HomeMy WebLinkAbout04-2873IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V.
PHYLLIS CAROTHERS,
Defendant.
NOTICE
No. ny -- aP?U
CIVIL ACTION - EQUITY
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 OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 S. Bedford Street
Carlisle, PA 17013
(717) 249-3166
(800) 990-9108
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V. No.
PHYLLIS CAROTHERS,
Defendant. : CIVIL ACTION -EQUITY
AVISO
USTED HA SIDO DEMANDADO/A EN COUTE. Si usted desea defenderse de
las demandas que se presentan mas adelante en las siguientes paginas, debe tomar
accion dentro de los proximos veiente (20) dias despues de la notificacion de esta
Demanda y Aviso radicando personalmente o por medio de un abogado una
comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objeccionee
a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de
tomar accion como se describe anteriormente, el caso puede proceder sin usted y un
fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra
reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya
por la Corte sin mas aviso adicional. Usted pued perder dinero o propiedad u otros
derechos importantes para usted.
USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO
INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE
A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE
PUEDE ENCONTRAR ASISTENCIA LEGAL.
Cumberland County Bar Assoication
32 S. Bedford Street
Carlisle, PA 17013
(717) 249-3166
(800) 990-9108
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V.
No. O4 - .203
PHYLLIS CAROTHERS,
Defendant.
CIVIL ACTION - EQUITY
COMPLAINT
C?ti?l. !E/tY?'1
AND NOW, COMES, Plaintiff, Manor Healthcare Corp. d/b/a ManorCare
Health Services - Carlisle, ("Plaintiff ManorCare'), by and through its attorneys,
KENNEDY BOGAR LLC, and files the within complaint against Defendant, Phyllis
Carothers, and in support thereof, provides as follows:
Plaintiff ManorCare is a Delaware corporation licensed to do business in
the Commonwealth of Pennsylvania, with its principal offices located at 940 Walnut
Bottom Road, Carlisle, Pennsylvania 17013.
2. Defendant Phyllis Carothers is an adult individual who currently resides
at 154 Lincoln Street, Carlisle, Pennsylvania 17013.
5. On or about October 8, 2003, Defendant Phyllis Carothers made
application on behalf of her Mother, Christine Brady, for admission to Plaintiff
ManorCare's skilled nursing facility.
6. On or about October 8, 2003, Plaintiff ManorCare and Defendant Phyllis
Carothers entered into a written Admission Agreement ("Agreement"), pursuant to
which Plaintiff ManorCare agreed to provide Defendant Phyllis Carothers' Mother with
skilled nursing care and services in exchange for her promise to pay a specific monetary
fee from Catherine Brady's assets and to make timely and proper application for
Medical Assistance benefits on Ms. Brady when she became eligible for such assistance
and pursuing any subsequent appeals if said application was denied. A true and
correct copy of the Agreement is attached hereto as Exhibit "A".
8. Shortly after Christine Brady's admission to Plaintiff ManorCare's skilled
nursing care facility, Ms. Brady allegedly became insolvent. As a result, pursuant to the
Agreement Plaintiff ManorCare notified Defendant Phyllis Carothers of her contractual
duty to make application for Medical Assistance, and she subsequently filed an
application for Medical Assistance benefits on her Mother's behalf.
9. The application for Medical Assistance benefits referenced above was
denied on June 3, 2004, because Defendant Phyllis Carothers failed to provide to the
Cumberland County Assistance Office certain financial information.
10. Subsequently, Plaintiff ManorCare timely filed an appeal of the
Cumberland Assistance Office's denial of Catherine Brady's application for Medical
Assistance benefits, and said appeal is currently pending before the Pennsylvania
Bureau of Hearings and Appeals.
11. If Defendant Phyllis Carothers fails to provide the documents requested
by the Cumberland County Assistance Office prior to or at the time of the hearing
scheduled on the aforementioned appeal, it will be denied, and any further appeal to
the Commonwealth Court would be without merit.
COUNTI
BREACH OF CONTRACT/ SPECIFIC PERFORMANCE
Plaintiff ManorCare v. Defendant Phyllis Carothers
12. The allegations contained in Paragraphs 1 through it are incorporated
herein by reference as if fully set forth at length.
13. Defendant Phyllis Carothers breached her Agreement with
Plaintiff ManorCare when she refused to make complete and proper application for
Medical Assistance benefits when her Mother, Christine Brady, qualified for such
benefits, and she continues to breach her Agreement with Plaintiff ManorCare by
refusing to properly pursue the aforementioned appeal.
14. Defendant Phyllis Carothers' breach of her Agreement with Plaintiff
ManorCare has irreparably harmed and continues to cause irreparable harm it.
15. Only a decree of specific performance will adequately protect the interests
of Plaintiff ManorCare and provide it with the benefits and/or protections promised
under the Agreement.
WHEREFORE, Plaintiff ManorCare seeks a decree from this Honorable Court
which orders specific performance of the Agreement between the parties.
Respectfully submitted,
KENNEDY BOGAR LLC
Dated: By ek k ? '
Chadwick O. Bogar
Attorney I. D. No. 83755
Bradley A. Schutjer
Attorney I.D. No. 75954
P.O. Box 959
Camp Hill, PA 17001-0959
717.909.5290
Attorneys for Plaintiff
4
Rx. Date/Time JUN-14-2004(MON) 13:44 717 249 0647
JUN 14 2004 15.26 FR MANOR CARE-CARLISLE 717 249 0647 TO 9095925
JUN-I4-2004(MON) 10:38 Kenneoy / 6^9ar LLC (FAX)717 909 5925
'VE URCATION
The undersigned hereby verifies that the statements of fact in the foregoing
P. 002
P. 02/02
P, 006/006
Complaint are true and correct to the best of my knowledge, information and belief. I
understand that any false statements therein are subject to the penalties contained in 1S
Pa. CS.A. § 4904, relating to unworn falsification to authorities.
Dated: &j14'7
S
JUN 14 2004 12:19
Amy M Director of Finance
717 909 5925 PonF.PA
** TOTAL PAGE.02 **
EXHIBIT "A"
HCR Manor Care
ADMISSION AGREEMENT
Pennsylvania
This Agreement is entered into by and among Manor Care Health Services, d.b.a. HCR
Manor Care ("HCR Manor Care"), the Resident, and the Responsible Party, if any, for the
purpose of providing for the rights and responsibilities of the parties with respect to the
Resident's stay at this HCR Manor Care's Center ("Center").
Center: MCHS-Carlisle
Resident: Christine R. Brady
Responsible Party: Jennifer Reid
Admission Date: 09/16/2003 Deposit: $ 0
Term: This Agreement begins on the day the Resident enters the Center and ends on the
day the Resident is discharged unless the Resident is readmitted within fifteen (15)
days of the Resident's discharge date.
I. RIGHTS AND RESPONSIBILITIES OF THE RESIDENT
1.01 Room and Board Rate. For the basic services provided for in Section 3.01, the
Resident will pay the applicable Room and Board Rate set forth on Attachment A hereto. The
Room and Board Rate is subject to change upon thirty (30) days written notice. The Room and
Board Rate set forth in Attachment A is payable in advance and is due upon receipt. The
Resident is responsible for the Room and Board Rate for the day of admission as well as the day
of discharge. This Section will not apply if the Resident is covered under a governmental
program (see Section 1.05) or by a third party payor or managed care organization (see Section
1.06).
1.02 Ancillary Charges. The Resident will pay to Center all charges for additional
medical, therapeutic, or personal care services or supplies that may be requested by the Resident,
ordered by the attending physician, or provided in the Resident's Plan of Care. The Center
reserves the right to charge for personal care items of the Resident if necessary for the well-being
of the Resident. Such "Ancillary Charges" are described on Attachment B hereto, and a current
ancillary charge list is maintained at the Center's business office for review during regular business
hours. Ancillary Charges will be included in the Resident's statement for the succeeding month,
and are payable in full, along with the Room and Board Rate upon receipt.
1.03 Collections/Late Pavments. Payment is due in full within thirty (30) days of billing.
Should the Resident's account for any reason be turned over for collection, the Resident will pay
the Center's collection costs, including attorney's fees.
1.04 Independent Providers. The Resident is directly responsible to independent
providers, including but not limited to, the Resident's attending physician for any health or
personal program in accordance with the terms of the program.
