elizabethtown A. Richard Geisler medical expense - Masonic Home 6,456.98
12/30/03 Monumental Life Insurance Co. A. Richard Geisler Life Insurance 2.27
01/05104 Columbia Gas Littlestown residence gal 184,40
01/05/04 First Energy Opco Littlestown residence electric 24.14
01/05/04 First Energy Opco Littlestown residence electric 12.16
01/11/04 Adelphia Cable Littlestown residence electric 39.18
01/11/04 Bom of Littlestown Wate & Sewer Littlestown residence water & sewer 328.60
01/11/04 Bore of W-Burg Sewer & Refuse Wormleysburg residence sewer & refuse 112.00
01/11/04 PA American Water - Wormleysbur!~ Wormleysbur~l residence water 26.43
Page 2 of 3
A. Richard Geisler Expenses 08/0812003 throuuh 04113/2004
Date Paid Payee Reason Amount
01/11/04 Physicians All Lancaster Regional A. Richard Geisler medical expenaa 26.00
01/12/04 Adelphia Cable Littlestown residence cable TV 39.18
01/12/04 Roy Taylor - for House Doctors Wormleysburg residence maintenance 1,681.28
01/14/04 Law Office of Msrielle Hazen A. Richard Geisler legal expense 240.00
01/14/04 Law Office of Marielle Hazen Betty R. Geisler iagel expense 375.00
01/15/04 PP&L Wormleyaburg Wormleysburg residence electric 79.15
01/26/04 PA American Water - Wormleysburg Wormleyaburg residence water 28.79
01/26/04 Protection Mutual Insurance Co. Wormleysburg residence homeowners insurance 189.00
02/03/04 Columbia Gas Littleatown residence gal 324.52
02/03/04 First Energy Opco Littleatown residence electric 24.81
02/03/04 First Energy Opco Littleatown residence electric 12.34
02/03/04 Masonic Homes Elizabethtown A. Richard Geisler medical _expense - Masonic Home 7,365.69
02/14/04 Law Office of Marlelia Hazen A. Rich,rd Geisler legal expecae 180.00
02/17/04 PP&L Wormleysburg Wormleysburg residence electric 81.5t
02/22/04 Comcast Cable Wormleyaburg residence cable TV , 79.28
02122104 ;Lancaster General Hospital A. Richard Geisler medical expense 7.00
02/22/04 Norlanco Medical A. Richard Geisler medical expense 286.00
03/01/04 Adelphia Cable Littleatown reslden_ce._c_a_b_l?.__TV i 39.18
03/01/04 Dennis P, Freiatlk - Collector !Wormleyaburg resld_e_n_c?2_0_0_3 Real Estate Tax 937,77
03/01/04 PA American Water - Wormleysburg Wormleyaburg residence water 25.26
03/03/04 Columbia Gas Littleatown residence gas 371.31
03104/04 First Energy Opco Littiaatown residence electric 22.94
03/04/04 First Energy Opco Littlestown residence electric 12.16
03/13/04 Lancaster General Hospital A. Richard Gel_~l_er me~i_c_~!._e~penae 113.04
03/14/04 Masonic Homal EIIzebethtown A. Richard Geisler medical expense - Masonic Home 8,283.52
03/15/04 Adelphia Cable Littlestown residence cable TV 39,18
03/15/04 PP&L Wormteyaburg Wormleyl burg r___e?_l_d ~_n ce ?l_e_.ct_r.i_c _ 75.30
03/27/04 Comcast Cable Wormiayaburg residence cable TV 42.23
03~27~04 Masonic Homes Ellzabethtown A. Richard Gei?_e_~_medica! ex_p_ense. Masonic Home 7,219.34
04/01/04 Columbia Gal Littleetown res_id_e_n_ce_~as _ __ 208.05
04104104 MSHMC Physicians Hershey Mad Ctr A. Richard Geisl~e_r._med!c_al e~x_p, ecae 30.10
04104/04 PA American Water - Wormleysburg Wormteysburg residence water 24.53
04105104 First Energy Opco Littlaltown residence electric 22.68
04/05/04 First Energy Opco LIttleatown residence electric 11.82
04/10/04 Roy Taylor - for House Doctors Wo rmleys b_~_~.'~_~e n <~e m~in~e~-n ce 1,390.00
04/13/04 PP&L Wormiayaburg Wormleyaburg_ r_e~idence ele??__rlc_ 63.50
EXHIBIT B
Page 3 of 3
1)
2)
3)
4)
I amthe
I was appointed Guardian by Order of Court dated May 19, 2003, which
was not modified by Court Order(s) dated July 3 !, 2003.
