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HomeMy WebLinkAbout70-023911 IN R E : ESTATE OF ROSEMARY In the Court of Common Pleas of Cumberland County, Penna. Orphans' Court Division L. DEAN, Alleged Inc on-:petent No. ;~ PETITION FOR APPOINTMENT OF A GUARDIAN TO THE HONORABLE, THE JUDGES OF SAID COURT: The Petition of Robert E. Dean respectfully represents; 1 -Petitioner is the husband of Rosemary L. Dean, both of whor~-± reside at 101 Lighthouse Drive, Mechanicsburg, Cumberland County, ~; i! ~', Pennsylvania. ~, 2 -The said Rosemary L. Dean is thirty years of age and is the mother of one child, Michael A. Dean, two years of age, 3 -The said Rosemary L. Dean, because of mental illness, is unable to manage her property and is liable to dissipate and become the 'i victim of designing persons. 4 -The estate of the said Rosemary L. Dean consists of the following items: a) Miscellaneous personal property having a worth of several hundred dollars. b) Disability rights under Social Security, approximating $12.70 per month. c) A cause of action for her mental condition which your petitioner believes will be the subject of a law suit. - 1 - 5 -Your petitioner is the sole sui juris heir living in the Commonwealth of Pennsylvania who would be entitled to share in her estate if she died intestate at this tithe. 6 -The proposed guardian is Dauphin Deposit Trust Cotr:pany, Harrisburg, Pennsylvania, who does business and maintains an office in Cumberland County, Pennsylvania. 7 - No other Court has assumed jurisdiction in an y proceeding to deterr?~ine the competency of the said Rosemary L. Dean. 8 -The alleged incompetent has no legal guardian of her estate ~~ or person. ,~ ?; WHEREFORE, your Petitioner prays that a citation issue directed to the alleged incorrapetent to show cause why she should not be judged an incompetent and a guardian of her estate be appointed. !' Robert E. Dean, Petitioner COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF ~~.~~~' ~-~-~ I~ ~ Robert E. Dean, being first duly sworn, deposes and says that I he is the Petitioner in the foregoing Petition for Appointn-~ent of a Guardian and that the facts set forth therein are true and correct to the best of his ~~ knowledge, information and belief. ~' i~ ~ ~ i Sworn and~•s,U'~sc,ribed to before me this Rober E. Dean ~~ ~i." da~;t3.'~rL~•,~,n. D. , 1970. f *4E -'' : . I ,~ ~. ~~R,,,ry4'/\Y ~ ~ Qom'' ~ ,-.. j =de ~, tdryrP'txlxl.~c My "~t.~rr f s s ~:~~a.i~e s : ~3'~z-h -2~_ ~ ~~ / ~ ..3 ,.. .. -2- IN RE: ESTATE OF ROSEMARY L. DEAN, Alleged Inco-rnpetent . In the Court of Cor~~m~on Pleas of Curr~berland County, Penna. . Orphans' Court Division No. ACCEPTANCE BY PROPOSED GUARDLAN Dauphin Deposit Trust Corx~pany does hereby certify that it rr_aintain5 offices in the County of Cumberland, Pennsylvania; that it is not the fiduciary of any estate of the alleged incompetent and has no interest adverse to the said alleged incompetent; and it does hereby agree to accept ~~ the appointx~~~ent as Guardian of the Estate of Roserr~ary L. Dean, an Alleged Incoz~npetent. DAUPHIN DEPOSIT TRUST COMPANY VICE • I~RES. & TRUST OFFICER bvuK ~~' ~AL~~~ - 3 - I~~ ~~~;. BSTRTE OF ROS RY L, DEAN F:LLEGED INCOMPETHI`TT Ind Tt?E COt3Ft,T OF a^_ OMuiO~~ P~~FA} Oi Ct7MBERLAI~3D C'//O~~t?TNT`T"v, PT ~~7'DTi P(^v'~A(,lT~ ORP HAD:S' Lt]V i'i rt; .'.i 1. `J 1~?Il.,'1Y I~IO, 21-70-239 CITATION tihlE CC)M~sAZ~7D, y~u that laying aside all businesv -z>.c? e~:cuw~, ~vE~atsoever,you J.~e and appear in your proper person ~~efore '~:~~~, Huno~~able Judgesof the Common Pleas Court, Orphans' Co~~.rt Dxc~i.sior. at a se~sion of the Baia Court therF to b;°~ ?e la, ~ni: t:'-ie Coil~:ty of Cu~berlana to shoti~ cause cvhy she sho~.i~_c~ not sa^ a~'judgec~ an inco~petent and a guardian of her esta±:e appointee<~; ?-:~~>aring to be he7~a at the Court House, Carlisle, P::'r".~~sylva.~ia, oi~ May 3, 1970 a~' I:30 o'clock, in Court Room 1, At least 5 novice of tr,e hearing shall be given tc: Roser~.~a.r_~r L:,Dean, the all ~~litr:~ss my h Pennsylc ar.,ia this) incompetent by personal servi~~c4. and official seal of office at Carlisle, 28th cay of P.pril, 1970, ,. , . Clerk of Ccmm~n Pleas`: Court, Ox~nans' Court ~ p Divisior~,C,a.rlisle,Pa. ~ , h1y Commission E~;pi.r~~.^ lst , Mon ,~,7`a.~ . l"974 , li 1~ IN RE: In the Court of Common Pleas of '~~ Cumberland County, Penna. ESTATE OF ROSEMARY Orphans' Court Division L. DEAN? Alleged Incompetent No. ,_ !' -- ~~~ PRELIMINARY DECREE AND NOW, April Z 1970, upon consideration of the annexed Petition, it is Ordered and Decreed that a Citation be awarded, directed to Rosemary L. Dean, to show cause why she should not be adjudged an incompetent and a guardian of her estate appointed; hearing to be held at the Court House, Carlisle, Pennsylvania, on '~~" - 7 ~/ at l~~ ~ V o'clock. ~ ~~~~ At least ~ notice of the hearing shall be given to Roser~lary L. Dean, the alleged incoz-r_,petent by personal service. BY THE COURT: ~~.G/~fl~~'- Y~ IN RE: ESTATE OF ROSEMARY L. DEAN, Alleged Incompetent In the Court of Comrr_~on Pleas of Cumberland County, Penna. Orphans' Court Division No. 21-70-239 FINAL DECREE ',~ AND NOW, ~J 1970, upon consideration i of the annexed petition and after a hear ng held following due notice, it is Ordered and Decreed that Roselrary L. Dean is adjudged an inconspetent and Dauphin Deposit Trust Cosr~pany is appointed Guardian of the Estate of Roseanary L. Dean. The said Guardian is directed to file an inventory in accordance with the provisions of Section 402 of the Incoi~rpetents' Estates Act of 1955. ~ ~ti !~ ~ ~~~~ i ~' ~, f'` BY THE COURT: P. J. COMMONWEALTH OF PENNSYLVANIA 1 COUNTY OP CUMBERLAND ss: 1 being duly sworn according to law, deposes and says that ~~ it is Guardian of the Estate of Rosemary L Dean ~~-~-Ins--omr?ten~-of--- ---- Cumberland County, Pa., c6a~aote:d and that the wi+hin is an inventory made by natfphin pgPgsit Truest Gomp~g- ., the said ~t~arrl; an of the entire estate of said decedent, consisting of all the personal property and real estate, except real estate outside the Commonwealth of Pennsylvania, and that the figures opposite each item of the Inventory represent it's fair value as of the date of decedent's death. DAUPHIN DEPOSIT TRUST COMPANY -- "~ ~'`L~r and subscribed before me, ~%.~.~'~%~.,,~~ /`~ ~~}~' `+~"'~° Bar ~ Assistant Trust Officer. ~-- H~xo~n~x~x Guardian 19~ ~- ~ 213 Market Street y ~~. ~ ~ Pxt1LJ1YE rci. ?iHLt.a ;ri"uirtnY r'lloi.li Harrisburg, Pennsylvania 17101 My Commission Expires September 14, 1978 Address Hurisburg, Pa. Dauphin County A pointment 5th Date of 11~z ___ Day Month 1970 Year INSTRUCTIONS I . An inventory must be filed within three months after appointment of personal representative. 7. A supplement inventory must be filed within thirty days of discovery of additional assets. 3. Additional sheets may be attached as to personalty or realty 4. See Article IV, Fiduciaries Act of 1949. ' I O Z O Z W Z >- ~ Q W ~ ~ W ~ W 1-- ~ J ll.. W J `Q ~ Z ~ Q O Z W Q d O per. U ~ + H c 7 ~ O V C cad N Q a }-I tb R d E U M m of G 00 s~ .~ m II~ ~~ ~ i0 ~ N ~ ~ O ~+ ,~ Q rl .'~!+ N .,~ 3 o ~ m ~e~~ ~.~:~ ~,cE 219 Inventory of the real and personal estate of Rosemary L. Dean ~~ An Incompetent PERSONALTY St. Paul Mercury Insurance Company - Awarded balance of final claim settlement REALTY " N 0 N E " $46,124 73 TOTAL $46 124 73 I ~ $- ~ I I i ~~ ~oox ~t~2 ~ HcE 218 ay 5, 1970 Carlisle, Bennsylvania MR. KLEIN: Your Honor, if it please the court, might I introduce myself. I am Macey E. Klein, and Z am a member of the Cumberland County Court by virtue of registration with the prothonotary. This is the day and time set for the petition for a hearing for the appointment of a guardian of Rosemary L. Dean, an alleged incompetent. I have here as prospective witne yes, of course, Mr. Dean, the husband of the alleged incompetent, and as an additional witness, Dr. Hensel, who will be able to advise Your Honor of Mrs. Dean's physical condition and her mental condi- tion. Mr. Dean will you take the stand, please. ROBERT E. DEAN, having been duly sworn, according to law, testified as follows BY MR. KLEII~T: Q, Will you state your full name? A. My name is Robert E. Dean. Q. And where do you live, Mr. Dean? A. I live at 101 Whitehouse Drive in Mechanics- burg. Q. That is in Cumberland County? A. Yes. Q. How old are you? 2 OBERT E. DEAN A. I am thirty-four. Q. To whom are you married? A. I °m married to Rosemary L. Dear. Q. And are you two living together? A. Yes, we are. Q. At the same address? A. Yes. Qo How old is your wife? A. My wife is thirty years old. Q. In addition to yourself and your wife, who else makes up your family? A. My son, Michael Dean. Q. How old is Plichael? A. Michael is two years old. Q. And is that the only child that you have? A. Yes, sir, that is. Q. Mr. Dean, up until when was your wife in apparent good, both physical and mental, condition? A. The last time was in August of 1968. Q. And as a result of some medication which she took at or about that time has her mental condition changed? A. Yes, sir, it has. Q. Can ,you tell us approximately of what your wife's estate consists at the present time? A. Right now just her clothing and some of hex personal articles. OBERT E . DEAN Q. Now, is she presently receiving any benefits under the Social Security Act? A. Yes, she is, she's receiving disability. Q. And does that run approximately `fi12~.7~ per month? A. Yes, sir. Q. Now, since her condition has changed what is her mental condition? I don't mean so much medically, Tell the court what her mental condition is insofar as being able to take care of herself, understanding things that are going on, and so forth? A. Mrs. Dean is unable to read or write and, therefore, she can't understand anything at all. Maybe basic questions as yes and no, but that's the limit. Q. In her daily personal actions would you say that her mental condition has been tremendously reduced, is that correct? A. Yes. Q. Do you think that Mrs. Dean would have any semblance of understanding of this particular proceeding which we're going through now? A. No, none whatsoever, Q. Tf the court should see fit to appoint a guardian for the estate of your wife should he find her to be mentally incompetent, whom do you recommend as such a guardian? 4 CBERT E. DEAN A. b2yself if it is possible. Q. And if that isn't so, whom else? A. Well, I don't know. Q. The Dauphin Deposit Trust Company? A. Yes, yes. Q. Now, your wife has never had any previous application for the appointment of a guardian for her, is that correct? A. No, sir, never. Q. So that the only adult person in your family who would be a possible heir of your wife if anything happened to her would be yourself and your son, B~ichael, is that correct? A. Yes, sir. Q. If there were any success in the proposed legal action which our office intends to take on behalf of your- self and your wife and an estate were created for her, do you think that she could become the victim of designing persons if the money were in her control? Could she handle the money? A. N o, definitely not. Q. And is I~Rrs. Dean at home presBntly? A. Yes, she is. Q. And is she under medical care? A. Yes, she is. Q. And did the doctors indicate to you that her condition is probably a permanent one? 5 OBERT E. DEAN A. Yes, they have said this. MR. KLEINs Does Your Honor have any further questions? THE COURTS Just a few. BY THE COURTS Q. When were you married, Pdr. Dean? A. July 1867. Q. And you mentioned the present condition of your wife, what was her condition prior to this? Was she employed before your marriage? A. Yes, she was. Q. What did. she do? A. She was Like a clerk-typist for State Auto- mobile Insurance Company of Harrisburg. Q. And did she still serve in that capacity after your marriage? A. Yes, sir, she did. Q. Up until about August of • 68? A. Until the time the baby was born, which was in December of '67, yes, Mike was born in '67. Q. And are her parents living? A. Yes, they are. Qo What are their names? A. Mr. and Mrs. Harold K. Trout. They reside in Foxcroft Drive, Wormleysburg. 6 HE COURTS I believe I have no other questions. MR. IffEIN s Thank you, A'tr. Dean, you can come down. Dr. Hensel, will you take the stand, please. PHILIP K. HEN SEL, having been duly sworn, according to law, testified as follows: BY MR . KLEIN s Q. Dr. Hensel, will you state your full name, please? A. Philip K. Hensel. THE COURTS May T interrupt to say T am familiar personally with the doctor's qualifications as a medical doctor so you needn't go through that for the record. MR. KLEIN s Thank you, judge. BY MR. KLETNs Q. Dr. Hensel, how long have you known Robert Dean, approximately? A. Approximately four months. Q. And how long have you known Rosemary L. Dean? A. The same period of time. THE COURTS Did I understand you to say four months? THE WITNESS: Yes. BY MR. KLEIPt s Q. Tn those four months how many times have you seen Mrs. Dean? 7 HILIP K. HETISEL A. I've seen her on several occasions an d I°ve had occasion to examine her on two occasions. Q. And when is the last time that you saw Py7rs. Dean? A. Other than briefly to wave to today I saw her on the 28th of April, 1970. Q. And the occasion for the April 2.8th visit was what? A. To serve the citation of this court on Mrs. Dean that a hearing would be held to appoint a guardian for her. Q. Did you read that citation to her? A. Yes, I did. Q. Will you state for the record first, in a very capsule form, what her mental condition is medically? A. Mrs. Dean suffered from a cerebrovascuiar accident in August of 1968 which has left her, along with a physical handicap, that is being paralyzed on one side, it has left her mentally in a mental defective range for her age. Q. Would you state for the court what level of intelligence you rate Mrs. Dean presently at? A. Yes, I had her tested by a clinical psycholo- gist and they give her an I.Q. of 48, which would put her some- where at the first to second grade school level. 8 HILIP K . HEN SEL Q. And are you of a similar opinion? A. Yes, I am. Q. Dr. ~iensel, do you think that her Condit:ion is a temporary one or a permanent one? A. It is a permanent one. Q. Do you think that Mrs. Dean would. have any understanding of this proceeding? A. Absolutely none. Q. And do you think that her presence here woixld be to her welfare in any respect at all? Ao N o, in fact it might be the opposite, may cause some frustations on her part. Q. Doctor, from your familiarity with Mrs. Dean, should an estate become available to her, do you think that she could become the victim of designing persons? A. Very definitely. Q. Do you think that she is mentally capable of handling any kind of money at all? A. She is not. Q. And you saw her as late as today? A. Yes. MR. KLEIN s Does Your Fionor have any further questions? THE COURT: I have no questions. MR. KLEIN: Thank you, Dr. Hensel. 9 R. KI,EIN: Your Honor, please, I have prepared a proposed final decree for your signature, reading as follows: "And Now, 1970, upon consideration of the annexed. petition, a hearing held following due notice, it is ordered and decreed that Rosemary L. Dean is adjudged an incompetent and Dauphin Deposit Trust Company is appointed guardian of the estate of Rose- mart' L. Dean. The said guardian is directed to file an inventory in accordance with the provisions of Section 402 of the Incompetency Act of 19 ~$. " THE COURTs If I may see counsel at sidebar. (Discussion off the record.) MR. KLEIN: If Your Honor please, the plaintiff would like to correct the date of his marriage. It was 1966. He made an error. ~~~~# (There being no further testimony, hearing was adjourned. ) 10 N RE: s IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ESTATE OF ROSEMARY L. DEAN , ~ ORPHAN S° COURT DIVISION AN ALLEGED INCOMPETENT r s N0. 21-70-239 IN REs APPOINTMENT OF GUARDIAN I hereby certify that the proceedings are con- tained fully and accurately in the notes taken by me on the above cause and that this is a correct transcript of same. -,~ January 29, 1975 Official Stenographer The foregoing record of the proceedings upon the above cause is hereby approved and directed to be filed. ~,~ ~ '~ ` ,~~. P.J. I1 Itd THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PEPINSYLVANIA ORPHANS' COURT DIVISION N0. 21-70-239 FIRST AND PARTIAL ACCOUNT OF Dauphin Deposit Bank and Trust Company, Guardian For ESTATE of Rosemary L. Dean, An Incompetent PROPOSED DISTRIBUTIONS To: Dauphin Deposit Bank & Trust Company, Guardian for the Estate of Rosemary L. Dean, An Incompetent - Entire balance for future accounting purposes Principal Cash; Univested Market Square Cash Manager 1 Securities: ,g1 units Fixed Income Collective Investment Fund 1,167 units Common Stock Collective Investment Fund Miscellaneous Metropolital Life Insurance Company, Insurance Policy Current Fiduciary Value Acquisition 04/11/88 _ Value ~ 35.77 ~ 35.77 5,600.00 5,600.00 87,336.70 81,487.07 17,186.08 12,736.04 1 .00 _ 1 .00 $ 110,159.55 $ 99,859.88 ..~ g ,_ S _ ~... }~ Income Cash: Univested Market Square Cash Manager 1 $ 73.82 600.00 $ 73. 2 $ 110,159.55 673.82 $ 110,833.37 $ 73.82 600.00 $ _` 73. 