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HomeMy WebLinkAbout02-0828IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA COUNTRY MEADOWS ASSOCIATES, a Pennsylvania Organization, d/b/a COUNTRY MEADOWS OF WEST SHORE IV, Mo Plaintiff HELEN C. YEINGST and TODD A. YEINGST, Defendants CIVIL ACTION - LAW/E. QUIT?/~ 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. Lawyer Referral Service 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717) 249-3166 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 veinte (20) dias despues de la notificacion de esta 65~7.1 Demanda y Aviso radicando personalmente o por medio de un abogado una comparecencia escrita y radicando en la Corte por escrito sus defendsas de, y objecciones 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 puede 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. Lawyer Referral Service 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717) 249-3166 72497 10 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA COUNTRY MEADOWS ASSOCIATES, a Pennsylvania Organization, d/b/a COUNTRY MEADOWS OF WEST SHORE IV, Plaintiff HELEN C. YEINGST and TODD A. YEINGST, Defendants CIVIL ACTION - LAW/EQUITY COMPLAINT AND NOW, COMES, Plaintiff, Country Meadows Associates, a Pennsylvania organization, d/b/a Country Meadows of West Shore IV, by and through its attorneys, Latsha Davis & Yohe, P.C., and files the within Complaint against Defendants, Helen C. Yeingst and Todd A. Yeingst, and in support thereof, provides as follows: 1. Plaintiff, Country Meadows Associates d/b/a Country Meadows of West Shore IV ("Country Meadows"), is a Pennsylvania organization organized and existing under the laws of the Commonwealth of Pennsylvania, with its principal offices located at 830 Cherry Drive, Hershey, Pennsylvania 17033. 2. Defendant Helen C. Yeingst ("H. Yeingst") is an adult individual currently residing at Claremont Nursing & Rehab Center, 375 Claremont Drive, Carlisle, PA 17013. 72497 3. Defendant Todd A. Yeingst ("T. Yeingst") is an adult individual currently residing at 2832 Rosegarden Boulevard, Mechanicsburg, Pennsylvania 17055. 4. At all material times to this cause of action, Defendant T. Yeingst represented himself to be Defendant H. Yeingst's son, attorney-in-fact and person responsible for her financial affairs. A true and correct copy of the Power of Attorney is attached hereto as Exhibit "A.' 5. At all material times to this cause of action, Defendant T. Yeingst acted as Defendant H. Yeingst's attorney-in-fact and person responsible for her financial affairs in dealing with Plaintiff Country Meadows. 6. At all material times to this cause of action, Defendant H. Yeingst was a resident at Plaintiff Country Meadows assisted living facility located at 4831 East Trindle Road, Mechanicsburg, Pennsylvania 17055. 7. On December August 28, 1997, Defendant H. Yeingst, by and through her attorney-in-fact Defendant T. Yeingst, made application for admission to Plaintiff Country Meadows' assisted living facility located at 4831 East Trindle Road, Mechanicsburg, Pennsylvania 17055. 8. Based upon Defendant T. Yeingst's representations as Defendant H. Yeingst's attorney-in-fact, Plaintiff Country Meadows agreed to admit Defendant H. Yeingst as a resident on August 28, 1997. 