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March 13, 2026 Get Citation Alerts Download PDF Add Note

T.C. v. G.R.C. v. M.N.G.

Superior Court of Pennsylvania

• Citations: None known
• Docket Number: 1193 WDA 2025
• Precedential Status: Non-Precedential

• Judges: Beck

• Opinion

• Authorities (5)

• Cited By (0)

• Summaries (0)

• Similar Cases (20.2K)

• PDF

Combined Opinion

                        by Beck

J-A06032-26

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT O.P. 65.37

T.C. : IN THE SUPERIOR COURT OF
: PENNSYLVANIA
Appellant :
:
:
v. :
:
:
G.R.C. : No. 1193 WDA 2025
v. :
:
:
M.N.G. :

Appeal from the Order Entered September 22, 2025
In the Court of Common Pleas of Allegheny County Family Court at
No(s): FD 18-002975-009

BEFORE: OLSON, J., MURRAY, J., and BECK, J.

MEMORANDUM BY BECK, J.: FILED: March 13, 2026

T.C. (“Maternal Grandmother”) appeals pro se from the order entered

by the Allegheny County Court of Common Pleas (“trial court”) granting

primary physical and sole legal custody of G.G. (a female born in December

2013) and B.G. (a male born in May 2017) (together, “Children”) to their

mother, G.R.C. (“Mother”), and permitting Mother to relocate with Children to

Steubenville, Ohio.1 Following our careful review of the record in this matter,

we affirm.

---

1 The record reflects that M.N.G. (“Father”) is incarcerated and did not
participate in the proceedings below. As discussed below, however, his
mother, E.G. (“Paternal Grandmother”), participated in the hearing and
testified on behalf of Mother.
J-A06032-26

The trial court aptly summarized the procedural history underlying this

matter:

Maternal Grandmother filed a complaint for custody on
December 2, 2022[, alleging medical neglect of Children by
Mother and physical abuse of B.G. and sexual abuse of G.G. by
Mother’s fiancé].[2] After this, the [trial] court scheduled an
interim relief hearing before a custody hearing officer. Following
the interim relief hearing, the trial court entered an order … dated
May 26, 2023, that granted Mother primary physical custody of []
Children and partial physical custody to Maternal Grandmother
every other weekend from Friday through Saturday. Maternal
Grandmother’s custody claims were preserved, and the case was
scheduled for a judicial custody conciliation on August 30, 2023.
Following the judicial conciliation, the court maintained the interim
custody schedule on alternating weekends for Maternal
Grandmother and reinforced the referral for the family to Dr.
Frieda Reid through the Family Check Up Program at the
University of Pittsburgh. A second remote judicial conciliation was
set for November 21, 2023, and a third remote judicial conciliation
was set for December 28, 2023.

In January 2024, the [trial] court entered an updated
interim custody [order] that expanded legal custody to shared
legal custody between Mother and Maternal Grandmother but
maintained the same shared physical custody schedule. A fourth
judicial conciliation was set for March 8, 2024. Around June 2024,
Mother relocated with [] Children from Pittsburgh, Pennsylvania
to Steubenville, Ohio. Maternal Grandmother presented an
emergency petition for special relief. The court originally directed
Mother to return to Pittsburgh with [] Children in an order … dated
June 24, 2024. However, when Mother failed to comply with the
emergency court order, the [trial] court entered a second interim
custody order that granted Maternal Grandmother temporary

---

2 The physical abuse allegations were based upon B.G.’s report to Maternal
Grandmother and are discussed below. The sexual abuse allegations were
based upon Maternal Grandmother’s observations of G.G.’s behaviors and her
alleged complaints about pain in her rear end. There is nothing in the record
regarding these allegations other than testimony that Maternal Grandmother
once saw G.G. sitting on his lap and his innocent explanation.

-2-
J-A06032-26

primary physical custody of [] Children and scheduled the matter
for a one [] day custody trial.

A [pretrial] conference occurred on January 30, 2025, and
the [trial] court scheduled a one [] day custody trial for May 7,
2025. On that date, the parties and [court appointed special
advocate (“CASA”)] appeared and participated in a judicial
conciliation rather than a trial. Following this, the court entered
an interim custody order dated June 20, 2025, that directed
Mother and Maternal Grandmother to share physical custody
during the summer with Mother exercising custody from Sunday
to Thursday and Maternal Grandmother exercising custody from
Thursday to Sunday each week. The parties appeared a second
time for a one [] day custody trial on August 11, 2025. Maternal
Grandmother and Mother both testified at the custody trial in
addition to L.H., Michelle
Bernard ([CASA]), … Paternal Grandmother[], O.F. (Mother’s
[fiancé])[,] and S.C..

