HomeMy WebLinkAbout03-0886IN THE MATTER OF
Frank B. Bruckhart, Jr., :
AN ALLEGED INCOMPETENT :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
PETITION FOR APPOINTMENT OF AN EMERGENCY GUARDIAN,
ADJUDICATION OF INCAPACITY AND APPOINTMENT
OF PLENARY GUARDIAN OF THE ESTATE AND PERSON
TO THE HONORABLE JUDGE OF THE COURT OF COMMONPLEAS:
1. Petitioners are Lynda E. Kyle who resides at 200 Red Tank Road, Boiling Springs,
Pennsylvania and Frank B. Bruckhart, III who resides at 20 Rock Ridge Road, Lewisberry,
Pennsylvania, the daughter and son of Frank B. Bruckhart, Jr., the alleged incapacitated
person.
2. Frank B. Bruckhart, Jr. was born on September 2, 1924, is 79 years of age and is divorced,
whose address is #10 Trudy Circle, Mechanicsburg, Pennsylvania ! 7050. However, he has been
hospilatized at Select Specialties Hospital, 503 N. 21 st Street, 5th floor, Camp Hill,
Pennsylvania.
3. The following persons are to the best of petitioner's knowledge, information and belief the
only living next-of-kin of the alleged incapacitated person:
A. Lynda E. Kyle, daughter, who resides at 200 Red Tank Road, Boiling Springs, Pa. P
B. Frank B. Bruckhart, III, son, who resides at 20 Rock Ridge Road, Lewisberry, Pa.
C. Calvin Bruckhart, son, who resides at 5420 Union Deposit Road, Harrisburg, Pa. P
D. Doris Christmas, sister, who resides at 10 Winding Hill Drive, Mechanicsburg, Pa.
E. Michael Bruckhart, grandson, who resides at 6612 Carlisle Pike, Mechanicsburg, Pa.
F. Melissa Bruckhart, granddaughter, who resides at 20 Rock Ridge Road, Lewisberry,
Pa..
4. Frank B. Bruckhart, Jr. is currently living
at Select Specialties Hospital, 503 N. 21 st Street,
5th floor, Camp Hill, Pennsylvania since August 20, 2003. Hospitalization is no longer
medically necessary and his physicians wish to transfer him to a nursing care facility..
(See Exhibits A, B, and C attached hereto and made a part hereof as though fully set
forth herein. The originals of Exhibits B and C will be filed with the Court upon receipt)
5. To the extent known by petitioners, the value of the assets of the alleged incapacitated person
are as follows A. Lot and mobile home located at Lot 206 Gray Us Mobile Estates, 206 Clara
Street, Sebring, Florida.
B. Life insurance - North America Life and Casualty Co.
C. Life insurance - Metropolitan Life Insurance Co.
D. Life insurance - Annuity - Metropolitan Life Insurance Co.
E. 1991 GMC Station Wagon
F. Mobile Home, 10 Trudy Drive, Mechanicsburg, Pennsylvania
G. Pension - CWA/ITU Negotiated pension plan $151.82 monthly
H. Social Security Monthly amount $923.00
I. Patriot News Pension $464.63 monthly
J. Susquehanna Valley Federal Credit Union, approximate balance in checking $7339.26
as of July 31, 2003.
K. Susquehanna Valley Federal Credit Union, balance $7678.80 as of August 31, 2003.
L. Two WS Lodge B.P.O.E. ownership certificates $250.00 each
6. Petitioner estimates the alleged incapacitated person's income to be $1539.45 per month. His
Social Security benefits are $923.00 per month. Frank B. Bruckhart, Jr. also receives $616.45
per month from retirement funds.
7. The alleged incapacitated person was not a member of the armed services of the United States
and is not receiving benefits from the United States Veterans' Administration.
8. The alleged incapacitated person has suffered from severe cognitive deficiency caused by
alcoholic dementia. He is currently under the care of Theresa A. Burick, D.O., F.A.C.P. whose
office is located at 888 Poplar Church Road, Camp Hill, PA 17011 .(See letter attached as exhibit
"A")
9. Because of his impaired mental condition, the alleged incapacitated person is totally unable to
manage his financial affairs, property and business and to make and communicate responsible
decisions relating thereto, including the ability to communicate his need for assistance in these
areas.
10. Because of his impaired mental condition, the alleged incapacitated person lacks the
capacity to make or communicate any and all responsible decisions concerning his person.
11. No other alternatives exist other than the appointment of a guardian of the estate and the
person of Frank B. Bruckhart, Jr.
12. The severity of the alleged incapacitated person's mental condition and the lack of viable,
less restrictive alternatives necessitate that plenary guardians of his estate be appointed to
manage and handle all aspects of Frank B. Bruckhart, Jr.'s person and estate, specifically
including, but not limited to medical decisions and financial decisions regarding his financial
affairs and property. It is imminently necessary to have him admitted to a nursing care facility
since his hospitalization is no longer medically necessary and he must be discharged from his
current hospitalization.
13. The proposed plenary guardians of the person of the alleged incapacitated person are Lynda
E. Kyle who resides at 200 Red Tank Road, Boiling Springs, Pennsylvania and Frank B.
Bruckhart, III who resides at 20 Rock Ridge Road, Lewisberry, Pennsylvania, the daughter and
son of Frank B. Bruckhart, Jr., the alleged incapacitated person.
14. The proposed plenary guardians of the person are (1) Linda E. Kyle, who is 49 years old,
resides at 200 Red Tank Road, Boiling Springs, Pennsylvania, and is a high school graduate and
hold an associates degree, and is employed by HighMark of Camp Hill, Pennsylvania, and (2)
Frank B. Bruckhart, III, who is 52, resides at 20 Rock Ridge Road, Lewisberry Pa., and
completed high school up to the 11th grade and is employed at Red Neck Trailer Supplies,
Carlisle, Pennsylvania. They are the daughter and son of the alleged incapacitated person.
15. The proposed plenary guardians have no interest adverse to the alleged incapacitated person.
16. The consent of the proposed plenary guardians are attached as Exhibit "B".
17. No other guardian has been appointed for the estate or person of the alleged incapacitated
person, to the best of Linda E. Kyle and Frank B. Bruckhart, III's knowledge.
WHEREFORE, petitioner respectfully requests that this court award a citation directed to
Frank B. Bruckhart, Jr., the alleged incapacitated person, and to such other persons as this Court
may direct, to show cause why Frank B. Bruckhart, Jr. should not be adjudged a fully
incapacitated person, and Linda E. Kyle and Frank B. Bruckhart, III be appointed plenary
guardians of his person and estate.
and
emergenc
Attorney for Petitioner
L/i~i~a E. Kyle, Peti~her
Frank B. Bruckhart, III.,
Petitioner
IN THE MATTER OF :
:
Frank B. Bruckhart, Jr., :
AN ALLEGED INCOMPETENT :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
CONSENT OF GUARDIAN
I, Linda E. Kyle and Frank B. Bruckhart, III., hereby consent to act as emergency
guardian of the estate and person of Frank B. Bruckhart, Jr., an alleged incapacitated person for
the purpose of authorizing any surgical or other medical procedure necessary for the health and
welfare of Frank B., or to authorize the discharge from hospitalization and admission to a
nursing home facility.
I Linda E. Kyle reside at 200 Red Tank Road, Boiling Springs, PA and am employed by
Highmark of Camp Hill, Pennsylvania.
I Frank B. Bruckhart, III reside at 20 Rock Ridge Road, Lewisberry, PA and am
employed by Red Neck Distribution.
I am a citizen of the United States and can speak, read and write the English language.
I have no interest adverse to Frank B. Bruckhart, Jr., the alleged incapacitated person.
Linda E. Kyle, Proposed43uardian
Frank B. Bruckhart, III., Proposed Guardian
Theresa A. Burlck D.O., F.A.C.P.
R. George Azizkhan D.O.
Steven A. Prophet M.D.
I URICK & AZIZK AN
INTERNAL MEDICINE ASSOCIATES
888 Poplar Church Road · Camp Hill, PA 17011 · Phone: 717.724.2126 · Fax: 717.724.2132
Ruby D. Weeks, Esq.