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
A. Richard Geisler, an incapacitated person FILE NO. 2,1-03-0278
GUARDIAN OF THE PERSON FINAL REPORT
[20 Pa.C.S.A. 5521 (¢)]
FROM: August 7, 2003 TO: Date of Death April 13,.2004
Limited X Plenary Guardian of the Estate of my ward, named above.
Is the incapacitated person still living? . No
If no, answer the following:
(a) Date of Death April 13, 2004.
(b) Place of Death Lancaster Regi,onal Hospital,,
(c) Name of Administrator/trix or Executor/trix Gina M. Robertson afld Mark A.
Geisler
(d) Date Guardian of the Person filed the last Annual Report August. 7, 200.3_
If the incapacitated person is still living, answer the following questions: DECEASED
(a) Date Guardian of the Person filed the last Annual Report?
(b) Current address of the incapacitated person:
(c) Current age: Date of birth of incapacitated person:
(d) The incapacitated person's residence is:
Ward's own residence
__ Nursing Home
__ Hospital or Medical Facility
(e) The incapacitated person has been living there since
If moved within the past year, state from where and the reason for the change:
__ My home/apartment
Relative's Home
__ Boarding Home
(f) I rate Ms/her living arrangement as:
5)
Date
(g)
I believe he/she is:
Physical Health
(a)
(b)
(c)
Content with the living situation
Unhappy with the living situation
Unaware with the living situation
Current physical condition of the incapacitated person is:
Excellent Good Fair Poor
(d)
His/her major physical health problems are as follows:
During the past year, his/her physical condition has:
Remained about the same.
Improved. Explain
Worsened. Explain
During the past year, he/she received the following medical treatment (include
check-ups and dental work):
Ailment Type of treatment Doctor's name
6)
Mental Health
(a) The incapacitated person's condition is:
Excellent Good
(b) His/her major mental health problems are as follows:
Fair Poor
(c)
During the past year, his/her mental condition has:
Remained about the same.
Improved. Explain
Worsened. Explain
(e) During the past year, treatment or evaluation by a psychiatrist, psychologist or
social worker was was not provided. Such mental health services are
briefly described as:
8)
9)
Social Activities/Services
(a) His/her current social condition is:
Excellent Good
(b) During the past year, his/her social condition has:
Remained about the same.
Improved. Explain
Worsened. Explain
Fair Poor
(c)
during the past year he/she has participated in the following activities:
Recreational
Educational
Social
__ Occupational
No activities available.
__ He/she refuses to participate in any activities.
__ He/she is unable to participate in any activities.
Visitation
(a)
(b)
(c)
During the last year, I visited him/her as follows:
The average amount of time I spent on each visit was
The last time I visited was on (date)
During the last year I have performed the following activities on behalf of the
incapacitated person:
10) I believe he/she has the following unmet needs:
11) The guardianship should __
modification because:
should not be continued without
12)
Please note any concerns about the incapacitated person's physical or mental well-being
or the finances that the Court should know:
13)
I X am __ am not the guardian of the incapacitated person's estate. If yes,
my report is attached.
I CERTIFY under the penalties of perjury that the information contained in this report is true and
correct to the best of my knowledge, information and belief.
Name: Gina Maria Robertson
Address: 293 Thomas Drive
Gettysburg, PA 17325
Name: Mark A. Geisler
Address: 3 East Miner Street
West Chester, PA 19382
Telephone No. (717) 334-6370
(717) 334-6254 ex.7102
Telephone No. (484) 432-0855
(home)
(work)
(home)
(work)
Gina Robert?on, Co-Guardian Date
Mark A. Geisler, Co-Guardian Date