2 $ 99,859.88 673.82 $ 100,533.70 ~~~ ~s Dauphin Deposit Bank and Trust Company, Guardian of the Estate of Rosemary L. Dean, an Incompetent, declares under oath that it has fully and faithfully discharged the duties of its office; that the foregoing Accounting is true and correct and fully dis- closes all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the Estate; and that all taxes presently due from the estate have been paid. Dauphin Deposit Bank and Trust Company rust Officer Subscribed and sworn to before me this ,~'~ day of ..,~`~ s'r r , 1888 ~~ _ ti _ ~ , Diotar.~~ubli~'?, , ~.~ -+ n~;~~v aN~ AFaGe~B~N. uoTA~rfrt~sti~_ N;~f:?~C,'i~~dG.;,G~U?l+I~i CfUNF~Y; PA ii,e;, F; r ;;~.ur~;a 1.5s°uc~a4+on *1,f,f'+~~r;as i ',' ~ __ ,,fir. .- lJ• ~ 2 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION N0. 21-70-239 FIRST AND PARTIAL ACCOUNT OF Dauphin Deposit Bank and Trust Company, Guardian For ESTATE of Rosemary L. Dean, An Incompetent Date of Court Order: May 05, 1975 Accounting Stated for the Period: June 03, 1975 to April 11, 1988 Purpose of the Account: Dauphin Deposit Bank and Trust Company, Guardian, offers this account to acquaint interested parties with the transactions that have occurred during its administration. The account also indicates the proposed distribution of the estate. It is important that the account be carefully examined. Requests for additional information or questions or objections can be discussed with: Dauphin Deposit Bank and Trust Company 213 Market Street P.O. Box 2961 Harrisburg, PA 17105 (717) 255-2087 SUMMARY OF ACCOUNT Principal Receipts Net Gain (or Loss) on Sales or Other Disposition Less Disbursements Balance before Distributions Distributions Principal Balance on Hand For Information: Investments P",ade Income Receipts Less Disbursements Balance before Distributions Distributions Income Balance on Hand For Information: Investments Made Combined Balance on Hand Current Fiduciary Value Acquisition Page 04/11/88 Value 3 $ 119,201.97 3 836.94 ~ 120,03 .91 4 4,820.23 $ 115,218.68 4 15,358.80 5 ~ 99,859.88 5-6 $ 90,452.85 6 81,029.03 $ 9,423.82 6 8,750.00 $ 673.82 7 $ 110,833.37 $ 100,533.70 2 RECEIPTS OF PRINCIPAL Assets Listed in Inventory per Copy attached Receipts Subsequent to Inventory 07/31/75 Metropolitan Life Insurance Policy 01/15/76- Transferred frccn Income 03/01/88 Total Receipts of Principal GAINS AND LOSSES ON SALES OR OTHER DISPOSITIONS Net Proceeds 06/15/81 $10,000.00 G. D. Searle & Company 8% Note due 06/15/81 $ 10,000.00 12/01/82 $10,000.00 Manufacturers Hanover Trust Corp. 8.375% Note due 12/01/82 10,000.00 12/17/84 $10,000.00 Smithkline Corp. 8.15 Note due 12/15/84 10,000.00 06/03/85 $10,000.00 Union Oil Co. of California Debentures 8.375% due 06/01/85 10,000.00 04/06/87 50 units Common Stock Collective Investment Fund 813.75 05/05/87 494 units Fixed Income Collective Investment Fund 5,009.75 Totals $ 45,823.50 Net Gain (or Loss) Transferred to Summary Fiduciary Acquisition Value $ 46, 124.73 1.00 73,076.24 $ 118,201.97 Fiduciary Acquisition Gain Value (or Loss) $ 9,975.00 $ 25.00 10,000.00 10,000.00 9,950.00 545.67 4,515.89 $ 4 ~9~~ 0.00 0.00 50.00 268.08 493.86 $ 836.94 -, ~ ~ n 3 DISBURSEMENTS OF PRINCIPAL General Disbursements 06/19/75 Richard E. Anderson - Cost of Filing Inventory and Appraisement 07/11/75 Pauline Haber - Notary Fees 08/29/79- Transfer to Income 03/18/88 Total Disbursements of Principal DISTRIBUTIONS OF PRINCIPAL 10/21/82- Robert E. Dean f/b/o Rosemary L. Dean 11/19/87 Total Disbributions of Principal PRINCIPAL BALANCE ON HAND Cash: Uninvested Market Square Cash Manager 1 Securities: 8,914 units Fixed Income Collective Investment Fund 1,167 units Common Stock Collective Investment Fund Miscellaneous Metropolitan Life Insurance Co., Insurance Policy ~ .. I _ ~ ^l ~ r 4 $ 3.00 1.00 Current Value 04/11/88 4,816.23 $ 4,820.23 $ 15 , 358.80 $ 15 358.80 Fiduciary Acquisition Value $ 35.77 $ 35.77 5,600.00 5,600.00 87,336.70 17,186.08 81,487.07 12,736.04 1.00 $ 110,158.55 1.00 $ 99,859 INFORMATION SCHEDULES - PRIPICIPAL Cost Investments Made 06/09/75 $10,000.00 Smithkline Corp., 8.15 Note due 12/15/84 $10,000.00 06/17/75 $10,000.00 Union Oil of California 8 3/8% Debenture due 06/01/85 9,950.00 06/23/75 $10,000.00 Searle & Company 8~ Note due 06/15/81 9,975.00 07/02/75 $10,000.00 Manufacutrers-Hanover Trust 8 3/8 ~ Note due 12/01/82 10,000.00 Various Dates Market Square Cash Manager 1 5,600.00 Various Dates 8,408 units Fixed Income Collective Investment Fund 86,00?_.96 Various Dates 1,217 units Common Stock Collective Investment Fund 13,281.71 RECEIPTS OF INCOME 08/29/78- Transferred from Principal 03/18/88 $ 4,816.23 10/03/79- Interest: Market Square Cash Manager 1 04/04/88 6,211.27 06/17/75- Interest: $10,000.00 Union Oil of California 8 3/8% 06/03/85 Debenture s due 06/01/85 8,340.07 07/02/75- Interest: $10,000.00 Manufacturers-Hanover Trust 8 3/8% 12/02/82 Note due 12/01/82 6,220.76 06/23/75- Interest: $10,000.00 Searle & Co., 8% Note due 06/15/81 06/16/81 4,793.33 5 06/18/75- Interest: $10,000.00 Smithkline Corp., 8.15% Note 12/18/84 due 12/15/84 07/03/75- Interest: Fixed Income Collective Investment Fund 04/05/88 02/02/80- Interest: Common Stock Collective Investment Fund 04/05/88 Total Receipts of Income DISBURSEMENTS OF INCOME 11/20/75- Dauphin Deposit Bank & Trust Company - Commission 02/17/88 01/15/76- Transferred to Principal 03/01/88 02/23/76- Personal Property Taxes 03/10/88 06/03/76- Fee for Preparation of Income Tax Letters of Advice 06/29/87 Total Disbursements of Income DISTRIBUTIONS OF INCOME 03/03/77 Partial Payment for 1976 jointly filed Income Tax Returns - Robert E. Dean $ 225.00 06/23/77 Balance Due 175.00 11/25/83- Paid to Robert E. Dean f/b/o Rosemary L. Dean 03/10/88 Total Distributions of Income 6 7,616.46 48,766.15 3,688.58 $ 90,452.85 $ 6,229.31 73,076.24 1,533.48 190.00 $ 81,029.03 as~~:ec $ 400.00 8,350.00 $ 8,750.00 BALANCE OF INCOME ON HAND Cash: Univested Market Square Cash P4anager 1 INFORP~.ATION SCHEDULES - INCOME Investments Made Various Dates Market Square Cash Manager 1 Current Fiduciary Value Acquisition 0~1/ 11 /88 Value $ 73.82 $ 73.82 600.00 600.00 ~7~2 73. 2 Cost $ 600.00 7 Dauphin Deposit Bank and Trust Company, Guardian of the Estate of Rosemary L. Dean, an Incompetent, hereby declares under oath that it has fully and faithfully discharged the duties of its office; that the foregoing Accounting is true and correct and fully discloses all significant transactions occurring during the accounting period; that all known claims against the estate have been paid in full; that, to his knowledge, there are no claims now outstanding against the Estate; and that all taxes presently due from the estate have been paid. Dauphin Deposit Bank and Trust Company Trust Officer Subscribed and sworn to before me ,.. this ,/~' day of ...~~ ~ ~ , 1988 ,; ~. >~ tary Public ` ~., MAR'! ANN ANDERSGN: NOTfiRY ~J~LTC.: NAR??B±IR ", DR(NPt?}N COI,FITY~ ,. Eder 1 'r. ~'~'~~ "yaYr.u. `ssc~~+aii ~ ~ ~t f:~; _..._ n - -r U.,. 8 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, P A In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 PETITION TO MODIFY GUARDIANSHIP TO THE HONORABLE, THE JUDGES OF SAID COURT: The Petition of Robert E. Dean seeks (1) permission for Manufacturers and Traders Trust Co., the Guardian of the Estate of Rosemary L. Dean, to use principal from Rosemary's guardianship trust account to help pay her nursing home and related expenses; and (2) to confirm that this trust account is "an available asset," when calculating the protected share of assets of the community spouse for medicaid application purposes. In support, Petitioner respectfully represents: 1. The Petitioner is Robert E. Dean, and Robert E. Dean as agent under a power of attorney for his incapacitated wife, Rosemary L. Dean. The power of attorney is dated December 16, 1996. A copy is attached hereto as Appendix A. 2. Petitioner's address is: Robert E. Dean 90 Wedgewood Circle Etters, PA 17319. 717-938-4708. 3. Rosemary is a patient at Manor Care Camp Hill 583, 1700 Market Street, Camp Hill, PA 17011, where she has resided since November 5,2003. She does not have a phone. 4. Petitioner's attorney is: S. Berne Smith, Esq. 107 N. 24th Street Camp Hill, PA 17011-3602 t'-> () g 717-737-6789. C;o ~ ~ r1 5. Manufacturers and Traders Trust Co. is Guardian of the Estate ofRosenj~E. I5&an -"-: ~n &"" and as such is a party in interest in this Petition. Its address is: :..r) ~~ _ -0 11 Sue Mauery, Vice President _ . . ::0 fTl (-") C) :n '0 \1 n-, o C)O "\" -rl ,~ .,.., :c2: C) r--::- r n V) l...:'::> -Tl 1 CJ1 W Trust Officer, Manufacturers and Traders Trust Co. 213 Market Street Harrisburg, PA 17101-2127 717-255-2051. 6. Rosemary was born November 21, 1939, and is 67 years old. Robert was born July 8, 1935, and is 71 years old. Robert and Rosemary were married July 2, 1966, and are still married. One child was born to the couple on December 21, 1967, a son, Michael. 7. In July 1968 ,Rosemary, then28 years of age, suffered severe brain damage from a stoke and was paralyzed, rendered unable to read or write, and impaired in speech. Robert cared for her at their home from the time of her discharge from the hospital until September of 2002, when she suffered another massive stroke. 8. As a result of her disabilities from the initial stroke in 1968, in 1970 a Petition for Appointment of a Guardian of her estate was filed by Robert and granted, appointing Dauphin Deposit Trust Company, Harrisburg, PA, guardian of Rosemary's estate. A copy of said petition and related items is attached hereto as Appendix B. 9. In March, 1970, suit was brought on her behalf against various parties for negligent prescription of a medication which allegedly had caused her stroke. In 1975, a settlement was reached. A copy of the Petition for Approval of Settlement is attached hereto as Appendix C. The net settlement proceeds ($46,124.73) were placed in a Guardianship account at Dauphin Deposit Trust Company far Rosemary. It is this guardianship account, now managed by Manufacturers and Traders Trust Co., that is the subject of the present petition. 10. Rosemary was able to live at home in Etters with her husband, Robert E. Dean, until the last Sunday in September 2002, when she suffered another massive stroke which basically left her unable to speak, see, eat without a feeding tube, or otherwise be responsive. Since October 15, 2002, she has been confined to nursing homes. She was first moved from the York Hospital to The Woodlands Nursing Home and was in its skilled nursing unit until the home went into bankruptcy and closed. On November 5, 2003, Rosemary was moved to Manor Care Camp Hill where she remains to this day. 11. Until May 5, 2006, Rosemary's expenses at the Woodlands and Manor Care nursing 2 homes were paid by insurance. The insurance payments ended May 5, 2006, and an application for long term care medical assistance (hereinafter, Medicaid) was filed on behalf of Rosemary with the Cumberland County Assistance Office and assigned case number 110162. 12. Under date of August 31, 2006, Rosemary was found not eligible for assistance because her total countable resources as of May 4, 2006, exceed the allowable resource limit by an amount of $86,761.35. A copy of the August 31, 2006, letter with its enclosures from the Cumberland County Assistance Office to Robert Dean is attached hereto as Appendix D. The letter notifies the Deans that before Rosemary will be eligible to receive Medicaid, the couple's available resources must be reduced by $86,761.35. 13. The largest available asset of Rosemary and Robert is the Manufacturers and Traders Trust Co. Guardianship trust account. It is listed on the Assessment Computation sheet, page 3 of Appendix D, under code 5 -Robert - M&T Investments 1254292205 in the amount of $147,488.63. This guardianship account is managed by Manufacturers and Traders Trust Co., and the amount varies daily. Attached hereto as Appendix E is a statement of the account as of August 31, 2006, showing a balance at that date of $148,506.20. Manufacturers and Traders Trust Co. is the successor bank to Allfirst Trust Company, which was the successor bank to Dauphin Deposit Trust Company. In its successor capacity, Manufacturers and Traders Trust Co. is the present guardian of the estate of Rosemary. 14. Manufacturers and Traders Trust Co. has no objection to and joins in this Petition. See Appendix F attached hereto. 15. Because the insurance payments are no longer available to pay the nursing home expenses, money from the Manufacturers and Traders Trust Co. Guardianship account is needed to pay Rosemary's expenses until she becomes eligible for Medicaid. Since May 4, 2006, Robert has paid Manor Care Camp Hill $1,988.00 from his checking account. However, as of August 3 1, 2006, Manor Care Camp Hill is still owed $22,650.00 for Rosemary's care. See Appendix G hereto, a copy of Manor Care Camp Hill's statement as of August 31. 16. In order for Manufacturers and Traders Trust Co. to pay Manor Care Camp Hill, it will have to use principal from the guardianship account, and it has asked Petitioner to file the instant petition to get authorization from the Court for the bank to do so. 3 17. In order for Rosemary to be eligible for Medicaid, the couple must spend down the excess resources and then re-file their application for Medicaid. The most liquid of their resources, in additional to the checking and saving accounts, is the Manufacturers and Traders Trust Co. Guardianship account. Over the years since the account was established in 1975, periodic payments from the account have helped to support them, particularly during periods of special need when Robert was unemployed or ill and after his retirement in 1995. Therefore, Petitioner asks that Manufacturers and Traders Trust Co. be authorized to make payments for the nursing care of Rosemary until the couple's excess resources are reduced to the protected community spouse's share of $99,540.00 for Robert and of $8,000.00 for Rosemary as shown in Appendix D. WHEREFORE, your Petitioner prays (1) that Manufacturers and Traders Trust Co. be authorized to make payments for the nursing home care and related expenses of Rosemary L. Dean; and (2) that the guardianship account be terminated after the pay down of the excess assets has been completed, and that the balance be paid to Robert E. Dean and be deemed to be a protected asset for his community spouse share if, and when, a further Medicaid application is filed on behalf of Rosemary L. Dean. 1~ Robert E. Dean, Petitioner, for himself and Agent under a Power of Attorney for Rosemary L. Dean COMMONWEALTH OF PENNSYLVANIA: COUNTY OF YORK Robert E. Dean, being first duly sworn, deposes and says that he is the Petitioner, in his individual capacity and as agent under a power of attorney for Rosemary L. Dean, in the 4 foregoing Petition to Modify Guardianship and that the facts set forth therein are true and correct to the best of his knowledge, information and belief. ~ ~~ Ro ert E. Dean Sworn and subscribed to before me this day of September, 2006. Notary Public My commission expires: -7 - 3 1-~ Seal COMMONWEALTH OF PENNSYLVANIA Notarial 3ea1 Patrk~a A. Gordon, Notary Pub4c Fairview Twp., York Coixriy My Conxniaebn E>q~ires July 31,2009 Member, Pennsylvania Asaociatbn of Notaries 5 TABLE OF CONTENTS TO APPENDICES: Appendix A Page 1 Appendix B Page 5 Appendix C Page 13 Appendix D Page 20 Appendix E Page 27 Appendix F Page 30 Appendix G Page 31 ~~ 5r~~ ~:y~y .