HomeMy WebLinkAbout98-06047
\.
~
~
.
<::)
~
)
~
\.
\I
-.Q
E
~
(..J
C4.
\l
~
"<
~
()
(
~
~
-
:;)
-
CJ
1:'--
:t-
o
.J
0;.
C>'
COlJNTY OF ('I ':-'IIlIRI \:\\l
('01 'I{ I ()I ('():-'I:-'lo:\ I'I.I':\S 01,
('I ;:-'lIILRI,\:\1l ('()l:1\ I '1',1',\
v.
1lIIIWFI.II:.llIlllI'l{
CIVil AlTION. \.,\\\'
NO, 'I, VI/CIVil. I'JlIX
;\OTICE TO I>EFEl'\1>
YOl/IIA VE BEE;\ slIIm IN COUR!'. I fyou \\ ish to delCnd against thc claims set
IClrth against you in the following pagcs. youmusttak~ action within (wcnty (20) days an~r this
Complaint and Notic~ arc scr\'cd. by entcring a wrill~n appcarancc pcrsonally or by attorney and
filing ill writing with th<: court your dclenscs or obj<:ction.s tothe claims s~l tilrlh against YOlJ.
You arc warned that if you 1;li Ito do so. thc eaus~ may proc~ed without you and a delimit
judgmcntmay hc ~ntcr~" against you by thc court withoutlilTther notice fi.1f an)' moncy claimcd
inlhc Complaint or t(,r any othcr claim or relicf requ~ste" by the Plaintiff. You may lose mone)'
or property or othcr rights important to you.
VOl! SHOULI) TAKE THIS I'AI'ER TO YOlJR LAWYER AT ONCE, IF YOU
DO NOT HAVE A LAWYER OR CANNOT AFFOIH> ONE, GO TO OR TELEI'HONE
THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL
HELl'.
Cumbcrland County Bar Association
2 Libcrty A venue
Carlislc.PA 17013
(717)24~~
/
C. Attorney Illr Plaintiff
~
i'
i
COUNTY OF n,:\l\IEIU,A:'\\l
Plaintiff
: IN TilE COIIRT OF COMMON PLEAS OF
: ('l1:\I\lERLAN\l COlI:"<TY, I'ENNSYLVANIA
v
BURnELL E, DITZLER
\lcfcntlunt
: CIVIL ACTION - LAW
: NO. '/J LeU CIVIL IlJlJH
COMPLAINT
I.
/'/
AND NOW. this 1
! I. / ii'
{ay 0 L A~
,llJ9X. comcs the J'laintilTthrough its
Solicitor, Robert C. Saidis. Esquire. and avers the 1()\Iowing causc of action as 1()lIows:
2. Plaintiff is the County of Cumberland. a County ot'the 4'" class, whose principal
ofliees arc loeatcd at Onc Courthousc Squarc. Carlisle. Cumberland County, Pennsylvania.
3. Plaintiff is charged with the operation of the Claremont Nursing and
Rehabilitation Center of Cumberland County, hcreinartcr Facility.
4. Defcndant was admillcd to the Facility on December 31. 1997, and did receivc
care and maintcnance while a rcsidcnt at Facility to the expense and detriment of Plaintiff.
5. Allaehcd hercto and markcd Exhibit "A" is a true and correct copy ofthc
Admission Agrecmcnt, the original of which is duly cxceuted by Dcfcndant.
6. Allached hercto and marked Exhibit "BOO is a truc and eorrcet copy of the
Statement of Agreement, the original of which is duly cxceuted by Defendant.
7. Defendant reeeivcd medical assistance bcnelits lor a portion of his care and
maintenance whilc at the Facility.
8. Dcfendant was rcsponsible for paying any outstanding balance lor his earc and
maintcnance while a resident at the Facility.
