HomeMy WebLinkAbout01-2193 CivilAREA AGENCY ON AGING, : IN THE couRT OF COM~4ON pLEAS OF
plaintif~ : CUMBERL~ID COUNTY, pENNSyLVANIA
:
. dant [ NO. 07-2193 CIVIL TERM
SARA Defien .... =~ A~~ E~
~D NOW, this 8th day o~ August, 2001, upon
consideration o[ the petition [or APP°intment of permanent plenary
Guardians o[ the person and Estate in the above-captioned matter,
and following a hearing at which the allegedly incapacitated
was present and represented by her
person, sara Marie McAlicher
court-appointed counsel, John A. Abom, Esquire, the son o[ Ms
McAlicher, Robert McAlicher, was present and represented by
Bradford Dorrance, Esquire, and the petitioner was present through
a representative and represented by its counsel, AnthOny L.
DeLuca, Esquire, sara Marie McAlicher is adjudicated an
incapacitated perSOn, and the petitioner, the Cu~erland county
Area AgenCy on Aging, is appointed plenary guardian o[ her person;
petitioner and Ms. McAlicher'S son, Robert McAlicher, are
appointed plenary co_guardians o~ her estate.
The guardians are directed to ~ile reports in
accordance with the provisions o[ the probate, Estates and
FidUciary'S code applicable to such guardians.
No bond shall be required o[ the guardians in this
Marie McAlicher
case.Notice is hereby provided to sara
through this order entered in open court in her presence and in
~he oresence o~ her court-appointed counsel o~ her right to appeal
and to petition to modify or terminate the guardianships created
herein.
The following special terms and conditions shall
apply to the guardians and guardianships created herein:
1. The medical assistance application shall be
completed on or before August 22, 2001, by Robert McAlicher. The
items to be furnished to the Department of Public Welfare are
those enumerated on Petitioner's Exhibit 1, a copy of which is
attached hereto and made a part hereof.
2. All of the monthly income of Sara Marie McAlicher
shall be direct-deposited to her account at West Shore Health and
Rehab Center.
3. Failure to comply with this order may be grounds
for the filing of a motion for contempt.
By the Court,
Anthony113 FrontL'streetDeLuca' Esquire ~ ~e~ley O1 r~ ~r.~ ~L7
Boiling Springs, PA 17007
For the Petitioner
John A. Abom, Esquire
8 South Hanover Street
Carlisle, PA 17013
Bradford Dorrance, Esquire
210 Walnut Street
P.O. Box 11963
Harrisburg, PA 17108-1963
For Robert McAlicher
pcb
Commonwealth of Pennsylvania
Department of Public Welfare
CUMBERLAND COUNTY BOARD OF ASSISTANCE
33 Westminster Drive
P.O. Box 599
Carlisle, PA 17013-0599
Telephone 240-2744 OR 1-800-269-0173 FAX: 249-0919
June 8, 2001 "
RE: Sarah B. McAlicher
Case: 89716
Nursing Home: West Shore Health & Rehab
Dear Mr. McAlicher,
We have received your application for Nursing Home Medical Assistance. In order to
determine eligibility, we will need the following items as indicated. Photocopies are acceptable.
Please send'th~ information to Doris Klingensmith by JUNE 22, 2001. Please call if you have
any questions, need help in obtaining the required information or would like to request_a face-.to-
face interview. Please provide only those items marked with a XX. ?- ...... ..
/ , --" ' · ," -'{", I
I)XX 1) Social Security card / ~.' ?'-'.-,; f,!':~ ..
2)XX 2) Proof of date of birth ~/' ~.'--.'~ ,?.
