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HomeMy WebLinkAbout04-1134SHIPPENSBURG/ , SOUTH HAMPTON MANOR, L.P. Plaintiff, MARY M. DITULLIO Defendant. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2004- ]/~ CIVILTERM CIVIL ACTION-LAW 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 an attorney and filing in writing with the court, your defenses or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. 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, Pennsylvania 17013 (717) 249-3166 SHIPPENSBURG/ : SOUTH HAMPTON MANOR, L.P.: Plaintiff, : MARY M. DITULLIO : Defendant. : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2004- //~,~ CIVIL TERM CIVIL ACTION-LAW COMPLAINT NOW, comes Shippensburg/South Hampton Manor Limited Partnership, ("Shippensburg Health"), by and through its attorneys, O'BRIEN, BARIC & SCHERER, and files the within Complaint and, in support thereof, sets forth the following: 1. Shippensburg/South Hampton Manor Limited Partnership is a Maryland limited partnership duly authorized to conduct business in the Commonwealth of Pennsylvania. 2. Shippensburg/South Hampton Manor Limited Partnership operates owns and operates a skilled care facility known as Shippensburg Health Care Center. 3. Defendant, Mary M. Ditullio, is an adult individual with a residence address of 745 Norland Avenue, Chambersburg, Pennsylvania 17201-421 I. 4. The Shippensburg Health Care Center is located at 121 Walnut Bottom Road, Shippensburg, Cumberland County, Pennsylvania. 5. On or about August 13, 2003, Mary Ditullio sought admission to the Shippensburg Health Care Center. 6. On or about August 13, 2003, Mary Ditullio executed an Admission Agreement. A true and correct copy of the Admission Agreement is attached hereto as Exhibit "A" and is incorporated by reference. 7. On or about August 13, 2003, Mary Ditullio became a resident of the Shippensburg Health Care Center. 8. During the period of her residency at Shippensburg Health Care Center, Mary Ditullio incurred charges for the costs of her care and services provided by Shippensburg Health Care Center to her. 9. As of the date of her discharge from the Shippensburg Health Care Center, Mary Ditullio owed Shippensburg Health Care Center the sum of $22,218.00 in accordance with the Statement attached hereto as Exhibit "B" which is incorporated by reference. 10. Demand has been made upon Mary Ditullio to pay the amount due and owing to Shippensburg Health Care Center for the costs of care and services provided. COUNT I- BREACH OF CONTRACT SHIPPENSBURG/SOUTH HAMPTON MANOR, L.P.v. MARY DITULLIO Plaintiff incorporates by reference paragraphs one through ten as though set forth 11. at length. 12. fulfilled. 13. All conditions precedent to recovery under the Admission Agreement have been Mary Ditullio is obligated to pay for the costs of her care provided by Shippensburg Health Care Center. 14. Mary Ditullio has breached the Admission Agreement by failing and refusing to pay for the services rendered. 15. The Admission Agreement provides, in relevant part, as follows: Penalties We may not charge you interest if you pay your bill in time. Your payment is on time if it is made within 45 days of the date the bill is post marked, or 30 days after the end of the billing period, whichever is later. The penalty we charge is 5% of the mount due, calculated on a per day basis. If you or your representative do not pay the money you owe us and we hire a collection agency or attorney, you agree to be liable for their fees and court costs. WHEREFORE, Plaintiffrequests judgment in its favor and against the Defendant for the sum of $22,218.00 plus interest, late charges, expenses and attorney fees. COUNT II-QUANTUM MERUIT SHIPPENSBURG/SOUTH HAMPTON MANOR, L.P.v. MARY DITULLIO 16. Plaintiff incorporates by reference paragraphs one through fifteen as though set forth at length. 17. During the period of her residency at the facility, Mary Ditullio enjoyed the benefit of the care and services provided by Shippensburg Health Care Center. 18. Mary Ditullio has failed and refused to pay for the costs of her care and services as provided by Shippensburg Health Care Center. 19. Mary Ditullio has been unjustly enriched by her use and enjoyment of the services and care provided by Shippensburg Health Care Center without making payment therefore. WHEREFORE, Plaintiff requests judgment in its favor and against the Defendant for the sum of $22, 218.00 plus costs, expenses and interest. Respectfully submitted, David A. Baric, Esquire ID # 44853 19 West South Street Carlisle, PA 17013 (717) 249-6873 Attorney fbr Plaintiff dab.dir/shcc/ditullio/complaint, pld 82/27/2884 15:~2 Z17249575~ ORS PAGE 07 .VITRIFICATION ~sembl~ by my a~ome7 in this li6~tio~ Thc [~$~ge oft~ ~mtemen~ i~ not my o~. I have read the s~t~m~; and to the e~t t~ ~ey ~ b~d upon ~o~a~on w~ch I have given to my co.scl, ~ey ~c ~e ~d co~ect to ~e best of my ~owl~d$e, ~ar~ti~ md belief. I ~d~st~d~at f~se ~m~ here~ 4904 relat~g to ~hi~n~b~ Hcal~ C~c 121 Walnut Bottom Road Shippensburg, Pennsylvania 17257-9005 (717) 530-8300 FAX (717) 530-8304 TTY 1-800-654-5984 ADMISSION AGREEMENT t his Ag, eement as be.r~een Sbppen~burg Health C,~e Center (the Facd~ty or we and) · "you") and, if you or the court have x~i~),,t't-~ ~ .