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HomeMy WebLinkAbout10-06-14 IN RF: CHARLES HOWE : IN THE COURT OF COMMON PLEAS OF :CUMBERLAND COUNTY,PENNSYLVANIA AN ALLEGED INCAPACITATED :ORPHANS' COURT DIVISION PERSON hhii 11 �� j _ :NO. PETITION FOR ADJUDICATION OF INCAPACITY AND APPOINTMENT OF PLENARY GUARDIAiV OF THE PERSON AND ESTATE c5 Q PURSUANT TO 20 PA C S &5511 o , n TO THE HONORABLE JUDGE OF SAID COURT: ''v z ro `-'-r CIO C C� The Petitioner, Diakon Lutheran Social Ministries d!b!a Cumberland Crossings;lay and o through its attorney Eric J. Bialas, Esquire, and Hynum Law Office, presents the following+—. Petition to this Honorable Court for the appointment of a permanent guardian of the Persotnd r" -o,t . Estate of CHARLES HOWE, an alleged incapacitated person, and in support thereof avers as follows: I. Cumberland Crossings is a long and short-term skilled nursing facility located at I Longsdorf Way, Carlisle, PA 17015, 2. CHARLES HOWE (the "alleged incapacitated person" or"All"') was born on March 5, I443, is 71 years of age, and has resided at Cumberland Crossings since August 10, 2012. 3. Petitioner is an interested party because CHARLES HOWE,the alleged incapacitated person, resides at Petitioner's facility and has provided and currently provides long-term care and nursing services to the alleged incapacitated person. Petitioner has a statutory and contractual obligation to act in the best interest of the alleged incapacitated person. 4. Because the alleged incapacitated person resides in Cumberland County, this court has jurisdiction pursuant to §711(10)of Title 20, the Probate, Estates and Fiduciary Code, of the Pennsylvania Consolidated Statutes, 5. The following persons, to the best of Petitioner's knowledge, information and belief, are the living next-of-kin of the alleged incapacitated person: Debra Grimm,who resides at 50 Green Park Road, Elliottsburg, PA 17024. 6. Cumberland Crossings brings this Petition because CHARLES HOWE's mental capacities are such that he cannot handle his personal or financial affairs and there has been a lack of contact with his next of kin. 7. Debra Grimm admitted the AIP to Cumberland Crossings in August 2012, signing the admission agrcement, furnishing a Power of Attorney, and agreeing to cooperate with Mr. Howe's care. However, Ms. Grimm has since been inaccessible. 8. Further, Charles Howe is a recipient of Medical Assistance, as such is required to pay his resident income to the facility for his costs of care. Mr. Howe is unable to do so due to his disabilities and Ms. Grimm has failed to do so despite repeated efforts from Petitioner and its counsel. The result is an outstanding balance of care in excess of$57,000.00, an amount which continues to increase monthly. 9. Continued nonpayment is a dischargeable event at Petitioner's facility, which is not in Mr. Howe's best interests as he requires the care he is currently receiving. 10. As such, Petitioner requests the Court remove Debra Grimm as Power of Attorney and appoint a Guardian for CHARLES HOWE's Person and Estate. 11. The exact extent of the AIP's income is currently unknown, however it is Petitioner's belief that monthly income is approximately $3,000.00 as indicated on the AIP's PA162 form, which is determined by the County Assistance Office. 12. Petitioner is unaware of any significant assets of the AIP. l 3. To the best of Petitioner's information,knowledge, and belief,the alleged incapacitated person was a member of the armed services of the United States,but is not receiving benefits from the United States Veterans' Administration. 14, The alleged incapacitated person's treating physician is: Dr. Darryl Guistwite 56 Ashton Street Carlisle, PA 17013 15. The alleged incapacitated person suffers from: Altered Mental Status resulting from CVA; Depressive Disorder; Dysphagia; Muscle Weakness; Epilepsy; Esophageal reflux; Aphasia; Muscle Spasms; Cardiac Dysrhythmia; Pressure Ulcers; and Paralysis. Attached hereto as Exhibit"A"please find a completed Physician's Affidavit for the AIP by Dr. Guistwite. 