Loading...
HomeMy WebLinkAbout11-5787HCR MANORCARE, INC., IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2011- 5'78x1 C iy i l T& -ate -, JAMES E. JOHNSON SR. r-rlw , ; rn c_ C= --n Vn Z Defendant r- APPLICATION TO CONFIRM ARBITRATION AWARD r = - ; NOW, comes HCR ManorCare, Inc., Plaintiff, by and through its attorneys, BARIC `--` SCHERER LLC, and files the within Application to Confirm Arbitration Award and, in support thereof, sets forth the following: The parties to this matter were bound by a certain Arbitration and Limitation of Liability Agreement, a true and correct copy of which is attached hereto as Exhibit "A" and is incorporated by reference. 2. A dispute arose amongst the parties and HCR ManorCare sought arbitration of the dispute under the terms of the Arbitration and Limitation of Liability Agreement. 3. Arbitration was held before Nathan C. Wolf, Esquire, Jacqueline M. Verney, Esquire and Katie J. Maxwell, Esquire after their appointment as arbitrators. 4. Bradley L. Griffie, Esquire as arbitration administrator, served the Defendants with notice of the arbitration hearing. Proof of said service is attached hereto as Exhibit "B" and is incorporated by reference. 5. The arbitrators have rendered an Arbitrators' Decision and Award in this matter a true and correct copy of which is attached hereto as Exhibit "C" and is incorporated by reference. O *94.00 P o AV--f /80(13 Ida(0 ao9/ 6. Pursuant to 42 Pa.C.S.A. §7313, a party to an arbitration may make application to the Court of Common Pleas for confirmation of the award by the Court. 7. Pursuant to 42 Pa.C.S.A. §7316, upon confirmation of the award, a judgment or decree shall be entered in conformity with the order. 8. Copies of the Arbitrators' Award was mailed to all of the parties on June 7, 2011. 9. No request for modification or correction of the award has been filed by the Defendant to the date of this application. WHEREFORE, Applicant requests that the award of the arbitration administrator be confirmed and judgment be entered in conformance therewith. Respectfully submitted, BARIC SCHERER LLC /'- d?v - David A. Baric, Esquire I.D.# 44853 19 West South Street Carlisle, PA 17013 (717) 249-6873 Attorney for HCR ManorCare, Inc. 17OLUN Ag AGREEMENT: It you do not accept this Agreement, the Patient will still be allowed to live in, and receive servites in, this Center. ARBITRATION AGREEMENT (".AGREEMENT") BY ACCEPTING THIS AGREEMENT, THE PARTIES ARE WAIVING THEIR RIGHT TO A TRIAL BEFORE A JUDGE ANA/OR A .TURY OF ANY DISPUTE BETWEEN THEM. PLEASE READ THIS AGREEMENT CAREFULIA' AND IN ITS F,NTIRETY BEFORE ACCEP`T'ING ITS TERMS. This Am-ccment made on a j (date) b and between the Parties, Patient ?C?,nnl II ?, ,?_ and/or Patient's J eJal Representative (collectively referred to as "Patient"), and the Center C is an Agreement intended to require that Disl)utes be resolved by arbitration. The Patient's Legal Rcpresen:tative agrees that he is signing this Agreement as a Party both in bis representative and individual capacity A. WHAT IS ARBITRATION?: Arbitration is a cost effective and time saving method of resolving, disputes without involving the courts. In using arbitration, die disputes are heard and decided by a. private individual called an arbitrator. The dispute will not be heard or decided by a judge or jury. B. AGREEMENT TO A BITBATE "DISPU'T'ES": Any and all claims or controversies arising out of or in any way relating to this Agreement. the Admission Agreement. or any of the Patient's stays at this Center, or any Center operated by azry subsidiary of HCR-Manor Care, Inc., whether or nor related to mcdica.l inalpractico, including but not limited to disputes regarding the snaking, execution; validity, enforceability, voidability, unconscionability, severability, scope, interpretation, preemption, waiver; or any other defense to enforceability of this Agreernnent or the Admission Agreement, whether arising out of State or Federal law. whether existing now or arislog in the al.ture, whether for statutory, compensatory or punitive damages and whether sounding in breach of contract, tort or breach of statutory duties (including, without lirrtitation except as indicated., any claim based. on Patients' Rights or a claim for unpaid Center charges), re¢ardless of the basis For the duty or of the legal theories upon which the clairn is asserted, shall be submitted to banding arbitration. Notwithstanding the above; nothing in this Agreement prevents the Patient. fi-onfiling a grievance or complaint with the Center or appropriate goverrimentzi agency; from requesting an inspection of the Center fronn such agency: or &orn seeking review under any applicable federal, state or local Jaw of any decision to involuntarily discharge or transfer the Patient from the Center. I. Administrator: The arbitration shall be adrniruzitcrud by National Arbitration forum ("NAF"), 6165 Wayzata Blvd., Suite 500, Minneapolis, 1vlN 55426; any- rbitration-forun. (hereinafter "Administrator"). If the Parties mutually agree in writing not to select NAF or if the NAF is u.nwillin; or unable to serve as die Administrator; die Parties shall agree upon another independent entity to sen e as the Administrator, unless the Parties mutually agree to trot have a.n. Administrator. 2. Demand for Arbitration shall be made in 'writing, sent to the other Party via certified mail, rettull receipt requested., and filed with NAF (unless NAF is mutually waived). 3. Arbitration Panel: .fhc arbitration shall be conducred by three (3) Arbitrators (the "Panel"). Each Party will select one Arbitrator. The two selected Arbitrators will select a third Arbitrator. Each Arbitrator must be a retired State or Federal Court Jude or a Member of the State Bar where the Center is located with at least t0 years of experience as an attorney. ~NAF approved Arbitrators do not have to be used. If one Party refuses to select its arbirator within 30 days of a written rcqu.cst for same, then the Administrator shall 90lect that Party's Arbitrator. 4- Sole Decision Maker: The Arbitration Panel is empowered with the sole jurisdiction to, and shall, resolve all disputes, including without limitation, any disputes about the snaking, validity, enforceability, scope, interpretation, voidability, unconscionabi.lity, preemption. severability and.'or waiver of this Agx-eernenr or the Admission Agrcatnent, EXHIBIT "A" as well as resolve the Parties' underlying disputes, as it is the Parties' intent to eornpletely avoid involving the court system. The Panel shall not have jurisdiction to certify any person as a representative of a class of persons and, by doing so, adjudicate claims of persons not du-cctly ticking pazt in llrbih ation. 5. Procedural Rules and Substantive Law: The Panel shall apply the Federal Rules of Evidence and Federal Rules of Civil Procedure except where other-vise stated in this Ameenrant. Also, the Parcel shall apply, urd the arbitration award shall be consistent with, the State substantive law (including any and all statutory damage caps) ;for the State in which the Center is located, except as otherwise stated in this Agreement or where preempted by the FAA. The Panel shall apply NAF's Code of Procedure (in effect as of May 1, 2006) unless otherwise stated in this Agreement- NAF's Code of Procedtu•e may be obtained froin NAF, (877) 656-7765, "ti?tiv.arbitration-forum.corx?. The Parties hereby opt- out of NAF Rules (45 reaarditi indigents; 43 regarding appeals and judicial review). 6. Refusal to Arbitrate: Any Party who refuses to go forward with arbitration acknowledges that the Pauel will go forward with the arbitration hearing and render- a binding award without the participation of such Panty or despite his absence at the hearing. 7_ Waiver of Claim: Ai-o.- claim shall be forever waived if it arose prior to the arbitration hearing and is not presented in such hearing. A claim that is not served within the statute of limitations period applicable to the same clainr in a court of law in the state in which this Center is located shall be forever waived. 8. Award: The panel's award must be uriarnirnous and shall be served no later than five (5) working days after the arbitration bearing. The award must staa:e hu detail the Panels' findings of fact and conchtsioras of la-w. shall be tna.rked "confidential", and must be signed by all three Arbitrators. If any damages are awarded. the award must delineate specific amounts for economic and/or uon-econornic dan.iages. 