HomeMy WebLinkAbout03-0536IN RE: ETTA E. MCMASTER,
an alleged incapacitated person
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO.
PETITION OF BEVERLY HEALTHCARE TO DECLARE
ETTA E. MCMASTER INCAPACITATED AND APPOINT
NEIGHBORHOOD SERVICES AS PLENARY GUARDIAN OF
ETTA E. MCMASTER AND HER ESTATE
AND NOW comes Petitioner Beverly Healthcare, by and through its attorney,
Mark K. Emery, Esquire, and files this Petition to Declare Etta E. McMaster
Incapacitated and Appoint Neighborhood Services as Plenary Guardian of Etta E.
McMaster and Her Estate, as follows:
1. Etta E. McMaster (hereinafter "McMaster") is an adult individual age 77,
currently residing at West Shore Health and Rehab Center, 770 Poplar Church Road,
Camp Hill, Cumberland County, Pennsylvania 17011.
2. Petitioner Beverly Healthcare, doing business as West Shore Health and
Rehab Center, is a licensed nursing home facility, located at 770 Poplar Church Road,
Camp Hill, Pennsylvania 17011.
3. McMaster is, to the best of Petitioners knowledge, a widower, and has no
living children.
4. Petitioner knows of only two relatives of McMaster, her sisters, Eleanor
Monaco (hereinafter "Monaco") and Esther Chilcoat (hereinafter "Chilcoat").
5. Monaco and Chilcoat have been contacted by the undersigned, and they
have stated that they do not desire to act as guardian, and do not contest the
appointment of a guardian.
herein.)
6.
7.
(See Exhibits "A" and "B", attached and incorporated fully
Currently, McMaster is being provided skilled nursing care by Petitioner.
Petitioner requests that this Court appoint Neighborhood Services of
Lancaster, Inc. (hereinafter "Neighborhood Services") as Plenary Guardian over
McMaster and her Estate.
8. Neighborhood Services has consented to act as guardian, as stated in the
attached Exhibit "C", incorporated fully herein.
Neither Petitioner nor Neighborhood Services has any interest adverse to
McMaster.
10.
Guardianship is sought in this instance as McMaster is currently
diagnosed with severe vascular dementia, and is unable to make decisions about her
care. A copy of a Psychology report is attached hereto as Exhibit "D" and incorporated
fully herein.
11. Petitioner is unable to obtain medical assistance through Pennsylvania's
Department of Public Welfare until such time as a Guardian is appointed for McMaster's
Estate and any assets of the Estate are accounted for, and the appropriate application
is made.
12. It is believed and therefore averred that, due to her mental condition,
McMaster's presence at a hearing would not promote her welfare, and therefore her
presence would not be facilitated by Petitioner unless requested by the Court.
13. It is believed and therefore averred that there are no less restrictive
alternatives to this Petition, and therefore no efforts have been made to find such.
2
14. It is requested that Neighborhood Services be provided plenary
guardianship over the Estate of McMaster and to allow the Guardian to liquidate the
corpus of such Estate. The total value of such Estate is unknown at this time.
15. Neighborhood Services is qualified to act as Guardian of McMaster, and
possesses the necessary qualities to act as Guardian.
WHEREFORE, Petitioner Beverly Healthcare respectfully requests this
Honorable Court declare Etta E. McMaster incapacitated and appoint Neighborhood
Services as the Plenary Guardian of Etta E. McMaster and her Estate.
Respectfully submitted,
LAW OFFICES OF MARK K. EMERY
DATED:
By:
Mark K. Emery
Supreme Court I.D. #72787
410 North Second Street
Harrisburg, PA 17101
Attorney for Petitioner
3
EXHIBIT 'A'
CONSENT TO APPOINTMENT OF GUARDIAN
FOR ETTA E. MCMASTER
I, Eleanor Monaco, am the sister of Etta E. McMaster. I know of only one
other living close relative of Etta E. McMaster, which is my sister, Esther
Chilcoat. I have been advised that West Shore Health and Rehab Center intends
to file a Petition to Declare Etta E. McMaster Incapacitated and Appoint a
Guardian for Etta E. McMaster. West Shore Health and Rehab Center has
inquired if I would desire to act as Guardian, and I have declined to do so. I do
not contest the Petition to Declare Etta E. McMaster Incapacitated, nor do I
contest the appointment of a suitable Guardian for both the person and estate of
Etta E. McMaster.