16. Because of his mental and physical 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. 17. Because of his impaired mental and physical condition,the alleged incapacitated person lacks the capacity to make or communicate responsible decisions concerning his person and is unable to: take care of himself in all aspects of his Activities of Daily Living. He is also unable to make decisions regarding his healthcare and finances. 18. The ATP executed a Power of Attorney on or about September 7,2011 naming Debra Grimm as agent. A true and accurate copy of Power of Attorney is attached as Exhibit`B". 19. Petitioner has analyzed viable alternatives to the appointment of a Guardian for the AIP, and has not pursued any other courses of action as it is the belief that no other options exist other than to appoint a,Guardian of the Person and Estate. 20. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a plenary guardian of his Estate be appointed to manage and handle all aspects of the alleged incapacitated person's estate, specifically, but not limited to: all issues relating to cash, checks,bank savings, stocks, bonds, personal property, real property, insurance policies,government entitlements,taxes, execution of documents, entry in contracts and the payment of reasonable compensation for services provided to the person. 21. The severity of the alleged incapacitated person's mental and physical condition and the lack of viable, less restrictive alternatives necessitate that a plenary guardian of his Person be appointed to handle all issues relating to the person of the alleged incapacitated person, specifically, but not limited to: living arrangements, medical and psychiatric care, administration of medication, employment and discharge of physicians, and other medical decisions as may be required. 22. To the best of Petitioner's information,knowledge, and belief the alleged incapacitated person has no will,but does have a DNR. Attached hereto as Exhibit"C"please find a copy of Charles Howe's DNR, Said DNR will be forwarded to the proposed Guardian 21 The proposed plenary guardian of the person and estate is Keystone Guardianship Services. The consent of the proposed plenary guardian is attached hereto as Exhibit"D". 24. The proposed plenary guardian has no interest adverse to the alleged incapacitated person. 25. To the best of Petitioner's knowledge,no other guardian has been appointed for the estate or person of the alleged incapacitated person. 26. Pursuant to Section 5122 (d), Title 20, of the Pennsylvania Consolidated Statutes, the Court may dispense with the requirement of a bond when for cause shown the Court finds that no bond is necessary. 27. Keystone Guardianship Services does not have any adverse interest to the alleged incapacitated person and thus does not present a situation that generally would require imposition of a bond. WHEREFORE, Petitioner respectfully requests that this Honorable Court issue a Citation, directed to the alleged incapacitated person, with notice thereof to be given to his next of kin, and to such other persons as this Court may direct, to show cause why CHARLES HOWE should not be adjudged fully incapacitated and KEYSTONE GUARDIANSHIP SERVICES should not be appointed plenary guardian of his person and estate. Respectfully m' ed HYNU A Eric . r as, Esquire Pa. Supreme Court I.D. No. 312326 Hynum Law 2608 North 3`d Street Harrisburg, PA 17110 (717) 774-1357 office (717) 774-0788 fax Ebialasghynumpc.com Attorneys for Petitioner VERIFICATION I, ��n ���ti ,am an authorized representative of Cumberland Crossings, Petitioner,in this matter, and do hereby verify that the facts contained in the foregoing Petition are true and correct to be best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. § 4904 relating to unworn falsification to authorities. Dated. 0� a � NIA , I i I 1 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: CHARLES HOWE, NO. AN ALLEGED INCAPACITATED PERSON DEPOSITION BY INDIVIDUAL QUALIFIED IN EVALUATION OF ALLEGED INCAPACITATED.PERSON The deposition of Dr. T) ,. a o+++s ;,4,, a witness in this matter, made on the 115 day of SW 2014, at C,,, y,s%e-. Pennsylvania. 