HomeMy WebLinkAbout96-05825
f" "
,',
",
..,I
"
,',
,'11
.<,
f"
"
,I
,I I
'~
..~,
'<'~
'';
31~
-fl
l
)
o
lO
'(1)
co
If)
I I
,
,)
(
"I
"
"
I,
1'1
I
,
or ;/'! ~ I,
,pt!'/, I,l'
;,11 ';
");',1'1
I,
I I
"
"I
I
!i
,
,
,
'I ,
, ,
I'"
"
1
,,'
I
I;'!
\ I
'I
I',
",
, i
1
II
,
/,,11
.,J ,II
,
I
':.'.,1,); ;_I!
1,-,
!;I
,
1;,,-,1
"
,ij
'// I
I
,'I:i
t" - ,':'I"J'
,,'; Ii'; 'I
i!,I.,,'" ",Ii!:"'
'I, ",I.'
I '
11,1
'I
::'/" -J
Ili.,j."-JIj'
,,/ ..
'1.1
,;1,
I
,"
,':. rlt
"
II :d
I
,
I,
, I P;: '"
,_'" "
,_;} - ,1'1
_'} lot"~
III/'\d
;1 ! I'
,
I,
I'
I,
r'jl'''';
, ill II ~ I 'j
'I'
,
"
"',",t
'I,
"
.,
"
,"
,
I I ~ I '
" ,j'
'J .','
,'!I' ' II
,'t jJ'
"
'ii',
'i
,
, ,
-I'i
I'
'1/1',/ -'
i "'1 ,',
"/,\1'
,,'
I. , /"
ill '{-
,I
"
1/
','I
'I"
,
'HI ,.,,1'1
'fl, 't;
"
'i 1-(
;,1
'I
,'I)'
,I,; 1',I',!
'Jll
.j,'l
I
,
~ !' 'II j" ,I, \
r" I
_" i I ; ~ : I -I
1,."1' 'Ii),' :','1
i 1\-' "i_ I
..'/il-i,l: _1;-'-',1-"
./ .,_, :, .' r ~ jI' !
1,';'-1 "J;'
,,_r:""l I"
I
'i,I;_'j
-/ "
,
1'1
01',
",
}I"
JI, t
: j ~ I
,/
-I"
I'
'J"
','
Fr' '1'1
'II
1.1.'." Ii,
" ,1,':'( ,'t:I'
'fl,I,,-'il:':- '(,-I,
"j;' ;_,lJ, jjl
. I ,,' ,,,; I i ~ I
" ." __I, ;'~I.';j' ,
,
;/
I,
1 ',,}I' ~ I, . J
,,'
,
"
,
"
,
I'
'!I;i
:,1_1 '
1,',/1'1'1'1'
I ,II
"
,
ill,
,'-,")"
"I' /
I )"
"I"';!
;' "
',\
,i" '
I,"
, I
'-'JJ
"
,
/'1-'
I'
, ,
!,
ill
I' " '~,
'), "
"
,Ill
",
1,1
':,
. LI!,,:. ]:1
"; ,"",;
\',1
,
,',If:I,'
,1",',"11
'iil:1
I' "
",,
"
I 'I,
;11 '
',II'!;'
"
d]'
,
,I! /,1'
'I'
':i
,I
,
"
'I,' I
"-I!
',I'"
;',1"
, ,
','If' ,,'I
" I
,'_ ,[_I,
,I
Iii
,\')
r" I
:]','
I:!"_I
I 1\'
I
,'1'1 i
Ii
\" ill
",;11'
"
, '
I
"
"
"
I, !,
.'
,
"
'I
"
"
,
",
L
I'
I'T}"
/11 ,'j
, ".'1
'j;- I!' ,..
, ,:11,
,t',1 I
" i
,Pi'
"
" '
:\ i I
I,
""', J
,
,'/'
-,/11\
" d
',I I'
I; ',} q,
"
"
'ill
, '~ "
;1,1
,-\I ,
"
"
I; {'
,-il' 'I
, I
'\
II'" "I
; I / d ;1
,-i(,J I
"
',I,il:':; :
"
,
",'",
.,
I
:/, ,),
,
i'
I
"]
"
"
'I!
"
,
"II
., I',
I
','
, '
,
"
11-,
.":1' ~ I '
I,
/!
,
'! ',-, L ! i ~, " I
, I,'
, ,il
I,,"
" ,
",1'11\
'lJ'
,,'
"
,
"
,I
I
.,,'1
,
ii'
I'
"
'" "
"
"
,,'
,
"
"
'I ',;
"
,))
'I"
, 'I'
, ,
, ,
"
, II 1,\
'-1-'
, .11,'"
"
, I'
1,.\:1,
" ,
'1-]"
'J
"
'I,'
, I
',)1
'"
,
"11,,l
',,",
.' "
"
,t ,I'
ill'
"
I,
" 'I
,
,
'"
,
,
,r'
III,';'
'1,'_,
',!,
"
'I!,
"
11 "'I)
,I
"
,I
'1,1 if
',I Ii, I,
, '
III,
t" 1(,':':-, I,
"
'(,I I'
, ,
'Itl
it'
I',
"
',Li'
, ,
'J,
':,
"
"
',.'.1
,
~ i ,_
'1,
'II': ' I,
1",1
'),'11'
(, -It),'
'/,:'!}Id
,_!;i ,\ \' ill
(1'I,J
"111;"-',
; {",I;;,I:
I I .1 '1
!_:i:!il;J!;.tl", ,! 'I
!1;./('u/riji(:::'1'I~I' \~, 1
__ . f',;I( 1- -, II: iL!', , I:' 'I
-j, - 'I'" 'I
I; I ''I ,,; -j_ I:' ~ _' Ij , J
('~'- :;;';1 ! / f
I"I,'! ' ,,'
, I" ,'I '
II, ,,1',1:"
'j '1..,';\ .1'
, !, f i <',_ /' ',~,- ,I' I
"I,:: -, I'
r,ll",! j,] '11\ll_:
"I, 1_;,-,; 'j' ,iT
":1 II 'j L"_ I r '- ':'1'-;- ;,' ,!