; ...I ~, /'; t,
3)XX 3) Medical coverage m~.mberahip cards : ,... ,.. ..,
a)XX a) Health Insurance premiums (frequency and amount) "- ! ' '"" .... [
b)YY-,X b) Medicare (red/white/blue card) " ..... ;!~?" -
........... r'-'~ 'J'-' .
c)XX c) Blue Cross / Blue Shield cards ~.0 ~z--- ~.~
d)XX d) Any other health insurance plan (s) . L,~- .... ,~
4)XX 4) Work history (if any in the past5 years) fi' !! ~, ~,
5)XX 5) Verification of assets/resources for the past 3 years (36 months)
· ***'*BANK STATEMENTS FROM 1998 TO PPdgSENT******
(Acceptable types of verification are: checkbook ledger, bank statements,
Copies of items, statements from source of resource/asset)
a)XX a) Bank accounts (checking, savings, money market, etc)
b) b) Stocks, bonds, or Certificates of Deposit
c) c) Christmas Club, Vacation Club, etc.
d) d) Trust Funds
e)XX e) IRA or KEOGH or Annuities
,-J~)OR 6) Tax returns, including the 1099-INT forms for last 3 years
7)XX 7) Verification of titles, vehicle registration (if more than one vehicle provide value of
each vehicle.
8)XX 8) All Life insurance policies (verification should include company's name, policy number,
type of policy, face amount of policy when purchased, ownership of policy and statement
on current cash value.
9) XX 9) Deed to Bu.rial plot(s) or Statement from cemetery
10)XX 10) Copy of Burial Trust (including Statement of Irrevocability) ~ ~~f/~~ I
:: ~":.:- i - ~ ' :' ' i~ :. '; : . : ;:.. ·
11)XX 11) Deed to all property (if transferred or sold within the last 36 months, a copy of the
new deed and the settlement sheet for all sold property).
12)12) Title to mobile home
13)XX13) Verification of any resource/asset that has been sold, traded or given away over the
· last 36 months.(amount received and date received)
14)X_:X14) Any medical bills you wish to have a determination made to see if Medical
Assistance would cover.
15)XX 15) Verification of all GROSS income
a)XX a) Interest income
b)XX b) Current award letter
c)XX c) Written statement from so'arce of check
d) d) Copy of check stub
e) e) All deductions from gross amount of check must be verified
16)XX 16) Power of Attorney or guardianship papers (if established)
17) 17) If there is a spouse living in the community the following must also be provided for
the spouse.
a) a) Verification of rent or mortgage
b) b) Taxes on property only
c) c) Insurance on home
d) d) Utility bills
e). e) Resource assessment form, if completed before application
18) 18)
By waiving the interview, you are certifying to this office, under penalty of fraud, that all
infon-nation you have provided is true, correct, and complete to the best of your -knowledge. You
agree to repo~ all changes in Ms. MeAlicher's circumsta~aces to this office within seven (7)
days.
!f dete_.rmi_ned eligible there will be a ACCESS card issued to the Nursing home which will
cover hospital, doctor and prescription drug expenses. If you receive any medical bills for the
period after the authorization date, submit them to the Business office at the Nursing Home as
they will have possession of the ACCESS card.
You will receive a PA 162 (Notice to Apl?~icant) form when the case has either been authorized
or denied. The notice will inform you of the amount that you w!ll pay monthly out of the
. resident's income, to the nursing home, or if they are not eligible, the reason.
This material is due in this office by JUNE 22, 2001. If information is not received by the
date listed, the application could be discontinued and reapplication would be necessary.
If you have any questions regarding this notice, please call Melanie Cohiek AT 1-800-269-
0173 OR IN CARLISLE AT 240-2719.
~ncerely, . -
IMC
soa.
AREA AGENCY ON AGING, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
:
V. :
: CIVIL ACTION - LAW
SARA McALICHER, :
Defendant : NO. 01-2193 CIVIL TERM
IN RE: PETITION FOR APPOINTMENT OF
PERMANENT PLENARY GUARDIANS OF THE PERSON AND ESTATE
BEFORE OLER, J.
OPINION and ORDER OF COURT
Oler, J., August 8, 2001.
At issue in the present case is whether Sara Marie
McAlicher should be adjudicated an incapacitated person, and, if
so, who should be appointed plenary guardians of her person and
her estate. A hearing was held on the matter on Wednesday, August
8, 2001, before the undersigned judge.
Based upon the evidence presented at the hearing, and
pursuant to an agreement of counsel with respect to the order to
be entered, the following Findings of Fact, Discusison and Order
of Court are made and entered:
FINDINGS OF FACT
1. The allegedly incapacitated person is Sara Marie
McAlicher, a domiciliary of Cumberland County, who presently
resides at the West Shore Health and Rehabilitation Center, 770
Poplar Church Road, Camp Hill, Cumberland County, Pennsylvania.