X. Dcklldallt ehcckcd hilnself oulof the 1ac'I1it\ Oil .III"" 11. Il)l)X,
I), ()lIor al,,'nt Angust II. I llIIX. a rc\isl'd kiln \\<" \L'lIttO Ilckndanl. c'oITeL'ling
thc amount dill' hy llL'll'lIdallt alld rcqllcstill!-, l'aY"ll'llli" his olll\lalldill!-, hill. a copy ofwhic'h is
attached hereto and madc a part hercof and marhl'd I',hihit "( ...,
Ill. Ilcklldant is liable to Plaillti IT li'r thc cost of caring li'r alld maintaining
Iklelldant at the Claremont Nursillg and Rchahilitatioll ('clltcr of( 'umhcrland COllnty in thc
amount 01'$ 3.211,7),
II. As of the date of this complaint. PlaintilThas not receiwd a rcsponsc from
Defendant.
WHEREFORE PlaintilTdemandsjudgmcnl in thc sum of$3.211.7) plus costs.
~)
I //J
Rohertl'. S'lid-i~.:S(IJre
'1\ttorncy j('r Plaintiff
Date:
10
IY- f'l,
Claremonl Nursing 11lHJ RchitbilaaHon Cenler
aOMo OF COUNTY
COMMISSIONEI\S
NlilCY A. eesch
ChQlrmQn
~rlf\'Keller
Viet Chairman
Maret. L. Myers
Secrttary
John S. Mrd
Chitl aerll
Dennis R Mulon
County Administrator
Horace ^. Johnson
Solicitor
oJ 1:lIlOlwrlllllll (lIIlfIIt,
Barry W Parks. O,Ed., N.H.....
Adm'll.s,rator
ADMISSION AGRE~E~r
})(jrdd/t.J\ f?J/~r
Resident Name
As part of admission to Claremont Nursing and Rehabilitation
Center, the Resident and the Responsible Party assisting the resident
acknowledge and agree to the following:
1. If Claremont Nursing and Rehabilitation Center determines that
the Resident is not appropriate or does not qualify for nursing home
care, the Resident will discharge from Claremont Nursing and
Rehabilitation Center following a 30 day notification of the need to
make alternate living arrangements. '
2. If the Resident cannot qualify for coverage under the Medical
Assistance or Medicare programs, the Resident will pay daily rate for
care at the nursing facility.
3. The Responsible Party (guarantor) assures that the Resident's
bill will be paid from the Resident's assets/funds. If the Resident
does not have personal funds or when personal funds are exhausted, the
Responsible Party will make application to medical Assistance on behalf
of the Resident. If the Resident does not qualify for Medical
Assistance funding, the Responsible Party will arrange discharge for the
Resident if the bill is not paid in a timely matter.
4. Unless otherwise provided for or designated, the Resident
appoints the'Administrator of Claremont Nursing and Rehabilitation
Center the Resident's lawful attorney, to ask, demand, sue for, collect,
recover and receive all sums of money, debts, a=ounts, legacies, dues,
bequests or any other sums which are now or shall hereafter become due,
owing, payable or belonging to the Resident; draw checks or drafts upon
and withdraw funds from any accounts or deposits in which the Resident
has any interest; sell, grant and convey the Resident's property, real
and personal, for such price as the attorney-in-fact deems best and to
do all acts to do all acts to carry out these powers and to turn over ny
money so collected or received to the Center to be held in trust for
payment of the Resident's past or future maintenance. So long as there
is any sum of money due the Center from the Resident, the power herein
granted shall not be subject to revocation; nor shall this power be
affected by the Resident's disability or incapacity, physical or mental.
5, The Resident authorizes Claremont Nursing and Rehabilitation
Center to release information concerning their assets, real or personal,
to the Cumberland County Board of Assistance,
..,..
, ,
i \ Exhibit ^
.~. )75 CI"emon! DrIVe. Carl,,'e, PA 17013.8805 . 71 7.243.20)1 or 7".766.1518 . pax
Continued...