" 't' ' [r\,;II'I,~ -'
II. /i ' ~ ' - -
, \ I 1"'; t'L: ;:-,1' 1 I
I I d ,[ III I 'I -: 1,,~L'i:_i' -' t '-'
;,1 "1'\ 1,\ ,,-:f/:;-,'!1:;j _;1' ,0'/ I !
I '''' 'J'.V' 1':J,'IJ!.'!/.I.:-1I,t'M.l/;-.1 '
, "1"'1'1': L 1_ ',-'" I ' - ,"
,1,'1":, ,,'::) \,' ,.1, ,I',;:/,~;' 1:):":/,>":,',,:~" ,'II'
,] :;,1\,1'11: !,::(/~",-;':' 1I,"1f \,1 /,1" ,,'l-'-!.,!! ,~ll, III
,I
-,1: "I'j' '''Ii;1 .}.-'
i-:~: Id'I" ,t /.;_'-1'" H
,t I ' I"
'\-,t ",' i'- )',1',1,'1,_;, ,I--j, 1'(-1
j' " J:i,';',:llli,I,:II'" "
'J'! ];"\,1,,' ,,-" 'J,,;I I'!:':
I" "I I \ ,-E')l : ~ \ \ )'..
L; ,',j, '_:' ','!' '0,1,'" (..1'
t,',,(-_--'L'I, d-':]. '/ ,1." ',p'
'i-,1~,j'i_; '_ -'\'I)':!: -kl i:_ 'j;,._"i~i,'l
'" '_ I ~,. , ~ J' , \ I "\'0' I " " I'
, ' , 11,-,' ~t 1.1' .le.,
,<;~:I)' ,,-I'! - .-,1;"," -'i-
,l>
"
"
II,
I
"
"
i/
"I-;";'{O
,_L,
,I' \1
('1
.,r'
"il
,
"
,'11;'1'/,
I '
I,! '
',/.l_'\',
f ',-I!
1,,'1'
"
,
/
,"
'ii, I-ill '-il I'!
, I' J ""
I
1,,/ '
_ ,H
Jl
"
" I
"I
I
"",:1/' ,I
ir,
1/'
oJ i! '. J';
:1
r' ,_ i !,
I-_"~-d-"
i < 'I, I - ~,
,!-I',
'I 'I,ll
'{;"I
,'; . ! ~ ~ '
'/(:' II
"
{t':;
';/1
'I
)) 'I
'," tl
, I ~ J,
',_,I"/i
"I
,! I.
,,/1 t
~ \:l-_)'li' -i ii J
,\ 1-,:, ; ",;,-,:,
,! J' _r I _1 ~ ;-}J. )
I't'r i:/';,-"
"Ii' 'f,
'.'./~, " 'il
',' . ~ )',
tt, Il"l iI!'
"'I'i,,:" '!i,,':'
'1;1,,"1
l. ,)', ~ll
'I d, 1
" " , ~ ,,' -I; /
,,'
"
,',i \.'
, \', C,~--.-.
/ ' -II,'j, I '
_1'-'" I
0\1 i ';j,: !I
III' "I'd ':J,
','I: l'i,I.-, I
Ii " I
I
,I:'
C',
I'
'I
.." ,
I;
",
I,_:'i,l:,',
Ii', '
. },,-I
1,-' I'
,I,'
"
I
!; ,J ~ I; ~ \ i
~ J/' , - )1 '
,_fd"
l"}i
r" i, ,
I , I) ,- ~I'
"
'II:'
'/\'!'
,
li,I,I.,1 i I"
<'-_',,1_1
'; - \~ ';, ,: \
I
"
I
,',
I,
,I
'I',
, ,
1'1'
"
11'1'
,
"/;'11
,-_'I
,
'J,'
" I
,t!l'
,,')
"/Ii
',I",
,;It
,/;;qll
,,"
I
,,'
,
:1'
",
I\.'
rI! ,,_;,
1,; '~'l
I
,I'
"
, '
"
,
"
.1",
I
,',
-<-'1'
;]-1'
..,
f"I,,1
"
'f-,
,'~)i dill
I; ,_,it ,;
,I, 'I \(1,
, " I', I ~, !
1'1,
I',
"
,l;l'
'!
,
ii, 'j,
"
, ~ t ;
, "
ir'
I'
'd II
',,;J-I": '
, "
01
'.-1
"
"
'Iii
, I
"I'" '__'j
, I.
" iji"
'i/I-'.-i'l
'I" '
"
,1-'
11,',1,
,
"
"
d,' I
1,1
'I-J
"~-I
"
'f",
" ,
'I'
..'
