HomeMy WebLinkAbout03-04-11IN RE: Margaret H. Fick, IN THE COURT OF COMMON~PLEAS .-~7
An Alleged Incapacitated Person :CUMBERLAND COUNTY, PENLVAIV~ ~'
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PETITION OF PRESBYTERIAN SENIOR LIVING INC. TO ADJUDICATE ANA' ~~
INCAPACITATED PERSON AND TO APPOINT A PLENARY GUARDIAN
OF HER PERSON AND ESTATE
AND NOW, comes the Petitioner, Presbyterian Senior Living, Inc., by and
through its counsel, Jane Adams, Esquire, and respectfully petitions this Honorable
Court pursuant to 20 Pa. C.S.A. §5511 for an Order adjudicating Margaret H. Fick, to
be an incapacitated person and appointing a guardian over her person and estate and
in support thereof states as follows:
1. Petitioner, Presbyterian Senior Living, Inc., (hereinafter "Petitioner"), is a
corporation properly registered and qualified to do business in Pennsylvania.
2. Petitioner operates a facility known as Green Ridge Village, at 210 Big Spring
Road, Newville, Pennsylvania, 17241.
3. The Alleged Incapacitated Person is Margaret H. Fick.
4. As the residential care provider for Margaret H .Fick, Petitioner has an
interest in her welfare given her status as an alleged incapacitated person.
5. Margaret H. Fick is eighty-nine (89) years old with a date of birth of August 2,
1921.
6. Residential services are currently being provided to the alleged incapacitated
person by Petitioner at Green Ridge Village.
7. Margaret H. Fick has the following diagnoses: dementia, diabetes, kidney
disease, adult failure to thrive. These conditions impair her ability to make any
decisions regarding her physical condition, health, well-being, and any other matters.
(See a Certification of Dr. Guistwite, attached hereto at Exhibit A)
8. Dr. Guistwite, a physician who has been involved in regular treatment of
Margaret H. Fick, believes that Margaret H. Fick is incapable of making any decisions
regarding her medical treatment at this time. (See Exhibit A).
9. Margaret H. Fick is unable to manage or take care of matters pertaining to her
own health and well-being without the existence of another individual who will act as
guardian of her person. She is unable to resist fraud or undue influence without the
assistance of a guardian.
10. Upon information available to the Petitioner, Margaret H. Fick has no valid
living will, advance directive for health care, power of attorney, or other document
regarding her wishes pertaining to her personal affairs and/or medical care in the event
of her incapacity while a residence at Green Ridge Village.
11. Upon Petitioner's information and believe, Margaret H. Fick has two
children. They are:
Margaret Bratek -daughter
7807 Albertta Drive
Rapid City, SD 57702
Gary Fick -step-son
1677 Old Kiln Road
Chambersburg, Pa. 17201
12. She also has two step-sons, Kevin Fick and Walter Fick. Their addresses
are unknown. It is believed her daughter and step-sons are not interested in being her
guardian.
13. Upon information and belief, Margaret H. Fick was never a member of the
United States Armed Forces.
14. Upon information and belief, no other guardians of the person or estate of
Margaret H. Fick have been appointed, and no other court has assumed jurisdiction in
any proceedings to determine the capacity of Margaret H. Fick, the alleged
incapacitated person.
15. Petitioner seeks the appointment of a guardian of the person and estate
because, in the opinion of the doctor, Margaret H. Fick is mentally incapacitated and
unable to make decisions regarding her personal affairs. Her condition is such that she
would be unable to resist fraud or undue influence without the assistance of another
non-interested individual to act as her guardian.
16. Presently, the alleged incapacitated person is a resident of Green Ridge
Village, Newville, Pennsylvania, in the skilled care unit. The essential requirements for
her health and safety are provided at the facility. A guardian over her person and
estate is required to provide consent for medical and surgical treatments, if necessary,
and to ensure that Margaret H. Fick's continued personal needs and financial
obligations are met.
17. Petitioner believes that there are no less restrictive appropriate alternatives
to seeking a guardianship, over the person and estate of Margaret H. Fick.
18. The proposed guardian over Margaret H. Fick is Good News Consulting, 140
Roosevelt Ave., Suite 206, York, Pa. 17401.
19. Good News Consulting has agreed to serve as Margaret H. Fick's guardian.
(See a copy of consent of Proposed Guardian attached hereto).
20. Upon information and belief, the proposed guardian has no interest adverse
to the alleged incapacitated person.
21. The proposed guardian is a qualified guardian pursuant to 20 Pa. C.S.A.
§5511(f).
22. Petitioner respectfully requests that the proposed guardian be given powers
over the person and estate of Margaret H. Fick.
23. Insofar as Petitioner can ascertain, Margaret H. Fick's assets and income
consist of the following:
A. Real Estate - 16770 Olde Kiln Drive, Chambersburg, Pennsylvania,
valued at $215,931.00.
B. CUNA Life Insurance Policy, face value - $3000.00
C. Prudential Life Insurance Policy, face value $500.00.
D. AT&T stock -valued at approximately $5000.00
E. Verizon stock -valued at approximately $20,553.00.
F. Irrevocable Burial Reserve with Cornelius Funeral Home,
Valued at approximately $8469.00.
