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Home My WebLink About05-18-15 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA �.� IN RE: ORPHANS' COURT DIVI�,4QN � � rn � No. �of 2015 ��' �' '"� `' �' HAYWOOD WILKERSON, '�" �' � .;, �� -� � :� An Alleged Incapacitated Person - ' ` ' , , r� ,_ _, ,.�� , � � . , ;;-, PETITION FOR APPOINTMENT OF GUARDIAN t' ' _�' � �� . : �; c,� ..... r�, TO THE HONORABLE, THE JUDGES OF SAID COURT: � ;� "� � JOHN HOLLY, EXECUTIVE DIRECTOR OF GOLDEN LIVING CENTER-WEST SHORE ("Golden Living Center"), files this Petition for Appointment of Permanent Plenary Guardian of Person and Estate under and 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. HAYWOOD WILKERSON (the "Alleged Incapacitated Person") is an eighty-four year-old (84) male born on June 1, 1930. 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 March 27, 2012 until discharge to his wife's care on September 7, 2013 and then was admitted again on May 29, 2014. 3. The Alleged Incapacitated Person has been approved for Medical Assistance Long Term Care ("MA-LTC") benefits, with an effective date of March 27, 2012. 4. Upon information, the Alleged Incapacitated Person is separated and has the following known relatives (including spouse, parents and presumptive adult heirs as may be applicable): .\r �� ,.-� rrinr ir rr� , Name Relationship Address Margie Wilkerson Wife 719 Cornish Drive Cambridge, MD 21613-2139 (Last known) Genieva Jackson Daughter 4216 Massachusetts Avenue Baltimore, MD 21229 Geraldine Miller Sister 4804 Lancer Court Lower Paxton, PA 17109-3209 5. The following persons or institutions provide the listed services to the Alleged Incapacitated Person: Name Address Service Golden Living Center 770 Poplar Church Road Residential Skilled Camp Hill, PA 17011 Nursing Services Edward Lamarque, M.D. 2920 Market Street Attending physician Camp Hill, PA 17011 AlixaRX 1041 Washington Pike Ste 100 Prescriptions Bridgeville, PA 15017 6. The Alleged Incapacitated Person's physicians have diagnosed his physical and mental condition as including, but not limited to, Depressive Disorder and Dementia with behavioral disturbances. 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 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 communicate responsible decisions is significantly impaired and currently preclude the Alleged Incapacitated Person from independently attending to issues of inedical 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 the Alleged Incapacitated Person's person and estate. 9. Golden Living Center has identified Keystone Guardianship Services, with an address of P.O. Box 804, Elizabethville, PA 17023, as a potential permanent plenary guardian of the Alleged Incapacitated Person's person and estate (the "Proposed Guardian"). The Proposed Guardian has advised that it 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's physicians. 11. Upon information and belief, the Alleged Incapacitated Person's assets and income include, but are not limited to, the following: . Social Security $347.00 per month for which Social Security has appointed Golden Living Center as representative payee; 12. 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, medical evidence is uncontroverted; the Alleged Incapacitated Person is cognitively impaired, demented and delusional; and Golden Living is acting as Representative Payee for the Alleged Incapacitated Person's Social Security payments. Golden Living Center does not know whether the Alleged Incapacitated Person's other known relatives have any objection to the relief requested herein. 13. 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 presence in court would be harmful and detrimental to his physical or mental condition. 14. To the best of Golden Living Center's knowledge, information and belief, there is not now, nor has there ever been, a guardian appointed for the person or estate of the Alleged Incapacitated Person. 15. To the best of Golden Living Center's knowledge, information and belief, no court has ever assumed jurisdiction in any proceeding to determine the capacity of the Alleged Incapacitated Person. 16. To the best of Golden Living Center's knowledge, information and belief, the Alleged Incapacitated Person was not a member of the Armed Services of the United States and is not receiving any benefits from the United States Veterans Administration. WHEREFORE, Golden Living Center 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 he should not be adjudged incapacitated and why a permanent plenary guardian of his person and estate should not be appointed. TUCKER ARENSBERG, P.C. gy �� Kevin L. all, squire Pa.l.D. #311826 Tucker Arensberg, P.C. 2 Lemoyne Drive, Suite 200 Lemoyne, PA 17043 Dated: � �� (717) 234-4121 � � . ilERIFlCATiQN Y�ir,� I, ��1� �c�� ;�US�tir,ts (A.�fo� Goiden Living Center state, that the facts contained in the foregoing Petitfan are true and correct to the best af my knowledge, information and belief. This Verification is made subject to the penaities of 18 Pa. C.S. §4804 relating ta unswo�n falsificatior�to authorities. GOLDEN LIVING CENTER `�✓��,,�-�.°.�� Prin Name: r<-- TiUe: `�' Dated: �.L....—_—� 2US� CONSENT TO SERVE AS GUARDIAN This is to certify that I, Constance E. Stoneroad, am the President of KEYSTONE GUARDIANSHIP SERVICES and am unrelated to HAYWOOD WILKERSON, the Alleged incapacitated Person. I have been informed that the Alleged Incapacitated Person has the illness stated in the Petition for Appointment of Guardian of Person and Estate. I am authorized to state that KEYSTONE GUARDIANSHIP SERVICES is willing to serve as guardian of the person and estate of HAYWOOD WILKERSON if so appointed by the Court. I also certify that a representative of KEYSTONE GUARDIANSHIP SERVICES will be present during the hearing for determination of the Alleged Incapacitated Person's capacity and the appointment of a guardian. KEYSTONE GUARDIANSHIP SERVICES has no interest adverse to that of the Alleged Incapacitated Person and is not a fiduciary of any estate, trust or similar fund in which the Alleged Incapacitated Person has an interest. KEYSTONE GUARDIANSHIP SERVICES, NPC By: ��:��o�.c.�.—' ame: Constance E. Stoneroad Title: President Dated: _��U � , 2015