Eleanor Monaco
EXHIBIT 'B'
CONSENT TO APPOINTMENT OF GUARDIAN
FOR ETTA E. MCMASTER
I, Esther Chlcoat, am the sister of Etta E. McMaster. I know of only one
other living close relative of Etta E. McMaster, which is my sister, Eleanor
Monaco. I have been advised that West Shore Health and Rehab Center intends
to file a Petition to Declare Etta E. McMaster Incapacitated and Appoint a
Guardian for Etta E. McMaster. West ,Shore Health and Rehab Center has
inquired ill would desire to act as Guardian, and I have declined to do so. I do
not contest the Petition to Declare Etta E. McMaster Incapacitated, nor do I
contest the appointment of a suitable Guardian for both the person and estate of
Etta E. McMaster.
DATE:
Esther Chilcoat
EXHIBIT 'C'
IN RE: ETTA E. MCMASTER,
An alleged incapacitated person
· THE ORPHANS COURT OF
· CUMBERLAND COUNTY, PENNSYLVANIA
NO.
CONSENT TO APPOINTMENT AS GUARDIAN
I, Vernon Fisher, Executive Director of Neighborhood Services of
Lancaster, Inc., in reference to Etta E. McMaster, do hereby certify that
Neighborhood Services of Lancaster, Inc. consents to be appointed plenary
guardian of the person and plenary guardian of the estate of Etta E. McMaster.
Neighborhood Services of Lancaster, Inc. is not the fiduciary of an estate in
which the alleged incapacitated person has an interest, nor the surety of such
fiduciary, and Neighborhood Services of Lancaster, Inc. does not have any
interest adverse to Etta E. McMaster.
DATE:
NEIGHBORHOOD SERVICES OF LANCASTER, INC.
vernon Fisl~r, Executive Director
EXHIBIT 'D'
05/24/2003 20:35 FAX 6103286768 Swarthmore Associates
Dal~
Rea
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been
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Find
the b,
heari
Mos!
rcspo
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R eeo',
aboul
Kenn
Psychology Consult
e: ERa McMaster Date: May 23, 2003
of Birth: February 1, ] 926 Referrln~ Physician: Dr. Kunlde
on for Referral: Confusion; competency
noshes: CVA, colon CA
~oactive Medications: None ~
Administered: Fols~ein MMSE, Geriatric Depression Sea/e, Wechsler subtests
t'y: We don'! have much background information. Mrs. McMaster was living in
am apartment until she suffered a CVA and came here in March. SinCe then, she has
hospitalized for colon CA. She has been very eon£used but pleasant and is on no
~oaetive medicines.
ings: Mrs. McMaster is resting iJn bed but she is fiiendly and appears to cooperate to
:st of her ability. She is extremely confused and has a significant hearing loss. Her
tg aid is working, and some of Set responses indicate that she heard the questions.
of her replies are irrelevant, however, because of her confusion. She can state her
and age, but little else. Sh~ is somewhat perseverative, that is, she gives the same ,
nsc rcpemed]y. MMSE score is O. She cannot respond meaningfully to the tests of
ct reasoning. She is too eon_fused to complete the depression scale, but her
asea to the simpler iterns indicate depression is not a problem.
rustic Impression: Severel vascular dementia
~mendations: Mrs. McMaster is severely demenled and unable to make decisions
her care. She should have a guardian to look after her interests.
you for allowing my participation in yom- patient's care.
eth R. Carroll, Ph.D.
004
VERIFICATION
I, Susan Metelevich, on behalf of Beverly Healthcare, hereby verify that I
have read the foregoing Petition and that the information contained therein is true
and correct tot he best of my knowledge, information and belief. I understand
that false statements herein are subject to the penalties of 18 Pa.C.S. § 4904
relating to unsworn falsification to authorities.