9. Feral with Limited Rights to Review (Appeal): The Panel `s award binds the Parties. The Parties have a limited right of review for only the e\press reasons allowed by the FAA. A. DISCOVERY. Discovery shall be goverzred by NAF s Code of Procedure. However, discovery shall be limited as follows: (1) Within 30 days after senIce, of the Demand, each Party nrirst comply with Fed. R. Civ. P., Rule 26(a)(1) and thereafter rrrust comply with Rule 20(e) regarding supplementation of disclosures and responses. (2) A Party may serve a nraxirnum of 30 %witten questions (interrogatories), 30 requests to produce documents and 30 requests for admissions; inclusive of subparts. (3) The following disclosures shall be served no later than ogre bundred fifty (150) days before the arbitration hearing by the Claimant, and one hundred twenty (120) days before the arbitration hearing by the Respondent: (a) list of witnesses to be called at tine Hewing (fiill name, title; address and phone number i f known) and an outline of each kitnesses' intended testimony; (b) list of documents to be relied upon at Hearing; except documents to be used solely for impeacluiient purposes: (c) any sworn recorded statements to be relied upon at Hearing including the fiil.l name, title, address and phone number of the person who gave the statement. The Parties shall supplement these disclosures per Fed. R. Civ Pr.. Rule, 26 (e). (4) Each Patty may have up to three (3) experts and no more than ten (10) lay witnesses tbi- its witness list, as well as for the Hearing. Depositious of witnesses shall be lirnitod to those people listed on the Parties' ,vitrness lists or in the Parties' Rule 26 disclosures or discovery responses but under no circurnstaiwes will a Party be allowed to take more than 13 depositions- A written report surmnarizing each expert's opinions and the basis for each opinion. and a list of all records contained in the expert's file, must be served at least thirty (30) days before the expert's deposition; (5) Discovery shall be completed 45 days before the Hearing and the Hearing shall begin no later than 365 days after Dernand for Arbitration is served, shall last in duration no longer than five (5) working days, and the heating time allowed shall be split on a pro rata basis suhiect to the Panel's discretion. (6) The Parties may ag(ce to modify these discovery terms or deadlines. E. RIGHT TO CHANGE YOUR lV JkNjD: This Agreement may be cancelled by written notice sent by certified mail to the Center's Adinbristrator within thirty (30) calendar days of the Patient's date of admission. If alleged acts underlying the dispute occur- before the cancellation elate- this Agreement sha.il be binding with respect to those alleged acts. if not cancelled, this Agreement shall be binding on the Patient for this and all of the Patient's other admissions to the Center without any need for farther renewal. F. O HER PROVISIONS: 1. No Caps/Lintits on Damages: There are no caps/limits on the amount of damages the Panel can award other than those already unposed by law in the state in which this Center is located. All state laws, statutes and regulations that limit awardable damages and define the scope of admissible and inadmissible evidence (i.c. regulatory surveys, incidelit reports, etc.) oxpressly apply to any arbitration hearing held pursuant to this Agreement. 2. Opportunity to Review & Right to Consult with Attorney: The Patient (if competent) and the Patient's Legal Representative acknowledge that the Patient and Legal Representative have each received a copy of this Agreement, and have had an opporttmity to read it (or have it read to him/her) and ask questions about it before accepting it. Please read this Agreement very carefully acrd ask any questions that you have before signing it. Feel free to consult with an attorney of your choice before Sigrzling this Agreement. 3. Benefits of Art0ration: The ;Parties' decision to select Arbitration is supported by the potential cost- effectiveness and tune-savings offered by selecting arbitration, which seeks to avoid the expense and delay in the court system. The Parties recognize that often the Patient is elderly and may have a limited life-expectancy, and therefore selecting a quick method of resolution is potentially to a Patient's advantage. The Parties a2ruc that the reasons stated above arc proper cotrsideration F.or the acceptance of the Agreement. 4. FAA: The Parties hereby agree and intend that this Ageement, the Admission Agreement and the Patient's stays at the Center substantially involve interstate conutrerce, and stipulate that the Federal Arbitration Act ("FAA") in effect as of November 1, 2008 and federal case law latcrpreting such version of the FAA shall -apply to this Agreement, shall pr"mpt any inconsistent State lax and shall not be revei-se preempted by the McCarran-Per2u:son Act; United States Code Title 15, Chapter 20, or other law. Any amendment to stied version of the FAA is hereby expressly waived. 5. Bin(litig oil Parties & Others: The Parties intend that this Agreerrieut shall inure to the direct benefit of and bind the Center, its parent, affiliates, and st.:bsidia y companies, management companies, executive directors, owmers, officers, partners, shareholders, directors, medical directors, employees, successors, assigais, agents insurers and any entity or person (including health care providers) that provided any services, supplies or equipment related to dre Patient's stay at. the Center, and shall inure to the direct ben.efrt of and hind the Patient (as defined herein), his/her successors, spouses, children, next of kill, guardians, administrators, legal representatives, responsible parties, assigns; agents, attorneys, health care proxies; health care satTogates, third Patrty beneficiaries, insuurers, heirs, trustees, survivors and representatives, includurc the personal representatives or executors of his/her estate, any person whose claim is derived throtzQh or on behalf of the Patient or relates in anv way to the Patient's stay(s) at this Center. or any person who previously assumed responsibility for providing Patient with necessary services such as food. shelter, clothing, or inedicine, and any person who executed this Azreentent or the Admission Agreernent- 6. Fees and Costs: The Panels' fees and costs will be paid by the Center except in disputes over non-payinent of' Center charges wherein such fees and costs will be divided equally between the Parties. NAF's administrative fees shall be divided. equally among the Partit:s. To the extent pennitted by law, airy Party who unsuccessfully challenges the enforcement of this Agreement shall be required to pay the succcssfu.l Parties' reasonable attorney fees and costs incurred to enforce such contract (i-e., Motion to Compel Arbitration). The Parties shall bean their own attorney fees and costs in relation to all preparation and attendance at the arbitration hearing, unless the Panel concludes that the law provides otherwise. Except as stated ahov,+, the Parties waive ariy right to recover attorneys' fees and costs. 7. Confidentiality: The arbitration proceedings shall remain confidential in all respects, including all fiingS, deposition transcripts, discovet?f documents, or other materials exchanged be.ttveen the Parties and the Panels' award. In addition, following receipt of the Pataels' award., each Party, agrees to rettun to the producing Party within 30 days the original and all copies of documents exchanged in discovery and at the arbitration Hearing. 8. Waiver of this Agreement: I'lither Patty may tale its dispute in a court of law if the other Patty approves, which approval shall only be established by such Pate filing a response to the, Complaint without moving it) a timely martner, as prescribed by the applicable rules of court. to enforce this Agreement. However; should one of the Parties to this Binding Arbitration Agreement breach its ternhs by initiating a lawsuit in the judicial forunh, the Patties expressly aeacc that participation in cooperative general discovery while a motion to compel arbitration is pending shall not constitute evidence of a waiver of the right to arbitrate. A waiver of the right to arbitrate a specific Dispute or series of Disputes. as described above, relieves neither Patty of the contractual obligation to arbitrate other Disputes, including both permissive and mandatory cotuhterclaims. unless also subsequently waived. 9. Severability, Integration and Survival: Any term, phrase or provision contained in this Agreement is severable, and in the event any of them is found to be void, iztvalid or unenforceable for any reason, this Agtreenient shhall be interpreted as if such terra, plu-ase or provision were not contained herein; and the remaining provisions of this Agreement shall not be affected by such detertnitration and shall remain in frill force and effect. This Agreement rep, esznts the Patties' entire aPreetnent regarding Disputes, supersedes any other agreement relating to disputes, and it may only be changed in writing signed by all Parties. This A reement shall retrain in Rill force and effect no[withstandutg the termination, cancellation or natural expiration of the Admission Agreement. 10. No Jury Trial: If this Agreement is found to be unenforceable and arbitration is not compelled, then its a default, the Parties agree that the disputes shall be resolved solely by a judge via a bench trial. Under no circumstances will a jtuy decide any dispute. 11. Health Care Decision: The Parties hereby stipulate that the decision to have the Patient move into this Center and. the decision to agree to this Agreement are each a health care decision. The Panics stipulate that there are other health care facilities in this conuntmi1.y currently available to meet the patient's needs. 