Ten West High Street
Carlisle, Pa. 17013
RE: Frank B. Bruckha~, Jr.
SS#
October 14,2003
Dear Ms. Weeks,
We have been caring for Mr. Bruckhart at Holy Spirit Hospital and Select Specialty
Hospital since August 20, 2003 when he was admitted for severe cellulitis and
Osteomyelitis of the right foot. This was due to poor hygiene and self care while living
independently.
While in the hospital the patient did go through Delirium Tremens from alcohol
withdrawal. Subsequent psychological testing reveals severe cognitive deficiency caused
by alcoholic dementia. This patient scored 15/30 on a MMSE. It is my opinion Mr.
Bruckhart is unable to care for himself. He is not cognitive to make decisions for himself
medically, financially, or otherwise.
If you have any further questions please feel free to contact me.
Sincerely,
Specialty Hosp taI
October 24, 2003
Ruby D. Weeks
Attorney at Law
Ten West High Street
Carlisle, Pennsylvania 17013-2955
Re: Frank B, BrucFdaart, Sr.
Social Security Number:. 20g-03-0944
Dear Ms. Weeks:
This letter is in response to your request for verification that Mr. Buclcb. art no longer
meets criteria to stay a! Select Specialty Ho,.,'pital. Mr. Bmck. ha~'s medical and routine
0.aily needs can be l~rovided in a leSser care environment such as a nursing home, As of
today, I have confirmed bed availability at Manor Care Nursing and Rehab in Carlisle,
PA for admission on Tuesday, October 28, 2003 or Wednesday, October 29, 2003.
Mr. Bruekhart continues with slightly impaired sensory perception and mobility. He
remains oriented to self only exhibiting impaired judgement regarding his ability to make
medical decisions, understaeding rislo vs benefits of recommendations and caring for his
daily nee~,
Thank you for your assist~ce wi:h this matter,
Sincerely,
Donna White, MSW LSW
Case Manager
505 Noah 21s~ $~rect 5th ¥1cot C:unp Hill, 'PA 170~ t
(717) 972-~5fi0 FaX (717) 972-4551
u~u,~t~el~trn, ec#¢alcor~, corn
~ 7~7 243 4"/~M Oc~. ~;~ ~ le:~r~M P'3
THE MATTER OF :
i~k B. B~o1~h~ ,1~., :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
OP. PHAI~' COUI~T DMSXON
'NO. Of 2003
.a. Pl~DAV1T TO EXCUSE ALLBOI~D INCAPACITATED
PER~ON FKOM COUI~T FffiARING
be~nli~edio~l;iomiuPem~'ylvauimsin,~ / "~"-/ , Idoherebys'w~mr
o~ ~ th~ wtthiu a t'easoual:,l~ dm~'~ of w~ii~l cmnkiut'y I I~lieve t, ha~: tt~ above ~rr~
alleg~i ln~l~ed Im~n should not alimd e~ 0ourt hms, inS tu lhe Oumbcrl~l Count,
Counlxnt~ b~caus~ in my profussi~aal opl, dolm his physical or m~! condition would, be
hsrmed by ~e. uampor~atio~ to thc co'a~om ~nd by his all~danoe ~.~ the co,tn hearing.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS ' COURT DIVISION
GUARDIANSHIP
2003 CIVIL TERM
PETITION OF LYNDA E. KYLE AND FRANK B. BRUCKHART, III
FOR GUARDIANSHIP OF
FRANK B. BRUCKHART, JR.
RUBY D. WEEKS, ESQUIRE
10 WEST HIGH STREET
CARLISLE, PA 17013-2955
717-243-1294
IN THE MATTER OF
Frank B. Bruckhart, Jr.,
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. %~¢ Of 2003
PRELIMINARY DECREE - CITATION AWARDED
AND NOW, on , on consideration of the petition of Lynda E.
Kyle who resides at 200 Red Tank Road, Boiling Springs, Pennsylvania and Frank B.
Bruckhart, III who resides at 20 Rock Ridge Road, Lewisberry, Pennsylvania, the
daughter and son of Frank B. Bruckhart, Jr., the alleged incapacitated person, it is
hereby ordered and decreed that a citation is awarded, directed to Frank B. Bruckhart, Jr.,
the alleged incapacitated person, to show cause why Lynda E. Kyle who resides at 200
Red Tank Road, Boiling Springs, Pennsylvania and Frank B. Bruckhart, III who resides
at 20 Rock Ridge Road, Lewisberry, Pennsylvania, the daughter and son of Frank B.
Bruckhart, Jr., the alleged incapacitated person, should not be appointed emergency
guardian of his person for the purpose of consenting to the admission of Frank B.
Bruckhart, Jr. to Manor Care Nursing Home, with the emergency guardianship to be
effect with respect tol Sh'guardianship of the person for a period of seventy-two (72)
hours from the date of this court's decree and with respect to the guardianship of the
estate for a period of thirty (30) days from the date of this court's decree.
Forty-eight (48) hour notice of hearing on this petition is to be given to Frank B.
Bruckhart, Jr., the alleged incapacitated person, with hearing on the same to be held
o'clock, Room , Cumberland County Courthouse, Pennsylvania.
By the Court:
Jo
IN THE MATTER OF
Frank B. Bruckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
IMPORTANT NOTICE
CITATION WITH NOTICE
A PETITION HAS BEEN FILED WITH THIS COURT TO HAVE YOU DECLARED
AN INCAPACITATED PERSON. IF THE COURT FINDS YOU TO BE AN
INCAPACITATED PERSON, YOUR RIGHTS WILL BE AFFECTED, INCLUDING YOUR
RIGHT TO MANAGE MONEY AND PROPERTY AND TO MAKE DECISIONS. A COPY
OF THE PETITION WHICH HAS BEEN FILED BY LYNDA E. KYLE AND FRANK B.
BRUCKHART, III IS ATTACHED.
AN EMERGENCY HEARING ON THE PETITION FOR INCAPACITATED PERSON
HAS BEEN SCHEDULED FOR AND YOU ARE HEREBY ORDERED TO APPEAR AT A
HEARING TO BE HELD IN COURTROOM NUMBER ~ , LOCATED IN THE
CUMBERLAND COUNTY COURTHOUSE, FOURTH FLOOR, CARLISLE,
PENNSYLVANIA, ONTHE ~ ~'~'D'AY OF 0~ba~_ ~//~, 2003, AT ~,'O~ O'CLOCK
~- .M. TO TELL THE COURT WHY IT SHOULD NOT FIND YOU TO BE AN
INCAPACITATED PERSON AND APPOINT A GUARDIAN TO ACT ON YOUR BEHALF.
A HEARING ON THE PETITION FOR THE APPOINTMENT OF A GUARDIAN
HAS BEEN SCHEDULED BEFORE THE HONORABLE
JUDGE, IN COURTROOM NUMBER ~, LOCATED IN THE CUMBERLAND
COUNTY COURTHOUSE, FOURTH FLOOR, CARLISLE, PA., ON THE DAY OF
, 2003, AT __ O'CLOCK .M.
TO BE AN INCAPACITATED PERSON MEANS THAT YOU RE 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 BE CONDUCTED AS TO YOUR ALLEGED INCAPACITY.
IF THE COURT DECIDED 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 OR FULL POWERS TO
ACT FOR YOU.
IF THE COURT FINDS YOU ARE TOTALLY INCAPACITED, YOUR LEGAL
RIGHTS WILL BE AFFECTED AND YOU WILL NOT BE ABLE TO MAKE A CONTRACT
OR GIFT OR YOUR MONEY OR 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 HEARING (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 ~ .t_ ~
i~1,~.~~. o t'BytheCourt, t ,
IN RE: Frank B. Bruckhart, Jr.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-2003-886
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 fights will be affected, including our right to manage
money and property and to make decisions. A copy of the petition whi~ch has been filed by LYnda E.
