HomeMy WebLinkAbout08-2831r
a
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: 08 - oI851 CivIl e
vs
GERTRUDE MURPH
Respondent. PETITION FOR CONFIRMATION
OF ARBITRATION AWARD
Filed on Behalf Of:
GOLDEN LIVINGCENTER-CAMP HILL
Counsel for this Party:
Chelsea D. Chase, Esquire
PA ID# 200545
Dodson & Chase, LLC
9800 McKnight Road
Suite 332 Building A
Pittsburgh, PA 15237
cchase@dodsonchase.com
412-635-9314 Phone
412-635-9358 Fax
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO:
VS.
GERTRUDE MURPH
Respondent.
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
2 Liberty Avenue
Carlisle, PA 17013
Telephone 717-249-3166
Date of mailing or other service:
'??
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: (2p. ;? 931 Cil _r`
vs.
GERTRUDE MURPH
Respondent.
PETITION FOR CONFIRMATION OF ARBITRATION AWARD
PURSUANT TO Pa.R.C.P.1327(1)(ii) and §1328
Petitioner GGNSC Camp Hill III LP d/b/a Golden LivingCenter-Camp Hill (hereinafter
referred to as "Petitioner") by and through its undersigned counsel, Chelsea D. Chase, Esquire,
Dodson & Chase, hereby petitions for Confirmation of Arbitration Award, and avers the
following in support:
1. Petitioner is a registered Pennsylvania entity doing business as Golden
LivingCenter-Camp Hill at 46 Erford Road, Camp Hill, Pennsylvania 17011.
2. Petitioner's business is the operation of a nursing home that administers care and
medical assistance to its residents.
3. Respondent Gertrude Murph is an adult individual residing at Golden
LivingCenter-Camp Hill, 46 Erford Road, Camp Hill, Pennsylvania 17011.
4. Respondent Gertrude Murph is a resident at Petitioner's facility.
5. Petitioner filed with the National Arbitration Forum (hereinafter referred to as the
"NAF"), a private arbitration service, a Claim on September 27, 2007.
6. This Claim was accepted by the NAF as proper and within the NAF's jurisdiction.
7. The Claim included a "Facility and Resident Arbitration Agreement" signed by
Petitioner and Respondent agreeing to arbitrate disputes arising due to nonpayment of bills. A
true and correct copy of the Arbitration Agreement is attached hereto, made a part hereof and
marked "Exhibit A".
8. The Claim was served on Respondent via certified mail on October 5, 2007, as
permitted by Rule 6 of the NAF's Code of Procedure (hereinafter referred to as the "Code"). A
true and correct copy of Petitioner's Proof of Service filed with the NAF is attached hereto, made
a part hereof and marked "Exhibit B".
9. Respondent failed to respond to the Claim.
10. Rule 25 and 26 of the Code provides at the option of either party the choice of a
Document Hearing or a Participatory Hearing. A Document Hearing is automatically scheduled
after a Response is filed and either party may elect and pay the fee for a Participatory Hearing.
11. Neither Petitioner nor Respondent elected to have a Participatory Hearing.
12. This case was submitted to the Arbitrator for a Document Hearing.
13. Arbitrator Jonathan Vipond III, Esquire was appointed to preside over this matter.
14. The Document Hearing was held and an Arbitration Award was issued on March
25, 2008 in favor of Petitioner and against Respondent in the amount of $11,987.00 The Award
is attached hereto, made a part hereof and marked "Exhibit C".
15. More than thirty (30) days has passed since the issuance of the award by the
Arbitrator and Respondent has failed to pay Petitioner the sum directed by the Arbitrator or any
part thereof.
WHEREFORE, Petitioner Golden LivingCenter-Camp Hill respectfully requests that this
honorable Court enters judgment in the form attached hereto confirming the Award of the
arbitrator and entering judgment in favor of Petitioner and against Respondent Gertrude Murph
in the amount of $11,987.00 together with costs of suit and interest according to the Admission
Agreement between the parties.