Trial Court Memorandum and Final Order of Court, 9/15/2025, at 1-2

(hereinafter, “Trial Court Decision”) (unnecessary capitalization omitted).

This is a particularly complicated custody and relocation matter based,

in large part, on Children’s medical fragility. Children are the third generation

on Father’s side of the family to be born with a rare form of congenital

nephrotic syndrome, which, the record reflects

is characterized by loss of the body’s protein through the urine,
and its severity varies from person to person. Complications of
this protein loss include body swelling, elevated cholesterol,
anemia, certain vitamin deficiencies and increased risk for
infection. This family’s form of congenital nephrotic is also
characterized by severe reactive airway disease. Many family
members have sustained good renal function, but some have
progressed to end-stage renal disease and transplantation. B.G.
has had a more severe course than his sister and has a history of
wheezing, consistent with other family members with this disease.

-3-
J-A06032-26

Exhibit 1 (CASA Report, 11/16/2023, at 1).3 Children require a low sodium

diet and daily weight checks, as rapid weight gain is a sign of excessive fluid

retention, which places them at risk of infection.

When this matter commenced and in the early days of the case, both

Children had been hospitalized numerous times for complications related to

their diagnoses. Notably, B.G. was admitted to Children’s Hospital of

Pittsburgh (“CHP”) for spontaneous bacterial peritonitis in November 2019 and

July 2020, and again in April 2022 for sepsis caused by pneumonia. Id. at 1-

1. Between December 2019 and September 2023, he was admitted more

than two dozen times for accumulated abdominal fluid. Id. at 2. This has

resulted in medication changes, including infusions, all with the goal of

keeping him out of the hospital and living a normal, healthy life. Id.

G.G. had not experienced the same level of complications as her

brother, but she had a very serious medical emergency in December 2021

when she was hospitalized for spontaneous bacterial peritonitis. Id. (CASA

Report, 3/8/2024, at 2). She reportedly nearly died, as she went into septic

shock, requiring two rounds of intubation during her seventeen-day

admission. Id.

---

3 Only the notes of testimony from the August 11, 2025 hearing appears in
the certified record before this Court. As the record reflects that the trial court
found the CASA to be credible and the parties agreed to the admission of all
the CASA reports as exhibit 1, we utilize these reports to detail the factual
history underlying this matter. See N.T., 8/11/2025, at 202-03; Trial Court
Decision at 10.

-4-
J-A06032-26

There have been concerns up until the final few months leading up to

the hearing about Mother’s failure to recognize when hospitalization was

needed, stay at the hospital when Children were admitted for lengthier periods

of time, and abide by Children’s dietary restrictions. For example, in March

2025, B.G. required a two-week hospitalization because of spontaneous

bacterial peritonitis. This episode occurred on the heels of Children spending

the weekend of February 21, 2025 in Mother’s care. She did not return them

to Maternal Grandmother on February 23 as ordered, instead keeping them

for the entire week, which required them to go without their medicine for an

extended amount of time. Id. (CASA Report, 5/7/2025, at 3).

As the case progressed, however, Mother slowly began taking a more

active role in ensuring Children received the low-sodium diet they needed,

working with CASA to learn new recipes and keeping a food journal as

requested by both CASA and Children’s medical providers.4 Mother explained

her prior inability to spend overnights at the hospital was because she has two

younger children who require care and her fiancé (their father) leaves for work

before 5:00 a.m. with no alternative care available for another hour or two.

See N.T., 8/11/2025, at 157.

---

4 During the pendency of this case, CASA assigned Michelle Bernard, MS, RD,
LDN, as Children’s advocate. Ms. Bernard “is a renal dietitian and nutrition
manager with 26 years' experience managing patients with all stages of End
Stage Kidney Disease. She also trains/mentors other new renal
professionals.” Exhibit 1 (CASA Report, 5/7/2025, at 1).

-5-
J-A06032-26

Children also had serious educational concerns, including excessive

absenteeism, unaddressed learning differences, and failing to complete

assignments. See Exhibit 1 (CASA Report, 11/16/2023, at 2-6). Mother had

reportedly been referred to the magisterial district judge based upon the

number of unexcused absences for Children. She historically had little

communication with Children’s school and was difficult to reach. For example,

although Mother contacted the school about having G.G. tested to see if she

qualified for special education services when she was in third grade, Mother

initially failed to respond to the school’s multiple attempts to reach her

thereafter or to return the paperwork to begin testing. She eventually did

respond, and G.G. was evaluated and found to qualify for special education

services just prior to Mother moving Children midyear from a brick-and-mortar

school to a cyber charter school. The charter school implemented G.G.’s

individualized education plan (“IEP”), but Children’s inconsistent attendance

and missing assignments continued. Mother moved them to a brick-and-

mortar charter school during the same school year a couple of months later,

where unexcused absences and difficulty contacting Mother continued to be a

problem.

