HomeMy WebLinkAbout08-2164
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
GOLDEN VENTURES NATIONAL
SENIOR CARE, LLC d/b/a
d/b/a WEST SHORE HEALTH AND
REHABILITATION CENTER
770 Poplar Church Road
Camp Hill, PA 17011
Plaintiff,
CIVIL DIVISION
NO. CS - 0164 0,11A ler"
VS. PETITION FOR CONFIRMATION
OF ARBITRATION AWARD
PURSUANT TO PA RCP 1328
JUNIOR ROSIER
770 Poplar Church Road
Camp Hill, PA 17011
JOHN W. ROSIER, SR.
11 Pine Hill Ave.
Mechanicsburg, PA 17050
Defendants.
Filed on behalf of Plaintiff
West Shore Health & Rehab
Counsel of Record for this Party:
NATHAN T. CHASE, ESQUIRE
Pa. I.D. # 200295
DODSON, MCCAFFREY & ASSOCIATES
Suite 332 Building A
9800 McKnight Road
Pittsburgh, Pa. 15237
(412) 635-9314
Nathan_Chase@dodsonmccaffrey.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
GOLDEN VENTURES NATIONAL
SENIOR CARE, LLC d/b/a
WEST SHORE HEALTH AND
REHABILIATION CENTER
Plaintiff,
CIVIL DIVISION
NO.
VS.
JUNIOR ROSIER
JOHN ROSIER
Defendants.
NOTICE TO FILE ANSWER
A party to these proceedings has filed a motion to confirm an arbitration award. If you
oppose the motion, you are required to file an answer to the motion within thirty (30)
days from the date below setting forth your objections to the motion. If you fail to file an
answer, a money judgment based on the arbitration award may be entered against you
without further notice. 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
32 South Bedford Street
Carlisle, PA, 17103
717-249-3166
Toll Free (in PA) 1-800-990-9108
Date of aiing:
! /
Nathan T. Chase, Esq.
Attorney for Petitioner
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
GOLDEN VENTURES NATIONAL
SENIOR CARE, LLC d/b/a
WEST SHORE HEALTH AND
REHABILIATION CENTER
Plaintiff,
CIVIL DIVISION
NO. DSr- -V67
VS.
JUNIOR ROSIER
JOHN ROSIER
Defendants.
PETITION FOR CONFIRMATION OF ARBITRATION AWARD PURSUANT
TO PA RCP 1328
1. Plaintiff, Golden National Senior Care, LLC d/b/a West Shore Health and
Rehabilitation Center, is a Pennsylvania registered business in good standing, being
engaged in the business of providing nursing home care and medical assistance and
having an address of 770 Poplar Church Road, Camp Hill, County of Cumberland,
Commonwealth of Pennsylvania.
2. Defendant John Rosier, is an individual and a Pennsylvania Resident having his
current address at 11 Pine Hill Avenue, Mechanicsburg, PA 17050.
3. Defendant Junior Rosier, is an individual and a Pennsylvania Resident having his
address at Plaintiff's nursing home facility located at 770 Poplar Church Road, Camp
Hill, County of Cumberland, Commonwealth of Pennsylvania.
3. Defendant Junior Rosier was admitted into Plaintiffs nursing home and healthcare
facility on or about March 28th of 2005 and he has remained at Claimant's facility until
the present date.
4. On or about the date of admission, March 28th of 2005, Defendants agreed to and
signed an Arbitration Agreement, which bound both Plaintiff and Defendants to resolve
any disputes through an independent private arbitration. A true and correct copy of the
Arbitration Agreement is attached hereto, made a part hereof and is labeled as Exhibit A.
5. During Defendant Junior Rosier's stay at Plaintiff's facility, Defendants had accrued
an unpaid balance due to Plaintiff for services and items received of $12,618.68.
6. Defendants failed to pay the above stated amount following numerous attempts to
collect the same; Plaintiff subsequently filed a claim with the National Arbitration Forum
pursuant to the Arbitration Agreement.
7. Following proper service and notice via certified mail, signed return receipt, through
the United States Postal Service, hearings were held before the arbitrators on or about
April 19th of 2007 and the parties were given a full opportunity to present all testimony
and evidence they desired in support of their positions.
8. After the hearing and review of the claim, the National Arbitration Forum issued an
Award for Plaintiff and against Defendants, individually and jointly and severably liable,
for the amount of Twelve Thousand Six Hundred and Eighteen Dollars and Sixty Eight
Cents ($12,618.68). A true and correct copy of the Arbitration Award is attached hereto,
made a part hereof and is labeled as Exhibit B.