I'
,,"I
!'"_'i
',I.' '--H)'"
,j-"
, ,I, , ,_ i ~',
I' ""
, '
III , 'i I'; '/ ,~I','
, ',,' ,,_ -', "'1
'I" Iq' ".'f"i:,!-!,-I;:}"
-tl )\:.1; ,n'I'
, _.I ",.' 'l t,' 'I ',-'il
I ' ~ ,,_ _ I' . t: ,I I .._i
_,;' 'c, ,1]lt, , ' ;"
'I, ' J'..I,' 'Ii
1-,' '1 ,poi
',;-'h" _il'-, 111--,1 I'
1-,_/01'-1.'"
, , ",',L! ,,'\1
,\
I.
"
I"~
"
11;!1',
" '
'! -'ill(:,- f
,;I -f'
"
'i'_IIJ': i,,'
!' '-I
01
',I,
\',
',i ' '
\:'"I_li'
, .'i,'/il
)j-,j-'
"'i'l,
';t",:- 'Jr'
Ii-'--'--'-"-"
,IL'.--___I;",
,
;," "
''':1
,
, !1
I '-I
'1-1 ; I'
,'-'
"
.\--t-"."
"
"
..
"
"
ii,
"
,;
'j' , "i
~ \ \ ' ;'
,J
;' '
J~! ;,1\;1
",'1',1,- !i(
I I ( 'I'i"d I
. lili ,j
'ill
'hi:!
'I:,J
.,
/' /'
,,')'
1,1;'
(;,;t;
I" I',
, I
'11,1
I I,
'I)'
..-"
I.,' (', '
I '-"I;i,
,','
,i ,i
,},'-\ :
'I fJ1r' tn 'I,
,'-' 'I
II,'
Ii.;
'I"
'I
"
'ill'
"
-,,11
,I
d 01
I
,,:i'
'h;
"
~ i "
",
,I
,\
't"
"r-,
I,
',1;-1,' ',"
,1',;-,
'Ii'
,
,'I
'I
'\
,)
"
,'I
I,
"
",j i,'
," ",/iI'
"l"
,
,
,
.",]
i!
"I"
,"
,,' ,I'd:,
I' '
1 " ~ f'
"
:Jt
:'i'
. ,
"
II"
"
':1". ,I"
'. ,I,
1"1-'/
"
"
,,\'
",
"
',J'
'I'
,
,11 ~:'
';11_1
,-i -,
" ,\,
"
"
,
'01
,
,
,"
,
'I" "
II
"
,"
",'
','1
l.i
,II:":"
,','
1','1
'I,"
,,it1' ,I'
,I
'I,' \
.1,,11' I'
'"
, '
"I
",'i
,
,
"
'.i
, ~
'I
I
"
'I"
"
:1,
,;'i,
'.,
,,'
"
" '
i',1'1>1
,t '_I
,"
"
"
"',
,
"
"
,
, '
,
I
, ,
,I,
',',
,
,
]t ,I
,',;1 "
'I
,'"
'-'
,I,
"
I
"
\,1'
'1.l1'
I I': ,~]I
'('
I',
"
,
I
I,'
"
" .,
,
"
,
,I
"
'I
i'l,
~ ,
"
',\
,
, '
,
il
'I
I
"
,
"
"'
, ,
,
Il'f-." I,
;I I
il
Ij ;1
"
"
'"
,I
"",
,
';j il
,I
.)
,I
"
"
"
:'
'I
,
1"\
,
"
'/'1
',(I,
,',
It
'"
"
"I.',H,I
",_,!_I
I,
"
1-\'
"
to',
I
i',,1
lid-i'
/';,
"Ii/'
1,\1'
I
i"
i;,
! '
'-'.
"
'\ ,../"
'I
, I
"I;,
,
, '
.I',
'.
"I
):<
"
II
.,
"J I
_tl"\, ,\!'
:',."
",
'I','
'--'I
',,_'1:'
i,'
1,("\ I,
',.'"
'I'"~
..
','
"t' I,'
,;1-\, '
,'-'" '
",;,',
,; ",,1
"I'
SARAH A. TODD MEMORIAL HOME,
Plaintiff
v
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION. LAW
RICHARD L, SWARTZ, SR.,
Defandant
: 96- :') f.J ')
CIVIL TERM
COMPLAINT
COMES NOW, the Plaintiff, Sarah A. Todd Memorial Home, by and through Its counsel,
Lindsay Dare Baird, Esquire, and states as follows:
1, The Plaintiff, Sarah A. Todd Memorial Home, Is s Pennsylvania corporation with
offices at 1000 West South Street, Carlisle, Cumberland County, Pennsylvania 17013.
2, The Defendant, Richard L. Swartz, Sr" Is an adult Individual residing at 1600
Longs Gap Road, Carlisle, Cumberland County, Pennsylvania 17013,
3, On October 21,1993, Defendant signed an Admission Agreement for Howard
E, Swanz,Jr, (now deceased), permitting Howard E, Swartz, Jr, to be admitted as a resident In
the fscllltles of the Plaintiff, The Admission Agreement establishes the Defendant as the
"Responsible Party" for Howard E, Swartz, .Jr.. A copy of the signed Admission Agreement is
attached hereto and made a part hereof as Plaintiff's Exhibit "A",
4, On March 27, 1995, Howard E, Swartz, Jr, signed a Durable Power of Attorney,
appolnllng Richard L. Swartz as his true and lawful attorney, A copy of the signed Durable Power
of Attorney is attached hereto and made a part hereof as Plaintlfrs Exhibit "B",
5, The cost of care at Plalntlfrs facilities for Howard E, Swartz, Jr, totals
$ 23,938,23 as of Septamber 30, 1996, No payment for the amount owed the Plaintiff has been
provided by Howard E, Swartz, Jr, or by the Responsible Party, Richard L. Swartz, Sr..