There was also a concern about Mother’s fiancé physically disciplining

B.G. In particular, he struck B.G. with a drumstick that B.G. was fighting over

-6-
J-A06032-26

with his younger half-sister, leaving a bruise on B.G.’s leg.5 N.T., 8/11/2025,

at 32. Child protective services reportedly conducted an investigation and

closed the matter with no involvement or findings of abuse. Both Mother and

her fiancé testified that they have ceased using any form of physical discipline

in their home. Id. at 168, 267.

Maternal Grandmother has been a stalwart support throughout

Children’s lives. She would visit Children in the hospital, stayed with them if

they had to remain there overnight, and was, at times, the one who took them

to the emergency room in the first place. She also communicated regularly

with their schools. During the early reports, CASA expressed concern about

Mother’s willingness and ability to address Children’s medical and educational

needs, recommending increased time with her, including awarding her

primary physical and shared legal custody of Children. See, e.g., Exhibit 1

(CASA Report, 3/8/2024, at 6; CASA Report, 8/5/2024, at 5; CASA Report,

5/7/2025, at 8).

When Children were placed in Maternal Grandmother’s primary care,

she enrolled them in her neighborhood public school for their fourth- and

second-grade academic years. She was highly involved in ensuring their

educational and dietary needs were met. She also enrolled them in counseling

through the school. Children’s school attendance, however, remained

---

5 Mother’s fiancé confirmed this story was true. N.T., 8/11/2025, at 268.

-7-
J-A06032-26

problematic in Maternal Grandmother’s care. Children each had several

unexcused absences (6 for G.G. and 2 for B.G.), they were late to school

almost daily, with 105 and 97 unexcused tardies, respectively, and numerous

excused absences (27 for G.G. and 57 for B.G.). Id. (CASA Report,

8/11/2025, at 3). She enrolled them in the school’s summer enrichment

program, where Children attended fifteen of sixteen sessions, but were late

eleven of those days.

Maternal Grandmother also began to have “intense disagreements” with

members of Children’s medical team. Id. at 5. Children had been followed

by Dr. Michael Moritz and Dr. Jacqueline Ho through CHP’s nephrology

department. Dr. Moritz left CHP to work at Akron Children’s Hospital, but Dr.

Ho remained as Children’s primary provider. Without consultation with the

medical team at CHP or Mother, Maternal Grandmother took Children for a

second opinion from Dr. John McAteer in the nephrology department at

Children’s Hospital of Philadelphia (“CHOP”). It was Maternal Grandmother’s

intention to make Dr. McAteer the primary provider for both Children,

notwithstanding that CHOP was more than 300 miles away. She only

confirmed this after Dr. Ho became aware from another source that B.G. had

been seen by CHOP and received treatment there. Dr. Ho expressed that

Children must be limited to a single care team for their safety, there was a

risk B.G. was receiving more diuresis than needed (which Maternal

Grandmother stated she did not understand), and that team could be through

-8-
J-A06032-26

any provider agreed to by both Maternal Grandmother and Mother. Id. at 6.

Maternal Grandmother also did not provide any food logs or diet information

to CASA or CHP, as requested. See N.T., 8/11/2025, at 76 (Maternal

Grandmother testifying on cross-examination that she did not “believe [she]

needed to do that [b]ecause I’m not the one that is not caring for your

children.”).

In July 2025, Maternal Grandmother brought B.G. to CHP for diuresis

treatments almost weekly. This was shortly after she took him to CHOP for a

diuresis treatment at the end of May (which had been preceded by two

additional diuresis treatments at CHP in May). On several occasions, CHP

concluded that B.G. was ready to be discharged, but Maternal Grandmother

disagreed and refused to take him home, requiring him to be released to

Mother’s care. After one such discharge to Mother’s care, Maternal

Grandmother returned to the CHP emergency room with B.G. the following

day (on July 31, 2025); the child was determined to be well and released

without treatment.6 Exhibit 1 (CASA Report, 8/11/2025, at 8); see also N.T.,

8/11/2025, at 107-08 (Mother testifying that CHP has been calling her more

because Maternal Grandmother refuses to take B.G. home after treatments).

---

6 That same day, a Childline report was made “alleging concerns of
maltreatment by overmedicalization by [Maternal Grandmother]. An
investigation has begun[.]” Exhibit 1 (CASA Report, 8/11/2025, at 8. At the
time of the hearing, no new information regarding the investigation was
available.