9. On August 28, 1997, Plaintiff Country Meadows and Defendant H. Yeingst, by and through her attorney-in-fact, Defendant T. Yeingst, entered into an 72497 2 agreement. A true and correct copy of the Admission Agreement ("Agreement") is attached hereto as Exhibit "B." 10. Pursuant to the Agreement, Defendant H. Yeingst, by and through her attorney-in-fact, Defendant T. Yeingst, agreed to pay Plaintiff Country Meadows a specific monetary fee for the assisted living care that it rendered to her. 11. As consideration for admitting Defendant H. Yeingst to Plaintiff Country Meadows' assisted living facility, Defendant T. Yeingst agreed to use Defendant H. Yeingst's assets and/or resources to pay Plaintiff Country Meadows for those services witch it provided and rendered to her. See Exhibit "B.' 12. Defendants H. Yeingst and T. Yeingst have failed to use Defendant H. Yeingst's assets and/or resources to pay Plaintiff Country Meadows in full for the assisted living care and services which Defendant H. Yeingst received at Plaintiff Country Meadows' assisted living facility. 13. As Defendant H. Yeingst's attorney-in-fact, Defendant T. Yeingst had a fiduciary duty to use Defendant H. Yeingst's assets and/or resources to keep her account with Plaintiff Country Meadows current. 14. Defendant T. Yeingst failed to use Defendant H. Yeingst's assets and/or resources to keep her account with Plaintiff Country Meadows current. 72497 3 COUNT I BREACH OF CONTRACT Plaintiff Country Meadows v. Defendant Helen C. Yeingst 15. Paragraphs 1 through 14 above are incorporated herein by reference as if fully set forth at length. 16. Defendant H. Yeingst, by and through her attorney-in-fact, Defendant T. Yeingst, entered into a written agreement with Plaintiff Country Meadows, whereby Plaintiff Country Meadows agreed to accept Defendant H. Yeingst as a resident at its assisted living facility and to provide her with living accommodations, dietary services, and medication/pharmacy services, in exchange for Defendant H. Yeingst's promise to pay a specific sum to Plaintiff Country Meadows. See Exhibit "B." 17. From August 28, 1997, to October 10, 2001, Plaintiff Country Meadows provided the above-mentioned care and services to Defendant H. Yeingst pursuant to the aforementioned Agreement. See Exhibit "B.' 18. From August 28, 1997, to October 10, 2001, Defendant H. Yeingst carried an overdue balance in her account with Plaintiff Country Meadows. 19. A balance in excess of Ten Thousand Two Hundred Dollars ($10,200.00) is currently due and owing to Plaintiff Country Meadows for the above-mentioned care and services that it provided to Defendant H. Yeingst. 20. Defendant H. Yeingst's failure to keep her account with Plaintiff Country Meadows current constitutes a breach of the Agreement. 72497 4 21. Defendant H. Yeingst's breach of the Agreement has caused Plaintiff Country Meadows to incur damages of Ten Thousand One Hundred Eighty-Seven and 80/100 Dollars ($10,187.80) plus interest. WHEREFORE, Plaintiff, Country Meadows, d/b/a Country Meadows of West Shore IV, demands judgment in its favor and against Defendant Helen C. Yeingst in an amount of Ten Thousand One Hundred Eighty-Seven and 80/100 Dollars ($10,187.80) plus interest and such other relief as deemed appropriate. COUNT II BREACH OF CONTRACT Plaintiff Country Meadows v. Defendant Todd T. Yeingst 22. Paragraphs 1 through 21 above are incorporated herein by reference as if fully set forth at length. 23. Plaintiff Country Meadows entered into a written agreement with Defendant T. Yeingst, pursuant to which Plaintiff Country Meadows agreed to accept Defendant H. Yeingst as a resident at Plaintiff Country Meadows' assisted living facility and to provide her living accommodations, dietary services, and medication/pharmacy services in exchange for Defendant T. Yeingst's promise to use Defendant H. Yeingst's assets and/or resources to pay for those services that it rendered to Defendant H. Yeingst. 