9. Since the award has been issued, Defendants had made several payments toward the
balance due; however, Defendants have failed to pay the balance due and have ceased
making any and all payments toward the balance.
10. The balance due is now Four Thousand Six Hundred Forty Four Dollars and Ninety
Cents ($4,644.90). This remaining balance has been past due for several months and
with no continuing payments being made, this petition is being filed.
12. This now current balance of $4,644.90 remains unpaid contrary to the arbitrator's
award and demand.
WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an
order in the form attached hereto confirming the award of the arbitrators and entering
judgment in favor of Plaintiff, West Shore Health and Rehabilitation Center and against
Defendants, John and Junior Rosier, in the amount of Four Thousand Six Hundred Forty
Four Dollars and Ninety Cents ($4,644.90), being the amount of the Arbitration Award
less payments received.
Respect sub ;tted,j`
VL/
Nathan T. Chase, Esq.
Dodson & Chase
Attorneys for Petitioner
VERIFICATION
the undersigned, being an attorney for West
Shore Health and Rehabilitation Center, verify that the statements and averments made in
the foregoing Petition for Confirmation of Arbitration Award 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. Section 4907, relating to unsworn
falsification to authorities.
U?
Date:
Nathan T. Chase, Esq.
Dodson & Chase
Attorneys for Petitioner
West Shore Health and Rehab Center
EXHIBIT A
ARBITRATION AGREEMENT
412871 1040 01W03p.m 12-11-2006 11!14
RESIDENT AND FACILITY ARBITRATION AGREEMENT
(NOT A CONDITION OF ADMISSION - READ CAREFULLY)
This Arbitration A eemetnt, is executed by tk_f_A ?- (the "Facility')
and ZZ)Dk yr"- ("Resident" or "Resident's Authorized Representative",
hereafter collectively referred to as "Resident") in conjunction with an agreement for admission and for
parties to this Arbitration Agreement acknowledge and agree that upon execution, this Arbitration y
Agreement becomes part of the Admission Agreement, and that the Admission Agreement evidences a
transaction involving interstate commerce governed by the Federal Arbitration Act. It is understood and
agreed by Facility and Resident that any and all claims, disputes, and controversies (hereafter collectively
referred to as a "claim" or collectively as "claims") arising out of, or in connection with, or relating in any
wav to the Admission Agreement or any service or health care provided-by-the Facility to the Resident
shall be resolved exclusively oy otnatng armirauon to oe conuuumu UL a FUME MS] VVU UPV1I Vy uic r a1 uw,
or in the absence of such an agreement, at the Facility, in accordance with the National Arbitration Forum
Code of Procedure, which is hereby incorporated into this Agreement% and not by a lawsuit or resort to
court process. This agreement shall be governed by and interpreted under the Federal Arbitration Act, 9
U.S.C. Sections 1-16.
This agreement to arbitrate includes, but is not limited to, any claim for payment, nonpayment, or refund
for services rendered to the Resident by the Facility, violations of any right granted to the Resident by law
or by the Admission Agreement, breach of contract, fraud or misrepresentation, negligence, gross
negligence, malpractice, or claims based on any departure from accepted medical or health care or safety
standards, as well as any and all claims for equitable relief or claims based on contract, tort, statute,
warranty, or any alleged breach, default, negligence, wantonness, fraud, misrepresentation, suppression of
fact, or inducement. However, this agreement shall not limit the Resident's right to file a grievance or
complaint with the Facility or any appropriate government agency from requesting an inspection from
such an agency, or from seeking review under 42 C.F.R. section 431.200 et seq. of a decision to transfer
or discharge the Resident.
The parties agree that damages awarded, if any, in an arbitration conducted pursuant to this Arbitration I
Agreement shall be determined in accordance with the provisions of the state or federal law applicable to
a comparable civil action, including any prerequisites to, credit against, or limitations on, such damages.
Any award of the arbitrator(s) may be entered as a judgment in any court having jurisdiction. In the event
a court having jurisdiction finds any portion of this agreement unenforceable, that portion shall not be y
effective and the remainder of the agreement shall remain effective.
0
It is the intention of the parties to this Arbitration Agreement that it shall inure to the benefit of and bind
the parties, their successors, and assigns, including without limitation the agents, employees and servants
of the Facility, and all persons whose claim is derived through or on behalf of the Resident, including any
parent, spouse, sibling, child, guardian, executor, legal representative, administrator, or heir of the
Resident. The parties further intend that this agreement is to survive the lives or existence of the parties
hereto.