717.2-10.1<152
(
Claremonl Nursing and RehablhlaHon Ccnlcl'
01 Cumberland (.unly
Barry W. Park.. D.ld., C.N.a.A.
Admln"'lfGtor
RESIDENT NAME:
Burdell Ditzler
RESIDENT NUMBER:
3676
aoMD or COU1ltY
COIolMtSSlONW
MEDICARE NUMBER:
Nancy A.llcscll
Cl\dl/nlllft
STATEMENT OF AGREEMENT
!ull\.lWIct
..."CI\d_
I. I bereby autborize tbe Claremont Nursing and Rebabilitation
~.::~ MJOn / Center of Cumbe~land County to provide medical and nursing
7 n ~.;.,,~ services to me. I further authorize the physician in charge
~hn~~: ~I of my care to administer any treatment or treatments that tbe
OUt/o". 1)/ ~ . physician may deem necessary or advisable for my care.
O,MlsI\.J " '
CouftIy~ I I bereby release, remise, .and discbarge tbe Governing body,
Claremont Nursing and Rebabilitation'Center of Cumberland County,
M.,AU A.)olINOl\ "its agents and employees of responsibility for tbe loss or damage
S/lh&flOr .
to any money, j eweb;y.... glasses. dentures, documents and all otber
articles retained in my possession.
:J e-Vl~i)
~~~~~lqy I
I bereby designate and transfer'responsibility for my financial
affairs to tbe Administrator of Claremont'Nursing and Rebabilit-
ation Center of Cumberland County. It is understood tbat all fin-
ancial transactions made on my bebalf will conform to applicable
state and federal regulations regarding resident funds. An account-
ing.Qf all financial transactions made on my bebalf will be avail-
able to me at least quarterly,
IV.
I acknowledge tbat I bave been made fully aware of the Resident
Rigbts both in discussion and by receiving a copy for my own use.
I acknowledge that I have been made fully aware of the Resident
Responsibilities both in discussion and by receiving a copy for
my own use.
(iD.
! ~ Exhibit B
315 Claremont Drive. Carlisle. P^ t10t).BB05 . 717.24).2031 or 717. 766.15tB · Fax: 7t7.240.t952
(
STATEMENT OF ACR!I!MENT
Page 2
I do authorize the r.l.... of the following information to volunt..r. or
organizations providing ..rvic. to the Clar.mont Nur.ing and R.habilitation
C.ntn of Cumb.rland Dounty: R.Ugion. Veteran Stetus, Birth. date, Responaibl. ,.. .';
Perlon. ,~
. .\:.
.;....~
t
VII.
A photocoPY of this document .hall have the .ame force, pover and effect a. the
odginal.
. .~
~/J/ /tl'J
Date
I/.s- /U'
/ . .~
. ....
Signed:l ..-{/..
(Re.ident, Guardian 0 n
/3:~.
~ ~--y~~
Wi'i::}~~
/~ /3/ /97
,
DaCf(./9i'
Witness
Date
ACCEPTANCE OF ADMINISTRATOR
The Administrator hereby accepts responsibility for the above resident's financial affairs.
~ _ ~-^- ~?::Q ~t'M
Admihistrator '
/-g' -'if
Date
I. Authorization of Medical Treatment
II. Release from Responsibility for
Valuables
III. Designation of Administrator as
Responsible for Financial Affairs
IV. Resident Rights
V. Resident Responsibilities'
VI. Release of Information
VII. Authorization of Photocopy
...
,. ,.,.".' "'."...,.,>.~
..-..:;.tM-:I'~"': ..t'l;.~'<',,:'
~:.t;.~. - , . ~ .}t~.
~, ".
.,
.
G1 TZLER, 9UR:':LL A-8
RECORD ::3678
;. : ;\1 T D A T '- 1 2 - 3 1 -1 997
"'OJ 10-29-1929
C :1 R C
L:
'4:
--:
~ ," ..
t:;: - ,
UJf) c"',
~r~ ,
~? :~~ . ,
- I
- .~ ,
c i
't ,-, ~ ,.
