HomeMy WebLinkAbout99-03883
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HCR MANOR CARE, INC.,
s/b/m/t MANORCARE HEALTH
SERVICES, INC.,
Plaintiff,
V.
RUTH GREGG and
PEGGY RICE, individually and
as attorney-in-fact for Ruth
Gregg,
Defendants.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. qq - ,38F3
CIVIL ACTION-6A-W and EQUITY
PRAECIPE FOR LIS PENDENS
TO: CURTIS LONG, PROTHONOTARY
Please enter the above-captioned action as a lis pendens agains the property located at 529
'h West Simpson Street, Menchanicsburg, Cumberland County, Pennsylvania.
O'B?R?IEN, BARK & S RER
David A. Baric, Esquire
ID#44853
17 W. South Street
Carlisle, PA 17013
(717) 249-6873
All that certain tract of land situate in Mechanicsburg Borough,
Cumberland County, Pennsylvania, bounded and described as follows:
BEGINNING at a stake on the South side of West Simpson Streetlat
lands now or formerly of Samuel B. Keller; thence along the same
South 13 deg. 30 min. East 172.2 feet to a stake; thence still along
lands now or formerly of Samuel B. Keller, South 76 deg. 30 min.
West 93.4 feet to lands now or formerly of George B. Voglesong; thence
along the last mentioned lands, North 21 deg. 30 min. West, 192.0
feet to a post on the Southern side of West Simpson Street, as
determined by a right-of-way agreement between Sameul B. Keller ani
Emma E. Keller, his wife, and the Borough of Mechanicsburg, Pa.,
dated July 1, 1949, and recorded in the Recorder's Office at Carlisle,;
Pa., in Misc. Docket No. 90, Page 241; thence along the South side
of West Simpson Street, North 78 dog. 45 min. East 54.3 feet to a !
post; thence still along the South side of Blest Simpson Street, North '
89 dell. 30 min. East 66.7 feet to the place of BEGINNING, said
description is based on a survey made by W. G. Rechel, Registered
Surveyor, dated July 16, 1956,1 having erected thereon a ranch dwelling!
house.
BEING the same property conveyed to Ruth E. Gottshall, by deed •i
of J. Vincent Narkley, et ux., dated December 9, 1961 and recorded
in Cumberland County Deed Book J, Vol. 20, at page 1147. The said
Ruth E. Gottshall has since intermarried with William W. Gregg. i
Thic, is a conveyance between husband and wife.
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Law OJjices
O'BRIEN, BARK' & SC'HERER
17 Nest South Street
Carlisle. Penn.svlvania 17013
Robert L. O'Brien
David A. Boric
Michael A. Scherer
VIA HAND DELIVERY
The Honorable Kevin Hess
Cumberland County Courthouse
One Courthouse Square
Carlisle, Pennsylvania 17013
March 24, 2000
RE: HCR ManorCare, Inc. v. Gregg/Rice
No. 99-3883 Equity
Dear Judge Hess:
(717) 249-6873
Fax (717) 149-5755
E-mail: obsa(.lobstaw.com
direct: dbarlc@obslaw.com
Presently, a pretrial conference in the above matter is scheduled for Monday, March 27,
2000 at 9:00 am in your chambers.
Enclosed find the first two pages of a bankruptcy petition filed by Ruth Gregg in the
United States Bankruptcy Court for the Middle District of Pennsylvania on or about March 13,
2000.
This filing automatically stays the above matter as to defendant, Ruth Gregg. I have
spoken with attorney O'Toole regarding this matter and, while I do not agree that the filing of the
bankruptcy petition stays this matter as to Peggy Rice, I would suggest that the pretrial
conference be held in abeyance until we can determine the effect of the stay.
Thank you for your attention to this matter.
DAB/jI
Enc.
Very truly yours,
O'BRIEN, BARIC & S HERER
6?
David A. Baric, Esquire
cc: Shaun O'Toole, Esq., VIA FACSIMILE: (717) 238-0592
File
dab. di r/litigation/manor/Qregg/hesa.l t r
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HCR MANOR CARE, Inc. s/b/m/t : IN THE COURT OF COMMON PLEAS
MANORCARE HEALTH OF CUMBERLAND COUNTY,
SERVICES, INC., PENNSYLVANIA
Plaintiff
E
V. NO. ;f- 36' 3-etyrt RM
RUTH GREGG and CIVIL ACTION-LAW and EQUITY
PEGGY RICE, individually
and as attorney-in-fact for
Ruth Gregg,
Defendants
You have been sued in court. If you wish to defend against the claims set forth
in the following pages, you must take action within twenty (20) days after this complaint
and notice are served, by entering a written appearance personally or by an attorney
and filing in writing with the court, your defenses or objections to the claims set forth
against you. You are warned that if you fail to do so, the case may proceed without you
and a judgment may be entered against you by the court without further notice for any
money claimed in the complaint or for any other claim or relief requested by the
plaintiff. You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF
YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR
TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN
GET LEGAL HELP.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, Pennsylvania 17013
(717) 249-3166
I'
HCR MANOR CARE, Inc. s/b/m/t
MANORCARE HEALTH
SERVICES, INC.,
Plaintiff
V.
RUTH GREGG and
PEGGY RICE, individually
and as attorney-in-fact for
Ruth Gregg,
Defendants
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
NO. 99-3883 CIVIL TERM
CIVIL ACTION-LAW & EQUITY
1. Plaintiff HCR Manor Care, Inc. (Manor) is a Ohio corporation, duly
authorized to conduct business in Pennsylvania and having offices at 800 King Russ
Road, Harrisburg, Dauphin County, Pennsylvania 17109. HCR Manor Care, Inc. is
the successor by merger to ManorCare Health Services, Inc.
2. Defendant Ruth Gregg, is an adult individual currently residing at
800 King Russ Road, Harrisburg, Dauphin County, Pennsylvania 17109.
3. Defendant Peggy Rice, is an adult individual residing at 5800 Derry
Street, Harrisburg, Dauphin County, Pennsylvania 17111.
4. Defendant Ruth Gregg has and continues to receive nursing home
services at the Manor facility located at 800 King Russ Road, Harrisburg for the period
of April 23, 1998 to the present.
1
5. Defendant, Peggy Rice, is the daughter of Ruth Gregg, and signed as
POA and/or responsible party in reference to Ruth Gregg's admission to the nursing
home. Ms. Rice represented that Ruth Gregg had as an asset a residence in
Mechanicsburg, Pennsylvania and, further, that Ruth Gregg had a monthly income of
$1,279.00 from pensions and/or annuities. Defendant's entered into a contract with
Plaintiff known as an Admission Agreement and Contract between resident and facility
("Admission Contract") and an Application for Residency which are attached hereto and
incorporated herein by reference as Exhibit "A."
6. At all times relevant hereto, Peggy Rice was the attorney-in-fact for Ruth
Gregg having been so appointed in a certain General Power of Attorney, the first page
of which is appended hereto as Exhibit "B" and is incorporated.
7. After her admission to the Manor facility the Defendant, Ruth Gregg,
made application for medical assistance. At the time of admission, Peggy Rice had
represented that Ruth Gregg had a residence worth $30,000.00 to $100,000.00 as an
asset to be used for her cost of care.
8. On or about August 10, 1998, Peggy Rice executed, individually and as
attorney-in-fact for Ruth Gregg, a mortgage in the amount of $60,000.00 using as
security for the loan the residence of Ruth Gregg located at 529'/2 W. Simpson Street
Mechanicsburg, Pennsylvania. The mortgage is recorded at Cumberland County
Mortgage Book 1476, page 596 at seq. and is incorporated herein by reference.
9. Defendant Peggy Rice received the proceeds from the mortgage
transaction on or about August 10, 1998.