24. Defendant T. Yeingst failed to pay Plaintiff Country Meadows from the resources and/or assets of Defendant H. Yeingst for all the care and services that Plaintiff Country Meadows rendered to her. 72497 5 25. As a direct result of Defendant T. Yeingst's failure to pay Plaintiff Country Meadows from Defendant H. Yeingst's resources and/or assets, Plaintiff Country Meadows has incurred damages in an amount Ten Thousand One Hundred Eighty- Seven and 80/100 Dollars ($10,187.80) plus interest. WHEREFORE, Plaintiff, Country Meadows, d/b/a Country Meadows of West Shore IV, demands judgment in its favor and against Defendant Todd A. Yeingst in an amount of Ten Thousand One Hundred Eighty-Seven and 80/100 Dollars ($10,187.80) plus interest and such other relief as deemed appropriate. COUNT III BREACH OF FIDUCIARY DUTY Plaintiff Country Meadows v. Defendant Todd A. Yeingst 26. Paragraphs 1 through 25 above are incorporated herein by reference as if fully set forth at length. 27. Defendant T. Yeingst, at all times material to this cause of action, represented himself to be Defendant H. Yeingst's attorney-in-fact. See Exhibit "A." 28. Defendant T. Yeingst, at all times material to this cause of action, acted as Defendant H. Yeingst's attorney-in-fact in dealing with Plaintiff Country Meadows. 29. As Defendant H. Yeingst's attorney-in-fact, Defendant T. Yeingst had a fiduciary duty to use Defendant H. Yeingst's assets and/or resources to keep her account with Plaintiff Country Meadows current. 30. Defendant T. Yeingst breached his fiduciary duty owed to Defendant H. 72497 6 Dated: Yeingst under the aforementioned Power of Attorney, to which Plaintiff Country Meadows was a beneficial party, by failing to use Defendant H. Yeingst's assets and/or resources to keep her account with Plaintiff Country Meadows current. 31. As Defendant H. Yeingst's primary caregiver, person responsible for her day to day care, and a beneficial party of the power of attorney between Defendants H. Yeingst and T. Yeingst, Plaintiff Country Meadows, as a direct result of Defendant T. Yeingst's breach of his fiduciary duty owed to Defendant H. Yeingst, has incurred damages in an amount of Ten Thousand One Hundred Eighty-Seven and 80/100 Dollars ($10,187.80) plus interest. WHEREFORE, Plaintiff, Country Meadows, d/b/a Country Meadows of West Shore IV, demands judgment in its favor and against Defendant, Todd A. Yeingst, in an amount of Ten Thousand One Hundred Eighty-Seven and 80/100 Dollars ($10,187.80) plus interest and such other relief as deemed appropriate. Respectfully submitted, LATSHA DAVIS & YOHE, P.C. r L. Latsha Attorney I.D. No. 32934 Chadwick O. Bogar Attorney I.D. No. 83755 P.O. Box 825 Harrisburg, PA 17108-0825 (717) 761-1880 Attorneys for Plaintiff, Country Meadows Associates, a Pennsylvania organization, d/b/a Country Meadows of West Shore IV 72497 7 VERIHCATION The madersig~ed hereby verifies that the statements of fact ir[ the foregoing are frae and correct to the best otE my knowledge, irfformatiart and belief_ I tmderstand that any false statemertts therein are subject to the penalties comairted irt 18 Pa. C. S- § 4904, relating to rmsworn f_aJ..ification to authoritie,$. Dated: Vincent I- ~'~'~ Vice President of Accounting. Finance and Management Ir~orraation for Co~ Meadows Assoc~s, a Pe~ylv~a organJza~on, d/b/a Co~ Meadows Ass~ates of York II 72497 Exhibit A 11/07/01 14:13 FAX 717 533 