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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE:
PAULINE K. COVER,
An Alleged Incapacitated Person
ORPHANS' COURT DIVISION
No. (~~ q of 2013
PETITION FOR APPOINTMENT OF
PERMANENT PLENARY GUARDIAN OF
PERSON AND ESTATE
Filed on behalf of:
GOLDEN LIVING CENTER- WEST
SHORE, Petitioner
Counsel of Record for this
Party:
Aaron C. Jackson, Esquire
Pa I . D. #200490
Nora Gieg Chatha, Esquire
Pa. I.D. #200446
Tucker Arensberg, P.C.
Firm #287
2 Lemoyne Drive, Suite 200
Lemoyne, PA 17043
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
IN RE:
ORPHANS' COURT DIVISION
PAULINE K. COVER,
An Alleged Incapacitated Person
No. I 1 of 2013
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PETITION FOR APPOINTMENT OF GUARDIAN°D -~'n ' ^ ~ °
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TO THE HONORABLE, THE JUDGES OF SAID COURT: ~ ~-' ~ G~
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GOLDEN LIVING CENTER -WEST SHORE ("Golden Livirag-f3enter"~files ::« ~~
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Petition for Appointment of Permanent Plenary Guardian of Person and Estate und ...~
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pursuant to the Probate Estates and Fiduciaries Code of 1972, 20 Pa. C.S.A. §§ 5501, et seq.,
as amended, and respectfully represents as follows:
1. PAULINE K. COVER (the "Alleged Incapacitated Person") is a
ninety-four-year-old female born on December 13, 1918.
2. The Alleged Incapacitated Person currently resides at Golden Living
Center -West Shore, with an address of 770 Poplar Church Road, Camp Hill, PA 17011,
following initial admission on or about July 11, 2012.
3. Golden Living Center since applied for Medical Assistance Long Term
Care ("MA-L'TC") on behalf of Alleged Incapacitated Person on or around November 28, 2012.
Based upon information provided by the Department of Public Welfare, which administers the
MA-LTC program, the MA-LTC application will be rejected as a result of either failure to provide
verification and/or transfers for less than fair for consideration effectuated on behalf of the
Alleged Incapacitated Person. This Petition is being filed in pertinent part in order to facilitate the
MA-LTC process in an effort to obtain coverage for the Alleged Incapacitated Person's long
term care needs and to have an independent representative advocate on her behalf.
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4. Upon information, the Alleged Incapacitated Person is widowed has the
following known relatives (including spouse, parents and presumptive adult heirs as may be
applicable):
Name Relationship Address
Kathy Wisner Daughter 35 Scarsdale Drive
Camp Hill, PA 17011
Rick Wisner Grandson 206 Pennsylvania Avenue
Camp Hill, PA 17011
Brenda Hall Step-Daughter 1141 Lambs Gap Road
Mechanicsburg, PA 17055
5. The following persons or institutions provide the listed services to the
Alleged Incapacitated Person:
Name
Golden Living Center
Thomas Kunkle, MD
Pharmerica
Holy Spirit Hospital
Address Service
770 Poplar Church Road, Residential Skilled
Camp Hill, PA 17011 Nursing Services
550 Brandt Avenue Attending physician
New Cumberland, PA 17070
900 Greengate Plaza Prescriptions
Greensburg, PA 15601
503 N 21st St. Hospitalizations as
Camp Hill, PA 17011 necessary
6. The Alleged Incapacitated Person's physicians have diagnosed her
physical and mental condition as including depressive disorder, senile dementia, and reactive
confusion. These physicians have opined that the Alleged Incapacitated Person's functional
limitations include an inability, without the care, supervision and the continued assistance of
others, to satisfy requirements for nourishment, personal and medical care, shelter, self-
protection and safety, and the management of financial resources, and that the treatment
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rendered to date has been unsuccessful in significantly improving the aforementioned
conditions and functional limitations.