1.05 Governmental Programs. If the Resident is eligible for coverage under any
governmental program, such as Medicare, Medicaid, or through the Veterans Administration, and
the Center participates in such program, the Center will accept payments under such program in
accordance with the terms of the program as set forth in the contract the Center has with the
program. The Resident is responsible for any co-insurance, deductibles or non-covered charges,
according to the same terms and conditions applicable to private pay residents. The Resident
must comply with all program requirements. In the event the Resident's coverage under the
governmental program(s) cease for any reason, the Resident will be charged at the Center's rate
for private pay residents in accordance with Sections 1.01 and 1.02.
The Center participates in the following programs: -x-Medicare, _x Medicaid and/or _VA.
Medicare may pay for some or all of the Resident's care. If Medicare agrees to pay for the
Resident's care, there is a required co-payment, which Medicare updates yearly. If the Resident
also participates in Medicare Part B, for physical, occupational, or speech therapy or other billable
charges (which are not covered by Medicare Part A), the Resident agrees to pay any required
deductible, any required co-insurance, and any non-covered services according to the same terms
and conditions applicable to private pay residents. The Resident and/or Responsible Party are
responsible for applying for Medicaid. If the Resident receives Medicaid, most of the Center
charges such as Room and Board and nursing services are covered, although Medicaid may
require the Resident to pay a portion of the Room and Board Rate from their monthly income.
The Resident agrees to pay on a timely basis, as set forth in this Agreement, the contribution
amount as determined and periodically adjusted by the State and/or local department(s) handling
Medicaid. If the Resident fails to pay the contribution amount, the Center may take such legal
action as necessary, including requesting a court to order such payment.
1.06 Third Partv Pavors and Managed Care Organizations. If a Resident is a participant
in a plan offered by a third party payor such as a Health Maintenance Organization ("HMO"),
Preferred Provider Organization ("PPO"), Provider Sponsored Organization ("PSO"), or
Physician Hospital Organization ("PHO"), indemnity plan or another similar entity with which the
Center has executed a provider agreement, the charges are governed by the applicable agreement.
The Resident is responsible for any co-payments, deductibles or non-covered charges, according
to the same terms and conditions applicable to private pay residents. If the Center has not
executed a provider agreement with the Resident's third party payor, the Center
2
will bill the Resident's third party payor as a service, but the Resident remains liable for charges
not paid or covered by that third party payor including charges not paid within a reasonable
period of time.
1.07 Private Pay Resident. The Resident is responsible for paying the Center for items
and services provided during the stay at the Center and during which time the Resident has not
been determined to be eligible for any governmental program or covered under any third party
payor or managed care organization plan. The Resident and/or Responsible Party will notify the
Center promptly if there is insufficient income or assets to meet the financial obligations to the
Center or to make prompt application to Medicaid for benefits. The Resident and/or Responsible
Party will notify the Center in writing when application to Medicaid is made. The Resident and/or
Responsible Party will cooperate fully in applying for Medicaid and in the eligibility determination
process. If the Resident is no longer able to pay for care at the Center or to have payment made
on the Resident's behalf, the Resident will be notified of the Center's intention to discharge the
Resident for non-payment in accordance with this Agreement, Resident Handbook and state and
federal laws.
1.08 Admission Information. The Resident and/or Responsible Party will notify the
Center and provide any needed information regarding all third party payors or governmental
coverages on admission and throughout the Resident's stay including copies of insurance cards,
identification or verification of eligibility and coverage information.
The Resident and/or Responsible Party will provide the Center in writing with
notice within five (5) davs of the Resident's disenrollment, enrollment, change in health care
coverage, failure to pay premium(s) or renewal of insurance coverage and any cancellations in
coverage as the Center relies on the information supplied regarding such coverage. The Resident
acknowledges that if the Resident fails to provide such information, the Resident may be
responsible for any denied charges due to lack of authorization, ineligibility, non-coverage or
other costs associated with the failure to provide such notice in accordance with the terms and
conditions of this Agreement.
1.09 Application for Benefits. The Resident and/or Responsible Party will apply for
coverage and to establish eligibility under any governmental, third party payor, managed care or
private insurance program. The Center has no obligation to bill any third party payor other than
the Responsible Party and, when applicable, a governmental program third party payor or
managed care organization with which the Center is under contract.
1.10 Primary Responsibility for Payment. Except for payments for services covered
under governmental programs or other third party payor provider agreements, the Resident
remains primarily liable for any and all charges for which the Center may agree to bill a third
party. The Resident and/or Responsible Party acknowledge that the insurance company, HMO,
PPO, PSO, PHO or managed care provider may not pay for non-covered services, supplies,
equipment, medications, and other care and services which may be delivered by the Center or its
subcontractors. This agreement serves as a written notice that the Center has notified the
Resident and/or Responsible Party that services provided at the Center may not be covered by a
3
governmental payor, third party payer or managed care organization. The Resident and/or
Responsible Party will be responsible for non-covered services. A price list of services is
maintained at the Center's business office and is available for review during regular business
hours.
1.11 Personal Physician. The Resident has the right to choose a personal physician,
provided that the physician selected is properly licensed and abides by applicable law and the rules
and policies of the Center. At the time of admission, the Resident must supply the Center with the
name of his/her personal physician. If the Resident changes physicians at any time after
admission, the Resident and/or Responsible Party must immediately notify the Center of the new
physician's name. If the physician chosen by the Resident fails to provide needed coverage and
attendance or fails to abide by applicable laws and regulations, the Center will call another
physician to attend to the Resident and the fees charged by such physician will be borne by the
Resident.
1.12 Pharmacy. The Resident and/or Responsible Party has the right to choose a
pharmacy of choice, provided the pharmacy selected is properly licensed, packages and supplies
pharmaceuticals in accordance with state law, abides by the Center's policies and procedures and
has a medication distribution system similar to the Center's ancillary pharmacy's medication
distribution system.
H. RIGHTS AND RESPONSIBILITY OF THE RESPONSIBLE PARTY
2.01 Legal Authority. The Responsible Party represents that he/she has legal access to
the Resident's income or resources and that the documents supporting such authority, if any, have
been delivered to the Center.
2.02 Agreement to Make Payments on Behalf of Resident. The Responsible Party will
pay promptly from the Resident's income or resources all fees and charges for which the Resident
is liable under this Agreement. The Responsible Party will incur personal financial liability on
behalf of the Resident should the Responsible Party fail to pay the charges for which the Resident
is liable under the agreement from the Resident's income or resources.
2.03 Requested Items. The Responsible Party will be personally liable for any services
or products specifically requested by the Responsible Party to be supplied to the Resident, unless
such services or products are covered by a governmental program.
2.04 Exhaustion of Resident's Funds. If the Resident's financial resources change such
that the Resident may be eligible for Medicaid, the Resident and/or Responsible Party must notify
the Center in writing and must promptly apply for Medicaid benefits. If the Resident and/or
Responsible Party fails to notify the Center in writing or fails to file for Medicaid or provide such
information as Medicaid representatives may require to qualify the Resident for eligibility to
Medicaid, the Center may end this agreement and transfer or discharge the Resident for
nonpayment upon reasonable and appropriate notice, as provided in Section 4.06. In addition, if
the Responsible Party fails to notify the Center in writing or fails to file for Medicaid in a timely
4
and proper manner, the Responsible Party will be personally liable for all charges and fees not
covered by Medicaid which otherwise would have been covered had application been made in a
timely and proper manner.
2.05 Cooperation for Financial Assistance. If the Resident is eligible for Medicaid, the
Responsible Party must provide such information about the Resident's finances as Medicaid
representatives require for continued coverage of the Resident and be personally responsible for
any charges denied the Center due to any lack of cooperation. If the Resident and/or Responsible
Party fail to provide such information as Medicaid representatives require for continued eligibility
for Medicaid payments, and as a result Medicaid does not pay for the Resident's care, the
Resident may be discharged or transferred upon appropriate and reasonable notice for
nonpayment, as provided in Section 4.06.
2.06 Acceptance Upon Discharge. Upon termination of this Agreement as provided in
the Resident Handbook, the Responsible Party agrees to arrange and pay for the departure of the
Resident from the Center. If after notice, the Resident is not removed as requested, then the
Center is authorized and empowered to remove the Resident by reasonable means of
transportation and to deliver the Resident to the residence address of the Responsible Party, if the
Resident's condition permits, who shall unconditionally be obligated to accept the Resident or
immediately make medically appropriate alternative arrangements and to pay promptly all charges.