1243 GI~LFCr. C]~OC -~ CHAD 0 BOGAP. ~]013 I, HELEN CATHERINE YEINGST, nee BOW~R~, residing at 4922 SIMPSON FEI~I~Y ROAD, HAMPTON TOWNSHIP, CUMBERLAND County of Pennsylvania, do her~y appoint my son and/or daughter-in-law, TODD A. and/or FRANCES J. YEINGST, as my ATTORNEY-IN-FACT to exercise the powers described in this inst~ment in my name and on my behalf. I EFFECTIVE DATE -- WHEN EXERCISED These powers may NOT be exercised u~le~s or until I am INCAPACITATED '[as defined in P~NNSYLVANIA LAW]. Such incapacity may be deemed to exist without a co%Lrt hearing when a duly licensed medical provider f~.milisr with my condition certifies ~uch ~ncapacity in writing to my ATTORNEY. 'II p~kNC~ ~EON - NON-LIABILITY Anyone dealing with my ATTORNEY may; until he/she receives actual notice of my revocation of thio POWER of ATTORNEY, or has actual knowledge to the contrary; ass~e that the ATTORNEY by presenting thio instrument or an exact copy thereof [by any mea/~ mechanical, electronic, photographic or otherwise], has received the notice of incapacity hereinabove, and shall be held harmless for their reliance thereon. No person dealing with my A.I-k0RNE¥ shall be obligated to see that any money or property paid to my ATTO~NEY is properly applied or to inquire into the validity or propriety of any act of my ATTORNEY or any provision herein. III TEI~INATION and REVOCATION -This POWER of ATTORAFEY shall remain effective until: A. TEP/~INATED by FACT. U~on loss of my incapacity due to recovery from such injuries or illness as caused or continued my incapacity, this POWER shall not be effective upon written notice give/% to the ATTORNEY from either a duly licensed medical practitioner or myself of such recovery. B. TERMINATED by LAW. U~on appointment of a GUARDIAN, in accordance 'with the provisions of Law, the ATTOI~NEY shall turn over to s%tch GUARDIAN all books, records and assets of mine, and such accounting of my estate as the court requires. C. REVOKED. Upon~ritten notice to the ATTORNEY, that I wish to revoke this inst~ment, ~nd all of its provisions. However, if the A'x-±'ORNEY has received previous notice of my incapacity, has not received notice of my recovery, therefrom; and has a good faith belief that I am still incapacitated, my ATTORNEY may petition any court of competent jurisdiction to determine the effectiveness of such revocation. IV ATTORNEY'S POWERS My ATTORNEY is authorized to manage all of my property, either wholly or jointly owned, for me, and in my name, may execute any document ne=essn~y to fulfill such responsibility, and FURTHER, to take such steps necessary to protect or improve my physical or mental health, except for the powers specifically granted by any LIVING WI?.?. then in existence. Such powers shall include all powers given to a fiduciary in the jurisdiction of my residence, or domicile and shall specifically include the following powers, whether gr~nted by law or not: drafted J~ly 29, 1994 page 1 of 3 11/07/01 14:13 FAX 717 533 1243 G~fLFC-CMOC ~ CHAD 0 BOGAP. DURABLE POWER of A'i-~'OP/~EY A. make deposits to or withdrawals from all BA~IKING ACCOUNTS of which I am a signor, including the right to change BANKS for any reason whatsoever; B. enter my SAFE DEPOSIT BOX(es) on my behalf ~nd remove any and all contents thereof; C. EMPLOY ~nd compensa~ ~uch professional and non-professional persons as needed to to which I have grown accustomed; D. prepare ~d file or hire someone to prepare and file all necessary TAX RETurNS on my behalf or on behalf of any business of which I ~m an