2. Ms. McAlicher was born on July 21, 1916, and is
presently 85 years old.
3. Petitioner is the Cumberland County Area Agency
on Aging, which has offices at 16 West High Street, Carlisle,
Cumberland County, Pennsylvania.
4. The allegedly incapacitated person, Sara Marie
McAlicher, has been diagnosed since December 26, 2000, with senile
dementia of the Alzheimer's type.
5. As a result of the aforesaid condition, Ms.
McAli~her is an adult whose ability to receive and evaluate
information effectively and communicate decisions is impaired to
such a significant extent that she is totally unable to manage her
financial resources and totally unable to meet the essential
requirements for her physical health and safety.
6. The duration of the aforesaid condition may be
said to be uncertain, and the condition at the present time is
such as to necessitate the establishment of plenary guardianships
with respect to the person and estate of Ms. McAlicher.
7. In lieu of the absence of a more favorable
prognosis at this time, the duration of the guardianships required
may be said to be indefinite and pending further order of Court.
8. Petitioner and Ms. McAlicher's son, Robert
McAlicher, whose address is 143 Henry Road, Enola, Cumberland
County, Pennsylvania, are qualified to serve as plenary
co-guardians of Ms. McAlicher's estate, and Petitioner is
qualified to serve as plenary guardian of her person.
9. The foregoing Findings of Fact are made on the
basis of clear and convincing evidence.
10. The terms of the Order of Court accompanying
'this opinion have been agreed to by counsel for the allegedly
incapacitated person, John A. Abom, Esquire, counsel for her son,
Bradford Dorrance, Esquire, and counsel for the Petitioner,
Anthony L. DeLuca, Esquire.
DISCUSSION
The provisions respecting an adjudication of
incapacitation have been recently amended and are contained in 20
Pa. C.S. Sections 5501 et seq. Petitioner has substantially
complied with these provisions, and based upon the forgoing
Findings of Fact the following Order of Court will be entered.
ORDER OF COURT
AND NOW, this 8th day of August, 2001, upon
consideration of the Petition for Appointment of Permanent Plenary
Guardians of the Person and Estate in the above-captioned matter,
and following a hearing at which the allegedly incapacitated
person, Sara Marie McAlicher, was present and represented by her
court-appointed counsel, John A. Abom, Esquire, the son of Ms.
McAlicher, Robert McAlicher, was present and represented by
Bradford Dorrance, Esquire, and the Petitioner was present through
a representative and represented by its counsel, Anthony L.
DeLuca, Esquire, Sara Marie McAlicher is adjudicated an
incapacitated person, and the Petitioner, the Cumberland County
Area Agency on Aging, is appointed plenary guardian of her person;
Petitioner and Ms. McAlicher's son, Robert McAlicher, are
appointed plenary co-guardians of her estate.
The guardians are directed to file reports in
accordance with the provisions of the Probate, Estates and
Fiduciary's Code applicable to such guardians.
No bond shall be required of the guardians in this
case.
Notice is hereby provided to Sara Marie McAlicher
through this order entered in open court in her presence and in
the presence of her court-appointed counsel of her right to appeal
and to petition to modify or terminate the guardianships created
herein.
The following special terms and conditions shall
apply'to the guardians and guardianships created herein:
1. The medical assistance application shall be
completed on or before August 22, 2001, by Robert McAlicher. The
items to be furnished to the Department of Public Welfare are
those enumerated on Petitioner's Exhibit 1, a copy of which is
attached hereto and made a part hereof.
2. All of the monthly income of Sara Marie McAlicher
shall be direct-deposited to her account at West Shore Health and
Rehab Center.
3. Failure to comply with this order may be grounds
fo~ the filing of a motion for contempt.
By the Court,
/s/ J. Wesley Oler, Jr.
J.
Anthony L. DeLuca, Esquire
113 Front Street
Boiling Springs, PA 17007
For the Petitioner
John A. Abom, Esquire
8 South Hanover Street
Carlisle, PA 17013
Bradford Dorrance, Esquire
210 Walnut Street
P.O. Box 11963
Harrisburg, PA 17108-1963
For Robert McAlicher
pcb