~ ~', ~w ~,~ POWER OF ATTORNEY OF ROSEMARY L. DEAN /~ KNOW ALL MEN BY THESE PRESENTS, That I, ROSEMARY L. DEAN, of 90 Wedgewood Circle, Etters,York Co', Pennsylvania 17319 have made, constituted and appointees my husband, ROBERT E. DEAN,cof the same address, and my sister, Margaret T. Bennercof 1369 Yorktowne Road, Mechanicsburg, Pennsylvania 17055 my true and lawful Attorneys, in my name, place and stead, from time to time, and at all times until revoked, the following powers to be exercisable at any and all times by any one (1) or more of said Attorneys-in-Fact: (a) To make gifts; (b) to create a trust for my benefit; (c) to make additions to an existing trust for my benefit; (e) to disclaim any interest in property; (f) to renounce fiduciary positions; (g) to withdraw and receive the income or corpus of a trust; (h} to authorize my admission to a medical, nursing, residential or similar facility and to enter into agreements for my care and to authorize medical and surgical procedures; (i) to engage in real property transactions; (j} to engage in tangible personal property transactions; (k) to engage in stock, bond and other securities transactions; (1} to engage in commodity and option transactions; (m} to engage in banking and financial transactions; (n) to borrow money; (o) to enter safe deposit boxes; NCT APPLICABLE FOR P1N NUMBER BDDl; 1 r~~ f a9E ~a$S`~ ~~S~N ~t~ ~~ (p) to engage in insurance transactions; (q) to engage in retirement plan transactions; (r) to handle interests in estates and trusts; (s) to pursue claims and litigation; (t) to receive government benefits; (u) to pursue tax matters. My Attorneys-in-Fact may generally do and perform all matters and things, transact all business, make, execute and acknowledge all contracts, orders, writings, assurances and instruments which may be requisite or proper to effectuate any matter or thing appertaining or belonging to me, with the same powers and to all intents and purposes with the same validity as I could if personally present. It is my intention in this pazagraph to give my Attorneys-in-Fact the broadest possible power, without limitation to any of the kinds or classes of matters or powers specifically enumerated above. I give to my said Attorneys full power to do and perform every act whatsoever requisite and convenient to be done in the premises as fully as I could do if personally present, hereby ratifying all that any one (1) or more of my said Attorneys shall do, or cause to be done, by virtue hereof. This Power of Attorney shall not be affected by disability of the principal. At the time I am eaecuting this Power of Attorney form I am unable to sign my name due to a physical handicap. I am putting my Mark on the document in lieu of my signature, pursuant to the provisions of § 5601 (a) of Title 20 of the Pennsylvania Consolidated Statutes, the Probate, Estates and Fiduciaries Code. A photocopy, xeroxcopy, or other copy of this Power of Attorney shall be as effective for all purposes as a manually executed and acknowledged copy. - 2 - TN WITNESS WHEREOF, I ROSEMARY L. DEAN have hereunto set my hand and seal by making my Mark on this /6'~z~ay of December, 1996. ROSEMARY L. DEAN (Seal) Her Mark (Subscription of e} In the)presence of: ~~ COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND On this IUD day of December, 1996, before me, a Notary Public, in and for said Commonwealth and County, personally appeared ROSEMARY L. DEAN, personally known to me; or satisfactorily proven to me, to be the person whose name is subscribed in the within instnzment and acknowledged that she executed the same by setting her Mark thereto for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. ,-~~~ (~ , /~1".//1~~~. / - ~ ~ ~t~- ~ ~ .. Notarial Sea{ M Commission Ex 1reS: Laure E. Kane, Notary Public Y P Camp HiH Boro, Cumberland County My Commission Expires Nov. 15, 1999 Member. Fennsylva,niz PSSr?r~21i^:n nr Mpt~ries (SEAL) - 3 - .~ YORK COUNTY RECORDER OF DEEDS 100 WEST MARKET STREET YORK, PA 17401 Randi L. Reisinger -Recorder Gloria A. Fleming -Deputy Instrument Number - 2006023456 Recorded On 3/27/2006 At 1:19:23 PM * Instrument Type -POWER OF ATTORNEY Invoice Number - 614225 * Grantor -DEAN, ROSEMARY L * Grantee -DEAN, ROBERT E User - JDB * Customer -ROBERT DEAN * FEES STATE WRIT TAX $0.50 RECORDING FEES $13.00 COUNTY ARCHIVES FEE $2.00 ROD ARCHIVES FEE $3.00 TOTAL $18.50 ,:,u•. ~t....w.r ...r.. N`,Y d Book -1799 Starting Page - 6885 * Total Pages - 4 I Certify This Document To Be Recorded In York County, Pa. ~Ea ' RE~o ga ~o ~`~ C~!7j ~. Fa. ~'~~~ ~o vP Recorder of Deed R~CpUN~~~ THIS IS A CERTIFICATION PAGE PLEASE DO NOT DETACH THIS PAGE IS NOYV PART OF THIS LEGAL DOCUMENT * -Information denoted by an asterisk may change during the verification process and may not be reflected on this page. Book: 1799 Page: 6888 ,,,,-~ ' ~. ~. F~'d ~ ~ : ~... 3~F~'.~~.N. i~ill~~Lac1 ,1racE~~-zi~sat~nt Tn tae Gnurt of Cbrnn'~nA Plea~a of Gurn1~®rtand Cc7u~zty. T~enn~.. ~ L?rphens~' Gourt I?ivitaion FsT;1"T'3.'TC?]:`+1 ~'t31~ ~i~pQg`~~T` Q. A iGT3A~~iIAN ~'~ T E~'iCfTZt~-itAT37..U, TI.3~ J€JI?~3~5 ~}T+' GOiJk~'T's ~'hQ Frstition of Ro~aert Y/. T.?e~rt ros+poc~fully x~prc~eate: 2 - ~etitiogter i~ tii~ l~ue~b~c,~3 of R,o~~s.7n~rp L.. L~a~~z, botri of ~tI~lE7~'Cc rer~fdEy 1'3Y L,i~bth~u~~ T~+n#~. Yvi~rclEz~snfic.~~sux•~~ ~urxz~~xlancY Co~:nty ~'+~~us~ylva;r~i~.. Th® aai~ ~oaexyaary Y.,. Y~~an is thixty ye~.~ra of gee anu is 4.h~ r~:~Ea9ta~x b1 au~ ck.%Id; Tt~aictaa~l ~. ~~an, t~vr y~~r~ of sae. 3 - 7E'h~ arxid Fo~+s:x~xy L,. 3e~ar~; b~ca~tr~e of r:aes~tal i1lnr~s~. ire un~bla t~s :x:,~.n~~o iaor propezfy and i$ lie~b3e to Ei4a~ipate an~k k~erome the victiiza. cif i~~~3~txin~ p~reors~ . ~~~~ ~~t~t~ of tlxE s~aici YTcr~~rna~cp L. Lyga~ con~si~t~ oft ~ fr~lfocxrn~ xt~~:iw: ~:j Y~zisceLL~a~xme~u~~ pe~xs~~«..i l~xop~rty lxavi•n~ a worti3 a£ eeverr~Y i~~.rndred EicrlYaar~. 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'~ ~ its c~th~~ ~c~urE hs.~a a~'irvrz'r~d juxisdlc~~c~~x in ~ prc+tsac9fub . ~+~ cf~-t~sc~.~iru~ the cc~rs~p~t~a~~yv a~ the ara~d ~as~an~ixy I;.. %~~xi~. ~f'he ali~s~rec3 i:YCVxripa$~~ hax+ txo la~a~ ~vtazdfan e~f Mer e$tate p3i p@~~Qil. '4~'I3~I~~~"CJI~~", yoxar 1~'otit~anear pxr~pe thmt a Citation iague aar~ct~d ko kbe a.~]:~~ed ~~tctx~pat~F~i ~n ~~icwv caua,r4 ~vhy sb~ s~boutd nQt be ,}u~l~se«~ ~~ inco~upctc~n.L ~d ~. $aa~.r~diaza ai her es~tatcs be a~apainie~r~. L - - -- -rf / ~~: ~tctbet~ ~..I~aan. iaaiug €i.rat duty e~+rora, d~poe+~$ and says that rrs i~ the ~+~tft:'srtn:er #n tine ~fa-x~~t~tazzl~ ~'atitit~~i for .~ppof~xanant o! ~ Gurirciias~ 8nc that tt~ fuCt~ acct forti~i th~refu are true and correct tt~ ~$ beet of hiss l;.tac~wl~d~~. fnft»rt~~:~fc~rn ~. h:~14~a~'_ extended Page 2 7 l~~ocr~wl~d~~, frr.~a~ra.~fc~n 8~ b~lfl~~'. mil- ~~i~--~- `~?` ~ ~ -~-~-E=-.L, .1 ~~varn c~nd ,~v-b~+crf~~~. td ~+e~or~a s~~ thus I~obesrt ~. Ttears ~ ~' I P~crt~xy z~~ltic ~.,.~ .. 7 ZN l~ ~; E5'~~.~~ C?~' ~.+4~'lEI~f.A.~:Y ~. ~i~AI:I',_ ~iXa,~ed Incorn~satoret r fn the C©urt cyf Gonxmon Plar~~ of GurYxb$rlazsci County, henna. r f~rphan$' G+~urt Iiiwi~ti+~n s P~7v, ~-1- ~o ' ~ 3 ~ }~au~xhir~ I~~~aosit ~r~~ C±a~xpar~y deae~ har~b~r certify that it muirita#n~ o~fir~~ ~.n th~r C~avnty of Cu~xabarla~nd, Par-nsylvaxtfa; that ft fe not the ff~lucfary ~f mnX ~st~-t~ ref #ha a~i~~~d 9;nca~xapstant a~ has x~o int~reet advera-~ to this paid t~lYag~d inc~r~r~pot~~t; anal it dose h~r~abg agree to acce~as the appo~~merat ~.~ u~x~rdnr~n a~ Chi ?:~,~tato o€ Ros~arx~~,~y .~... ~+~su, sn .~i.~eged ,cxYapat+~nt. r~~up~v ~~~c~~~ rz~u~~ c~~z~~r~x ~~ ~(. r ~~C C il/ - //'LL ~ ~ ;L2 ~-;~' f ~ /'t-Lw ~ '~/`~ ewe ~ ~ (' 8 j... ~Y,v k,,;var.y. ~t ~;,[1J.r.~~ti117(l~ f,}~6iS39f i1V AE: ESTATE Oi~' R©SEh~1~.EtY L DEAI~I', Alleged Incorn.petent In the Court of Comu~non Pleas of Cumberland County, Penna. Clxphans' Court Division No. .2/- 70 ~ ~3 ~ PREx.IMI1~IARY DECREE: AT3D NOW, April ~, 1970, uppn consideration of the annexed Pet~;tion, it is C'7rderQd and Decreed that ss Gitatiosa: be award®d, directed t,~ Rosemary 1.,. Demn, to ahc~v cause vuhy the ~ahould not be adjudged an incompetent a:nd a guardian of her est$te appointed; hearing to lac held s.t the Court I-louse, Ce.rliel~, Pennsylvania, oa ~~' ~~. S~ / % ? ~, as / ; 3 d o'clock. ~'~ ~ _ At 1ea.st c-,--.~- ~-~t~ _____ notice of the hearing ®hall be given to Rosemary L. TJean, tl~e alleged inctixnpetent by personal aQrvice. ~Y T1-iE C©UR'T: I ~ '' ~ ~~ IN RE= _ s ESTATE OF' R4SF.MAP.Y L. DEAN a AI,LFCED INCOt9PETET7T e CITATION IN TFiE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA. ORPHALdS' COURT DIVISION N0. 21-70-239 WE CUMMAND, you that laying aside all, business and excuses whatsoever, you be and appear in your proper person before the Honorable Judges of the Common Pleas Court, Orphans' Court Division gat a session of the said Court there to be held, for .the County of Cumberland to-show cause why she should not be adjudged an incompetent and a guardian of her estate appointed] hearing to be h®L:3 at the Court F~ouse, Carlisle, Penn~s~lvania, on May 5, 1970 at 1:30 o'clock, in Court Room 1. At least 5 notice of the hearing shall be given to Rosemary L.l~ean, L-he alleged incompetent by personal service. Witness my hand and official seal of office at Ca,rl3~le, Pennsylvania this 28th day of April, 1.970. ~jClerk of Comanon Pleas; Court, ~ Qr~aha~s' ~ Court vivisian,Canisle,Pa,~'~P~ , My Com-nis.s~ic~z~ Expires ~~~"~ 1st. Mori~.~T~in`.~~1~7A. ~~ ~,: .; _ ~ ~ .. ~ .. .. .. " e. ..., ,_ .... t _. ~~ ~i~d,:~ ii ROB ~'r'l'1JZX :G . n_~,~r:; ~ a ~Cncompet~~ n ~= by DAC12fi PJ D~iPOS-r`i' TRUST COP•:P~1.IL h?r Guardi~in Zncl f~~V ifZ~.~' ~. _ Df:.ii23 f Plaintiffs tr J . ROBERT STEVENSOiI, et al, Defendants :Ci'~i i'ii~? COUt 1 O' G'~r'i'~_Ci`i i u~;-~~i D~~iJPfi.L!; COu~iiX, PECit?SYL~/~•;I=1 ido. 10":0 "~p,C(~ T~i.•(, 197(1 Ira TP.ESPASS PETITION I'OR APPROVAL OF SETTLEP.IL~1T The petition of Robert. E. Dean, by his attorneys, Hurwitz, Klein, Benjamin & A_ngino, represents: 1. He is one of the Plaintiffs in the above action. 2_ Said action cvas instituted to recover da;nages for brain damage allegedly causing and resulting to petitioner's ~•rife from the use of her upon the prescription of defendants of birth control pills which it is alleged was negligently prescribed by defendants. The claim was a strongly disputed one and would have been strenuously contested. 3. That on April l~, 1975, trial t,ras co<<enced t~efore F~is Honor Judge ~Jilliam B_ Cald~,ell wro heard testimony as presented by plaintiffs an the lial~il? ~y iss>>~. Lefore compl~>t=ion of `the presentation of plair_tiifs' c~~se on the ]_tabtli(~y, -L-tle partzes agreed to se.ttlr th~~ c.a~~e for the SUi:{ r' Cl: ~~` ~'l~lt ~~--tl_t.%(_ T1~O;:.-„ i?C'L r. r ~ ` t 'I i .,G ~.v ~i.c t{~frrovral c>~ }rou2- uonnr~{b:Lc Co{:irt. 1~ 4. Pursuant to said agreement of settlement, the said Judge Caldwell heard testimony Pram petitioner as to his clear and thorough understanding of the settlement and its legal effects of completely terminating the action, and his further understanding of the necessity of paying from said settlement the amount of Seventy-five Thousand ($75,000.00) Dollars attorneys' fees and costs incurred in preparation for the trial. 5. Your petitioner had retained the firm of Hurwitz, I{lein, Benjamin & Angino, who associated with Thomas L. Rutter, Esquire, to prosecute the action on a contingent fee agreement of 33 1/3~ of any recovery plus reimbursement of their costs. Petitioner i.s satisfied said agreement of settlement is and was a fair and reasonable one. 6. Petitioner to the best of his. knowledge and belief, represents that there are no outstanding unpaid medical bills in connection with his wife`s sickness-and consequent treatment therefor. Your, petitioner waives any share in the proceeds of said settlement in favor of his wife's estate.. 7. ~~7herefore, petitioner prays your Honorable Court to approve said settlement and allocate the amount thereof as follows: L.~ -2- TOTAL AP~IOUNT OF SETTLEMENT: $75,000.00 DEDUCTIONS: Hurwitz, Klein, Benjamin & Angino for Attorneys' Fees (33 1/3% of $75,000) $25,000.00 Hurwitz, Klein, Benjamin & Angino - Reimbursement of Expenses 472.36 Thomas L. Rutter, Esq. Reimbursement of Expenses 1,902.91 G7illiam Silvernail, M.D. (This expense is the result of Dr. Silvernail cancelling three days of surgery to come to Harris- burg from Dothan, Alabama, and includes his traveling expenses and expenses while in Harrisburg) 1,500.00 TOTAL DEDUCTIONS: $28,875.27 Balance to Dauphin Deposit Trust Company, as Guardian of the Estate of Rosemary L. Dean $46,124.73 8. Attached hereto is the written consent of Dauphin Deposit Trust Company, as Guardian for Rosemary L. Dean, to the settlement and the allocation of the settlement amount as stated above. Respectfully submitted, HURWITZ, KLEIN, BENJAMIN & ANGINO Attorneys for and in behalf of Petitioner, Robert E. Dean ~.~~ -3- xuSt~;MAttY L. DEAN, an Incompetent by DAUPHIN DEPOSIT TRUST COP•IPANY, her Guardian and ROBI,RT E . DEAN , Plaintiffs v_ ROBERT STEjTENSON, ALFRED J. SHERPdAN and JOHN B. GOEDECKE, Individually and as Partners, Defendants IN THE COURT OF COi`~11`JION PLEI~S DAUPHIN COUNTY, PEiJNSYLVAPiI11 No. 1040 ILIARCH TER1~I, .1970 IN TRESPASS JOIPIDER AND NO~V, ,~~ !"1~~ 1 1975, Dauphin Deposit Trust Company, Guardian of Rosemary L. Dean, an incompetent, certifies that it has read the foregoing Petition and joins in the prayer. thereof. DAUPHIN DEPOSIT TRUST COP~IPANY BY ~ l ~A~~ ~ ~~ N~~ t~ ~i ~ LC ~'S'-.~~cxrtJC ~~ !6 i COM.MON~r]EALTH OI' PENNSYLVANIA ) SS: COUNTY OF DAUPHIN ) Personally appeared before me, a Notary Public in and for said Commonwealth and County, ROIIEtT E. DEAP1, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct. ~. ~~~~~ ~ • Rq• ert- E. Dean Sworn to and subscribed before me this '~ ~' day of April, 1975. '~ ~- ' ~~ ~' /+' „~ • '' '' Notary Public ~~ ,. ~~ • ~;'~ ~•',' ~, P~1y~, Commission Expires February 6, 1978 ~'! ROSLP'IARY L. DEAN, an Incompetent by DAUPHIAT DEPOSIT TRUST COMPANY her. Guardian and ROBERT E. DEAN, Plaintiffs vs. ROBERT STEVENSON, et al, Defendants Ii1 TFIE COURT OF COMMOrd PLEAS DAUPHIN COUNTY, PEI.3NSYLVANI~'1 No. 1040 *R.ARCH TERP~i, 1970 IP~! TRESPASS ORDER OF COURT AND NOW, May Y 1975, the Court having heard testimony in the above action, as well as testimony of Robert E. Dean of his full and complete understanding of thQ settlement and its effect on the suit, as set forth in the foregoing Petition, and the Court being satisfied the settlement is a fair one, it is hereby ordered that. the said settlement in the gross sum of Seventy-f_ive Thousand ($75,000.00) Dollars is hereby approved. It is further ordered that said settlement amount shall be allocated. as follows: TOTAL AMOUNT OF SETTLE~I.ENT: DEDUCTIONS: Hurwitz, Klein, Benjatt:in & Angino Attorneys' Fee $25,000.00 Hurwitz, Klein, Benjarlin & Angino Reimbursement of Expenses 472.36 Thomas L. Rutter, Esq., Reimbursement o-c E:rpei:sE_s 1, 902 , 91 ~,1i11iam Siivernail, 1`'i. D. , ~-~_tness fee and ExpEr~ses 1,500.00 TOTAL DI;DUCTI0~1S BALA_7CE to Dauphin Deposit j D• Trust Company as Guardian of the Estate of Rosemary L. Dean $75,000.00 $28,875.27 $46,124.73 t Upon payment of the sums as set forth above to t11e respective parties by Defendants, Plaintiffs shall satisfy of record the above entitled action, execute any reasonable release requested by Defendants after all of which it is ordered that the action by discontinued with prejudice. BY THE COURT .7 . ~ ~ rlAi'@fJ~t C r'~~.4`~ ~~'ic2~: '119 ~OZ'8€;p~{lf; ~. ~ ~~'2.3 utxCX ~~C}X`I'',?C~i aop~ .p,~ `' ~.~ to 9~'• J~ ~~~ c ~~ iy~ ~-?xCL`2~#~ ~~ lQ i- ..~ - '~ ~~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, Pennsylvania 17013-0599 1-800-269-0173 717-240-2704 August 31, 2006 Robert Dean Re: Rosemary Dean 90 Edgewood Circle Record: 110162 Etters, PA 17319 Dear Mr. Dean: Rosemary Dean was found not eligible for long term care medical assistance because her total countable resources as of the May 4, 2006 requested effective date exceed the resource limit of $8000.00 ($2000.00 resource limit with a $6000.00 disregard). Resources on May 4~' totaled $186,301.35. After deducting the maximum protected spousal share of $99,540.00 resources totaled $86,761.35. In order for 1Vt~s. Dean to become resource eligible total resources must be reduced. Total resources include, and consist mainly of, the M&T Investment (guardian) account 1254292205. This asset is considered an available resource by the Department of Public Welfare and should be used for Mrs. Dean's care which includes nursing home costs. If you believe that the M&T Investment account should not be considered a resource available to Mrs. Dean please provide guardianship/ court documents stating the purpose of this account and that it is not to be used for Mrs. Dean's care. Until these documents are received we will have to continue to consider M&T Investment acco~.znt 1254292205 an available, countable resource. If you have any questions about this re}ection or the results of the resource assessment please feel free to call me at 717-240-2704. Thank you, .. ) ~ ~'~.i. c ~ r :/`. ~`~'~ Marcia Mikos, IMCW CC: Attorney Smith, Manor Care PA FS,82-4-04 NOTICE TO APPLICANT VLSI 1 IR F7 F(~FNT APPf IC'ATICIN. 1-IAC RFCnr PFi/IC1nYCn Anulvnl ro cr ,r_,o,r ,rv 1-800-269-0173 717-240-2700 DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE nEClee • • • - ® • 33 WESTMINSTER DRIVE BENEFIT ELIGIBLE ELNI ~B~ E PENDING P. O. SOX 599 CARLISLE, PA 17013-0599 ' ASSISTANCE CHECK After the first check which may be a special amount you will receive $ ~ Twice a Month ~ Once a Month ^ In the Ntail ^ At the Bank ^ MEDfGAL ASSISTANCE ~ ^ You have a patient pay liability of $ I for the eriod be innin and endin P 9~ 9 g ^ Effective Date FOOD STAMPS You wiL' receiva w a month from for the month(s) cf then you will receive food stamp; in the amount of S I to ^ In the Mail ^ At the Bank NURSING HOME CARE ,~ Level of care authorized you are expected to pay S a month Toward your care. SOCIAL OTHER ^ SERVICES ^ S eci ) THE FOLLOWING PERSONS ARE INCLUDED LINE NO. NAME ASST. CHECK FOOD STAMPS MED. ASST. SOC. SERVICE LINE NO. NAME ASST. CHECK FOOD STAMPS MED. ASST. SOC. SERVICE ~:~ ~ isy ..~ ~ ._ • ``~~~ I~C7 S~t:~(~.i ' '~/u-w> - ~ S •_~, _ s • • (~,,, 1.4~'C IS ~-~1:'u ll! ~L"1 5~.~! iC` ~ 7z+ • • ~ R~eg~ula~~tion ~. t _ ~ t~ ~., t Reason Code ~ ~, 'C:Y'k:~ ~r!Y1 ~.4 L'Y. J"I'~Lfc'.i,~al_5:,,~r ~S ~ t S ~ILLZ~7c~1, Cit. Y ~1:.:iX :a~'r_I` ~+...