12. Legal Representative: The Patient's Legal Representative, by his or her signature below, hereby represents and stipulates that he/she has been authorized by the Patient to sign this Agreernettt on behalf of the Patient. 13Y SIGNING BELOW, THE PARTIES CONFIRM THAT EACH OF THEM HAS READ ALL FOUR (4) PAGES OF THIS AGREEMENT AND UNDERSTANDS THAT EACH HAS WAIVED THE RIGHT TO A TRIAL BEFORE A JUDGE OR KRY AND THAT EACH OF THEM CONSENT'S TO ALL OF THE TERMS OF THIS VOLUNTARY AGREEMENT. PATIENT: - Ips,)o Printed. Name (Date) S ).ree of atient PATIENT'S LEGAL REPRESENTATIVE: Printed Name (Date) Signature of Patients Legal Representative' in his/her Representative capacity CENTEt?I'R .''IV Patients Legal Representative should sign on q.t It hues above containaig the phrase-Patient's Legal Representative." Signature v i cr Rep ivc Signature of Patient's Legal Rfpre-sentative in his/her individual capacity Attmaevs Gnu.' Counselors ar La v Bradley L. Griffie, Esquire Hannah Herman-Snyder, Esquire Robin J. Bassett Office Manager Kelly L. Perez Legal Assistant Reply to: Carlisle December 28, 2010 David A. Baric, Esquire 19 West South Street Carlisle, PA 17013 James E. Johnson, Sr. 322 Pine Street Steelton, PA 17113 RE: HCR ManorCare vs. James E. Johnson, Sr. Dear Mr. Baric and Mr. Johnson: 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 100 Lincoln Way East, Suite D Chambersburg, PA 17201 (717) 267-1350 (800) 347-5552 Fax (717) 243-5063 Please be advised that the following attorneys will serve as the Arbitration Panel to resolve the issue of collection of past clue fees claimed by HCR ManorCare against Mr. Johnson: Nathan C. Wolf, Esquire 10 'West High Street Carlisle, PA 17013 Jacqueline M. Verney, Esquire 44 South Hanover Street Carlisle, PA 17013 Katie J. Maxwell, Esquire Mart:son Law Offices 10 East High Street Carlisle, PA 17013 Please be advised 'that pursuant to the Arbitration Agreement executed by HCR ManorCare and by Mr. Johnson, I have scheduled the Arbitration hearing in this matter for Tuesday, May 24, 2011., at 9:00 a.m. to take place at my office at 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. At this time, I remind Mr. Johnson that he has obligations under the Arbitration Agreement to disclose information that he intends to prove at the time of trial. HCR ManorCare has previously made the necessary disclosures as described :i.n paragraph "D" of the Arbitration Agreement by providing a list of witnesses to be called by HCR ManorCare and by providing other relevant information as described in that paragraph. EXHIBIT ":B" Page 2 David A. Baric, Esquire James E. Johnson, Sr. December 28, 2010 Mr. Johnson's information must be provided immediately to be in compliance with paragraph "D". Mr. Johnson must provide us with the following: (a) list of witnesses to be called at the hearing (full name, title, address and phone number if known) and an outline of each witness' testimony; (b) list of documents to be relied upon at the hearing; except document to be used solely for impeachment purposes; and (c) any sworn, recorded statements to be relied upon at hearing, including the full name, title, address and phone number of the person who gave the statement. This information must be provided promptly as it is to be provided no less than 120 days before the hearing, pursuant to the Agreement. I again remind Mr. Johnson, as well as Mr. Baric, that we will be moving forward with this Arbitration as scheduled absent a resolution between the parties by agreement, which is confirmed with me in advance of the hearing. As the Arbitration Agreement provides that the fees incurred by the Arbitration Administrator and the panel are to be shared equally by the parties, I am instructing each of you to deposit the sum of $750.00 with my office to use as compensation to the Arbitrators and for my fees by April 24, 2011. I anticipate that this hearing will not be continued from this date without good cause shown, which will be at my discretion. Your attention to these matters I appreciated. Very Truly Yours, Griffie BLG/klp Enclosure Cc: Nathan C. Wolf, Esquire Jacqueline M. Verney, Esquire Katie J. Maxwell, Esquire HCR MANORCARE INC. ARBITRATION PROCEEDING V. JAMES E. JOHNSON, SR. : NOTICE OF HEARING It is hereby directed that the hearing in the above captioned matter shall be held Tuesday, May 24, 2011, to begin at 9:00 a.m., said Arbitration Hearing to be held at the law offices of Griffie and Associates, 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. No later than fourteen (14) days prior to the said Arbitration Hearing, each party shall exchange a list of witnesses to be called at the hearing, including their full name, title, address, and phone number, and an outline of each witnesses intended testimony. Within the same time frame, each party shall exchange a list of documents to be relied upon at the hearing and any sworn recorded statements to be relied upon at the hearing, including full name, title, address, and phone number of the statements declarant. The hearing shall proceed pursuant to the terms of the Arbitration and Limitation of Liability Agreement executed by the parties on July 22, 2009. 1? ? 1 U Date ra ffie, Esquire Arbitra or 100 Lincoln Way East, Suite D Chambersburg, PA 17201 (717) 267-1350 200 North Hanover Street Carlisle, PA 17013 (717)243-5551 (800)347-5552 Distribution: David A. Baric, Esquire James E. Johnson, Sr. ?7-11 L HCR MANORCARE, INC., Plaintiff : ARBITRATION PROCEEDING vs. JAMES E. JOHNSON, SR., Defendant ARBITRATION PANEL DECISION AND AWARD 1. PROCEDURAL HISTORY: By correspondence of November 9, 2010, counsel for HCR ManorCare, Inc. (hereinafter "the facility") requested the services of Bradley L. Griffie, Esquire, to serve as Arbitration Administrator pursuant to the terms of an Arbitration Agreement executed by a representative of the facility and by James E. Johnson, Sr. (hereinafter "Patient"). The Arbitration Administrator gave notice of his willingness to serve in this capacity by correspondence dated November 11, 2010, further confirming that he had no interest in the facility nor knowledge of the parties in a manner that would cause the Arbitration Administrator to be unable to be independent. By correspondence dated November 16, 2010, the facility gave notice to the Arbitration Administrator of the facility's intended witnesses and exhibits, pursuant to the requirements of the Arbitration Agreement. By correspondence dated November 16. 2011; the facility named Attorney Nathan Wolf as its Arbitrator. Upon failure of the Patient to name an Arbitrator after two written notices and requests to do so, the Arbitration Administrator named Attorney Jacqueline Verney as the Patient's Arbitrator. Mr. Wolf and Ms. Verney selected Attorney Katie J. Maxwell as the third Arbitrator for the panel. EXHIBIT "C" By correspondence and Notice of Hearing dated December 28, 2010, a hearing was scheduled in this matter to take place on Tuesday May 24, 2011 to begin at 9:00 a.m. at 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. Notice was provided to the Arbitration Panel, legal counsel for the facility and the Patient, all at their last known mailing addresses. No requests for a continuance were received from either party or counsel. Appearing at the hearing before the Arbitration Panel on Tuesday, May 24, 2011, were Steve Vignati, Business Office Representative of HCR ManorCare, Inc. and David A. Baric, Esquire for HCR ManorCare, Inc. II. FINDINGS OF FACT: 1. On July 20, 2009, James E. Johnson, Sr. (hereinafter "Patient"), executed an Admissions Agreement and an Arbitration Agreement associated with the Patient's admission to the facility located at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 2. Paragraph 3.2 of the referenced Admission Agreement provided confirmation from the Patient that he would pay the room and board rates to the facility, exclusive of expenses covered by insurance, Medicaid, Medicare, Veteran's Administration payments, or related payments, on behalf of the Patient. 3. Pursuant to paragraph 3.2A of the said Admission Agreement, Patient agreed that he would pay all charges that he incurred while at the facility located at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 4. While the Patient originally entered the facility as a Medicare patient, thus having all room and board fees paid by Medicare, the room and board charges to the patient were $7,099.00 per month effective August 17, 2009 and $7,533.00 per month effective November 1, 2009 for services provided to the Patient while at the facility at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 5. Statements of charges were submitted to the Patient for the period from August 17, 2009 through and including the period covering November 9, 2009 for room and board services, cable charges, beauty shop charges and related charges, that were billable on a private pay basis. 6. All appropriate insurance payments or applicable payments from Medicare or Medicaid have been applied to the outstanding bill of the Patient by the facility. 7. The facility billed the Patient directly on a monthly basis for services provided to the Patient. 8. The facility provided monthly past-due notices to the Patient for fees due to the facility for services rendered which remained unpaid. 