6, On September 4, 1996, Plaintiff, by and through its counsel, Lindsay Dare
Baird, Esquire, demanded payment of $20,500,13, the amount owed as of August 30, 1996, on
or before September 15, 1996, Defendant failed to make the demanded payment, A copy of the
letter of demand for payment sent to the Defendant is attached hereto and made a part hereof as
Plalnlifrs Exhibit "C",
arbitration,
7, The amount owed Plalnllff exceeds the jurisdictional amount for compulsory
COUNT 1 . CONTRACT
fully set forth,
e. Paragraphs 1 through 7 Bre Incorporated In reference thereto as though more
1
SARAH A. TOllD MEMOIllAI. HOM~:
ADMISSION ~GllEEMENT
. t
AGREEMENT made and 'entered thl6 ....~_ day of .QdDm:__ 19jj l
by and between SARAH A. TODD MEMOIHAL HOME (het'e-in-after referred to AS Todd
.Home] and -.111Cl:llUL.6l.u1Lt~ (or guardian, tlext of kin,
sponsoring agency, represontative payor, or responsible party here-in-after
referred to as "Responsible Party" J, who agree to the following terms,
conditiolls and arrangements to provide for the medical, nur:ling and personlll
care of (here-in-after referNd to
as "Resident"].
WITNESSETH r
1.
Todd Home agrees to furniah room, board, beddin~ and laundered linens,
nursing care, if applicabJ,e, and such other personal services as may
be required for the health, safety, welfare, good grooming, and well-
being of Resident.
2,'.
The Todd Home agrees to obtain the services of a licensed physician
of Resident's choice whenever necessary, or the services of
another physician if a personal physician has not been designated or
is not available. This requirement is to insure that medications
and treatments are prescr'ibed by his/her physician.
ta] If Resident is found to be mentally disturbed and cannot
be managed after admission, immediate arrangements will be made
via the attending physician for transfer of Resident to an
appropriate facility at the earliest practical time.
(b] If a change occurs in Resident's physical condition
which necessitates a change in care which Todd Home is not
prepared to provide, immediate arrangements will be made to have
Resident transferred to another appropriate facility which can
care for Resident.
"t'"".,
(cl Except in an emergency, Resident will not be transferred or
discharged from Todd Home without prior notification of
Resident and his/her Responsible Party, Suitable clinical notes,
a list of orders, and all medications as directed by an attending
physician shall accompany Resident when transferred to
another faCility.
3. The Todd Home agrees to attempt to, [1] arranRe for It.nsfer of
Resident to a hospital when such transfer is ordered by the attending
physician and (2] immediately to notify Resident's Responsible Party.
PLllINTIFF'S EXHIBIT "An
,. r"_';',I..', "j-'''' t
'.
;''''1),1'
-,f'
page 2
'..
'.-t,lkl'
" . ,,t
::-.:':..':'.J
.....:~,
4/\.,The Todd Home agrees to pel'mit Resident to request to upgrade or
,~"change the room ass'igned to Resident at any Ume, for I1ny reason,
",::~.~:". f,::provided the room requested is readily available and Resident is
""", financially abh to pay for the requested room.
".,1.",;,
. "'W~I
5'.:;Todd Home agrees to comply with the provisions of the Federal Civil Rights
!Act of 1964 and the appropriate State Human Relations Act, and all require-
';ICments imposed pursuant thereto, to the end that no person shall, on grolJnds
of race, color, national origin, ancestry, age, sex, or religious creed be
excluded from participation in, bc denied benefits of, or otherwise be sub-
ject to discrimination in the provision of any care or service. The non-
discrimination policy of the Todd Home applies to ReSidents, physicians, and
employees. Under no circumstances will the application of this policy
result in the segregation or resegregation of buildings, wings, floors,
and rooms, except for toilet facilities, for reason of race, color, national
origin, ancestry, age, sex, or religious creed.
~
" '
6. Todd Home prefers not to manage Resident's personal financial affairs.
Todd Home may elect under specific conditions to manage Resident's
personal financial affairs when the Resident or Responsible Party
cannot manage those financial affair's and designates the transfer
of such responsibility in writing to the Todd Home. Prior consideration
and negotiation of this transaction must be done with the Todd Home.
If such transfer of responsibility is done, Todd Home will provide
"...:',,",......,Resident and/or Responsible Party with a quart,erly accounting of all
financial transactions made on Resident's behalf.
:':1':
, ,.,
7. Resident or Responsible Party agrees to provide such personal clothing
.',,', and effects as needed or desired by Resident [as space permits].
~~'Restrictions would apply to items that would infringe upon rights of
..,' other Residents or that are contradicted as documented by Resident's
physician in the medical record.
e. The Todd Home will investigate losses and damagas reported by the
Resident or Responsible Party, and agrees to aid Residents by recommending.
~egal counsel when prosecution of any individual/individuals is desired.
The Todd Home accepts no liability to replace or be responsible for
stolen, damaged, lost or misplaced personal property. The Todd Home
will not accept responsibility for personal valuables and Todd Home
strongly recommends that no jewelry or other valuabl.es be brought or
maintained at the premises.
9. Resident or Responsible Party agrees to provide personal funds required
by Resident,
10. If the Resident feels he/she is eligible for any governmental assistance
in which the T odd Home participates, Resident or Responsible Party shall
notify the Administrator who will assist in applying for that
assistance. The Todd Home will process this application on behalf
, of the Resident when requested, Eligibility, with refusal to apply
for any governmental assistance available will void this agreement.