~~ . . . . . [~ FQOD STAMPS Number of Persons~- . . . . . [_] ASSISTANCE CWECK Numiser a1 Persons Name GROSS MONTHLY EARNED INCOME Name GROSS MONTHLY EARNED INCOME $ $ $ $ $ $ Name GROSS MONTHLY UNEARNED INCOME Name GROSS MO UNEARNED I NTHLY NCOME $ $ l $ $ ~~~ ' TOTAL GROSS MONTHLY INCOME $ TOTAL GROSS MONTHLY INCOME $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MEDICAL COSTS $ Telephone Water/Sewage 0 ME®1Ca1L ASSISTANCE Number of Persons Electric Garbage/Trash Name GROSS MGNTHL`r EARNED INCOME Gas Utility Installation $ ~~ ~ Oil Other GROSS UTILITY COSTS/UTILITY STANDARD" $ $ fl~ii RENT7MORTGAGE $ Name UNE~ANEDOWCONtE TAXES $ , $ //; ~ , /i INSURANCE COST ON HOME $ $ i TOTAL SHELTER COST $ $ ~~~ /~~ The household may switch between the aCfUai Uflilty COStS and .the TOTAL GROSS MONTHLY INCOME $ standard utility allowance at the time Of reappliCatlOn and One di i i l i d " NET MONTHLY INCOME/NET SEM!-ANNUAL INCOME $ ona ad t t me ur ng each twelve-month l ieriDd. INCOME LIMIT $ CO RECORD NUMBER CAT CTR DIG D1ST 21 f iC t l:. z.. i%,~ . Wit.. ' ;'~ ~ i. - ~1 Worker's Signature 'Date Telephone Number L J If you do not understand our decision or have any questions, contact your worker. LEGAL HELP IS AVAILABLE AT l LEfaAL SERVICES, INC. 8 IRVINE ROW CARLISLE, PA 17013-3019 717-243-9400 717-755-847r RESOURCE ASSESSMENT COM PUTATION SHEET PAGE ONE OF TWO Completed By: Marcia Mikos Institutionalized Spouse: Rosemary Dean County: Date ofAdmission: ' Cumberland Area: ;--~,~'12002 ountable eri ied CODE TYPE LOCATION OF RESOURCE -COMMENTS Amount Yes No 01 Cash on Hand $ 02 Savings Account Robert- M&T account 950557320 $ 15,948.98 X Savings Account $ Savings Account $ 03 Checking Account Robert- M&T account 1939793 $ 7,019.65 X Checking Account $ Checking Account $ Checking Account $ 04 ChristmasNacation Club $ ChristmasNacation Club $ 05 Stocks/Bonds Robert- MetLife stock 200 shares $ 4,754.00 X Stocks/Bonds Robert- M&T Investments 1254292205 $ 147,488.63 X Stocks/Bonds $ Stocks/Bonds $ Stocks/Bonds $ O6 Trust Fund $ Trust Fund $ 07 Burial Reserve Rosemary-Shalonis FH Irrevocable? Enter Y or N »> Y $ ended X Burial Reserve Irrevocable? Enter Y or N »> Y 08 Burial Plot Robert- hestnut Grove Exempt? Enter Y or N » Y $ e~ X Burial Plot Exempt? Enter Y or N » Y Life Insurance Rosemary-MetLife 640801588PR Face $ 5000.00 Cash $ 0 0.00 X 09 Life Insurance Robert-Prudential 22065405 Face $ 5,000.00 Cash $ 3,603.95 $ 2,603.95 X Life Insurance Robert-MetLife 666802890A Face $ 5,000.00 Cash $ 7,305.06 $ 7,305.06 X Life insurance Robert-MetLffe 872432962M1 Face $ 10,000.00 Cash $ 5,099.10 $ 5,099.10 X Life Insurance Robert-MetLife697120451A1 Face $ 10,000.00 Cash $ 10,311.48 $ 10,311.48 X Life Insurance Robert-MetLife 686328212A Face $ $10,000 Cash $ $5,126.46 $ 5,126.46 X Life Insurance Rosemary-MetLife 14037908A Face $ 1000.00 Cash $ 3366.60 3,366.60 X 10 Non-Resident Property $ 11 Motor Vehicle Robert-2000 M onom Exempt? Enter Y or N » Y e~s#u X Motor Vehicle Exempt? Enter Y or N » N 12 Other Vehicle(s) $ Other Vehicle(s) $ Other Vehicle(s) $ 13 Cert. of Deposit $ Cert. of Deposit $ Cert. of Deposit $ Cert. of Deposit $ Cert. of Deposit $ Cert. of Deposit SUBTOTAL VERIFIED COUNTABLE RESOURCE $ $ 209,023.91 2 RESOURCE ASSESSMENT COM PUTATION SHEET PAGE TWO OF TWO G®C!F!t~llle 4reri feed CODE TYPE LOCATION OF RESOURCE -COMMENTS Amount Yes No 14 Annuities $ Annuities $ Annuities $ Annuities $ 15 Savings Bonds $ Savings Bonds $ Savings Bonds $ Savings Bonds $ Savings Bonds $ Savings Bonds $ 16 Mutual Funds $ Mutual Funds $ Mutual Funds $ Mutual Funds $ 17 Sole Proprietorship $ Joint Partnership $ 18 Life Interest $ 19 Other $ Other $ Other $ Other $ SUBTOTAL VERIFIED COUNTABLE RESOURCES (page two) $ 0.00 SUBTOTAL VERIFIED COUNTABLE RESOURCES (page one) $ 209,023.91 8/31/06 Notification Sent 8/31106 Data Entered Verification/Documentation TOTAL COUNTABLE RESOURCES $ 209,023.91 PROTECTED SPOUSAL SHARE (MAXIMUM) $ 99,540.00 Preparer n; n Signature: ~ `l~Gt~~~~~---- Needed: 23 Commonwealth of Pennsylvania T~e~w meat cf P::~l:c iT;'et:::~ CUMBERLAND COUNTY ASST OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, PA 17013-0599 Telephone 240-2704 OR 1-800-269-0173 EXT. 3704 FAX: 249-8141 RESULTS OF RESOURCE ASSESSMENT Dear Mr. and Mrs. Dean: The Department of Public Welfare has completed the Resource Assessment received on August 18, 2006. Based on the information you provided, the total value of the countable resources owned by you and your spouse as of the date of your admission to the nursing facility is $209,023.91. A copy of the Resource Assessment Form is enclosed. The purpose of the assessment was to determine what portion of the total resources owned by you and your spouse maybe protected for the spouse at home. This portion is called the "protected spousal share" and is not considered available to pay for nursing facility care. This protected spousal share is generally one-half of your joint resources, up to a maximum, set by federal law (currently $99540) and not less than a minimum (currently $19908). Based on that formula, your protected spousal share is $99,540.00. Except as described below, you should apply for Medical Assistance when the total countable resources of you and your spouse are reduced to an amount approximately equal to the protected spousal share (above) plus $8004.00. In some cases, mare resources may be protected for the spouse at home. In order to be able to protect more resources, you must apply for Medicaid sooner and request a hearing. Information describing when you are permitted to protect more resources for your spouse at home was included in Part 3 of the Admissions Notice Packet you received from the Nursing facility when you were admitted. You should refer to this information if the income of the spouse at home is less than $2489 per month. If you need another copy of Part 3, contact the admission office of your nursing facility. It is important for you to calculate the monthly income allowance and actual monthly income needs of the spouse at home in order to appropriately protect resources and provide income to your spouse at home as permitted by federal law. The enclosed worksheet will help you in making this determination. Once you have applied for Medicaid benefits, either you or your spouse may request a fair hearing if you are dissatisfied with the Department's determination of the community spouse's share of resources or monthly income allowance, or to establish that your spouse should receive a higher income or resource allowance. If you have any questions about this letter, you may contact me by telephone at (717) 240-2704 or 1-800-269-0173 EXT. 2704 or by writing to the address above. Copies: Nursing Home Marcia Mikos ~~ ~ INCOME ASSESSMENT WORKSHEET You, the spouse living at home, are entitled to a minimum protected monthly income level. Currently, that level is $1650, plus shelter costs over $495, up to no more than a total of $2489. The following chart will enable you to compute your own protected monthly income level and your actual monthly income. The allowances for utility costs are based on a set standard, not on your actual costs. If you pay separately (for example, not included in rent) for heating and/or cooling and for other utilities you should enter $397.00 in the appropriate space in the chart below. If you do not pay for heating or cooling, but pay for other utilities (besides telephone service), you should enter $211. If you do not have any utility costs, but pay only for telephone service, you should enter $29. For all other shelter items, compute and enter your actual monthly cost, even if you pay on another time basis (for example, quarterly or annually). If you do not make payments for a specific item, leave that item blank. MONTHLY EXPENDITURES (1) UTILITIES ($397, $211, OR $29) (2) RENT (3) MORTGAGE (PRINCIl'AL & INTEREST) (4) REAL ESTATE TAXES (MONTHLY) (5) HOMEOWNER'S INSURANCE (MONTHLY) (6) CONDOMINIUM FEES (7) SUB TOTAL (ADD LINE 1-6) (S) LESS $495 (9) YOUR SHELTER COSTS (10) CURRENT FEDERAL BASE LEVEL (11) PLUS YOUR SHELTER COSTS (LINE 9) (12) TOTAL -MONTHLY INCOME ALLOWANCE (1) (2) (3) (4) (5) (E) (~) (8) -495.00 (9) (10) 1650.00, (1I) + (12) This total is the minimum monthly income amount which you are entitled to as a community spouse, under Federal Medicaid law. If your total is greater than $2489, the Department of Public Welfare will use the figure of $2489, because that is the maximum allowance under federal law. ,~-. S,~- -2- TO DETERMINE YOUR ACTUAL MONTHLY INCOME, USE THE FOLLOWING PROCEDURE: MONTHLY INCOME OF SPOiJSE AT HOME (13) SOCIAL SECURITY (13) (14) PENSIONS (14) (15) OTHER (15) (16) INTEREST OR DNIDENDS FROM PROTECTED SHARE OF RESOURCES* (FROM RESULTS OF RESOURCE ASSESSMENT(lE (17) TOTAL MONTHLY INCOME (1'n * Actual rate of return OR reasonable rate of return on a 1 year C.D. whichever is larger. Example: if a 1-year C.D. currently earns 3.% 1yr. and you have your standard spousal share of resources invested at a rate of only 1.5%, the Department of Public Welfare will use 3.% as the rate of return or interest. If the total on line 17 (your income) is less than the total on line 12 (your monthly income allowance) you are permitted to have more monthly income. For Example: if your protected monthly income level (line 12) is $2019 and your total monthly income (line 17) is : ~ 1200 you may seek additional income of : $ 819 If you want to protect additional resources for the purpose of producing this income, your spouse should apply for Medicaid now and request a hearing to establish that you need a greater share of the resources in order to bring your income up to the protected level. In the alternative, your spouse in the nursing facility can give you some of his or her income each month. Your spouse does not have to apply for Medicaid or have ~ hearing to do this. You should make sure that the total of your combined incomes is enough to provide the monthly income allowance. If you and your spouse choose to supplement your income through a monthly income contribution from your spouse in the nursing facility instead of protecting a greater share of yo~,zr resources, then your spouse does not have to apply for Medicaid until the total resources are reduced to approximately your protected share (indicated on the Results of Resource Assessment) plus $2400. REMINDER: The maximum protected amounts for both resources and income for the spouse at home is revised annually. ~-. 0 `` o M V O ~~ p N ~ ~~ ~O N`Lq V~ a W 0 N 4 dWJ ~ O~ ~F-Y W s~ d0~ ~ W N waa ~ © Kco ~°a ~ N K U ~ V w `~ ~ a o . w w S ~ 6 H ~ d O 27 W J U d_ 4f]~ W ~ ~Or' ywa d d N ~, w w 0 0 -~--- ~O~W r 1`•, t~ 1 if ~~ P ~ ~; r 11'1 >O ~ N W t Q l~L•1 T N W ~ N t~ r J 4 U N z 0 w ~w z os W n' I Cfl~ l I Ihf U~11 n~ fi nnn7 • ~ Ian r. ti 17 'CAN `Z g O Q 0. w O M O x U Y O ~ ~ ~ ~ 4 O ~o ~ to v f ~ ~ ~ ti z o ~ ~ s o ~ rn U O 4 U U Q O _O rx W d W 2 H O ~N J ON+ } ~ ~~ T w O F- S Z ,~ 2 O a ~' w A4 Z •d ~br l •~N + °o o I ~ ~° ,° 0 ~ t- ~ ~ Q ~' Ih r I t i 0000 000 t11t•70M Ou100 r p. .* O M '- -- ~ N W_ S a _ y V z o w H. w V m ~ ~ H z ¢ a ' m ~ y W W ti ~ F- D U = ~ O N y Q t /) O m V ~ ~ ~ O O K S ~ J ~- ~ CJ ti Q Q O W ~ O H W 2z Z m O D y J O Q W Z Z S 0. J 'E ~OeKH J !L S F .~fnWW 6 O W-W- Q C7 N N ~tr14 x '- U H~ 2 a N ~ m U C w W0 ~ z O p 4 . H apU F - m I O O ~~ ~~ O.7 ~~ } N _> M U a J r w W A z Q N ~ W ~ Q m K ~ F- dN H O M M O Y1 LI\ N Y1 w U x a m S 2 U W U 2 Q U W ~ Z 5 J K 4 ~ U O W Q F- + + IC(lUl I IAI + iuil/l•+, nnn~ •i ~~~ N w c~ d a d m d S Y ~ Q f ~ ~ N O .. z ° ~ `, o rp o d O rt W a W Y N O 4~ ~ ~ ~ ~b O M ? r 1 p ~ `~ LCD p ~ M N N O ~ ~ ~,. Y 4 f N z O 4 J U z O U a W J d H w Y d d S W W a y 4 '4 y v w ~ a z ~ ~; ~ ~ J 4 ,- sn ~ d ~ N z O m tD J d' ` Z ~ }.~ a W '~ y ~ z -- d a N W ~~ m 4 0 ~ w p -^ 62 `~ C~ U !.-" ~a -. .n Al ~n~3on~fi nnn~ ~~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 JOINDER TO THE HONORABLE, THE JUDGES OF SAID COURT: AND NOW, September ~ , 2006, Manufacturers and Traders Trust Co., Guardian of the Estate of Rosemary L. Dean, certifies that it has read the foregoing Petition to Modify Guardianship and joins in the prayer thereof. Manufacturers and Traders Trust Co. By ~ ~.~ l ~ ~~u-~ Sue Mauery, Vice President, Trust Officer ~© HCR•ManorCai~e MANORCARE CAMP HILL 583 1700 MARKET STREET CAMP HILL, PA 17011 (717) - 737-8551 MS. SUE MAUERY, VICE PRESIDENT TRUST OFFICER MST BANK 213 MARKET STREET HARRISBURG, PA 17101-2127 DEAN, ROSEMARY L. 5/4-5j31/06 5/4-5/31/06 5/4-5/31/06 5/15-5/31/06 06/08/06 6/1-6/30/06 6J1-6/30/06 07/10/06 7/1-7/31/06 7/1-7/31/06 08/07/06 8/1-8/31/06 ROOM CHARGE TOTAL INCONT-DLY FEE NTRTNL/ENTRL SERV GRP 2 WOUND TREATMENT PAYMENT FROM MR.DEAN ROOM CHARGE TOTAL INCONT-DLY FEE PAYMENT FROM MR.DEAN ROOM CHARGE TOTAL INCONT-DLY FEE PAYMENT FROM MR.DEAN ROOM CHARGE PAYMENT DUE UPON RECEIPT PRIVATE PAY ROOM 312-A 11/06/20C3 5,460.00 196.00 lz.oo 408.00 988.00 6,045.00 210.00 500.00 6,045.00 217.00 500.00 6,045.00 $22,650.00 ~. .~ RECEIPT FOR PAYMENT ------------------- ------------------- GLENDA FARNER STRASBAUGH Cumberland County - Orphans Court One Courthouse Square Carlisle, PA 17613-3387 DEAN ROSEMARY L File Number: 1970-00239 Paid By Remarks: S BERNE SMITH ESQ CMM ------------------------ Fee/Tax Description PETITION Check## 762 Total Received......... Receipt Date: 9/14/2006 Receipt Time: 15:13:24 Receipt No.: 1031380 Receipt Distribution ------------------------ Payment Amount Payee Name 15.00 CUMBERLAND COUNTY GENERAL FUN ---------------- $15.00 $15.00 3 S. BERME SMITH $~~ ~ ~ ~~~ Attorney-at-Law 107 N. 24"' Street Camp Hill, PA 17011-3602 PHONE: (717) 737-6789 FAX: (717) 737-6783 September 14, 2006 In re: Estate of Rosemary L. Dean, Alleged Incompetent, Orphans' Court Division, No: 21-70-239 Ms. Glenda Farner Strasbaugh Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 Dear Register: Enclosed you will find the original of a Petition to Modify Guardianship. The Guardianship pertains to the estate of Rosemary L. Dean and is not a guardianship with respect to her person. Her husband, Robert E. Dean, Petitioner herein, has a durable power of attorney for Rosemary. My check in the amount of $15.00 is enclosed for the filing fee. A proposed Order is attached to the Petition. You will note that all parties in interest to the petition have already joined the Petition. They are Petitioner, Robert E. Dean in his individual capacity; Rosemary L. Dean by her Agent under her Power of Attorney, Robert E. Dean, her husband; and M&T Trust, the Guardian of the Estate. Extra copies of the enclosed Petition and mailing envelops are submitted so that notice can be sent by the Court to Rosemary, to M&T Trust and to Robert E. Dean. We believe that this is all that is required. We respectfully request that this matter be assigned to a Judge and that hearing be scheduled as soon as reasonably convenient. Please note that I will not be available October 27-November 5, 2006, and respectfully request that no hearing be scheduled during this period. Thank you for your assistance. Sincerely yours, ~~ ,' S. Berne Smith Enclosures: cc: Robert E. Dean Robert E. Dean, Agent for Rosemary L. Dean Ms. Sue Mauery, Vice President, M&T Trust Co. Ms. Rebecca McCurdy, Manor Care Camp Hill S. Berne Smith Attorney-at-Law 107 N. 24th Street Camp Hill, PA 17011-3602 Phone: (717) 737-6789 Fax(717) 737-6783 Robert E. & Rosemary L. Dean Oct 17. 2006 90 Wedgewood Circle Etters, PA 17319 File #: 52002 Attention: Inv #: Sample RE: Robert E. and Rosemary L. Dean -Elder Law Matters DATE DESCRIPTION HOURS AMOUNT LAWYER May-10-06 Meeting with Bob Dean to review application 1.50 112.50 SBS filing for medicaid; scheduling meeting with Rebecca McCurdy at Manor Care to go over and complete the form. May-l 1-06 Meeting with Rebecca McCurdy to go over 1.20 90.00 SBS and begin to fill out Medicaid application and financial assessment forms. Jun-06-06 Meeting with Bob Dean to review information 0.50 37.50 SBS still needed to complete Financial Assessment Form. Jun-22-06 Meeting with Bob Dean and Rebecca 1.50 112.50 SBS McCrudy to complete Financial Resource Assessment form. Jul-07-06 Meeting with Bob Dean to review letter re 1.00 75.00 SBS additional data needed and to begin to collect the same; call to Rebecca McCurdy re need for further meeting with her. Jul-17-06 Meeting with Bob Dean to review additional 1.50 l 12.50 SBS data collected in response to County's letter. .Iu1-18-06 Meeting with Bob Dean and Rebecca 0.60 45.00 SBS McCurdy to organize data; need to deed the property back from Bob and Michael to Bob and Rosemary. Jul-31-06 Telephone conference with Bob Dean; attempt 0.50 37.50 SBS to reach Todd Blitz, preparation of deed. Aug-Ol-06 Calls, fax and letter to Todd Blitz re cash value 1.50 112.50 SBS information needed; unhelpful conversation with Todd Blitz; calling persons that Todd suggested with unsatisfactory results; call to ~xI11h ` i- Bob Dean re deed finished. I~~L I ~ :~'v l,~ Aug-02-06 Letter to Met-Life home office to try to get cash value information; meeting with Bob Dean re deed and request to get checks from December of 2004 re stock sale and payment for annuity. Aug-04-06 Further work on information needed. Aug-07-06 Meeting with Bob Dean to review deed and checks; need for additional financial information. Aug-08-06 Preparing summary of additional information requested by County. Aug- I l -06 Further calls re Prudential Insurance cash value; meeting with Bob Dean to try to expedite matter; review of information from Bank re MetLife stock check. Aug-17-06 Preparing addendum to Medicaid Application; meeting with Rebecca McCurdy and Bob Dean; putting application together and preparing cover letter. Aug-18-06 Meeting with Bob Dean re filing of medicaid application. Aug-25-06 Reviewing request for supplemental information from County Assistance Office; telephone calls to Bob Dean and to Marcia Mikos; gathering requested information and preparing addendum to the assistance application. Aug-28-06 Putting supplemental filing together; calls re scheduling a meeting with Marcia Mikos to go over the material obtained. Aug-31-06 Meeting with Marcia Mikos and Bob Dean to review Medicaid application; discussion of need for further spend down; calls to Sue Mauery and Rebecca McCurdy and need to petition court to modify guardianship. Sep-OS-06 Reviewing letter from County Assistance Office, denying Medicaid application; telephone conference with Bob Dean. Sep-06-06 Beginning preparation of petition to modify guardianship. Sep-07-06 Further work on petition and related documents; calls to Bob Dean, Sue Mauery and Rebecca McCurdy; fax draft of petition to M&T Bank. Sep-08-06 Review of Cumberland County Court Rules; telephone conference with Register of Wills to discuss filing of petition; draft of cover letter and letter to parties; revision of draft of Petition. 