2
10. The Pennsylvania Department of Public Welfare conducted an
investigation of the assets and property of Ruth Gregg and disallowed Ruth Gregg as
eligible for medical assistance based at least in part upon Peggy Rice's failure to
account for the $60,000.00 in proceeds from the mortgage transaction.
11. Plaintiff Manor provided nursing home services to Ruth Gregg during
her period of disallowance and continues to so provide services to Ruth Gregg.
Plaintiff has billed the Defendant's its customary and reasonable rates for the care
provided to Ruth Gregg.
12. As of the end of September 1, 1999, there remained due the sum of
$77,927.17 for the services, care and materials supplied to Ruth Gregg during her stay
at the facility a copy of a Statement setting forth these charges is appended hereto as
Exhibit "C" and is incorporated.
13. Peggy Rice has made the following payments against charges accruing
for the care of Ruth Gregg, October 6, 1998- $5,024.00; September 10, 1998-$449.00
and June 9, 1998- $63.00.
14. Upon information and belief, Peggy Rice has and is continuing to use the
funds of Ruth Gregg to make payment for the repayment of the mortgage referred to
above and charges accruing to the apparent use of the property in Mechanicsburg, to
wit: electric bills, water, sewer and trash bills, telephone and cable television bills.
3
Further, Peggy Rice has been and is continuing to permit her son to reside in the
residence neither charging nor receiving any rental income for the property.
15. Upon information and belief, Peggy Rice has been receiving Social
Security benefits payable to Ruth Gregg and has failed to account for the disposition of
those funds.
COUNT I -VS. PEGGY RICE
Breach of Fiduciary Duty
Failure To Make Required Disposition of Funds Received
16. Plaintiff incorporates Paragraphs 1 thru 15 herein.
17. At the time that Defendant Peggy Rice received funds from the mortgage
transaction and Social Security benefits of Ruth Gregg she was aware that she had a
legal obligation to dispose of those funds to or for the benefit of Ruth Gregg. Further,
Peggy Rice was aware that charges were accruing for the services being provided by
Manor Health Care to Ruth Gregg.
18. Peggy Rice is continuing to receive funds of Ruth Gregg and she is aware
that she has a legal obligation to dispose of those funds to or for the benefit of Ruth
Gregg.
19. Knowing that she had the aforesaid obligation the Defendant, Peggy Rice
appropriated and is continuing to appropriate those funds of Ruth Gregg to her own
use and benefit.
4
20. The Defendant, Peggy Rice has refused to pay the sum of $77,927.17
due to Plaintiff for the nursing home services provided to Ruth Gregg.
WHEREFORE, Plaintiff demands judgment against Defendant, Peggy Rice for
$77,927.17, additional charges accruing for services and care rendered to Ruth Gregg,
interest, punitive damages, costs and attorney fees.
COUNT II VS. PEGGY RICE
Breach of Fiduciary Duty - Misapplication of Entrusted Property
21. Plaintiff incorporates Paragraphs 1 thru 20 herein.
22. Defendant Peggy Rice has been and is serving in a fiduciary capacity by
virtue of serving as Ruth Gregg's attorney in fact and exercising her duties under a
Power of Attorney.
23. Defendant Peggy Rice took property entrusted to her as a fiduciary and
appropriated it to her own use and benefit.
WHEREFORE the Plaintiff demands judgment against the Defendant Peggy
Rice for $77,927.17, additional charges accruing for services and care rendered to
Ruth Gregg, interest, punitive damages, costs and attorney fees. Additionally, Plaintiff
requests that the Court impose a constructive trust on the funds so held by Peggy Rice.
COUNT III VS. RUTH GREGG
Breach of Contract
24. Plaintiff incorporates Paragraphs 1 thru 23 herein.
5
25. Defendants Ruth Gregg and Peggy Rice, as her attorney-in-fact, are
obligated by the terms and conditions of the contract by and between themselves and
the Plaintiff to pay for Ruth Gregg's cost of care at Plaintiffs facility.
26. Defendants Ruth Gregg and Peggy Rice have been billed the sum of
$77,927.17 for the cost of care and accrued late charges of Ruth Gregg. Ruth Gregg
and Peggy Rice have refused to pay the amount demanded.
27. The contract provides for the imposition of interest for late payments in
the amount of 1.5% per month (18% per annum).
28. The contract provides for the recovery of legal fees incurred by Plaintiff in
the event it retains counsel to pursue collection of amounts due under the contract.
WHEREFORE, Plaintiff demands judgment against the Defendants Ruth Gregg
and Peggy Rice for $77,927.17, additional charges accruing for services and care
rendered to Ruth Gregg, interest, costs and attorney fees and in an amount in excess
of the limits requiring compulsory arbitration.
COUNT IV VS. PEGGY RICE
UNJUST ENRICHMENT
29. Plaintiff incorporates paragraphs 1 through 28 herein.
30. Peggy Rice has used and enjoyed the proceeds of the mortgage
transaction and Social Security benefits paid for Ruth Gregg. Including, but not limited
to, permitting her son to reside in the residence without deriving rent; purchasing tools
and materials; paying amounts from the mortgage proceeds and Social Security
6
benefits to herself and her son, paying utility charges for the residence.
31. Peggy Rice did make such disbursements knowing that such funds had
been pledged as a resource to pay for the cost of care of Ruth Gregg at the Manor
Care facility.
32. Peggy Rice's has enjoyed the services and care provided to Ruth Gregg
by Manor Care without making payment for those services and care and has been
unjustly enriched thereby.
WHEREFORE, Plaintiff demands judgment against Peggy Rice for the value of
the services rendered to Ruth Gregg plus attorney fees, costs and expenses and
requests that the Court impose a constructive trust on the funds held by Peggy Rice.
Respectfully submitted,
Date:
O'BRIEN, BARI/-:1 C & S RER
A
David A. Baric, Esquire
I. D. # 44853
17 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
dab.dir/litigation/manor/gregg/gregg.com
P9i02/'1999 15:05 7172495755 CBS L.1'.J OFFICE.
? FAC,E 1P
VERIFICATION
I verify that the statements made in the foregoing Complaint are true and correct
to the best of my knowledge, information and belief. I understand that false statements
herein are made subject to the penalties of 18 Pa. C.S § 4904, relating to unswom
falsification to authorities.
MANORCARE HEALTH SERVICES, INC.
BY: a4 A1#A
DAN DAUB
Dated: / / 1 l/q /
Health Services .
THIS ADMISSION AGREEMENT (the "Agreement") is entered into this W'? day of
0 19 1212 , between (Marc, Care . (the "Facility"), and
(the "Patient/ Resident"), and/or (inn ig Rl"
J 70-J-7
ty"). As used herein, the term "Patient/Resident" shall also mean the Responsible
(the "Responsible ar
Party, if any. The parties agree as follows:
1. Commencement. This Agreement shall begin on the date of admission of the Patient/Resident
to the Facility.