1. What is your name and your professional address? A. My name is ,w+0. My professional address is 5t. Asap„s+ 2. Please describe your education, training and background with particular emphasis on your expertise in evaluating individuals with incapacities. If you prefer to do so, please attach curriculum vitae to these interrogatories that details this information. A. (Cross out the answer that does NOT apply.) (a) My curriculum vitae detailing this information is attached. (b) I received my college degree at / 7°c �QtS,G_ LA and my post graduate training at P G O M e t. and I have practiced (V W Qt-(x —C (e.g. medicine, psychiatry, psychology, gerontological social work, etc.) since 200 Z� My special qualifications and E EXHIBIT ' -A I training with respect to evaluating persons with incapacities consists of 4 3. In what states are you licensed to practice medicine? A. I am licensed to practice medicine in the following states: P A 4. In your capacity as (e.g. physician, psychologist, social worker, etc.) have you had the opportunity to meet with, examine, speak with and otherwise become acquainted with CHARLES HOWE and if so, upon what occasions and in what fashion have you been able to do so? A. I first became acquainted with CHARLES HOWE the month of-AU0 usk 19_or 20 j2. when he was brought to my attention by means of odrr:�9s�on 10 c\wre.ri C onyx I have since that time (visited / spoken with/ examined/treated) him on vv�o other occasions with an average frequency of 1-2 times per n+on+h (day/ week/month /year). 5. To a reasonable degree of medical certainty, do you have an opinion as to whether the ability of CHARLES HOWE to receive and evaluate information effectively and to communicate decisions is in any way impaired to such significant extent that he is: (a) partially unable to manager his financial resources; or, © totally unable to manage his financial resources. Answer. E 6. To a reasonable degree of medical certainty, do you have an opinion as to whether the ability of CHARLES HOWE to receive and evaluate information effectively and to communicate decisions is in any way impaired to such significant extent that he i3: (a) partially unable to meet essential requirements for his physical health and safety; or, totally unable to meet essential requirements for his physical health and safety. Answer. 7. Please describe the type and severity of any impairments of the alleged incapacitated person using the chart below. A. The impairments of CHARLES HOWE are as follows: F-- --(check one) --� List Impairment None Mild Moderate Severe (a) cz � [ kI [ I . (b) (c) (d) [ ] [ ] [ I [ ] (e) [ 1 [ ] [ ] [ ] (g) [ ] [ l [ I [ 8. To a reasonable degree of medical certainty, can you express an opinion as to whether CHARLES HOWE is partially or totally unable to manage his financial resources? A. The ability of CHARLES HOWE to manage his financial resources is impaired (not at all, partially, totally)as follows: J r y vS � F + i e • ' 9. To a reasonable degree of medical certainty, can you express an opinion as to whether CHARLES HOWE is able to meet essential requirements for his physical safety and health? A. The ability of CHARLES HOWE to meet essential requirements for his physical health and safety is impaired (not at all, partially, totally) as follows: Oc- - � - 10. Can you please evaluate the present condition of CHARLES HOWE with respect to incapacities of the type alleged in the Petition. In particular, could you comment on the nature and extent of the alleged incapacities and disabilities and also, insofar as you are able, the mental, emotional and physical condition of CHARLES HOWE his adaptive behavior, and his social skills? A. Based upon my education, training and experience, as well as my acquaintance with CHARLES HOWE as stated above, it is my opinion that his incapacities and disabilities are as follows: y Jts l,Qj h