'" ;
- ~:..: '" , .n
fj:l.t' t- i \" ;;
T
[. ( , 1'1'
f' '.,IJ
'L U ~. . ..1-..
0 (I") :)
0' U
~
j~
~
t'"
J
e. '2 ;>
. './ ""
~...",;
.. :r
~~
~
.
r( :~IIlERI.\N1l {'Olrll\
I'lililltlll
IN 'IIIE CUl!/('/' OJ; COMMON I'LEAS OF
('tIMBERLAND COUNTY, I'ENNSYI.VANIA
NO, liH- 1111.1 i'
CIVil.
19'iH
v.
Il1IJWI'I.I. I'. IlllZIl:I~
Ilel ,,"dil"t
RULE 1312-1.
rIlle Petition for Appointment or Alhitra(ors ~hi\1I he \uh."llanlially in the fullowing form:
PETITION FOIt APPOINTMENT OF AIUIIT1tATOItS
TO TilE HONORABLE. TilE JUDGES OF SAID COURT:
Rober! r. Sit i d is, counsel for the plainlirr;defendant in the above action (or actions).
respectfully represents that:
I. The above-captioned action (or actiulls) is (are) at isslIe.
2. TIle claim of the plaintiff in the action is $.-4257. 2'i
TIle ccunterclaim of the ddcmlanl in the action is
The following attorneys arc intcrcstcu in the casc(s) as ~ollnsel or arc otherwise disqualilicc.l to sit as arbitrators:
Ron Turn
WHEREFORE, your petitioner prays your lIonorable Court 10 appuintthree (3) arbitrators to whom the case shall be
submilled.
.
OHllIm OF COURT
Respectfully submitted,
ROhelZt::-" ,aidis, Esquire
,-
~
\
'l, .~ /JC
AND NOW, /If Ii."--du Vi' J
foregoing petition, t(; rt.ujl .Ac I:' /1 .J
-', f, ~. J; J,
Esq.. and ri./ c.& cu./!!"! t.'c.;:}.../'
actions) as prayed for.
,19/'9 ,in consideration of the ~
- .' ,J // !,/,
Esq.. /JUC/(M..JG, ~<t~
tI
. Esq., arc appointed arbitrators in the above captioned action (or
P.J.
-..
,
\
I"~
(
,
'L
(f' ,
(.
I'
l._
,
"
~
>- \.n ~
n- c p.",
-:;'
,-
LUr~ C- ~ 'or)
O. ; ~ ~
C"l
,-,
":'"i 'R
(l) ( ','" ~-(
C:~. C',' ~
u' -'
-, i. -....
u_ -1
,,, ... (\L ~ ~
" c.
() (,',
, ~-
\,
COUNTY OF cUi\IIIERLA,,"D
Plaintiff
: IN TilE COllin OF COi\Ii\ION PLEAS OF
: ('(1i\IIlERLA:"<D CO(l:"<TY, PENNSYLVANIA
V.
Hl!lmELL E, DrrZUm
Defendant
: CIVIL ACTION - LAW
: NO, 98-(,11-17 CIVIL 1998
To: Burdcll E. Ditzler
Date of Notice: I ' .
IMPORTANT NOTICE
YOU ARE IN DEFAULT BECAUSE YOU I IA VE FAILED TO ENTER A WRITTEN
APPEARANCE PERSONALL Y OR BY ATTORNEY AND FILE IN WRITING WITII TI IE
COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAUvlS SET FORTH AGAINST
YOU. UNLESS YOU ACT WITHIN TEN DA YS FROM THE DATE OF THIS NOTICE, A
JUDGMENT MA Y BE ENTERED AGAINST YOU WITlIOUT A IIEARING AND YOU
MA Y LOSE YOUR PROPERTY OR OTIIER IMPORTANT RICilITS. YOU SHOULD TAKE
TillS NOTICE TO A LA WYER AT ONCE. IF YOU DO NOT IIA VE A LA WYER OR
CANNOT AFFORD ONE. GO TO OR TELEPHONE TIlE FOLLOWING OFFICE TO FIND
OUT WHERE YOU CAN GET LEGAl. I1ELP.