Susan Metelevicl~
I~eceived Jun-2;-200~ lO:~O=m From-2;8§8~4 To-W~$T SHORE HEALTH AH P~'e 009
6t: 6\I
all rst
EFTA MCMASTER
301 MOHN ST APT 609
STEELTON PA 17113-2086
I,,,111,,,I,,,11,,,11,,11,,,1,111,,,I,,I,,11,,11,,,,,,1111,,,I
Page ! of 3
Relationship Checking
February 15, 2003 thru March 14, ~-~03
Efta McMaster
Activity Summary
Acct No 00591-8584-8
allfirst.com 0 24-hour
Customer Service
1-800-533-4630
Number of checks safekept
Avg. daily ledger balance $30,685.50
Deposits and additions
Date Description
Balance on 02/14
Deposits and additions
Checks
030,5q5.12
638.00
-371.77
Balance on 03114
Amount
03/03
ACH CREDIT
US TREASURY 303 SOC SEC
3031036030ETTA MCMASTER
210122447D SSA
20030595363471
$638.00
Checks
* Denotes missing sequence number
Number Date Amount Number
$638.00
We are safekeeping
Date Amount Number Date Amount
1427 02/24 06.00 1431 03/11 036.93 1434 03/07 $23.57
1428 02/25 22.73 1432 03/05 ?.q0 1435 03/13 10.00
1429 02/28 6.00 1433 03/05 ].93.00 1436 03/10 6.00
1430 03/03 60. lq
your checks for
your convenience.
$371.77
End of Day Ledger Balance
Account balances are updated in the section below on days when transactions posted
to this account.
Date Balance Date Balance Date Balanc,
02/14 $30,5q5.12 03~03 $31,088.25 03110 $30,858.28
02~24 30,539.12 03105 30,887.85 03111 30,821.35
02/25 30,516.39 03~07 30,86q.28 03113 50,811.35
02~28 30,510.39
002684
0008-98317484062 050
I~ PETITIONER'S ~
LAW OFFICES OF MARK K. EMERY
410 North Second Street
Harrisburg, PA 17102
(717) 238-9883
Mark K. Emery, Esquire
Fax (717) 238-9884
e-mail memerylaw@aol.com
July 8, 2003
Ms. Eleanor Monaco
5215 Terrace Road
Mechanicsburg, PA 17050
Ms. Esther Chilcoat
1620 North Fourth Street
Harrisburg, PA 17102
RE: Etta E. McMaster
Dear Ms. Monaco and Chilcoat:
I enclose the Petition to Declare Etta McMaster Incapacitated, which has
been filed with the Court. You will also see a notice of the hearing on that matter.
You are in no way required to attend the hearing. I simply wanted to keep you
both fully informed of the actions that are occurring.
Should you have any questions, please do not hesitate to contact me.
Thank you.
Very truly yours,
LAW OFFICES OF MARK K. EMERY
MKE/vh
By:
Mark K. Emery
PsY"holollY Consult
Ella McMaster
of Birth: Feb~ i, 1928
R.e~on for Referral: Confusion; compcmney
Diaignoses:
Hist,
bee~
F~nd
the I~
hear
Mos
Date: May 23, 2003
ReferrinR Physician: Dr. Kunkle
CVA, colon ~
~o~eti~'e Medication: None .
Administered; Folsteill IViI~E, ~eriarH¢ Depression Scale, Wechsler subtests
fY: We don'~ have much back~ouncl information. Mrs. McMaster was livi~l in
~ apartment ttnlil she s~ffered a CVA a~d came here in Marek gince then, see has
hospitalized for colon CA_ Sh~ has beea vcr~ eor~fu.~ed but pleasan! and is on
Mrs. McMast~r is rest/rig im bc~ but ~he is ~en~y ~d a~s to ~pcm~ to
ofh~ abi~. She is e~em~ly ~d ~d
~d is woz~n8, ~fl ;ome of her r~po~es ~ca~ th.t ~ ~ the q~o~,
ofh~ ~Ees ~e ~~{, hoover, bede ofh~ eo~siom
ag~ but li~le ~se.
~e~g. She is too
~ ~e s~pl~ i~ in8i~te depm~on is not a problem.
R, eeo~_ menchtioas: M~. McMaster is scvc~ly clem~-lted and unabl~ to make decisions
her care, Sh~ shovel have a guardian to loo~ afl~- her interests,
you for allowing my parti~ipat/on in your patient's care.
Kenn
et.h lq.. Carroll, Ph.D.
IN RE: ETTA E. MCMASTER
an alleged incapacitated person
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
MOTION TO ALLOW TELEPHONIC TESTIMONY OF
DR. KENNETH CARROLL
AND NOW comes the Petitioner, by and through its attorneys the Law Office of
Mark K. Emery, and files this Motion to Allow Telephonic Testimony of Dr. Kenneth
Carroll, as follows:
1. Petitioner filed a Petition to Declare Etta E. McMaster Incapacitated and
Appoint Neighborhood Services of Lancaster, Inc. as Plenary Guardian of Etta E.