1.20 90.00 0.30 22.50 0.20 15.00 0.40 30.00 0.60 45.00 5.50 412.50 0.40 30.00 3.50 262.50 1.50 112.50 2.20 165.00 0.40 30.00 0.50 37.50 4.00 300.00 1.60 120.00 SBS SBS SBS SBS SBS SBS SBS SBS SBS SBS SBS SBS SBS SBS Sep-l 1-06 Meeting with Bob Dean to review draft of 1.00 75.00 SBS petition; noting corrections to facts; revision of draft; attempt to reach Sue Mauery and call to Rebecca McCurdy. Sep-13-06 Further revisions of Petition after message 0.80 60.00 SBS from Sue Mauery; faxing revised draft to her. Sep-14-06 Conference with Sue Mauery at M&T; 3.50 262.50 SBS preparing petition for filing and various cover letters; meeting with Bob Dean to sign and file petition in Carlisle; follow up letter to Register of Wills to send Hearing Order; preparing same and certificate of service; mailing copy to Sue Mauery. Sep-25-06 Reviewing Order scheduling hearing; call to 1.20 90.00 SBS client; letter to all parties; meeting with client; organizing file re guardianship and medicaid application. Oct-03-06 Responding to telephone message from Cathy 0.30 22.50 SBS Bosch, Trust Officer, in Buffalo, NY, office. Oct-OS-06 Telephone conference with Cathy Bosch re 0.80 60.00 SBS status of Guardianship Account for Rosemary; discussion of background and pending petition to modify Guardianship to pay bills and qualify for Medicaid; Cathy's suggestion that Court permission be sought for payment of legal fees to come from the Guardianship Account. Oct-06-06 Telephone conference with Sue Mauery at 0.40 30.00 SBS M&T Trust re additional bill from Manor Care for September and October; getting fax copy of the bill. Oct-18-06 Meeting with Bob Dean to prepare for hearing. 1.30 97.50 SBS Totals DISBURSEMENTS Photocopy Expense Postage Expense 41.40 $3,105.00 Disbursements Receipts 41.30 17.88 Totals $59.18 $0.00 Total Fees, Disbursements X3,164.18 Previous Balance $884.00 Previous Payments $884.00 Balance Due Now $3,164.18 S. BERNE SMITH Attorney-at-Law 107 N. 24"' Street Camp Hill, PA 17011-3602 PHONE: (717) 737-6789 FAX: (717) 737-6783 September 14, 2006 In re: Estate of Rosemary L. Dean, Alleged Incompetent, Orphans' Court Division, No: 21-70-239 Ms. Glenda Farner Strasbaugh Register of Wills Courthouse 1 Courthouse Square Carlisle, ~ A 170 ~ 3-3387 ATTENTION: COLLEEN Dear Register: Enclosed you will find a Hearing Order with respect to the Petition to Modify Guardianship that I filed with you today in the above proceeding. I am sorry that I misunderstood the instructions that I received from the Court with respect to the proposed Order that I was to attach to the Petition. I also want to confirm that copies of the Petition have been served on all parties in interest. A certificate of service is enclosed. We left with you address cards so that you can notify everybody of the hearing date. I am now enclosing a stamped return envelop for you to give me notice. Thank you for your assistance. Sincerely yours, S. Berne Smith Enclosures: cc: Robert E. Dean Robert E. Dean, Agent for Rosemary L. Dean Ms. Sue Mauery, Vice President, M&T Trust Co. Ms. Rebecca McCurdy, Manor Care Camp Hill IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS" COURT DIVISION No: 21-70-239 CERTIFICATE OF SERVICE S. Berne Smith, Esq., a duly admitted attorney in the Commonwealth of Pennsylvania in good standing, certifies that he has personally served a copy of the Petition to Modify Guardianship filed in the above proceeding September 14, 2006, on Robert E. Dean and on Robert E. Dean as Agent for Rosemary L. Dean, his wife, by handing him a copy of the Petition on September 14, 2006, and that he has served a copy of the Petition by first class mail, postage paid, on Ms. Sue Mauery, Vice President and Trust Officer, Manufacturers and Traders Trust Co., 213 Market Street, Harrisburg, PA 17101-2127, this same date by depositing same in the Camp Hill Post Office. Dated at Camp Hill, PA, this 14t~ day of September, 2006. /~ ti S, Berne Smith, Esq. Attorney LD. 07254 107 N. 24`" Street Camp Hill, PA 17011-3602 717-737-6789 i~ , '.. S. BERNE SMITH Attorney-at-Law 107 N. 24th Street Camp Hill, PA 17011-3602 PHONE: (717) 737-6789 FAX: (717) 737-6783 June 21, 2007 In re: Estate of Rosemary L. Dean, Alleged Incompetent, Orphans' Court Division, No: 21-70-239 Ms. Glenda Farner Strasbaugh Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 ~ C::) ~~ ~ ~:Fo ~ ::O~Fn N ~05~ N 000 > 09"" ::c: o~ - Enclosed you will find the original and a copy of a Petition to Terminate Guar~hip. 'I1ie Guardianship pertains to the estate of Rosemary L. Dean and is not a guardianship WRh respect2'd, her person. Her husband, Robert E. Dean, Petitioner herein, has a durable power of attorney for" Rosemary. My check in the amount of$15.00 is enclosed for the filing fee. A proposed Hearing Order is attached to the Petition, as well as a proposed order to terminate the guardianship. Dear Register: You will note that the Petition is on behalf of all parties in interest to the Guardianship. They are Petitioners, Robert E. Dean in his individual capacity and as Agent for Rosemary L. Dean by her Power of Attorney, Robert E. Dean, her husband; and M&T Trust, the Guardian of the Estate. I also want to confirm that copies of the Petition have been served on all parties in interest. A certificate of service is enclosed. Two sets of mailing envelops are enclosed so that notice of the hearing date and of the final order can be sent by the Court to Rosemary and Robert Dean and to M&T Trust and to me. We believe that this is all that is required. We respectfully request that this matter be assigned to a Judge and that hearing be scheduled as soon as reasonably convenient. Please note that I will not be available until July 17, 2007, and respectfully request that no hearing be scheduled during this period. Thank you for your assistance. Sincerely yours, ~ep--~ / 's. Berne Smith Enclosures: cc: Robert E. Dean Robert E. Dean, Agent for Rosemary L. Dean Catherine G. Bosch, Trust Officer, M&T Trust Co. " ~I."" ~1~ '.:::..:4 r:J rrl ;-'1 :.u CJ C"" ......" -,---, (~ rn \4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 CERTIFICATE OF SERVICE S. Berne Smith, Esq., a duly admitted attorney in the Commonwealth of Pennsylvania in good standing, certifies that he has personally served a copy of the Petition to Terminate Guardianship filed in the above proceeding June 21, 2007, on Robert E. Dean and on Robert E. Dean as Agent for Rosemary L. Dean, his wife, by handing him a copy of the Petition on June 20, 2007, and that he has served a copy of the Petition by first class mail, postage paid, on Catherine G. Bosch, Trust Officer, Manufacturers and Traders Trust Co., P.O. Box 1377, Buffalo, NY 14240, this same date by depositing same in the Camp Hill Post Office. Dated at Camp Hill, P A, this 21 st day of June 2007. ~8~.~ ~....., S, Berne Smith, Esq. Attorney I.D. 07254 107 N. 24th Street Camp Hill, PA 17011-3602 717-737-6789 "e ;s:~ co m (') :n r- :;..93 .,;:.;..cnA ona 00-n QC ; ::0 ~~ ~ c::::J c::;) -..I c.... c:: Z N N Ii (1'1 rT) ,:') (7,) (~:) ..",..;~ 7) ~~C~ rnrn ::D CJ o -n :!3 (-) rn x- X C5 .. ~; ./"> N N 't'O' f., IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA I n Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 PETITION TO TERMINATE GUARDIANSHIP TO THE HONORABLE, THE JUDGES OF SAID COURT: The Petition of Robert E. Dean and of Manufacturers and Traders Trust Co., the Guardian of the Estate of Rosemary L. Dean, seeks (1) approval of the attached final accounting of the Guardianship, (2) permission for Manufacturers and Traders Trust Co., (hereinafter M&T Trust) to terminate the Guardianship, (3) to make final distribution to a custodian account for the benefit of Rosemary L. Dean under the management of Robert L. Dean, Rosemary's Agent under a Power of Attorney, and (4) to discharge M&T Trust from further responsibilities as Guardian. In support, Petitioners respectfully represent: 1. The Petitioners are Robert E. Dean, Robert E. Dean as agent under a power of attorney for his incapacitated wife, Rosemary L. Dean, and M&T Trust, the Guardian of the Estate of Rosemary L. Dean. This is a followup petition to one filed September 14, 2006, at the same docket which sought, and was granted, permission to modify the Guardianship as part of a process to qualify Rosemary Dean for Medicaid Assistance. We respectfully incorporate by reference all of the factual averments in the prior petition and of the Order of the Court dated October 20, 2006, into the present petition to terminate the guardianship. A copy of the Court order is attached as Appendix A. 2. Petitioners' addresses are: , '<Id '08 GNf\B# l.'tlnoo ~~~ jO )\Q:J , 0"4 :0\ ",~"4~ ltOflUUi _~\'?" If'. {' " ' '" -I'.J . ~. -'.' , "--, , ~! t. ~ -) . . _., r, t,'"-..,t \.....\..'1 " .....^\ t \^ G,~.tt \tJ'd'J ~,u -j'JijjU .....J Robert E. Dean 90 Wedgewood Circle Etters, P A 17319. 717-938-4708 and Catherine Bosch, Trust Officer Manufacturers and Traders Trust Co. P.O. Box 1377 Buffalo, NY 14240 1-716-842-5545 1 ~' 3. Rosemary L. Dean is still a patient at Manor Care Camp Hill 583, 1700 Market Street, Camp Hill, PA 17011, where she has resided since November 5, 2003. She does not have a phone. 4. Petitioners' attorney is: S. Berne Smith, Esq. 107 N. 24th Street Camp Hill, PA 17011-3602 717-737-6789. 5. The Order of Court dated October 20, 2006, anticipated that Rosemary L. Dean would file a further Medicaid Application after the couple had spent down excess assets to meet the Medicaid requirements, and that once this was accomplished the M&T Trust Guardianship for Rosemary L. Dean would cease and remaining assets in the account would be turned over to Robert E. Dean, the community spouse. The followup Medicaid Application has been filed, and by letter dated June 12, 2007, and attachments thereto, the Deans were notified that the application was approved for medical assistance and nursing home care effective as of March 13, 2007. A copy of the Notice and attachments are attached hereto as Appendix B. 6. In compliance with Appendix B, M&T Trust is transferring to the account of Robert E. Dean from the Guardianship account #1254292205 the amount of $84,254.55, and is paying to Manor Care Nursing Home for the account of Rosemary the amount of $4,268.80 to pay the amounts owed by Rosemary for the months of March, April, May and June, 2007. 7. The balance of the Guardianship account will be paid by M&T Trust into a custodial account for the benefit of Rosemary L. Dean upon approval of this petition. Robert E. Dean, Rosemary's agent under her power of attorney, will manage that account going forward for her benefit. 8. The final account of Petitioner, M&T Trust, is attached hereto as Appendix C. 9. Petitioner Robert E. Dean in his own capacity and as agent for Rosemary L. Dean, has reviewed the final account of M&T Trust with respect to the Guardianship and has no objections to the account filed and to the proposed final distributions. 10. There are no other persons who have any beneficial interest in or standing to object to the relief sought in this Petition. WHEREFORE, your Petitioners pray that this honorable Court issue an order which 2 (1) approves the attached final accounting of M&T Trust with respect to the Guardianship; (2) grants permission for M&T Trust to terminate the Guardianship; (3) authorizes M&T Trust to make final distribution to a custodian account for the benefit of Rosemary L. Dean under the management of Robert L. Dean, Rosemary's Agent under a Power of Attorney; and (4) discharges M&T Trust from any further responsibilities as Guardian of the Estate of Rosemary 1. Dean. ~ ~ "- Robert E. Dean, Petitioner, for himself and as Agent under a Power of Attorney for Rosemary L. Dean. Manufacturers and Traders Trust Co. By (h~~J1. BO)~ Catherine Bosch, Trust Officer COMMONWEALTH OF PENNSYLVANIA: COUNTY OF YORK Robert E. Dean, being first duly sworn, deposes and says that he is a Petitioner, in his individual capacity and as agent under a power of attorney for Rosemary L. Dean, in the foregoing Petition to Terminate the Guardianship and that the facts set forth therein are true and correct to the best of his knowledge, inform~ .~ " '-.. Robert E. Dean Swo~d subscribed to before me this L 0 day of June, 2007. r p---~~ Notary Public My commission expires: 7'-.5 I .. La <:) 5' ~MONWEALTH OF PENNSYLVANIA Notarfat s8aI 3 Patrici$ A. Gordon. Ndary Public FairvieWTWI).. York County My Comrn8slon Expires July 31. 2009 Member I Pennsylvar\la AaeociatiOn of Notaries STATE OF NEW YORK: COUNTY OF ERIE: Catherine Bosch, being first duly sworn, deposes and says that she is Trust Officer on behalf of Manufacturers and Traders Trust Co., Guardian of the Estate of Rosemary L. Dean and that M&T Trust is a Petitioner herein in the Petition to Terminate the Guardianship and that the facts set forth above are true and correct to the best of her knowledge, information and belief. ~ --fLJ. clfuu~ 11. {6d:JcL Catherine Bosch Sworn and subscribed to before me this \ ~ day of June, 2007. ~/"1!kn- Notary Public 8Hl.::~~;}~ M. BLUM M .. . -'. ,". /:,,>.' ~"'e,u'(ork y commISSIon expl~s.:'J F\(':l;~;, .;.itE:~Ki OJ ,~. '11V S I " Q' r ~c;!;n';t~ in ;:I',~!~ County ea ''''"..."...~.u t.,........, .., My Commission Expires Sept. 3D. 20 \ ~ 4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 ORDER OF COURT ANDNOW,O:f()~Y"" c20 , 2006, the Court having considered the facts set forth in the Petition to Modify Guardianship, all parties in interest having been joined and there being no objection to the relief sought, and the Court, after hearing, being satisfied that the relief sought is reasonable and appropriate under the circumstances, approves the petition and grants relief as follows: 1. Manufacturers and Traders Trust Co. is authorized to make payments from the Guardianship account for the nursing home care and related expenses of Rosemary L. Dean until the assets of the couple have been spent down to the protected Medicaid amount, on the occurrence of which the Manufacturers and Traders Trust Co. Guardianship for Rosemary shall terminate; and 2. That the balance of Manufacturers and Traders Trust CO.'s Guardianship account, after the pay down of the couple's excess assets has been completed, shall be deemed to be a protected asset for the benefit of the community spouse share of Robert E. Dean, Rosemary's husband, and shall be paid over to Robert E. Dean when a further Medicaid Application is filed on behalf of Rosemary L. Dean; and, further, 3. That Manufacturers and Traders Trust Co. is authorized to make payments from the Guardianship account to pay the legal fees incurred by Robert E. Dean and owed to S. Berne Smith, Esq., for preparing and filing the Medicaid Application(s) for Rosemary and for filing the instant Petition to Modify Guardianship, upon presentment to the Trust Co. by Attorney Smith of his detailed statements for legal services, which fees shall be calculated at the rate of $75.00 per hour and in the aggregate shall not exceed $5,000.00. BY THE COURT ATAUECOPY FROM RECORD In Testimony wherof. I hereunto set my hand and the seal of said Court at Carlisle. PA s:;~aY of():u~'200~ ... '. .~~JCpu--t.. (' Clerk of the Orphans Court 1 Cumberland County P p r cE AI;'"") I ~ M~W9-rtiiH~ ~r~ :_.~\~j '~,;L.J_-j ;~) J. S S :5 !]U O-J 1'.'I(".(I\~ (, ~,.~~~.J ~:LL~L, _..