Cumberland COllnty Bar Association
2 Libcrty Avcnuc
Carlisle, PA 17013
(717) 249'3.:g...
{ /""
Attorney lor Plaintiff
COLJNTY OF ClIMIlEIU.ANU
PllIinliff
: IN TilE cOllRI' OF COMMON PLEAS OF
: ClIMIlERLANU cOllNTY,PENNSYLV ANIA
V.
IlLJRI>ELL E. DITZLER
Ucfcndlllll
: CIVIL ACTION - LAW
: NO. 9H-60-l7 CIVIL 199H
Date: )}"'!
1(,. /
, .,
;/)0 I!)
//
J
") .
/" /:;; ,/ ;~,' ,"
CERTIFICATE OF SERVICE
I. Janct A. Walter. hcreby cerlilY that I scrvcd a trlle and corrcct copy ofthc Il>regoing
Important Notice on the Dclendant. Burdell E. Ditzlcr, by mailing sllch a copy to 121 Spruec
Strcet, Carlisle, I'A 17013, by ccrtilied return rcceipt requested Unitcd Statcs mail. postagc
prepaid, in thc date hcrcinancr scl!'1flh.
/ ./ \
II
I,
ii THE COUNTY OF CUMBERLAND,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 98-6047 CIVil TERM
: CIVil ACTION - LAW
::
I'
I,
i:
v.
II BURDEll E. DITZLER,
II
II Defendant
!i
'I
~ I
I
II
I
I
I
i
ANSWER
1. Admitted.
2. Admitted.
3. Admitted.
4. Admitted.
I, 5. Admitted and denied. It is admitted that a copy of the Admission
II Agreement is attached. It is denied, however, that Defendant executed the Agreement
knowingly and intelligently.
6. Admitted and denied. It is admitted that a copy as attached. It is denied,
however, that Defendant executed the original knowingly and intelligently.
7. Admitted.
8. Denied. The allegations of paragraph 8 are legal conclusions to which no
responsive pleading is required.
8. (Misnumbered) Admitted.
9. Admitted.
10. Denied. The allegations of paragraph 10 are legal conclusions to which
no responsive pleading is required.
I
II 11. Admitted.
WHEREFORE, for all the above reasons, the Defendant respectfully requests
this Court to dismiss Plaintiff's complaint.
Respectfully Submitted
TURO LAW OFFICES
III X Ie? g
Date
lDC//-
Ron Turc, Esquire
32 South Bedford Street
Carlisle, PA 17013
(717) 245-9688
Attorney for Defendant
II
,
I
II
II
CUMBERLAND COUNTY
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
v.
BURDELL E. DITZLER
NO. 98-6047 CIVIL TERM
IN RE: APPOINTMENT OF ARBITRATORS
ORDER OF COURT
AND NOW, April 13, 1999, the appointment of David Lanza, Esquire as
chairman of the arbitration panel in the above-captioned case is vacated, and
~
t ~
~~
"
,
1
,
Robert Kline, Esquire, is appointed in his stead.
By the Court,
Robert Kline, Esquire
Chairman
P.J.
Michael Pykosh, Esquire
tlL/"Lt'~.l.-
.'
.'r>t(tt..l,(C,
'f/13)<i 1.
~".,).
Michael Travis, Esquire
_J
Court Administrator
:ssg
;.j
, ,
,
!
)-
, ):
:j JJ
'- ,
~ '- .: \ ~
J 1
) ,'j
'., "
" ,
J "
.j- i,
I.:;
.,
,.:! '~
, < 1
8> " ,
''-. I ! h.