When the Todd Home receives approval, on the basis of established criteria,
that the Resident's care may te reimb0rsed wholly or in part, the Todd
Home will submit a claim to the fiscal intermediary for payment.
/
"'_''''rt
. -':"""'"
. .-..-...
...,..~,.f..
Page 3
[Paragraph 10 Continued]
.
.
The fact that Todd.Home aubmite a claim for payment, indicating that \
~ care may be reimbursed, doea not relieve Resident or Responaible Party
from liability to Todd I'lome if it is determined by the fiacal intermediary
that Resident does not qualify I'or reimbursement. The Todd Home agrees
to continue to provide services of the same quality and type of care
regardleas of the source of payment.
11.
Resident or Responsible Party hereby acknowledges that no representation,
statement, or claim haa been made by anyone connected with Todd Home that
the services to be provided to Resident are or will be covered by or
under Publi~ Law 89-97 [M~dicare, Part A or Part B], or any other govern-
ment assistance program. Todd Home makes no guarantees of any kind
that services will be covered by Medicare.
12.
Reaident or Responsible Party hereby releases Todd Home, its agents
and employees, from any liability or responsibility in connection with
Resident's potential claim for coverage under Part A or Part B of the
Medicare program or any other government assistance program.
13. The financial agreement and understanding of the, parties hereto is as
follows I
On a,monthly basis, the Resident and/or Responsible Party agrees to pay
.....:, the Todd Home for care and services rendered, based upon the following!
'..1. Room, board, and nursing care, if applicable [either a or b],
a. Computed daily upon attending physician's "level of care"
,certification and Todd Home's current "schedule of rates
and charges."-
b. The amount determined by the appropriate funding source
as payable by the Resident,
2. Charges for special services and supplies [see copy of fee schedule]-
not included in the Todd Home per diem rate when 1-a is used,
or benefits of the governmental assistance program when l-b is u~ed.
Explanations of these will be given upon request and pre-
sentation of statement being questioned.
3. The cost of co-insurance as provided by PUblic Law 89-97 [Medicare]
for I-a.
Where l-b applies, the cost of co-insurance will be billed to the
Medi~"i<l ~,'ogram.
4. Physician and medication charges will be billed directly to the
Resident by the physician/pharmacist, unless such provider
agreements exist which place the burden of deductibles and co-
insurance on the facility. In this circumstance, Resident will be
billed for the amounts due.
.
"
,;.,
'.,',\""'"
',":~'; ~,"
l"i'~; " ~
.~.!'Q!:';
, "
,"
~".II!'
..
..!c.';,'
..'?Z'
;,\.-
,~':! I
~i~r.,. .
-r'Ol:,.
Page I,
5. Cost of physical therapy treatment when physical therapy is ordered
by the attend1~g physician.
. \
· All chargea are based upon current expenses and are sUbject
to change with 30 days written notice.
14.
/
Resident and/or Responsible Party agrees to be responsible for the
payment of all charges incurred by or on behalf of Resident. All
, notices shall be considered delivered to the Responsible Party if they are
sent by regular mail to that address, unless a newer address has been
furnished in writing.
15. Either Party may terminate this agreement on 30 days written notice.
This agreement will remaln in effect until a different or subsequent
agreement is executed. Noti r1catl,on of adjustment in charges for room,
board, nursing care, etc., shall be considered an amendment to thlS
agreement, but at the time of such adjustment, execution of a different
or SUbsequent agreement shall not be necessary to effect such a change
of rates. However, this in no way shall be construed to mean that
Resident will be forced to remain in Todd Home against his/her will for
any period of time.
16. This contr'act may be terminated immediately by either party upon showing
of negligence, lack of due diligence, intemperance, immorality, in-
competency, cruelty, mental derangement, willful violation of laws or
governmental regulations or willful violations of explicit rules and
regulations of Todd f1omo. From the viewpoint of the Todd Home, the term
.." "negligence" includes non-payment of charges due. The account will be
considered past due when it is not paid by the 15th of the month follow-
ing the calendar month of presentation of itemized billings. A service
charge la% per month will be added to all past due accounts. Non-payment
of all charges by due date may result in notification to the Resident
'to vacate the premises.
17, If a Resident receives notir1cation of transfer' or discharge for
other than medical reasons, those rea~ons shall be documented. An
I impartial hearing may be requested by the Resident or Responsible
Party within 14 days of receipt of notification. The request must be in
writing, addressed to the Administrator of the Todd Home and must offer
suggestions and assume responsibility in the resolution of the documented
reason[s] for discharge. The Administrator shall give a decision, in
writing, within 10 working days, a condition to any hearing requires
up-to-date status of an account, The facility excludes the right to
any hearing it' the transfer or discharge is because of non-payment.
18. The Resident and lor Responsible Party, by ~irtue of their signing this
agreement, declares that said agreement has been fully explained and
understood.