~"j ~j:~';j~~::) A NOTICE TO APPLICANT CUMBERLAND CAO 33 WESTMINSTER DRIVE PO BOX 599 CARLISLE, PA 17013-0599 YOUR RECENT APPLICATION HAS BE EN REVIEWED AND YOUR ElIGIHllITY HAS BEEN DETERMINE:O FOR THl BENtoFITS SHOWN BELOW c l:[j ./ [] .t After the first check which may be a special amount you will receive $ o Twice a Month 0 Once a Month 0 In the Mail 0 At the Bank [J You have a patient pay liability of $ for the. period beginning You wm receive $ a month from and ending for the month(s) of to 0 In the Mail o Effective Date then you will receive food stamps in the amount of $ o At the Bank Level of care au1hortzed PANOO you are expected to pay $ see attached a month toward your care. N NAME 01 Rosemary Dean reC# 5601827156 NAME THIS ACTION HAS BEEN TAKEN BECAUSE OF THE FOLLOWING FACTS AND REGULATIONS . egulatiorss Pa Code 181.1 eason ode 985 Mrs. Dean was found eligible for long lenn care medical assistance effective 3/13/07. See the enclosed income computation sheet for details. Report all changes within 10 days to your ongoing caseworker William Palm (717-240-2736). TOTAL GROSS MONTHLY INCOME $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MEDICAL COSTS $ Telephone Water/Sewage Electric GarbagefTrash Gas Utility Installation Oil Other GROSS UTILITY COSTS/UTILITY STANDARD" $ RENT/MORTGAGE $ TAXES $ INSURANCE COST ON HOME $ TOTAL SHELTER COST $ TOTAL GROSS MONTHLY INCOME GROSS MONTHLY DEPENDENT CARE COSTS $ $ Name D MEDICAL ASSISTANCE Name TOTAL GROSS MONTHLY INCOME $ NET MONTHLY INCOME/NET SEMI-ANNUAL INCOME $ INCOME UMIT $ CO RECORD NUMBER 21 0110162 Marcia Mikos Worker's Signature 6/12/07 Dale 717 -240-2704 Telephone Number LEGAL HELP IS AVAILABLE AT LEGAL SERVICES INC. a IRVINE ROW CARLISLE, PA 17013-0000 (717) 243-9400 -, Robert Dean 90 Wedgewood Circle Etters, PA 17319 cc: S.Beme Smith, Manor Care-CH ..J If you do not understand our decision or have any questions. contact your worl<er. o CLIENT o APPEAL COPY A P f e "-JJ?, >' V3 o CASE RECORD COpy PAlFS 162 If 07 NAME Rosemary Dean RECORD NUMBER 110162 SOCIAL SECURITY # 161-32-2945 INITIAL: , !,-/ 3/07 4/07 5/07,6/07 MONR MOIYR MONR Gross RSDI 836.50 836.50 836.50 Met Life 83987~ 90.20 90.20 90.20 Guardianship Ac 375.00 375.00 375.00 7/07 MO/YR 836.50 90.20 375.00 GROSS MONTHLY INCOME 1,301.70 1,301.70 1,301.70 1,301.70 MONTHLY INCOME AVAILABLE 1,301.70 1,301.70 1,301.70 1,301.70 .PERSONAL CARE ALLOWANCE 40.00 40.00 40.00 45.00 -COMMUNITY SPOUSE! HOME MAINTENANCE 0.00 0.00 0.00 0.00 GROSS PATIENT PAY (53) 1,261.70 1,261.70 1,261.70 1,256.70 - MEDICAL EXPENSES Drugs(54) Medicare (55) 93.50 93.50 93.50 93.50 Be/BS/other Medical Ins. (55) 101.00 101.00 101.00 101.00 Other(56} -----------------------------------... TOT AI.. MEDICAL EXPENSES 194.50 194.50 194.50 194.50 NET PATIENT PAY (57) NOTE: Future changes in medical expenses should be reported to the nursing facility. /1' ( ,'/1,:( ,,1, ,,/tv' ---" SIGNATURE 6/11/07 DATE REMINDER: The resource limit is $2,000. with $6000 disregard I $2,400. See attached Addendum COMMONWEALTH OF PENNSYLVANIA CUMBERLAND COUNTY PUBLIC ASSISTANCE 33 WESTMINSTER DRIVE CARLISLE, PA 17013-0599 June 12, 2007 Robert Dean 90 Wedgewood Circle Etters, PA 17319 Re: Rosemary Dean Record: 110162 Manor Care-CH Dear Mr. Dean: In accordance with procedure 55 PA Code 178.125 NHH 440.33 on Nursing Home spousal impoverishment, the resources owned by both you and Mrs. Dean are to be transferred to your name only and become your property. Accounts owned solely by Mrs. Dean may need to be closed or transferred into your name. Please provide us with verification of the accounts that you transfer or close. In order for Mrs. Dean to remain eligible for payment of nursing home care, her resources must be under $8000.00. Fifty percent of all jointly owned resources will count toward her resources as well as one hundred percent of all resources she alone owns. You have until September 12, 2007 to complete the resource transfer and provide verification. If this is not completed within ninety days of authorization Mrs. Dean's resources will have to be used for her care. The following is a list of accounts that may need to be transferred or closed: M& T Investments account 1254292205 Provide verification of all resources that were closed or transferred by September 12, 2007. If you have any questions, please call me at 717-240-2704. Please sign the attached resource transfer agreement and return no later than June 25, 2007. Sincerely, 1 J II ?{,l,~. (/1(/ ---- Marcia Mikos, IMCW CC: S. Berne Smith, NH NAME OF HOME I, TRANSFER S Manor Care-CH (21/0110162) Rosemary Dean PATIENT NAME 84,254.55 AMOUNT Robert Dean DEPENDENT NAME AM WILLNG TO OF MY RESOURCES TO NURSING HOME PATIENT SIGNATURE OTHER RESPONSIBLE PARTY IF ABOVE IS AN "X" OR IF PATIENT IS UNABLE TO SIGN DATE Please sign form & return in provided envelope Thank You! ..,,- ..,,> %Z :XO 0< O~ ZI"1 Z- 1""1(1) I""1Z ..-i % (I) 1""1 -i Z :::0 -I > "'"'" 0 0 "'TI ::D ""1 (") 1""1 ::0 01> 01(') OZ 0> 00 0-4 1::0 1% NI""1 NI""1 """ """::0 010 01- 1"'0 IZ \11> \111""1 ...Z ~ ~> ~O:l ...(1) ...0 % C/) c: (') ~ % ""1 0 ::D 3: > -4 Z :x c 1""1 > ." 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Cft \1\- ~\~ -------- ~II~ 1\)110 \11110 +:110 I\) II c:: ~IIZ I\) II ~ I\) II =II::: 011 \1111 II II 011- WIIC 0\11 1\)11=11::: II II II 1\)11 \1IlIttl ~II(,,) wlICJ) \111=11::: =II::: 0 ~ < 0 CJ) CJ) 0\ ::J: =II::: 0 ~ < ~ CJ) CJ) 0\ ~ ~ C ~ ~ W Z 0 ~ -I ~ :I: C ,." ~ :::tI Z Z ,." C/) ~ to :::0 0 ~ C/) ~ (") 0 :I: :::0 CJ) Z ~ ~ ,." ." ~ C') W 1"'1 ~ CJ) .. Trust Officer, Manufacturers and Traders Trust Co. 213 Market Street Harrisburg, PA 17101-2127 717-255-2051. 6. Rosemary was born November 21, 1939, and is 67 years old. Robert was born July 8, 1935, and is 71 years old. Robert and Rosemary were married July 2, 1966, and are still married. One child was born to the couple on December 21, 1967, a son, Michael. 7. In July 1968 , Rosemary, then28 years of age, suffered severe brain damage from a stoke and was paralyzed, rendered unable to read or write, and impaired in speech. Robert cared for her at their home from the time of her discharge from the hospital until September of 2002, when she suffered another massive stroke. 8. As a result of her disabilities from the initial stroke in 1968, in 1970 a Petition for Appointment of a Guardian of her estate was filed by Robert and granted, appointing Dauphin Deposit Trust Company, Harrisburg, P A, guardian of Rosemary' s estate. A copy of said petition and related items is attached hereto as Appendix B. 9. In March, 1970, suit was brought on her behalf against various parties for negligent prescription of a medication which allegedly had caused her stroke. In 1975, a settlement was reached. A copy of the Petition for Approval of Settlement is attached hereto as Appendix C. The net settlement proceeds ($46,124.73) were placed in a Guardianship account at Dauphin Deposit Trust Company for Rosemary. It is this guardianship account, now managed by Manufacturers and Traders Trust Co., that is the subject of the present petition. 10. Rosemary was able to live at home in Etters with her husband, Robert E. Dean, until the last Sunday in September 2002, when she suffered another massive stroke which basically left her unable to speak, see, eat without a feeding tube, or otherwise be responsive. Since October 15, 2002, she has been confined to nursing homes. She was first moved from the York Hospital to The Woodlands Nursing Home and was in its skilled nursing unit until the home went into bankruptcy and closed. On November 5, 2003, Rosemary was moved to Manor Care Camp Hill where she remains to this day. 11. Until May 5, 2006, Rosemary's expenses at the Woodlands and Manor Care nursing 2 homes were paid by insurance. The insurance paYments ended May 5, 2006, and an application for long term care medical assistance (hereinafter, Medicaid) was filed on behalf of Rosemary with the Cumberland County Assistance Office and assigned case number 110162. 12. Under date of August 31,2006, Rosemary was found not eligible for assistance because her total countable resources as of May 4,2006, exceed the allowable resource limit by an amount of $86,761.35. A copy of the August 31, 2006, letter with its enclosures from the Cumberland County Assistance Office to Robert Dean is attached hereto as Appendix D. The letter notifies the Deans that before Rosemary will be eligible to receive Medicaid, the couple's available resources must be reduced by $86,761.35. 13. The largest available asset of Rosemary and Robert is the Manufacturers and Traders Trust Co. Guardianship trust account. It is listed on the Assessment Computation sheet, page 3 of Appendix D, under code 5 - Robert - M&T Investments 1254292205 in the amount of$147,488.63. This guardianship account is managed by Manufacturers and Traders Trust Co., and the amount varies daily. Attached hereto as Appendix E is a statement of the account as of August 31, 2006, showing a balance at that date of$148,506.20. Manufacturers and Traders Trust Co. is the successor bank to Allfirst Trust Company, which was the successor bank to Dauphin Deposit Trust Company. In its successor capacity, Manufacturers and Traders Trust Co. is the present guardian of the estate of Rosemary. 14. Manufacturers and Traders Trust Co. has no objection to and joins in this Petition. See Appendix F attached hereto. 15. Because the insurance payments are no longer available to pay the nursing home expenses, money from the Manufacturers and Traders Trust Co. Guardianship account is needed to pay Rosemary's expenses until she becomes eligible for Medicaid. Since May 4,2006, Robert has paid Manor Care Camp Hill $1,988.00 from his checking account. However, as of August 31,2006, Manor Care Camp Hill is still owed $22,650.00 for Rosemary's care. See Appendix G hereto, a copy of Manor Care Camp Hill's statement as of August 31. 16. In order for Manufacturers and Traders Trust Co. to pay Manor Care Camp Hill, it will have to use principal from the guardianship account, and it has asked Petitioner to file the instant petition to get authorization from the Court for the bank to do so. 3 17. In order for Rosemary to be eligible for Medicaid, the couple must spend down the excess resources and then re-file their application for Medicaid. The most liquid of their resources, in additional to the checking and saving accounts, is the Manufacturers and Traders Trust Co. Guardianship account. Over the years since the account was established in 1975, periodic payments from the account have helped to support them, particularly during periods of special need when Robert was unemployed or ill and after his retirement in 1995. Therefore, Petitioner asks that Manufacturers and Traders Trust Co. be authorized to make payments for the nursing care of Rosemary until the couple's excess resources are reduced to the protected community spouse's share of $99,540.00 for Robert and of$8,000.00 for Rosemary as shown in Appendix D. WHEREFORE, your Petitioner prays (1) that Manufacturers and Traders Trust Co. be authorized to make payments for the nursing home care and related expenses of Rosemary L. Dean; and (2) that the guardianship account be terminated after the pay down of the excess assets has been completed, and that the balance be paid to Robert E. Dean and be deemed to be a protected asset for his community spouse share if, and when, a further Medicaid application is filed on behalf of Rosemary L. Dean. i2~ Robert E. Dean, Petitioner, for himself and Agent under a Power of Attorney for Rosemary L. Dean COMMONWEALTH OF PENNSYLVANIA: COUNTY OF YORK Robert E. Dean, being first duly sworn, deposes and says that he is the Petitioner, in his individual capacity and as agent under a power of attorney for Rosemary L. Dean, in the 4 foregoing Petition to Modify Guardianship and that the facts set forth therein are true and correct to the best of his knowledge, information and belief ~~ Ro ert E. Dean Sworn and subscribed to before me this / </ t-1 day of September, 2006. ~ ~ C'-<1..,..~ Notary Public My commission expires: 7-:3 >-~ 7- Seal COMMO EALTH OF PENNSYLVANIA I. NOcadea Sell PaIrtcla A. Gordon. ~ PI.t1IIc FllMewT~ YorkCoooly Mt CommlI8Ion.~J4It 31. 2009 Member, Pennsylvania AsIocIatlOn of Notaries 5 TABLE OF CONTENTS TO APPENDICES: Appendix A Page 1 Appendix B Page 5 Appendix C Page 13 Appendix D Page 20 Appendix E Page 27 Appendix F Page 30 Appendix G Page 31 ~ . \\r:~ ~fT\ t Sf -;,10>.<1' '-'f')? POWER OF ATTORNEY OF ROSEMARY L. DEAN ~ KNOW ALL MEN BY THESE PRESENTS, That I, ROSEMARY L. DEAN, of 90 Wedgewood Circle, Etters,York CoUJ)1Y, Pennsylvania 17319 have made, constituted and appointed""' my husband, ROBERT E. DEAN,tOfthe same address, and my sister, Margaret T. Beoner,cof 1369 Yorktowne Road, Mechanicsburg, Pennsylvania 17055 my true and lawful Attorneys, in my name, place and stead, from time to time, and at all times until revoked, the following powers to be exercisable at any and all times by anyone (1) or more of said Attorneys-in-Fact: (a) To make gifts; (b) to create a trust for my benefit~ ( c) to make additions to an existing trust for my benefit; ( e) to disclaim any interest in property; (f) to renounce fiduciary positions; (g) to withdraw and receive the income or corpus of a trust; (h) to authorize my admission to a medical, nursing, residential or similar facility and to enter into agreements for my care and to authorize medical and surgical procedures; (i) to engage in real property transactions; G) to engage in tangible personal property transactions~ (k) to engage in stock, bond and other securities transactions; (I) to engage in commodity and option transactions; lJ\ (m) to engage in banking and financial transactions; (n) to borrow money; (0) to enter safe deposit boxes; NOT APPUCABLE FOR PIN NUMBER Bool: 1 '799 f'o!le 688~. A A FftfN"(j!. ". (p) to engage in insurance transactions; (q) to engage in retirement plan transactions; (r) to handle interests in estates and trusts; (s) to pursue claims and litigation; (t) to receive government benefits; (u) to pursue tax matters. My Attorneys-in-Fact may generally do and perform all matters and things, transact all business, make, execute and acknowledge all contracts, orders, writings, assurances and instruments which may be requisite or proper to effectuate any matter or thing appertaining or belonging to me, with the same powers and to all intents and purposes with the same validity as I could if personally present. It is my intention in this paragraph to give my Attorneys-in-Fact the broadest possible power, without limitation to any of the kinds or classes of matters or powers specifically enumerated above. I give to my said Attorneys full power to do and perform every act whatsoever requisite and convenient to be done in the premises as fully as I could do if personally present, hereby ratifying all that anyone (1) or more of my said Attorneys shall do, or cause to be done, by virtue hereof. This Power of Attorney shall not be affected by disability of the principal. At the time I am executing this Power of Attorney form I am unable to sign my name due to a physical bandicap. I am putting my Mark 00 the document io lieu of my signature, punuant to the provisions of ~ 5601 (a) of Title 20 of tbe Pennsylvania Consolidated Statutes, tbe Probate, Estates and Fiduciaries Code. A photocopy, xeroxcopy, or other copy of this Power of Attorney shall be as effective for all purposes as a manually executed and acknowledged copy. - 2 - 2 IN WITNESS WHEREOF, I ROSEMARY L. DEAN have hereunto set my hand and seal by making my Mark on this /o'liay of December, 1996. ROSEMARY L. DEAN /( (Seal) Her Mark f( cn-"->-'~-'-7 [ a e<._, (Subscription of N4h1e) In the presence of: L2 fJ~ t_,_~.. ~~~-77 I ----. -- \-,) (". /' (l,v,~,/\~V')..'\.v ;\.i;./lvlA.<\ COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND On this l{pih day of December, 1996, before me, a Notary Public, in and for said Commonwealth and County, personally appeared ROSEMARY L. DEAN, personally known to me; or satisfactorily proven to me, to be the person whose name is subscribed in the within instrument and acknowledged that she executed the same by setting her Mark thereto for the purposes therein contained. ' IN WITNESS WHEREOF, I hereunto set my hand and official seal. Crt -~ ~ ''L&1fljt. . . ' ..., ~ Notarial Seal Laure E. Kane. Notary Public Camp Hill Boro, Cumberland County My Commission Expires Nov. 15. 1999 Member Pennsyf\f?,nia fl,~~(1r.i;lt!()!1 f'rf Notaries My Commission Expires: (SEAL) - 3 - J . . YORK COUNTY RECORDER OF DEEDS 100 WEST MARKET STREET YORK, PA 17401 Randi L. Reisinger - Recorder Gloria A. Fleming - Deputy Instrument Number - 2006023456 Recorded On 3/27/2006 At 1:19:23 PM * Instrument Type - POWER OF ATTORNEY Invoice Number - 614225 * Grantor - DEAN, ROSEMARY L * Grantee - DEAN, ROBERT E User - JDB * Customer - ROBERT DEAN Book - 1799 Starting Page - 6885 * Total Pages - 4 * FEES STATE WRIT TAX RECORDING FEES COUNTY ARCHIVES FEE ROD ARCHIVES FEE TOTAL SO.50 $13.00 $2.00 $3.00 $18.50 I Certify This Document To Be Recorded In York County; Pa. ~'~T Recorder of DeedIi THIS IS A CERTIFICATION PAGE PLEASE DO NOT DETACH THIS PAGE IS NOW PART OF THIS LEGAL DOCUMENT * - Information denoted by an asterisk may change during the verification process and may not be reflected on this page. Book: 1799 Page: 6888 Lf , . \",I I ~, . , , ' ,;; " .. ,:,: ~,~~~.::~~~~" .. 'O:'i. .'...._~~.. ,:",,-':~ "',"1':~~";:,;; 'H~~~".."'. j --. -~-,~,..