Kyle and Frank B. Bruckhart, III is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 5th, Cumberland
County Courthouse, Carlisle, Pennsylvania, on 29th October ,2003, at 3:00 P.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 fight to appear, to be represented by an attorney, and
to request a jury trial. If you do not have an attorney, you have the fight 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 fight 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
886 of 2Q03 .....
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CITATION IMI'H IIOTI~ AND
mid. tubj~ Io Ihl pwlltin od lO pl.c.$.a. 14004
Room
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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 fights will be affected
and you will not be able to make a contract or girl of your money to other property. If the
court finds that you are partially incapacitated, your legal fights will also be limited as
directed by the Court.
If you do not appear at the hearing (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, Orphans' Court Divisior~ /
Cumberland County, Carlisle, PA
My Commission Expires 1 st Monday,
January, 2003
IN RE: Frank B. Bruckhart, Jr.
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHANS' COURT DIVISION
:
: NO. 21-2003-886
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 Lynda E.
Kyle and Frank B. Bruckhart, III is attached.
You are hereby ordered to appear at a hearing to be held in Court Room No. 5th, Cumberland
County Courthouse, Carlisle, Pennsylvania, on 29th October ,2003, at 3:00 P.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 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 tights 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, Orpl.~mis,~Co-urt Divi~ioh 1~''
Cumberland County, Carlisle, PA
My Commission Expires 1st Monday,
January, 2003
IN THE MATTER OF
Frank B. Bruckhart, Jr.,
AN ALLEGED INCOMPETENT
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
AFFIDAVIT TO EXCUSE ALLEGED INCAPACITATED
PERSON FROM COURT HEARING
'-~,'J~e.~.S~) fi'7 L'~i.IF,CJ~ ~'"~, 0- , am a licensed physician (or psychologist). I have
been licensed to practice in Pennsylvania since /~ ~ ~. . I do hereby swear
or affirm that within a reasonable degree of medical certainty I believe that the above referred to
alleged incapacitated person should not attend the court hearing in the Cumberland County
Courthouse because in my professional opinion his physical or mental condition would be
harmed by the transportation to the courtroom and by his attendance at the court hearing.
I have based by opinion on a personal examination of the person (and/or an examination
of medical records). My diagnosis is as follow:~~,_2~ O()~/q)/? I. Jf. i;~.jr/'~ C.l~C U
My prognosis is as follows: ~. ~. ~Tt~ t~ ~ ~q ~- /~
SignOre of physi~~sychologist
COMMONWEALTH OF PE~SYLVANIA ·
· SS.
CO~TY OF CUMBE~AND ·
SWO~ TO AND SUBSC~BED BEFO~ ME THIS ~ ~AY OF
200~.
Notafi~l S~al
Susan K. Panne~;aker,
H _aljlpden
My Commission, Exp ms Oct 1 'l 200-~
~/IL Burick D.O., F. AC.P.
R. George Az/zkhan D.O.
Steven A. Prophet M.D.
BURICK &., AZIZKI-.IAN
INTERNAL ,MEDICINE ASSOCIATES
888 Poplar Church Road · Camp Hill, PA 17011 · Phone: 717.724.2126 · Fax: 717.724.2132
Ruby D. Weeks, Esq.
Ten West High Street
Carlisle, Pa. 17013
RE: Frank B. Bruckhart, Jr.
SS# - 204-03-0944
October 14, 2003
Dear Ms. Weeks,
We have been caring for Mr. Bmckhart at Holy Spirit Hospital and Select Specialty
Hospital since August 20, 2003 when he was admitted for severe cellulitis and
Osteomyelitis of the right foot. This was due to poor hygiene and self care while living
independently.
While in the hospital the patient did go through Delir/um Tremens from alcohol
withdrawal. Subsequent psychological testing reveals severe cognitive deficiency caused
by alcoholic dementia. This patient scored 15/30 on a MMSE. It is my opinion Mr.
Bruckhart is unable to care for himself. He is not cognitive to make decisions for himself
medically, financially, or otherwise.
If You have any further questions please feel free to contact me.
Sincerely,
lC
Fr~-SEC£CT $1~CIALTY HOSPITAL
?IT ~T2 4581
Select,
Specialty'~Hosp~tai
October 24, 2003
Ruby D. Wee~
Attorney at Law
Ten West High Street
Carlisle, Penmylvania 17013-2955
Re: Frank B. Brucldaan, Sr.
Social Security Number:. 20~-03-0944
Dear Ms. Weeks:
This letter is in re~on~e to your request for verification that Mr. Buckl~art r.o longer
meets criteria to stay at Select Specialty Ho,vpital. Mr. Bruekhart's medical mcr routMe
deily need~ ca~ be provided in a lesser care environment such as a nursing home..4.s of
today, I have confirmed bed availability at Manor Care Nursing and Rehab in Carlislo,
PA for admission on Tuesday, Omober 28, 2003 or Wednesday, Ootober 29, 2003.
Mr. Bruckhart continue~ with slightly impaired sensory perception and mobility. He
remains oriented to self only exhibiting impaired judgement regard/ng his ability to make
medical decisions, tmderst/mding risk~ vs benefit~ of recommendations and caring for his
daily needs.
Thank you for your assistatce wi:h this matter,
Skncerely,
Donna White, MSW LSW
Case Manager
505 North 21st Street 5th Floor CLwag Hill, PA 170I
(717) 972.,1~60 Fax (717) 972-4561.
www, sel~medtcalcorp,¢om
IN THE MATTER OF
Frank B. Bruckhart, Jr.,
AN ALLEGED INCOMPETENT
ANDNOW, on ~)~ 1~'~//
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ~0 Of 2003
DECREE
~O D~, on consideration of the petition of Lynda E. Kyle
who resides at 200 Red Tank Road, Boiling Springs, Pennsylvania and Frank B. Bruckhart, III
who resides at 20 Rock Ridge Road, Lewisberry, Pennsylvania, the daughter and son of
Frank B. Bruckhart, Jr., the alleged incapacitated person, and after hearing held with forty-eight
(48) hour notice thereof as directed by the court, the court finds that Frank B. Bruckhart, Jr.
currently lacks sufficient mental capacity to make or communicate, or even participate in
responsible decisions concerning his person, and that failure to appoint an emergency guardian
will result in irreparable harm to his person, in that he is imminently to be discharged from his
current hospitalization and must be admitted to a nursing care facility.. It is therefore ordered
and decreed that Lynda E. Kyle who resides at 200 Red Tank Road, Boiling Springs,
Pennsylvania and Frank B. Bruckhart, III who resides at 20 Rock Ridge Road, Lewisberry,
Pennsylvania, the daughter and son of Frank B. Bruckhart, Jr., the alleged incapacitated
person, are appointed emergency guardians of the person of Frank B. Bruckhart, Jr. ~
c.f :,cv_--n~,,m,e ~-m~,. ~, ?~:,uro ",,,,,, ....... ,,,.' ........ ,~,~,. ,,~ ,,o ,.,,,,, & ~,.~,.,~ and guardian of the estate of
Frank B Bruck_hart, Jr. fer ~ ?,4,,a eftF.::-~ ............ "'"' .......... d
may consent to the adhaission of Frank B. Bruckhart, Jr. to Manor Care Nursing Home
o_r. an}, other such appropriate facility. ~"~'~ ~ ~ ~ ~
,, 30
J.
IN THE MATTER OF ·
Frank B. Bruckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
Final Decree - Appointment of Emergency Guardians and Permanent Guardians in One
Proceeding.
AND NOW, on , judicially to determine petitioner's request for
the appointment of emergency guardians and permanent guardians, the following
directives are hereby ORDERED and DECREED:
1. The Clerk of the Orphans' Court shall issue a citation upon the above captioned
alleged incapacitated person to show cause for the following:
(a) Emergency plenary guardians or emergency limited guardians should not be
appointed;
(b) The above-captioned alleged incapacitated person should not be adjudged an
incapacitated person and permanent plenary guardians or permanent limited guardians
should not be appointed.
2. An evidentiary hearing on the request for emergency guardians shall be held before
the Honorable in Courtroom No.