2.07 Additional Responsibilities. The Responsible Party will comply with the other
duties and responsibilities for the Resident and to the Center as set forth in this Agreement,
Resident Handbook, and Attachments.
2.08 Misuse of Resident Funds. In the event that the Responsible Parry misappropriates
the Resident's income or resources or otherwise illegally transfers assets for purposes of avoiding
the Responsible Party's obligation to make payments on behalf of the Resident under Section 2.02
or for purposes of qualifying the resident for Medicaid eligibility, the Responsible Party may be
liable to the Medicaid agency and/or the Center for care that should have been paid for from the
Resident's income or resources. Such misappropriation of the Resident's income or resources
may also result in the imposition of criminal or civil sanctions against the Responsible Party.
III. RIGHTS AND RESPONSIBILITIES OF THE CENTER
3.01 Room and Standard Services. As part of the Room and Board Rate, the Center
will furnish basic room, board, common facilities, housekeeping, laundered bed linens and
bedding, general nursing care, personal assessment, social services, and such other personal
services as may be required pursuant to the plan of care prepared by the Resident's physician and
the Center, with the Resident's consent, for the health, safety and general well-being of the
Resident.
3.02 Other Services. The Center will act in accordance with the Resident Handbook,
which is incorporated by reference in this Agreement.
5
3.03 Deposit. The Center acknowledges receipt of the Deposit, if any, noted at the
beginning of this Agreement. The Deposit will be applied to the charges for the first month of the
Resident's stay at the Center.
3.04 Refunds. Any refund owed to the Resident for advance payments will be paid by
the Center within thirty (30) days after discharge or transfer or within the time frame required by
State law. In the case of Medicaid Residents, any such refund will be paid within thirty (30) days
of the Center's receipt of the final Medicaid payment for care of the Resident.
IV. GENERAL PROVISIONS
4.01 Consent to Release of Information. The Resident and/or Responsible Party hereby
consents to the release of the Resident's medical records to the following persons: Center
personnel, attending physicians and consultants; any person, firm, government entity, third party
payor or managed care organization responsible for all or any part of the payment or
reimbursement of the Resident's charges, including any utilization review or quality assurance
reviews or payment audits performed by such; the personnel of any hospital or other health care
facility or provider to whom or which the Res dent may be transferred; the Center's liability
insurance carrier; and any person authorized by la to review the medical records.
4.02 Consent to Treat. The Resident
disclosure of Resident's protected health informa
the Center, obtaining payment for healthcare ser%
healthcare operation needs. The Resident and/o
authorizes the appropriate staff of the Center
(hereinafter "Treatment") as are necessary to m.
but not limited to, assistance with bathing, hyg
general nursing care, the administration of medi
therapies, as prescribed by the Resident's person
required from time to time in the exercise of
provided to the Resident by federal and/or state h
nd/or Responsible Party consent to the use and
on for the purposes of receiving treatment from
:es provided to Resident, and the Center's own
Responsible Parry, by signing this Agreement,
o perform such functions, care and services
ntain the well-being of the Resident, including
ne, dressing, toiletry, and daily activities; and
ttions and treatments, and the performance of
physician in the Resident's Plan of Care, or as
;ood nursing judgment, subject to any rights
As applicable, the undersigned R
legal authority to make health care decisions on b
such authority have been delivered to the Cente
behalf of the Resident to the Treatment described
4.03 Consent to Photograph. The R
Center taking a photograph of Resident for use
photograph in the Medication Administration R
uses of the photograph for Center and staff to id
4.04 Notice of Services. Policies and t?
Responsible Party acknowledge that the items lister
copies of the items or policies and procedures, if
ponsible Party represents that he/she has the
alf of the Resident, that documents supporting
and that such Responsible Party consents on
lent and/or Responsible Party consent to the
identifying the Resident, for placement of the
rd or other records and for any other similar
fv the Resident,
dditional Information. The Resident and/or
below have been explained and have received
applicable. The Resident and/or Responsible
6
Party acknowledge they have had the opportunity to ask questions and questions have been
answered satisfactorily.
a. Assignment for Payment of Benefits. See Attachment C.
b. SNF Medicare Determination Notice. See Attachment D.
c. Medicare Secondary Payor Questionnaire. See Attachment E.
d. At the request of the Resident and/or Responsible Party, the Center will
maintain the Resident's personal funds in compliance with the laws and
regulations relating to the Center's management of such funds. A description
and/or policies and procedures of protection of resident funds and the Personal
Trust Fund Agreement, Resident Personal Funds Authorization and any other
related documents. See Attachments F-1 and F-2.
e. Center Supplement:
1. Policy and procedure on bedholds, election of bedholds and
readmission.
2. Social Service Agencies and Advocacy Groups addresses anc
phone numbers.
3. Name, address and phone number of Ombudsman.
4. Location in the Center where the names, addresses and telephone
numbers of state client advocacy groups, state survey and
certification agency, the state licensure office, the state ombudsman
program, the protection and advocacy network and the Medicaid
fraud control unit.
5. The name, specialty and way of contacting the attending physician,
medical director and other physicians who serve the Center.
6. Procedures, name, address and phone number on how to file a
complaint with the state survey and certification agency concerning
resident abuse, neglect, mistreatment and misappropriation of
property.
f. The Resident Handbook.
g. Resident/Patient Rights.
h. Medicare/Medicaid information and display of such information including
how to apply for and use Medicare and Medicaid benefits, and how to
receive refunds for previous payments.
7
i. Receipt of information on advance directives including a copy of "Refusal
of Life Sustaining Treatment", which summarizes HCR Manor Care's
Limited Treatment Practices and a copy of the State summary of its laws
governing the Resident's right to direct his/her medical treatment. See
Attachments G-1 and G-2.
j. Privacy Act Notification, See Attachment H.
k. Notice of Information Practices and Receipt of Notice of Information
Practices. See Attachments I-1 and I-2,
1. Ancillary Services Management Form. See Attachment J.
4.05 Assignment of Benefits. The Resident and/or Responsible Party request that
payment of authorized government and/or third party payor benefits as described in Sections 1.05
and 1.06, if any, be made as set forth in Attachment C to this Agreement either to Resident or on
Resident's behalf for any service furnished by or in the Center. The Resident and/or Responsible
Party authorize the Center and any holder of medical or other information to release such
information to the Centers for Medicare and Medicaid Services "CMS" and its agents and to third
party payors any information needed to determine these benefits or benefits for related services.
4.06 Termination, Discharge and Transfer. This Agreement may be terminated as set
forth below and as set forth in the Resident Handbook under the Section Heading "Discharge".
The Resident and/or Responsible Party may terminate this Agreement by providing the Center
written notice of the Resident's desire to leave at least seven (7) days in advance of the Resident's
departure. If the Resident leaves before the end of that time, the Resident must still pay for each
day of the required notice unless the Center fills the bed before the end of the notice period.
Except in the event of an emergency or death, the Resident will be responsible for all charges for
the Room and Board Rate and for all services performed up to the end of the day that the
admission ends. Discharge from the specialized units such as the Transitional Care Unit or
Subacute Unit may require less than seven (7) days notice.
If discharge or transfer becomes necessary because the Resident and/or Responsible Party or
someone else abused the Resident's funds, the Center will request that local, state and federal
authorities, as appropriate, investigate, which may result in prosecution.
4.07 Indemnification. The Resident will defend, indemnify and hold the Center harmless
from any and all claims, demands, suit and actions made against the Center by any person
resulting from any damage or injury caused by the Resident to any person or the property of any
person or entity (including the Center), except in the case of negligence of the Center's employees
and agents.
8
4.08 Changes in the Law. Any provision of this Agreement 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 Agreement and, it is agreed that to the extent possible, the Resident and the
Center will continue to fulfill their respective obligations under this Agreement consistent with the
law.
THE UNDERSIGNED CERTIFY AND ACKNOWLEDGE THAT THEY HAVE
EACH READ AND UNDERSTOOD THE FOREGOING AGREEMENT, AND THAT
THEY HAVE HAD AN OPPORTUNITY TO ASK QUESTIONS AND THAT ANY
QUESTIONS HAVE BEEN ANSWERED TO THEIR SATISFACTION.
Signature of Resident:
Signature of Responsible Parry: /I y -"./ a?sJ
Date:
Dater /Q--
Center Representative: Date: (c".