owner; E. INSURE my health, llfe an4 property, and maintain all such existing INSURANCE; F- sell, exchange, or purchase P~EAL or PERSONAL PROPERTY, or OPTIONS thereon or therefor; G. pay my DEBTS in whole or by installment, and borrow monies, and pledge much assets am collateral am appropriate~ execute CON~RACT$ and other instr%~ents and docuanents; I. create .or sever JOINT T~NANCIES; J. create or te~a, inate TRUSTS, or make grants thereto or withdrawals therefrom; K- contin6e to make GIFTS for or to benefit my son and/or daughter-in-law or other family members in such amounts, such kinds, a~d under such conditions as I had prior to my incapacity; L- settle arbitrate, contest, abandon, collect or pay any CLAIMS against me or my property, or in favor of me; and, M. admit or secure my release from any medical or nursing facility; consent or withhold consent on my behalf for MEDICAL TREATMENT [but only to such extent that such treatment is not covered by a valld LIVING WI?J.] for ~ny disease or injury from which I ~m suffering; have FULL and COMPT~TE ACCESS to my MEDICAL RECORDS. Any health care provider may rely on this POWER of ATTORNEY to divulge information about my mental and/or physical condition to my ATTorNEY. V MA~AGING and COTJ~CTING PROPERTY bpon notification of my incapacity, my A'±"MOP~FEY shall take much steps as are reasonable and necessary to collect and manage all my assets, and further, to contract such of my advisors, of which my ATTORNEY has personal knowledge. My ATTORNEY shall not be required to take physical possession of my automobile(s) or personal property, but should take such actions as will protect and preserve them. VI PROTECTING M~ HEALTH My ATTORNEY is responsible for taking such reasonable steps to protect and improv9 my PHYSICAL and/or MENTAL H~ALTH. However, if at some time my attending health care professional determines that my condition is terminal; except, for the use of "extra-ordinary" life sustaining means, which will NOT lead to a recovery, and ass,~ming I have NOT left a valid L~VING WILL to ~upercede this paragraph, then; my ATTORNEY may withhold or withdraw such life. sustaining means. My ATTORNEY should consent to the administration of medication, hydration or sustenance to make my final days as comfortable and free 9f pain as possible. drafted July 29, 1994 page 2 of 3 init~ 11/07/01 14:13 FAX 717 $33 1243 GMLFC-CMOC -~ CHAD 0 BOGAP. ~015 DUi, iA.~T~ PO~ Of VII CO~ENSATION, BONDS and LIABILITY My ATTORNEY shall be entitled to such reasonable compensation as the size of my emtate or the n~,~ber of hours of work necessary requires, whichever im less, at such rates as are reasonable and customary for the location of my'ATTORNEY. VIII SUCCESSOR ATTORNE~ A. If for ~ny reason, my son and/or daughter-in-law, TODD A. and/or FRANCES J- YEINGST, shall fail or cease to act as my ATTOPd~EY, they shall appoint a suoes~or act as my ATTORNEY-in--FACT. B- such SUCCESSOR ATTORNEY shall have all the rights, responsibilities and powers set forth herein, ~nd any person who relies on the written certification of the SUCCESSOR ATTORNEY of his appointment under this paragraph shall be deemed to h~ve acted under the direction of my ATTORNEY. c. My ATTORNEY may resign this position by notifying both myself and ~he SUCCESSOR A'A-A'0RNEY in ~rlting of such resignation. SIGNATURE md ACCEPTANCE I have executed this instr,,~ent with the intent of being legally bound hereby, as a free and independent act, and hereby revoke any previous POWERS of ATTOP~NEY, on this 29TH day of JULY, 1994. HE*.