Courthouse, Cumberland County, Pennsylvania, on the day of '
, at o'clock .m.
3. Relative to the request for emergency guardians and as provided in 20 Pa. Cons. Stat.
Section 5511 (A), the petitioner shall cause personal service upon the alleged
incapacitated person with the following:
(a) Petition for appointment of emergency guardians with attached notice.
(b) Notice of the time and place of the evidentiary hearing.
(c) Citation with rule to show cause why emergency guardians should not be appointed
for the alleged incapacitated person.
(d) the contents and terms of the petition and attached notice shall be explained to the
maximum extent possible in language and terms the individual is most likely to
understand.
4. Because of time constraints resulting from emergency conditions and pursuant to 20
Pa. Cons. Stat. Section 5513, the court finds the following provisions of 20 Pa. Cons.
Stat. Section 5511 are not feasible under the circumstances and are hereby
waived:
5. In addition to personal service upon the alleged incapacitated person, the following
are to be given notice of the petition for appointment of emergency guardians and the
evidentiary
hearing:
6. An evidentiary hearing on the request for permanent guardians shall be held before the
Honorable , Courtroom No. , Courthouse,
Cumberland County, Pennsylvania.
BY THE COU~T,
IN THE MATTER OF :
FRANK B. BRUCKHART, JR. :
AN ALLEGED INCOMPETENT :
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 21-03-886
ORDER OF COURT
AND NOW, this 1st day of December, 2003, by
agreement of the parties, the record is kept open in this matter
for 45 days to give the parties the opportunity to submit the
deposition testimony of Dr. Darryl Guistwite. During said time
frame, our Order of October 29, 2003, shall remain in full force
and effect.
By the Court,
Edward E. Guido, J.
Ruby D. Weeks, Esquire
For the Petitioners
Michael J. Whare, Esquire
For Frank B. Bruckhart, Jr.
srs
IN THE MATTER OF ·
Frank B. Bruckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. 886 Of 2003
PETITION FOR EXTENSION OF TIME TO TAKE
PHYSICIAN'S DEPOSITION OR TO RESCHEDULE HEARING
TO TAKE PHYSICIAN'S TESTIMONY
TO THE HONORABLE, THE JUDGES OF THE SAID COURT:
The petition of the temporary guardians, Linda Kyle and Frank Bruckhart III, represents
that:
1. The Order of this Honorable Court dated December 1, 2003, provided 45 days to take the
deposition of Darryl Guistwite, M.D...
2. Due to the holidays and the fact that Dr. Guistwite is on vacation and not available to even
schedule the deposition until January 12, 2004, the temporary guardians request an
extension of time to take the doctor's deposition or in the alternative to set another
hearing date to allow the doctor to be subpoenaed and have his testimony taken as to the
continuing incapacity of the alleged incompetent who remains at Manor Care Nursing
home.
3. It is also requested that the order granting temporary guardianship to Ms Kyle and Mr.
Bruckhart be extended until further order of this Court can be entered granting permanent
guardianship.
4. Counsel for the alleged incompetent has no objection to either of the above solutions to the
problem of obtaining Dr. Guistwite's testimony and does not object to the continuation of
the temporary guardianship.
WHEREFORE, petitioners respectfully request that this court either grant an extension of
time to take the deposition of Dr. Guistwite or schedule another hearing at which Dr.
Guistwite's testimony could be taken, and extend the Order granting temporary guardianship to
allow the temporary guardians to act until such time as this Court can enter a permanent order of
guardianship.
January 9, 2004
Ruby D. Wee~, Esquire, Attorney
For Temporary Guardians
IN THE MATTER OF '
Frank B. Bruckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ~ Of 2003
ORDER OF COURT
AND NOW, this ~ 13~ day of January, 2004, by agreement of the parties, the record is
kept open in this matter until February 27, 2004, to give the parties the opportunity to submit the
deposition testimony of Darryl Guistwite, M.D. During said time frame, our Order of October
29, 2003, shall remain in full force and effect.
By the Court,
Ruby D. Weeks, Esquire
for the petitioners
Michael J. Whare, Esquire
For Frank B. Bruckhart, Jr.
Edward E. Guido, J.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
886 TERM 2003
Petition for Extension of Time to Take Deposition
RUBY D. WEEKS, ESQUIRE
10 WEST HIGH STREET
CARLISLE, PA 17013-2955
717-243-1294
IN RE:
FR3LNK B. BRUCKHART, JR.,
AN ALLEGED INCOMPETENT
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
:
:
: ORPHAN'S COURT DIVISION
: NO. 886 OF 2003
PRAECIPE
TO THE OFFICE OF THE CLERK OF THE ORPHAN'S COURT:
Please docket the attached transcript in the above matter and forward
the transcript to Judge Guido along with the enclosed letter to Judge
Guido, who is awaiting the transcript to issue a final order in this
matter.
Dated: 2-9-04
Ruby D. Wee~, Esquire
cc: Michael Whare, Esquire
ATTORNEY AT LAW
?;L£PHON£ 717-243-1294
~..~A:~01.q,~ TEN W£ST HIGH STR££T
February LE, P£NNSYLVANIA 17013-2955
The Honorable Edward E. Guido
Judge, 9th Judicial District
4th Floor, Cumberland County
Courthouse
Carlisle, Pa. 17013
Re: Frank B. Bmckhart, Jr.
An Alleged Imcompetent
Dear Judge Guido:
As you ordered on January 13, 2004, a transcript of the testimony of Darryl Guistwite,
M.D. has now been taken. I have filed that transcript and requested the Clerk of the Orphan's
Court to forward that transcript to you so that you may issue an opinion and order in this matter.
For your convenience, I have enclosed a proposed final order.
Sincerely,
Ruby D. ~eeks, Esquire
rdw/c
enclosures
cc Michael J. Whare, Esquire for Frank B. Bmckhart, Jr.
Linda Kyle and Frank Bmckhart III, petitioners
IN RE:
FRANK B. BRUCKHART, JR. ,
AN ALLEGED INCOMPETENT
: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: ORPHAN'S COURT DIVISION
: NO. 886 OF 2003
TRANSCRIPT OF PRCEEEDINGS
DEPOSITION OF DARRYL GUISTWITE, M.D.
Proceedings held in the Office of Ruby D. Weeks, Esquire
Ten West High Street, Carlisle, PA
on February 3, 2004, at 8:15 a.m.
APPEARANCES:
Ruby D. Weeks, Esquire
For Guardians Linda Kyle and Frank Bruckhart, III
Michael J. Whare, Esquire
Court-Appointed Counsel for Frank B. Bruckhart, Jr.
FOR GUARDIANS
Darryl Guistwite, M.D.
INDEX TO WITNESSES
DIRECT CROSS
REDIRECT
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DARRYL GUISTWITE, M.D.,
having been duly sworn, testified as follows:
DIRECT EXAMINATION
BY MS. WEEKS:
Would you give your name and your employment,
Q
doctor?
A
Darryl Guistwite, employed as a family physician
primarily on South Pitt Street in family practice but also
medical director of Manorcare.
Q Are you licensed to practice medicine in
Pennsylvania?
A Yes.
Q Mr. Whare and I have agreed to stipulate to your
qualifications as an expert family practitioner.
A
weeks now.
Camp Hill?
A
Q
Okay.
Do you know Frank Bruckhart, Jr.~
Yes.
How do you know him?
He has been a patient here at Manorcare for several
Did he come there from Select Specialty Hospital in
I believe so, yes.
What is his current diagnosis?
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A His current diagnosis -- he probably has multiple
diagnoses. He was admitted here for treatment of osteomyelitis
of his foot, which I am reading about.
Q Generally, that is what?
A He has hypertension, GERD, gastrointestinal reflux
disease, renal insufficiency.
Q Anything else?
A He has a history of dementia and schizophrenia.
Q Is that current, are those latter two current
problems that you are treating him for?
A No.
Q Does he still suffer from those conditions?
A He still suffers from mild confusion. I was
mistaken, he has one more somewhat important diagnoses, a
history of alcohol abuse.