9. Neither the Patient nor anyone on his behalf objected to the billings. 10. The Patient was discharged from the facility on November 9, 2009. 11. All payments made to the facility from all sources have been applied to the Patient's billing for services provided by the facility. 12. While some private payments have been received, an outstanding balance remains due for services provided to the Patient by the facility for which private payment is still due. 13. The total balance due for services provided to the Patient from admission on July 21, 2009 to the date of hearing is $21,282.81. 14. Pursuant to paragraph 6 of the Arbitration Agreement executed between the parties, in a dispute over non-payment of facility charges the Panel's and Administration fees will be paid equally by the parties. 15. The dispute between the parties in this matter involved the non-payment of charges. 16. The facility made a formal Demand for Arbitration pursuant to the terms of the Arbitration Agreement upon the Patient and the Responsible Party by correspondence October 27, 2010. 17. Proper notice of the time and place of the hearing was provided to the facility and to the Patient, pursuant to the terms of the Arbitration Agreement. 18. No,:gequest for a continuance, nor other contact, was made by the Patient with the..Arbitration Administrator, nor with any member of the Arbitration Panel, prior to the hearing. 19. The hearing began at 9:15 a.m. on Tuesday, May 24, 2011 at 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania, after delaying the hearing 15 minutes from the original scheduled start time for the hearing of 9:00 a.m., to allow the Patient to appear or otherwise make contact with the Arbitration Administrator. 20. The Arbitration Administrator is not aware of any efforts made by the Patient nor anyone on his behalf to contact the Arbitration Administrator relative to the Patient's inability to attend the hearing. III. CONCLUSIONS OF LAW: The Patient, James E. Johnson, Sr., (hereinafter "Patient") entered into the terms and conditions of the Admission Agreement and the Arbitration Agreement executed by the Patient's Legal Representative, with the facility, HCR ManorCare, Inc., on July 20, 2009. The contracts are binding and provide all appropriate notices pursuant to Pennsylvania law. The binding Arbitration Agreement provides that all claims and controversies between the facility and the Patient will be resolved through application of the terms of the Arbitration Agreement. The Patient has failed to meet his obligations under the terms of the Admission Agreement to compensate the facility for services provided to the Patient. Proper notice of services rendered and fees incurred was provided by the facility to the Patient pursuant to the terms of the Admission Agreement. The parties and legal counsel received proper notice of all proceedings under the Arbitration Agreement, including Notice of the hearing. ARBITRATORS' AWARD Pursuant to the findings set forth herein, Judgment is hereby entered against James E. Johnson, Sr., in favor of HCR ManorCare, Inc. in the amount of $21,282.81. Administration fees for the Arbitration Administrator in the amount of $360.00 and Arbitrator's fees of $450.00 ($150.00 per Arbitrator) shall be divided equally between the parties, such that HCR ManorCare, Inc. shall compensate the Arbitration Administrator for his fees and for compensation of the Arbitrators the sum of $405.00 and James E. Johnson, Sr. shall likewise compensate the Arbitration Administrator for his fees and for compensation of the Arbitrators the sum of $405.00. In the event that HCR ManorCare, Inc. compensates the Arbitration Administrator in the full amount of fees and costs due, HCR ManorCare's Judgment is adjusted from the $21,282.81 amount set forth above to include the share of Arbitrator's fees and costs of James E. Johnson, Sr. in the amount of $405.00 for a total Judgment of $21,687,81. Nathan Wolf, Esq 1. r acqu ' e M. Verney, Esquire Katie J. xwell, Es4uire rl-. Griffie, Esquire tion Administrator HCR MANORCARE, INC., ; Plaintiff vs. ARBITRATION PROCEEDING JAMES E. JOHNSON, SR., Defendants CERTIFICATE OF SERVICE 7 I, Bradley L. Griffie, Esquire hereby certify that I did, the 7 day of June, 2011, cause a copy of the Arbitration Panel Decision and Award to be served upon the Plaintiff by first class mail, postage prepaid, and upon Defendant by serving him by first class mail, postage prepaid, and certified mail, restricted delivery, at the following addresses: David A. Baric, Esquire 19 West South Street Carlisle, PA 17013 James E. Johnson, Sr. 322 Pine Street Steelton, PA 17113 DATE: / riffie, Esquire 'r o n Administrator RIFFIE & ASSOCIATES 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 1 . HCR MANORCARE, INC., IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO.2011- JAMES E. JOHNSON, SR., Defendant RULE AND NOW, this day of , 2011, upon consideration of thet foregoing Application To Confirm Arbitration Award, it is hereby ordered that (1) a rule is issued upon the Defendant to show cause why the Plaintiff is not entitled to the relief requested; (2) the Defendant shall file an answer to the Application within Z O days of this date; (3) the Application shall be decided under Pa.R.C.P. No. 206.7; (4) depositions shall be completed within days of this date; (5) argument shall be held on I? the ? ' day of 2011, at a.m./. in Courtroom -?/- of the Cumberland County Courthouse; and (6) notice of the entry of this order shall be provided to all parties by the Plaintiff. BY THE COURT, ? Dau ?d A . I.?arie, ?a? J. a SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy '0 I AUG 10 PM 2: S Richard W Stewart ,•^,UM$ERLA O , Solicitor ?" `" • ??` ?`?'?? HCR ManorCare, Inc. Case Number vs. James E. Johnson, Sr. 2011-5787 SHERIFF'S RETURN OF SERVICE 07/25/2011 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: James E. Johnson Sr., but was unable to locate him in his bailiwick. He therefore deputized the Sheriff of Dauphin County, Pennsylvania to serve the within Rule and Application to Confirm Arbitration Award according to law. 07/28/2011 08:09 AM - Dauphin County Return: And now July 28, 2011 at 0809 hours I, Jack Lotwick, Sheriff of Dauphin County, Pennsylvania, do hereby certify and return that I served a true copy of the within Rule and Application to Confirm Arbitration Award, upon the within named defendant, to wit: James E. Johnson Sr. by making known unto Samuel Morris Jr., adult in charge at 322 Pine Street, Steelton, Pennsylvania 17113 its contents and at the same time handing to him personally the said true and correct copy of the same. SHERIFF COST: $37.44 August 04, 2011 SO ANSWERS, RON R ANDERSON, SHERIFF is Coua}ySuttc shenft Iej'oc oT. In:;. HCR MANORCARE, INC., Plaintiff V. JAMES E. JOHNSON, SR., Defendant IN THE COURT OF COMMON PLEAS QF 17 ,. , CUMBERLAND COUNTY, PENNSY ?N 3 , NO. 2011-5787 CIVIL TERM -Z' CY'' ,-, c, , -;c- MOTION TO MAKE RULE ABSOLUTE AND NOW, comes Plaintiff, HCR ManorCare, Inc., by and through its attorneys, Baric Scherer LLC, and files the within Motion to Make Rule Absolute and, in support thereof, sets forth the following: 1. Plaintiff filed an Application To Confirm Arbitration Award in this matter, a true and correct copy of said Application is attached hereto as Exhibit "A" and is incorporated. 2. By Rule dated July 22, 2011, the Honorable Kevin A. Hess, directed the Defendant, to show cause why the Application should not be granted within twenty (20) days of service. A true and correct copy of the Rule is attached hereto as Exhibit "B" and is incorporated. 3. To August 16, 2011, no answer has been filed by the Defendant. WHEREFORE, Plaintiff requests confirmation of the arbitration award in this matter in the amount of $21,687.81 and a judgment entered of record in this matter. Respectfully submitted, F-RARIC SCHERER LLC r A David A. Baric, Esquire I.D. # 44853 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 Attorney for Plaintiff HCR MANORCARE, INC., IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 2011- -51767 Ct JAMES E. JOHNSON, SR., Defendant APPLICATION TO CONFIRM ARBITRATION AWARD NOW, comes HCR ManorCare, Inc., Plaintiff, by and through its attorneys, BARIC SCHERER LLC, and files the within Application to Confirm Arbitration Award and, in support thereof, sets forth the following: 1. The parties to this matter were bound by a certain Arbitration and Limitation of Liability Agreement, a true and correct copy of which is attached hereto as Exhibit "A" and is incorporated by reference. 2. A dispute arose amongst the parties and HCR ManorCare sought arbitration of the dispute under the terms of the Arbitration and Limitation of Liability Agreement. 3. Arbitration was held before Nathan C. Wolf, Esquire, Jacqueline M. Vernev, Esquire and Katie J. Maxwell, Esquire after their appointment as arbitrators. 4. Bradley L. Griffie, Esquire as arbitration administrator, served the Defendants with notice of the arbitration hearing. Proof of said service is attached hereto as Exhibit "B" and is incorporated by reference. 