~N CATHERINE Y~INGST~ nee BOWERS I HEREBY ACCEPT appointment as ATTORNEY-IN-FACT in accordance with the te~_~ and conditions of this document as of the date set forth hereinabove. TODD A. YEIN S J. YE GS U drafted July 29, 1994 page 3 of 3 init.~ 11/07/01 14:14 FA~ 717 533 1243 GMLFC-CMOC ~ CHAD 0 BOGAP ~016 DUI~ABT.R POWER of ATTOP~WEY AFFIDAVIT CO~MO~LLTH of pEN}~SYLVANIA ) )) ss. cOUI~TY of DAUPHIN ) We, having been duly qualified according to la~, depose a~.d say that we were present and signed the foregoing instrument;that at was signed a~ ou~ free, individual and voluntary act for the p~r~oses expres_~ed therein; that each of us mn the sight and hearing of each other signed ~-he ~hove; ~/%d that to the best of o~r k~owledge each of ~s wa~ at ~hat time 18 or more years of age, of ~ound mind and u~der no constraint or undue influence. HF. LEN CATHERINE YEINGST~ FRANCES ~. YE2NG~ ~ or affixed, and a¢~owled~, before me by the Subscribed, sworn to the ~, . day of~-~/~, 1994 A.D. --'F' ' / drafted July 29, 1994 page 4 of 3 init- Exhibit B 11/07/01 14:12 FAX 717 533 1243 GMLFC_-CM~0C ~ CHAD 0 BOGAP ~009 ~7' by~ and Detween C~ountr~eaOow~, pe y Associates, and ~ followinq Rp_~ldent(s): N~m~ Street Address u 1. ~ene~].. Resident is hereby ~otified that his/h~r applisatioD been accepted to reside at country Meadows of ~ _ ' 2. ~f~- ~is le~se shall be in effect ~o~ initial and will aut~ti~ally be r~ed for a period of mo~th, at the then prevailin9 rate for t~e ,mit. ~e Resident mu~ 9ire the A~nis~rator w~itten notice of intent not ~o renew at least (30) days before th~ end of the current te~. Resident and Co~t~ Mead~$ ~derst~d ~nd agree that no ~e t~ ~e month's rent shall be char~ed in the event this A~eemenu is by ReSident. Refund in the e~nt of death or infirmity are covered by Ite~ 7, p~ge 2. 3. ~t~ P~t. Resider agrees to pay count~ ~eadow~ ~he rent due under this A~c~t in monthly pa~ent~ of $ each, pay~le in advance on or before the ~irst o~ the ~nth~ Co~t~ 'Meadows a~rees that ~is monthly rent shall n~t be increased durin9 the ~rrent Ee~. ~r~her, Co~5~ Mead~s a~rees to ~i~ Resident ~hirty (30) days notice, in writing, of ~y rent increase which would effect at the ti~ of renewal- ~y additional cha~es are specified in Item 9, pa~e 3 of this A~reem~t. 4. Se~es pro~ed ~ C~t~ Meadows- In addition ad lodgln~, as a pa~ of the ~nthly rent, Co~t~ Meadows a~ees to fu~ish: (a) breskfast, l~ch and di~er daily in ~e ~inin~ room; (b) hou~ekeepin9 ~d linen se~ices includin9 the la~d~rin~ of linens; (c) educational, recreatio~l, fire safety ~d wellness activities; (d) facilities for receivin~ personal ~il; (e) ~4-h~r availability of asslst~ce with taskSteleph~neOf ~ilY~d ~' ' ,a~ded; _ (f) all utilities, except personal When o~ered a selected by the resident, ~Will~.am P---- Win~ p~ides additional se~ices for the physically challenged resident. ~~ .and Mead~a Plus Wi~ provide a sec~e social ~d physical environ~nt and thera~utic pro,rams which utilize the dementia residen~'~ c~ntinuln9 ~t ch~in~ strengths and abilities to provide experiences- The Selected Wing's "rent" in item 3, page 1 i~ the charge for that particular win9 and se~ice- Adnt%02x (Page 1 of 4) ~o~, ~/~q: ~/~1: 9/91: l~/q3: 12/95: 5/96: 7/97 ll/U7/~i 14:1~ FA~ T17 533 1~43 G~LFC-CMOC ~ C~ 0 BOGAP. ~010 5. R__~_~sponslbillties. Resident asrees to accept, comply with, and/or participate in the following: The Country Meadows Total Wellness Pro,ram; b. Educational and recreational activities; c. Inoculations for flu and pneumonia unless disapproved by personR1 