Respectfully submitted,
EXHIBIT A
RESIDENT AND FACILITY ARBITRATION AGREEMENT
(NOT A CONDITION OF ADMISSION - READ CAREFULLY)
This itration Agreeme is execut by t[_ - C
an?ao (the "Facility")
("Resident" or "Resident's Authorized Representative",
her feetively r eerrto as "Resident") in conjunction with an agreement for admission and for
the n of nursing facility services (the "Admission Agreement") by Facility to Resident. The
paris Arbitration Agreement acknowledge and agree that upon execution, this Arbitration
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
way to the Admission Agreement or any service or health care provided by the Facility to the Resident
shall be resolved exclusively by binding arbitration to be conducted at a place agreed upon by the Parties,
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 Agreementll , 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 rec?estin an inspection
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
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 dais agreenterrt unenforceable, that portion shall not be
effective and the remainder of the agreement shah remain effective.
It is the intention of the parties to this Arbitration Agreement that it shall inure to the benefit ofand bind
the parties, their successors, and assigns, including without limitation the
of the Facility, and all agents, employees and servants
persons whose claim is derived though 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 l vvs or existence of the parties
hereto.
" rnfolrnation atxU the Nationel Arbitration Forum, in.:Wng a complete cop} or the Cock OfProc,.J=, can he
the Forum at 8M474-2371, by fax ai 651-6,04-6,778 or toll-free fox at 966-7434517, or on the inCCrnc l at http:Nvc%ti1r art? from
forum.c obt
am.
Rev. 05/13/03
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White - Business Office Pink - Medical Reeotds Yellow - Resident
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.
THE PARTIES UNDERSTAND AND AGREE THAT THIS CONTRACT CONTAINS A BINDING
ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES, AND THAT BY
ENTERING INTO THIS ARBITRATION AGREEMENT, THE PARTIES ARE GIVING UP AND
WAIVING THEIR CONSTITUTIONAL 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
OR AWARD OF DAMAGES.
The Resident understands that (1) he/she has the right to seek legal counsel concerning this Arbitration
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 A
explained to him/her, that he/she understands its contents, and has received ya coat of b fully
that he/she is the Resident, or a person duly authorized by the Resident or otherwise to executeprovision
e hiss
agreement and accept its terms_
Date:
Signature:
(Resident)
Witness:
If the resident is unable to consent or sign this provision because of
incompetence or is a minor and an authorized physical disability or Fneatal
following: representative is signing this provision, complete the
Date:
Relationship to Resident.
Signature
(Autho ' represettative)
Witness-
For Facili
Rev. 05/13/03
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IVfate - Business Office Pink - Medical Records Yellow - Resident
Date f
Authorized Representative Signature:
Print Name and Title: I I-e- 0s V7'-7
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Rev. 03/13/03
White - Business OW=- Pink - kfc&W R=OF& Yellow - Resident
EXHIBIT B
Nation at
Arbitration
IHForumo
Name, address, and phone number for
Cialmant(s)
GGNSC Camp Hill III LP d/b/a Golden
LivingCenter-Camp Hill
46 Erford Road
Camp Hill, PA 17011
Telephone: 717-763-7361
Name, address, and phone number for
Respondent(s)
Gertrude Murph
Golden LivingCenter-Camp Hill
46 Erford Road
Camp Hill, PA 17011
Beatrice Conrad
322 North Second Street
Apartment 1906
Harrisburg, PA 17101
CLAIMANT'S PROOF
OF SERVICE
File Number: MX0709002009245
1. I, the Claimant(s), have Delivered the following Documents to the Respondent(s):
® Initial Claim ® Documents Supporting the Claim
® Notice of Arbitration
Arbitration Agreement
2. All of the above Documents were Delivered to the Respondent(s) by:
? United States Postal Service Regular Mail
® United States Postal Service Certified Mail Signed Return Receipt (attach return receipt)
? Delivery by Private Service (attach delivery receipt)
? Other Service (describe service)
1, Chelsea A Dodson Esquire assert, under penalty of perjury, that the above listed
Documents were served on the Respondent(s) Gertrude Murph on October 5, 2007
and that this service
applicable law.
Claimant's
to the requirements of Rule 6 of the NAF Code of Procedure and the
Date: W7 lt/
P.O. Box 50191, Minneapolis, MN 55405-0191 • Tel: 800-474-2371 • Fax: 866-743-4517 9 www.arbitration-forum.com
1/2006
¦ Complete items 11 2, and 3.
¦ Pen 4 if Restricted Deliveryi?desiredplete
so that ur name and address. on the reverse
¦ Attach this an return the card to you.
card to the back of the mallpiece,
or on the front if space
? • ddm permits.
Article g ssed to:
Gertrude Murph
Golden Living Camp Hill
46 Erford Road
Camp Hill, PA 17011
A.