5. The arbitrators have rendered an Arbitrators' Decision and Award in this matter a true and correct copy of which is attached hereto as Exhibit "C" and is incorporated by reference. EXHIBIT "A" 6. Pursuant to 42 Pa.C.S.A. §7313, a party to an arbitration may make application to the Court of Common Pleas for confirmation of the award by the Court. 7. Pursuant to 42 Pa.C.S.A. §7316, upon confirmation of the award, a judgment or decree shall be entered in conformity with the order. 8. Copies of the Arbitrators' Award was mailed to all of the parties on June 7, 2011. 9. No request for modification or correction of the award has been filed by the Defendant to the date of this application. WHEREFORE, Applicant requests that the award of the arbitration administrator be confirmed and judgment be entered in conformance therewith. Respectfully submitted, BARIC SCHERER LLC AZ , - J?V-- David A. Baric, Esquire I.D.# 44853 19 West South Street Carlisle, PA 17013 (717) 249-6873 Attorney for HCR NlanorCare, Inc. VOLUNTARY AGREEMENT: If you do not accept this Agreement, the Patient will still be allowed to live in, and receive services in, this Center. ARBITRATION AG EMEN'T ("<IGREEMEN " BY ACCEPTING THIS AGREEMENT. THE PARTIES ARE W.kIV[NG THEIR RIGHT TO A TRIAL BEFORE A JUDGE A.NWOR A JURY OF ANY DISPUTE BETWEE_NI THEM. PLEASE READ THIS AGREEMENT CAREFULLY AND IN ITS ENTIRETY BEFORE ACCEPTING ITS TERMS. This Am-cornent made: on (dare) b and bat,veen the Patties, Patient ?C•I?MII x, ,11 and/or Pa.ti, nt's Legal Representati.?-c ? - ._ (callectivelyra£etred to as `Patient"), and the Center ` is an Agreetnlent intand.ed to require that Disputes be -: resoived by arbitration, The .Patient's Legal Rcpresen:tative agrees that he is sivning rbis rtgreeu3ent as a Party, both in his representative and individual capacity A. WHAT IS AJ2BITRATION': Arbitration is a cos' effective and [Ilse saving method of tesolving disputes without involving fihe courts. to using arbitration, [tie disputes arc heard and decided by a. private individual called ar arbitrator. Me dispute,,3ill not be heard or decided by a judge orjury. B. AGREEMENT TO ARBITRATE "DISPUTES,,: Any and all claims or controversies arising out of or in cart' wall' relating to this Agreement; the Admn &Sioa Agreement or any of the Patient's stays at this Center, or any Center operated by azty subsidiary of HCR-Manor Care, Inc., whether or not related to incdical in.alpracticc, including but not limited to disputes regarding the m.at<ing, execution; validity, enforceability, voidability, uaeonscionability, severability, scope, mterpretatiotn< preemption, waiver, or arty other defense to ea;orceability of 'his Agreement or the Admission Age-zinent, whether arisin? cut of State or Federal law. whether eNisting now or aiisiog in the filtare. whether for statutory, compensatory or punitive damages and whether sounding in breach of contract, tort or breach of sta.tut.ory duties (inc...udina, without i rnitation except as indicated., any claim based. oa Pat;ems' Rights or a claim for unpald Cetiuer charges), regardless of the basis For the ditty a of the legal theories upon which the Claim is asserted, shall be submitted m biidin2 arbitration. Not,,i?imstandi iu the above, nothing in this Agreement przveuts the Patient 5:om filing a grizvance or complaint with the Center or appropriate ?overnmentrtl agenci,; from regiiasting an insp?ction of the Ccn'er f:oln such agency; or fi-om seeking review under any applicable federal, state or loca'. law of any dacisios to involuntarily discharge or transfer the Patient from the Center. 1. Administrator: The arbitration shat] be admiitistcrr.d by Narioaal Arbirration Forum. -NAF'), 6465 Wayzata Blvd„ Suite 500, Minneapolis, Ivfti 5142.6 wzvtic,arbitratiort-farurl, (hereinafter "Administrator`) Ifthe Parties mutually agree in writing not to select NAF or if the NAF is unwilling or unable to serve as the Administrator; 1te Parties shall azre2 Ltpon -another in.dc.pendent entity to serva 33 the Adwinistrator, unle>s tha ?ixties, mutually agrae to riot have ail .-administrator. 2. Demalyd for Arbitration shall be suade in writing. sent to [tie other Patty r;a -aiTifiad mail, rcluln receipt requested, and tiled with NAF (unless NAF is mutually «aived). 3. Arbitration Panel: fbc arbitration shall be conducred by thug (3) Art,itc•arors (dic "Panct"). Each Party will select ona Arbitrator. The t,,vo selected Arbitrators will select a third ,Arbitrator. Each Arbirator [Host be a retired State or Federal' Colu't Jude or a Member of the State Bar wllere the Center is located xic[I at least N years of experience as an attorney. NAF approved Arbitrators do not have to be used. if one Party refiises to select its arbin ator within 30 days of a written rcqu.c?t. For same, then the Administrator 311;1]1 3alect. that Patty's Arbitrator. 1- Sole Decision Maker: The Arbitratiou Panel is ?rnpowared with th.a sole jiLI-isdiction to7 anct =halt, resolve all disputes; including without limitation, any disputes about the staking; validity, enforceability, :cope, interpretation, voidahility, ttncorscionabili ?, preemption. severzbility and/or wuver of this Ageernenr or the \dniission Agrecuierrt, EXHIBIT "A" as well as [-solve tl e Parties' tuiderlyina disputes, as it is the Paities' alter[ to completely avoid atvolvinz rate tour, system. Tlic Panel shall not have jurisdiction to certify ally person as a repre3ent3ttve of a lass of nersOtls and, by doing so, adjudicafe claims of persons not db-ectly taking part is :Arbitration 5. Procedural Rules and Substantive Law: The Panel shall apply th:: Federal Rttles of'rvidence and Federal Rules of Civil Procedure except where otherwise stated in this Agreement Also, the Panel shall apply. uid the arbitration award shall be corlsistent xith, the Sate substantive iaW (in.cluding any and all statutoiy damage caps) for the State in which the Gcnrer is located. except as otherwise stated i i this Agzeeuient or where preempted b the FAA, The Panel shall apply NAF's Code of Procedure (in effect as of May 1, 2006) unless othetvtise stated in this Agreement. NAF's Code o;`Procedtu•e may be obtained from •N<AF, (877) 666-7755, z:ti?tiv,arbitration forwr.com The Parties hereby opt- out of NAF Rules (45 reaarftZ, indigents; 43 regarding appeals and ittdicial rr,view). 6. Refusal to Arbitrate: Any Patty who refuses to go forward with arbitration aclenowledoes that the Panel will go forward with the arbitration hearing arid render a bind.,rig award without the patticipation of such Pat y or despite his absence at tIc hearing. I. Waiver of Claim: ka claim shall ba forever waived if it arose prior to the arbin-atioa hearing and is not pr:sented in suet,, hearing. rN claim that is not served Mtliin the statute of lirnimtioas period appkcable to the -ante olaint in, a count cf law in the state in wliich this Center is located shall be farvcr waived. S. Award: Tile Panel's award must be unanullous .111d shall be served no later that[ rive (;) working days after the arbitration hearing. The award inust state in detail the Panels' findings of fact and conclusions of la,v, shall be rnarked ''confidential". and must be signed by all three Arbitrators. If any damages are awarded, the a,.v,-lrd must delirieat2 speci`,c atnounrs for economic and;;)r non-cconornic damages 9. Final with Limited Rights ro Review (Appeal): The Panels award binds tits Parties l ate Patties have a limited riatt of revi2sv for only tha etpress reasons allo,ved 6y the FA.4. D. D _SCOV RY: Discovor y shall be governed by NAP's Code of Procedure. HoWwer, discovery shall be limited as follows. (1) Withal 30 days after seraice? of the Demand, each Party must :onrply with Fad. R. Civ. P., Rule 26(a)(1) and thereafter must comply with Rule 26)(e) regarding supplementation of disclosures and responses. (2) A Party may sei e a matirttum of 30 writtan questions (intau,ogatories), 30 requests ic produce documents and 30 requests for admissions; ittclusv-_ of subparts. (3) The followtn2 disclosures shall he served no Icier titan one Iiuudred fifty (150) days befor° the arbitration hearing by the Claimant. and one hundred twenty (120) days before the arbitration hea.rittg by the Respondent: (a) list of witnesses to be called at die Hatu ng (Rill name; title, address and phone number If known) and an outline of each witnesses' bltended testimony; {b) dg at docunents to be relied upon at Hearing; except documents to be used solely for impeaclunent purposes; (c) any shorn recorded staterrtenrs to be relied upon at Hearing inci,,din_v- the fill.. name, title, address and phone number of the person who gave the statement. The Pasties shall supplement These disclosures oer Fed. R. Civ_ Pr . Rule. 26 (e). (4) Each Patty niay ha?e tip to three 3) axpzrts and no more than teri (10) lay wimasses for its wimess li_t, as well as fcr:hc Hearing. Depositions of witncsscs shall be limi`.od to those people listed on the Parties' witness lists or in the Psr'.i_s' Rule 26 disclosures or, disco every responses but under no circtunstatices wili a Party be allowed to take Dior- d^an 1 depositions- A Written report surmnarizing each expert's opinions and the basis for each opinion, and a list of all record; contained in the axpez- s file, mast ba served at least thirty (30) days before the expert's deposition; (5) Discovery sha11 be completed 45 days before the Haaiinz and the Hoaring shall begin no later than 365 days alter Deimmd for Arbi!ralicn is served, shall fast in :b.rration no gouge- thar. the (5) ?xorkirg days- and the hearalg tune allowed shall be split on a pro rata oasis sub;ecr t-) the Panel's discrction. (6) The Parties may agree to modifti these discose? tertzs or deadlines. E. RIGHT O CHANGE 1:7OUR MfUNQD: This Agreement may be cancelled b;, ?