2. Termination of Agreement Discharge and Transfer.
a. Termination by Patient/Resident. The Patient/Resident may terminate this Agreement by
giving the Facility at least five (5) days advance written notice. The Patient/ Resident is responsible
for payment of all charges for five (5) days after notice is given, or until the Patient/ Resident actually
leaves the Facility, whichever is last. If the Patient/ Resident leaves the Facility (i) before the attending
physician discharges the Patient/Resident, or (it) against medical advice, the Patient/Resident and
Responsible Party agree to assume all responsibility for injury or harm to the Patient/ Resident, and
hereby release the Facility, its employees and agents, from all liability connected with such departure.
b. Termination by Facility. The Facility may terminate this Agreement and discharge the Pat-
ient/Resident upon at least thirty (30) days prior written notice if (1) the Patient/ Resident's needs
cannot be met; (2) the Patient/ Resident presents a danger to the health or safety of other indivi-
duals; (3) the Patient/Resident fails to pay charges for supplies or services after notice; (4) the
Patient/Resident's health has improved sufficiently so that the Patient/Resident no longer needs the
services provided; or (5) the Facility ceases to operate. However, the Patient/ Resident may be
transferred or discharged upon less than thirty (30) days notice if: (1) an immediate transfer or
discharge is required due to the Patient/ Resident's medical needs; (2) the Patient/ Resident presents
a threat to the health and safety of individuals in the Facility; or (3) the Patient/ Resident has not
resided in the Facility for thirty (30) days. Such notice shall be given as soon as practical. The
Patient/ Resident acknowledges receipt from the Facility of materials as to the Patient/Resident's right
to appeal a discharge decision with State authorities and the appeals process. If this Agreement is
terminated and/or the Patient/ Resident is discharged by the Facility, the Responsible Party agrees
to accept custody of the Patient/Resident upon discharge and cooperate with the Facility to facilitate
the Patient/ Resident's discharge.
3. Responsible Party. The Patient/ Resident shall execute Exhibit A regarding Responsible Party
appointment.
4. Fees & Payments. The Patient/ Resident is responsible for, and shall pay, the daily rate and
charges for supplemental services and supplies not paid by any third party as described in the Fee
Schedule, attached as Exhibit B, as well as applicable co-insurance and deductible amounts and all
expenses of discharge or transfer.
5. Release of Information. The Patient/ Resident hereby authorizes all persons and/or entities to
release all or any part of his/her medical/health records to the Facility. The Patient/Resident also
authorizes the release of records or information to any health care institution to which the Patient/
Resident may be transferred, any provider involved in the care of the Patient/ Resident, any third
party payor, including, but not limited to, government and private insurers, or any other person entitled
or authorized to receive such information by law or by the Patient/Resident.
YMCA -W
I of 3
EXHIBIT "A"
n? „ caw V: a V. e i L14t •IJ II•p? r,. i?: .w ,, c ,, vv mt,. u w cw rr.b11.:y ILA '. ? a• + :. t 2r.7
lre ztment under the general or special instructions of said physician or in CESb of emter; Envy. T
7. Attending Physician. The Patient/Res-dcnl is sole!y responsible for selection of a licensed
etlend'ng physician. The Pwienl/Resident a, ees that the Facility may require the Patiant/P,es.cent
to utilize another physician If the attending physician (1) has his/her own profess'onal license limited.
suspended or revoked; (2) fails to follow th7 Facility's rules and regulations; or (3) is unavaitable in
case of emergency. The Patient/Resident is responsible !or all chages for physician services.
8. Pharmacy. The Pal enl/Resident shall execute the Pharmacy Agreement attached as Exh bit C.
9. Independent Contractors. The Pslient/Resident acknowledges and agrees that ali phys'cians.
dentists and barbers /beauticians, including those whose services are arranged by the Fac'.I y, are
independent contractors and are not emp!o',,ees or agents of the Facility, and the Faci ily shall not
I?
be r6sponsib!c for their acts or omlLSions of fcf the consequences of foilo-,6n, FF.yE174n cr eentist
C -de rs.
10. Private Duty Personnel. The Pallenl/Res:denl acknowledges that a•.I private duty persornel that
the Patlent/Resident utilizes are not employees or agents of the Facility and that the Facility is not
liable for acts or omissions by such personnel. Employees of the Facility may not be employed as
private duty personnel at the Facility. All private duty personnel shall comply w:th all policies and
procedures of the Facility as may be amended from time to time without notice. Failure to do so
may result in their being denied access to the Facility. Patient/ Resident and Responsible Party shall
be solely responsible for the cost of private duty personnel.
11. Facility Guide!ines for "No Heroics" Requests. Decisions regarding life support should be
considered by each Patient /Resident or his/her authorized surrogate decision-maker. The Patient/
Resident acknowledges receipt of rights under state law to make decisions about medical care, in-
cluding rights to accept or refuse care and rights to make an advance decision about care. T`r_
Patient/Resident acknowledges receipt of a summery of the "Facility G'udel:nes !cr No Heroics
Requests" (the "Guidelines"). A full text of the Guidelines will be provided upon request. !n part. the
C;JIdCI!res prO.!de that the Fa:i!ity vAl no. wtnhold or withdraw !.fe-suE:air.mg Cr !!fE-prolong•ng
moasu'es from a Patient/F.cs:dent with77t a vvrlttan and legally viffic'ent a'Jfho,:zet.on of a cc rpstent
Patient/Resident or legally authorized surrogate decisio i-.maker and a phys;cian order. The Patient/
Resident agrees to comply with the Guidelines.
12. Liability and Irdernnifica:ion. The Patiant/Resident understands that the Facility is liable only
for injuries caused by the nevi igent acts w emissions of the Facility ano as rEqui!ed by lawn. The
Patient/ Resident shall indernni!y and hole the Facility harmless !rera any anc all cla:ms, suits a^d
actions made aga'nst the Facility by any person resulting from an; darrag or injury caused by the
Patient/Residen: to any person or the propely cf any person or entity (Including the Feci;il) ).
13. Patient/Resident's Handoook. The Patient/Resident sckno'v.ledges receipt of the Fac;: y's Res!-
dent's Handbook and agrees to compy wit'i such Rules and Regulations contair.ec therein. h
'^
Pa!ie^t/RE Sic-Evil aC'r,;tO:;i3'?;fS c'r1:t 4;rlc: tr.Lt ne/ShC ShE'i be fESrOa.'C71? tor and S^c I h-c •1=
FL::'. I ty',z Td: e f ter arq irt;wi: !. w dE'`.c^': v, hi:.`, a'E ca VSid ty t.14 Pah2..!Fic
c7rnn:y %vith E'JCh rules and regulations. Tne pcilciES, procedures, rules c7d reUuiaUOns rE-anc•
!'F. 1GIlOl7inz are3F, amcrg ctners, are dclaiud In the res dent's Handbook:
. 1a1.11 ,cr+. /S l o J 2 of 3
• Federal Hesident Rignts
• Resident Responsibilities
•'.LIfe Sustaining Treatment Policy
• Medical/Nursing Education
• Dental, Vision and Hearing Services
• Interdisciplinary Care Conference
• Utilization Review Meetings (if applicable)
• Personal Laundry Policy
oat {Jut j c`bauty au( vrt oa
• Mail Policy
• Voting Materials
• Photo/Media Events
• Personal Fund Account Procedure
• Tobacco Policy
• Grievance Procedures
• State Resident Rights (if applicable)
14. GOVERNING LAW. THIS AGREEMENT SHALL BE GOVERNED AND CONSTRUED IN
ACCORDANCE WITH THE LAWS AND REGULATIONS OF THE STATE WHERE THE FACILITY IS
LOCATED. TO THE EXTENT ANY PROVISION HEREOF CONFLICTS WITH STATE LAW, STATE LAW
SHALL CONTROL. THE STATE LAW ADDENDUM ATTACHED HERETO AS EXHIBIT D SETS FORTH
ANY DELETIONS FROM OR ADDITIONS TO, THIS AGREEMENT REQUIRED BY STATE LAW, WHICH
AMENDMENTS SHALL BE A PART OF THIS AGREEMENT.
15. Miscellaneous. The provisions of this Agreement shall bind the parties, their respective executors,
administrators, heirs, beneficiaries, and assigns. The waiver by either party of any breach or default
of this Agreement shall not operate as a waiver of any subsequent breach or default. The provisions
of this Agreement shall be severable and the invalidity or unenforceability of any provision shall not
affect the validity or enforceability of any other provision. This Agreement and all Exhibits are the
entire agreement and any changes shall be in writing and signed by both parties.