~,~C0\\\(~3 (the "Resident" o( designate.~/ an indivktual to act on your behalf, or the, e is another individual to act on your behalf, or operation of law, ("your representative"). A checklist of the rights and responsibilities applicable to your representative is listed in Exhibit 1 attd is incorporated into this Agreement. Pavine for Your Care If you are applying to this facility as a private-pay resident, you must provide all financial information requested by us. If we later find that the information you or your representative provided was incomplete or inaccurate; we will consider that as a breach of this Agreement wh/ch gives us the right to pursue all legal remedies against you or your representative. Who Can Be RetRfired lo Pay for Your Care Only you and your insurer can be required to pay for your care. No other person, (i.e. a family member, fi"iend, neighbor, legal representative or guardian) can be required to pay from their own funds for your care, although he or she may knoxdngly and voluntarily agree to guarantee paymer:t [bt the cost of ye, ur care. We require the person responsible for making payments on your behalf to pay for your care under the terms of this contract in a timely manner. if you are a beneficiary of Medicare, Medicaid or any other third-party payment plan, your representative agrees to make all necessary payments from your funds. Your representative could face a civil penalty for intentionally failing to pay required amounts from your funds and could face a crhninal penalty for abusing your funds. Private Pay Resideuts The items and services included in our daily rate is basic room, board and general nursing care as required by your medical condition. Payment for items and services that are included in the daily rate and is payable one month in advance and due on the first of each month. Items and services included in your daily rate are listed in Exhibit 2.A. You will be charged separately for additional items and services not included in our daily rates such as special nursing care, special equipment, pharmacy charges, laboratory charges, medical transportation and additional services such as telephone expense, dry cleaning, beauty and barber services and newspapers. Items and services for which you will be charged are listed in Exhibit 2.B. Payment for these additional items and services are due after you have requested them, and; you have received and have been billed for them. Within 30 days of receiving an item or service, EXHIBIT "A" you have the right to ask us for an itemized financial statement that briefly but clearly describes each item and the amount charged for it. You will be given an updated listing of services and related charges, including any charges for services not covered under Medicai'e or by the facilities basic per diem charges, annually on or about January 1 of each year. Medicare Residents We participate in the Medicare Program. Medicare may pay for some or all of your nursing home care. For information on Medicare, see Exhibit 3. If you are eligible for Medicare, you have the right to have claims for your nursing home care submitted to Medicare. Medicaid Residents We participate in the Medicaid program. For information on Medicaid, see Exhibit 3. You are not required to give up any of your rights to Medicaid benefits to be admitted or to stay here. If your private funds are used up during your stay here and you are eligible for Medicaid; we will accept Medicaid payments although Medicaid may require you to pay some amount in addition to ~vhat Medicaid pays for your care. If you are planning on applying to Medical Assistance later, you may want to find out now if your are "medically eligible" for nursing home payment by Medicaid. You are responsible for applying for and obtaining Medicaid benefits and we will assist you. We may not charge, ask for, accept or receive any gift, money, donation or consideration other than Medicaid reimbursement as a condition of your admission or continued stay here except that Medicaid may require you to pay certain amounts from your private funds. If you receive Medicaid, most of your nursing home charges such as room, board, and general nursing care are covered. For a list of services covered by Medicaid, see Ex}fibit 4.A. The local Board of Assistance will tell you