-n•irtai, uotzce sent b,- certified maid to the Center's Alin usistrator .within thiry (30) calendar dais of the Patients data of adinission. If alleged acts utcierlvir rite dispute occur before the canc,?liaiion dote. this .'1Rraement -hat's be l bA: g with respect ro those aileoed acts. If not cancelled, this Agz-eemEmt shall be binding on the Patient for rJT; and all of the Patient's other admissions to the Center wit}tout any need for fbrTher renewal. F. OTHER PR.OVZS -01NM: 1. No Caps/Lintits on Damages: There arP no caps/limits on the amount of damages the Panel can award other than those already unposed by law in the state ui which this Center is located. All state lams, ststtaes and regulations that limn awardable damages Ind define the =cope of admissible and inadmissible ewdencs (i.c. regulatory surveys, incident reports, etc.) axprcasly apply to any arbitration hearing held pursuant to this A7r°etalent. 2. Opportunity to Review & Right to Consult With Attorney: Tire Patient (if competent) and die Patient's Legal kepresentative acknowledge that the Patient and Legal Representative leave each recei,ied a copy of this Agreement, and have had an opportunity to read it (or leave it read to him/her) and ask questions about it before accepting it. Plaase road rhis Agaemert very carefully aitd ask any question- rha.t you have before s?_gnnz it. Feel -tee to consult with an attorney of your choice before sigzling this Azy=uent. 3. Benefits of Arbitration: The Patties' decision to select kibitrarion is suppcrtad by the potential cost- a-,,,d tune-savings offered by selecting arbitration. which seeks to avoid the expense and delay in the tout? system. The Parties reco.plize that often the Patient is elderly and may have a limited life-expectancy; and therefore selecting a quiok method of resolurion is potentially to a Patient', advanuage The Parda3 a?co that the reasons stated above are; prover aowsiderauion for the acceptance of the Agreement 4. FAA: The Parties hareb- agee and intend that this Agreensert, the Acbrission ,1 e attar and rha Patient's stays at the Canter subsr ttiaiiy involve interstate coniznerce, Ind stipulate that the Federal Vbilxazion Act ("FAA'') in effecr as of NovctnC?er 1, 2008 and federal case lain intotprerin- such version of the FAA Shall apply to this ??lcCarrait-Ferguson Ajeemenr, shall pr, ? ipt any inconsistent State law and skull not be reverse preempt-,d b-y the cr. United Status Code Tula I I, Chapter 20, or other law. Any atnendnaent to such version of the FAA is hareb,? expressly waives, 5. Dimling on Parties & Others: The Parties intend that this Agreement shall inure :o the direct benefit of and birld the Center, its parent, of iliates, and suibsidivy companies; management colnparies. axecutive directors, owners, of scars, partners, shareholders, directors, medical directors, employees, successors, assi. sis, agents, insurers and any entity or person (including health cm•e providers) that provided an, service, supplies or equipment related to cite Patient's stay at tk:a Center; anti shall inure to the direct benefit of and hind the Patient (as defined herein), his/her successors, spouses, children; next ofkut, guardians, administrators, legal representatives, rasporisibia parties. assign;, agents. attonleys, health tale proxies; health care su.tTowates, third Pat^y bereticiaries, instuers, heirs, trustees, survivors arid represcntatives, lncludnac the personal represcntativzs or B.x=itot3 of ilis/iar estate, ,iny person whose claim -s derived throrth or oil behalf of the Patient or relates in an_i way to the Patients stay(s) a- `his Center, or any Verson who previously assutlaed responsibility for providitlg Patient ,v;t1l necessary servi;es suc,l as food. shelter, clothu.g. or medicine, and any person who executed this Aa-eeinent er the Admissiou A4reenjent_ 6. Fees and Costs: The Panels' fees aad costs will be paid by the Center e;ccept ut dispu.es over non-payment or Center charges wharein such fees and costs will he divided equally bei:lveen the fames. NAF's administrative fees shall be divided. equall) among the Parties To the extent permitted by 1gWw M), Paid who unsuecesslahly cltalleri-ges the er-,orcemenr of this Agreement shall be required to pay the succcssfuJ Parties' reasonable attorney fees and costs incurred to enforce such coattract (i.e., Motion to Compel Arbitration.). The Parities shali bear theu. owri attorney foes acid costs in relation, to all, preparation and attendance qt the arbitration hearing, unless ti:e Panel concludes tat the law provides )therwis2. Except as stated above, the Firties waive any ri.aht to recover atronleys' fees and costs. Confidentiality: Tree arbitration prcccedings shall remain confidential ut all respect;- tn0lading al'?filings, deposition `ranscnpts, discover; documents, or other mate-nals exchanged '?ehs'azn the P3rti?s and the Panel' award In addition, following receipt of the Panels' award.. each Part, agaees to renull to the producing Party within 30 days the original and all copies of documents exchanged in discovery and at tare arbitration Hearing. 3. Waiver of this Agreement: hither Pasty stray tilt its dispute ur a court of iaw if the other Patty approves, which approval shall only be established by such Pate riling a response to the Complaint without moving in a timely inanner, as prescribed by the applicable rules of torsi, to enforce this AD7,;atent. However, should one of the Parties to this Binding Arbitration Agreement breach its terms by initiating a lawsuit in the Judicial foruntr the Pmti05 expressly agree that participation in cooperative general discovery %vlila a motion to compel arhitration is pending shall not constitute evidence of a waiver of the right to arbitratf. A Waiver of the ri;bt to arbitrate a specific Dispute or series of Disputes. as described above, relieves neither Parry of the contractual obligation to arbitrate othc)- Disputes. including borlr perrnissive and mandatory cotuaterclaims. tu11CS5 also subsequently waived. 9. Scverability, Integration and Survival: Any term, phrase or provision contame3 in this Agreement is severable, and in the event any of diem is found to be void, invalid or unenforceable for any tea on, this Agreement shall be interpreted as if such term, plu•ase or provision ware not contained herein, and the remaining provisions of rhis A21-eement shall not be affected by such dctertnirtation and shall remain in fitll force and affect. This Agreement represents the Parties' entire a_a_reamant rebar1ng Disputes, supersede, as-ly other aat'eement relating to disputes, and it May only ''oe changed in t.G.-i_ting signed by all Parties. This A Arc. sni :nt shall r-ernain in pill force and effect nottwitastauduig the reiminadon, cancellation or natural expiration of the Admission .1 eetneur. 10. No Jury Trial: Ifthis Agreement is found to be unenforceable and arbitration is not compelled, then as a defauit. the Panics agree That talc disputes 9Jlall be resolved solely by ajudge via a beach trial Under no circumstances will a ]lliy decid.; an`: dispute 11. Health Care Decision: The Parties iaereby stipuisze that the derision to have die ?atiinn° move into this Conte, and :1.e decision to agree to this AueeMent are each a ileaiih care dccisiort. Ttre Patios stipulate that tlicr3 other heal?lr care facilities in this conuuunity currently 3vai1ible to meet the Patients needs 12. Legal Representative: The. Patient's Legal Representative, by his or t'.er signattue belo,v. hereby represents and stipulates that he/she has been authorized by the Patient to sign this ,4greeuient on behalf of tine Patient. BY SIGNING BELOW, THE PARTIES CONFIRM THAT EACH OF THEM HAS READ ALL FOUR (4) PAGES OF THIS AGREEMENT AND UNDERSTANDS THAT EACH HAS WAIVED THE RIGHT TO A TRIAL BEFORE. A JUDGE OR JURY AND THAT EACH OF THEM CONSENTS TO ALL OF THE TERivIS OF THIS VOLUNTARY AGREEMENT. PATIENT: ??"