-.._._...,~._-_..._. - ESTATE OF r{OSE)I~RY In tbe Court 01 COmD10n Pleas of Cumbel'land County. penna. t Orpha~e a Court D1 vi.ion IN BE: L. DEAN. J~l1.ued.~ ompetent No. ;1..1- ?D 411' ,,;2, 9 PETITION FOR!'4PpOUfTMENT O:f A aUA'-DlAN TO THE HONORABlE. THE JUDOES OF SAID COURT: Tho Petition of l\ob~rt E. Dean zoeepecttully r.proe.ente: Penn.ylwldA. I 1 .. Potltioner i$ the husband ot ao.e.ma~y L. Dean, both of whom re81dfob at 1 01 LighthoulSe DJrtve. Iv1ecb.Anlcsburg. Cumberland County, z- The ea.id BoaernaryL. D.An 1. thirty yea..s of age and is th" m~other bt Que crJ.ld. Micbael A. Dean. two year. of afle. ~ ..'X'he saId ROlle:rJu"y L. Dean. becaUB$ of mental ilIne81. \\ i.s unable to 11lanage he~ p:ropcny and il Ue.blc to dl..lpate a.lld become the I II I I vlctb'l.'l of designing per.oDs. -4 -The estate of the aaid n08emat'y L.tJe.a.n consists of the following lterns: a) 1',.U.ctllla.neou~pel'.onal property having e. worth of eeverfll hundred dollaro.. b) Dlsabilltyrights uncleI"' Soelal Security, app;r-oxln'lating $lZ4.70 per month. ~ c) A cause of action ,fo~ her l'uental condi~iOll. which your petitioner believes will b. the subject of tl law suit. r:d"tF)J/J/ X VJ' .'t',".,~,,,....~ ....;.....t.-;.{.:.-. 5 .. Your petition... I. the .ole euijurl." belS'llrilll in the CODlmOnrNeA1th of PeJln4ylvania.'Who wou.ld be entitled to .ha.." in'her estate UebedifJd t.te.t.te at tbl. tlme. 6 .. The pl'<tpO$8d .ua"dian. 1. na.uphl'l1Dapo8it Trust Company. HUJ'l.but\. P.lln..,ylv&nl&,wh$ d.oee buall1..e andmaltltat.a aD office in Cu.rnberlan4 County. Pennsylvanla. 7 .... No other Court haaae.u.tXl0d J\l~i.<llcdotl i~"', pl'ocoed.ing .. to deternUne the competency otth.e .ald 1\ OH m.&1' V 1". Do.n. 8 .. The allesod incompetent De 11(1 1eaalluaJ'41all of her estate OT pe~'.ot\.. WHEREFOIUC. your Pcrtit10ner p".Y. that Ii citation i.sue diJ"ecteo to the aUeged inc:ompet41ttt to .how caUQ.e 'Why .he .hould not be iudsed an incompetent aad a luar-dlanot her estate be appointed. !~j ve:'-4.J-'. C r 4-4~-, 'Roben Jt;. Deal'l. petitioner 6 COMMONWEALT'll. or PENNSYLVA1'11A ( COUNTY OF k~~ : Robert E. Dem'l, being fi1'at duly .\1Iora. depo... and says that he 1,8 the potiticn.er in the lOllegoing PetltLoJ;1 for AppolJlt.tne11t of .-. Ouardia.n -.nd. that thefac:ta .at fonh thel"eln ....e tl'U8 Qt6d correct to the beat of hiS! knowledso. information a=d beUef. as: xt7nded page 2.1 7 ....-.....,. -..,-- -- '---"""'- kDOV/ledgo. information aDd betUef. ,~IIU,d E - ~ ,-,,' Swo~n and eubeeribed to before In$ thie It obert . E. Dealt .', ~f-z:i day of Ap1"U, A.D.. 1970. ( L f) _~I 4tfd.u-..~, )1 ," U-.~ ! .v, notary r.tubllc . l\'lV conm'li".lon expir:-ea: Clj--t..:'.( ;;. f, / r J J. r/ - 2 .. I ~ IN BE: l In the Coul't of Common Pleas 0{ Cumberland County, Peana. Ol'phalUl' Coun Divlaloll ESTATE OF ROSE:t.IiARY L. DEAN, Alleged Incompetent s ~to. ~J-?b'-;J-.3! ACCEPT.ANCEBY PROPOSED OUAltDlAN Dauphin Depo.it Trutt CompaQ,. eloe. he~.by certlty that it mail1taiu offices la. the Couaty at CU)n"l'land. P.nll.ylva.Di&~ that it 18 not the ficluclal"yofany ..t.te of the alleged incompet.. and baa 110 interest ad1fer.. to the .aid alleged blttornpeteut: and it doe_uhby agree to accept the appoint'meDt ... Qual'dian of the Ee~to of B.o..l'l'lIAry L. Dean. an AU.,ed &competent. DAUPHIN DEPOSIT TRUST COMPANY :l5Y Ii / !J. I. ;.i~~J ~'l(.~.1 ... fILL~<.J.i~ ~ rfI;,.~__t. # "t-'-, L- 4,- .~.~.............., ~ l;O.u:Al.J.IUV-..bJW\lv. f.l\ '''''~~'\~':N,':' .''t~. ";,~l':'~ ESTATE OF.ROSEh.iARY In the Court of Gommon Pleas of Cumberlafid County. Penna. Orphans' Court Divieion IN HE: L. . DEAN. Alle~ed Incompeten.t No. .,2.(,. 7 tJ ".)..3 1 PRELIMlNAay DECREE ANI> NOW ,Apl'U~. 1970, upon consideration of the annexed Pe.tition. it is Ordere4 and Decreed that.. Citation be awarded. dtrectedto ,aosemary L. Dean, to ehow cause why she abould not be adjudged .an incompetent and a guardian of her ..tate appointed; hearing to be beld,.t the Court House, Carlisle', Pennsylvania, on )J-<-?C-7 ~ / 7 ) ( a.t I >3 () o'clock. t. /J) At least 'I~' 1-....<-/<> aotice of the hearing I shall be gi'<7en to Rosemary L. Dean. tlte alleged incompetent by personal se..vice. BY THE COURT: c; 1>1 dld(L. f 4:4~~~~ r P J t'" '.. . ~i;~: :<~). ~t< ~~~~; ~\" ~;. \~!t ~ ~.. ~E.:.:.\.' :.l : t ~: ~ 'i~? ( ( I. ~ . f /D \ . " ". . ''\.~ I. .~.' ....,- ". ........ ........,. -\i , . -..a~"v~riL IN REI IN THE COURT OF COMMON PLEAS OF I I : I : I CUMBERLAND COUNTY, PENNA. ORPHANS' COURT DIVISION NO. 21-70-239 ESTATE OF ROSEMARY L. DEAN ALLEGED INCOf~ETENT CITATION WE COMMAND, you that laying aside all business and excusee whatsoever, you be end appear in your proper person before the Honorable Judges of the Common Pleas Court, Orphans' Court Division at a session of the said Court there to be held, for the County of Cumberland to show cause why oheshould not be adjudged an incompetent and a quardianof her estate appointed: .:. 'Io~ .,~.. hearing to be held at the Court Ifouse, carlisle, penn.-flvania, ~;'..{,;~,. -. on May 5, 1970 at 1:30 o'clock, in Court Room 1. At least 5 notice of the hearing shall be given to Rosemary L.Dean, the alleged incompetent by personal service. Witness my hand ana official seal of office at Carl;sle, Pennsylvania this 28th day of April, 1970. ~/) ') ""Ofl '....., .L.' r. . - t' LZf'...l:l,..v"-,, Clerk 9f~ommon Ple . ~ Court,;orphaos';courto DivisiQn ~arllsle pa ~PB, . ,,,,, . , . ~ ' My comm~~~~p~ExPire8~~pvJ 1st. 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'1\','; )/\' .... . . ~ ..t'~{ ~:.,' .~1~ \', ,,;. ':",,,, '. .' i .ctt t~)~.:.:: . . .\.' ~'t'~.i.~('):i;\l~'. . . .' /' ............c-'\.-:. - ...--..... ..._.........~.\.~~"i.1 . .::;~'ii:' " ':"~,':' ~ '.,,' . )\.t~ ~~~!':,~ of.. ~s Cou'!,J', ...., ",: ',~,.' .~, -- '. ".~i ~f".,yumbert2rnd CountY 'r~: '" '-':'; ,,', 1.::,~~ :~'W;;: " '<:<';:i~!~!~\~[;'S':::;~~f~~~~l ,'.i' ,.;: '>\. ....'1-.,. ....~ 'l:'.-l~l('" ){J~. J....;;. . ',."..,~:~'~:.':",...'~,. ,;.~~,.~.~~~~~..t:~i.[~~~;~. 't,.i;':' .:,1 tl . W4-, i.~.1r...!;,M~'" . ',;M:(:i;~(:;.i!,(~;" "".. k . .. " i .~\:.-~. .: -'. ,:; -',~ , ":';;:.';;'i;:J;!'~~'1,';.~.;:.i.~'~" - !- ;.:'\:~.,-'~ " . .... ' ~,' it',..,::,:.~.".,:,.:.:.c.-: ~~/' .....~:::,.~..:' ,:.l~:... . ,.11' ~ "',:1 " >:".:.~:/\;.-, ~ ", ;': j .: '~,; ,.~',>ir~{'\":":-:;,, . ; .' .:.~.1 / ! , ~".\":r.! -;: __': ,:;,' , .;';'1: t. ..\" .,,'... "; .',,-.',-!'; .- ;".' ,; ; , l~ ',,~,; ~', ':~, . ;.H:,J ",':-'; :"';:"::J':'- ,~ : ,,; 12- ROSEr-'ll\. RY :L _ DEAN, an Incompetent by DAUPHIN DEPOSIT TRUST COMPANY her Guardian and HOBERT E. DEAN, Plaintiffs IN THE CO(JF~T OF CO!'li.iO:'.j PLEAS DAUPfiI~: COU"0f'I"{, PENNSYLVll.NIA No. 1 O~: 0 ~.1ARCH 'l'EP,N, 197 () V5. ROBERT STEVENSO~, ,et al, Defendants IN TRESPASS PETITION 'FOR APPROVAL OF SETTLEtmNT The petition of Robert E. Dean, by his attorneys, Hurwitz, Klein, Benjamin & k~gino, represents: 1. He is one of the Plaintiffs in the above ac,tion. 2. Said action was instituted to recover damages for brain damage allegedly causing and resulting to petitioner's ~life from the use of her upon the prescription of defendants of birth control pills which it is alleged was negligently prescribed by defendants. The claim was a strongly disputed one and would have been strenuously contested. 3. That on April 14, 1975, trial \'laS commenced before His Honor Judge William B. Caldwell who heard testimony as presented by plaintiffs on the liability issue. Before completion of the presentation of plaintiffs' case on the liability, the parties agreed to settle the case for the sum of SC\lenty-fiver.rhousand ($7S,OOO.OO) [villars, sub~i,(~c:': to tl:c; ilPi1rOvi:11 of your Honor<lblc Court.. I ;3 jJ ,ftFJVD -IX C 4. Pursuant to said agreement of settlement, the said Judge Caldwell heard testimony from petitioner as to his clear and thorough understanding of the settlement and its legal effects of completely terminating the action, and his further understanding of the necessity of paying from said settlement the amount of Seventy-five Thousand ($75,OOO.OQ) Dollars attorneys' fees and costs incurred in preparation for the trial. s. Your petitioner had retained the firm of Hurwitz, Klein, Benjamin & Angino, who associated with Thomas L. Rutter, Esquire, to prosecute the action on a contingent fee agreement of 33 1/3% of any recovery plus reimbursement of their costs. Petitioner is satisfied said agreement of settlement is and was a fair and reasonable one. 6. Pe-titioner to the best of his knowledge and belief, represents that there are no outstanding unpaid- medical bills in connection with his wife's sickness and consequent treatment therefor. Your petitioner waives any share in the proceeds of said settlement in favor of his wife I s estate.- 7. Wherefore, petitioner prays your Honorable Court to approve said settlement and allocate the amount thereof as follows: /11 -2- TOTAL AMOUNT OF SETTLEMENT: $75,000.00 DEDUCTIONS: Hurwitz, Klein, Benjamin & Angino for Attorneys' Fees (33 1/3% of $75,000) $25,000.00 Hurwitz, Klein, Benjamin & Angina - Reimbursement of Expenses 472.36 Thomas L. Rutter, Esq. Reimbursement of Expenses 1,902.91 William Silvernail, M.D. (This expense is the result of Dr. Silvernail cancelling three days of surgery to come to.Harris- burg from Dothan, Alabama, and includes his traveling expenses and expenses while in Harrisburg) 1,500.00 TOTAL DEDUCTIONS: $28,875.27 Balance to Dauphin Deposit Trust Company, as Guardian of the Estate of Rosemary L. Dean $46,124.73 8. Attached hereto is the writien consent of Dauphin Deposit Trust Company, as Guardian for Rosemary L.. Dean, to the settlement and the allocation of the settlement amount as stated above. Respectfully submitted, HURWITZ, KLEIN, BENJAMIN & ANGINO By J.J 1(,c\.\'i\'L\) c. ~t..)Q..Il'lO Attorneys for and in behalf of Petitioner, Robert E. Dean ,..) -3- KU~~MAUY L. DEAN, an Incompetent by DAUPHIN DEPOSIT TRUST COMPANY, her Guardian and ROBERT E. DEAN, Plaintiffs IN THE COURT OF CO~10N PLEAS DAUPHIN COUNTY, PENNSYLVANIA No. 1040 HAReH TERl'1, 1970 v. ROBERT STEVENSON, ALFRED J. SHERMAN and JOHN B. GOEDECKE, Individually and as Partners, Defendants IN TRESPASS JOINDER AND NOW,~. MA"\'\ , 1975, Dauphin Deposit Trust Company, Guardian of Rosemary L. Dean, an incompetent, certifies that it has read the foregoing Petition and joins in the prayer thereof. DAUPHIN DEPOSIT TRUST COMPANY By },\ ~,,~ -J ~L~~H ~tl8t Offi<.-er \1\. ~ ~~\t.x:.f\J\ AW~ Setv\\)tL,) ~,. Wl(~ I b 1 " .. ~ . " Jl ..... ~ ". .,.. """7""""""",",,,," COMMONWEALTH OF PENNSYLVANIA ) ) 55: COUNTY OF DAUPHIN ) Personally appeared before me, a Notary Public in and for said Commonwealth and County, ROBERT E. DEAN, who, being duly sworn according to law, deposes and says that the facts set forth in the foregoing Petition are true and correct. i/G;{EJ ~t~{ z..' ~;.y'} Rq.Y:;er"t- E. Dean '- Sworn to and subscribed . , ~~ d before me thlS. ay ~f April, 1975. . . . J . .'' ....) ,. .. ./, ....>.,;...'1.'1... '.~ ~" . ( , /:.<:,::' "'~~~~ ~ ':,,: ',\ :: , . l~o~ary publ ic - . . I .J. ..- \:\,- ;',~"/' \"1 >.,.' ':.! .......i:1'\.. r.'ly' C'o~ission Expires: , ~ ..1 f I J '., February 6, 1978 '7 ROSEHARY L. DEAN, an Incompetent by DAUPHIN DEPOSIT TRUST COMPANY her Guardian and ROBERT E. DEAN, Plaintiffs IN THE COURT OF COMMON PLEAS DAUPHIN COUNTY, PENNSYLVANIA No. 1040 r1ARCH TERM, 1970 vs. ROBERT STEVENSON, et aI, Defendants IN TRESPASS ORDER OF COURT AND NOW, May ~ , 1975, the Court having heard testimony in the above action, as well as testimony of Robert E. Dean of his full and complete understanding of the settlement and its effect on the suit, as set forth in the foregoing Petition, and the Court being satisfied the settlement is a fair one, it is hereby ordered that the said settlement in the gross sum of Seventy-five Thousand ($75,000.00) Dollars is hereby approved. It is further ordered that said settlement amount shall be allocated as follows: TOTAL AMOUNT OF SETTLEMENT: $75,000.00 DEDUCTIONS: Hurwitz, Klein, Benjamin & Angina Attorneys' Fee $25,000.00 Hurwitz, Klein, Benjamin & Angino Reimbursement of Expenses 472.36 Thomas L. Rutter, Esq., Reimbursement of Expenses 1,902.91 William Silvernail, M.D., Witness fee' and ExpEnses 1,500~OO TOTALDF.DUCTIONS: $28,875.27 J CG BALANCE to Dauphiri Deposit Trust Company as Guardian of the Estate of Rosemary L. Dean $46,124.73 .J. _._.._....4~__._.._ ~_..- .--,. .-~' ._...,_-......~.."'... --., ..- ....-.--;...:c'>r~".''*~~ --"".--:.-.."" ,..'............-.......~.'.."'V' Upon payment of the sums as set forth above to the respective parties by Defendants, Plaintiffs shall satisfy of record the above entitled action, execute any reasonable release requested by Defendants after all of which it is ordered that the action by discontinued with prejudice. BY THE COURT ~) 0~~' LQ. C~~ ,1 . ,.I' ,/,.! . ".'J~ .. ", ,z / c(... bi- 19 7...,'- t ;I hs'reby c '~-titY'. . th:at. tha . Orego1nlY 1~" ... , . ~ 00 . i .~~. S a .true and lCor~ot m P1.~t t~e or~g1nal fiaed to " Q~.~o fa,'...., n: ~ Term, .19?~ ' .. . " , , . /:etf.e ~. /./" ?~"I" - ~ --' \ ", . / I-+-, ~~ (/1', -v7----- · ( P.to. thOno t..rz.~' , /~ .J - ') .}- }') ~ COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, Pennsylvania 17013-0599 1-800-269-0173 717-240-2704 August 31, 2006 Robert Dean 90 Edgewood Circle Etters, PA 17319 Re: Rosemary Dean Record: 110162 Dear Mr. Dean: Rosemary Dean was found not eligible for long term care medical assistance because her total countable resources as of the May 4, 2006 requested effective date exceed the resource limit of $8000.00 ($2000.00 resource limit with a $6000.00 disregard). .Resources on May 4th totaled $186,301.35. After deducting the maximum protected spousal share of $99,540.00 resources totaled $86,761.35. In order for Mrs. Dean to become resource eligible total resources must be reduced. Total resources include, and consist mainly of, the M&T Investment (guardian) account 1254292205. This asset is considered an available resource by the Department of Public Welfare and should be used for Mrs. Dean's care which includes nursing home costs. If you believe that the M&T Investment account should not be considered a resource available to Mrs. Dean please provide guardianship! court documents stating the puxpose of this account and that it is not to be used for Mrs. Dean's care. Until these documents are received we will have to continue to consider M&T Investment account 1254292205 an available, countable resource. If you have any questions about this rejection or the results of the resource assessment please feel free to call me at 717-240-2704. Thank you, /~" 1 J r, 1 t(,1,(!.L (~ /vJf1.,") Marcia Mikos, IMCW CC: Attorney Smith, Manor Care L6 Arf(f'NP'o<. ]) PAlFS 162 - 4-04 NOTICE TO APPLICANT BENEFIT O ASSISTANCE CHECK ELIGIBLE EL;:'~JLE PENDING 1-800-269-0173 717-240-2700 DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE OFFICE 33 WESTMINSTER DRIVE P. O. BOX 599 CARLISLE, PA 17013-0599 YOUR RECENT APPLICATION HAS BEEN REVIEWED AND YOUR ELIGIBILITY HAS BEEN DETERMINED FOR THE BENEFITS SHOWN BELOW 11:'1 MEDICAL WI ASSISTANCE After the first cheCK which may be a special amount you will receive $ o Twice a Month 0 Once a Month 0 In the Mail o You have a patient pay liability of $ for the period beginning and ending o At the Bank \ o Effective Date O FOOD STAMPS You will receive $ a month from for the month(s) of then you will receive food stamps in the amount of $ to 0 In the Mail 0 At the Bank ~ Level of care authorized you are expected to pay $ a month toward your care. ASST. FOOD MED. SOC. CHECK STAMPS ASST. SERVICE ,l( LINE NO. NAME FOOD MED. S C. STAMPS ASST. SERVICE THIS ACTION HAS BEEN TAKEN BECAUSE OF THE FOllOWING FACTS AND REGULATIONS Regulation ~t Calt.ll t.l Reason Code 0 i' Ko~'rUf;\ ~"\ l..lXlsfot,v")(lllct aJl~LL-k \b'I!\ hfY\ ((:v-e..~ tus..:du,,\(a. ?\i..o..~ ~ ~ (,~C~ l...a.t\.c..r {r ~ \C\~f~ . TOTAL GROSS MONTHLY INCOME GROSS MONTHLY DEPENDENT CARE COSTS GROSS MEDICAL COSTS $ $ $ TOTAL GROSS MONTHLY INCOME GROSS MONTHLY DEPENDENT CARE COSTS $ $ Telephone Water/Sewage Electric Garbage/Trash Gas Utility Installation Oil Other GROSS UTILITY COSTS/UTILITY STANDARD* $ RENTIMORTGAGE $ TAXES $ INSURANCE COST ON HOME $ TOTAL SHELTER COST $ *The household may switch between theactu;afutilitYcosts and the standard utility allowance at. the time of. .reapplic3tion and. one additional time during each twelve-month period. Name Number offlersons..... GROSS MONTHLY EARNED INCOME $ $ $ Name $ $ $ TOTAL GROSS MONTHLY INCOME NET MONTHLY INCOME/NET SEMI-ANNUAL INCOME INCOME LIMIT $ $ $ Il 0 t l.:o ""2.. DIST rV\LV,-c.<)\~n Worker's Signature RECORD NUMBER r I ~ "1\} C>.'-iD -T10Lf Date Telephone Number LEGAL HELP /S AVAILABLE AT 2f L ~Q~+ ~/""\ q 0 '[d1~::d C, \,.:..-\ e- t:~I~F\ 1'73iQ cor~ to A-tr~ SrY"\jh I }V ~ \ LEGAL SERVICES, INC. 8 IRVINE ROW CARLISLE. PA 17013-3019 717-243-9400 717-766-8475 -.J If you do not understand our decision or have any questions, contact your worker. CUENT COFY tO/~ . (:9 ~ S.:lNd 80:1 '1;H~"r-~.:'~:;\1'--';;-id -1 '-e;qdjapBjiWd ;JL eu.';OOluCr,v\i . d_;Sl\ht?:8(J . Jf3fS8Lj:J 's:~.Jr;8 , IFH"j"E;'f\' ; ~,~(j;,;SUFJ3c j~/j~J';?