whether you have to pay part of the charge for your care and, if so, how much. Some of the items and services that we offer are not covered by Medicaid. If you want any items or services, which are not covered by Medicaid, you or your representative will have to pay for them. A list of the items and services not covered by Medicaid and the charges for them are in Exhibit 4.B. Payment for items and services that are not covered by Medicaid is due after you have requested them, and; have received and have been billed for them. Within 30 days of receMng the item or service, you have the right to ask us for an item/zed statement that briefly but clearly describes each item and the amount charged for it. Increases in Charl~es and Fees .4aV time we increase a fee or charge for item or service or add a new item or service, we will provide you and your representative with 30 days advance written notice. Penalties V','e may not charge you interest if you pay your bill in time. Your payment is on time if it is made within 45 days of the date the bill is post marked, or 30 days after the end of' the billing period, ~vhichever is later. The penalty we charge is 5% of'the amount due, calculated on a per day basis. If you or your representative do not pay the money you owe us and we hire a collection agency or attorney, you agree to be liable for their fees and court costs. Private Duty Nurses Geriatric Aides If you want a private duty nurse or a private duty geriatric aide, you are responsible for selecting a person licensed and/or certified according to Pennsylvania laws and regulations. You are also responsible for paying him or her and for letting us know that you have hired one. The person you hire is not an employee or agent of the facility, but he or she must meet our standards and follow our policies and procedures. Employees of the Facility may not serve as private duty nurses or private duty geriatric aides. ltoldino~ Your Bed if You Leave the Facility If you are hospitalized or on leave from the Facility, we will hold your bed for you as follows: If you are private-pay resident, or arc receiving inpatient care reimbursed under Medicare Program (and you are not covered under Medicaid), unless you notify us othenvise, we will hold your bed for as long as you pay for it at the daily rate you are currently being charged. If Medicaid pays for part or all of your nursing home care and you need to be hospitalized, we will hold your bed for up to the maximum number of days required by this state, currently 15 days. If you leave for an>' other reason, we will hold your bed for up to the maximum number of days required by this state, currently 18 days. You have a right to be readmitted to the facility to the first available appropriate bed. While we are holding your bed, you are still required to pay the Facility any amount for which you are liable as determined by the Medicaid Program. If you have applied for Medicaid, your bed will be reserved in accordance with Paragraph B. However, if you are found to be ineligible for Medicaid, then you are required to pay for the bed as a private pay resident as described in Paragraph A. Other third-party payers may or may not have a bed hold policy. We will discuss this if it applies to you. Your Ri~oht to Make Complaints and Suffeest Chan~es in Policies and Services As a nursing home resident, you have many rights according to State and Federal law. These are described in detail in Exhibit 6, which is attached and is part of this Contract. You may make complaints about your care in the Facilky and you may also suggest changes in the policies and services of the Facility. You will not be harassed or discriminated against for making a complaint or suggesting a change in a policy or service. You may present your complaints to facility, management company or to one of the following State agencies: Larry D. Cottle, LNHA Administrator Shippensburg Health Care Center 121 Walnut Bottom Road Shippensburg, PA 17257 717-530-8300 Peter E. Perini, Sr. President Magnolia Management, Inc. 1710 Underpass Way Hagerstown, MD 21740 301-745-8700 Ombudsman Office of Aging 16 West High Street Carlisle, PA 17013 717-240-6110 717-532-7286 Ext. 6110 Department of Health 100 North Cameron Street 2"~ Floor Harrisburg, PA 17101 717-783-3790 Your Right to Make Decisions You have the right to make your own medical decisions and to manage your personal affairs. If you become disabled, it may be necessary for someone else to make decisions for you. For this reason, we recommend that you have a living MIl and/or advance directive for medical decisions and a financial Power of Attorney but you are not required to do so. See Exhibit 7 for a description of your legal rights to decide about your future medical treatment. Transfer. Relocation