11 Information about the National Arbitration Forum, including a complete copy of the Code of Procedure, can be obtained from
the Forum at 800-474-2371, by fax at 651-604-6778 or toll-free fax at 866-7434517, or on the internet at http://www.arb-
forum.oom.
Rev. 05/13/03
White - Business Office Pink - Medical Records Yellow - Resident
412871 1040 0109:32 p.m 12-11-2006
All claims based in whole or part on the same incident, transaction, or related course of care or services
provided by the Facility to the Resident shall be arbitrated in one proceeding. A claim shall be waived
and forever barred if it arose and should reasonably have been discovered prior to the date upon which
notice of arbitration is given to the Facility or received by the Resident and such claim is not presented in
the arbitration proceeding.
r .,. S Til?iT11 - STANDA1?T i1 A CONTA S A $ iNG
a-sa?arz-aa.ai ,.
ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES, AND THAT BY
ENTERING INTO THIS ARBI'T'RATION AGREEMENT, THE PARTIES ARE GIVING UP AND
WAIVING THEIR CONSTPTUTIONAL RIGHT TO HAVE ANY CLAIM DECIDED IN A COURT
OF LAW BEFORE A JUDGE AND A JURY, AS WELL AS ANY APPEAL FROM A DECISION
R
OR AWARD OF DAMAGES.
The Resident understands that 1 he/she as the right to see legal counsel concerning tins ration
Agreement, (2) that execution of this Arbitration Agreement is not a precondition to admission or to the
furnishing of services to the Resident by the Facility, and (3) this Arbitration Agreement may be rescinded
by written notice to the Facility from the Resident within thirty days of signature. If not rescinded within
thirty days, this Arbitration Agreement shall remain in effect for all subsequent stays at the Facility, even
if the Resident is discharged from and readmitted to the Facility.
The undersigned certifies that he/she has read this Arbitration Agreement and that it has been fully
explained to him/her, that he/she understands its contents, and has received a copy of the provision and
that he/she is the Resident, or a person duly authorized by the Resident or otherwise to execute this
agreement and accept its terms.
Date:
Signature:
(Resident)
Witness:
If the resident is unable to consent or sign this provision because of physical disability or mental
incompetence or is a minor and an authorized representative is signing this provision, complete the y
following: 2
0
Date:
Relationship to Resident:
representative)
Witness:
For Facility:
Rev. 05/13103
White - Business Office Pink - Medical Records Yellow - Resident
412 871 1040 01 09:50 p.m 12-11-2006 13114
Date:
Authorized Representative Signature:
Print Name and Title:
h
Z
0
Rev. 03/13/03
White - Business Office Pink - Medical Reoords Yellow - Raident
EXHIBIT B
ARBITRATION AWARD
I?? NATIONAL ARBITRATION
111 FORUM
Golden Gate National Senior Care, LLC f/k/a/ Beverly Ent., PA-Inc., d/b/a West Shore Health & Rehab
770 Poplar Church Road
Camp Hill, PA 17011
CLAIMANT(s), AWARD
RE: Golden Gate National Senior Care, LLC f/k/a Beverly Ent., PA-Inc., d/b/a West Shore
Health & Rehab v Junior Rosier & John W. Rosier Sr.
File Number: FA0612000873265
Claimant Account Number: ####
Junior Rosier John W Rosier Sr.
770 Poplar Church Road 11 Pine Hill Ave
Camp Hill, PA 17011 Mechanicsburg, PA 17050
RESPONDENT(s).
The undersigned Arbitrator in this case FINDS and CONCLUDES:
Case Summary
I. The Claimant has filed a Claim with the National Arbitration Forum.
2. After Proof of Service of the Claim was filed with the Forum, where no Response has been filed, the Forum mailed to Respondent a
Second Notice of Arbitration.
3. The Respondent has filed a Response with the Forum and served it on the Claimant.
4. An arbitration hearing notice was duly delivered to the Parties as required by the Forum Rules.
5. The Arbitrator conducted a Hearing in this case in accordance with the Forum Rules.
6. The Parties have had the opportunity to present all evidence and information to the Arbitrator.
7. The Arbitrator has reviewed all evidence submitted in this case.
Decision
1. The Arbitrator knows of no conflict of interests that exist.
2. This matter involves interstate commerce and the Federal Arbitration Act governs this arbitration.
3. The Claim was properly served on the Respondent by Claimant in accordance with Rule 6, including a Notice of Arbitration.
