HomeMy WebLinkAbout11-26-14 �►+�``""°�°�►,,,, CUMBERLAND COUNTY
� ,.
`'' '�� A���� 8�:� � �- MMUNITY SERVICES
z 1 �`',`"''' ' .:._:� 11��CLARP�MONT RD CARLISLE,PA 1��1`J
,` (717)240-6110 Ox 1-888-697-0371 ExT 6110
�
¢ \ _---� ?;�??`i t,�i'�J C 0 ";� � �; rnx:(717)24o-611s
� �
Barbara B Cross
One Team...One Mi.r.rion �i_'_; - c'ha�rman
���� - Jim Hertzler
t�� �� ,,
�� . � - � - � , Vice Chairntan
CiJt�=�jl ' , .
_ Gary Eichelberger
� Secretary
1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY�PENNSYLVANI�`�'L Bazley
Uirector
ORPHANS' COURT DIVISION
In re: �
. No.2009-968
James Pague
an incapacitated person .
ANNUAL REPORT OF GUARDIAN OF THE PERSON UNDER
SECTION 5521(c)OF THE PROBATE,ESTATES AND FIDUCIARIES CODE
Far the period:November 2013 to November 2014
Part I
Status of Guardianship
1. Cumberland County Aging and Community Services is the plenary guardian of the person
of the above-named incapacitated person.
2. The Agency was appointed guardian by Court Order dated November l2,2009,which has not been
modified by subsequent Orders of Court.
3. The incapacitated person continues to live.
Part II
Living Arrangements
5. The incapacitated person was born on July 23, 1948and is 66 years of age.
6. The incapacitated person's current address is The Claremont Nursing and Rehabilitation Center,
1000 Claremont Road,Carlisle,PA 17013
7. The incapacitated person's residence is a nursing home.
8. The incapacitated person has been living at this since October 19,2009
9. The following is a brief description of the incapacitated person's living arrangements and the social,
medical,psychological,and other support services he or she is receiving: Mr.Pague resides in a nursing facility. He
is seen every other month by a physician who manages his medical and psychological issues with medication or
other treatments. He receives social support by the the nursing home staff,other residents and Agency staff
members and other residents.
10. I rate the incapacitated person's living arrangements as Above Average
]1. I believe the incapacitated person is content with the living situation.
�MAIL US AT aging@ecpa.net OR vIsi1'oUK WEBSITE AT www.ccpa.net/aging
�
Part III
Physical Condition
12. The current physical condition of the incapacitated person is Fair
13. The incapacitated person's major physical health problems are:
Chronic dementia, accelerated hypertension, history of alcohol abuse, obstructive sleep apnea, hypokalemia,
depression, arthrities, right frontal lobe hematoma /lacunar infarct, ambulation dysfunction, muscle weakness,
cognitive disorder,delusions,hyperlipidemia,pain.
14. During the past year,the incapacitated person's physical condition has remained stable.
15. During the past year,the incapacitated person has received the following medical treatment(including
check-ups and dental work):
Date Ailment Tvpe of Treatment Doctor's Name
Every 2 Maintenance Foot and nail care Dr. Goelich
months
Every 2 Maintenance and med Physical check up Dr. Gawlas
months updates
Annual Maintenance Dental Assessment Nursing staff
Annual Maintenance Eye Exam Dr.West
Part IV
Mental Condition
16. The incapacitated person's current mental condition is Fair
17. The incapacitated person's major mental health problems are chronic dementia, depression and delusions
and behavior problems
18. During the past year, the incapacitated person's mental condition has improved and as a result he was
taken off one of his psychotropic medications.
Part V
Social Condition
19. The incapacitated person's current social condition is goof.
20. During the past year, the incapacitated person's social condition has improved. He has a new roommate
that shares many of his interests.
21. During the past year,the incapacitated person has participated in the following activities recreational and
social activities as provided by staff of the nursing home.
Part VI
Guardianship Activities
22. During the past year, Agency staff visited the incapacitated person 9 times.
23. The average amount of time staff spends with the incapacitated person on each visit was 30 minutes.
24. The last time Agency staff visited the incapacitated person was on September 4,2014.
25. During the past year, Agency staff have performed the following activities on behalf of the incapacitated
person: attended quarterly care plans, attended the Christmas party and delivered his Christmas presents, took him
out to eat 3 times.
Part VII
Concerns and Recommendations
26. The Agency does not believe the incapacitated person has unmet needs.
27. The Agency does not have other concerns about the incapacitated person's physical or mental well-being
or finances.