Q In fact, was he admitted to Manorcare because of
problems as a result of his alcohol abuse?
A Yes, as well as other problems.
Q Has he improved while he has been at Manorcare, or
is his condition substantially the same as it was when he was
admitted to Manorcare?
A
He has improved substantially.
Is he, in your opinion, aware of his assets?
Yes.
Is he aware of his daughter and son who have been
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appointed his temporary guardians?
A Yes.
Q If I were to tell you that when they go there he
often does not recognize them, would that surprise you?
A I don't know, I am not sure. I have never been
here with his family; but with his type of dementia, that would
somewhat surprise me, yes, because he recognizes me.
Q How often do you see him?
A Every three weeks, every two to four weeks.
Q Is he competent in your opinion, doctor, to make
decisions about his life and his situation?
A Is he capable?
Q Yes.
A He is capable to appoint someone to make decisions
for him. Is that what you are asking?
Q No, I am asking is he competent to make decisions
about himself and his life choices on his own, in other words,
to manage his affairs and to be able to give consents for
things?
A Yes, he is.
Q Would that include property in Florida if I told
you that he had such property?
A Is he capable of making decisions regarding
property in Florida?
Q And managing that property?
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that.
A
Q
No, he is not capable of managing places such as
Is he capable of making the arrangements himself to
manage such property?
A Probably not.
Q To your knowledge, what kind of things is he
presently capable of doing on his own in terms of --
A He is capable of mostly taking care of himself. I
believe he is aware of greater things that need to be done; but
I don't believe that he can personally manage such as his own
finances or personally manage his own retirement plans,
etcetera.
Q
A
Q
A
He couldn't balance a checkbook?
No, he would not be deemed safe to do that.
How about budgeting, is he capable of that?
No.
MS. WEEKS: I am going to see if Mr. Whare has any
questions for you, doctor.
CROSS-EXAMINATION
BY MR. WHARE:
Q Good morning, doctor.
A Good morning.
Q Just a couple of questions. Ail these opinions you
have been making here this morning, they are all within a
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reasonable degree of medical certainty?
A Yes.
Q In your opinion, do you feel that it would be in
Mr. Bruckhart's best interest to have somebody appointed to
overlook his affairs?
A Certainly, yes.
Q These conditions that he is suffering from, do you
see any improvement in the long term, or do you think he is
basically going to be suffering from these problems for the
remainder of his life?
A I believe since his admission here he has improved
to the point that he will improve to, being on medication, as
well as off alcohol for this amount of time. I think he has
improved and plateaued; and, no, I don't see him improving
drastically in the future.
Q So like 6 months down the road it is still probably
your opinion that he wouldn't be able to manage his checking
accounts or budget?
A No, I don't believe he should be expected to be
able to do that this year or 5 years from now.
MR. WHARE: Thank you, doctor, that is all I have.
MS. WEEKS: I have one further.
BY MS. WEEKS:
REDIRECT EXAMINATION
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Q Doctor, you mentioned medications, what medication
is Mr. Bruckhart on?
A He is on Aricept, 10 milligrams, which is used to
treat dementia; he is on Catapres for hypertension.
A-R-I-C-E-P-T, C-A-T-A-?-R-E-S.
Q That is for what?
A Hypertension.
Q Anything else?
A Doxazosin; Hytrin, H-Y-T-R-I-N, for BPH.
Q BPH being blood pressure?
A Benign prostate enlargement.
Q Anything else?
A He is on Norvasc, N-O-R-V-A-S-C, for hypertension.
Q Anything else?
A Prevacid for GERD.
Q That is the gastrointestinal reflux?
A The other significant drug he is on is folic acid.
Q That is for what?
A Folic acid is for treatment of anemia secondary to
alcohol intake.
Q So he is getting absolutely no treatment for his
schizophrenia?
A
diagnosis.
medications.
Schizophrenia, yes, he has that as an admission
I don't see it on his most recent monthly
He is on RP, Restoril, which could be considered
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Q
mentioned?
A
for treatment, as well as Lorazepam. These are nonspecific
drugs for schizophrenia, but they are being used for that.
Would you spell those?
R-E-S-T-O-R-I-L and Ativan, A-T-I-V-A-N.
Is that the Lorazepam that you previously
Temazepam, Lorazepam, yes, I believe that is the
generic of it. Restoril is a trade name.
Q Are those the major medications that he is on that
apply to his conditions that could impact on his ability to
manage his own care?
A Absolutely.
MR. WHARE:
MS. WEEKS:
appreciate your help.
(Discussion held off the record.)
MS. WEEKS: Anything else, Mr. Whare?
I have nothing further.
Thank you very much, doctor, we
CERTIFICATION
I hereby certify that the proceedings are contained
fully and accurately in the notes taken by me on the above
cause and that this is a correct transcript of same.
Patricia C.
Official Stenographer
10
IN THE MATTER OF
Frank B. Bruckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. ~(~& Of 2003
Final Decree - Adjudication of Totally Incapacitated Person
and Appointment of Plenary Guardian
AND NOW, on ~"~ on consideration of the annexed petition and
after hearing held following duc notice, it is hereby ORDERED and DECREED that,
based on a finding that Frank B. Bmckhart, Jr. suffers from severe cognitive deficiency
unable to make communicate ' ' · ~ · · ~ ~
, or part~mpate in any dems~on relating to his estate or ~
person, Frank B. Bmckhart, Jr. is adjudged totally incapacitated. Linda E. Kyle and
Frank B. Bruckhart, III are appointed plenary guardians of the person of Frank B.
Bmckhart, Jr, and Linda E. Kyle and Frank B. Bruckhart, III. are appointed plenary
guardian of the estate of Frank B. Bmckhart, Jr.
With 12 months of the date of this decree and at least annually thereafter, the respective
guardians shall file with this Court a report that includes all information as required
pursuant to 20 Pa. Cons. Stat. Ann. § 5521 (c).
Frank B. Bruckhart, Jr. has twenty (20) days from the date of this decree to file
exceptions. Failure to file exceptions within that time will result in this decree becoming
final. Frank B. Bruckhart, Jr. has been advised of his right to appeal and to petition to
modify or terminate the guardianship by copy of this decree and by the Statement of
Rights attached hereto.
By the Court:
Jo
Li.: I.d 6[ B3J ~,
IN THE MATTER OF
Frank B. Bmckhart, Jr., ·
AN ALLEGED INCOMPETENT ·
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
ORPHANS' COURT DIVISION
NO. Of 2003
Statement of Rights - Adjudication of Totally Incapacitated Person
AN ORDER HAS BEEN ENTERED WHEREBY YOU HAVE BEEN
ADJUDICATED A TOTALLY INCAPACITATED PERSON AND UNABLE
TO CARE FOR YOURSELF AND/OR MANAGE YOUR PERSONAL AND
FINANCIAL AFFAIRS. YOU HAVE THE RIGHT TO FILE EXCEPTIONS TO
THE COURT'S DECISION WITHIN TWENTY (20) DAYS OF THE DATE OF
THE COURT'S ORDER. IF YOU FAIL TO FILE EXCEPTIONS, THE ORDER
WILL BECOME FINAL. IN THE EVENT THAT YOU 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 PLENARY GUARDIANSHIP IF
THERE IS A SIGNIFICANT CHANGE IN YOUR CAPACITY OR IF YOUR
PLENARY GUARDIAN FAILS TO PERFORM HIS/HER DUTIES IN
ACCORDANCE WITH THE COURT'S ORDER.
IF YOU WISH TO FILE EXCEPTIONS TO OR FURTHER APPEAL THE
ORDER OR TO PETITION THE COURT TO MODIFY OR TERMINATE THE
PLENARY GUARDIANSHIP, YOU MAY BE REPRESENTED BY AN
ATTORNEY. IF YOU DO NOT HAVE AN ATTORNEY, YOU MAY
REQUEST THAT THE COURT APPOINT ONE TO REPRESENT YOU. IF
YOU CANNOT AFFORD AN ATTORNEY, THE SERVICES OF AN
ATTORNEY WHOM THE COURT MAY APPOINT WILL BE PROVIDED AT
NO COST TO YOU.
law@romin§erlaw, com
www. romin§erlaw, com
KARL E. ROMINGER, ESQ.