\J
?? ??
? ,
Gt -,
-n
? ? -r? , , -??>.?
?,
JUL 0 7 2004
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V. No. 04-2873 Civil Term
PHYLLIS CAROTHERS,
Defendant. : CIVIL ACTION -EQUITY
PLAINTIFF'S PETITION FOR PRELIMINARY INJUNCTION
AND NOW, COMES, Plaintiff, Manor Healthcare Corp. d/b/a ManorCare
Health Services - Carlisle, ("ManorCare') pursuant to the provisions of Pa. R.C.P. §
1531, and makes the following petition for preliminary injunction and, in support
thereof, avers:
On June 22, 2004, ManorCare filed its Complaint against
Defendant Phyllis Carothers.
2. The Complaint sets forth a single claim against Defendant Phyllis
Carothers' relating to her breach of an Admission Agreement ("Agreement"). See
Complaint, Exhibit "A."
3. The very nature of the breach of the Agreement, i.e., Defendant Phyllis
Carothers' failure to provide information requested by the Cumberland County
Assistance Office, presents an issue of immediate and irreparable harm to ManorCare.
5. The requested injunction would restore the parties to the status quo as it
existed immediately prior to Defendant Phyllis Carothers' breach of the Agreement.
6. Greater injury would result from the denial of the requested injunction
than from the granting of the same.
7. ManorCare's right to relief is clear.
8. ManorCare lacks an adequate remedy at law.
9. A bond in the amount of $100 should be adequate in the event that it is
later determined that the issuance of the instant petition was in error.
WHEREFORE, Plaintiff, ManorCare, respectfully requests that this Honorable
Court schedule an immediate hearing on its request for injunctive relief, and thereafter
issue a Decree ordering specific performance of the Agreement by and between the
parties hereto.
Respectfully submitted,
KENNEDY BOGAR LLC
Dated: 'l Id OL?
By 0
tadwick O. Bogar
Attorney I.D. No. 83755
(717) 909-5920
Bradley A. Schutjer
Attorney I.D. No. 75954
(717) 909-5921
P.O. Box 959
Camp Hill, PA 17001-0959
Attorneys for the Plaintiff
Rx Date/Time JUL-06-2004(TUE) 10:41 717 249 0547
.FUL 06 2004 12:24 FR MANOR CARE-CARLISLE 717 249 0647 TO 9095925 P.05i05
•?. "11.1 nanneuy / DDQar LLL (FPX)717 909 5925
VHRIFICATTON
The undersigned hereby verifies that the statements o£ fact in the foregoing
Petition for Preliminary Injunction are true and correct to the best of my knowledge,
information and belief. I understand that any false statements therein are subject to the
Penalties contained in 1S Pa. CS.A. § 4904, relating to unswarn falsification to
authorities.
Dated:_ (o dW
JUN 26 2004 10:25
P. 005
P 005/005
rn?
Amy h, ?
Dz?
A_`6iSttxn1 13usuKS6 A4 MBy.
'119 9rA0 ca^ic
** TOTAL PAGE.05 **
EXHIBIT "A."
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V.
PHYLLIS CAROTHERS,
Defendant.
No. 0q-.2PB
.: CIVIL ACTION -EQUITY
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 OR CANNOT AFFORD ONE., GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 S. Bedford Street
Carlisle, PA 17013
(717) 249-3166 c> N
(800) 990-9108 =
. ,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
v. No.
PHYLLIS CAROTHERS,
Defendant. CIVIL ACTION -EQUITY
AVISO
USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de
las demandas que se presentan mas adelante en las siguientes paginas, debe tomar
accion dentro de los proximos veiente (20) dias despues de la notificacion de esta
Demanda y Aviso radicando personalmente o por medio de un abogado una
comparecencia escrita y radicando en la Corte por escrito sus defensas de, y objeccionee
a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de
tomar accion como se describe anteriormente, el caso puede proceder sin usted y un
fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra
reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya
por la Corte sin mas aviso adicional. Usted pued perder dinero o propiedad u otros
derechos importantes para usted.
USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO
INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO O NO PUEDE PAGARLE
A UNO, LLAME O VAYA A LA SIGUIENTE OFICINA PARA AVERIGUAR DONDE
PUEDE ENCONTRAR ASISTENCIA LEGAL.
Cumberland County Bar Assoication
32 S. Bedford Street
Carlisle, PA 17013
(717) 249-3166
(800) 990-9108
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V. . No.
PHYLLIS CAROTHERS,
Defendant. : CIVIL ACTION -EQUITY
COMPLAINT
AND NOW, COMES, Plaintiff, Manor Healthcare Corp. d/b/a ManorCare
Health Services - Carlisle, ("Plaintiff ManorCare"), by and through its attorneys,
KENNEDY BOGAR LLC, and files the within complain]: against Defendant, Phyllis
Carothers, and in support thereof, provides as follows:
Plaintiff ManorCare is a Delaware corporation licensed to do business in
the Commonwealth of Pennsylvania, with its principal offices located at 940 Walnut
Bottom Road, Carlisle, Pennsylvania 17013.
2. Defendant Phyllis Carothers is an adult individual who currently resides
at 154 Lincoln Street, Carlisle, Pennsylvania 17013.
5. On or about October 8, 2003, Defendant Phyllis Carothers made
application on behalf of her Mother, Christine Brady, for admission to Plaintiff
ManorCare's skilled nursing facility.
6. On or about October 8, 2003, Plaintiff ManorCare and Defendant Phyllis
Carothers entered into a written Admission Agreement ("Agreement"), pursuant to
which Plaintiff ManorCare agreed to provide Defendant Phyllis Carothers' Mother with
skilled nursing care and services in exchange for her promise to pay a specific monetary
fee from Catherine Brady's assets and to make timely and proper application for
Medical Assistance benefits on Ms. Brady when she became eligible for such assistance
and pursuing any subsequent appeals if said application. was denied. A true and
correct copy of the Agreement is attached hereto as Exhibit "A".
8. Shortly after Christine Brady's admission to Plaintiff ManorCare's skilled
nursing care facility, Ms. Brady allegedly became insolvent. As a result, pursuant to the
Agreement Plaintiff ManorCare notified Defendant Phyllis Carothers of her contractual
duty to make application for Medical Assistance, and she subsequently filed an
application for Medical Assistance benefits on her Mother's behalf.
9. The application for Medical Assistance benefits referenced above was
denied on June 3, 2004, because Defendant Phyllis Carothers failed to provide to the
Cumberland County Assistance Office certain financial information.
10. Subsequently, Plaintiff ManorCare timely filed an appeal of the
Cumberland Assistance Office's denial of Catherine Bra.dy's application for Medical
Assistance benefits, and said appeal is currently pending before the Pennsylvania
Bureau of Hearings and Appeals.
11. If Defendant Phyllis Carothers fails to provide the documents requested
by the Cumberland County Assistance Office prior to or at the time of the hearing
scheduled on the aforementioned appeal, it will be denied, and any further appeal to
the Commonwealth Court would be without merit.
COUNTI
BREACH OF CONTRACT/ SPECIFIC PERFORMANCE
Plaintiff ManorCare v. Defendant Phyllis Carothers
12. The allegations contained in Paragraphs 1 through 11 are incorporated
herein by reference as if fully set forth at length.
13. Defendant Phyllis Carothers breached her Agreement with
Plaintiff ManorCare when she refused to make complete and proper application for
Medical Assistance benefits when her Mother, Christine Brady, qualified for such
benefits, and she continues to breach her Agreement with Plaintiff ManorCare by
refusing to properly pursue the aforementioned appeal.
14. Defendant Phyllis Carothers' breach of her Agreement with Plaintiff
ManorCare has irreparably harmed and continues to cause irreparable harm it.
15. Only a decree of specific performance will adequately protect the interests
of Plaintiff ManorCare and provide it with the benefits and/or protections promised
under the Agreement.
WHEREFORE, Plaintiff ManorCare seeks a decree from this Honorable Court
which orders specific performance of the Agreement between the parties.