-9-
J-A06032-26

Indeed, the nephrology department observed that as of the end of July 2025,

B.G. had “been admitted monthly over the past year, although several of

[these] admissions have been primarily for observation, related to concerns

of his [Maternal G]randmother regarding fluid retention[.]” Exhibit 1 (CASA

Report, 8/11/2025, at 9) (quoting Nephrology Report, 7/27/2025). The

record reflects that Maternal Grandmother has a deep distrust for Children’s

medical team. See, e.g., N.T., 8/11/2025, at 88 (Maternal Grandmother

referring to Dr. Ho as being in “cahoots” with Mother).

CHP held a care conference on July 10, 2025, at which Mother, Maternal

Grandmother, Dr. Ho, an insurance case manager, CASA, and Dr. McAteer (for

the first twenty minutes, virtually) attended. The goals established by Dr. Ho

were to have Children thrive in daily living, stay out of the hospital, and grow,

and to determine Children’s primary nephrology provider. It was here that

the record provides some insight into Maternal Grandmother’s disagreements

with CHP’s treatment of Children, especially B.G. As summarized by CASA:

Dr. Ho highlighted [B.G.’s] most recent hospitalization [at that
time] from July 1, 2025-July 3, 2025[, initiated by Maternal
Grandmother,] where he was admitted at 55.6 lbs. for an infusion
and left around 53.7 lbs. She spoke of her observation of him
playing before he received any infusions at 55 lbs. and he was
running, jumping, skipping down the hall, laughing, eating,
drinking and very full of life. She said that visually his abdomen
was distended; however, it was also soft and compressible and he
did not have any shortness of breath. She stated that a distended
abdomen is a hallmark symptom of his diagnosis of congenital
nephrotic syndrome, and the goal is not to treat him to the weight
and point where that is completely gone. She discussed the risk
factors that are associated with excessive diuresis and taking his
weight too low, namely blood clots and strokes.

• 10 - J-A06032-26

Exhibit 1 (CASA Report, 8/11/2025, at 7); see also N.T., 8/11/2025, at 189

(CASA testifying that “the diagnosis of the congenital nephrotic syndrome

basically is going to have fluid retention, and it’s going to have a distended

abdomen. So it comes down to if it’s hard, if he’s short of breath, if he has

symptoms of fluid overload or if he doesn’t.”). Dr. McAteer stated that he

agreed with the course of treatment CHP was providing B.G. and made one

additional suggestion to determine whether the child’s body responded

appropriately to vaccinations he received as a baby and toddler, potentially

taking additional steps to protect B.G. from the bacteria that caused three of

his five hospitalizations for peritonitis. Maternal Grandmother was reportedly

silent throughout the care conference and asked no questions.

The record shows the relationship between Mother and Grandmother

has become more and more acrimonious as the case progressed. For

example, although Mother and Maternal Grandmother were awarded shared

legal custody of Children in the June 2025 interim custody order and both

were to be involved in Children’s medical decisions, Maternal Grandmother did

not inform Mother about the second opinion she sought through CHOP, refused

her access to the CHOP patient portal, and changed the login information for

Children’s medical insurance. Exhibit 1 (CASA Report, 8/11/2025, at 5).

Children very much feel stuck in the middle of two people they love

dearly. Each has expressed a preference to all parties—Mother, Maternal

Grandmother, CASA—as well as to their therapist, to live with Mother, but

• 11 - J-A06032-26

B.G. especially feels a sense of disloyalty to his Maternal Grandmother as a

result.

Both Mother and Maternal Grandmother proceeded pro se at the

hearing, at which the trial court patiently and respectfully allowed each to

testify, call witnesses, cross-examine each other and the other’s witnesses,

and enter exhibits into the record. CASA also entered reports detailing her

independent investigations into the concerns about Children and made

recommendations to the trial court regarding the custody dispute.

As noted in the trial court’s decision, Mother relocated to Ohio during

the pendency of the custody matter without informing or seeking permission

from the trial court. According to Mother, she was unaware that she needed

to obtain permission prior to moving. She stated, however, that she has

arranged for Children’s medical care at Akron Children’s Hospital where, as

previously stated, Children’s prior primary nephrologist currently works. She

also has vowed to make arrangements to stay with Children in the event they

require additional hospitalizations—including asking for help from Father’s

family to care for her other children and utilizing a Ronald McDonald House

located near the hospital—as Akron Children’s Hospital is approximately an

hour away from her home in Steubenville.7

---

7 Mother’s fiancé further testified that there is an adult hospital very near to
their home and in “a medical emergency,” they would take Children there to
be transported to Akron Children’s Hospital. N.T., 8/11/2025, at 266.