MARK F. BAYLEY, ESQ.
MICHAEL J. WHARE, ESQ.
LAw OFFICES
February 19, 2004
The Honorable Edward E. Guido
Cumberland County Courthouse
Courthouse Square
Carlisle, PA 17013
SSN: 204-43-0944
155 SOUTH HANOVER STREET
CARLISLE, PENNSYLVANIA 17013
TEL: 717.241.6070
FAX: 717.241.6878
Orphan's Court # 886 of 2003
Dear Judge Guido:
The purpose of this letter is to confirm my agreement with the proposed Order
requesting that Linda E. Kyle and Frank B. Bruckhart, III be appointed plenary guardians
of the person of Frank B. Bruckhart, Jr.
After hearing the testimony of Dr. Guisewhite, the undersigned counsel believes
that due to Frank Bruckhart's mental condition, it would be in his best interest to have
Linda E. Kyle and Frank B. Bruckhart, III appointed guardians to manage and take care
of his affairs.
If you have any questions concerning this matter, please do not hesitate to contact
me.
Sincerely,
Michael J. Whare, Esquire
MJW/jge
cc: Ruby D. Weeks, Esquire
ADVOCACY -- ADVICE -- ANSWERS
MarJone A Wevodau
First Deputy
One Courthouse Square
Carlisle, Pa 17013
,-.., ~.. '-'-'~ ~,.. .-..- -
uICI)UQ 'Cillt'1
,'\eglst8" of Wills g
Clerk of the Orphans Court
f<irk S" SOhonage, Esquire
Solicitor
(717) 240-5345
FAX (717) 240-7797
OFFICES OF
3Regtster of WHrs anb QClerk of tbe Cl&rpIJans' Q[ourt
<COUl1tp of (fumlJer(anb
December I, 2005
Linda E Kyle
200 Red Tank Road
Boiling Springs P A 17007
Frank B. Bruckhart 1II
20 Rockridge Road
LewisbelTY PA 17339
IN RE: Estate of Frank B. Bruckhart, Jr., an incapacitated person
File No.2 I -03-0886
Dear Sir/Madam:
It has come to my attention that you have not filed the guardian repOlis required
by 20 Pa.C.S.A. 9552 I (c) in the above captioned guardianship. Enclosed you will find
the suggested form(s),
Please mail those reports, along wi th a check for the filing fee which is $15 for
each report Bled, payable to the Clerk of Orphans' Court, to the following address within
(30) days:
Clerk of Orphans' Court
One Courthouse Square
Carlisle, P A 17013
If you have any questions, please contact your attorney.
Respectfully,
cc: Ruby D, Weeks, Esquire
r:lpllrl~ l=i~rnprO;;:h'~<:h~llcrh
'-'~'-.k._"""", -~,~-_.- ~.....~~--~~-~-v--
Clerk of the Orphans' Court
Clerk of Orphans' Court of Cumberland County
>...:J
INRE:
Docket No. j.' -~.~. (j ~ ,%.~
C,,)
C"-I
;-=--,
An Incapacitated Person
r. ~ '! ) i
r">
f,)
C::)
ANNUAL REPORT OF GUARDIAN OF THE PERSON
I, _t~o.Mk 6. &uclhrui JJJ- 4 h.mdi.{ ~ KjlL , was /were:appoi~~d
plenary guardian(s) of the person of fRQ. nk 13 13R. uL/CHAAJ S~ by Decree o}1he
Honorable Judge taWJ/l.~ t. G-u \ da dated K hIt "2oeN . This is my annual report for
the period from _. 1- J - 0:3 _ to __J1-fJ...'1 - c () C S , ("The Report Period").
2.
\h f{f.hC.{b
(v.,p.[{ lY\tUj
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9-17-05
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4.
1.
Present age of the incapacitated person:
Jl / Yrs.
p~W\G\~yd- ~f),'dfYlCf
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6l u ~ R I ~ r l (h 4T Ea 4
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Current address of the incapacitated person
G t. \ll/l'-~ the, H h ( c.v~ f-
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The incapacitated person's residence is:
D own home/apartment
D nursing home
'" boarding home/personal care home
D guardian's home/apartment
D hospital or medical facility
D relative's home
(Name and relationship)
D other:
(describe)
c ,.....::-
The incapacitated person has been in the present residence since t -I 7 - u.:>
. If
the incapacitated person has moved within the past year, state change and reason(s) for
pJ.
change:
BK()L~~ to 01"\ ~IJ-c5, T\ \ J1~[h(,fh,
I \_ ,.-hb_ , .....-LL '"' Sll'\(~
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5. Name and address of the incapacitated person's primary care giver: J ()"'uJh~/.1'u l.V~sl'dn
8lul chC(h(Jl.1 sW-P- L,nc\~ E K~J(
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6. The major medical or mental problems of the incapacitated person are as follows:
c~ \ ( ohm
G- tAD I
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7.
Specify what, if any, social, medical, psychological and support services the incapacitated
person IS receIvmg:
v A P R €, SeA. l'p -t) O"r\ .)
D tZ p. -z.. \ m m ~'YY\ an - iY\ E L ~ a h 1 c. s b LV-~ 1 f1.
Cl cti \j \ .il ~.~ 0 i. (,{ 5s'i n ~ L
8.
It is our opinion as guardian of the person that the guardianship should: (check one)
9continue, 0 be modified, 0 be terminated. (Briefly explain your response)
cI kCA\J~ bf LY\ .to..kUlj C~l of ~LI df h u- n ~~Js
5Jr\c(' ~j ;200'3;
During the past year, I have visited the incapacitated person ~ Lf times with the
,...,.,.,.0....,." ~o T:r~("I~+ lnl_"'+~_rr
aV\.,.lJ.Q,.5'"" VJ..:>lL. J.u..~:H..J..l..l6
9.
'1~-b() lY\ln5 l\V\~Lt.-~GUA~~
(State number of hours 1m in utes, etc) . . k _ t W I G~ \\n a 003 i.JOdI
~/,lJ J'~ ( 14-& h\1~11 5{) Yl- nz.~ ' \~. _
}Jo.d b{,L{.J::. J b~\c\\(.ttr' no lH ~ I 15 I'" dOCP
()\'\L<Lv\Jh~V\ vYlO~[d JIr [' X (~.1f W~~l'\ --u,olc to
,-os - a S5'i \ I v I VI. 9 4-0 ~ V\o.>p ImJ
~
The report of a social service organization employed by the guardian to oversee and coordinate
the care of the incapacitated person for the period covered by this report may be attached to
supplement this report.
I verify that the foregoing information is correct to the best of my knowledge, information and
belief; and that this verification is subject to the penalties of 18 Pa. C.S.A. ~4904 relative to
unsworn falsification to authorities.
1 d- - ~ S -~
j;)-7f -O~
1~~ B1f1
si~l~G~dian I IJ;~
Date
* FILING FEE $15 MUST ACCOMPANY THIS FILING.
~
Clerk of Orphans' Court of Cumberland County
An Incapacitated Person
Docket No. ')....\ -~ ~ - ~ t ~(C>
j"",~)
c;:)
INRE:
I. SUMIVJ ARY
A. Value of principal assets at the beginning of the Report Period?
B. Total amount of income earned during the report period?
Total amount of all expenditures made for care and maintenance of the
C. incapacitated person during the Report Period?
1. From principal
2. From income
D. Total amount spent for all other purposes during the Report Period?
E. Total amounts remaining at the end of the Report Period?
1. Principal
2. Income
Total Income and Principal
\. .'
$ 48}ObO,
$ ~ ~ I D S8 (
$ ~3J 351
$ fAY, 3~~
$ -' b I 3,5 I
I
$ 3'7, 0 3 SL\ V1 nq .)
$~ch<l:.Jq~
$/bJb.JY
pj.