McMaster and her Estate on July 1, 2003.
2. The Court has set a hearing date for July 21 at 11:30 a.m. before the
Honorable George E. Hoffer.
3. Petitioner intends to present the testimony of Dr. Kenneth Carroll, a
treating physician of Efta E. McMaster.
4. In order to alleviate the need for Dr. Carroll to appear in person, Petitioner
requests that Dr. Carroll be allowed to testify telephonically.
5. It is believed and therefore averred that no prejudice will occur by allowing
telephonic testimony of Dr. Carroll.
WHEREFORE, Petitioner respectfully requests this Honorable Court allow Dr.
Kenneth Carroll to testify telephonically at the hearing on the Petition.
Respectfully submitted,
LAW OFFICES OF MARK K. EMERY
DATE: July 7, 2003
Mark K. Emery
Supreme Court I.D. No. 72787
410 North Second Street
Harrisburg, PA 17101
(717) 238-9883
Attorney for Petitioner
IN RE: ETTA E. MCMASTER
an alleged incapacitated person
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
AND NOW, this ~"
ORDER
_ day of July, 2003, upon consideration of Petitioner's
Motion to Allow Telephonic Testimony of Dr. Kenneth Carroll, it is hereby ORDERED
that Dr. Kenneth Carroll may provide telephonic testimony.
BY THE COURT,
[0: 6~,: L- ltl? [0.
JUL
IN RE: ETTA E. MCMASTER,
an alleged incapacitated person
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-0'3-
PRELIMINARY DECREE
AND NOW, this --~,'~ day of (~-z4/'~, 2003, upon consideration of the
annexed Petition, it is ORD.E,RED.^ND DF:~RE~ that a hearing on this matter is set
for the ,,~../SY- day of ~03 in Courtroom No. _~ , at/!,' 3~/flM. at
the Cumberland County Coj~rthou~, One Courthouse Square, Carlisle, 15~nnsylvania,
and that a Citation be issued to Efta E. McMaster commanding her to show cause why
she cannot appear at the aforementioned hearing pursuant to the Petition of Beverly
Healthcare to have Etta E. McMaster adjudicated an incapacitated person and to have a
plenary guardian appointed for her person and her estate. Notice of the hearing shall
be given to Etta E. McMaster by counsel for the Petitioner in accordance with 20 P.S. §
5511 (a).
BY THE COURT,
Jo
IN RE: Etta E. McMaster
an alleged incapacitated person
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-0536
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 Beverly
Healthcare d/b/a West Shore Health and Rehab Center is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 3, Cumberland
County Courthouse, Carlisle, Pennsylvania, on July 21 ,2003, at 11:30 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 heating, 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 tights 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 heating in your absence and may appoint the Guardian requested.
Clerk, Orphans' Court Division
Cumberland County, Carlisle, PA
My Commission Expires 1st Monday,
January, 2006
IN RE: ETTA E. MCMASTER
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 21-03-536
AFFIDAVIT OF SERVICE
I, Mark K. Emery, Esquire, do hereby swear and affirm that service of the Petition
to Declare Etta E. McMaster Incapacitated and Appoint Neighborhood Services as
Plenary Guardian of Etta E. McMaster and Her Estate was made via hand delivery and
by personally reading such Petition to her on July 10, 2003.
DATE: July 10, 2003
Mark K. Emery~
Supreme C~-I:O. 72787
410 Nor+~H~econd Street
Harrisburg, PA 17101
IN RE: ETTA E. MCMASTER,
an alleged incapacitated person
THE ORPHANS COURT OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO.
~- ORDER
AND NOW, thi day 2003, after Petition and hearing,
it is ORDERED that Etta E.McMaster be d~ incapacitated and Neighborhood
Services of Lancaster, Inc. is hereby appointed Plenary Guardian of Etta E. McMaster
and her Estate.
BY THE COURT,
)
"., .,
v-
.. .