IN WITNESS WHEREOF, the parties hereto have executed this Admission Agreement as of the day
and year above written.
C1rMM 1 YA A, Q-q C I M4
Facility eprese tative - Signature
Jannlfr (' A. 1 eth GSL-?
Facility Representative - Printed Name & Title
1 -41.).3 IaR
Date
R sponsi Via - Signat? ?
Responsible Party - Printed Name
41as'g8
Date
YNC•C .ft (Rw.4/60) pg 5 3 of 3
The Patient/Resident's Responsible Party may be any person legally responsible for the Patient/
Resident. A competent Patient/Resident shall not be required to designate a Responsible Party.
Please check one of the four following, whichever is most appropriate.
W The undersigned has been legally appointed guardian, conservator and/or holder of a power
of attorney to act on the behalf of the Patient/Resident and shall serve as Responsible Party
for the Patient/Resident. The undersigned has delivered to the Facility copies of the legal
documents designating him/her as the guardian, conservator and/or holder of a power of
attorney of the Patient/Resident. In consideration of the Facility's agreement to admit the
Patient/Resident to the Facility, the undersigned, individually and personally, hereby warrants,
represents, covenants and agrees to the Conditions (as herein after set forth and defined).
? The Patient/Resident does not have a legally appointed representative and wishes to give
the responsibility to someone else. I hereby appoint
as my representative (the "Responsible Party") and hereby authorize him/her to handle my
finances, pay my expenses, receive my personal funds and, if I am unable, to execute the
Admission Agreement on my behalf. Any signature of Patient/Resident or Responsible Party
on the Admission Agreement and/or this or any other exhibit or document attached thereto
or referenced therein shall be considered binding on both the Patient/Resident and the
Responsible Party. The undersigned hereby agrees to the Conditions (as herein after set forth
and defined).
?1Id1ML i?
rac u? nepre 4nta?rv a ?t Signature
Facility Representative - Printed Name & Titie
ti
Date 1 g!
T`
lJp 40..E C .! ?,cc¢_ ?Q d f}?
Fa lent/ - Signature
Patient/Resident - Printed Name
Li Ia?Irn7
Date
? The Patient/Resident is competent and does not have a court-appointed guardian, conser-
vator or power of attorney and has not appointed a Responsible Party, but alone shall execute
the Agreement. In consideration of his/her admission to the Facility, the undersigned hereby
agrees, warrants and represents to the Conditions (as herein after set forth and defined).
? The Patient/Resident is mentally or physically incapable of executing this Agreement, handling
his/her own affairs or appointing a Responsible Party and does not have a guardian, conser-
vator or durable power of attorney. The Patient/Resident's physician will certify in writing
that the Patient/Resident is incapable of executing the Agreement and that placement in the
Facility is appropriate. The undersigned voluntarily agrees, on behalf of the Patient/ Resident,
to act and serve as Responsible Party for the Patient/Resident. In consideration of the Facility's
agreement to admit the Patient/Resident to the Facility, the undersigned individually hereby
warrants, represents, covenants and agrees to the Conditions (as herein after set forth and
defined).
MM -O -2e IRev. 4/991 e0e
1 oft
'Conditions (collectively referred to as "Conditions") -?
1. The assets of the Patient/Resident will be utilized to pay, when due, all costs incurred by
the Patient/Resident at the Facility not covered by a third party payor, at the rates set forth
in the Fee Schedule (Exhibit B). The Responsible Party will arrange for the provision of
personal clothing and care supplies as needed or desired by the Patient/Resident and as
required by the Facility.
2. The assets of the Patient/Resident will be utilized to replace any and all furnishings or other
property of the facility, other Patient/Residents or employees of the facility damaged by the
Patient/Resident.
3. All of the information, including but not limited to that contained on the attached Application
for Residency, dated _ y- )a3 , 199 )? , and which is attached hereto and
-r
made part of this Exhibit and of the Admission Agreement, is true and accurate as of this
date and all assets listed in the application are in fact available to the Patient/ Resident for
the Patient/Resident's care while at the facility.
4. Neither the Responsible Party nor the Patient/Resident will take action to dissipate or other-
wise transfer the Patient/Resident's assets and/or assets which are available for the Pat-
ient/ Resident's care so as to prevent such assets from being used to pay for the care of
the Patient/ Resident while at the facility.
5. When the assets available to pay for the Patient/Resident's care at the Facility are not
sufficient to pay for the anticipated length of stay, the Responsible Party or Patient/Resident
will so notify the Facility and will file, on behalf of the Patient/Resident, all applications and
other documents necessary or advisable to qualify him/her for all third party payor programs
for which he/she may be eligible, including Medicaid.
6. If the Patient/Resident is a Medicaid Patient/Resident, that Responsible Party or Patient/
Resident will provide financial information regarding monthly credits, increases and decreases
in the Patient/Resident's bank account(s) and other assets to the Facility to enable the
Facility to provide requested data to Medicaid representatives.
7. If the Patient/Resident is covered by a third party payor, the assets of the Patient/Resident
will be utilized to pay extra charges not covered by the third party payor in a timely manner,
and to notify the administrator of the Facility of any problem anticipated in paying such charges.
The undersigned understands and acknowledges that the Facility is relying upon the above Conditions
in admitting the Patient/Resident to the Facility and understands and acknowledges that if the above
warranties and representations are not true, or if the above covenants and agreements are not
complied with, the Facility will have detrimentally relied upon them and the Facility will suffer financial
harm and loss.
:L444 rp-
Respons e - Signa ure
Responsible Party - Printed Name '
?,Zi I?
Date .
El¢H0B X' p
?.ULE
/r1 it ??n.
1. Daily Rate. The dally rate is The monthly rate equals the daily rate multiplied by the
number of days in the month. The daily rate is billed one month in advance and Includes:
• Routine Nursing Care • linens •
• Meals (additional fees may apply) • Activities Social Services
• Room (circle one): Private Semi-Private iplo • Housekeeping
The following are paid by Medicare in addition to the Items Included in the dally rate:
• Approved Rehabilitative/Therapy Services •
• Approved Nursing Supplies • Approved Medications
Approved Equipment
The following are paid by Medicaid In addition to the Items included in the daily rate (to the extent
covered and paid for by the state program):
• Approved Rehabilitative/Therapy Services •
• Approved Nursing Supplies • Approved Medications
• Approved Routine Personal Hygiene Items/Services Approved Equipment
• Other approved services/items covered and paid for under the state Medicaid program.
2. Supplemental Services & Supplies. The daily rate may not Include the following items, which
will be provided at request of Patient/ Resident and/or by physician order at the rate set forth in
the attached facility rate sheet and will be the responsibility of the Patient/Resident.
I
ITEM RATE
• Private Room
• Prescription & Non-Prescription Drugs Based on location & level of care
• Nursing & Personal Care Supplies
• T As determined by pharmacy
See business office for current
rice
ransportation
• Nursing Care (Other than ordinary nursing care) p
s
As determined by transport company
• Physical, Occupational & Speech Therapies See attached fee list
See attached fee list
• Phone, Cable TV, Newspaper, Barber/Beauty See attached fee list
• Special Equipment
• Bed Hold Fees See attached fee list
• Personal Laundry (Personal Clothing) See attached fee list
See attached fee list
• Nutritional Supplements
• Alternative Nutrition (Tube Feeding
TPN
t See attached fee list
,
, e
a) See attached fee list
3. Bed Hold Fee. The Facility charges a daily fee for reserving a bed whenever a Patient/Resident
leaves the Facility. For Medicaid Patient/ Residents, bed holds are pursuant to state law.