II. ADDITIONAL INFORMATION
A. Principal:
1. Total amount remaining at the end of the Report Period?
$ 411- 03
2. How is principal currently invested?
snV\f\q) U((()~T
S ~J f; Utt /I f ~ n ~ (. U I
3. Have there been any expenditures from principal during the Report
Period? ~Yes 0 No
If you answered YES, was there Court approval for all expenditures
from principal? ~Yes 0 No
4. Did you l~ceive any principal assets Juring the report period which V
were not included on the inventory or a prior report filed for the estate? E! Yes 0 No
If you answered YES, did you receive Court approval prior to receiving
additional principal? )( Y es 0 No
5. State the sources and amounts of the additional principal you received:
..L i'~ S
$ 7Y,
$
B. Income:
1. State sources and amounts of income received during the Report Period (i .e., social
security, pension, rents, etc.):
$ :J. 3,335:
$_1 ~ I S7'1.
,
LJ,09'1.
Total Income received during Report Period $ 'f;l) uS: tf:
2. How is income currently invested? (Please specify, restricted bank accounts, client care
account, etc.)
s;; 0<;' I &~ I
S ~(-LG~. Ity
(..... \ JI
U VI....I-
cuJ A
$
Sn V 11llyJ .j c h u k l--'hf
j'wt' \Jo/k1 ,rd
[{ c {I>
c-e~~~I+UY1l ~
3. Specify what payments were made for the care and maintenance of the incapacitated
person (i.e., clothing, nursing home, medicine, support, etc.).
tV lJ.fl. > (;, ~ h 0 "-11 f J V), t. ~ I C 'l'~) )1'\ t d I ( Q,~ [ j) f cI u. (' t"zt hI f ,I
oVY\bv\\~e.. <;LNV/Ct.. C/~f-;-RI~S. doc-tnA.S
J , /
~J
4. Specify what other payments were made during the Report Period.
e~ t. pl1 I d +id)'l L1. ~ ) t- L[~J"~J+'Cft. ~ 7 >1 -/-cA_ oX ~ >1
( q ~ In.) ct A fLUI ;,/.Zs LA 1,' liTI i .s I J 1A~..s n f (A,~rl1{JP~
I I J /-7
-t.R U i J E& I h PI () R ,'d 0.; Lv.. WI..{ ~ I hf'/ <JR.I d c{-/u Y f 1/ 1'fl.a,1JA
In.s VV'::(,i h( f f R. t m', V\ W\ S', Ch,Rl ~\1'1(l~~ 9ff~rs .!SSJC\ ",,\ '2o::}1
I verify that the foregoing information is correct to the best of my knowledge, info~~i;6JI~~ V\ I j (,/-<t.../~
belief; and that this verification is subject to the penalties of 18 Pa. C.S.A. ~4904 relative to
unsworn falsification to authorities.
I~-ZS -US
JfJ- 27--ct>
Date
19J BB~
avnd." t, I~
19l1ature of Guardian
* FILING FEE $15 MUST ACCOMPANY THIS FILING.
ANNUAL REPORT OF
GUARDIAN OF THE PERSON
COURT OF COMMON PLEAS OF
COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
Estate of J IZQ. n Ie (3 ~i1 j Gl. t'h.1 ~ ~CJj1 cvz.., t :; ~ncapacitated Person
No. ;) 1-03-0~r6
I. INTRODUCTION
\-.1:~
~NDA- ce.. KYLE- 4 FM-tJlL B 6~ud<tiMt: J[PPointed
o Plenary Limited Guardian of the Person by Decree of _ (cl-u:; ~d ~& u. \' d Q, 1.,
dated (2- 0
f\I A. This is the Annual Report for the period from 11-1- 0.5 .,
7' to . /,0 -'3 1- 0 7, . (the "Report Period"); or
o B. This is the Final Report for the period from
.,---
to
(the "Report Period"), and is filed
for the following reason:
1. The death of the Incapacitated Person. Date of death:
2. The Guardianship was terminated by the Court by Decree of
J., dated
For a Final Report, omit Sections II through IV.
Form G-O] reI'. 10.13. or,
Page 1 of 4
<(I
Estate of
, an Incapacitated Person
II. PERSONAL DATA
Age of the Incapacitated Person:
J>3
Date of Birth:
q-~ '-I~~'1
III. LIVING ARRANGEMENTS
A. Current address of the Incapacitated Person:
\1u. C"h 0. -rE<l\A - (3 <(.. \) etA l'j C a.,f{ [
10 hou.,)~ Av(
C.u YkfJ rh \ / I Pc-t. I 7 oil
B. The Incapacitated Person's residence is:
D own home / apartment
D nursing home
.a boarding home / personal care home
D Guardian's home / apartment
D hospital or medical facility
D relative's home (name, relationship and address)
D other:
C. The Incapacitated Person has been in the present residence since 7 - ~ l/ - 0 S'
. If the Incapacitated Person h~s moved within the
past year, state prior residence and reason(s) for move:
Form G-03 rev. /0./3,06
Page 2 of4
Estate of
, an Incapacitated Person
D. Name and address of the Incapacitated Person's primary caregiver:
DA~t'h (M-1 Ll v\~~Q ~ Ie ~ I [
V 2GO ~(J lank RJ
!30\' IU:lj Sp~,vi~ 5 ~ 17007
r({o.. Y\ k ~ BRu.lkAcui;.
d-O A:\oc k 1<1 a 1 (: Rd ~~
Lf:.-IJ..JlJ b~ t>a \ 73.:
IV. MEDICAL INFORMATION
A. The major medical or mental problems of the Incapacitated Person are as follows:
ct} Co h6 \ d~ yY\ ~V\t'l C( .
C0V\.~"L'.>tl\J<i. Ytt~Ri- ~,l~f
G-tAD
C. ~.l \ ~ \ ,'+ L/ 5
nO-.r (}Y\ ~ sh nt "
,^Q..~ :2 h~ok~ n. ), \,? ..s I hl.l-l L'S wal k-Vh'( ~ owVl.
. B. Specify what, if any, sodal, medical, psychological and support services the
Incapacitated Person is receiving: . . C }~'II iVl
V A pA..f.5 Cr<-lP t> em> - /'nR. 1tJ, G.E I U. ~ ou I r I
or<-- 2- \ ~ I'"h. 'V'\Vh <l/l1- /Vl ~ c ka V\ \ cS b v~ ~
CAC.-b'v lit 'i.> 0.-\ Cl ))+ hQ rn[
V. GUARDIAN'S OPINION
A. It is the opinion of the Guardian of the Person that the guardianship should:
~ continue
=r h.aV'i. b~01 -\7Akl~q C(,W't of li\1 hl'}
~v\QV\clc..1 'i O~SoV\C{\ j,1~Ld.s Since 1fu:J
1 ::1.005.
D be modified
D be terminated
Form G-03 rev. 10. 13JJ6
Page 3 of4
Estate of
, an Incapacitated Person
The reasons for the foregoing opinion are:
::r h.aUl. b(tvt ~k\ ~~ cV\A.r
c\ p V-S (JY\o..l Vl ~ ~d .) 5 I Yl C t
cJ.-( V\ \. S r;J.1J~ Y\ C ;4/
/tl~Cj -:lODY
B. During the past year, the Guardian ofthe Person has visited the Incapacitated Person
!: 7 times with the average visit lasting I hours, minutes.
F({a. Yl)c g, B(.luclcltwct ~ MIL 5 S E~ n Y\l n-,
.
o -hmu
The report of a social service organization employed by the Guardian to oversee and
coordinate the care of the Incapacitated Person for the period covered by this Report may be
attached to supplement this Report.
I verify that the foregoing information is correct to the best of my knowledge,
information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. ~ 4904
relative to unswoll1 falsification to authorities.