Respectfully submitted,
Dated: 6 I`
KENNEDY BOGAR LLC
By?s? --
Chadwick: O. Bogar
Attorney 1. D. No. 83755
Bradley A. Schutjer
Attorney I.D. No. 75954
P.O. Box 959
Camp Hill, PA 17001-0959
717.909.5290
Attorneys for Plaintiff
ltx Uate/lime JUN- I4-2004(MON) 13:44 717 249 0647
JUN 14 2004 15:26 FR MANOR CARE-CARLISLE 717 249 0647 TO 9095925
JUN-la-2006(MON) 10:38 Kenneog / Boear LLC (FAX)717 909 5925
VERMCATION
P. 002
P. 02/02
P. 006/006
The undersigned hereby verifies that the statements of fact in the foregoing
Complaint are true and correct to the best of my knowledge, information and belief-. I
understand that any.false statements therein are subject to the penalties contained in 18
Pa. C.S.A. § 4904, relating to urwworn falsification to authorities.
Datcd: C?
Amy Marsk Director of Finance
5
EXHIBIT ".E?"
HCR Manor Care Pennsylvania
ADMISSION AGREEMENT
This Agreement is entered into by and among Manor Care Health Services, d.b.a. HCR
Manor Care ("HCR Manor Care"), the Resident, and the Responsible Party, if any, for the
purpose of providing for the rights and responsibilities of the parties with respect to the
Resident's stay at this HCR Manor Care's Center ("Center").
Center: MCHS-Carlisle
Resident: Christine R. Brady
Responsible Party: Jennifer Reid
Admission Date: 09/16/2003 Deposit: S 0
Term: This Agreement begins on the day the Resident enters the Center and ends on the
day the Resident is discharged unless the Resident is readmitted within fifteen (15)
days of the Resident's discharge date.
1. RIGHTS AND RESPONSEBILITIES OF THE RESIDENT
1.01 Room and Board Rate. For the basic services provided for in Section 3.01, the
Resident will pay the applicable Room and Board Rate set forth on Attachment A hereto. The
Room and Board Rate is subject to change upon thirty (30) days written notice. The Room and
Board Rate set forth in Attachment A is payable in advance and is due upon receipt. The
Resident is responsible for the Room and Board Rate for the day of admission as well as the day
of discharge. This Section will not apply if the Resident is covered under a governmental
program (see Section 1.05) or by a third party payor or managed care organization (see Section
1.06).
1.02 Ancillary Charges. The Resident will pay to Center all charges for additional'
medical, therapeutic, or personal care services or supplies that may be requested by the Resident,
ordered by the attending physician, or provided in the Resident's Plan of Care. The Center
reserves the right to charge for personal care items of the Resident if necessary for the well-being
of the Resident. Such "Ancillary Charges" are described on Attachment B hereto, and a current
ancillary charge list is maintained at the Center's business office for review during regular business
hours. Ancillary Charges will be included in the Resident's statement for the succeeding month,
and are payable in full, along with the Room and Board Rate upon receipt.
1.03 Collections/Late Payments. Payment is due in full within thirty (30) days of billing.
Should the Resident's account for any reason be turned over for collection, the Resident will pay
the Center's collection costs, including attorney's fees.
1.04 Independent Providers. The Resident is directly responsible to independent
providers, including but not limited to, the Resident's attending physician for any health or
personal program in accordance with the terms of the program.
1.05 Governmental Programs. If the Resident is eligible for coverage under any
governmental program, such as Medicare, Medicaid, or through the Veterans Administration, and
the Center participates in such program, the Center will accept payments under such program in
accordance with the terms of the program as set forth in the contract the Center has with the
program. The Resident is responsible for any co-insurance, deductibles or non-covered charges,
according to the same terms and conditions applicable to private pay residents. The Resident
must comply with all program requirements. In the event the Resident's coverage under the
governmental program(s) cease for any reason, the Resident will be charged at the Center's rate
for private pay residents in accordance with Sections 1.01 and 1.02.
The Center participates in the following programs: x_Medicare, _x Medicaid and/or _VA.
Medicare may pay for some or all of the Resident's care. If Medicare agrees to pay for the
Resident's care, there is a required co-payment, which Medicare updates yearly. If the Resident
also participates in Medicare Part B, for physical, occupational., or speech therapy or other billable
charges (which are not covered by Medicare Part A), the Resident agrees to pay any required
deductible, any required co-insurance, and any non-covered services according to the same terms
and conditions applicable to private pay residents. The Resident and/or Responsible Party are
responsible for applying for Medicaid. If the Resident receives Medicaid, most of the Center
charges such as Room and Board and nursing services are covered, although Medicaid may
require the Resident to pay a portion of the Room and Board Rate from their monthly income.
The Resident agrees to pay on a timely basis, as set forth in this Agreement, the contribution
amount as determined and periodically adjusted by the State and/or local department(s) handling
Medicaid. If the Resident fails to pay the contribution amount, the Center may take such legal
action as necessary, including requesting a court to order such payment.
1.06 Third Party PUors and Managed Care Organizations. If a Resident is a participant
in a plan offered by a third party payor such as a Health Maintenance Organization ("HMO"),
Preferred Provider Organization ("PPO"), Provider Sponsored Organization ("PSO"), or
Physician Hospital Organization ("PHO"), indemnity plan or another similar entity with which the
Center has executed a provider agreement, the charges are governed by the applicable agreement.
The Resident is responsible for any co-payments, deductibles or non-covered charges, according
to the same terms and conditions applicable to private pay residents. If the Center has not
executed a provider agreement with the Resident's third party payor, the Center
will bill the Resident's third party payor as a service, but the Resident remains liable for charges
not paid or covered by that third parry payor including charges not paid within a reasonable
period of time.
1.07 Private Pay Resident. The Resident is responsible for paying the Center for items
and services provided during the stay at the Center and during which time the Resident has not
been determined to be eligible for any governmental program or covered under any third party
payor or managed care organization plan. The Resident andior Responsible Party will notify the
Center promptly if there is insufficient income or assets to meet the financial obligations to the
Center or to make prompt application to Medicaid for benefits. The Resident and/or Responsible
Party will notify the Center in writing when application to Medicaid is made. The Resident and/or
Responsible Party will cooperate fully in applying for Medicaid and in the eligibility determination
process. If the Resident is no longer able to pay for care at the Center or to have payment made
on the Resident's behalf, the Resident will be notified of the! Center's intention to discharge the
Resident for non-payment in accordance with this Agreement, Resident Handbook and state and
federal laws.
1.08 Admission Information. The Resident and/or Responsible Party will notify the
Center and provide any needed information regarding all third party payors or governmental
coverages on admission and throughout the Resident's stay including copies of insurance cards,
identification or verification of eligibility and coverage information.
The Resident and/or Responsible Party will provide the Center in writing with
notice within five (5) days of the Resident's disenrollment, enrollment, change in health care
coverage, failure to pay premium(s) or renewal of insurance coverage and any cancellations in
coverage as the Center relies on the information supplied regarding such coverage. The Resident
acknowledges that if the Resident fails to provide such information, the Resident may be
responsible for any denied charges due to lack of authorization, ineligibility, non-coverage or
other costs associated with the failure to provide such notice in accordance with the terms and
conditions of this Agreement.
1.09 Application for Benefits. The Resident and/or Responsible Party will apply for
coverage and to establish eligibility under any governmental, third party payor, managed care or
private insurance program. The Center has no obligation to bill any third party payor other than
the Responsible Party and, when applicable, a governmental program third party payor or
managed care organization with which the Center is under contract.
1.10 Primary Responsibility for Payment. Except for payments for services covered
under governmental programs or other third party payor provider agreements, the Resident
remains primarily liable for any and all charges for which the Center may agree to bill a third
party. The Resident and/or Responsible Party acknowledge that the insurance company, HMO,
PPO, PSO, PHO or managed care provider may not pay for non-covered services, supplies,
equipment, medications, and other care and services which may be delivered by the Center or its
subcontractors. This agreement serves as a written notice that the Center has notified the
Resident and/or Responsible Party that services provided at the Center may not be covered by a
governmental payor, third party payor or managed care organization. The Resident and/or
Responsible Party will be responsible for non-covered services. A price list of services is
maintained at the Center's business office and is available for review during regular business
hours.
1.11 Personal Physician. The Resident has the right to choose a personal physician,
provided that the physician selected is properly licensed and abides by applicable law and the rules
and policies of the Center. At the time of admission, the Resilient must supply the Center with the
name of his/her personal physician. If the Resident changes physicians at any time after
admission, the Resident and/or Responsible Party must immediately notify the Center of the new
physician's name. If the physician chosen by the Resident fails to provide needed coverage and
attendance or fails to abide by applicable laws and regulations, the Center will call another
physician to attend to the Resident and the fees charged by such physician will be bome by the
Resident.