7. Golden Living Center has been advised and believes that the Alleged
Incapacitated Person's ability to receive and evaluate information effectively and to
communicate responsible decisions is significantly impaired and currently preclude the Alleged
Incapacitated Person from independently attending to issues of medical treatment, residential
care and all matters concerning personal affairs and also the management of any financial
affairs.
8. Golden Living Center requests the appointment of a guardian due to
medical and psychiatric information received (as set forth above), which information contributes
to Golden Living Center's belief that the Alleged Incapacitated Person is totally incapacitated
within the meaning of 20 Pa.C.S. §§ 5501, et seq. with regard to matters concerning person and
estate.
9. Golden Living Center has identified Keystone Guardianship Services as a
potential permanent plenary guardian of the Alleged Incapacitated Person's person and estate
(the "Proposed Guardian"). The Proposed Guardian has advised that he or she has no interest
adverse to the Alleged Incapacitated Person and is not a fiduciary in any estate for which the
Alleged Incapacitated Person has an interest.
10. Golden Living Center has investigated less restrictive alternatives to the
relief requested herein, but such are not feasible due to the current situation and conditions
described above. Such conditions preclude the making of voluntary, informed judgments by the
Alleged Incapacitated Person regarding the management of personal and financial affairs. The
relief requested herein is believed to be the least restrictive available, in accordance with the
recommendation of the Alleged Incapacitated Person' physicians.
11. To Golden Living Center's knowledge, the Alleged Incapacitated Person
has an estimated gross estate consisting of a possible bank account administered by Kathy
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Wisner as alleged agent under Power of Attorney. Golden Living Center is without a copy of the
alleged Power of Attorney instrument or knowledge concerning the balance, if any, held in such
accounts.
12. To Golden Living Center's knowledge, the Alleged Incapacitated Person
has Social Security income in the amount of $1,271.90 per month, for which Social Security has
appointed Golden Living Center as representative payee; and a Pension in the amount of
$131.00, for which Golden Living Center has sought appointment as payee.
13. Upon information, the Alleged Incapacited Person previously owned real
estate located at 35 Scarsdale Drive, Camp Hill, Pennsylvania, which according to government
sources was transferred to her daughter and alleged agent under Power of Attorney Kathy
Wisner in March of 2012.
14. Golden Living Center believes, and therefore avers, that the potential for
conflict with regard to issues of the identity of guardian and of incapacity are minimal, as: the
medical evidence is uncontroverted; the Alleged Incapacitated Person is cognitively impaired;
and Golden Living is acting as Representative Payee. Golden Living Center does not know
whether the Alleged Incapacitated Person's other known relatives have any objection to the
relief requested herein.
15. Due to the Alleged Incapacitated Person's general medical conditions, it
is believed that the Alleged Incapacitated Person's treating physicians would likely find that
his/her presence in court would be harmful and detrimental to his/her physical or mental
condition.
WHEREFORE, your Petitioner respectfully requests the appointment of a
permanent plenary guardian of the person and estate and that a Citation be issued directed to
the Alleged Incapacitated Person to show cause why she should not be adjudged incapacitated
and why a permanent plenary guardian of her person and estate should not be appointed.
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TUCKER ARENSBERG, P.C.
By _ _
Aaron C. Jackso
Pa. I.D. #200490
Nora Gieg Chatha
Pa. I.D. #200446
Tucker Arensberg, P.C.
Firm #287
2 Lemoyne Drive, Suite 200
Lemoyne, PA 17043
(717) 234-4121
BANK FIN:445704-1 026135-158252
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VERIFICATION
I , ~~ l ~~ iz~r ~'~ ~-. for Golden Living Center state, that the
facts contained in the foregoing Petition are true and correct to the best of my knowledge,
information and belief. This Verification is made subject to the penalties of 18 Pa. C.S. §4904
relating to unsworn falsification to authorities.
GOLDEN LIVING CENTER
Print Name:
Title: ~ e, -
Dated: / , 2013