4. Other Charges. Because at Admission, the Facility is unable to ascertain all services/supplies
which may be needed by and provided to the Patient /Resident, all additional costs/charges may
not be listed here. If such services/supplies are provided to the Patient/Resident, the bill will reflect
associated charges and he/she agrees to pay them in accordance with the Agreement.
5. Adiustment of Charges. The Facility may adjust any and all rates upon thirty (30) days prior
written notice, or, in case of emergency or change in level of care, with such prior notice as is
reasonably possible. Adjustments shall be deemed agreed to by the Patient/Resident unless the
Facility is notified in writing to the contrary within ten (10) days after mailing such a notice. If the
Patient/Resident does not consent to the rate adjustment, the Patient /Resident agrees to leave the
Facility no later than the day before the rate increase is effective.
•--VVt
7. ^'?ding Sources. The Facility makes no assurances that the Patient/Resident's care will be,{Ca
covered by any third party payor. 11 r
8. Payment Policy. All amounts due shall be paid promptly within ten (10) days of billing. Failure
to pay any amount when due is a breach of this Agreement for non-payment of stay and grounds
for termination of this Agreement and discharge of the Patient/Resident. Any account not paid in
full shall be subject to a one and one-half percent (11/2%) service charge on the past due
balance each month until the balance due is paid in full. This amounts to eighteen percent
(18%) annually on the unpaid balance. If the maximum annual service charge allowed by state
law is less than eighteen percent (18%), the maximum interest rate allowed by state law shall
apply. Should the Patient/ Resident's account be turned over for collection to an attorney or
collection agency, or should the Facility seek to interpret or enforce any other provision of the
Agreement, the Patient/Resident agrees to pay all court costs and reasonable attorney's fees
of the Facility if the Facility prevails.
9. _Responsibilities. The Patient/ Resident is responsible for, and shall pay, the daily rate and charges
for supplemental services/supplies not paid by any third party, as well as applicable co-insurance
and deductibles and all expenses of discharge or transfer. The daily rate may change if the Patient/
Resident is transferred to a different room or the level of care or payor status changes. The Patient/
Resident and/or Responsible Party will be notified of the rate change. If the Patient/Resident or
Responsible Party refuses supplemental services/supplies or to make payment for them, the Facility
is released from all liability for harm which may result.
Medicare Beneficiaries: The Patient/Resident understands that Medicare eligibility and coverage is
established by federal guidelines which limit payment to a fixed number of days. If the Patient/Resident
enters the Facility and the Medicare application is denied, the Patient/Resident shall be liable for
all charges. The Patient/Resident is responsible for payment for items covered by Medicare supple-
mental insurance and for applying for reimbursement from his/her insurer.
Medicaid Beneficiaries: (circle correct number)
1) The Facility does not currently participate in the Medicaid program. Accordingly, persons who
are admitted as another payor status will be unable to convert to Medicaid status. In order to facilitate
proper discharge planning, the Patient/ Resident and/or Responsible Party agree to provide the
Facility with at least four (4) months prior written notice of the Patient/ Resident's becoming eligible
for the Medicaid coverage or their being unable to pay privately;
OR
2) The Facility currently participates in the Medicaid program. If the Patient/ Resident believes
e/she qualifies for Medicaid, he/she shall promptly complete and submit all documents required
to apply for coverage, including pre-admission approval. If Medicaid coverage is denied, the Patient/
Resident will be liable for all charges from the admission date. When Medicaid pays for only a
portion of the incurred charges, the Patient/ Resident shall be responsible for paying his/her portion,
as determined by Medicaid regulations. This charge will be billed to the Patient/Resident by the
Facility and shall be his/her responsibility. The Patient/ Resident shall also be responsible for pay-
ment of Facility's current charges for any requested non-Medicaid covered services/supplies. The
Patient/ Resident will provide financial information regarding monthly credits, increases/decreases in
the Patient/ Resident's bank account(s), and other assets to the Facility for provision to Medicaid
representatives.
MHC-WS-20 Mw 4/96) P9 9 2 Of 2
ManorCare
APPLICATION FOR RESIDENCY Health Services
To apply for admission at our Nursing Center, please complete the following questionnaire,
sign, and return it to the Admissions Office. This application will become a part of the
"Admission Agreement" and should be completed in its entirety. All information will be held
in confidence. The complete medical history and physical examination results will be
recorded on another form.
Date: ' 5 q`d
Name of Prospective
Resident: Ru??1 E GTt Q, Sex: Age: `73
0 0- Address: Sag's In/ Simpson S-f
Telephone No.: i L 1106 - 1035 Social Security No.: - 2 ) 7 - a 0 - 9S
Date of Birth: Month SeT Day - 17 Year (q C94
Place of Birth: City -rU l V t r C 4V State (County) PA
Marital Status: Married
Single
Widowed X-
Name oflnauirer._P ?nh iiC?° Relationship: r1IA??t?er
Address: 5300 ru S F Telephone No.: 11 -7- Slay'- 40$,k
_Navrtsbv.rc? PA 1111 1 +-kNs Uy
k ((5o rlfA?S OlA,
m C. 5K G.-(- w o k
Other persons to contact (in case of er rgency)
Name Relationship Address Telephone No.
lr?an PQ cc Son=m-La,?) 5800ler-64 ubG S(oy- yoS
n+t 0b ' W6r4CO)'5 061r? gogq lp)T1 9AA 0_ci-7110- s4s-:?6Ri
How did you hear about aYLQo - Q&A-t- Nursing Center
1. Personal Referral 6. Newspaper/Magazine
2. Hospital n s# o 7. Television/Radio
3. Physician 't? ?? gT? . o S. Yellow Pages
4. Other Nursing Home/ACLF 9. Mailing/Brochure
5. Health Dept.
HAVE YOU VISITED ANY OTHER NURSING CENTERS? YES NO
MHc.oo8.617/961
IF YES, WHICH ONES? ?ks 00 -1 Y9GQ v?`? ?p ( ?7
MEDICALIPERSONAL DATA
Resident's Current Physician:a
Physician to Follow at Facility:
1. X Mentally Alert
2. Slightly Forgetful
3. Confused
4. X Ambulatory
5. Walks with Assistance
6. `?' Requires Bedrails
-rra Ac- UR-Lp s(P
7. X Bed Ridden
8. Requires Special Diet
9. Able to Eat Without
Assistance -?eea s hey s?ell? b L&
10. Requires Assistance with I,uJs 4o
Eating C,U4.-?D0&
11. x Incontinent C LL+ U-P .
12• Continent
Admission Desired On: - ?I a q R Resident Now At: Yyoumor,- wg-
0-
_KW)
A 0. -01c
YES ph?Sic?-<..?.F?u??,hcv? rod- w .. sil?ce a(??F(?f8'.
The Name(s) of the person(s), other than the resident, who will be financially responsible
for the cost of care (the "guarantor"), if any. While a guarantor is not required for admission,
the facility does require that a source of payment be identified to pay for the Resident's
care.
Name
Address
Home Telephone
(Any person(s) whose names are listed here must also sign this application.)
Has a trust account been established? Yes X No Vl?fy?t
Has a power of attorney conferred on the person(s) to be financially responsible?
Yes No If yes, please provide a copy.
Prz?o R? , lnc? Pa u -ems.
?S'C emer?\
I jJ n o
l ' / l.
n n ?) "„ o
Has a legal guardian been appointed by a court? Yes No
If yes, please.provide a copy. 0
FINANCIAL DATA
To process your application, the following information is needed. The information supplied
is confidential and allows us to assist you in your long-term planning. The financial data
should be that of the Resident and/or the Guarantor. All income and amounts listed,
whether under the Resident or Guarantor section, must either be owned by the Resident or
in fact be available to the Resident to pay for the Resident's stay while at the facility. Your
cooperation Is appreciated in order to expedite admission. Please note that it is not
mandated that a Resident have a Guarantor, only that an adequate source of payment be
identified. Thus, any person who agrees to be a Guarantor is doing so voluntarily.
