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HomeMy WebLinkAbout03-5187Presbyterian Homes, Inc., Plaintiff Vo Marjorie Parsons, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ACTION IN EJECTMENT No. C)~ - 8'l,07 ~'o~ NOTICE 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 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH iNFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 717-249-3166 McNEESWALLACE &NURICK LLC Dated: September 30, 2003 Kimberly M. Colonna I.D. No. 80362 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108 (717) 232-8000 Attorneys for Plaintiff Presbyterian Homes, Inc., Plaintiff V. Marjorie Parsons, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : ACTION IN EJECTMENT COMPLAINT Presbyterian Homes, Inc., by its attorneys, McNees Wallace & Nurick LLC, hereby files this complaint against the Defendant, Marjorie Parsons, and avers the following: 1. Plaintiff Presbyterian Homes, Inc. ("Presbyterian Homes" or "Landlord") is a Pennsylvania non-profit corporation, which maintains its principal place of business at 1217 Slate Hill Road, Camp Hill, Pennsylvania. Presbyterian Homes does business as Green Ridge Village and operates a continuing care community with the name Green Ridge Village in Newville, Pennsylvania ("Green Ridge Village," "the Facility"). 2. Upon information and belief, Defendant Marjorie Parsons ("Parsons" or "Tenant") is an adult individual who is currently admitted to Green Ridge Village, where she resides in a cottage located at 92 Locust Lane, Newville, Pennsylvania (the "Cottage," or the "Premises"). 3. Green Ridge Village offers independent living, assisted living, and skilled care accommodations. 5. On or about December 18, 1995, Presbyterian Homes and Parsons entered into a Residence and Care Agreement (the "Agreement"), amended January 27, 1997, by which Presbyterian Homes, as Landlord, admitted Parsons and her husband Richard Parsons to independent living at the Cottage at 92 Locust Lane within Presbyterian Homes' continuing care facility at Green Ridge Village. A true and correct copy of the Agreement is attached hereto as Exhibit A and incorporated herein by reference. Count I: Ejectment 6. Paragraphs one (1) through five (5) are incorporated herein by reference. 7. The Agreement states that Presbyterian Homes will provide Parsons with "living accommodations and facilities, in independent living, personal care or nursing for and during the balance of [Parsons]' life or for such shorter period as shall apply under this Agreement." Agreement at §2(A). 8. The Agreement also states that the Medical Director of Green Ridge Village "may transfer [Parsons] to a hospital or other facility as he deems best and, if he determines it to be advisable, he may require that [Parsons] be returned to a health center or other level of care." Agreement at §3(H)(3). 9. The Agreement provides that "If [Presbyterian Homes] determines that [Parsons]' mental condition is such that [Parsons]' continued living in any accommodation in the facility is either dangerous or detrimental to the life, health, safety or peace of [Parsons] or other residents, then [Presbyterian Homes] may transfer [Parsons] to an institution of [Presbyterian Homes]' choosing, subject to the Board of Review's decision." Agreement at §3(K). 10. The Agreement further provides that "If the Board of Review finds that continued occupancy of the living accommodation by [Parsons] creates a serious threat to the life, health, safety or peace of [Parsons] or other residents or persons on the premises, immediate termination of this Agreement maybe necessary." Agreement at §5(B). 2 11. The Agreement additionally provides that "after consultation with [Parsons] and/or [Parsons]' family or designated representative, [Presbyterian Homes] may transfer [Parsons] to another living accommodation if it detemfines that such a move should be made for the benefit of [Parsons], or for the proper operation of the facility, or to meet the requirements of law... The decision as to the permanency of the transfer shall be made by the Board of Review." Agreement at §7. On July 21,2003 the Green Ridge Village Board of Review met to discuss 12. Parsons. 13. Dianne Burfeindt, Interim Executive Director of Green Ridge Village explained to the Board that Parsons had been exhibiting signs of dementia for a prolonged period, and had been repeatedly leaving her home, wandering the Facility without knowing her way home, and wandering into the homes of other residents. Burfeindt also explained that she had discussed these problems with Parsons and her husband, but that they had denied that there was any risk to Parsons' health and safety. 14. After discussion, the Board concluded that Parsons' continued presence in the independent living unit at 92 Locust Lane is "dangerous and is detrimental to the health, safety and peace of both Mrs. Parsons and the other residents," and agreed that Presbyterian Homes should permanently transfer Parsons to Presbyterian Homes' assisted living facility. A true and correct copy of the minutes of this meeting is attached hereto as Exhibit B. l 5. Presbyterian Homes staffmet with Mr. and Mrs. Parsons on several occasions during July and August 2003. At each meeting, Presbyterian Homes' staff expressed their 3 concern for Parsons and explained the serious dangers presented by Parsons continuing to reside at the independent living Cottage. 16. Presbyterian Homes' staff offered to transfer Parsons to an assisted living facility in accordance with the Board of Review's conclusion. 17. Mr. and Mrs. Parsons have rejected Presbyterian Homes' offer to transfer Parsons to an assisted living facility. 18. Because of Parsons' refusal to transfer to an assisted living facility despite the Board of Review's finding that Parsons' occupancy of the Cottage threatens Parsons' life, health, safety and peace, and that of others, the Agreement was terminated. COUNT I - Eiectment Paragraphs one (1) through eighteen (18) above are incorporated herein by 19. reference. 20. On September 12, 2003, Presbyterian Homes hand-delivered to Parsons a "Notice to Quit," explaining that the Agreement had been terminated and instructing her to vacate the Cottage within fifteen (15) days. A true and correct copy of this Notice to Quit is attached hereto as Exhibit C. 21. Pursuant to the Notice to Quit provided to Parsons, Parsons should have vacated the Cottage as of 11:59 P.M. on September 27, 2003. 22. 23. 24. Parsons has failed to vacate the Cottage. As of the filing of this Complaint, Parsons continues in possession of the Cottage. Parsons' continued possession of the Cottage is wrongful. 4 25. Because the Agreement has terminated, Parsons has no right to continue in possession of Cottage. 