28. The Agency believes guardianship should be continued without change.
29. The Agency is also the guardian of Jim Pague's estate. My annual report is attached as well.
t certify that the information contained in this report is true and correct to the best of my knowledge,
information,and belie£ This statement is made subject to the penalties of 18 Pa.C.S. §4904(relating to unsworn
falsificetion to autharities).
Date:November 25,2014
;.,�^,�..�t �^��� ��� C�...,.�t��.�.� C.c�.
�r.nC� C�M(r �t=�"a.tJ�r.vi.i+ -I �Jc'�!L'ti1�'�i
Guardiari'of James Pague
1100 Claremont Dr., Carlisle, PA 17015
Telephone : 717-240-6110
�,�������,.,,� CUMBERLAND COUNTY
� ��; AGIr���:�,�����,�1�MUNITY SERVICES
,E
�� � � �-�_��' "' ;_,�-� 11 OO CLARFMONT RI� CARLISL�,PA 1701$
�� � . ._
����/ (717)240-6110 ox 1-888-697-0371 ExT 6110
"''�� � r� `�," ��^� '� l�C� FAX:(717)240-6118
�.:i`I �L,lt� LO . i � ,
. . Bazbara B Cross
One Team ...One Mz.r.raon ;. . - _ cnarrma„
t,.�,� Jim Hertzler
G i7{"i Vice Chairman
��..�? ._ , '' �, Gary Eichelberger
' Secretary
Terry L Barley
Director
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA
ORPHANS' COURT DIVISION
In re: .
. No.2009-968
James Pague .
an incapacitated person .
ANNUAL REPORT OF GUARDIAN OF THE ESTATE UNDER
SECTION 5521(C)OF THE PROBATE,ESTATES AND FIDUCIARIES CODE
For the period:November 2013 through October 2014
1. Cumberland County Aging and Community Services(The Agency) is the plenary guardian of the estate
of the above-named incapacitated person. The Agency was appointed guardian by Order of the Court dated
November 12,2009, which has not been modified by subsequent Court Orders.
2. The incapacitated person is living.
3. At the beginning date of this reporting period,my initial balance on hand was$4120.52
4. Attached is a copy of income and expenses summary for this period and a copy of the check register.
5. The only source and amount of income that the Agency expects the incapacitated person to receive is
from Social Security which is currently$951.00.
6. The expected monthly expenses for the incapacitate are:
To Whom Paid Amount
]. Claremont Nursing and Rehab Center $806.02 (based on Social
Security
2. Cumberland Co Aging and Community Services $100.00(guardianship fee)
3.
4.
5.
6.
7. It is not expected that there will be a need for extraordinary expenditures on behalf of the incapacitated
person in the next 12 months. During this year,payment had to be made to the Capital Tax Collection Bureau for the
local income tax far the 3 years prior to the guardianship that the incapacitated person did not pay.
8. The Agency is the designated payee to received the incapacitated person's Social Security Benefits.
�MAIL US A'i' aging@ccpa.net oR VISI'I'OUR WF,BSITE AT www.ccpa.net/aging
C '
,�
9. The Agency is also the guardian of the person of James Pague. My annual report is attached as well.
I certify that the information contained in this report is true and correct to the best of my knowledge,
information, and belief. This statement is made subject to the penalties of 18 Pa.C.S. §4904 (relating to unsworn
falsification to authorities).