?? CIO nflS:Gt? -- Printed Name ();Jere) ?J S )re of anent PATIENT'S LEGAL REPRESENTATIVE; Printed Naine (Date} Si2jnaturv of Patient's Legal Representative' ill his/lrer Representat-,- capacity Patient's Legal Representative should sign on b9il lines above containirig the please Twient's Legal Representative." Si?na[ure v I cr Rcp Lvc Si-nature of Patient's Legal Rapres-,nrativa in his/h.er Indivildual capacity car ASSOCIATES Attorneys and Co,znseiors a` L v Bradley L. Griffie, Esquire Hannah Herman-Snyder, Esquire Robin I Bassett Office Manager Kelly L. Perez Legal Assistant Reply to: Carlisle David A. Baric, Esgtl.ire 19 West South Street Carlisle, PA 17013 James E. Johnson, Sr 322 Pine Street Steelton, PA 17113 December 28, 2010 RE: HCR ManorCare vs. James E. Johnson, Sr. Dear Mr. Baric and Mr. Johnson: 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 100 Lincoln Way East, Suite D Chambersbur;, PA 17201 (717) 267-1350 (800) 347-5552 Fax (717) 243-5063 Please be advised that the following attorneys will serve as the Arbitration Panel to resolve the issue of collection of past due fees claimed by HCR ManorCare against Mr. Johnson: Nathan C. Wolf, Esquire 10 West High Street Carlisle, PA 17013 Jacqueline M. Verney, Esquire 44 South Hanover Street Carlisle, PA 17013 Katie J. Maxwell, Esquire Martson Law Offices 10 East High Street Carlisle, PA 17013 Please be advised that pursuant to the Arbitration Agreement executed by HCR ManorCare and by Mr. Johnson, I have scheduled the Arbitration hearing in this matter for Tuesday, May 24, 2011, at 9:00 a.m. to take place at my office at 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. At this time, I :remind Mr. Johnson that he has obligations under the Arbitration Agreement to disclose information that he intends to prove at the time of trial. HCR ManorCare has previously made the necessary disclosures as described in paragraph "D" of the Arbitration Agreement by providing a list of witnesses to be called by HCR ManorCare and by providing other relevant information as described in that paragraph. EXHIBIT "B" Page 2 David A. Baric, Esquire James E. Johnson, Sr. December 28, 2010 Mr. Johnson's information must be provided immediately to be in compliance with paragraph "D". Mr. Johnson must provide us with the following: (a) list of witnesses to be called at the hearing (full name, title, address and phone number if known) and an outline of each witness' testimony; (b) list of documents to be relied upon at the hearing; except document to be used solely for impeachment purposes; and (c) any sworn, recorded statements to be relied upon at hearing, including the full name, title, address and phone number of the person who gave the statement. This information must be provided promptly as it is to be provided no less than 120 days before the hearing, pursuant to the Agreement. I again remind Mr. Johnson, as well as Mr. Baric, that we will be moving forward with this Arbitration as scheduled absent a resolution between the parties by agreement, which is confirmed with me in advance of the hearing. As the Arbitration Agreement provides that the fees incurred by the Arbitration Administrator and the panel are to be shared equally by the parties, I am instructing each of you to deposit the sum of $750.00 with my office to use as compensation to the Arbitrators and for my fees by April 24, 2011. I anticipate that this hearing will not be continued from this date without good cause shown, which will be at my discretion. Your attention to these matters I appreciated. y Yours, Griffie BLG, Jp Enclosure Cc: Nathan C. Wolf, Esquire Jacqueline M. Verney, Esquire Katie J. Maxwell, Esquire HCR NLANORCARE INC. ARBITRATION PROCEEDING ?T JAMES E. JOHNSON, SR. NOTICE OF HEARING It is hereby directed that the hearing in the above captioned matter shall be held Tuesday, May 24, 2011, to begin at 9:00 a.m., said Arbitration Hearing to be held at the law offices of Griffie and Associates, 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. No later than fourteen (14) days prior to the said Arbitration Hearing, each party shall exchange a list of witnesses to be called at the hearing, including their full name, title, address, and phone number, and an outline of each witnesses intended testimony. Within the same time frame, each party shall exchange a list of documents to be relied upon at the hearing and any sworn recorded statements to be relied upon at the hearing, including full name, title, address, and phone number of the statements declarant. The hearing shall proceed pursuant to the terms of the Arbitration and Limitation of Liability Agreement executed by the parties on July 22, 2009. Date ra `fie, Esquire Arbitra or 100 Lincoln Way East, Suite D Chambersburg, PA 17201 (717) 267-1350 200 North Hanover Street Carlisle, PA 17013 (717)243-5551 (800)347-5552 Distribution: David A. Baric, Esquire James E. Johnson, Sr. V AIL HCR MANORCARE, INC., Plaintiff ARBITRATION PROCEEDING vs. JAMES E. JOHNSON, SR., Defendant ARBITRATION PANEL DECISION AND AWARD 1. PROCEDURAL HISTORY: By correspondence of November 9, 2010, counsel for HCR ManorCare, Inc. (hereinafter "the facility") requested the services of Bradley L. Griffie, Esquire, to serve as Arbitration Administrator pursuant to the terms of an Arbitration Agreement executed by a representative of the facility and by James E. Johnson, Sr. (hereinafter "Patient") The Arbitration Administrator gave notice of his willingness to serve in this capacity by correspondence dated November 11, 2010, further confirming that he had no interest in the facility nor knowledge of the parties in a manner that would cause the Arbitration Administrator to be unable to be independent. By correspondence dated November 16, 2010, the facility gave notice to the Arbitration Administrator of the facility's intended witnesses and exhibits, pursuant to the requirements of the Arbitration Agreement. By correspondence dated November 1.6; 2011; the facility named Attorney Nathan Wolf as its Arbitrator. Upon failure of the Patient to name an Arbitrator after two written notices and requests to do so, the Arbitration Administrator named Attorney Jacqueline Verney as the Patient's Arbitrator. Mr. Wolf and Ms. Verney selected Attorney Katie J. Maxwell as the third Arbitrator for the panel. EXHIBIT "C" By correspondence and Notice of Hearing dated December 28, 2010, a hearing was scheduled in this matter to take place on Tuesday May 24, 2011 to begin at 9:00 a.m. at 200 North Hanover Street, Carlisle, Cumberland County, Pennsylvania. Notice was provided to the Arbitration Panel, legal counsel for the facility and the Patient, all at their last known mailing addresses. No requests for a continuance were received from either party or counsel. Appearing at the hearing before the Arbitration Panel on Tuesday, May 24, 2011, were Steve Vignati, Business Office Representative of HCR ManorCare, Inc. and David A. Baric, Esquire for HCR ManorCare, Inc. II. FINDINGS OF FACT: 1. On July 20, 2009, James E. Johnson, Sr. (hereinafter "Patient"), executed an Admissions Agreement and an Arbitration Agreement associated with the Patient's admission to the facility located at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 2. Paragraph 3.2 of the referenced Admission Agreement provided confirmation from the Patient that he would pay the room and board rates to the facility, exclusive of expenses covered by insurance, Medicaid, Medicare, Veteran's Administration payments, or related payments, on behalf of the Patient. 3. Pursuant to paragraph 3.2A of the said Admission Agreement, Patient agreed that he would pay all charges that he incurred while at the facility located at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 4. While the Patient originally entered the facility as a Medicare patient, thus having all room and board fees paid by Medicare, the room and board charges to the patient were $7,099.00 per month effective August 17, 2009 and $7,533.00 per month effective November 1, 2009 for services provided to the Patient while at the facility at 1700 Market Street, Camp Hill, Cumberland County, Pennsylvania. 5. Statements of charges were submitted to the Patient for the period from August 17, 2009 through and including the period covering November 9, 2009 for room and board services, cable charges, beauty shop charges and related charges, that were billable on a private pay basis. 6. All appropriate insurance payments or applicable payments from Medicare or Medicaid have been applied to the outstanding bill of the Patient by the facility. 7. The facility billed the Patient directly on a monthly basis for services provided to the Patient. S. The facility provided monthly past-due notices to the Patient for fees due to the facility for services rendered which remained unpaid. 9. Neither the Patient nor anyone on his behalf objected to the billings. 10. The Patient was discharged from the facility on November 9, 2009. 11. All payments made to the facility from all sources have been applied to the Patient's billing for services provided by the facility. 12. While some private payments have been received, an outstanding balance remains due for services provided to the Patient by the facility for which private payment is still due. 13. The total balance due for services provided to the Patient from admission on July 21, 2009 to the date of hearing is $21,282.81. 14. Pursuant to paragraph 6 of the Arbitration Agreement executed between the parties, in a dispute over non-payment of facility charges the Panel's and Administration fees will be paid equally by the parties. 15. The dispute between the parties in this matter involved the non-payment of charges. 16. The facility made a formal Demand for Arbitration pursuant to the terms of the Arbitration Agreement upon the Patient and the Responsible Party by correspondence October 27, 2010. 