26. As of the filing of this Complaint, Parsons' wandering behaviors have continued and she continues to pose a serious threat to her own health and safety and is detrimental to the health, safety and peace of other residents WHEREFORE, Presbyterian Homes requests that Marjorie Parsons be ejected from 92 Locust Lane, Green Ridge Village, Newville, Pennsylvania. COUNT II - Ecluitable Relief (Plead in the Alternative) Paragraphs one (1) through twenty-six (26) above are incorporated herein by 27. reference. 28. Parsons' right to reside in the Cottage terminated because the Board of Review as a result of the Board of Review's determination that Parsons' continuing to reside at the Cottage was dangerous and is detrimental to the health, safety and peace of both Mrs. Parsons and the other residents. 29. Parsons has failed and refused to transfer or move from the Cottage. 30. Parsons' continuing to reside in the Cottage since the termination of the Agreement is inequitable and dangerous. WHEREFORE, Presbyterian Homes requests that the Court enter an order compelling Marjorie Parsons to cease residing at the Cottage. McNEES WALLACE & NURICK LLC By · Colorma Attorney I.D. No. 80362 100 Pine Street P. O. Box 1166 Harrisburg, PA 17108-1 166 (717) 232-8000 Attorneys for Plaintiff Presbyterian Homes Dated: September 30, 2003 PLAN 1 ENDOWMENT PLAN PRESBYTERIAN HOMES, INC. GREEN RIDGE VILLAGE NEWVILLE, PA RESIDENCE AND CARE AGREEMENT SECTION 1: SECTION 2: SECTION 3: SECTION 4: SECTION 5: SECTION 6: SECTION 7: SECTION 8: SECTION 9: SECTION 10: SECTION 11: SECTION 12: SECTION 13: SECTION 14: SECTION 15: SECTION 16: SECTION '17: SECTION 18: SECTION 19; SECTION 20: SECTION 21: ADDENDUM TABLE OF CONTENTS DEFINITIONS OF WORDS AND PHRASES ..........................................2 ACCOMMODATIONS PROVIDED BY CORPORATION ........................ 3 SERVICES PROVIDED BY CORPORATION ......................................... 4 FEES,...[ .................................................................................................. 6 TERMINATION OF AGREEMENT .......................................................... 8 SURVIVING OR REMAINING RESIDENT'S OPTION TO MODIFY AGREEMENT ................................................................... 9 TRANSFER TO OTHER LIVING ACCOMMODATIONS ......................... 9 REFUNDS OF ALL OR PART OF ENTRANCE FEE .............................. 9 ARRANGEMENTS FOR GUARDIANSHIP AND FOR ESTATE ........... 11 RIGHTS AND OBLIGATIONS OF RESIDENT ...................................... 11 NOTICE ................................................................................................. 12 ENTIRE AGREEMENT ............................................ : ............................. 13 NONDISCRIMINATION ................................ ; ........................................ 13 ACTS OF FORBEARANCE ................................................................... 13 SEVERABILITY ..................................................................................... 13 NON WAIVER CLAUSE ........................................................................ 13 SUBROGATION WHERE ACCIDENT OR INJURY CAUSED BY OTHERS .................................................................................. 13 NOTICE OF RIGHT TO RESCIND ........................................................ 15 AVERAGE ANNUAL COST OF PROVIDING CARE ............................. 16 WAITING LIST ...................................................................................... 16 ENTRANCE FEE AND MONTHLY FEE SCHEDULES ......................... 17 08'1194RES&C'I PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 2 THIS AGREEMENT, made this~/~~' day of~'~<~., - .. , 19 '~ ~,, between GREEN RIDGE VILLAGE / PRESBYTERIAN HOMES, INCORPORATED, a Pennsylvania non-profit corporation, hereinafter called "CORPORATION," and Mr. & Mrs. Richard H. Parsons, hereinafter called "Resident" for admission to 92 Locust Lane, WHEREAS, Corporation conducts at the facility, a continuing-care community; WHEREAS, Resident has applied for admission, which application has been received by Corporation; NOW, THEREFORE, the parties, intending to be legally bound hereby, agree as follows: SECTION 1: DEFINITIONS OF WORDS AND PHRASES ADMINISTRATOR: means the person who is designated to administer the facility and to whom every member of the staff is accountable, APARTMENT~COl-rAGE INVESTMENT FEE: means the portion of the Residency Investment Fee for the living unit. ASSIGNMENT OF INSURANCE: authorization to facility to apply for and collect Medicare or other insurance benefits from Res]dent's insurance carrier for services furnished to Resident or on Resident's behalf by facility. BOARD OF REVIEW: consists of the Administrator, Medical Director, Director of Nursing, and Social Service Representative. CO-RESIDENT: means one of two persons who sign as residents to occupy one living accommodation. COMMUNITY INVESTMENT FEE: means the entrance investment made by each Resident for the community center, land cost and common space. DOUBLE OCCUPANCY: means occupancy of one living accommodation by co-residents, HEALTH CENTER: means the on-site nursing care facility or, when no vacancy, an alternate facility approved by Corporation. HEALTH SERVICE INVESTMENT FEE: means the advance investment for a portion of the health care costs provided by this agreement. 081 'I94RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 3 INSURANCE: means Medicare (A and B), Blue Cross/Blue Shield 65 Special, or equivalent, which Resident is required to carry. LIVING ACCOMMODATION: means the living unit or nursing bed provided for exclusive occupancy by Resident. MEDICAL DIRECTOR: means the physician designated by the Administrator to supervise the medical affairs of the facility and of the residents of said facility. OCCUPANCY: means the actual possession or use of a living accommodation, or immediate right to such possession or use. PROBATIONARY PERIOD: means the first three months of occupancy of a living accommodation. RESIDENCY INVESTMENT FEE: means the payment by the Resident prior to occupancy which is comprised of the total of the Community Investment Fee, the Health Service Investment Fee and the Apartment Investment Fee. RESIDENT: Applies to person or persons executing this agreement and residing at facility. Masculine adjectives or pronouns are sometimes used herein in referring to the resident, but the word RESIDENT applies equally to a woman. REMAINING RESIDENT OR SURVIVING RESIDENT: means the resident who continues to occupy a living accommodation after the death or withdrawal of a co-resident, or the permanent transfer of a co-resident to a health center or to any other facility authorized under this Agreement. SURRENDER: means to cease to occupy a living accommodation, to remove all possessions therefrom, and to turn in all keys therefor. TERMINATE THIS AGREEMENT: means the end of Resident's right of occupancy, whether in a living accommodation or in a health center. SECTION 2: ACCOMMODATIONS PROVIDED 13Y CORPORATION A, Living Accommodation - From and after the date when Resident takes occupancy in accordance with the terms of this Agreement, Corporation will provide Resident with living accommodation and facilities, in independent living, personal care or nursing for and during the balance of Resident's life or for such shorter pedod as shall apply under this Agreement. Corporation shall have the right at all reasonable times to enter and inspect the living accommodation. 