IN THE COURT OF COMMON PLEAS O:F(Y.,.rt~COUNTY, PENNSYL VANIA
I
ORPHANS' COURT DIVISION
IN RE:
ftf,-/\lCI ltlstev ,
an incapacitated person
'1 U '-.1... r-::.;.-... &:
No.~' rv.:.J JJ
GUARDIAN OF THE ESTATE ANNUAL REPORT
[20 Pa.C.S. ~ 5521(c))
For the period:
Jj
. , <t-
. '"'f .~I->
,20t:Jto-1J'CI d/$J- ,200.5
I
1. I am the Limited ~';'idrcle one) Guardian of the Person of my war ,
named above. I was appointed Guardian by Order of the Court dated, '~d/sr C
~ which was /.~rcle one) modified by Court Order(s) dated
.~ /::)
2. Is the incapacitated person stillliving?~ / No (circle one)
If no, answer the following.
a Date of Death:
b. Place of Death:
c. Name of Administrator or Executor:
d. Date Guardian of the Estate filed the last annual report:
PLEASE ANSWER THE FOLLOWING QUESTIONS
WHETHER THE INCAPACITATED PERSON
IS LIVING OR DECEASED
. -.J
"-::)
,--)
(' . ~~f
')
(.!',
3. My initial Inventory was filed on
total estate value of $ / OJ 0 . .tJff
~J~/8/J
, (
L.
"
,
. ..
':- \.
The Inventory listed a total monthly income of $
comprised of the following: ~ ~
$( 1~O- 0lJ
4.
I
I
i
I
I
I
I
I
At the beginning date of this reporting period, my initial balance on hand was
I
I
$
5. During this reporting period, the following reflects all sources of income
received by me for my ward (add additional pages ifneeded):
Date Received Source of Income Amount
1.
2.
3.
4.
5.
6.
~
~
TOTAL I
6. During this reporting period, the following reflects all payments I have mfie
for my ward (add additional pages if needed):
~. To Whom Paid Reason For Payment Amount
1.
<j
4.
5.
6.
TOTAL
7. The present principal assets of my ward are:
Description of Asset
1 \ ~
2 ~~\
3.
4.
5.
6.
Present Value
2
. ,.
8. The present amount and sources of income for my ward are:
Sources of Income Amount of Income
I
(Indicate whether mon~y,
quarterly or annually) I
L
2.
3.
4.
5.
6.
~-
f, 73 D tF/J
~ ~~vf
9. The regular monthly expenses of my ward that I pay are:
To Whom Paid Amount
L
2.
3.
4.
5.
6.
LD;f ~f:;,~~~~
I
cle one) petitioned the Court for permission to invad,
principal to meet the of my ward. i
I
(If applicable) The following expenses of my ward have been paid from principal:
To Whom Paid Purpose Amount
1.
2.
3.
4.
5.
6.
TOTAL
11. I have / have not (circle one) paid myself compensation for services I ren1ered
as guardian. i
3
.' ~~,
The amount I paid myself totaled $ and was calculatedl at
the following rate: per w€r mo~cle one). I
12~' Ie the correct response and complete, if applicable.
a There will not be a need for extraordinary expenditu.... on behalf of
my ward n the xt twelve (12) months.
b. There will be a need for extraordinary expenditures on behalf ot my
ward in the next twelve (12) months because:
13. CircJ~ the correct response and complete, if appropriate.
a. My ward receives monthly social security benefits
directly.
b. I am the designated payee to receive my ward's soci~
security benefits. I
c. The designated payee of my ward's social security I
benefits is Dh
\.^J (/,)+ ()\" () y -L.- +-\&1 aJ.~ t-, "of ,~ . o.h , wrose
address is: ''I). i", r~ h l)~1 !
qO 't1: ~(" V LVU Key. , i
!
I
.1
,
/ is not (circle one) related to my ward as :
(insert relationship).
14. Please note any concerns about the incapacitated person's physical or menW
well being or the finances that the Court should know.
15. .' am jam not (circle one) the guardian of the incapacitated person's per~. If
I am, my re on IS attached.
4
. .
I
I
I certify under the penalties of 18 Pa.C.S. ~ 4904 (relating to unsworn falsificatiOll to
authorities) that the information contained in this ort is true and correct to the best of rPY
knowledge, information and belief.
DATE:
q - I - D5
Name:
Address:
NEJemRnRlI'llOD SERVICES
134 SOlTTH PRINCE STREET
P.O. BOX 1593
LANLAS.i]!;.K, rA l/11U8-1Sll
5