X
C. D o
Is delivery ad tiss diff d
If YES, enter delive event finrn Item' e,
liver address below: 0 N.
2• Article Number
(Transfer bom sendce /abed
P8 Fo?113811, February 2004
3• Service Type
0 Certified
? Mall 0 Express Mall
Registered 0 Return Receipt for Merch
0 Insured Mail
C.O.D. andise
4• Restricted Delivery? (Extra Fee) 70117 0220 OQl?3 1754 192 ? Yes
Domestic Retum Receipt
1o25g5-02 M.jUO
t
UNITED STATES POSTAL SERVICE
i
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
Chelsea Dodson, Esq.
Dodson, McCaffrey & Associates, Inc.
9800A McKnight. Road, #332
Pittsburgh, PA 15237
9tfil#fltl?+t??i7i?fllaalltff/rlllflfalt?il)I71:t1'1f.1Trl?ffifl
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EXHIBIT C
NATIONAL ARBITRATION
FORUM
GGNSC Camp Hill III LP d/b/a Golden LivingCenter-Camp Hill
46 Erford Road
Camp Hill. PA 17011
CLAIMANT(S), AWARD
RE: GGNSC Camp Hill III LP d/b/a Golden LivingCenter-Camp Hill v Beatrice Conrad &
Gertrude Murph
File Number: MX0709002009245
Gertrude Murph
Golden LivingCenter-Camp Hill
46 Erford Road
Camp Hill, PA 17011
RESPONDENT(S).
The undersigned Arbitrator in this case FINDS and CONCLUDES:
Case Summary
1. The Claimant has filed a Claim with the National Arbitration Forum.
2. After Proof of Service of the Claim was filed with the Forum, the Forum mailed to Respondent a Second Notice of Arbitration.
3. An arbitration hearing notice was duly delivered to the Parties as required by the Forum Rules.
4. The Parties have had the opportunity to present all evidence and information to the Arbitrator.
5. 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 accord with Rule 6, including a Notice of Arbitration.
4. On or before September 27, 2007 the Parties entered into a written agreement to arbitrate their dispute.
5. No Party has asserted that this Arbitration Agreement is invalid or unenforceable.
6. The Parties' Arbitration Agreement is valid and enforceable and governs all the issues in dispute.
7. This matter is arbitrable under the terms of the Parties' Arbitration Agreement and the law.
8. This matter has proceeded in accord with the applicable Code of Procedure Rules.
9. The evidence submitted supports the issuance of this Award.
10. The applicable substantive law supports the issuance of the Award.
Therefore, the Arbitrator ISSUES:
An Award in favor of the Claimant, for a total amount of $11,987.00.
Entered and Affirmed in the State of Pennsylvania
o he "I
Jonathan Vipond I, Esq.
Arbitrator
Date: March 25. 2008
ACKNOWLEDGEMENT AND CERTIFICATE
OF SERVICE,
This Award was duly entered and the I orum hereby certifies that
pursuant to the Parties- Arbitration Agreement. a copy of this Award
was sent by first class mail postage prepaid to the Parties at the above
referenced; addresses. or their Representatives, on this date.
Honorable Harold Kalina, Ret.
Director
March 26. 2008
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO:
VS.
GERTRUDE MURPH
Respondent.
VERIFICATION
I, CHELSEA D. CHASE, ESQUIRE, of Dodson & Chase, Counsel for Petitioner herein,
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.
Date: ?(? Q
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO:
Vs.
GERTRUDE MURPH
Respondent.
CERTIFICATE OF SERVICE
I hereby certify that a true and correct copy of the within Petition for Confirmation of
Arbitration Award was served by mailing same first class mail, postage prepaid to counsel of
record on the 2,&day of TT (,Qj 2008, as follows:
Gertrude Murph
Golden LivingCenter-Camp Hill
46 Erford Road
Camp Hill, PA 17011
V& 64- c?) PY?
it
Cl a
71
0
SHERIFF'S RETURN - REGULAR
CASE NO: 2008-02831 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
GGNSC CAMP HILL III LP ET AL
VS
MURPH GERTRUDE
WILLIAM CLINE , Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within PETITION was served upon
MURPH GERTRUDE the
RESPONDANT , at 1932:00 HOURS, on the 7th day of May 2008
at 46 ERFORD ROAD
CAMP HILL, PA 17011
GERTRUDE MURPH
a true and attested copy of PETITION
by handing to
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
18.00
15.00
.00
10.00
.00
43.00
Sworn and Subscibed to
before me this day
of ,
So Answers:
R. Thomas Kline
05/08/2008
DODSON & CHASE
By.