r Gc� His mental condition is: _ v^cz fow- fc� y✓'C-� p S S,- _f His emotional and physical conditions are P 11. Is the condition of CHARLES HOWE such as would make him susceptible to be taken advantage of by unscrupulous or designing persons? A. His adaptive behavior is His social skills are 12. What recommendations would you make concerning services necessary to meet the essential requirements for the physical health and safety of CHARLES HOWE. A. I would recommend that his physical health and safety be protected by ck u,r X r�ov— 13. What recommendations would you make concerning management of the financial resources of CHARLES HOWE? A. I would recommend ^o�`(S"s c^ -F4 � C7" lug_ �a Sy 6 T SSz- E Sari 14. What recommendations would you make concerning the development or regaining of physical or mental abilities of CHARLES HOWE? A. I would recommend the following: r^ ? S Sf CL+,CQ� 15. What types of assistance do you think are required by CHARLES HOWE? A. I believe he needs assistance with ce z (( z�q D c- S 16. Why is it that no less restrictive alternatives would be appropriate? A. Less restrictive alternatives would NOT be appropriate because 17. What is the probability that the extent of incapacities of CHARLES HOWE may significantly lessen or change: A. In my judgment, and based upon my training, experience and acquaintance with CHARLES HOWE, I believe the probability that his incapacities may significantly lessen or change is: a 18. Would the physical or mental condition of CHARLES HOWE be harmed by his presence in open court? A. I believe that the presence of CHARLES HOWE in open Court would be harmful to him because: 14 Q z `F 1 fi NOTE: Pennsylvania law(20 Pa.C.S. §5511(a)(1) requires that the alleged incapacitated person must be present at the hearing unless a physician or licensed psychologist provides by testimony or statement, an opinion that his physical or mental condition would be harmed by his presence. VERIFICATION Cnu�% .;A3C verify that the statements made in the foregoing depositiori are true and correct to the best of my knowledge, information and belief. 1 understand that the statements herein are subject to the penalties of 18 Pa.C.S. §4904 relating to unswom falsification to authorities. . Date: Signatu eponent CHARLES HOWE F 1 � � � .. 4 , I� 1 ' � � ., "**** NOTICE***** THE PURPOSE OF THIS POWER OF ATTORNEY IS TO GIVE THE PERSON YOU DESIGNATE(YOUR"AGENT")BROAD POWERS TO HANDLE YOUR PROPERTY, WHICH MAY INCLUDE POWERS TO SELL OR OTHERWISE DISPOSE OF ANY REAL OR PERSONAL PROPERTY WITHOUT ADVANCE NOTICE TO YOU OR APPROVAL BY YOU. THIS POWER OF ATTORNEY DOES NOT IMPOSE A DUTY ON YOUR AGENT TO EXERCISE GRANTED POWERS, BUT WHEN POWERS ARE EXERCISED,YOUR AGENT MUST USE DUE CARE TO ACT FOR YOUR BENEFIT IN ACCORDANCE WITH THIS POWER OF ATTORNEY. YOUR AGENT MAY EXERCISE THE POWERS GIVEN HERE THROUGHOUT YOUR LIFETIME, EVEN AFTER YOU BECOME INCAPACITATED, UNLESS YOU EXPRESSLY LIMIT THE DURATION OF THESE POWERS OR YOU REVOKE THESE POWERS OR A COURT ACTING ON YOUR BEHALF TERMINATES YOUR AGENT'S AUTHORITY. YOUR AGENT MUST KEEP YOUR FUNDS SEPARATE FROM YOUR AGENT'S FUNDS. A COURT MAY TAKE AWAY POWERS OF YOUR AGENT IF IT FINDS YOUR AGENT IS NOT ACTING PROPERLY. THE POWERS AND DUTIES OF AN AGENT UNDER A POWER OF ATTORNEY ARE EXPLAINED MORE FULLY IN 24 PA.C.S. CH. % IF THERE IS ANYTHING ABOUT THIS FORM THAT YOU DO NOT UNDERSTAND, YOU SHOULD ASK A LAWYER OF YOUR OWN CHOOSING TO EXPLAIN IT TO YOU. I HAVE READ OR HAD EXPLAINED TO ME THIS NOTICEAND I UNDERSTAND ITS CONTENTS. 1� "1 lr , fy Charles L. Howe, Rrinoipal Date EXHIBff BEING mindful that my affairs be properly managed notwithstanding any future disability, this Power of Attorney shall not be affected by my disability. In the event of my disability, my said agent shall have all of the powers as set forth above IN WITNESS WHEREOF, I, t ab ve-n med principal have hereunto set my hand and seal this'y1 ,_day ofv , 2011. WITNESS: Principal COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND On this, the--?