1.12 Pharmacy. The Resident and/or Responsible Party has the right to choose a
pharmacy of choice, provided the pharmacy selected is properly licensed, packages and supplies
pharmaceuticals in accordance with state law, abides by the Center's policies and procedures and
has a medication distribution system similar to the Center's ancillary pharmacy's medication
distribution system.
U. RIGHTS AND RESPONSIBILITY OF THE RESPONSIBLE PARTY
2.01 Legal Authority. The Responsible Party represents that he/she has legal access to
the Resident's income or resources and that the documents supporting such authority, if any, have
been delivered to the Center.
2.02 Agreement to Make Payments on Behalf of Resident. The Responsible Party will
pay promptly from the Resident's income or resources all fees and charges for which the Resident
is liable under this Agreement. The Responsible Party will incur personal financial liability on
behalf of the Resident should the Responsible Party fail to pay the charges for which the Resident
is liable under the agreement from the Resident's income or resources.
2.03 Requested Items. The Responsible Party will be personally liable for any services
or products specifically requested by the Responsible Party to be supplied to the Resident, unless
such services or products are covered by a governmental program.
2.04 Exhaustion of Resident's Funds. If the Resident's financial resources change such
that the Resident may be eligible for Medicaid, the Resident and/or Responsible Party must notify
the Center in writing and must promptly apply for Medicaid benefits. If the Resident and/or
Responsible Party fails to notify the Center in writing or fails to file for Medicaid or provide such
information as Medicaid representatives may require to qualify the Resident for eligibility to
Medicaid, the Center may end this agreement and transfer or discharge the Resident for
nonpayment upon reasonable and appropriate notice, as provided in Section 4.06. In addition, if
the Responsible Party fails to notify the Center in writing or fails to file for Medicaid in a timely
and proper manner, the Responsible Party will be personally liable for all charges and fees not
covered by Medicaid which otherwise would have been covered had application been made in a
timely and proper manner.
2.05 Cooperation for Financial Assistance. If the Resident is eligible for Medicaid, the
Responsible Party must provide such information about the Resident's finances as Medicaid
representatives require for continued coverage of the Resident and be personally responsible for
any charges denied the Center due to any lack of cooperation. If the Resident and/or Responsible
Party fail to provide such information as Medicaid representatives require for continued eligibility
for Medicaid payments, and as a result Medicaid does not pay for the Resident's care, the
Resident may be discharged or transferred upon appropriate and reasonable notice for
nonpayment, as provided in Section 4.06.
2.06 Acceptance Upon Discharge. Upon termination of this Agreement as provided in
the Resident Handbook, the Responsible Party agrees to arrange and pay for the departure of the
Resident from the Center. If after notice, the Resident is not removed as requested, then the
Center is authorized and empowered to remove the Resident by reasonable means of
transportation and to deliver the Resident to the residence address of the Responsible Party, if the
Resident's condition permits, who shall unconditionally be obligated to accept the Resident or
immediately make medically appropriate alternative arrangements and to pay promptly all charges.
2.07 Additional Responsibilities. The Responsible Party will comply with the other
duties and responsibilities for the Resident and to the Center as set forth in this Agreement,
Resident Handbook, and Attachments.
2.08 Misuse of Resident Funds. In the event that the Responsible Party misappropriates
the Resident's income or resources or otherwise illegally transfers assets for purposes of avoiding
the Responsible Party's obligation to make payments on behalf' of the Resident under Section 2.02
or for purposes of qualifying the resident for Medicaid eligibility, the Responsible Party may be
liable to the Medicaid agency and/or the Center for care that should have been paid for from the
Resident's income or resources. Such misappropriation of the Resident's income or resources
may also result in the imposition of criminal or civil sanctions against the Responsible Party.
M. RIGHTS AND RESPONSIBILITIES OF THE CENTER
3.01 Room and Standard Services. As part of the Room and Board Rate, the Center
will furnish basic room, board, common facilities, housekeeping, laundered bed linens and
bedding, general nursing care, personal assessment, social services, and such other personal
services as may be required pursuant to the plan of care prepared by the Resident's physician and
the Center, with the Resident's consent, for the health, safety and general well-being of the
Resident.
3.02 Other Services. The Center will act in accordance with the Resident Handbook,
which is incorporated by reference in this Agreement.
3.03 Deposit. The Center acknowledges receipt of the Deposit, if any, noted at the
beginning of this Agreement. The Deposit will be applied to the charges for the first month of the
Resident's stay at the Center.
3.04 Refunds. Any refund owed to the Resident for advance payments will be paid by
the Center within thirty (30) days after discharge or transfer or within the time frame required by
State law. In the case of Medicaid Residents, any such refund will be paid within thirty (30) days
of the Center's receipt of the final Medicaid payment for care of the Resident.
IV. GENERAL PROVISIONS
4.01 Consent to Release of Information. The Resident and/or Responsible Party hereby
consents to the release of the Resident's medical records to the following persons: Center
personnel, attending physicians and consultants; any person, firm, government entity, third party
payor or managed care organization responsible for all or any part of the. payment or
reimbursement of the Resident's charges, including any utilization review or quality assurance
reviews or payment audits performed by such; the personnel of any hospital or other health care
facility or provider to whom or which the Resident may be transferred; the Center's liability
insurance carrier; and any person authorized by law to review the medical records.
4.02 Consent to Treat. The Resident and/or Responsible Party consent to the use and
disclosure of Resident's protected health information for the purposes of receiving treatment from
the Center, obtaining payment for healthcare services provided to Resident, and the Center's own
healthcare operation needs. The Resident and/or Responsible Party, by signing this Agreement,
authorizes the appropriate staff of the Center to perform such functions, care and services
(hereinafter "Treatment") as are necessary to maintain the well-being of the Resident, including
but not limited to, assistance with bathing, hygiene, dressing, toiletry, and daily activities; and
general nursing care, the administration of medications and treatments, and the performance of
therapies, as prescribed by the Resident's personal physician in the Resident's Plan of Care, or as
required from time to time in the exercise of good nursing judgment, subject to any rights
provided to the Resident by federal and/or state law.
As applicable, the undersigned Responsible Party represents that he/she has the
legal authority to make health care decisions on behalf of the Resident, that documents supporting
such authority have been delivered to the Center, and that such Responsible Party consents on
behalf of the Resident to the Treatment described above.
4.03 Consent to Photograph. The Resident and/or Responsible Party consent to the
Center taking a photograph of Resident for use in identifying the Resident, for placement of the
photograph in the Medication Administration Record or other records and for any other similar
uses of the photograph for Center and staff to identify the Resident.
4.04 Notice of Services. Policies and Additional Information. The Resident and/or
Responsible Party acknowledge that the items listed below have been explained and have received
copies of the items or policies and procedures, if applicable. The Resident and/or Responsible
Party acknowledge they have had the opportunity to ask questions and questions have been
answered satisfactorily.
a. Assignment for Payment of Benefits. See Attachment C.
b. SNF Medicare Determination Notice. See Attachment D.
c. Medicare Secondary Payor Questionnaire. See Attachment E.
d. At the request of the Resident and/or Responsible Party, the Center will
maintain the Resident's personal funds in compliance with the laws and
regulations relating to the Center's management of such funds. A description
and/or policies and procedures of protection of resident funds and the Personal
Trust Fund Agreement, Resident Personal Funds Authorization and any other
related documents. See Attachments F-1 and F-2.
e. Center Supplement:
1. Policy and procedure on bedholds, election of bedholds and
readmission.
2. Social Service Agencies and Advocacy Groups addresses anc
phone numbers.
3. Name, address and phone number of Ombudsman.
4. Location in the Center where the names, addresses and telephone
numbers of state client advocacy groups, state survey and
certification agency, the state licensure office, the state ombudsman
program, the protection and advocacy network and the Medicaid
fraud control unit.
5. The name, specialty and way of contacting the attending physician,
medical director and other physicians who serve the Center.
6. Procedures, name, address and phone number on how to file a
complaint with the state survey and certification agency concerning
resident abuse, neglect, mistreatment and misappropriation of
property.
f. The Resident Handbook.
g. Resident/Patient Rights.
h. Medicare/Medicaid information and display of such information including
how to apply for and use Medicare and Medicaid benefits, and how to
receive refunds for previous payments.
i. Receipt of information on advance directives including a copy of "Refusal
of Life Sustaining Treatment", which summarizes HCR Manor Care's
Limited Treatment Practices and a copy of the State summary of its laws
governing the Resident's right to direct his/her medical treatment. See
Attachments G-1 and G-2.
j. Privacy Act Notification. See Attachment H.
k. Notice of Information Practices and Receipt of Notice of Information
Practices. See Attachments I-1 and I-2.