081194RES&C1 PRESBYTERIAN HOMES, INC,/GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 4 B. Furnishings - Corporation will furnish self-defrosting refrigerator, stove with self cleaning oven, garbage disposal in the living accommodation. All other furnishings shall be provided by Resident subject to supervision of and approval by the Administrator. C. Common Facilities - Resident may use, in common with others, the dining room, activities areas and other facilities provided by Corporation for all residents. D. Availability - Corporation anticipates (but does not promise) that the living accommodation shall be ready for occupancy beginning on , Corporation shall notify Resident at least two months in advance of the date when resident may take occupancy. SECTION 3: SERVICES PROVIDED BY CORPORATION A. Utilities - Corporation will provide water, sewer, trash collection, and in house television service. Electricity will be billed to each unit with expense paid by resident. Telephone service will be made available in each unit when desired at Resident's expense. B, Housekeeping - Resident will maintain the living accommodation in clean, sanitary, and orderly condition and will perform all usual light housekeeping tasks in connection therewith. Corporation will provide housecleaning service on an annual basis to each unit. If Res[dent does not perform housekeeping tasks to maintain the living accommodation in a proper manner, Corporation, after notice to Resident, shall have the right to maintain the accommodation and the cost of such maintenance shall be charged to Resident. Additional housekeeping service will be provided upon Resident's request at Resident's expense. C. Maintenance and Repair - Corporation will perform and provide groundskeeping, snow removal, necessary repairs, and maintenance and replacement of Corporation's real property and equipment. Repairs, maintenance and replacement of Resident's personal property will be the responsibility of Resident. D. Other Services - Assigned parking is provided for resident's own car pursuant to procedure established by Corporation. E. Structural Changes - Any structural or physical change of any kind within the living accommodation will be made only after approval by the Administrator and thereafter will be subject to Administrator's supervision. The cost of any change requested by Resident will be borne by Resident, unless otherwise agreed to in writing by Corporation. Options are not considered part et' the Residency Investment Fee. F, Redecoration - Redecoration of living accommodation, in addition to or other than that scheduled by Corporation, will require the approval of the Administrator and will be at Resident's expense. Any change or replacement by Resident of the furnishings provided by Corporation in the living accommodation vests title thereto in Corporation unless otherwise agreed to in writing by Corporation. 081194RES&C1 G. Food 1, PRESBYTERIAN HOMES, INC. ~GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 5 and Meals Dining Room Service - one meal per person per day is available as a part of the monthly fee. Additional meals and guest meals may be purchased at additional cost to Resident in accordance with Corporation's cost schedule. Resident may apply for credit for missed meals when absent from the facility for more than seven days. Tray Service - Tray service approved by the Medical Director will be provided at no additional cost to Resident on a temporary basis. Other Service ~ Meals containing substitute or alternate diets (special) will be provided when ordered by the Medical Director at no additional cost to Resident. Health Care Services P~'ovided by Corporation - Corporation will provide when prescribed by the Medical Director assisted living, semi-private (or private, at additional cost to Resident) care in a health center, and home health services. Physician Services - Resident at his own expense may employ the service of any outside physician or surgeon, but Corporation may require reimbursement for its cost in caring for any complications resulting from such services and for the cost of medical, surgical, hospital and nursing care ordered by any such outside physician or surgeon not approved by the Medical Director. Transfer to Hospital or other Facility ~ The Medical Director may transfer Resident to a hospital or other facility as he deems best and, if he determines it to be advisable, he may require that Resident be returned to a health center or other level of care. Resident may indicate his preference of hospitals from among those with whom transfer agreements have been arranged; however, no guarantee of bed availability at the preferred hospital can be made by Corporation. Payment for hospital service is not covered by Corporation and is the responsibility of Resident. 4. Corporation's Right to Insurance Proceeds - Resident acknowledges the right of Corporation to receive proceeds to which Resident is entitled under insurance and benefit programs required by the Agreement, and hereby assigns and transfers over to Corporation a~l right, title, and interest of Resident to such public and private insurance and benefits to the extent necessary to pay Corporation for services provided in Section H,1. Resident hereby authorizes Corporation to make any and all claims for such insurance and benefits and agrees to execute all documents necessary to enable Corporation to collect or enforce such claims. If for any reason Corporation cannot apply directly for such benefits, Resident agrees to make such application individually and to pay to Corporation the proceeds received. 