• 12 - J-A06032-26

Further, Mother testified that she has taken a more proactive approach

to Children’s education. She visited the school B.G. will attend if returned to

her care during the 2025-2026 school year to ensure it can meet his

educational and medical needs. She has also identified the school G.G. will

attend and plans to visit there prior to the start of the school year.

In her testimony, Mother recognized the importance of ensuring

Children’s medical and educational needs are met, but she also expressed

concern about their “[e]motional development.” N.T., 8/11/2025, at 113. To

address this, she wants to enroll them in activities, such as baseball (which

B.G. has played before and enjoyed), and gymnastics, flag football, and

wrestling (all of which G.G. has expressed an interest), and not let their

diagnoses define them and their lives. Id. at 113-14; see also id. at 108

(Mother testifying that with Maternal Grandmother, Children do not play

outside or have any social outings).

Paternal Grandmother provided testimony in support of Mother. She

stated that she has been living for nearly sixty years with the same diagnosis

with which Children are afflicted, and numerous family members, including

four of her children, four of her grandchildren, and her niece, great-niece, and

nephew, are also living with this illness. And although her fourteen-year-old

niece has a distended stomach ninety percent of the time, “[s]he plays sports

and she cheerleads,” stressing that Children “can carry on like a normal child.

So it’s livable.” Id. at 209. Paternal Grandmother acknowledged the

• 13 - J-A06032-26

difficulties associated with the condition, noting that the same niece she spoke

of “was in a coma for a couple of months” as “[s]he was septic[, … b]ecause

the fluid on the belly can get infected.” Id. at 212.

For her part, Maternal Grandmother expressed continued concern about

Mother’s failure to address Children’s medical needs. In her view, Mother “has

neglected her children’s medical and educational needs and continued to do

so with the help of her [fiancé] and the kids’ neglectful nephrology care team.”

Id. at 46. According to Maternal Grandmother, she is the only one who has

fought for Children’s medical and educational needs, as well as their safety

and security, and she has “earned the right to continue caring for them until

their mother gets her mind right.” Id. at 43, 55. Maternal Great-

Grandmother echoed much of Maternal Grandmother’s testimony, confirming

that Maternal Grandmother, and not Mother, has addressed Children’s needs.

CASA made its recommendation at the hearing that Children be returned

to Mother’s primary custody and that she be granted full legal custody:

I’m concerned that [Maternal Grandmother] is driven in
ways around overmanaging his medical status, and she’s not
seeing the holistic medical picture of him and the detriment that
that could cause to him as he grows up with just how he views
himself and his own medical management and his diagnosis.

[Mother], I feel like, has a better, more grounded
perspective of the kids holistically as growing children, and she
wants to not allow that diagnosis to define them. She wants to
teach them not to allow that diagnosis to define them.

Id. at 192. Further, in CASA’s view, Mother has “been open to feedback for

better care and better management of their medical needs,” and “shown more

• 14 - J-A06032-26

openness and desire to have feedback” as to Children’s dietary and

educational needs. Id. at 192, 194. CASA stressed in the report that the

“recommendation is not reservation,” as Mother’s ‘increased involvement is

relatively recent and we do not downplay or discount the shortcomings of her

not meeting the medical and educational needs of [Children] in the past.”

Exhibit 1 (CASA Report, 8/11/2025, at 10). “Despite these reservations, it is

each [party’s] approach to [C]hildren’s current medical needs and the current

ChildLine investigation that is the determining factor in our recommendation.”

Id.

The trial court took the matter under advisement, issuing its written

decision on September 15, 2025. After considering the separately

enumerated relocation and custody factors of sections 5337 and 5328 of the

Child Custody Act, it determined “the relocation factors were either neutral or

favored [] Children relocating to Steubenville, Ohio; and [] the custody factors

favored Mother as the primary physical and sole legal custodian with partial

physical custody to Maternal Grandmother in a manner that provided []

Children with an ongoing and consistent relationship with her.” Trial Court

Opinion, 11/12/2025, at 5-6 (pagination supplied).

Maternal Grandmother filed a timely notice of appeal along with her

concise statement of errors complained of on appeal as required by Rule

1925(a)(2)(i) of our Rules of Appellate Procedure. Therein, as interpreted by

the trial court, she challenges the sufficiency of the evidence to support a

• 15 - J-A06032-26

finding that it was in Children’s best interests to grant Mother’s request to

relocate with Children to Ohio and return Children to Mother’s primary physical

and full legal custody. See Notice of Appeal at 1; Trial Court Opinion,

11/12/2025, at 1-2.