/0- ':2r-07
Dale
Ll/v PIl ~ /< Vt-[
Name of Guardian of the Person (type or print)
c20D ^~j) n'ff\llc I\j)
Address
/301 L \NCr sftZuv 6s. PA- 1;007
City. State. Zip
117 l{ 56 S'-!3b
Telephone
Form G-0.3 reI'. 10. 13. 06
Page 4 of 4
ANNUAL REPORT OF
GUARDIAN OF THE ESTATE
COURT OF COMMON PLEAS OF
COUNTY, PENNSYL VANIA
ORPHANS' COURT DIVISION
Estate of
F<: q VI Ie B~t1Ja Vh J ~ 8,'( u cle~a.it a;r-~apa~i,ta.t(~d Person
No. ;Q 1 -03 - OS'fb
l. INTRODUCTION l_.
llf\/PA f. I<.YL~ c::l F.RANI< ~ 8~\.{(t.t:l:&1T W~appointed
~lenary 0 Limited Guardian of the Estate by Decree of ~d UJ~d Gu. ft~ . ;..~
dated fCc.-b l~) ~OQ~
)f' A. This is the Annual Report for the period from / 1- J - os- _,
to I 0'-"3 ~ ":Z:.-, (the "Report Period"); or
o B. This is the Final Report for th~l'eriod from
\ ';
-,--
to
(the "Report Period"), and is filed
for the following reason:
1. The death of the Incapacitated Person. Date of death:
Name of Personal Representative:
2. The Guardianship was terminated by the Court by Decree of
J., dated
Form (i.02 rev. 10.13.06
Page 1 of 5
~
Estate of
, An Incapacitated Person
II. SUMMARY
A. State the value of the estate reported on the Inventory
$
tV! Ii
B. State the value(s) of principal assets at the beginning of
the Report Period. (Same as Inventory if first Report,
otherwise, ending balance from last Report.) $
C. What is the total amount of income earned during the
Report Period? $
D. What is the total amount of income and principal
spent for all purposes during the Report Period? $
E. What are the balances remaining at the end of the Report
Period?
l. Principal $
2. Income $
3. Total of Principal and Income $ 0.00
III. ADDITIONAL INFORMATION
(Ifmore space is needed, please attach additional pages.)
A. Principal
I. How is the principal balance listed above currently
invested? (Please specify, e.g., real estate,
certificates of deposit, restricted bank accounts, etc.):
2. Have there been any expenditures from the principal
during the Report Period? ............................ DYes D No
I f yes:
a. Have all expenditures from the principal been {'or
the sole benefit ofthe Incapacitated Person? . . . . . . .. 0 Yes 0 No
Form G-02 rev. /0./3.06
Page 2 of 5
Estate of
b. List purpose and amount of expenditures:
, An Incapacitated Person
$
$
$
$
c. Was Court approval received prior to
expending the principal? ....................... 0 Yes 0 No
3. Were additional principal assets received during the
Report Period which were not included in the
Inventory or a prior Report filed for the Estate? ........... 0 Yes 0 No
If yes:
a. Was Court approval requested prior to
receiving the additional principal? . . . . . . . . . . . . . . .. 0 Yes w No
b. State the sources and amounts of the
additional principal received:
B. Income
I. State sources and amounts of income received
during the Report Period (e.g. Sc.cial Security,
pension, rents, etc.):
5'0 clAL
f 'r:..NSt 0 tJ
P~NS ION
0\\11 PCWD
S Ec-tAft. rTY
~~~
(boll!)
Total income received during Report Period:
Form G-02 rev. J O. i 3. 06
$
$
$
$
$
$ a3.rJ.'i~oo
,
$ Il)511"'2..
$ 3 bY 3. b'S
$ I~'OO
$
$
$ 3 9)0 (; 0.00
3 9 OS"1~ go
Page 3 of 5
Estate of
, An Incapacitated Person
2. How is income currently invested? (Please
specify, e.g., restricted bank accounts, client
care account, etc.):
hCA> ch ~d(.~ ~ aGcJ fbA.. d Lf(l),i c)f
V\ U.) 7 C\ Vlfi"StJ uc6i ba. l t L{ 7 ,03
,
I Y\ c.. ISYl'1 (.>
C. Expenses for Care and Maintenance
Specify what expenditures were made from the principal and
income for the care and maintenance of the Incapacitated
Person (e.g., clothing, nursing home, medicine, support, etc.):
Q5st, h \AA S I y\~ A(JyYUl-- .;l. q I I b 7, s 0 -'2.'1.~5 (Z <'.hQb. - ~5'S,
Sf.C.A.N, <\ \~ 51 /. fA.~r'h~t.lWl - 5 5" 7~ i 90 ~'~ ~~
m. ~ d. \ c..- '- ~ _.J.{OO,- '2 ~f2- s-
c..lo~\~ - ~OO, -'2 '1~s
P D - fop... YV\.t~l(.oJ<~ ---~ '1/. ~ ~ftS.
VA ~1)- ;(00. 1<.,0. ;30. - 3:JO, ln~dS.
D. Other Expenditures
Specify what other expenditures were made during the Report
Period. (Do not include any items stated in response to
question C above.) h Q ~ c-v(D\ g, pCUZ W\.. avJ-h - 4 3 ~. - 'Z ~ ~ S ,
-tbo cl Wm Ec.ofn L \fY'\CA\CC{ft I L+c l./ Y ~. - ;( LV~-S
, )
Vl~WSpOf~>
G\F-1 11) G1(j\NDPTIZ {bDO. ~OOb,-:l
E. Guardian's Commissions
List amounts of compensation paid as Guardian's commission
and state how amount was determined:
100
: I.'
Method of Determination
fZ ~ \0 ~ vV' ~'i:.,.n~ ~i ..0 ~k-
O~ .f"Q 1~~VYt~ MOM .
r . vY> II r ,\<\7ck """1 ~cef
Co II rt
Approval Obtained
Amount
DYes ~No
DYes D No
Forlll C;-O] rev. !IU3.06
Page 4 of 5
Estate of
, An Incapacitated Person
F. Counsel Fee
List amounts paid as counsel fee, and indicate whether Court approval was obtained.
Amount
lv/A
Court
Approval Obtained
DYes DNo
DYes DNo
I verify that the foregoing information is correct to the best of my knowledge,
information and belief; and that this Verification is subject to the penalties of 18 Pa.C.S. S 4904
relative to unsworn falsification to authorities.
(0 -~ t( "-OJ
-du ~,
Dale
L , /\i Pit$' }(.. 'l L f:.:
Name of Guardian of the Estate (type or prill/)
.;zO(} ~ tD TIt-f\J Ie ~ D
Address
eOILlJ\J&- S PfZ\N6S fA 1/007
City, State, Zip
717L{fbs-Y~ ~
Telephone
Form G.Ol rev,ll!./3,06
Page 5 of5
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IN THE MATTER OF IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Frank B. Bruckhart, Jr., ORPHANS' COURT DIVISION
AN ALLEGED INCOMPETENT NO. ~j~ ~j Of 2403
Final Decree -Adjudication of Totally Incapacitated Person
and Appointment of Plenary Guardian
AND NOW, on ~' ~ ~ ~~ on consideration of the anne
xe1 petition and
after hearing held following due notice, it is hereby ORDERED and DECREED that,
based on a finding that F~anylc B. Bruckhart, Jr. suffers from severe cognitive deficiency
h
unable to make, communicate or participate in an ision relating to his~e or v
person, Frank B. Bruckhart, Jr. is adjudged totally incapacitated. Linda E. Kyle and
Frank B. Bruckhari, III are appointed plenary guardians of the person of Frank B.
Bruckhart, Jr, and Linda E. Kyle and Frank B. Bruckhart, III. are appointed plenary
guardian of the estate of Frank B. Bruckhart, Jr.
With 12 months of the date of this decree and at least annually thereafter, the respective
guardians shall file with this Court a report that includes all information as required
pursuant to 20 Pa. Cons. Stat. Ann. § 5521 (c).
i .. ,°,
By the Court:
J.
Frank B. Bruckhart, Jr. has twenty (20) days from the date of this decree to file
exceptions. Failure to file exceptions within that time will result in this decree becoming
final. Frank B. Bruckhart, Jr. has been advised of his right to appeal and to petition to
modify or terminate the guardianship by copy of this decree and by the Statement of
Rights attached hereto.
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