physici~; d. All fire drills; e. Use of Med-l-Sets for all prescribed medications; Eatin9 meals in the facility's or wing's dining room; Havin~ applicable "therapy" evaluation(s) performed to assist in rehabilitation; h. Havin~ annual medical evaluation and/or ~eriatric assessment and i. ~ouse Rules. $. Resld.ent's Fir~ R~S~- Resident agrees to accept and to comply with the following financial responsibilities: a. Paying all charges for ~y and all professional treatmen~ and services ~equ~red by the Resident, includln~ but not limited to hospitalization, medical and dental care, whether such services are rendered at Residen~'s request, or at the request ~f a Country Meadows' staff member in an emergency; b. Payin~ such additional c~ar~es as may be incurred by Resident or by Country Meadows on Residenz's behalf. See Item 9, pa~e 3, "Additional Charges"; and c. If eligible0 purchasin~ and mintainln~ Medicare Part "B" and Medicare Supplemental Insurance, e.~-, "65 Special." 7_ Adjustments in Rent for~ial Circumst~nce~. Country Meadows asrees that the rent due under this A~reement may be reduced, or waived, under the followin~ circumstances: a. In case of R~sident's requirement of higher level of care nor available at Country Meadows, or death, rent shall be waived as soon as the Resident's tacit is vacated of personal belongings and furnishings. The Security Deposit will be refunded except for any portion used to make repairs to the unit over and above reasonable wear and tear. Refunds shall be made within thirty (30) days of above conditions bein9 met. b. Durin9 such time as Resident shall te~[~orarily reside in a hospital or long term care facility and wish to hold Resident's current unitt or Resident shall be away from the facility contimuously for five (5) or more days, Country Meadows agrees ~o reduce rent by $ . ~. ~o per day durin~ the a~sence. 8. Reside~n~ Rights an~ ~h~ HouSe_j~ are iii th___fie~_ Meadows "Resident Ha~clbook-. Adm-102x (Pa~e 2 of 4) Rev. 5/89; 5/9~; 9/91; ~/92; 5/93; ~2/93; 3~/R5.; 5/9~; 7/97 11/07/01 14:12 FAY~ 717 533 1M43 -~ CHAD 0 BOGAP. ~011 G~ILFC-CMOC 9. ~__C~__Z~ The gollowing services and items will be billed to the Resident monthly when the service is received. a. ~ti~ Personal Care__Support: ~esidents needing addltio~al help with activities of daily living will be charged in half hour increments per day at the rate of $6.00 per half hour. b.- ~l%en Resi~nt~ov~s from one "level" to ~Or~-~, t~s~reement s~es notice to the Resident for those additional cha~es. Breakfast $ 2.50; Lunch $ 3.50; Dinner $ 6.50 d. M~eeal Tray _i~Roo~: $1.00 each AS charge~ by restaurant. f. L~,~nd.~ Charues: $2.00 per load in Assisted Living I. Billed directly by authorized pharmacy. h. ~.-~.~ esl & IneOn%~ence ~upplle~: Billed at cux~enC market cost. i. Unschedu/e~TX~--s~ortation: $5.00 per trip, if available. Basic Cable TV: $ ~__~_~__ per ~onth, if applicable. k. Newspaper~: Billed dlr~ctly by dealer, personal arrangement. 1_ 1 an/ Cost set by cleaner selected. m. Personal T~lh~_~_~_~Billed directly by telephone company. Garage Space: $30.00 per month (if available) Beau~/Barl)~r ShoD: Wu~n's Cut $ ~-00; Men's Cut Shave $. ~'~; Wash & Set $.f6.0~ ; Rinse $ ~-(~ ; Tint Conditioner $~ .C30; ~"~CUre $. ~O~ ; Pe~anent Wa~ $.