4. On or before 12/28/2006 the Parties entered into a valid, written agreement to arbitrate their dispute.
5. The Parties' Arbitration Agreement is valid and enforceable and governs all the issues in dispute.
6. This matter is arbitrable under the terms of the Parties' Arbitration Agreement and the law.
7. The matter has proceeded in accord with the applicable Forum Code of Procedure Rules.
8. The evidence submitted supports the issuance of this Award.
9. The applicable substantive law supports the issuance of this Award.
Therefore, the Arbitrator ISSUES:
An Award in favor of the Claimant, for a total amount of $12,618.68.
Entered and Affirmed in the State of Pennsylvania
i
- 1 7: ?;2 W? Jo D. Hendricks, E
Arbitrator
ACKNOWLEDGEMENT AND CERTIFICATE
OF SERVICE
This Award was duly entered-and-the Forum hereby certifies that
pursuant to the Parties' Atbi t}pn -mgrit, a copy of this Award
was sent by first class mdil purge p id to'the Parties at the above
referenced addresses„ 6r their Representatives, on this date.
Date: 04/18/2007
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SHERIFF'S RETURN - REGULAR
CASE NO: 2008-02164 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
GOLDEN VENTURES NATIONAL SENIO
VS
ROSIER JUNIOR ET AL
KENNETH GOSSERT , Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within PETITION was served upon
ROSIER JUNIOR the
RESPONDANT at 0010:58 HOURS, on the 10th day of April 2008
at 770 POPLAR CHURCH ROAD
CAMP HILL PA 17011
by handing to
BEVERLY FRY EXECUTIVE DIRECTOR
a true and attested copy of PETITION together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
... Affidavit
Surcharge
So Answers:
18.00
12.00
.00
.00 R. Thomas Kline
00
30.00 04/11/2008
SRL
Sworn and Subscibed to By:
before me this day
of A.D.
r..
CASE NO: 2008-02164 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
GOLDEN VENTURES NATIONAL SENIO
VS
ROSIER JUNIOR ET AL
KENNETH GOSSERT Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within PETITION was served upon
ROSIER JOHN W SR the
RESPONDANT , at 0011:27 HOURS, on the 10th day of April 2008
at 11 PINE HILL AVENUE
MECHANICSBURG, PA 17050 by handing to
ISABEL COPICCOLL ADULT IN CHARGE
a true and attested copy of PETITION together with
SHERIFF'S RETURN - REGULAR
.r.
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
4)14 )bY (%-
So Answers:
6.00
15.00
.00
.00 R. Thomas Kline
.00
2 1. 0 0 04/11/2008
SRL
Sworn and Subscibed to By:
before me this day
of A.D.
w
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
GOLDEN GATE NATIONAL CIVIL DOCKET
SENIOR CARE, LLC d/b/a
GOLDEN LIVINGCENTER -
WEST SHORE
Plaintiff, NO. 08-2164 - Civil Term
vs.
PRAECIPE FOR JUDGMENT
PURSUANT TO PA RCP 1328(e)
JUNIOR ROSIER
JOHN W. ROSIER, SR.
Defendants,
Filed on behalf of Plaintiff
Golden LivingCenter - West Shore
Counsel of Record for this Party:
NATHAN T. CHASE, ESQUIRE
Pa. I.D. # 200295
DODSON, MCCAFFREY & ASSOCIATES
Suite 332 Building A
9800 McKnight Road
Pittsburgh, Pa. 15237
(412) 635-9314
Nathan_Chase@dodsonmccagrey.com
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
GOLDEN GATE NATIONAL
SENIOR CARE, LLC d/b/a
GOLDEN LIVINGCENTER -
WEST SHORE
Plaintiff,
vs.
JUNIOR ROSIER
JOHN W. ROSIER, SR.
Defendants,
CIVIL DOCKET
NO. 08 - 2164 - Civil Term
PRAECIPE FOR JUDGMENT FOR FAILURE TO ANSWER PETITION FOR
CONFIRMATION OF ARBITRATION AWARD PURSUANT TO PA RCP 1328(e)
To the Prothonotary:
Please enter judgment on the award of arbitrations filed in the above captioned matter as
Defendants have failed to answer within 30 days after having been served by the Sheriff
of Cumberland County. Service of the petition was completed to both Defendants on
April l0 h of 2008 as is required by PA RCP 1328(e), which does NOT require a 10 day
notice. Please assess damages in favor of the Plaintiff and against Defendants as follows:
Total AmounlVl)ue from Ay#ard / Petition $ 4,644.9
By:
Nathan T. Chase, Esq.
Attorney for Plaintiff
Damages Assessed as Above:
Date: d
d 1* &.A &d;
Prothonotary
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