At the outset, we note that Maternal Grandmother’s brief fails to

conform to our Rules of Appellate Procedure in nearly every respect.8 Most

significantly, the entirety of her statement of the facts is based upon events

that occurred after the hearing in this matter, see Maternal Grandmother’s

Brief at 1-4, and her legal argument does not include citations or any statute,

rule or case law, see id. at 4. Instead, she badly states the trial court erred

by accepting Mother’s testimony and failing to give credence to her own, which

she contends supports reversing the trial court’s decision. Id. Maternal

Grandmother further contends that a “material change in circumstances” has

occurred since the issuance of the trial court’s order, as Mother continues (as

before) to “refuse[] to provide appropriate care for her child(ren) to prevent

multiple hospital admissions and when the child(ren) need medical care she

refuses to take them, she has also refused the children to be transferred to a

better care team,” requiring Children “to suffer until Maternal Grandmother

has her visitations.” Id. at 4, ¶ 1 (unnecessary capitalization omitted).

---

8 Neither Mother nor Father filed a brief on appeal. At oral argument in this
matter, Mother appeared and informed the panel that she did not file a brief
because she did not receive Maternal Grandmother’s brief.

• 16 - J-A06032-26

Although we could find waiver for any of the above reasons, we decline

to do so because of the very serious nature of the matter at hand. We note,

however, to the extent Maternal Grandmother seeks for us to consider matters

that have occurred after the custody hearing that is at issue in this appeal, “it

is black letter law in this jurisdiction that an appellate court cannot consider

anything which is not a part of the record in the case.” Smith v. Smith, 637

A.2d 622, 623 (Pa. Super. 1993) (citation omitted).9

Further, this Court cannot reverse the trial court on issues of witness

credibility and the weight assigned to the evidence presented; those are

“exclusively for the trial court as fact-finder in custody matters, … as the trial

court had the opportunity to view and assess the witnesses first-hand.” A.L.B.

v. M.D.L., 239 A.3d 142, 149 (Pa. Super. 2020) (citation omitted). Instead,

our review of custody decisions is limited to determining whether the trial

court abused its discretion. Graves v. Graves, 265 A.3d 688, 693 (Pa. Super.

2021) (citation omitted).

We are not authorized to nullify the fact-finding function of the trial
court in order to substitute our judgment for that of the trial court.
Rather, we are bound by findings supported by the record, and
may reject conclusions drawn by the trial court only if they involve
an error of law, or are unreasonable in light of the sustainable
findings of the trial court.

---

9 As to Maternal Grandmother’s claim of a “material change in circumstances,”
we remind her that a petition for modification of custody may be filed before
the trial court to bring any new information to that court’s attention in the first
instance. See 23 Pa.C.S. § 5328.

• 17 - J-A06032-26

Marshall v. Marshall, 814 A.2d 1226, 1229 (Pa. Super. 2002) (cleaned up).

We further observe:

It is axiomatic that in custody disputes, the fundamental issue is
the best interest of the child. In a custody contest between two
biological parents, the burden of proof is shared equally by the
contestants. Yet, where the custody dispute is between a
biological parent and a third party, the burden of proof is not
evenly balanced. In such instances, the parents have a prima
facie right to custody, which will be forfeited only if convincing
reasons appear that the child’s best interest will be served by an
award to the third party. Thus, even before the proceedings start,
the evidentiary scale is tipped, and tipped hard, to the biological
parents’ side.

Charles v. Stehlik, 744 A.2d 1255, 1258 (Pa. 2000) (cleaned up).

The trial court fully reviewed each of the custody and relocation factors

and found, based upon its credibility determinations, that it was in Children’s

best interests to move to Ohio with Mother and for her to have full legal and

primary physical custody subject to Maternal Grandmother’s periods of partial

physical custody. Beginning with its consideration of the custody factors,10

---

10 Pursuant to the version of section 5328 in effect at the time of the custody

hearing in this matter, when ordering any form of custody, a trial court must
determine the child’s best interest by considering each of the factors below,
with weighted consideration to be given to factors (1), (2), (2.1), and (2.2),
which impact the child’s safety:

(1) Which party is more likely to ensure the safety of the child.

(2) The present and past abuse committed by a party or member
of the party’s household, which may include past or current
protection from abuse or sexual violence protection orders where
there has been a finding of abuse.
(Footnote Continued Next Page)

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(2.1) The information set forth in section 5329.1(a) (relating to
consideration of child abuse and involvement with protective
services).

(2.2) Violent or assaultive behavior committed by a party.