17. Proper notice of the time and place of the hearing was provided to the facility and to the Patient, pursuant to the terms of the Arbitration Agreement. 18. No: Bequest for a continuance, nor other contact, was made by the Patient with the.lArbitration Administrator, nor with any member of the Arbitration Panel, prior to the hearing. 19. The hearing began at 9:15 a.m. on Tuesday, May 24, 2011 at 200 worth Hanover Street, Carlisle, Cumberland County, Pennsylvania, after delaying the hearing 15 minutes from the original scheduled start time for the hearing of 9:00 a.m., to all Icvv the Patient to appe r or othGrwlse rnak- contact with tn-? Arbitration Administrator. 20. The Arbitration Administrator is not aware of any efforts made by the Patient nor anyone on his behalf to contact the Arbitration Administrator relative to the Patient's inability to attend the hearing. III. CONCLUSIONS OF LAW: The Patient, James E. Johnson, Sr., (hereinafter "Patient") entered into the terms and conditions of the Admission Agreement and the Arbitration Agreement executed by the Patient's Legal Representative, with the facility, HCR ManorCare, Inc., on July 20, 2009. The contracts are binding and provide all appropriate notices pursuant to Pennsylvania law. The binding Arbitration Agreement provides that all claims and controversies between the facility and the Patient will be resolved through application of the terms of the Arbitration Agreement. The Patient has failed to meet his obligations under the terms of the Admission Agreement to compensate the facility for services provided to the Patient. Proper notice of services rendered and fees incurred was provided by the facility to the Patient pursuant to the terms of the Admission Agreement. The parties and legal counsel received proper notice of all proceedings under the Arbitration Agreement, including Notice of the hearing. ARBITRATORS' AWARD Pursuant to the findings set forth herein, Judgment is hereby entered against James E. Johnson, Sr., in favor of HCR ManorCare, Inc. in the amount of $21,282.81. Administration fees for the Arbitration Administrator in the amount of $360.00 and Arbitrator's fees of $450.00 ($150.00 per Arbitrator) shall be divided equally between the parties, such that HCR ManorCare, Inc. shall compensate the Arbitration Administrator for his fees and for compensation of the Arbitrators the sum of $405.00 and James E. Johnson, Sr. shall likewise compensate the Arbitration Administrator for his fees and for compensation of the Arbitrators the sum of $405.00. In the event that HCR ManorCare, Inc. compensates the Arbitration Administrator in the full amount of fees and costs due, HCR ManorCare's Judgment is adjusted from the $21,282.81 amount set forth above to include the share of Arbitrator's fees and costs of James E. Johnson, Sr. in the amount of $405.00 for a total Judgment of $21,687,81. Nathan C /Wolf, EI?57 O acqu ' e M. Verney, Esquire Katie J. ax"well, NtIire L. Griffie, Esquire on Administrator HCR MANORCARE, INC., Plaintiff : ARBITRATION PROCEEDING vs. JAMES E. JOHNSON, SR., Defendants CERTIFICATE OF SERVICE 7? I, Bradley L. Griffie, Esquire hereby certify that I did, the day of June, 2011, cause a copy of the Arbitration Panel Decision and Award to be served upon the Plaintiff by first class mail, postage prepaid, and upon Defendant by serving him by first class mail, postage prepaid, and certified mail, restricted delivery, at the following addresses: David A. Baric, Esquire 19 West South Street Carlisle, PA 17013 James E. Johnson, Sr. 322 Pine Street Steelton, PA 17113 DATE: & fb? / / Sr- . Griffie, Esquire ion Administrator RIFFIE & ASSOCIATES 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 HCR MANORCARE, INC., Plaintiff v. JAMES E. JOHNSON, SR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2011- 5 787 RULE AND NOW, this Af? day of?--, 2011, upon consideration of the foregoing Application To Confirm Arbitration Award, it is hereby ordered that (1) a rule is issued upon the Defendant to show cause why the Plaintiff is not entitled to the relief requested; (2) the Defendant shall file an answer to the Application within A days of this date; (3) the Application shall be decided under Pa.R.C.P. No. 206.7; (=1) depositions shall be completed within days of this date; (5) argument shall be held on the day of I Al R 04 _, 2011, at 9:15 a.m./fit. in Courtroom -4- of the Cumberland County 70" " Courthouse; and (6) notice of the entry of this order shall be provided to all parties by the Plaintiff. BY THE COURT, s J. EXHIBIT "B" CERTIFICATE OF SERVICE I hereby certify that on August 1 b , 2011, I, David A. Baric, Esquire of Baric Scherer LLC, did serve a copy of Motion To Make Rule Absolute, by first class U.S. mail, postage prepaid, to the party listed below, as follows: James E. Johnson, Sr. 322 Pine Street Steelton, Penn lvania 17113 David A. Baric, Esquire 4. HCR MANORCARE, INC., Plaintiff V. JAMES E. JOHNSON, SR. Defendant TO THE PROTHONOTARY: IN THE COURT OF COMMON PLEAS OF, v CUMBERLAND COUNTY, PENNSYL16*- M `- 1 r-q zi?? r NO. 2011-5787 CIVIL TERM'- c? ? T r AFFIDAVIT OF SERVICE - I certify that the attached correspondence dated July 26, 2011 along with a copy of the July 22, 2011 Rule signed by Judge Hess was mailed to the Defendant via United States First Class mail and was not returned to me as undeliverable. r David A. Baric, Esquire DATE: August 16, 2011 BARIC Attorneys at Law SCHERER LLC David A. Baric Michael A. Scherer Tricia D. Naylor Bret P. Shaffer 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 (717) 249-5755 - Fax dbaric@baricscherer.com July 26, 2011 James E. Johnson, Sr. 3 22 Pine Street Steelton, Pennsylvania 17113 RE: HCR ManorCare v. James E. Johnson. Sr. No. 2011-5787 Civil Term Dear Mr. Johnson: Enclosed find a copy of the Rule signed in the above matter by Judge Hess on July 22, 2011 in connection with the Application To Confirm Arbitration Award I filed on behalf of my client, HCR ManorCare, Inc. Very truly yours, BARIC SCHERER L David A. Baric, Esquire DAB/jl Enc. cc: Steve Vignati w/Enc. VIA FACSIMILE: (717) 737-2189 (!ED dab. dir/manoreare/johnson-james/james2.ltr HCR MANORCARE, INC., Plaintiff V. JAMES E. JOHNSON, SR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2011- 5 787 RULE AND NOW, this day of , 2011, upon consideration of the foregoing Application To Confirm Arbitration Award, it is hereby ordered that (1) a rule is issued upon the Defendant to show cause why- the Plaintiff is not entitled to the relief requested; (2) the Defendant shall file an answer to the Application within ob days of this date; (;) the Application shall be decided under Pa.R.C.P. No. 206.7; (4) depositions shall be completed within days of this date; (5) argument shall be held on t`idQ.V , the _ day of 2011, at 5 a.m./. in Courtroom -4- of the Cumberland County Courthouse; and (6) notice of the entry of this order shall be provided to all parties by the Plaintiff. BY THE COURT, s A. 4ms& J. HCR MANORCARE, INC., IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2011-5787 CIVIL TERM JAMES E. JOHNSON, SR., Defendant --- ' ORDER OF COURT AND NOW, this / day of /??'I4, - , 2011, upon review of the attached Motion To Make Rule Absolute, it is hereby ordered and decreed that Rule previously issued relative to this matter is absolute and the arbitration award is confirmed and a judgment in the amount of $21,687.81 is entered of record in this matter BY THE COURT, /David A. Baric, Esquire Baric Scherer LLC 19 West South Street Carlisle, Pennsylvania 17013 01 James E. Johnson, Sr. 322 Pine Street Steelton, Pennsylvania 17113 ?,Pies M0?11? ? ? g116100 t x HCR MANORCARE, INC., Plaintiff V. JAMES E. JOHNSON, SR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA c C= NO. 2011-5787 CIVIL TERM • rnww =rn s r- r1o .e V ca <a z o p„c w PRAECIPE TO ENTER JUDGMENT ON ORDER -+ TO THE PROTHONOTARY: Please enter judgment in the above-captioned matter pursuant to the Order Of Court signed by the Honorable Kevin A. Hess on August 17, 2011, entering judgment in favor of the Plaintiff in the amount of $21,687.81. Respectfully submitted, B C SCHERER LLC 1 David A. Baric, Esquire I.D. 44853 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 3 7e c rnr-- ?o =o d? ? , , .,., Q., 4. HCR MANORCARE, INC., Plaintiff V. JAMES E. JOHNSON, SR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2011-5787 CIVIL TERM ORDER OF COURT AND NOW, this _J_*- day of _, 2011, upon review of the attached Motion To Make Rule Absolute, it is hereby ordered and decreed that Rule previously issued relative to this matter is absolute and the arbitration award is confirmed and a judgment in the amount of $21,687.81 is entered of record in this matter BY THE COURT, David A. Baric, Esquire Baric Scherer LLC 19 West South Street Carlisle, Pennsylvania 17013 James E. Johnson, Sr. 322 Pine Street Steelton, Pennsylvania 17113 --t*4'evin A. Hess, J. C?I WI 1 1?' 1 CERTIFICATE OF SERVICE I hereby certify that on August 23, 2011, I, David A. Baric, Esquire of Baric Scherer LLC, did serve a copy of the Praecipe Enter Judgment On Order, by first class U.S. mail, postage prepaid, to the party listed below, as follows: James E. Johnson, Sr. 322 Pine Street Steelton, Pennsy is 17113 David A. Baric, Esquire