Todd Home Representative & Title
Witness
Responsible Party
is-:1t.,~ --~-_._--~
l
DURABLE I)OWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that I, J1 ,,'1,,1 t.. S,(,\1(h of
('lln1h"{\,)i'\rL_County, PeDnsylvania, have constituted, made and appointed, and by
diesel presents do constitute, make and appoint,
11\1' j1n((U_. (. /V](r!_ of {'IllY' 11'(: ,",,'y7 County, Pennsylvania, my true and lawful
attorney:
1, To ask, demand, sue for, recover and receive all sums of money, debts, goods.
merchandis", chattels, effu-ts and things of whatsoever nature or description which are
now or hereafter shall become owing, due, payable or belonging to me in or by any right
whatsoever, and upon receipt thereof, to make, sign, execute and deliver such receipts,
releases or other discharges for the same respectively, as he shall think fit,
2. To deposit IlDY monies which may come into his bands as such attorney with
any bank or banker, or any money market institution, either in my nlme or his nlDle, and
any of such money or any other money to whiCh I am entiUed which now is or shall be
so deposited to withdraw as he shall see fit; to sign mutual savings bank and federal
savings and loan association withdrawal orders; to sign and endorse checks payable to my
order and to draw, accept, make or otherwise deal with any bills of exchange, checks,
promissory notes or other commercial or mercantile instruments; to borrow any sum or
sums of money on such terms and with such security as he may think fit and for that
purpose to execute all notes or other instruments which may be necessary or proper; and
to have access to any and all safe deposit boxes registered in my name,
3, To sell, assign, transfer and dispose of any and all stocks, bonds, including
U,S. Savings Bonds, bans, mortgages, or other securities registered in my name; and to
collect and receipt for all interest and dividends due and payable to me.
4, To invest in my name in any stock, shares, bonds, sccllrities or other property,
real or personal, and to vary such investments as he, in his sole discretion may deem best;
and to vote at meetings of shareholders or other meetings of any corporation or company
and to execute any proxies or other instruments in connection therewith,
5, To enter into and upon all and singular my real estate to let, manage and
improve the same or any part thereof, and to repair or otherwise improve or alter, and
to insure any buildings thereon; to sell, either at public or private sale, or exchange any
put or parts of my real estate or personal property for such considerations and upon sueh
conditions as he shall think fit, and to execute and deliver good and sufficient deeds or
other instruments for the conveyance or transfer of the same, with such covenants of
wuranty or otherwise as he shall see fit, and to give good and effectual receipts for all
or any part of the purchase price or other con'sideration and to mortgage, include purchase
.money mortgage, and to execute bonds and warrants and all other instruments and
documents in connection with and relating thereto, and such power shall not be in
1
PLAIN1'IFF'S l-:XHII.ll'l' "Il"
/
limitation of any other power bereln set forth.
, 6. To contract with any person for leasing for sucb periods, at sucb rents, and
subject to sucb conditions 15 be sball see fit, all or any of my said rca1 estate; to let any
sucb person into possession thereof; to execulC all sucb leases ud contracts IS sball be
necessary or proper in that bebalf; to give notice to quit to any tenant or occupier thereof;
and to receive and recover from al\ tenants and occupiers thereof or of any part thereof
all rents, arrears of rents, and sums of money which now are or shall bereafter become
due ud payable in respect thereof; and also on non-payment thereof or of aDY part
thereof; to take all necessary or proper means a.od proceedings for determining the
tenancy or occupation of such tenants or occupiers, and for eju:tlng the tenants or
occupiers and recoveriDg the possession therwf.
7. To comroeDce, prosecute, discontinue or defeDd all actioDs or other legal
proceedings touching my estate or any part whatsoever, or touching any matter in which
I or my estate may be in any wlse cODcerned; to settle, compromise, or submit to
arbitration any debt, demand or other rigbt or maller due me or cODcerning my estate, as
be, in his sole discretioD, sball deem best and for such purpose to execute anI! deliver
sucb releases, discharges or other instrumeDts as he may deem Decessary and advisable;
and to s':\tisfy mortgages, including the execution of a good and sufficieDt release, or
other discharge of sucb mortgage,
8. To execute, acknowledge and me federal, state and local income tax and
personal property tax retunJs,
9, To engage, employ and dismiss any ageDts, clerks, servants or other persons
IS he, in his sole discretion, sball deem advisable and necessary.
10. To make bealth care decisions for me if and wben I am unable to make my own
bca1th care decisions, This gives my attorney-iD-fact the power to conseDt to giving,
withholdiDg or stoppiDg any bealth care treatmeDt, service, or diagnostic procedure, and
to authorize mt admission to a medical, DursiDg, residential or similar facility.
11. In geDeral, to do all other acts, deeds, matters and things whatsoever in or
about my estate, property and affairs and thiDgs herein, either particularly or geDerally
dC!!:ribcd IS fully and effectually to all inteDts and purposes as I could do iD my own
proper person if personally present, giving to my said attorney power to substitute others
under bim as attorney or attorneys for all the purposes berein described, hereby ratifying
and cODfirming all that said attorney or substitute or substitutes shall do thereiD by virtue
of these preseDts,
2
~ "
S"'It.... \\ A. \ ..J.j l-\"", 01\' c:., ~ \\ """'c
'P~,,,,"~
"
~,...L,..vj l. "Swa....h. c;;".
t::w~~J ",...'t
.
A-L1!.We:1ft, C>~ c.o~ fl..,,,- \-
. 'N 1"~E co....~1 d~ G,M~o"
; flleo." <::>~ c:.... -. \,. v ~" 'oJ
c........\'.) I ~...."'~~Lu.... "'."....
C I \l' \. k-\-\ow ~ lJ>>uJ
~c.. S~~I:) CIV',\ TER~
I. ":t:.. ..4....4 "'~"e... 1A.J,.\.1, ..\..\"'''. ":t:..,,,,,, :5Cl''' 4~~"1
l.G~'" \ c.."'......o::, \..