081194RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN t PAGE 6 Resident Not Liable for Services Rendered Under Agreement - Resident shall not be liable to a health care provider for services rendered under the Agreement. In the event a health care provider seeks payment from Resident, Corporation shall assume liability for payment of the health care services rendared, if the health care services rendered are services which Corporation agrees to furnish under Agreement. I, Exclusions - Corporation does not pay for refractions, eye-glasses, hearing aids, prescription medications, podiatry, dentistry, dentures, inlays, orthopedic appliances, ambulance service, therapy for psychiatric disorders, hospitalization, physician services, any services not provided in Section H.1, and the cost of care for pre-existing conditions. VVhen approved in writing by Administrator, care for pre-existing conditions shall be provided at the current daily rate for nursing care at a health center. A pre-existing condition is a disease, illness, sickness or physical condition for which medical care, advice or treatment was recommended by or received from a physician within the five year period preceding the date of admission. Pre-existing conditions which constitute an exclusion are as follows: J. Illness or Accident away from Facility - If Resident suffers an accident or illness while away from the facility, Corporation shall have no responsibility to pay for Resident's medical, surgical, hospital, or nursing care incurred or resulting therefrom until Resident returns to the actual care of the Medical Director. K. Mental Illness - The facility is not designed to care for persons who are afflicted with mental illness. If Corporation determines that Resident's mental condition is such that Resident's continued living in any accommodation in the facility is either dangerous or detrimental to the life, health, safety or peace of Resident or other residents, then Corporation may transfer Resident to an institution of Corporation's choosing, subject to the Board of Review's decision. SECTION 4: FEES A. RESIDENCY INVESTMENT FEE - Resident shall pay to Corporation a Residency Investment Fee comprised of the total of the Community Investment, Health Service Investment, and Apartment/Cottage investment. The total Residency Investment Fees of $157,000.00 is made as follows: $1,000.00 deposit made April 21, 1995, $10,000.00 payment upon return of this agreement to corporation, further payments as scheduled. If two persons sign thi~ Agreement as Ce-residents, the sums stated in this paragraph cover both persons. All funds, beginning with the receipt of th~ initial payment, shall earn passbook savings rate interest until the final payment is made. Corporation reserves the right to reduce or increase the interest rate based upon market conditions. The interest shall be paid in lump sum thirty (30) days after occupancy. No interest shall be paid if occupancy is not taken when offered. No interest shall be paid on any deposit until the initial monthly payment is made. The deposit will be refunded in full if the applicant rescinds this Agreement within seven days in accordance with the terms of section 18 of this Agreement. If the Agreement is not rescinded within seven days, the deposit becomes part of the entrance fee and can only be refunded in accordance with the terms of section 8 of this Agreement. 081194RES&C1 PRESBYTERIAN HOMES, INC,/GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 7 B. MONTHLY FEE - Resident shall pay to Corporation monthly in advance, a Monthly Fee of $2,080.00. Payment of the Monthly Fee is due on the established occupancy date and upon receipt of a monthly statement from Corporation. The statement shall show the amount due for the Monthly Fee and any other sums which are chargeable to Resident. If any Monthly Fee or charge is not paid within sixty (60) days of delivery of statement, then Corporation, subject to its subsidization policy and the provisions of section 4C of this agreement, may terminate this Agreement, Upon reasonable notice, an allowance shall be made against the Monthly Fee when Resident, while visiting or traveling, is away from the facility for a period of at least seven (7) consecutive days. It is the intent of Corporation that this Monthly Fee, with any adjustments thereto authorized under this Agreement, shall remain in effect whether Resident remains in the living accommodation or is permanently transferred to a health center or other facility authorized under this Agreement. Upon at least thirty (30) days written notice, the monthly fee may be adjusted to reflect changes in the cost of doing business by Corporation, and the fees may be increased or adjusted in accordance with changes in the costs of providing the required services to Residents. C. Financial Inability - To the extent funds are available, it is the policy of Corporation to furnish financial assistance and, subject to the accuracy of Resident's representations regarding his financial condition, Resident shall not be dismissed nor this Agreement terminated solely because of Resident's financial inability to pay the monthly fee or other charges, provided Resident presents to Corporation facts which, in Corporation's opinion, justify special financial consideration. In such event, Corporation in Corporation's sole discretion, shall padly or wholly subsidize Resident's monthly fee and other charges, provided that such subsidy can be granted without impairing the ability of Corporation to provide care to its other Residents. D. Reduction of Income - Resident shall make every reasonable effort to meet his financial responsibilities to Corporation. Resident represents that.he has made no gift prior to the date of his application and will make no gift thereafter, other than to Corporation, which would Substantially impair his ability or the ability of his estate to satisfy his financial responsibilities to Corporation. If Resident's sources of income are inadequate to meet his financial responsibilities to Corporation, he will make every reasonable effort to obtain assistance elsewhere and, if he can qualify, shall take all necessary steps to obtain federal, state, or municipal aid or assistance. E. Subsidy by Corporation - In the event Corporation subsidizes partly or wholly Resident's Monthly Fee and/or other charges, any property of Resident which remains in his possession or control at his death shall be transferred by Resident's personal representative, heirs, devisees and assigns, to Corporation for the purpose of repaying to Corporation (to the extent of the value of such property) the subsidy furnished Resident by Corporation. This Agreement shall operate as an assignment, transfer, and conveyance to Corporation of such property, and may be enforced as a claim against Resident's estate. Corporation may from time to time request financial statements from any Resident whose Monthly Fee is subsidized by Corporation. This subparagraph shall apply whether or not Resident is in residence at the facility. F. Co-Resident's Responsibility- I~n the case of Co-Residents, each of thPm ~hall bc and severally liable for all payments which shall be due here~'~aer.