Deputy Sheriff
A. D.
T
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner,
vs
GERTRUDE MURPH
Respondent.
CIVIL DIVISION
NO: 08-2831 Civil Term
PRAECIPE FOR ENTRY OF
JUDGMENT
Filed on Behalf Of.
GOLDEN LIVINGCENTER-CAMP HILL
Counsel for this Party:
Chelsea D. Chase, Esquire
PA ID# 200545
Dodson & Chase, LLC
9800 McKnight Road
Suite 332 Building A
Pittsburgh, PA 15237
cchase@dodsonchase.com
412-635-9314 Phone
412-635-9358 Fax
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: 08-2831 Civil Term
vs
GERTRUDE MURPH
Respondent.
PRAECIPE FOR ENTRY OF JUDGMENT PURSUANT TO PA.R.C.P. 1328(e)
To the Prothonotary:
Kindly enter judgment in favor of Petitioner GGNSC CAMP HILL III LP D/B/A
GOLDEN LIVINGCENTER-CAMP HILL and against Respondent GERTRUDE MURPH for
Respondent's failure to answer to the Motion in this action within the required time. The Motion
contains a Notice to File Answer within 30 days from the date of service thereof. Respondent
was served with the Motion on May 7, 2008, and Respondent's answer was due to be filed on
June 9, 2008.
Please assess. damages as follows:
As set forth in Claim $11,917.00
Costs granted in Award $ 70.00
Interest granted in Award to 6.10.08 $ 2,662.92
Total $14,549.92
I certify that the foregoing assessment of damages is for specified amounts alleged to be
due in the Motion and is calculable as a sum certain from the motion.
By:
D. Chase
? for Plaintiff
AND NOW " - J3 , c?O!A -, Judgment is entered in favor of
Petitioner and against Respondent Gertrude Murph for want of an answer and damages assessed
at the sum of $14,649.92 as per the above certification.
L L___?_
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Pro onotary
I
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: 08-2831 Civil Term
vs
GERTRUDE MURPH
Respondent.
AFFIDAVIT OF NON-MILITARY SERVICE
CHELSEA D. CHASE, ESQ., hereby verifies that she is attorney for the Petitioner in the
above-captioned matter, and that on information and belief, she has knowledge of the following
facts, to wit:
a. Respondent GERTRUDE MURPH is not in the Military or Naval Service of the
United States or its Allies, or otherwise subject to the provisions of the Soldiers and Sailors Civil
Relief Act of Congress of 1904 and its amendments, 50 U.S.C. App. § 501 et seq.
b. Respondent GERTRUDE MURPH is over 18 years of age and has a permanent
address at Golden LivingCenter-Camp Hill, 47 Erford Road, Camp Hill, Pennsylvania 17011.
C. Petitioner GGNSC CAMP HILL III LP is a limited partnership conducting business
under the Laws of the Commonwealth of Pennsylvania as GOLDEN LIVINGCENTER-CAMP
HILL with an address of 46 Erford Road, Camp Hill, Pennsylvania 17011.
d. This statement is made subject to the penalties of 18 Pa. C.S. Section 4904 relating
to unsworn falsification to authorities.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: 08-2831 Civil Term
vs
GERTRUDE MURPH
Respondent.
CERTIFICATE OF SERVICE
I hereby certify that a true and correct copy of the within Praecipe for Entry of Judgment
was served by mailing same first class mail, postage prepaid to counsel of record on the
Mday of "kA a 2008, as follows:
Gertrude Murph
Golden LivingCenter-Camp Hill
46 Erford Road
Camp Hill, PA 17011
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OFFICE OF THE PROTHONOTARY
COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
TO: GERTRUDE MURPH
GOLDEN LIVINGCENTER-CAMP HILL
46 ERFORD ROAD
CAMP HILL, PA 17011
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
GGNSC CAMP HILL III LP d/b/a CIVIL DIVISION
GOLDEN LIVINGCENTER
-CAMP HILL,
Petitioner, NO: 08-2831 Civil Term
vs
GERTRUDE MURPH
Respondent.
NOTICE
Pursuant to Pa. R.C.P. 236, you are hereby notified that a JUDGMENT BY DEFAULT
has been entered against you in the above proceeding.
P ,I
Pr onotary