1.. '"='= J,,~*' "'I.~v." ..... ,~'" ~l",. . :r:: .."'" '!.... ~ '~
.
4j" \ c..", '" Co, ,
~. r de>'" "'" <\~ v.... UJ ,..\.L +t.,... . .::x::- c-. '- S......~\...~
\ 0'::l0.1.. C.. .......c" I..
l.\. LV ,k ~ /.., ." . .::I ,
':t:. do... ' J.. C\~V.. "'... 5 .... fr. .. .,
\ .<:'"" t Co,"" "'c. \
6
\..Vl~\ -\-~:'!>.
I .,>>.,....+ '\~"...
le~... \ eo.....c, l
J.: J)"", '..{ ""j VH
\...~c.. C .....~~ l
.00--.' ~
'<J' ~l. -\-C "'
,
t
'. :r.
,,\~\J'_ \N1J-~ ,....H,'l:, .
\':100:.'
c........:c,\ \.
'if.':t- J..",''!'' "I~v..
~l;)" \. C C>....."'c., I...
q.:::.- ~-........
WI ~~ -\l., 'i> .
G\'jV- W\~\ ~\,''') . 1:
t,''1'" \ Co> <..."",.. \
'o...:t c.\.",... I -{. ~\I'c-f' tN I ~~ -\1-., 'So ,
I \,"'" J.,... .~ 11_ lJ"J.L. ,t.:,,,,,. . \ c.......
:::t "" .... ... .... .lr, '" ~
::t.. -=''- -oe-c~,....,
T ....... S"'~~''''''''
3:
""""'" :5.. ~'''' .,
"'\...... S.,....\(,"'1.
I",,,,,,, S.Gl \r", '0 l.j"lC......:\
SQ;.k,.. \.ec.,.. \. cc...... c.'.. l
I'
, ,
"
.iil
, , ,
I
,
,
'"
I)
Iii i'
.. "
, I,
I , 1
, ,
, ,
, ,
I ,
,Ii
"
Ii
,
,
'I
,
I,"
"
.,
,
/.,
"
"
,
,
"
"II
1.1'
,,'
.,
,
, ,
"
"
,i,
"
"
.. /-
...
~up.c.~~\~ ~1;,,,,,,,4j)
u8~ I ~ s~-,.
I c.. -- l.o-~ Gl..r uJ.. .
Cc....\.&l...a. ..... \ic:>\~
I '
~ - 2-tt ~ ~ \ '3 '"
" ,
, '
!
i
'"
#'
SARAH A. TODD MEMORIAL HOME,
P/a/ntlff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY. PENNSYLVANIA
: CIVIL ACTION. LAW
,96. 'n';} ,{ CIVIL TERM
v
RICHARD L SWARTZ. SR..
Defendant
COMPLAtNT
COMES NOW, Ihe Plalnllff, Sarah A. Todd Memonal Home, by and through lis counsel.
LIndsay Dare Baird, Esquire. and states as follows:
1, The Plainllff, Sarah A. Todd Memorial Home, is a Pennsylvarlla corpora lion wilh
offices at 1000 Wesl Soulh Slreel, Carlisle, Cumberland County, Pennsylvarlla 17013,
2, The Defendanl, Richard L. Swartz, Sr" Is an adult indiVidual residing al 1600
Longs Gap Road, Carlisle, Cumberland Counly. Pennsylvania 17013,
3, On Oclober 21, 1993, Defendanl signed an Admission Agreement for Howard
E, Swartz,Jr, (now deceased), permitllng Howard E. Swartz, Jr, 10 be admitled as a residenl in
Ihe facl/llies of Ihe Plaint,f' The Admission Agreemenl establishes Ihe Defendanl as Ihe
"Responsible Party" for Howard E. Swartz, Jr.. A copy of the signed AdmiSSion Agreement i3
attached harelo and made a part hereof as Plalntlfrs Exhibit "A",
4, On March 27. 1995, Howao'd E, Swartz, Jr, signed a Durable Power of Allorney,
appoinllng Richard L Swartz as his true and lawful allorney, A copy of Ihe signed Durable Power
of Allorney is allached hereto and made a part hereof as Plainlifrs Exhlbll "0"
5, The cost of care al Plainlifrs facililles for Howard E, Swartz, Jr lolals
$ 23.936,23 as of Seplember 30, 1996, No paymenl for Ihe amount owed Ihe Pla",llff has been
provided by Howard E Swartz, Jr, or by the ResponSible Party, Richard L. Swartz, Sr,
6, On Seplember 4,1996, Pla;nliff, by and through Its counsel, Lindsay Dare
Baird, Esquire. demanded paymenl of $20,500,13, the amounl owed as of AuguSI 30, 1996, on
or before September 15, 1996, Defendant failed to make Ihe demanded paymenl A copy of Ihe
letter of demand for payment senl to Ihe Defendant Is allached herelo and made a part hereof as
Plalnllfrs Exhibil "C",
arbllralion
7, The amounl owed P/alnllff exceeds Ihe jurlsdiclional amount for compulsory
COUNT 1 . CONTRACT
fully set forth,
8, Paragraphs 1 through 7 are incorporated in reference Ihereto as though more
1
,
.
"
VBRIrICA'l'ION
I VERIFY that the statements set forth in the attached
dooument are true and correct to the best of my knowledqe,
information and bel.ief.
I understand that false statements
herein are made subject to the penalties of 18 Pa. Section 4904
relating to unsworn falsification to authorities.