and Discharge You have the right to remain here, and you may not be transferred, relocated or discharged against your will, except for the following reasons: (1) A medical reason (i.e. the facility cannot provide the kind of care that you need, your condition has improved so that you no longer need the care we provide, or a medicaI emergency arises; (2) Your welfare or the welfare of other residents or staff; (3) Nonpayment for a stay, or (4) the Facility ceases to operate. If we decide that you should be transferred or discharged, we will notify you, and an immediate family member or legal representative, by letter 30 days in advance. If you are transferred because of an emergency situation, we will provide the required notice as soon as practicable. The letter will contain the reasons for the transfer or discharge and its effective date. The letter will also tell you how you can appeal our decision to transfer or discharge you. If you are discharged involuntarily, we will attempt to make other appropriate arrangements for your care. However, if other arrangements are not available, your representative agrees to accept you into his or her custody if it is medically appropriate. Your Right to End This Contract If you decide to end this Contract and leave the Facility, you must pay your bill before you leave. You must give us five (5) days written notice to terminate this contract. If you leave before the end of that time, you must still pay for each day of the required notice. In the event you die while a resident of the facility, your representative is responsible for making the funeral arrangements. We will notify your representative immediately. If we .are unable to reach your representative, we will contact the funeral home of your choice to facilitate arrangements. Additional Documents It is not possible to cover everything that is important to your stay in our Facility in the body of this Contract. Therefore, we have included additional important documents as Exhibits. These Exhibits are part of this Contract. Please veri~ that you received the Exhibits and that the contents of the Exhibits were explained to you by placing your initials on the line next to the description of each Exhibit. Exhibit 1. Rights and Obligations of Representatives. Exhibit 2. For Private Pay Residents: (a) Items and services covered by daily rate. (b) Items and services not covered by daily rate. Exhibit 3. How to Apply For and Use Medicare and Medicaid Benefits. __ Exhibit 4. (a) Items and Services Covered by Medicaid. (c) Items and Services Not Covered by Medicaid. __ Exhibit 5. Physicians Who Practice at the Facility. __ Exhibit 6. Legal Rights of Pennsylvania to Decide Future Medical Treatment. __ Exhibit 7. Policies and Procedures Concerning Your Personal Funds and Your Personal Property. __ Exhibit 8. Services Provided by Outside Health Care Providers. Chan~es in Law An3' provision of this Contract that is found to be invalid or unenforceable as a result of a change in State or Federal law will not invalidate the remaining provisions of this Contract. If there are sen'ices we have agreed to provide that are later found to be impossible to render as a result of a change in State or Federal law, it is agreed that to the extent possible, the Resident and the Facility will continue to fulfill our respective obligations under this Contract consistent with the law. Witness uSgippensburg Health Resident If the Resident has been adjudicated disabled or the Resident's doctor determines that the Resident is incapable of understanding or exercising his or her rights and responsibilities, the Facility may require the signature of another person on this contract. The other person may be: (1) An appointed healthcare agent under an advance directive for medical care; (2) A guardian or Power of Attorney of the person; (3) A surrogate or family member. Witness Responsible Party ('Name) Title: Indicate whether you are (1), (2) or (3) STATEMENT SHIPPENSBURG HEALTH CARE CTR 121 WALNUT BO'II'OM RD SHIPPENSBURG, PA 17257 Facility Phone: 717-530-8300 Resident: MARY DiTULLIO ORRSTOWN BAN K .BA.T-~*t' 77 E. KING STREET SHIPPENSBURG, PA 17257 Date Service Through Qty Description Char.qes 12/01/03 09/04/03 09/30/03 27 Room Charges 12/01/03 10/01/03 10/31/03 31 Room Charges 12/01/03 11/01/03 11/30/03 30 Room Charges 12/31/03 12/01/03 12/31/03 31 Room Charges Cash Receipts/Adiustments 10/30/03 10/21/03 10/21/03 12/01/03 11/18/03 11/18/03 Payment Payment Statement Date: 12/31/03 Sub Total Balance Sub Total Balance Amount 4,968.00 5,714.00 5,670.00 5,859.00 22,211,00 22,211.00 -7.00 -7.00 -14.00 22,197.OO Ancillarv/Other CharQes 10/21/03 10/21/03 10/21/03 1 CABLE 11/18/03 11/18/03 11/18/03 1 CABLE 12/24/03 12/24/03 12/24/03 1 CABLE Sub Total Balance as of: 12/31/03 Total Amount