~.O~ Other: $ Adm-102x (Page 3 of 4) Rev. 5/89; 5/91; 9/91; 1/92; ~/93; 12/93; 12/95; 5/96; 7/97 11/07/01 14:lZ FAX 717 533 1243 GMLFC-CMOC ~ CHAD 0 BOGAP. ~012 This Agreement. The Resi~nt's Riahts, The HooM~ Rules. and The ~id~nt Handbook have b~en reviewed bv ma and exDtalned to me by the Marke~in~ Director or Administrator. ~d I have b~. ~E~n m co~ ~ each. % ,,nd~r~t~d ~hat thru ~inistrator ~t ~ve ~ th~r~ (30) intends to ch~n~e any part of th4s A~fee~nt. or if a~v ~ges are tO de in the H~se Rules h the Resident Han~oo~ spouse"s Signature (if also a resident) '~si~ns the ' -=beck, if other t~h--an ~he Resident ~eting ~i~ccor/Ad~inis~ator' s Si~,,_~ture Date D~te Date Designated Person or Referral Agency (O~tional) Signa=ure Date If a Resident is ,,~al~le to sign his/her n~me, Resident should show his bet mark below: Resident ' s Mark Date MarkeO Witness to Mark Date (May not be Administrator or Marketin~ Director) Adml02x (Pa~e 4 of 4) Rev. 5/89; 5/91; 9/91; 12/93; 12/95; 5/96; 7/97 SHERIFF'S RETURN - REGULAR CASE NO: 2002-00828 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND COUNTRY MEADOWS ASSOCIATES VS YEINGST HELEN C ET AL DOUGLAS DONSEN , Sheriff or Deputy Sheriff of Cumberland County, Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT - EQUITY was served upon YEINGST HELEN C the DEFENDANT at CLAREMONT NURSING & REHAB CARLISLE, PA 17013 , at 1545:00 HOURS, on the 19th day of February , 2002 375 CLAREMONT DRIVE by handing to HELEN C. YEINGST a true and attested copy of COMPLAINT - EQUITY NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 3.45 Affidavit .00 Surcharge 10.00 .00 31.45 Sworn and Subscribed to before me this /~- day of ~ ~2~ A.D. , t~rothonot ary So Answers: R. Thomas Kline 02/20/2002 LATSHA DAVIS & YOHE Deputy Sheriff SHERIFF'S RETURN - REGULAR CASE NO: 2002-00828 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND COUNTRY MEADOWS ASSOCIATES VS YEINGST HELEN C ET AL DOUGLAS DONSEN , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT - EQUITY was served upon YEINGST TODD A the DEFENDANT at 2832 ROSEGARDEN BLVD , at 1900:00 HOURS, on the 19th day of February , 2002 MECHANICSBURG, PA 17055 by handing to FRAlqCES YEINGST, WIFE OF DEFENDANT a true and attested copy of COMPLAINT - EQUITY NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing 6.00 Service 7.59 Affidavit .00 Surcharge 10.00 .00 23.59 Sworn and Subscribed to before me this /4~- day of ~z~k~ ~_o~ 2~ A.D. I ~othonOtary So Answers: R. Thomas Kline 02/20/2002 LATSHA DAVIS & YOHE Deputy Sheriff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA COUNTRY MEADOWS ASSOCIATES, : a Pennsylvania Organization, d/b/a : COUNTRY MEADOWS OF WEST SHORE IV,: : Plaintiff : : V. : : HELEN C. YEINGST and TODD A. YEINGST,: : Defendants : No. 02-828 CIVIL ACTION - LAW/EQUITY PRAECIPE TO WITHDRAW WITHOUT PREIUDICE Kindly mark the above-captioned appeal as Withdrawn, Discontinued, and Ended without Prejudice. Respectfully Submitted, LATSHA DAVIS & YOHE, P.C. Date: -b-///(J ~._~ By: Chadwick O. Bo~r Attorney I.D. No. 83755 P.O. Box 825 Harrisburg, PA 17108-0825 (717) 761-1880 Attorneys for Plaintiff, Country Meadows Associates of West Shore IV 74463 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA COUNTRY MEADOWS ASSOCIATES, a Pennsylvania Organization, d/b/a COUNTRY MEADOWS OF WEST SHORE IV, Mo Plaintiff HELEN C. YEINGST and TODD A. YEINGST, Defendants No. 02-828 : . CIVIL ACTION - LAW/EQUITY CERTIFICATE OF SERVICE The undersigned hereby certifies that a true and correct copy of the foregoing Praecipe to Withdraw without Prejudice was served via U.S. Mail, First Class upon the following individuals: Ms. Helen C. Yeingst Claremont Nursing & Rehabilitation Center 375 Claremont Drive Carlisle, PA 17013 Todd A. Yeingst 2832 Rosegarden Boulevard Mechanicsburg, PA 17055 Date: Chadwick O. Bogar, E~l'uire 74463