1. Ancillary Services Management Form. See Attachment J.
4.05 Assignment of Benefits. The Resident and/or Responsible Party request that
payment of authorized government and/or third party payor benefits as described in Sections 1.05
and 1.06, if any, be made as set forth in Attachment C to this Agreement either to Resident or on
Resident's behalf for any service furnished by or in the Center. The Resident and/or Responsible
Party authorize the Center and any holder of medical or other information to release such
information to the Centers for Medicare and Medicaid Services "CMS" and its agents and to third
party payors any information needed to determine these benefits or benefits for related services.
4.06 Termination. Discharge and Transfer. This Agreement may be terminated as set
forth below and as set forth in the Resident Handbook under the Section Heading "Discharge".
The Resident and/or Responsible Party may terminate this Agreement by providing the Center
written notice of the Resident's desire to leave at least seven (7) days in advance of the Resident's
departure. If the Resident leaves before the end of that time, the Resident must still pay for each
day of the required notice unless the Center fills the bed before the end of the notice period.
Except in the event of an emergency or death, the Resident will be responsible for all charges for
the Room and Board Rate and for all services performed up to the end of the day that the
admission ends. Discharge from the specialized units such as the Transitional Care Unit or
Subacute Unit may require less than seven (7) days notice.
If discharge or transfer becomes necessary because the Resident and/or Responsible Party or
someone else abused the Resident's funds, the Center will request that local, state and federal
authorities, as appropriate, investigate, which may result in prosecution.
4.07 Indemnification. The Resident will defend, indemnify and hold the Center harmless
from any and all claims, demands, suit and actions made against the Center by any person
resulting from any damage or injury caused by the Resident to any person or the property of any
person or entity (including the Center), except in the case of negligence of the Center's employees
and agents.
4.08 Changes in the Law. Any provision of this Agreement 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 Agreement and, it is agreed that to the extent possible, the Resident and the
Center will continue to fulfill their respective obligations under this Agreement consistent with the
law.
THE UNDERSIGNED CERTIFY AND ACKNOWLEDGE THAT THEY HAVE
EACH READ AND UNDERSTOOD THE FOREGOING AGREEMENT, AND THAT
THEY HAVE HAD AN OPPORTUNITY TO ASK QUESTIONS AND THAT ANY
QUESTIONS HAVE BEEN ANSWERED TO THEIR SATISFACTION.
Signature of Resident:
Date:
Signature of Responsible Party
Date: -eq?
Center Representative: C
-Date: (G ?' C??
?' 1 N
C:' I
_ J
3v
_{ fA
T
rn
^I^ Ti
C, -j
7v i'q
{
JUL 0 7 2004 V
IN THE COURT OF COMMON ;PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V. No. 04-2873 Civil Term
PHYLLIS CAROTHERS,
Defendant. : CIVIL ACTION -EQUITY
ORDER
AND NOW, this day of 2004, a
hearing in the above-captioned matter on Plaintiff's petitio or the issuance of a
preliminary injunction is scheduled for 2004, at
V al
4.m. in Court Room No. J Cumberland County
Courthouse,1 Courthouse Square, Carlisle, Pennsylvania.
BY THE COURT:
' C- o 0
S? p °r T
° c
T D3
77
O! jz . -o n
r 77
I
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP,
d/b/a MANORCARE HEALTH
SERVICES - CARLISLE,
Plaintiff,
V.
PHYLLIS CAROTHERS,
Defendant.
No. 04-2873 Civil Term
CIVIL ACTION - EQUITY
AFFIDAVIT OF SERVICE
I, Paul B. Kennedy-, being duly sworn according to law, depose
and say that I served via hand delivery upon the Defendant, Phyllis Carothers,
who identified herself tome, with the Complaint and Plaintiff's Petition for
Preliminary Injunction in the above-captioned matter, at her respective place
of residence on the 7 day of ui ly , 2004, at approximately
5:45 p.m.
Dated:l U
Sworn to iqLnd Subscribed before me
this day of
2004.
Notary Publ'
My Commis ' Expires:
Notarial Seal
ic
Christy A. Long, Notary Z&
City of Harrisburg, DaupM1ty
My Commission Expires Dec. 22, 2005
Paul 1B. Kennedy
cn- ° O
_- r T
r l U.' c._ 2
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff
v
PHYLLIS CAROTHERS,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
04-2873 CIVIL TERM
CIVIL ACTION - EQUITY
IN RE: PRELIMINARY INJUNCTION
ORDER OF COURT
AND NOW, this 14th day of July, 2004, upon
consideration of Plaintiff's Petition for Preliminary Injunction,
following a hearing held on this date, and the Court finding on
the basis of the evidence presented (1) that the preliminary
injunction is necessary to prevent immediate and irreparable harm
which could not be compensated for by damages, (2) that greater
injury will result from the denial of the preliminary injunction
than from the granting of it, (3) that issuance of the
preliminary injunction will operate to restore the parties to the
status quo as it existed prior to the alleged wrongful conduct,
(4) that Plaintiff's right to a preliminary injunction is clear,
and (5) that general equity jurisdiction is warranted, the
petition for a preliminary injunction is granted and Defendant is
enjoined to cooperate with Plaintiff and Plaintiff's counsel with
respect to the pending application for medical assistance
benefits for her mother and to provide any and all records needed
for the said application, or demonstrate to the satisfaction of
the Cumberland County Assistance Office that such records are not
required under the circumstances.
THIS PRELIMINARY INJUNCTION shall be effective upon
Plaintiff's posting of a bond or cash in the amount of $100.00,
in accordance with Pennsylvania Rule of Civil Procedure 1531(b).
In the event the requisite bond or cash is not posted or
Go :b E_!'j 0' IFJ Uoz
3c, JO
deposited within 10 days of the date of this order, the order
shall be deemed automatically dissolved.
By the Court,
/Chadwick 0. Bogar, Esquire
P.O. box 959
Camp Hill, PA 17001-0959
For the Plaintiff
?Phyllis Carothers, Pro Se
154 Lincoln Street
Carlisle, PA 17013
:mae
_r)Q -0 L
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff,
V. No. 04-2873 Civil Term
PHYLLIS CAROTHERS,
Defendant. : CIVIL ACTION -EQUITY
PLAINTIFF'S PETITION FOR CIVIL CONTEMPT
AND NOW, COMES, Plaintiff, Manor Healthcare Corp. d/b/a ManorCare
Health Services - Carlisle, ("Plaintiff ManorCare") and files this Petition for Civil
Contempt and, in support thereof, avers:
On July 14, 2004, this Court granted Plaintiff ManorCare's petition for
preliminary injunction and entered the Order attached hereto as Exhibit A.
2. Pursuant to the attached Order, Defendant Phyllis Carothers was required
to produce documents previously requested by the Cumberland County Assistance
Office to determine her Mother's eligibility for Medical Assistance benefits. These
documents were to be produced on or before August 4, 2004-the date on which
Plaintiff ManorCare's appeal referenced in its petition for preliminary injunction was to
be heard by the Bureau of Hearings and Appeals. Unforitunately, Defendant Phyllis
Carothers failed to produce any of the documents requested by the Cumberland County
Assistance office on or before August 4, 2004, thereby violating this Court's Order.
3. On August 3, 2004, Administrative Law Judge Andrew P. Maloney of the
Bureau of Hearings and Appeals denied Plaintiff ManorCare's motion for continuance
and, further, advised Plaintiff ManorCare that it would be required to present evidence
at the August 4, 2004 hearing in support of its appeal. Not having the requisite
evidence to support its appeal because Defendant Phyllis Carothers failed to produce
the documents requested by the Cumberland County Assistance Office in violation of
this Court's Order attached hereto as Exhibit A, Plaintiff ManorCare withdrew its
appeal. Fortunately, an agreement was reached between Plaintiff ManorCare and the
Cumberland County Assistance, giving Plaintiff ManorCare additional time to qualify
Defendant Phyllis Carother's Mother for Medical Assistance benefits.
