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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'