~t~ one of the Co-Residents dies or 081194RES&CI PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 8 leaves the facility, the remaining resident shall be responsible for the Monthly Fee as a single occupant. G, Cost of Medical Examination - Each applicant for residency must be examined by the Medical Director or other physician designated by the Administrator and must make the results of the examination available to Corporation. The cost of the physical examination must be paid by the applicant. H. Shared Living Arrangement Resident/Former Non-resident - In the event of a shared living arrangement or marriage of Resident, where a new partner desires to become a Resident of the facility, the new Resident shall be required to execute a separate Residence and Care Agreement and pay the difference between the Residency Investment Fee paid by the original Resident of the living unit and the current Residency Investment Fee, Further, the new Resident of the shared living arrangement shall be responsible for paying the difference between the one and two person monthly fees for maintenance and services at said living Unit. Resident/Former Resident - In the event of marriage or other shared living arrangement between two Residents of the facility, an addendum shall be signed and attached to each Residence and Care Agreement providing for the following: Resident vacating his/her living unit shall receive any refund due in accord with the odginal Residence and Care Agreement. b4 The new Resident In the shared living arrangement being entered into shall pay the difference between the entrance fee paid by the odginal Resident of the living unit and the current Residency Investment Fee. The new Resident of the shared living arrangement shall be responsible for paying the difference between the one and two person Monthly Fees for maintenance and service with all other applicable maintenance and service fees then current for two persons sharing said accommodation. SECTION 5: TERMINATION OF AGREEMENT A. By Resident - At any time prior to occupancy, Resident may terminate this Agreement upon delivery by Resident of notice to Corporation. At any time dudng the probationary period, Resident may terminate this Agreement by delivery of written notice to Corporation and surrender of the living accommodation, such termination to be effective upon such surrender. Resident may also terminate this Agreement at any time after the conclusion of the probationary period by delivery of notice at least thirty (30) days prior to termination to Corporation. In the event of termination after occupancy, any refunds will be made in accordance with section 8 of this Agreement, 081194RES&C1 PRESBYTERIAN HOMES, INC,/GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 9 B. By Corporation - At any time prior to occupancy, Corporation may terminate this Agreement by delivery of written notice to Resident. At any time during the probationary period, or at any time if Resident is found to have made any material misrepresentation or omission in his application, Corporation may terminate this Agreement by delivery of written notice to Resident effective thirty (30) days after delivery or upon the sooner surrender of the living accommodatioo Corporation may terminate this Agreement upon delivery of such written notice. If the Board of Review finds that continued occupancy of the living accommodation by Resident creates a serious threat to the life, health, safety or peace of Resident or other residents or persons on the premises immediate termination of this Agreement may be necessary, C. By Death ~ Unless sooner terminated by Resident or by Corporation, and except as to enforcing rights granted herein, this Agreement shall terrn[nate at the death of Resident and surrender of living accommodation. Any unused portion of a Monthly Fee shall be refunded to the estate of Resident. If this Agreement has been signed by Co-Residents, it shall remain in full rome and effect as to the surviving or remaining Co-Resident. SECTION 6: SURVIVING OR REMAINING RESIDENT'S OPTION TO MODIFY AGREEMENT Upon the termination of this Agreement as to a Co-resident, the surviving or remaining Resident shall have the option for a period of sixty days thereafter to elect: A. To retain the same living accommodation and pay the Monthly Fee for single occupancy thereof, or B. To move to a smaller living accommodation, if and when available, and, after moving, to pay the Monthly Fee for single occupancy in such living accommodation. Failure to make an election within the option period shall be deemed an election under A. above. No option shall be given to a surviving or remaining Resident who has been permanently transferred to a health center or other authorized facility. SECTION 7: TRANSFER TO OTHER LIVING ACCOMMODATIONS After consultation with the Resident and/or Resident's family or designated representative, Corporation may transfer Resident to another living accommodation if it determines that such a move should be made for the benefit of Resident, or for the proper operation of the facility, or to meet the requirements of law. If Resident is transferred permanently to a health center or to any other facility authorized under this Agreement, Corporation may declare Resident's living accommodation vacant. The decision as to the permanency of the transfer shall be made by the Board of Review. SECTION 8: REFUNDS OF ALL OR PART OF RESIDENCY INVESTMENT FEE Upon termination of this Agreement, Corporation shall refund the Residency Investment Fee in accordance with the following provisions: 081194RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 10 A. Refund During Construction - In the event Resident terminates this Agreement during Construction of apartment phase to which the Resident has applied for admission, no refund to which Resident is entitled shall be made until an equal number of apartment homes has been reserved as the number reserved at the time Resident gave notice of withdrawal to Corporation. In the event that the refund is made more than ninety (90) days after termination interest at the rate of the 26 week United States Government Treasury Bill will be paid on deposits made to Corporation, B, Termination by Death - In the event of death and surrender of the living accommodation during the first fifty (50) months of residency, the Residency Investment Fee shall be refunded less two (2) percent times the number of months occupied plus any cost incurred by the health protection plan. After fifty (50) months of occupancy, there shall be no refund. C. Other Termination - In the event either party terminates this Agreement prior to occupancy, all moneys shall be refunded. If this Agreement is terminated by either party after occupancy, alt moneys shall be refunded less a sum equal to ten (10) percent of Residency Investment Fee or two (2) percent of the Residency Investment Fee per month of residence until surrender of living accommodations, whichever is greater. After fifty (50) months of occupancy, there s h a~reATnd. D, Termination after Transfer - in the event a transfer of Resident to a health center Or. othej* facility authorized under this Agreement, prior to fifty (50) months of occupancy, the refund shall be: the balance of the unamortized Residency Investment Fee at the terminatJon of this agreement less any cost incurred by the health protection plan. E. Co-Residents - If the entrance fee has been paid on behalf of Co-Residents, one-half of the Residency Investment Fee shall be deemed to be paid on behalf of each Co-Resident. Unless (1) Co-residents specify othe~vise in writing, or (2) a court order is served upon Corporation stating otherwise, any refund required to be made to Co-residents under this Agreement shall be paid by a check made payable to Co-residents. ' ~. Du.