MONTHLY INCOME
Salary RE ID NT GUARANTOR (If soul
$
Social Security
PenslonS/Annuities `7 . 00
IRA
Interest0vidend Income
Rental Income
Trust
Investments/Other
TOTAL MONTHLY INCOME $ Z'? 7 9, 00 $
ASSETS:
Cash (Itemize by bank/account #)
PILE /40-02Y (005 $ 300,40 $
_3-CD,S SUUO.00
CommtlMr,k, -501531`t`0y ??Soo.vo
Securities (Stocks/bonds) $ $
Trust $ $
3
Ell: 3 bdrm, rw.. 3 raps M.., AfffMwo, ii RESIDENT , GUARANTOR (if
aml
3z 2df0)'A m r h cul- 30,000.0 .0 A5 /S -k
oa. o $
5agi %LLJ. S?moSC?- Sf, ecy (rs
?h r?G? ye>L h aa? haute
Other ssets: i5 Ih
Cash Value of Life Insurance $ unh?a(,.j $zVu? r-op/lihok- -
Vested Pension Benefits
?-
Business Interests Qny /% 1{QS (?c
00. 00
Automobiles .5?
Other
TOTAL ASSETS: $ 5ro a v o, a o?
Llabllldes:
Home Mortgage $ 1)ex-0-
Credit Cards/Charge Accounts /0 0 - 0 0
Loans _1Z1)me-
Other Debts M0, UAi /% 49 5 300-60
Taxes Owed pewn- r-Q, rerl,?- o ge9 a, o c>
0 - 44AJi- QL rp 0 .
TOTAL LIABILITIES $
f-/OG!/,111arc S a.?e c ?ck?otert? a,?c?r?5
NET WORTH (ASSETS - LIABILITIES): $ 100-00 $
/ho w b & c% hayptz a c?a-vim- wi4Gt
Please Sign Below: 6fyya, n (,f?{/,(n 9 - ct5S f 54e ?e
I hereby warrant and represent that the informati provided is accurate and complete. I
understand that the nursing facility will rely upon the accuracy and completeness of the
above financial information in making an admission decision. I also understand that if any
of the information is not accurate or not complete, the Facility will have detrimentally relied
upon the above financial information and will suffer financial loss and harm. The assets
listed are in fact available to the Resident to pay for the Resident's care.
24, , rr t,ce P o-/I-) ?1061>z'
Res or Responsible arty's Signature Date'
Guarantor's Signature
Reviewed by:
Oinis'dtrator"s ' s Dire rs Signature
° ature e 4
ig
Date
41a/QA
Date
Date
HCR•Maror{'ane
MANORCARE HARRISBURG 657
800 KING RUSS ROAD
HARRISBURG, PA 17109
(717)-657-1520
PEGGY RICE
FOR RUTH GREGG
5800 DERRY STREET
HARRISBURG, PA 17111
Statement
Please Return This Portion
With Your Payment
PRIVATE
ROOM FIG -C
------GR???,_HIIUi----------------------Q@@@? ---99L? L9e ----------- OPIRL99 --
TE OF CODE SERVICE RENDERED CHARGES CREDITS
DAERVICE
S
08/01/99 BALANCE FORWARD 72,367.66
08/31/99 11600 CABLE RENTAL ( QTY 1 ) 10.00
09/01-09/30/99 ADV ROOM CHARGE 4,464.00
08/31/99 UNPAID- 1.503 ON$72367.66 1,085.51
** YOUR ACCT IS NOW 180 DAYS PAST DUE **.
AMOUNT DUE 77,927.17
EXHIBIT "B"
GENERAL POWER OF ATTORNEY
I, Ruth E. Gregg, residing at 529 1/2 W. Simpson Street, Mechanicsburg,
Pennsylvania 17055, hereby appoint Peggy A. Rice of.5.800 Derry Street,
Harrisburg, Pennsylvania 17111, as my Attorney-in-Fact ("Agent").
My Agent shall have full power and authority to act on my behalf. This
power and authority shall authorize my Agent to manage and conduct all
of my affairs and to exercise all of my legal rights and powers,
including all rights and powers that I may acquire in the future. My
Agent's powers shall include, but not be limited to, the power to:
Open, maintain or close bank accounts (including, but not limited
to checking accounts, savings accounts, and certificates of
deposit), brokerage accounts, and other similar accounts with
financial institutions.
a. Conduct any business with any banking or financial
institution with respect to any of my accounts, including but
not limited to, making deposits and withdrawals, obtaining
bank statements, passbooks, drafts, money orders, warrants,
and certificates or vouchers payable to me by any person,
firm, corporation or political entity.
b. Perform any act necessary to deposit, negotiate, sell or
transfer any note, security, or draft of the United States of
America, including U.S. Treasury Securities.
c. Have access to any safety deposit box that I might own,
including its contents.
2. Sell, exchange, buy, invest, or reinvest any assets or property
owned by me. Such assets or property may include income
producing or non-income producing assets and property.
3. Purchase and/or maintain insurance, including life insurance upon
my life or the life of any other appropriate person.
4. Take any and all legal steps necessary to collect any amount or
debt owed to me, or to settle any claim, whether made against me
or asserted on my behalf against any other person or entity.
5. Enter into binding contracts on my behalf.
6. Exercise all stock rights on my behalf as my proxy, including all
rights with respect to stocks, bonds, debentures or other
investments.
7. Sell, convey, lease, mortgage, manage, insure, improve, repair,
or perform any other act with respect to any of my property (now
owned or later acquired) including, but not limited to, real
estate and real estate rights (including the right to remove
tenants and to recover possession). This includes the right to
sell or encumber my homestead legally described as: 1 Story
EXHIBIT "C"
n
CERTIFICATE OF SERVICE
I hereby certify that on September 13 , 1999, I, David A. Baric, Esquire,
of O'Brien, Baric & Scherer, did serve a copy of the Praecipe to Discontinue, by first
class U.S. mail, postage prepaid, to the parties listed below, as follows:
Shaun O'Toole, Esquire
Killian and Gephart
218 Pine Street
Harrisburg, PA 17101
Ruth E. Gregg
800 King Russ Road
Harrisburg, PA 17109
Peggy Rice
5800 Derry Street
Harrisburg, PA 17111
e4w,zl?4,d
David A. Baric, Esquire
Date: qi 11 3l /
o
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y ? Z
U ? ?
? U ? }
? a ?
J m
Z y
41 _
C ¢
p] <
V
v
? - ?-
HCR MANOR CARE, INC.,
s/b/m/t MANORCARE HEALTH
SERVICES, INC.,
Plaintiff,
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
No.
V. CIVIL ACTION-L-AW and EQUITY
RUTH GREGG and
PEGGY RICE, individually and
as attorney-in-fact for Ruth
Gregg,
Defendants.
PRAECIPE FOR WRIT OF SUMMONS
TO: CURTIS LONG, PROTHONOTARY
Please issue a summons in the above matter.
BRIEN, BARIC & S RER
e??
David A. Baric, Esquire
ID#44853
17 W. South St.
Carlisle, PA 17013
(717) 249-6873
Attorney for plaintiff
TO: RUTH GREGG, PEGGY RICE
You are hereby notified that HCR Manor Care, Inc. has commenced an action against
you.
Date: toI*gq
Curtis Long, Prothonotary
Ruth Gregg Peggy Rice
800 King Russ Rd. 5800 Derry Street By: ?a ?71?1 -'ACYY1
Harrisburg, PA 17109 Harrisburg, PA 17111 (Deputy)
J
4
ui
9
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rn
T
c?