(2.3) Which party is more likely to encourage and permit frequent
and continuing contact between the child and another party if
contact is consistent with the safety needs of the child.

(3) The parental duties performed by each party on behalf of the
child.

(4) The need for stability and continuity in the child’s education,
family life and community life, except if changes are necessary to
protect the safety of the child or a party.

(5) The availability of extended family.

(6) The child’s sibling relationships.

(7) The well-reasoned preference of the child, based on the child’s
developmental stage, maturity and judgment.

(8) The attempts of a party to turn the child against the other
party, except in cases of abuse where reasonable safety measures
are necessary to protect the safety of the child. A party’s
reasonable concerns for the safety of the child and the party’s
reasonable efforts to protect the child shall not be considered
attempts to turn the child against the other party. A child’s
deficient or negative relationship with a party shall not be
presumed to be caused by the other party.

(9) Which party is more likely to maintain a loving, stable,
consistent and nurturing relationship with the child adequate for
the child’s emotional needs.

(10) Which party is more likely to attend to the daily physical,
emotional, developmental, educational and special needs of the
child.

(11) The proximity of the residences of the parties.
(Footnote Continued Next Page)

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the trial court largely found the factors were either neutral, inapplicable, or

favored both Mother and Maternal Grandmother equally. See generally Trial

Court Decision at 3-13. Most significant for our purposes, the trial court

conducted a lengthy review of factor 10—the party more likely to attend to

Children’s daily physical, emotional, educational, developmental, and special

needs—and concluded that it favored Mother:

Both Mother and Maternal Grandmother acknowledge []
Children are diagnosed with congenital nephrotic syndrome as
well as reactive airway disease. This is a serious condition, and []
Children require regular and routine medical care as well as
frequent emergency medical treatment. While Mother and
Maternal Grandmother have always conflicted with each other,
they initially were able to coordinate medical care for [] Children
and at least work in a parallel relationship to make sure that []
Children received the care that they required. At some point in
the last two years, this changed when Mother started to show less
of an ability to provide good care and good judgement when
parenting [] Children and meeting their medical needs. Maternal
Grandmother took on a more primary decision making and care
provider role. Despite this, Maternal Grandmother continued to
involve Mother, or at a minimum, update Mother with information

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(12) Each party’s availability to care for the child or ability to make
appropriate child-care arrangements.

(13) The level of conflict between the parties and the willingness
and ability of the parties to cooperate with one another. A party’s
effort to protect a child or self from abuse by another party is not
evidence of unwillingness or inability to cooperate with that party.

(14) The history of drug or alcohol abuse of a party or member of
a party’s household.

(15) The mental and physical condition of a party or member of a
party’s household.

(16) Any other relevant factor.

Id. § 5328(a) (effective Aug. 13, 2024-Aug. 28, 2025).

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about [] Children’s medical conditions and treatment, even if she
criticized Mother at the same time. Additionally, Maternal
Grandmother continued to follow the recommendations of []
Children’s medical treatment providers. The same is true about
[] Children’s educational and developmental needs, with Maternal
Grandmother ensuring that [] Children were enrolled and
attended school and therapy when Mother did not. If fact, the
primary reason that the [trial c]ourt temporarily placed []
Children[] in Maternal Grandmother’s custody was directly related
to Mother’s decisions to remove [] Children from their routine and
regular educational and medical providers. Michelle Bernard, the
[CASA,] has credibly documented these behaviors and decisions
in their prior reports dated November 16, 2023, March 8, 2024,
March 17, 2025, May 5, 2025, and August 11, 2025, where she
relied on detailed information that she gathered from [] Children’s
doctors, teachers, specialists, family members, etc.

Recently, this has changed again. The credible testimony
and evidence presented at trial confirmed that Maternal
Grandmother is more driven by overmanaging [] Children’s
medical status while Mother has a holistic approach to the
Children’s diagnosis and does not want it to consume their entire
existence. Additionally, Maternal Grandmother has questioned or
doubted [] Children’s current and regular medical providers,
researched her own medical treatments, blocked and/or
eliminated Mother from access to information and obtained
secondary or duplicate treatment without Mother’s consent or
knowledge by [] Children’s current doctors. More specifically,
Mother was removed from [] Children’s Highmark medical
insurance login while in Maternal Grandmother’s custody and
Mother could not see [] Children’s care plans unless it was directly
through [CHP]. Additionally, Maternal Grandmother sought
treatment for [] Children at [CHOP] and attempted to transfer []
Children’s medical care to this hospital without telling Mother or
[] Children’s doctors in Pittsburgh. Maternal Grandmother has
become suspicious of [] Children’s medical providers, testifying at
trial that they withheld information and that they were not
transparent. Maternal Grandmother believes that they are not
getting the highest level of treatment with their current doctors
and no longer aligns fully with the treatment plan here in
Pittsburgh. Finally, Maternal Grandmother is hyper focused on []
Children’s weight and fluid retention, which while a significant part
of treating their medical condition, is not the only indicator of their
level of health.