Date: November 26,2014
�;J,t..�,.,�� �-�^�.,.�sC� +a�J` �,���n�z,r��.�.a �..� ,
4��t�/l�1 c:ti•�� L�:cx w..,4.��.( S�e,r .�,c.�5 ,
Guardi na of James Pague
1100 Claremont Rd,Carlisle,PA 17015
Telephone: 717-240-6110
� � D �
o � �
� � mc ` c � D � � � � o � � ;tv�i
�-a � � � � � � � c� < 0 3 � �
� � '� � � � � � � � � � � �
A A A � �i A � � l� .A W W W 0
V =
� �
V
� �
� � �
W (O CO (D t� CO CO (fl CO CO CO Cfl CO n �
00 CJ7 U1 CJ� CJ� U7 U7 CJ� CJ� U7 U1 W W O
,p .� � � � � .� � � � �] J �f �
000000000000o SocialSecurit �D
0 0 0 0 0 0 0 0 0 0 0 0 o Y
w c,.�
0 o Miscellaneous
W o o m
... ,� _ � .� � �
� � o� �, ooaornao rn wwrn �
� m � N rnrnrvrn rv rnrnrn .nCOi
� k f� � Cn O O o � O O --� O
� o � � iv .r� rn N � � N rn Room and Board
N <D �
fD �
N �
W O
o Medical x
�
�
� �
N > � � � � j � � � > > � N
� 0 � � � 0 � 0 � � � � � �
O O O O O O O O O O O O O y
000000000000o Guardianshi Fee
0 0 0 0 0 0 0 0 0 0 0 0 o P
� �
� � A
O W � Cfl 00 �
00 � OD IV Cr O O CJi
<O CO V O N N O O
� a�o o N .i' � o o Miscellaneous
�
�
w cfl co cfl co cfl co co co cfl cfl co co
ao cn cn cn cn cn cn cn cn cn cn w w
� � � � � � � � � � � � �
i00000000ifl0000 TotallnCome
0 0 0 0 0 0 0 0 0 0 0 0 0
�
0
� _
0 � � � � � ' � � � � � ' �
� � � � Q � � � � N � � �
COODN � ONO � � � ONO �
o�orn � rnoivorna�ir�vorno TotalExpense °
v
� cn rn cn cs cn cn cn cn cn � � �
A N O CO � CO -� O O 00 CO CO �
00 l� O � � �1 N �1 N O Cn O N
(O � �1 W N W N �I OD W N �1 O
w io io 0 0 � � � w � � in in galance
A O l� O O N N 00 A � � N N
Name James F Pague
Acct#9850787566
Check Deposit Ending
Date Check# Amount Amount Balance Description
10/24/2013 373 687.06 $4,120.52 CNRC - November x
11/1/2013 937.00 $5,057.52 Soc Sec x
11/8/2013 374 100.00 $4,957.52 Aging &Comm Svcs x
_ 11/8/2013 375 50.00 $4,907.52 Cash - Personal account x
12/3/2013 937.00 $5,844.52 Soc Sec x
12/6/2013 376 100.00 $5,744.52 Aging &Comm Svcs x
12/20/2013 377 792.06 $4,952.46 CNRC-January x
1/3/2014 951.00 $5,903.46 Soc Sec x
1/15/2014 378 100.00 $5,803.46 Aging & Comm Svcs x
2/3/2014 951.00 $6,754.46 Soc Sec x
2/5/2014 379 792.06 $5,962.40 CNRC - February x
2/20/2014 380 100.00 $5,862.40 Aging & Comm Svcs x
2/27/2014 381 834.06 $5,028.34 Jan -$14, Feb$14 & March x
3/3/2014 951.00 $5,979.34 Soc Sec x
_ 3/11/2014 3.90 $5,983.24 Deposit x
3/25/2014 382 806.06 $5,177.18 CNRC -April x
3/25/2014 383 100.00 $5,077.18 Aging &Comm Svcs x
4/3/2014 951.00 $6,028.18 Soc Sec x
4/25/2014 384 806.06 $5,222.12 CNRC - May x
4/25/2014 385 100.00 $5,122.12 Aging & Comm Svcs x
5/2/2014 951.00 $6,073.12 Soc Sec x
5/13/2014 386 100.00 $5,973.12 Aging & Comm Svcs x
6/2/2014 387 806.06 $5,167.06 CNRC-June x
6/3/2014 951.00 $6,118.06 Soc Sec x
6/6/2014 388 100.00 $6,018.06 CNRC-guest fund x
6/16/2014 389 100.00 $5,918.06 Aging & Comm Svcs x
_ 6/26/2014 390 806.06 $5,112.00 CNRC-July x
7/3/2014 951.00 $6,063.00 Soc Sec x
7/14/2014 391 100.00 $5,963.00 Aging &Comm Svcs x
8/1/2014 951.00 $6,914.00 Soc Sec x
8/8/2014 _ 392 806.06 $6,107.94 CNRC-August x
8/8/2014 393 100.00 $6,007.94 Aging & Comm Svcs x
9/1/2014 951.00 $6,958.94 Soc Sec x
_ 9/8/2014 394 806.06 $6,152.88 CNRC -September x
9/8/2014 395 100.00 $6,052.88 Aging & Comm Svcs x
9/25/2014 396 805.98 $5,246.90 CNRC-October x
10/3/2014 951.00 $6,197.90 Soc Sec x
10/3/2014 397 100.00 $6,097.90 Aging &Comm Svcs x
10/10/2014 398 602.54 $5,495.36 Capital Tax Collection Bureau x
10/23/2014 399 200.00 $5,295.36 Cash -Guest Account
10/27/2014 400 806.02 $4,489.34 CNRC - November