C2j?~/~-V
,
,
"
"
"
"
',1..
,
, ,
I'i
,
, '
, '
it
"
'I
, '
,", j:
I,
"
"
,
,
"
,
"'I
I' ,
, ,
"
,
"
"
,
"
>,'1
, '
..
, I,
,
,. , I "
"
" ',' , ,
" , "
,I.
" I , I'
,
;fir
, , , , I,~! "
'II .,
" !' " , t" I i
" i"
" , , , , "
, , , ,. ,
I ,
:,1 ! :'1 " '}
, " "
, ;'1 "
" I', , J,'
, "
, " 'I <i,' I :,
,
I. I
'I ,
, " I' , '/
,I "
" ,
iii' C) ",-~ , ,
J_~' &::: ,.- "II, "
tJ' ('1 '~ .I. ' I'
LJ.lr' " II 'I
;,-; I "
l~: ~t: -, t,,~ , i' , ,
I ,! I
1'4).. l'.~J :)' " ,
',. ... " I
~,.) ;.\';) "
, ,
I, I ,I"y' , ,
I
Iil' 6:: l'lO " ",', I ;'.1 " "
~ e; jr~ II , I , ,
t.~ , "
~ S; d , 'I
, , 'I, I
" I '"
I' "
, ,
I' " " " I
, , " , , " ,
I. , i' " " I"
, ': I
I' , , H\I " ,I I,
i
;, I .\,
, , ,
, , ,I I
',', " 'I
" ',/I ,I I.d 'II
, , , " ,',I)
" ,
, ,1, Ii oi' I ,
I , ,
" ,
I " " I I
I , , ,I , .1 " 'ii
I, ," , " ,I I , ,
"
" , , 'I " , "
" , I , ,
" I
I I' ,
, "
I I
" 'I " 'I
" , ,
"
q .'
'-',I
" 1,\
,
') " I "I 'I; ,1
',' I, "
"
"
, , ,
,
I
. .
'-
.
\
",
.f
','
,I,'
,I'
)1,
",!
':
j I'. rill !Il I 1 'J.J l'll~j j J ~ 1<"1 ,'1, I I .
,r, ,r, )1,//11 'I \tl i ")"1" W\~~~ 1 '."'~'''dl:~ ,\1.'/ 'ii,
", , I" ",1 'l'{!'\\h!/lhlll""l'", ,
I H,l).': :'If'i\[\}Jj'I'I}l\ilj'tt~I~I'!I'lr\'i''.'! \1/1" 'In,;' l'li"
)., ~.~I' 'i,.ifl},l), 'flit!WII,:;,l/f' !l1\11 ',I!. 'i!
, 'JI1.'\ "II/'ll'I"ll I' ~ oj;, Il. \ 1/,
r II } '. I" 'I" \I~ ~ . !' F I,', I" '
"q I ... I' ! \ j "
!" I '!J!l;~'JII;;";,'h;: "(;'1 . ',- ( ,
\', ;';~,.j!'/;,:I;jji'\:~1{;ffr/r. ':':' t'),\"
.. "1, ,I':,i',"'ip),c/'""J ;;""1'
I I',: I,""I".;..,!/I,." {i." ..
Ii',.,'"! i'j] l'~'!rJi!r'I~I:~';(_"i: l.'l 1'\'
)',Ili\'(' I ,~,I!I t!',_J'",;j';YIi '
',',',-' ,-,,' . '-" <); rt. '
q-I- 1')-. :'jl..1 I
,1;''''.4''\':{i''';lt-'':l,!~.'/t:,'j~;l I
~,' ." 'FT;'t)', i'ejf'l ;,L"(I ,',;,
'~I "'Jj\'" "it, 1'1,,';-;1".j
'_,I: "'11/,,-:1' -'Ii
"I' .' i;~ I,! r:,:: -il,'/- ',I
"1.1'/, ',-::,,;,, !,\~r J,j,'" Llj,:_ II
"";'I!""il"~ '.']':
'IV;"i
"
,
II ,-'r:',
n
,-'
I)',
"
'I
, "
..,
I'
"
"
,
I'.,
,
, ,
..
"
,
,1,1
I
I, ,
,U/IID8AV DAAIE 8AIAD. .SQUIRE
, , A~"".~ ~'I: t.Aw
.., I8OU"" H~OY." .,.,....,
'CA,Rl.l8l:.1r. PI:NN8VL.vANIA '1701'"
J1~'" ........,.. "AX' ...~.UO I
~E~
8'~ 1997"
, "
I.,
"
'.-11 i
,
"
"
'1'
I'"
1.,11'
'J
'1,\1"
"
"I
,
, ,
'I
,
"
" " , ,
,
,
, " 'I
I
"
,
I, it. "
"
,f
..
, ,
"
"
"
"
"
,
I
"
I,'
"
I'
"
',1'
,
,
, ,
"
" " " ,
" "
C) ~" ,
f I
" ,
'- I I , I
~~:r: ii, 1;1 I I
..
-' r')~}
" I'
(~ ...... J')~
.... 'I e.:.f.
,,' 0.- I.'~;:'~
I,:,
f L'') "[ft ,
't. ,'~ ,
L-_ N ffi. ) ., "
~~': fu I' '"
"
I" ~, , "
-- V- ;i , , 'I , ,
"
~ t; a I ,
, I
,
, ,
.
d,
" ,
" ,I ,
, ,
,.
.. '"
" ,
I,
I "
,t" ,
,
It'l Ii!
.. "
,
'.'
..
"