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In contrast to this, Mother testified that she wants a life for
[] Children where they are defined as more than just their illness.
This is different than Maternal Grandmother, who through her
testimony, appears to be focusing primarily on providing []
Children with lives that only stress the importance of protecting
them from risks of their diagnosis. Mother called upon [] Paternal
Grandmother who credibly testified about living with the same
diagnosis as the Children for the last sixty [] years. Paternal
Grandmother recognized that while serious, there was no one way
to “deal” with it and that fluid retention, infections and swelling
were all part of a life with this diagnosis. Paternal Grandmother
testified that not only is she living with the disease, but her four
children, four grandchildren and teenage niece all live with the
same diagnosis. All these family members have productive lives.
Mother wants the same for [] Children. Mother wants [] Children
to be involved in activities and sports that match their interests.
Mother wants [] Children to feel “normal” and give them the
freedom to explore their futures without being held back by their
medical conditions.

As stated above, the positive impact of Mother’s actions on
[] Children’s lives is reinforced by the current and credible
recommendations of the [] CASA. Unlike the prior CASA reports
that listed very specific concerns about Mother, in the August 11,
2025 report, CASA indicated that Mother has made increased
efforts to be more appropriately responsive to Children’s medical
and educational needs. She has visited with their potential school
and sought out resources, the [sic] has been more open to
working with medical professionals and tracking information that
assists with [] Children’s medical care. She has been proactive
with communicating with [] Children’s teachers and medical team.
Mother has taken steps to ensure that the Children can move
closer to having a life that is not defined by their medical
condition, even when meeting the needs of their medical
treatment.

Id. at 9-11.

As our recitation of the facts underlying this matter hereinabove reflects,

the trial court’s findings are fully supported by the record. Moreover, the trial

court’s determination here is based upon its credibility determinations and the

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weight it decided to accord to the evidence presented. As such, we have no

basis to reverse the trial court’s custody decision.

The same is true for its relocation decision. The trial court fully

considered each of the relocation factors, as required by section 5337(h).11

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11 In determining whether to allow a request for relocation, the trial court
must consider the following, with weighted consideration to be given to any
factor affecting the safety of the child:

(1) The nature, quality, extent of involvement and duration of the
child’s relationship with the party proposing to relocate and with
the nonrelocating party, siblings and other significant persons in
the child’s life.

(2) The age, developmental stage, needs of the child and the likely
impact the relocation will have on the child’s physical, educational
and emotional development, taking into consideration any special
needs of the child.

(3) The feasibility of preserving the relationship between the
nonrelocating party and the child through suitable custody
arrangements, considering the logistics and financial
circumstances of the parties.

(4) The child’s preference, taking into consideration the age and
maturity of the child.

(5) Whether there is an established pattern of conduct of either
party to promote or thwart the relationship of the child and the
other party.

(6) Whether the relocation will enhance the general quality of life
for the party seeking the relocation, including, but not limited to,
financial or emotional benefit or educational opportunity.

(7) Whether the relocation will enhance the general quality of life
for the child, including, but not limited to, financial or emotional
benefit or educational opportunity.
(Footnote Continued Next Page)

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See id. at 13-16. Based on the evidence of record, for which the court made

credibility determinations and ascribed the weight to be accorded thereto, it

found that Mother’s relocation of Children to Ohio was in their best interests,

finding nearly all factors favored relocation (two the court found to be neutral

as inapplicable). Id. Again, we have no basis to disturb the trial court’s

determination.

As the trial court correctly and succinctly put it at the end of its decision:

The success of this family relies on two things. First, Mother must
continue down this new path of ranking [] Children’s medical,
educational, emotional, and social needs first (even when it is
most difficult in Mother’s own life)[. Second,] Maternal
Grandmother needs to recognize and support Mother’s efforts
when she is doing a good job at parenting (even if different th[a]n
how Maternal Grandmother would do it).

Id. at 17.

Order affirmed.

Judge Murray joins the Memorandum.

Judge Olson concurs in the result.

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(8) The reasons and motivation of each party for seeking or
opposing the relocation.

(9) The present and past abuse committed by a party or member
of the party’s household and whether there is a continued risk of
harm to the child or an abused party.

(10) Any other factor affecting the best interest of the child.

23 Pa.C.S. § 5337(h).

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DATE: 3/13/2026

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