-t—k_day ofj 2011, before me, the undersigned officer, personally appeared Charles L. Howe, known to me to be the person whose name is subscribed to the within instrument and acknowledged that he signed same for the purposes therein stated. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public COMMONWEALTH Or PMNSnVANCA Nalanarsm Patricia A Ned,Notary Public Cadtsk Brno,Cumberiand Coady My ComMSfon EVM Nov,8,2813 Member,Pmm*aaiaAsodadon of Notaries AGENT ACKNOWLEDGMENT I, Debra D. Grimm, have read the attached power of attorney and am the person identified as the agent for the principal. I hereby acknowledge that in the absence of a specific provision to the contrary in the Power of Attorney or in 20 Pa.C.S. when I act as agent: I shall exercise the powers for the benefit of the principal. I shall keep the assets of the principal separate from my assets. I shall exercise reasonable caution and prudence. I shall keep a full and accurate record of all actions, receipts and disbursements on behalf of the principal. " IN WITNESS WHEREOF, I the above-named I agent have hereunto set my hand and seal this Y64 day of _ , 2011. WITNESS: (SEAL) Debra D. Grimm, Agent COMMONWEALTH OF PENNSYLVANIA : SS. COUNTY OF CUMBERLAND On this, the 7tZ day of t';'1' -, 2011, before me, the undersigned officer, personally appeared Debra D. Grimm, known to me to be the person whose name is subscribed to the within instrument and acknowledged that she signed same for the purposes therein stated. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. Notary Public COMMONW_EAM OF PENNSYLVAMA Notarial Seal Patrlcta A Medy Notary Public CarWe Sort,Cumberland County My Commtsslon EYOM Nw.0,2013 Mernl> ,Pemsvhxnia A%otlabon or Notatles I DIAKON LUTHERAN SOCUL WNISTRIES CPR ORDER SHEET PENNSYLVANIA Resuscitative measures,including cardiopulmonary resuscitation(CPR)(chest compressions and mouth-to-mouth rescue breathing),defibrillation,assisted ventilation,endotmcheaLintubation,and cardiotonic medications are used when the heart stops and/or breathing stops in cardiac and/or respiratory arrest CPR keeps oxygenated blood flowing to the brain until advanced life support can be initiated. If a cardiac and/or respiratory arrest occurs,CPR will be administered to residents by a person or persons qualified to administer CPR,unless the resident has chosen not to be resuscitated, Once CPR has been initiated,emergency personnel will be called and the resident will be transferred to the hospital for f n-ther'treatmcat. I have been informed about DNR orders,risks and alternatives,and my attending physician has discussed my decision with me. I choose to have CPR and/or other resuscitative measures administered if I am ever in cardiac and/or respiratory arrest I do NOT want CPR and/or other resuscitative measures administered if I am eves in cardiac and/or respiratory arrest. Signature of Resident OR Health Care Agent/Surrogate Date v ( z Attending Physician S' a Date PHYSICIAN ORDER o� t�� Physician Signature: Date: Time: Nurse transcribing order: Date: Time: Charles Howe 1899CCNC - EXHIBIT NSC,003P(02.08) MR NUMBER DIAKON I .. r k. { _ � .. 1 * � ', 4I �� IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION IN RE: ESTATE OF CHARLES HOWE: NO. Alleged Incapacitated Person ACCEPTANCE OF PROPOSED PLENARY GUARDIAN OF THE PERSON AND ESTATE Keystone Guardianship Services, proposed plenary guardian of the Person and Estate of CHARLES HOWE, the alleged incapacitated person, agrees to accept the appointment as permanent plenary guardian of the Person and Estate and avers that: 1. Keystone Guardianship Services provides guardianship services and is not related in any way to the alleged incapacitated person. 2. Keystone Guardianship Services has no interest in nor is fiduciary of any estate in which the alleged incapacitated person has an interest; and, 3. Keystone Guardianship Services has no interest adverse to that of CHARLES HOWE, the alleged incapacitated person. Keystone Guardiarir,k ip Services C " , J r✓ ��zf>� , ConstanceStoneroad kLS JX WIBIT "`. s