" ~ -. -
<.l' ," "
to '>; "
)
~ :.::$ i ,
, C
<j -.j
~ -'
~ "- 0
~ i K
" J
" "
~ u ' ,
'-
~ . .
f~ 0\ ;-
Lf'; ';~
l'. ~ <;'-: 9 :") c
c', ., , I "
',,- " " ~: l.
'" -0.:
S' " '-', ~_I
U .., r-;=;
L:.; )
:...:~ . '_~.:7
"- =.5 :.IUJ
j:..-: -, ,"I.;u...
..;~
l :~ CI'\ ~:)
0 CI'\ U
/
CUMBERLAND COUNTY
v.
IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
98-6047 CIVIL TERM
BURDELL E. DITZLER
IN RE: ARBITRATION
ORDER OF COURT
AND NOW, June 1, 1999, the Court having been informed that the parties
have reached a settlement, the Board of Arbitrators previously appointed is hereby
vacated. The Chairman, Robert P. Kline, Esquire, shall be paid the sum of $50.00.
By the Court,
P.J.
Robert P. Kline, Esquire - ('wj-'-j- "",,,,,o.,Jd,," lrJ:J./(~,\~
Court Administrator
:ss9
limn:IlT I"':TI~R IiU~I':
Attorney & Counsellor at Law
331 Brldgo Stroot, Sullo 350
Post Ollico Box 461
Now Cumborland, Ponnsylvanla 17070.0461
(717) 770.2540
fax (717) 770.2553
May 2X, 1999
Robcrt C. Saidis, Esquirc
Cumbcrland County Snlicitor's Oflicc
Cumbcrland Cuunty Courthousc
I Courthousc Square
Carlislc, PA t 70 13
Ron A. Turo, Esquirc
32 S. Bcdford Strcet
Carli sic, PA 17013
>-
C-
O Deaf Bob and Ron:
(.)
Re: Cumberland County v. Burdell E. Ditzlcr
No. 98-6047 Civil Tcrm
This lcttcr will scrve as confirmation that I have been advised thatthc abovc-rcfcreneed
case has becn settled and thatthc arbitration hearing that had becn sehcdulcd for Wednesday,
June 23, 1999, at 9:00 AM can bc canceled.
By copy of this letter, I am advising thc Court and all othcr arbitrators of this cancellation.
1 am also requcsting that the appointment of arbitrators be vacatcd so that your Praecipe for
Judgment Upon Stipulation and Admission can bc entered on thc record.
Very truly yours,
ROBERT PETER KLINE, ESQUIRE
RPK!srf
ec: Michacl J. Pykosh, Esquire
Michael S. Travis, Esquirc
Sandy Gobreeht
Court Administrator
Prothonotary (with filc)
'.
'.
(11'IIlF ~ L P 111l-f.WW.TV-
III I Ill' ('tlUI't of ('UIllIlIUIII'It':I\ IIr
( '11111 ht'l"LlIHI ( 'ollllf)'. 1'~'IlIl\)I\ :lIIiil
I
.
I
\!
r
VS,
.'\,;ll
f) ~~ - .5.J 1/1 I
~"
I
('1\'11. It) .?_~~_______
flllllfJ r I
E.. IlITLlrp
"
Tot h e Pro tho not a r v.:
Please mark the ahove case settled and satisfied.
f.'
f
,
r
I
,
1-.
"
i'
I'
!
,
To Cur tis R. Lon q
ProlhullOI.:.Jry
---I
~I //
l,?, /
~
.
Januarv 4
2000
I\llorncy for Plaintiff
f
~'.' ;-
-f?
;;:1,
,.
;,f
.
"
.'
..
~/:t,
l
" <\~,~~~:.r'
'I
I
I
i
i
'~'~:
",.'
....
.
, i
'" .,.~
I'