4. Pursuant to the terms of the above-referenced agreement between Plaintiff
ManorCare and the Cumberland County Assistance Office, Plaintiff ManorCare has
until August 24, 2004 to seek additional judicial intervention to obtain the documents in
question. If, however, ManorCare fails to produce the documents by August 24, 2004,
the Cumberland County Assistance will again deny Defendant Phyllis Carother's
Mother's application for Medical Assistance benefits, forcing ManorCare to seek yet
another appeal.
WHEREFORE, Plaintiff ManorCare respectfully requests that this Honorable
Court schedule an immediate hearing on its Petition for Civil Contempt, and thereafter
issue a Decree ordering Defendant Phyllis Carothers to produce the documents
requested by the Cumberland County Assistance Office by August 23, 2004 or face
incarceration until such time as this Honorable Court directs.
Respectfully submitted,
KENNEDY BOGAR LLC
Dated: 6 O
By C
Chadwick O. Bogar
Attorney I.D. No. 83755
(717) 909-5920
Bradley A.Schutjer
Attorney I.D. No. 75954
(717) 909-5921
P.O. Box 959
Camp Hill, PA 17001-0959
Attorneys for the Plaintiff
EXHIBIT "All
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
Plaintiff
v
PHYLLIS CAROTHERS,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
04-2873 CIVIL TERM
CIVIL ACTION - EQUITY
IN RE: PRELIMINARY INJUNCTION
ORDER OF COURT
AND NOW, this 14th day of July, 2004, upon
consideration of Plaintiff's Petition for Preliminary Injunction,
following a hearing held on this date, and the Court finding on
the basis of the evidence presented (1) that the preliminary
injunction is necessary to prevent immediate and irreparable harm
which could not be compensated for by damages, (2) that greater
injury will result from the denial of the preliminary injunction
than from the granting of it, (3) that issuance of the
preliminary injunction will operate to restore the parties to the
status quo as it existed prior to the alleged wrongful conduct,
(4) that Plaintiff's right to a preliminary injunction is clear,
and (5) that general equity jurisdiction is warranted, the
petition for a preliminary injunction is granted and Defendant is
enjoined to cooperate with Plaintiff and Plaintiff's counsel with
respect to the pending application for medical assistance
benefits for her mother and to provide any and all records needed
for the said application, or demonstrate to the satisfaction of
the Cumberland County Assistance Office that such records are not
required under the circumstances.
THIS PRELIMINARY INJUNCTION shall be effective upon
Plaintiff's posting of a bond or cash in the amount of $100.00,
in accordance with Pennsylvania Rule of Civil Procedure 1531(b).
In the event the requisite bond or cash is not posted or
deposited within 10 days of the date of this order, the order
shall be deemed automatically dissolved.
By the Court,
C dwick O. Bogar, Esquire
0. box 959
Camp Hill, PA 17001-0959
For the Plaintiff
Phyllis Carothers, Pro Se
154 Lincoln Street
Carlisle, PA 17013
mae
CERTIFICATE OF SERVICE
I hereby certify that a true and correct copy of the foregoing Plaintiff's Petition
for Civil Contempt was served via first-class, United States mail, postage prepaid, upon
the following:
Phyllis Carothers
154 Lincoln Street
Carlisle, PA 17013
John Broujos, Esquire
Broujos & Gilroy
4 North Hanover Street
Carlisle, PA 17013
Dated: 9 0-& N By:
Christy A. o g, Paralegal
co
1
' T1
...
1 {
TM Z T,
1 1 _:
'
.1 i-n
AUG 0 6 2004
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
MANOR HEALTHCARE CORP. d/b/a
MANORCARE HEALTH SERVICES -
CARLISLE,
V.
PHYLLIS CAROTHERS,
Plaintiff,
No. 04-2'873 Civil Term
Defendant. : CIVIL ACTION -EQUITY
ORDER
AND NOW, this day of _?5 2004, a
hearing in the above-captioned matter on Plaintiff's ManorCare's Petition for Civil
Contempt is scheduled for ?g 2004, at !/' 0 k-.m.
in Court Room No. Cumberland County Courthouse,1 Courthouse
Square, Carlisle, Pennsylvania.
oy.o`I
BY THE COURT:
i1,! Y
rooz
MANOR HEALTHCARE CORP. IN THE COURT OF COMMON PLEAS OF
d/b/a MANORCARE HEALTH CUMBERLAND COUNTY, PENNSYLVANIA
SERVICES - CARLISLE,
Plaintiff CIVIL ACTION - EQUITY
v
PHYLLIS CAROTHERS,
Defendant 04-2873 CIVIL TERM
IN RE: CIVIL CONTEMPT
ORDER OF COURT
AND NOW, this 18th day of August, 2004, upon
consideration of Plaintiff's Petition for Civil Contempt, and
following a hearing at which the Defendant did not appear and at
which evidence was presented on behalf of the Plaintiff which
fully supported the petition, the Court finds that the Defendant
has intentionally, voluntarily, and willfully failed to comply
with the terms of the Order of Court dated July 14, 2004, and she
is adjudicated in contempt.
The sanction for the Defendant's failure to
comply with the preliminary injunction issued on July 14, 2004,
is that the Defendant undergo imprisonment in the Cumberland
County Prison for a period of 1 month. The condition of purge
with respect to the sentence is that on or before August 25,
2004, the Defendant fully comply with the terms of the aforesaid
order of Court.
By the Court,
.O
Co
_'.J1 v
'
_...1. l ..
r u
A
?
F
-
V KJ
P Esquir
.O. Box 95 9 e
P.O. Box 9
Hill, PA 17001-0959
Camp
For the Plaintiff
,/P?iyllis Carothers
154 Lincoln Street 2
Carlisle, PA 17013 Q?j 2yQ
CCP
mae
MANOR HEALTHCARE
CORP., d/b/a
MANORCARE HEALTH
SERVICES - CARLISLE,
Plaintiff
V.
PHYLLIS CAROTHERS,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 04-2873 CIVIL TERM
ORDER OF COURT
AND NOW, this 25 h day of August, 2004, upon consideration of the attached
letter from Chadwick O. Bogar, attorney for Plaintiff; it is hereby determined that
Defendant has met the condition of purge contained in the order of court dated August
18, 2004.
J.
Chadwick O. Bogar, Esq.
P.O. Box 959
Camp Hill, PA 17001-0959
Attorney for Plaintiff
Phyllis Carothers
154 Lincoln Street
Carlisle, PA 17013
Defendant, pro se
:rc
BY THE COURT,
VlWr\IXSNN31
Z 0 ? 11 b1tl LZ OOtl hQOZ
??Vi ????y 4113
kennedyl I
Attorneys At law
Email:
Direct Dial:
LLC
cbogar@kennedybogar.com
(717) 909-5920
August 25, 2004
VIA FACSIMILE - (717) 240-6462
The Honorable J. Wesley Oler, Jr.
Cumberland County Court of Common Pleas
1 Courthouse Square
Carlisle, PA 17013-3387
Re: Manor Healthcare Coro v Carothers
Docket No. 04-2873
Dear Judge Oler:
It has been represented to us by the Cumberland County Assistance Office that
the Defendant in the above-referenced matter has fully complied with your Honor's
Order of August 18, 2004, attached hereto, by producing all documents necessary to
determine Defendant's Mother's eligibility for Medical Assistance benefits.
If your Honor has any questions, please feel free to contact me.
Si?IyGZ-C
Chadwick O. Bogar
cc: Phyllis Carothers
W 2 ?j nz4
P.O. Box 959, Camp Hill, PA 17001-0959 • Fax: (717) 909.5925
Curtis R. Long
Prothonotary
(Office of the Protbonotarp
Cumberlanb Cuuntp
Renee K. Simpson
Deputy Prothonotary
John E. Slike
Solicitor
041 -.2873 CIVIL TERM
ORDER OF TERMINATION OF COURT CASES
AND NOW THIS 5TH DAY OF NOVEMBER 2007 AFTER MAILING NOTICE OF
INTENTION TO PROCEED AND RECEIVING NO RESPONSE - THE ABOVE
CASE IS HEREBY TERMINATED WITH PREJUDICE IN ACCORDANCE WITH PA
R C P 230.2.
BY THE COURT,
CURTIS R. LONG
PROTHONOTARY
One Courthouse Square • Carlisle, Pennsylvania 17013 • (717) 240-6195 • Fax (717) 240-6573