G. Burial space at Broad Top City Cemetary.
H. Social Security income of approximately $1316.00 per month.
I. Pension benefits of approximately $700.00 per month.
J. Quarterly dividend payment from AT&T of approximately
$385 per quarter.
K. Quarterly dividend payment from Verizon of approximately
$1168 per quarter.
24. Margaret Fick is unable to manage such assets and income and pay her
bills and it is imperative that a guardian be appointed to assist her with managing her
affairs.
25. Margaret H. Fick's mental and physical condition mandates that a guardian
be appointed to make decisions concerning her person and estate, including, but not
limited to, her living arrangements, her medical and psychiatric care, the administration
of medications, surgical interventions, the employment and discharge of physicians,
dentists, nurses, etc., for her physical care and to make decisions regarding her
personal finances.
WHEREFORE, Petitioner respectfully request that this Honorable court issue a
citation directed to Margaret H. Fick, the alleged incapacitated person, with notice to
such persons at this court may direct, to show cause why she should not be adjudged a
totally incapacitated person, and why Good News Consulting should not be appointed
guardian over her person and estate.
Date: 3 ~ ~,~
Ily subm
J e Adams, Esquire
. . No. 79465
West South Street
Carlisle, Pa. 17013
(717) 245-8508
ATTORNEY FOR PETITIONER
VERIFICATION OF DR. DARRYL GUISTWITE
I, Dr. Darryl Guistwite, do hereby state that the following is true and correct
based upon my personal knowledge, information, and belief:
1. I am a physician licensed in good standing to practice medicine in the
Commonwealth of Pennsylvania.
2. I am the attending physician for Margaret H. Fick. I attend to her on a
regular basis at Green Ridge Village, 210 Big Spring Road, Newville, Pennsylvania,
17241.
3. Margaret H. Fick was born on August 2, 1921, and she is eighty-nine (89)
years old.
4. She suffers from: dementia, HTN, diabetes, adult failure to thrive, and kidney
disease.
5. Ms. Fick's condition is not curable or reversible. Her diagnosis for
improvement is poor.
6. I have determined within a reasonable degree of medical certainty that Ms.
Fick is unable to receive and evaluate information effectively and communicate
decisions, and that her abilities are impaired to such a degree as to render her totally
unable to meet the requirements for her physical health and safety without the
assistance of another individual or organization who will act as a guardian over her
person and estate.
7. It is my opinion that Ms. Fick is unable to resist fraud or undue influence
without the assistance of a guardian to make decisions regarding her health care.
8. It is my opinion that the failure to appoint a guardian with authority to provide
consent for Ms. Fick to receive appropriate medical care and treatment will result in
irreparable harm to her Person.
I declare that the above statements are true subject to penalties of 18
Pa.C.S.§4904 relating to unsworn falsification to authorities.
Date a~as~~i
P ~°
Dr. r I Guistwite
CONSENT OF PROPOSED GUARDIAN
Good News Consulting hereby consents to act as Plenary Permanent
Guardian of the Person and Estate of Margaret H. Fick, an alleged incapacitated
person.
Good News Consulting is an S-corporation organized under the laws of
the Commonwealth of Pennsylvania and is doing business at 140 Roosevelt Ave., Suite
206, York, Pa. 17401.
Good News Consulting provides guardianship services allowing for the highest
quality of care available in the least restrictive setting available. Good News Consulting
will provide a full range of human services, including taking responsibility for medical
and personal care decisions, handling financial affairs, providing one-on-one contact
and monitoring, and other services, as necessary.
Good News Consulting and its agents have no interests (financial or otherwise)
adverse to those of the alleged incapacitated person, and no agents of Good News
Consulting reside in the same household or facility with the alleged incapacitated
person.
Date: Tina Hess, BS, CMC, NCG
~ _ Z J_ // VP of Operations
Good News Consulting
CERTIFICATION OF WALTER KINGERA,
EXECUTNE DIRECTOR OF GREEN RIDGE VILLAGE
i, Walter Kingera, do hereby state under penalty of perjury that the following is
true and correct based upon my personal knowledge:
1. I am the executive director at Green Ridge Village, 210 Big Spring Ave.,
Newville, Pennsylvania, 17241, which provides skilled nursing and rehabilitation
services for elderly patients.
2. Green Ridge Village is operated by Presbyterian Senior Living, a licensed
corporation by which I am employed.
3. Margaret H. Fick is currently a resident of Green Ridge Village.
4. Upon information available to the Petitioner, Margaret H. Fick has no valid
executed living will, advance directive for health care, or other document regarding her
wishes pertaining to her personal affairs and/or medical care in the event of her
incapacity while a resident at Green Ridge Village in Newville, Pennsylvania.
5. The undersigned knows of no one who would oppose the appointment of
Good News Consulting as Guardian of the Person and estate of Margaret H. Fick.
Under penalty of perjury, I declare that the above statements are true to the best
of my knowledge and belief.
A
Date: ~ / ~~ Walter Kingera,