-Dater Refund Payments - Any refund of the Residency investment Fee shall be payable only when the living accommodation of Resident has been surrendered and when Corporation has accepted and entered into a Residence and Care Agreement with a new resident who has accepted the living accommodation formerly occupied by Resident, In the event of Co-Residents, refunds are made only upon withdrawal or the death of surviving resident. In the event of transfer, refunds are made after withdrawal or death of Resident, or in the case of Co-residency, upon the withdrawal or death of the surviving resident. G. Release of Obligation - Upon termination of this Agreement, Corporation shall be released from any further obligations to Resident except for payment of any refund due under this Section 8. H. Taxation Disclosure - Tax code changes enacted by Congress may affect Resident's taxable income. The Internal Revenue Service may interpret the new law, pertaining to below-market interest rate leans, as imposing an income tax liability on the refundable portion of the Residency 081194RES&C1 PRESBYTERIAN HOMES, INC./tSREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 11 Investment Fee paid to Corporation. The IRS might treat the refundable portion of this fee as a loan from Resident to Corporation and attribute to Resident receipt of interest income on the outstanding balance of the fee, even though Resident does not receive interest payments. Resident should consult with his accountant or attorney to determine how changes in the tax laws might be applied. SECTION 9: ARRANGEMENTS FOR ESTATE A. W~li and Funeral Arrangements Required - If not previously made, Resident, within one (1) month after the date of this Agreement, shall make a V~II providing for the disposal of his furniture and possessions and/or appointment of an executor of his estate, and make funeral and burial arrangements. SECTION 10: RIGHTS AND OBLIGATIONS OF RESIDENT A, Right of Self-Organization - Residents of the f~cility shall have the right of self-organization. The facility shall hold quarterly meetings which Resident may attend for the purpose of free discussion of subjects which may include income, expenditures and financial matters as they apply to the facility and proposed changes in policies, programs, and services. At least seven (7) days' notice of each quarterly meeting shall be given. B. Right to Receive Disclosure Statements - Corporation shall deliver to Resident at the time of the execution of this Agreement and at least annually thereafter, the disclosure statement required by Act No. 82 of 1984. (see Section 16) C. Guest Privileges - Resident shall have the rig ht to have guests in his living accommodation, provided that the period of visitation of any guest shall not exceed two (2) weeks. D. Rights to Property ~ The rights and privileges granted to Resident by this Agreement do not include any right, title or interest in any part of the personal property, land, buildings and improvements owned or administered by Corporation. E. Responsibility for Damages - Any loss or damage to real or personal property of Corporation caused by' the fault, negligence or intentional misconduct of Resident shall be paid for by Resident. At the effective date of termination of this Agreement. Resident shall vacate the living accommodation and leave it in good condition except for reasonable Wear and tear, In the event of the death of Resident, the estate of Resident shall be liable for any loss or damages. If any fault, negligence or intentional misconduct of Resident results in injury, illness, or damage to any other resident, Corporation assumes no responsibility therefor, and Resident hereby releases and discharges Corporation from any injury er damage to Resident or to Resident's personal property caused by the fault, negligence or intentional misconduct of other residents. F. Responsibility for Protection of Resident's Property - Corporation shall not be responsible for the loss of any property belonging to Resident or to Resident's estate, for any cause, unless the care and control of said property is specifically accepted in writing by Corporation, and then only for 081194RES&C1 PRESBYTERIAN HOMES, INC,/GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 12 lack of ordinary care to safeguard and account for such property. Resident shall have the responsibility, at his own expense, of providing any insurance desired by him to protect against any such loss. If Resident has become unable to occupy the living accommodation, or has died, or this Agreement has been terminated for any other reason, Corporation, at Resident's cost, may remove all property of Resident from the living accommodation and store the same, in which case Corporation shall exercise ordinary care to protect such property against theft or other loss while stored. If the property should be stored in a commemial storage safehouse, Corporation shall have no responsibility for such property thereafter. In the event of Resident's death, any property of Resident in the living accommodation or held in storage shall be delivered to Resident's personal representative, or if none qualifies within one (1) month after Resident's death, to any of Resident's next of kin. Corporation will hold such properly for such period at the risk of Resident's estate or persons entitled thereto, subject to ordinary care by Corporation in safeguarding the same until delivery can be made. G. The parties named in this Agreement hereby agree as follows: each party hereby releases the other from any claim or recovery for any loss or damage to any of its property which is insured und&r valid and collectible insurance policies to the extent of any recovery collectible under such insurance. It is further agreed that this waiver shall apply only when permitted by the applicable