>i8LL'CS .bL~I:1C:,'.;V" "3' ;/\:2,'':" '7:;t<jl:~ ~':'~;1tJL'P(,r:sn':: ~;,r:;<,~ nlG'-, ' jC'!_~}!::j ;_;S:.:":?\.r\~ :;~:!);~nL;~S '~JC~G::l.2c't..;~';CN '~6!qGl 'S~J98 :dO;:i Sf\gOV38 "\VG/\ LOjL-C"\ >JDP/\~iS '/\JJGd .pUBpaqU)nquOI'.! .1nC}UGii\} \!!lUn/\~ j6U!~JC~::;f.l ;UO:F]q2~ ';::'~S-r::1~~'r:; lr?~:?;~":~;~ '~Jcr:n .:l~~l~H 'UCljrl::i 'U~]>tl;9~~ i~j!L;dnE(J r-,lj!?\J:;.Qil,Hl8 '?T~U8,J 'S;.UBPV ~t:10:d 9bn8~;-ida\iH r I I SNOLL'v'801 mm:::JV3H #3NOHd3T:ll 3!::1nJ..\iN~ilS 1-N3iT) I I =l'liO! j SS3t:10GIi lN31l8! --,-------, : I =1un : t'~lC)i" -,^: L':""! N:;;<:<::iUd=1U "i::irlr;! 311-'" I _c, _v. "';"- .:J d. 'f~, ._,_~U _O_~. '_1 #: 31'.:OHd31~..L :3snV'J38 8N!tiV3H V lS3n031::l OllN'if/\!\ i I I L-----.. I I '(OS6f.>89L"L~L) SIBedd'f pUS sfU(JBe~~~ JO fTeeing eql ire8 es-e21d 'JaV3Jdle~Lq UN,O .H1Cfi. 18B J81Ef ~nq JeV3Jct~8+Ll! U'E ,jO} ~rSE no!. 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H\{iSf2002 Countable Verified CODE TYPE LOCATION OF RESOURCE - COMMENTS Amount Yes No 01 Cash on Hand $ 02 Savings Account Robert- M& T account 950557320 $ 15.948.98 X Savings Account $ Savings Account $ 03 Checking Account Robert- M& T account 1939793 $ 7.019.65 X Checking Account $ Checking Account $ Checking Account $ 04 ChristmasNacation Club $ ChristmasNacation Club $ 05 StocksIBonds Robert- MetLife stock 200 shares $ 4,754.00 X StocksIBonds Robert- M& T Investments 1254292205 $ 147,488.63 X StocksIBonds $ StocksIBonds $ StocksIBonds $ 06 Trust Fund $ Trust Fund $ 0 Burial Reserve Rosemary-8halOnis FH I Irrevocable? Enter Y or N >>> r Y $ X Burial Reserve I Irrevocable? Enter Y or N >>> T Y $ 08 Burial Plot ~ Robert:chestnut Grove I Exempt? Enter Y or N >>::t Y 1$ X Burial Plot I Exempt? Enter Y or N >>::t Y 1$ Life Insurance Rosemary-MetLife 640801588PR Face $ 5000.00 Cash $ 0 0.00 X 09 Life Insurance Robert-Prudential 22065405 Face $ 5,000.00 Cash $ 3.603.95 $ 2,603.95 X Life Insurance Robert-MetLife 666802890A Face $ 5,000.00 Cash $ 7,305.06 $ 7,305.06 X Life Insurance Robert-MetLife 872432962MI Face $ 10,000.00 Cash $ 5,099.10 $ 5,099.10 X Life Insurance Robert-MetLife697120451A 1 Face $ 10,000.00 Cash $ 10,311.48 $ 10,311.48 X Life Insurance Robert-MetLife 686328212A Face $ $10,000 Cash $ $5,126.46 $ 5,126.46 X Life Insurance Rosemary-MetLife 14037908A Face $ 1000.00 Cash $ 3366.60 3,366.60 X 10 Non-Resident Property $ 11 Motor Vehicle IRobert-2000 GMC Sana"" Exempt? Enter Y or N >>::t Y 1$ X Motor Vehicle I Exempt? Enter Y or N >>=1 NU 1$ 12 Other Vehicle(s) $ Other Vehicle(s) $ Other Vehicle(s) $ 13 Cert. of Deposit $ Cart. of Deposit $ Cert. of Deposit $ Cert. of Deposit $ Cert. of Deposit $ Cart. of Deposit $ SUBTOTAL VERIFIED COUNTABLE RESOURCE $ 209,023.91 2'- TYPE Annuities Annuities Annuities Annuities LOCATION OF RESOURCE. COMMENTS $ $ $ $ $ $ $ $ $ $ Mutual Funds Mutual Funds Mutual Funds Mutual Funds $ $ $ $ Sole Proprietorship Joint Partnership $ $ Life Interest $ <2.3 Commonwealth of Pennsylvania Department of Public Welfare CUMBERLAND COUNTY ASST OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, PA 17013-0599 Telephone 240-2704 OR 1-800-269-0173 EXT. 3704 FAX: 249-8141 RESULTS OF RESOURCE ASSESSMENT Dear Mr. and Mrs. Dean: The Department of Public Welfare has completed the Resource Assessment received on August 18, 2006. Based on the information you provided, the total value of the countable resources owned by you and your spouse as of the date of your admission to the nursing facility is $209,023.91. A copy of the Resource Assessment Form is enclosed. The purpose of the assessment was to detennine what portion of the total resources owned by you and your spouse may be protected for the spouse at home. This portion is called the "protected spousal share" and is not considered available to pay for nursing facility care. This protected spousal share is generally one-half of your joint resources, up to a maximum, set by federal law (currently $99540) and not less than a minimum (currently $19908). Based on that formula, your protected spousal share is $99,540.00. Except as described below, you should apply for Medical Assistance when the total countable resources of you and your spouse are reduced to an amount approximately equal to the protected spousal share (above) plus $8000.00. In some cases, more resources may be protected for the spouse at home. In order to be able to protect more resources, you must apply for Medicaid sooner and request a hearing. Information describing when you are pennitted to protect more resources for your spouse at home was included in Part 3 of the Admissions Notice Packet you received from the Nursing facility when you were admitted. You should refer to this information if the income of the spouse at home is less than $2489 per month. If you need another copy of Part 3, contact the admission office of your nursing facility. It is important for you to calculate the monthly income allowance and actual monthly income needs of the spouse at home in order to appropriately protect resources aild provide income to your spouse at home as permitted by federal law. The enclosed worksheet will help you in making this determination. Once you have applied for Medicaid benefits, either you or your spouse may request a fair hearing if you are dissatisfied with the Department's determination of the community spouse's share of resources or monthly income allowance, or to establish that your spouse should receive a higher income or resource allowance. If you have any questions about this letter, you may contact me by telephone at (717) 240-2704 or 1-800-269-0173 EXT. 2704 or by writing to the address above. Marcia Mikos Copies: Nursing Home ~L. '-1 \Q 0 ..... r- 0 ~ 0 ..... II) ~ 0 en&.. U'\ ::c ~o 0 ~ N .....U I-W N z= ..... 0\ ::20 U)ctz ~ 8~ a=1-<C LWU)W Il\ 01- t::ll.&JQ N C < .... \Cl a:W-' &..0 ~:: .. 0"" 1->- a= "" Q 0::: W 1-0 Zu.ct ! Z..... <COE wee w ::l ~o cnzcn z w c:ctO I-C w-cr: I- <0 cr:C z: .....- ::2cr: = tno::: 1-< 0 UJ ~5 (J c. 0 &.. <C w = ::c ~ t- o::: :IE 0 w. LW .J (J a:: Z-Q\ <I;,).- W C'i'l eel'-' Or -'0 :lie( >1.JJ4. =0 ceO(/) Zr...ItC W;:S:W ~o~ C=Q\W 27 If f ftEf'JOIX E.. 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SUE MAUERY, VICE PRESIDENT TRUST OFFICER M&T BANK 213 MARKET STREET HARRISBURG, PA 17101-2127 DEAN, ROSEMARY L. ;---1~~elg-~-------r-" - ST4 - 5731706~' ROOM CHARGE 5/4-5/31/06 TOTAL INCONT-DLY FEE 5/4-5/31/06 NTRTNL/ENTRL SERV GRP 2 5/15-5/31/06 WOUND TREATMENT 06/08/06 PAYMENT FROM MR.DEAN 6/1-6/30/06 ROOM CHARGE 6/1-6/30/06 TOTAL INCONT-DLY FEE 07/10/06 PAYMENT FROM MR.DEAN 7/1-7/31/06 ROOM CHARGE 7/1-7/31/06 TOTAL INCONT-DLY FEE 08/07/06 PAYMENT FROM MR.DEAN 8/1-8/31/06 ROOM CHARGE 5,460.00 196.00 12.00 408.00 6,045.00 210.00 6,045.00 217.00 6,045.00 PAYMENT DUE UPON RECEIPT :?( j}f'IEtJt>rx c: PRIVATE PAY ROOM 312-A 11/06/2003 988.00 500.00 500.00 $22,650.00 ~ S. BERNE SMITH Attorney-at-Law 107 N. 24th Street Camp Hill, PA 17011-3602 PHONE: (717) 737-6789 FAX: (717) 737-6783 September 14, 2006 In re: Estate of Rosemary L. Dean, Alleged Incompetent, Orphans' Court Division, No: 21-70-239 Ms. Glenda Farner Strasbaugh Register of Wills Courthouse 1 Courthouse Square Carlisle, PA 17013-3387 ATTENTION: COLLEEN Dear Register: Enclosed you will find a Hearing Order with respect to the Petition to Modify Guardianship that I filed with you today in the above proceeding. I am sorry that I misunderstood the instructions that I received from the Court with respect to the proposed Order that I was to attach to the Petition. I also want to confirm that copies of the Petition have been served on all parties in interest. A certificate of service is enclosed. We left with you address cards so that you can notify everybody of the hearing date. I am now enclosing a stamped return envelop for you to give me notice. Thank you for your assistance. /2 13:::'~ S. Berne Smith Enclosures: cc: Robert E. Dean Robert E. Dean, Agent for Rosemary L. Dean Ms. Sue Mauery, Vice President, M&T Trust Co. Ms. Rebecca McCurdy, Manor Care Camp Hill IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 CERTIFICATE OF SERVICE S. Berne Smith, Esq., a duly admitted attorney in the Commonwealth of Pennsylvania in good standing, certifies that he has personally served a copy of the Petition to Modify Guardianship filed in the above proceeding September 14, 2006, on Robert E. Dean and on Robert E. Dean as Agent for Rosemary L. Dean, his wife, by handing him a copy of the Petition on September 14, 2006, and that he has served a copy of the Petition by first class mail, postage paid, on Ms. Sue Mauery, Vice President and Trust Officer, Manufacturers and Traders Trust Co., 213 Market Street, Harrisburg, PA 17101-2127, this same date by depositing same in the Camp Hill Post Office. Dated at Camp Hill, PA, this 14th day of September, 2006. AI3~~ S, Berne Smith, Esq. Attorney I.D. 07254 107 N. 24th Street Camp Hill, PA 17011-3602 717-737-6789 r"" IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 HEARING ORDER AND NOW, ~ Jl ,2006, hearing on the above captioned Petition to Modify Guardianship with respect to the Estate of Rosemary L. Dean will be held on D~ ,0 , 2006, at 1: 'D o'clock *.~, in Court Room 3 when all parties in interest may appear and present testimony. J. Vd "" lUn(j~'; =iO ..,i.;nJ >110 -'~....- I ,',,-,:..J J tr :6 l:l~ ., Z ;:jS C10r 7 (" (,.~ JutJ.... ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: Estate of Rosemary L. Dean, An Alleged Incompetent CUMBERLAND COUNTY PENNSYL VANIA NO. 21-70-0239 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 09/21/06 JUDGE'S INITIALS: EEG TIME STAMP DATE: 09/21/06 IN RE: ORDER OF COURT HEARING SCHEDULED-PET TO MODIFY GUARDIANSHIP ...... '" 'I ....... 'I ......... ...... ......", ............ ......... ...... '\"...... ...".. ......... ... ......... ... 'I ...... 'I'" ......".. ........................ ...... ... ..."..............."".................. "I 'I"'''''''''''''''''''''' 'I"'''''''''''''''''''''''''' ........ ........... ......"... ..."" "..."......... ................. " SERVICE TO: ROSEMARY L DEAN. MANOR HEALTH CARE: ROBERT E DEAN. SUE MAUERY. M&T S BERNIE SMITH METHOD OF MAILING: ENVELOPES PROVIDED BY: cgj USPS DRRR o HAND DELIVERED o OTHER_ [8J PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: 09-22-06 """""""""""""""""""""""""""""""""""""""""""""",...""""""""""""""" SERVICE TO: METHOD OF MAILING: ENVELOPES PROVIDED BY: o USPS DRRR o HAND DELIVERED o OTHER_ D PETITIONER D JUDGE D CLERK OF ORPHANS COURT MAILED: ~A~J~' Y Deputy , Clerk of Orphans' Court --====- IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 AND NOW, ORDER OF COURT o ~ ;.0 , 2006, the Court having considered the facts set forth in the Petition to Modify Guardianship, all parties in interest having been joined and there being no objection to the relief sought, and the Court, after hearing, being satisfied that the relief sought is reasonable and appropriate under the circumstances, approves the petition and grants relief as follows: 1. Manufacturers and Traders Trust Co. is authorized to make payments from the Guardianship account for the nursing home care and related expenses of Rosemary L. Dean until the assets of the couple have been spent down to the protected Medicaid amount, on the occurrence of which the Manufacturers and Traders Trust Co. Guardianship for Rosemary shall terminate; and 2. That the balance of Manufacturers and Traders Trust Coo's Guardianship account, after the pay down of the couple's excess assets has been completed, shall be deemed to be a protected asset for the benefit of the community spouse share of Robert E. Dean, Rosemary's husband, and shall be paid over to Robert E. Dean when a further Medicaid Application is filed on behalf of Rosemary L. Dean; and, further, 3. That Manufacturers and Traders Trust Co. is authorized to make payments from the Guardianship account to pay the legal fees incurred by Robert E. Dean and owed to S. Berne Smith, Esq., for preparing and filing the Medicaid Application(s) for Rosemary and for filing the instant Petition to Modify Guardianship, upon presentment to the Trust Co. by Attorney Smith of his detailed statements for legal services, which fees shall be calculated at the rate of $75.00 per hour and in the aggregate shall not exceed $5,000.00. B , . ,'nr"\ 'v'd u, i iL...Jji~1 Iv 181\0:) S.i\j'liH&IO :l0 >18318 28 :6 WV 02 1:10 900Z J. I , '('I J'.j''\iJ.10 (1'::;'0" }..I((r:j~ .:<... :J iJ.JV \..J... U'-"..I....c.I - IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION , No: 21-70-239 HEARING ORDER AND NOW, :f' ~ ,..~ , 2007, hearing on the above captioned Petition to Terminate Guardianship with respect to the Estate of Rosemary L. Dean will be held on rlC./.) ~Jq 27 ,2007, at /6:3' o'clock A""~, in Court Room ~ when all parties in interest may appear and present testimony. o s;o ~D26 .c ,'1 ....,- 0 ..~""""r: :! ~ f-n -: U3 ?2 ~] C) 0 ':) 9-n ~ --:) '-- :~ -0 -;> J. ~ c::::J c:;:) --J c.... c: % N -.J -u ::I: --' ~-~~3 :-.0 ,...., ,::::[1 o o -Ti ..n ?'S M N vr( ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: EST OF ROSEMARY L DEAN ALLEGED INCAPACITATED PERSON CUMBERLAND COUNTY PENNSYLVANIA NO. 21-70-0239 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 06/26/07 JUDGE'S INITIALS: EEG TIME STAMP DATE: 06/27/07 IN RE: HEARING ORDER SERVICE TO: CATHERINE G BOSCH ROBERT E DEAN ROSEMARY L DEAN S BERNE SMITH METHOD OF MAILING: ENVELOPES PROVIDED BY: [8] USPS DRRR o HAND DELIVERED o OTHER_ [gI PETITIONER o JUDGE D CLERK OF ORPHANS COURT MAILED: 06/28/07 SERVICE TO: METHOD OF MAILING: ENVELOPES PROVIDED BY: D USPS DRRR D HAND DELIVERED o OTHER_ D PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PA In Re: Estate of Rosemary L. Dean, Alleged Incompetent ORPHANS' COURT DIVISION No: 21-70-239 ORDER OF COURT AND NOW, T ~ d 7 ,2007, the Court having considered the facts set forth in the Petition to Terminate Guardianship, all parties in interest having been joined and there being no objection to the relief sought, and the Court, after hearing, being satisfied that the relief sought is reasonable and appropriate under the circumstances, approves the petition and grants relief as follows: 1. The Petition to terminate the Guardianship is approved; 2. The final accounting of M&T Trust attached to the Petition with respect to the Guardianship is approved without objection; 3. After the transfer of$84,254.55 from the guardianship account to Robert L. Dean, M&T Trust is directed to make final distribution of the balance of the guardianship account :2Jj~to~.A..~~T. account for the benefit of Rosemary L. Dean under the management of Robert L. Dean, Rosem;;':T ~~~ Agent under a Power of Attorney; and 4. M&T Trust is discharged from any further responsibilities as Guardian of the Estate of Rosemary L. Dean. \.0 :L < -?: 1-_ u. a: : ...,r.... LL Fj c- Oe) ~'-r"'. 0::: ::::..~ ~~t o~ (.) J. LL.l ~;~ ~. . ~ '-.....; ~ r-~-~< l"- N -I :::> J r0- c::::> c::::> C'o.l c.::~ /-'- '- . c',,) 1 .f I :' VJf In Re: ROSEMARY L DEAN ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 21-07-0239 CERTIFICA TE OF SERVICE OF ORDER ORDER DATE: 07-27-07 JUDGE'S INITIALS: EEG TIME STAMP DATE: 07-27-07 IN RE: ORDER "'.......... '\.... '\""..""" '\... '\...,' '\ '\.. 'I" '\ '\ '\ '\ '\ '\ 'I 'I '\ '\ '\..... '\ '" '\... '\".. '\ '\... '\...... '\ '\.. "'"...... '\ '\.... '\ '\.... '\.. '\ '" "''''' "" "'" '\.. '\ '\....".. '\......... '\ '\ '\........ 'I" '\... '\.. '\... '\.. '\ '\ SERVICE TO: BERNE SMITH MARGARET T BENNER METHOD OF MAILING: ENVELOPES PROVIDED BY: o USPS DRRR [gJ HAND DELIVERED o OTHER_ o PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: 07-27-07 .. '\.......... '\ 'I" 'I" '\ '\.... 'I" '\ '\ '\" '\ '\....." ",.......... '\ '\ '\.... '\ '\ 'I"" '\.. '\...... '\ 'I" '\.. '\ '\ 'I '\ '\ '\ 'I" '\.. '\.. '\.. 'I '\ '\.. '\ 'I '\ '\ '\.."... '\ '\ """""....." ", 'I 'I" 'I""" 'I 'I""""" 'I""""""" SERVICE TO: o USPS DRRR o HAND DELIVERED o OTHER_ ENVELOPES PROVIDED BY: o PETITIONER o JUDGE o CLERK OF ORPHANS COURT METHOD OF MAILING: MAILED: crm1iN ~~([fi) eputy Clerk of Orphans' Court ORPHANS' COURT DIVISION COURT OF COMMON PLEAS OF In Re: ESTATE OF ROSEMARY L DEAN ALLEGED INCAPACTATED CUMBERLAND COUNTY PENNSYLVANIA NO. 21-70-239 CERTIFICATE OF SERVICE OF ORDER ORDER DATE: 07/27/07 JUDGE'S INITIALS: EEG TIME STAMP DATE: 07/27/07 IN RE: ORDER OF COURT '\ ,'\"" 'I '\" '\... '\ 'I 'I '" '\ ,"',....... '\ '\......" '\ '\" '\ '\ '" "... ,... "" '\ '\ '\ '\" '\ '\ '\" '" '\ """""'" 'I '''' '\"1 '\ '\ '\ 'I '\ """""" '\ " '\"" '\ '\ '''''' '\... ""'" ""..." '\ SERVICE TO: CATHERINE G BOSH ROBERT E DEAN/ROSEMARY L DEAN METHOD OF MAILING: ENVELOPES PROVIDED BY: [8J USPS DRRR o HAND DELIVERED o OTHER_ [8J PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: 07/27/07 "'1'1""'" '\ '\ '\.. '\ '" '\ '\ ,,,...... '\... '\ 'I '\ '\ '\ '\ 'I'" '\... '\... ",..." ,... '\... '\ '\ '\ '\ '\ '\ 'I'" 'I '\... '\ """"'" 'I" '\ '\... 'I" '\" '\ ......"""......", 'I"'''' 'I'" '\ '\..."... "'" "......"... '\... '\... 'I"'" SERVICE TO: METHOD OF MAILING: ENVELOPES PROVIDED BY: o USPS ORRR o HAND DELIVERED o OTHER_ o PETITIONER o JUDGE o CLERK OF ORPHANS COURT MAILED: o~~