Due 7.00 7.00 7.00 21.00 22,218.00 22,218.00 EXHIBIT "B" SHERIFF'S RETURN CASE NO: 2004-01134 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SHIPPENSBURG SOUTH HAMPTON VS DITULLIO MARY M - OUT OF COUNTY R. Thomas Kline duly sworn according to law, and inquiry for the within named DEFENDANT , DITULLIO MARY M but was unable to locate Her in his bailiwick, deputized the sheriff of FRANKLIN County, serve the within COMPLAINT & NOTICE , Sheriff or Deputy Sheriff who being says, that he made a diligent search and to wit: He therefore Pennsylvania, to On April 14th , 2004 , this office was in receipt of the attached return from FRANKLIN Sheriff's Costs: Docketing 18.00 Out of County 9.00 Surcharge 10.00 Dep Franklin Co 34.90 ,00 71.90 04/14/2004 OBRIEN BARIC SCHERER SO answer R. Thomas Kiine Sheriff of Cumberland County Sworn and subscribed to before me this /~ day of ~y ~3~/ A.D. z Prothonotary~ ~ T~e Court of Common Pleas of Cumberland County, Pennsylvania Shippensburg South H~pton M~nor LP VS. Mary M. Ditullio 04-1134 civil No. iN'OW, March 18, 2004 hereby deputize the Sheriffof Franklin deputation being made at the request and risk of the Plaintiff. Sheriff of Cumberland County, PA , I, SHERIFF OF CUMBERLAND COUNTY, PA, do County to execute this Writ, this Affidavit of Service Now, ~c~£~\ T-n3 ,20Orr,at RT/~ o'clock ~ M. servedthe within by handing copy of the original and made known to 'D-lOr'~ ~ '~)~'}cx(tlz~ So answer$~ Sworn and,~cribed before me this c~'4'~ay ~'~_.~, 20 ~¥5 the contents thereof. Sheriff of ¢'r'o ~/r' ),',~ COSTS sERVICE MII.EAGE AFFIDAVIT County, PA SHERIFF'S RETURN - CASE NO: 2004-01130 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GREENPOINT CREDIT LLC VS PARSONS JENNIFER J ET AL REGULAR KENNETH GOSSERT , Cumberland County, Pennsylvania, says, the within COMPLAINT - REPLEVIN PARSONS JENNIFER J DEFENDANT , at 1015:00 HOURS, at 86 RUSTIC DRIVE SHIPPENSBURG, PA 17257 JENNIFER PARSONS a true and attested copy of COMPLAINT - REPLEVIN Sheriff or Deputy Sheriff of who being duly sworn according to law, was served upon on the 24th day of March by handing to the 2004 together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 13.80 Affidavit .00 Surcharge 10.00 .00 41.80 Sworn and Subscribed to before me this j~ ~ day of /P'rothonoZary So Answers: R. Thomas Kline 04/14/2004 VOELKER & ASSOC SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2004-01130 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND GREENPOINT CREDIT LLC VS PARSONS JENNIFER J ET AL R. Thomas Kline duly sworn according to law, and inquiry for the within named DEFENDANT BONNER SCOTT W but was unable to locate Him deputized the sheriff of LEHIGH serve the within COMPLAINT , Sheriff or Deputy Sheriff who being says, that he made a diligent search and to wit: in his bailiwick. County, - REPLEVIN He therefore Pennsylvania, to On April 14th , 2004 attached return from LEHIGH Sheriff's Costs: Docketing 6.00 Out of County 9.00 Surcharge 10.00 Dep Lehigh County 37.00 .00 62.00 04/14/2004 VOELKER & ASSOC Sworn and subscribed to before me this ]{~ day of 0~ ~loo4 A.D. t Prothonotary ' this office was in receipt of the So answers: R. Thomas Kline Sheriff of Cumberland County Ih The Court of Common Pleas of Cumberland County, Pennsylvania Greenpoint C~dit LLC VS. Jennifer J. Parsons et al SERVE: Scott Wo Bonner No. 04-1130 civil Now, March 25, 2004 , I, SHERIFF OF CUMBERLAND COUNTY, PA, do hereby deputize the Sheriff of Lehigh County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. Sheriff of Cumberland County, PA Now~ within upon at by handing to a and made known to Affidavit of Service ,20 , at o'clock copy of the original So answers, M. served the the contents thereof. Sworn and subscribed before me this __ day of ,2O Sheriff of COSTS SERVICE MILEAGE AFFIDAVIT County, PA PAID V S (CL,.IYtBE:RL.AND SHIPPENSBURG/ SOUTH HAMPTON MANOR, L.P. Plaintiff, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2004-1134 CIVIL TERM MARY M. DITULLIO Defendant. CIVIL ACTION-LAW TO: PRAECIPE TO DISCONTINUE Curtis Long, Prothonotary Please mark the above-captioned action as being discontinued without prejudice. O'BRIEN, BARIC & SCHE~R David A. Baric, Esquire Attorney for Plaintiff Shippensburg/South Hampton Manor, L.P. SHIPPENSBURG/ : SOUTH HAMPTON MANOR, L.P.: Plaintiff, : MARY M. DITULLIO : Defendant. : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2004-1134 CIVIL TERM CIVIL ACTION-LAW CERTIFICATION OF SERVICE I hereby certify that on July 13, 2004, I, David A. Baric, Esquire, of O'Brien, Baric & Scherer, did serve a copy of the PRAECIPE TO DISCONTINUE, by first class U.S. mail, postage prepaid, to the party listed below, as follows: Mary M. Ditullio 745 Nofland Avenue Chambersburg, PA 17201-4211 David ,4.. Baric, Esquire Attorney for Plaintiff