policy of insurance. H, Rights of Resident are Personal and Non-transferable - The rights and privileges of Resident under this Agreement to the living accommodation, facilities, services, and medical care provided for herein are personal to him and cannot be transferred or assigned by act of Resident, or by any proceeding at law, or otherwise. No person other than Resident may occupy or use the living accommodation covered by this Agreement, except with the approval of Corporation. I. Obligation to Obtain insurance - Resident is obligated to obtain and maintain insurance coverage under the following plans: Medicare (A and B) and Blue Cross/Blue Shield 65 Special, or the equivalent. If the equivalent plan benefit is less than the aforementioned standard, Resident shall pay the difference when claims are incurred. If Resident fails to maintain this insurance, Corporation has the right to terminate the Residence and Care Agreement consistent with the termination provisions contained herein. In the event Resident lacks insurance coverage, the costs of skilled nursing care shall be the responsibility of Resident. SECTION 11: NOTICE - Notice, when required by the terms of this Agreement, shall be deemed to have been properly given if and when delivered personally or, if sent by mail, when postmarked, postage prepaid and addressed as follows: To Corporation: Administrator Green Ridge Village 210 Big Spring Rd. Newville, PA 17241 081194RES&C1 PRESBYTERIAN HOMES, INC,/~REEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 13 To Resident (before taking occupancy): Mr. & Mrs. Richard H. Parsons 19 Schoolhouse Lane Morristown, NJ 07960 SECTION 12: ENTIRE AGREEMENT - This Agreement, together with the Application Form, Medical Records, and Financial Statement submitted by Resident, constitutes the entire contract between Corporation and Resident, Corporation shall not be liable for any statements, representations or promises made by any person representing or purporting to represent Corporation, unless such statements, representations or promises are set forth in this Agreement. Resident agrees to observe the rules adopted by Corporation for the convenience, comfort and safety of all Residents, This Agreement may not be modified except by agreement of the parties in writing and affached hereto, signed .by the party against whom enforcement of any waiver, change, modification, extension or discharge is sought. SECTION 13: NON-DISCRIMINATION - Corporation operates on a non-discriminatory basis and provides access to its facilities and services for all persons regardless of sex, race, color, religion, national odgin, handicap or disability. SECTION 14: ACTS OF FORBEARANCE - No act of forbearance or failure to insist upon prompt performance of any of the terms hereof or agreement or statement of Resident under this Agreement, shall be construed as a valid waiver of any of the rights granted herein or by the Continuing-Care Provider Registration and Disclosure Act intended for the benefit or protection of Resident. SECTION 15: SEVERABILITY - If any prevision of this Agreement is determined to be invalid or unenforceable, the remainder of this Agreement shall remain in full force and effect. SECTION 16: NON WAIVER CLAUSE - No act, agreement or statement of Resident, or of an individual purchasing care for Resident under any agreement to furnish care to Resident, shall constitute a valid waiver of any provision of the Continuing-Care Provider Registration and Disclosure Act, Act of June 18, 1984, P.L. 391, No. 82, Sections 1-25, 40 P.S. Section 3201 et. seq., intended for the benefit or protection of Resident or the individual purchasing care for Resident. SECTION 17: SUBROGATION WHERE ACCIDENT OR INJURY CAUSED BY OTHERS - When Resident fails to pay to Corporation the monthly fees due under the agreement or where the cost to Corporation of Resident's care is increased due to injury to Resident caused or occasioned by other parties. Corporation shall be subrogated to Resident's claims or causes of action arising therefrom, including the right to damages for the injury and all expenses incurred as a result thereof, and 081194RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 14 Resident hereby assigns all such right of recovery to Corporation. Corporation, in such event, may sue on and enforce any cause of action for Resident for injury or damages so resulting, in the name of Resident, or in its own name. After all costs and expenses incurred by Corporation (including legal fees and cost of injury) shall have been paid for and reimbursed to Corporation by such subrogation, either from settlement, judgment, or otherwise, the balance of any such payment will be refunded or credited to Resident or, in the event of Resident's death, will be paid to Resident's estate or the person legally entitled thereto. 081194RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 15 SECTION 18: NOTICE OF RIGHT TO RESCIND - Date rescission period begins Resident may rescind and terminate this Residence and Care Agreement without penalty or forfeiture, within seven (7) days of the above date. Residents are not required to move into the continuing care facility before the expiration of this seven (7) day period. No other agreement or statement Resident signs shall (~onstitute a waiver of the right to rescind this Agreement within the seven (7) day period. To rescind this Agreement, mail or deliver a signed and dated copy of this notice, or any other dated wdtten notice, letter or telegram, stating the desire to rescind to the following address: Administrator Green Ridge Village 210 Big Spdng Rd. Newville, PA 17241 not later than midnight of (last day for rescission). Pursuant to this notice, I hereby cancel my Residence and Care Agreement. DATE PROSPECTIVE RESIDENT'S SIGNATURE(S) 081194RES&C1 PRESBYTERIAN HOMES, INC./GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 16 SECTION 19; AVERAGE ANNUAL COST OF PROVIDING CARE - The average annual cost of providing care during the most recent twelve month period for which report is available for Independent living units is $7,627.00 and in the Health Center is $34,380.33 during the same period, Therefore, the overall average annual cost of providing care and services to residents in accord with the terms of this Agreement is $16,157.21, (This would be the average of both independent living costs and health care costs.) SECTION 20: WAITING LIST - A waiting list of applicants for residency is maintained by the facility. An application is placed on the waiting list on the date that complete application for admission is received. Selection of qualified applicants from the waiting list is done in sequence, beginning with the earliest date of application. It must be recognized that many applicants choose to defer admission to a later time in which case the original date of their application is maintained. 