00
SHERIFF'S RETURN - OUT OF COUNTY
CAS$ NO: 1999-03883 P 1-1y -
COUNTYWOFLCUMBERLLANDSYLVANIA:
HCR MANOR CARE INC ET AL
VS.
GREGG RUTH ET AL
R. Thomas Kline , sheriff, who being duly sworn according
to law, says, that he made a diligent search and inquiry for the within
named defendant, to wit: GREG- RUTH
but was unable to locate Her in his bailiwick. He therefore
County, Pennsylvania.
deputized the sheriff of DAUPHIN
to serve the within WRIT OF SUMMONS
On Jul 13th, 1999 this office was in receipt of
DAUPHIN County, Pennsylvania.
the attached return from
Sheriff's Costs: So answ s;
Docketing 18.00??/mss
Out of County 9.00 omas ine, eri
Surcharge 8.00
DEP. DAUPHIN CO 45.25 $$
5 07/RI/N BARIC & SCHERER
Sworn and subscribed to before me
this 13 `-- day of
19 ?9 A.D.
---fir- ro nOIlc??aiy,
f
SHERIFF'S RETURN - OUT OF COUNTY
CAS$ NO: 1999-03883 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
HCR MANOR CARE INC ET AL
VS.
GREGG RUTH ET AL
R. Thomas Kline Sheriff, who being duly sworn according
to law, says, that he made a diligent search and inquiry for the within
named defendant, to wit: RICE PEGGY
but was unable to locate Her in his bailiwick. He therefore
deputized the sheriff of DAUPHIN County, Pennsylvania.
to serve the within WRIT OF SUMMONS
On July 13th 1999 this office was in receipt of
the attached return from DAUPHIN County, Pennsylvania.
Sheriff's Costs: So answe
Docketing 6.00
Out of County 00
Surcharge 8.00 omas in ri
$I4OU O'BR3 N BARIC & SCHERER
07 199
Sworn and subscribed to before me
this /3`= day of
19 q? A.D.
??ono a yAa yA
(Off-ice of tkeooh-eriff
Man Jane Smder
Rcol Estatc I):puh
William T. Tullv f
Solicitor
Dauphin County
Harrisburg. Pennsylvania 17101
ph: (717) 255.2660 I'ax: (717) 255.2889
Jack Lotwick
Sheriff
Commonwealth of Pennsylvania , HCR MANORCARE INC
vs
County of Dauphin GREGG RUTH
Sheriff's Return
Ralph G. McAllister
Chief Deputy
Michael W. Rinehart
Assistant Chief Deputy
No. 1319-T - - -1999
OTHER COUNTY NO. 99-3883
AND NOW: July 8, 1999 at 1:35PM served the within
PRAECIPE FOR WRIT OF SUMMONS upon
GREGG RUTH by personally handing
to SHAWN O'TOOLE, ATTORNEY FOR DEFT 1 true attested copy(ies)
of the original PRAECIPE FOR WRIT OF SUMMONS and making known
to him/her the contents thereof at DAUPHIN COUNTY COURTHOUSE
HARRISBURG, PA 00000-0000
Sworn and subscribed to
before me this 8TH day/ fnJ`UL^Y, 1999
PROTHONOTARY
So Answers,
Sheriff of Dauphin County, Pa.
BY , ?SCG?? cL, ?.
Deputy' Sheriff
Sheriff's Costs: $45.25 PD 06/30/1999
RCPT NO 125462
BC
M f f tee of tog l*heri f f
Man' Jane Snyder
Real Estate la:puty .•?
William T. Tully t
Solicitor
Dauphin County
Harrisburg. Pennsylvania 17101
ph:(717) 255-2660 t'ax:(717)255-2889
Jack Lotwick
Sheriff
Commonwealth of Pennsylvania HCR MANORCARE INC
VS
County of Dauphin GREGG RUTH
Sheriff's Return
Ralph G. McAllister
Chief' Deputy
Michael W. Rinehart
Assismm Chief Deputy
No. 1319-T - - -1999
OTHER COUNTY NO. 99-3883
AND NOW: July 8, 1999 at 1:35PM served the within
PRAECIPE FOR WRIT OF SUMMONS upon
RICE PEGGY by personally handing
to SHAWN O'TOOLE, ATTORNEY FOR DEFT 1 true attested copy(ies)
of the original PRAECIPE FOR WRIT OF SUMMONS and making known
to him/her the contents thereof at DAUPHIN COUNTY COURTHOUSE
HARRISBURG, PA 00000-0000
Sworn and subscribed to
before me this 8TH day of JULY, 1999
PROTHONOTARY
So Answers,
?Ie?°lc.
Sheriff of Dauphin County, Pa.
Yom/ ?? c ?l
Deputy Sheriff
Sheriff's Costs: $45.25 PD 06/30/1999
RCPT NO 125462
BC
In The Court of Common Pieas of C.umberiand County, Pennsvivania
HCR ManorCare, Inc, et. al.
vs.
Ruth Gregg, et, al.
Serve: Ruth Gregg
No. 99-3883 Civil
19
Now, 6/28/99 19_, I SHERIFF OF CUMBERLAND COUN'T'Y, PA do hereby deputize the Sheriff of
Dauphin County to execute this Writ, this deputation being made at the request and risk of the Plaintiff:
?-a7?0?- e
Sheriff of Cumberland County, Pa.
Affidavit of Service
Now,
at
by handing to
attested copy of the original
the contents thereof.
So answers,
Sheriff of
COSTS
Sworn and subscribed before
me this day of_
19 ,
SERVICE _ S
19_ MILEAGE
AFFIDAVIT
o'clock M, served the
County, Pa.
a true and
and made known to
S
In The Court of Common Pieas of Cumberiand County, Pennsylvania
HCR ManorCare, Inc., et. al.
VS.
Ruth Gregg, et. al.
Serve: Peggy Rice
No. 99-3883 Civil 19
Now, 6 / 2 8 / 99 19_, f gtTERIFF OF CUMBERLAND COUNT]', PA do hereby deputize the Sheriff of
a,,,,h i n County to execute this Writ, this deputation being made at the request and risk of the Plaintiff.
- - <e ---e
Sheriff of Cumberland County, Pa.
Affidavit of Service
Now,
19 , at o'clock M, served the
by handing to
attested copy of the original
the contents thereof.
So answers,
a true and
and made known to
Sheriff of
COSTS
Sworn and subscribed before
me this day of_
SERVICE S
19 MILEAGE
AFFIDAVIT
County, Pa.
S
Mary Jane Snyder amftlcle of " je ^eri .f
Rea! Estate Deputy
William T. Tully
Solicitor ...... tL
t
Dauphin County
Ilarrisburg, Pennsylvania 17101
(717) 255.2660
J.R. Lotwick
Sheriff'
ACCEPTANCE OF SERVICE
Ralph O. McAllister
Chief Deputy
Michael W. Rinehart
Assistant Chief Deputy
l accept service of the ?`OX C` e,? -QLC LLD, -?- (?,I Jc ?1 n vnOn 5
(on behalf of ce cLJ--,d 'R;yt
t-2
and certify that I am authorized to do so).
-8-99
(Date)
(D ndant or Authorized Agent)
oz V.-, 9m c-L V?HJ.S1 ?k 1711.7
(Mailing a dress)
HCR MANOR CARE, Inc. s/b/m/t
MANORCARE HEALTH
SERVICES, INC.,
Plaintiff
V.