081194RES&C1 PRESBYTERIAN HOMES, INC. IdREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN l PAGE 17 SECTION 21: ENTRANCE, MONTHLY MAINTENANCE FEES, AND ANY ADDITIONAL SERVICE FEE SCHEDULES ARE STAPLED TO THIS PAGE. BEDROOM COTTAGE B]EDR.OOi~ COTTAGE BEDROOlvf DELUXE COTTAGE FEES l~e~s Sabjo.-'t. to Chan§c MONTttL Y FE.E~ One P~on ~o P~onx $ 90,000.00 $1,175 $1,880 $141,000.00 $1,280 $1,9~5 2nd Person Entnmce Fee $16.000 ~.cluded in Monthly Fee: Selective d[rmer mean served in 8racious dL. dng room with pznoramic Rehab~tatlve and long term care services i~ quality h~[th center. Comprehensive ttanspoaation to: - Shopping lVlaUs -- Cn-ocety $to~es -- Do~ors' Offices -- Evenh~ M~al -- Local Churches - Co~u~ Sod~ Evems Assisted liv~ng ~n private accommodations ~d bath ia beautifully decorated Gil~land Utilities - Public water and sewer, trash a~d snow removal, major television network service connection. Complete building and appliance ma~enance. At~act~e l~mdscaplng with la~a ca~e Community areas - Library, wood working shop, craft areas, garderk a~d conferenco rooms, Green Ridge VHIage A Service ofP~byteria~ Homc~, hoc. 210 Big Spring Road ,. Nm,,,nn~e, PA 17241 717-776-3192 081194RI=$&C1 PRESBYTERIAN HOMES, INC,/GREEN RIDGE VILLAGE RESIDENCE AND CARE AGREEMENT PLAN 1 PAGE 18 IN WITNESS WHEREOF, GREEN RIDGE VILLAGE / PRESBYTERIAN HOMES, INCORPORATED, has caused this Agreement to be duly signed, and the party or parties Resident has or have hereunto affixed his/her/their signature(s), the day and year first above written. PRESBYTERIAN HOMES, INCORPORATED Officer of Presbyterian Homes, Inc. (SEAL) (SEAL) !/ Resident (SEAL) 210 Big Spring l~mcl. NewvJlle, Pe~r~yl~ 17241-9486 Phone (717) 776-3192 - Fax (717) 776-6266 EJ~ibit "A" Confidential Minutes of Board of Review, These are the minutes of the Green Ridge Village Board of Review meeting h~ld on July 21, 2003. The following individuals were present at the meeting: Karen Picking, Qiane, Burfeindt, Connie Kenes, land Dr. Townsend. ' , Ms, Burfelndt presented information about Marjorie and Richard Parsons who currently reside at 92 Locust Lane. Ms. Burfeindt explained that Mrs. Parsons, who exhibits signs of dementia, has been repeatedly leaving her home and wandering around the campus and into other residents' homes, without knowing her way home. Mr. Parsons does not always notice when his wife leaves their home, and at times has denied that his wife is leaving the home. The staff has discussed the seflousness of this issue with the Parsons but the behavior has continued. The staff has discussed the seriousness of this issue with the Parsons, but Mr. Parsons has denied that there is a risk to her health and safety despite the facts presented, In fact, Mr. Parsons does not believe that his wife is leaving unnoticed, and the behavior continues. After discussion, the Beard of Review concluded that Mrs, Parsons' mental condition appears to be such [hat Mrs. Parsons continuing in independent living is dangerous and is detrimental to the hearth, safety end peace of both Mrs. Parsons and the other residents. As such, the Board of Review agreed that the corporation might permanently transfer Mrs. Parsons to its assisted living facDty, There being no other business, the meeting of the Board of Review was adjourned. Respectfully submitted, Recording Secretary [~d~B:SL 90-88-de9 ~IHd :~ 1UaS 210 Big Spring Road · Newville, Ptnrmyl~ania 17241-9486 Phone (717) 776-3192 - Fax (717) 776-6266 NOTICE TO OUI~ Directed To: Mrs. M.a~jorie Pa,'mons cJo Mr. Richard Pamons 92 Loou~ L~ue · Newville, PA 17241 Dated: · Sep~aber 12, 2003 You are h{u-eby placed on notice that the Residence and Care Agreement between Mrs. Ma~jofie P~rso~ and Presbyterian HomeS, Inc. d/b/a Gre~ P, idge. Village h~ b*~n temainat~d because the ~r~n Ridge Villagc Board of lt. eview det. ermi,~ed that Mrs. P~r$on~ con'dnucd occupm~cy of 92 Loomst Lane czeate~ a scriou~ tl~ca! tO ~e life, heJSth, aafoty Or peace of Mr~. Parsons and other residents of Gr*en Ridge Village, Therefore, Mrs. Mmjorie P~rsom is hereby direoted to v~cato the l~ed pr~nises located at 92 Locust Lane within FIFllgEN (15) DAYS from the date this not/ce is hand-dollvored to you. Failure to vaoate a~ ir~-uc~ in tiffs notice will result in an eviction action bdng fil~d against you, PRESBYTBRIAlq HOMES, INC. Diane Buffeindt Interim Executive Director Green Ridge Vinage I certify that I have, tMs ~ d~y of September 2003, hand-delivered this Notice to to Iris. and Mrs. Richard Par~ons, Diane Burf~4adt/' A s~r~tce of Presbyt~r~n H0m~, Inc. f0zg [IHd :AB SHERIFF'S RETURN CASE NO: 2003-05187 P COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND PRESBYTERIAN HOMES INC VS PARSONS MARJORIE - NOT SERVED R. Thomas Kline according to law, the within named DEFENDANT PARSONS MARJORIE unable to locate Her COMPLAINT & NOTICE , Sheriff who being duly sworn says, that he made a diligent search and inquiry for to wit: in his bailiwick. He therefore returns but was the the within named DEFENDANT NOT SERVED , as to , PARSONS MARJORIE 92 LOCUST LANE GREEN RIDGE VILLAGE NEWVILLE, PA 17241 SERVICE STOPPED PER FAX FROM ATTORNEY. Sheriff's Costs: Docketing 18.00 Service .00 Affidavit .00 Surcharge 10.00 .00 28.00 So answers: Sheriff of Cumberland County MCNEES WALLACE NURICK 10/03/2003 Sworn and subscribed to before me this %? day of Prothonotary PRESBYTERIAN HOMES, 1NC., : : Plaintiff : MAJORIE PARSONS, : Defendant : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ACTION IN EJECTMENT NO. 03-5187 - CIVIL TERM PRAECIPE TO DISCONTINUE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Pursuant to Pa. R. Civ. P. 229(a), please mark this matter discontinued. Dated: October 7, 2003 McNEES WALLACE & NURICK LLC By K[mberl3 M. Colonna, Esq. Attorney I.D. No. 80362 100 Pine Street P. O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5278 Attorneys for Plaintiff Presbyterian Homes, Inc. SHERIFF'S RETURN - NOT SERVED ~--~ASE NO: 2003-05187 COMMONWEALTH OF PENNSYLVANIA cOUlqTY OF CUMBERLAND PRESBYTERIAN HOMES INC VS PARSONS MARJORIE R. Thomas Kline according to law, says, that the within named DEFENDANT PARSONS MARJORIE , Sheriff , who being duly sworn he made a diligent search and inquiry for to wit: but was unable to locate ~er_ in his bailiwick. He therefore returns the COMPLAINT & NOTICE the within named DEFENDANT NOT SERVED , as to , PARSONS MARJORIE 92 LOCUST LANE GREEN RIDGE VILLAGE NEWVILLE, PA 17241 SERVICE STOPPED PER FAX FROM ATTORNEY. Sheriff's Costs: Docketing 18.00 Service .00 Affidavit .00 Surcharge 10.00 .00 28.00 ----7~.Thomas Kl~e' Sheriff of Cumberland County MCNEES WALLACE bIURICK 10/03/2003 Sworn and subscribed to before me this day of prothonotary