RUTH GREGG and
PEGGY RICE, individually
and as attorney-in-fact for
Ruth Gregg,
Defendants
NO. 99-3883 CIVIL TERM
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION - LAW & EQUITY
DEFENDANTS' ANSWER TO COMPLAINT
AND NOW, come Ruth Gregg and Peggy Rice, by and through their attorney, Shaun E.
O'Toole, and in support of this Answer to Complaint aver the following:
1. Admitted upon information and belief.
2. Admitted.
3. Admitted.
4. Admitted.
5. Admitted.
6. Admitted.
7. Admitted in part, denied in part. It is admitted that Defendant, Ruth Gregg, made
application for medical assistance after her admission to the Manor facility. It is also admitted
that Peggy Rice, at the time of admission of her mother to the Manor facility, represented that
Ruth Gregg had a residence worth $30,000 to $100,000. It is specifically denied that Peggy Rice
represented that the residence was an asset to be used for the cost of care for Mrs. Gregg. By way
of further answer, Mrs. Gregg has always intended to return to the residence upon being
discharged from the Manor facility.
8. Denied as stated. It is admitted that Peggy Rice, in her capacity as attorney-in-fact
for Ruth Gregg, executed a mortgage in the amount of $60,000 and secured the obligation
thereunder with the residence of Ruth Gregg located at 529'/2 W. Simpson Street,
Mechanicsburg, Pennsylvania. It is specifically denied that Peggy Rice "individually" executed
said mortgage.
9. Admitted.
10. Admitted in part, denied in part. It is admitted that the Pennsylvania Department of
Public Welfare conducted an investigation of the assets and property of Ruth Gregg and
disallowed Ruth Gregg eligibility for medical assistance. It is denied that the Pennsylvania
Department of Public Welfare reached this conclusion based upon Peggy Rice's failure to
account for the $60,000 in proceeds from the mortgage transaction.
11. Admitted upon information and belief.
12. Denied as a conclusion of law to which no responsive pleading is required.
13. Admitted.
14. Denied. It is denied that Peggy Rice has ever used the funds of Ruth Gregg for any
purpose other than for the benefit and care of Ruth Gregg and the maintenance of Ruth Gregg's
property.
15. Admitted in part, denied in part. It is admitted that Peggy Rice, in her capacity of
attomey-in-fact for her mother, Ruth Gregg, receives her mother's social security checks. It is
specifically denied that Peggy Rice has failed to account for the disposition of these funds.
16. No response required.
17. Admitted.
18. Admitted.
19. Denied. It is specifically denied that Peggy Rice appropriated and is continuing to
appropriate the funds of Ruth Gregg for her own use and benefit.
20. Denied as stated. Although Peggy Rice has refused to pay the sum of $77,927.17, it
is denied that Peggy Rice refuses to pay for the nursing home services provided to Ruth Gregg.
21. No response required.
22. Admitted.
23. Denied. It is specifically denied that Peggy Rice took property entrusted to her as a
fiduciary and appropriated it to her own use and benefit.
24. No response required.
25. Denied as a conclusion of law to which no responsive pleading is required. Byway
of further answer, it is specifically denied that Peggy Rice is personally obligated to pay for the
cost of care provided by Plaintiff for her mother, Ruth Gregg.
26. Denied as stated. It is admitted upon information and belief that Ruth Gregg has
been billed the sum of $77,927.17 for the cost of care by Plaintiff. It is further admitted that
Peggy Rice has refused to pay this sum only because she believes her mother owes Plaintiff an
amount less than $77,927.17.
27. Denied. The contract speaks for itself, and any characterization of it by Plaintiff is
specifically denied.
28. Denied. The contract speaks for itself, and any characterization of it by Plaintiff is
specifically denied.
29. No response required.
30. Denied. It is specifically denied that Peggy Rice has used and enjoyed the proceeds
of the mortgage transaction and Social Security benefits for any purpose other than the provision
of care for Ruth Gregg and the maintenance of Ruth Gregg's property.
31. Denied. It is specifically denied that Peggy Rice made the disbursements referenced
here.
32. Denied. It is specifically denied that Peggy Rice has been unjustly enriched while
tending to affairs of her mother.
WHEREFORE, Defendants respectfully request this Honorable Court to dismiss
Plaintifrs Complaint.
Respectfully submitted,
Dated: October 22, 1999 1117
1 a ?
haun E. O'Toole, Esquire
Attorney I./D. #44797
2813 North Second Street
Harrisburg, Pennsylvania 17101
(717) 232-1851
CERTIFICATE OF SERVICE
On October 22, 1999, I hereby certify that I served the foregoing Defendants' Answer To
Complaint on the following by depositing a true and correct copy in the United States Mail,
postage prepaid, addressed to:
David A. Baric, Esquire
O'Brien, Baric & Scherer
17 West South Street
Carlisle, Pennsylvania 17013.
-Shaun E. O'Toole, Esquire
Attorney I. D. # 44797
2813 North Second Street
Harrisburg, Pennsylvania 17101
(717) 232-1851
VERIFICATION
I hereby verify that the statements of fact made in the foregoing document are true and correct
to the best of my knowledge, information and belief. I understand that any false statements therein
are subject to the criminal penalties contained in 18 Pa. C.S. Section 4904, relating to unsworn
falsification to authorities.
Dated: (v I l?iy u q
PEGG CE
r l`
N
r
7C z
O u Cam' f._, L;
U ?r i?
PRAECIPE FOR LISTING CASE FOR TRIAL
(Must be typewritten and submitted in duplicate)
TO THE PRO'IWNDTARY OF CUMBERLAND COUM
Please list the following case:
(Check one) ( ) for JURY trial at the next term of civil court.
( X ) for trial without a jury.
-----------------------------------------
CAPTION OF CASE
(entire caption nest be stated in full) (check one)
HCR MANORCARE, INC., s/b/m/t
MANORCARE HEALTH SERVICES, INC.
( ) Civil Action - Law
( ) Appeal from Arbitration
(x ) EQUITY
(other)
(Plaintiff)
VS.
RUTH GREGG AND PEGGY RICE
individually and as
attorney-in-fact for Ruth Gregg
(Defendant)
Vs.
The trial list will be called on
and
Trials comnence on
Pretrials will be held on
(Briefs are due 5 days before pretrials. )
(The party listing this case for trial shall
provide forthwith a copy of the praecipe to
all counsel, pursuant to local Rule 214.1.)
No, 3883 X29M EQUITY TERM 19 99
Indicate the attorney who will try case for the party who files this praecipe:
David A. Baric, Esq., O'Brien, Baric S Scherer, 17 West South Street
ar is e, Pennsylvania 17013
Indicate trial counsel for other parties if known:
Shaun E. O'Toole, Esq., 2813 North Second Street, Harrisburg, PA 17110
This case is ready for trial. Signed:
Date: ,/ Z &/ LSD
Print Name: DAVID A. BARIC, ESQUIRE
Attorney for:
PLAINTIFF
t
?': ? ??
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;t_ ?_.
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C; ?-
?:J
,`i t?
'
+
?C i
?
!J .
HCR MANORCARE, INC.,
s/b/m/t MANORCARE
HEALTH SERVICES, INC.,
Plaintiff
VS.
RUTH GREGG and PEGGY
RICE, individually and as
attorney-in-fact for Ruth
Gregg,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
99-3883 EQUITY
CIVIL ACTION - EQUITY
IN RE: NONJURY TRIAL
ORDER
AND NOW, this /y, day of February, 2000, a pretrial conference in the
above captioned matter is set for Monday, March 27, 2000, at 9:00 a.m. in the Chambers of the
undersigned.
BY THE COURT,
David A. Baric, Esquire
For the Plaintiff
Shaun E. O'Toole, Esquire
For the Defendant
Court Administrator
Kev' A?.?Hess,JJ.)
„"'/""'"?r.
a -/S -00
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