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HomeMy WebLinkAbout09-22-05 IN THE COURT OF COMMON PLEAS - CUMBERLAND COUNTY ORPHANS' COURT DIVISION IN RE: BARBARA SALIARIS f"<~, f"'-'" , " (.-..., O.c. No. '2\-Oc;- offiZ:'] ;--.) ["<: PETITION FOR ACCOUNTING AND TURN OVER OF ASSETS i AND NOW, COMES, Petitioner, HCR ManorCare- Carlisle ("ManorCare"), by and through its attorneys, SCHUTJER BOGAR LLC, and files the within Petition against Defendant, Niki Ritter ("Ritter") and in support thereof, provides as follows: 1. Barbara Saliaris was admitted as a resident of ManorCare, a skilled nursing facility, on August 12, 2003. 2. Upon information and belief, Niki Ritter was Ms. Saliaris's agent in fact pursuant to a Power of Attorney. 3. At all times relevant hereto, Ms. Ritter exercised control of Ms. Saliaris's income and other funds in her capacity as agent in fact for Ms. Saliaris. 4. On October 23, 2003, Ms. Saliaris, through her agent in fact, Ms. Ritter, applied for Medicaid benefits with the Pennsylvania Department of Public Welfare. 5. As a condition of eligibility for said Medicaid benefits, Ms. Saliaris and her agent in fact were required to disclose any and all of Ms. Saliaris's financial assets and resources to the Department of Public Welfare. -n ~-'"1 :---',-' ", '.-'J . . ) . C J '. J ,----1 \~:J ;" -) oil ~ 1-\ -i -".- i--i 1 "") CD 6. On February 3, 2004, based on the information provided to it on the application, the Department of Public Welfare determined Ms. Saliaris eligible for Medicaid benefits while she was a resident of ManorCare. A true and correct copy of the PA-162 issued by the Pennsylvania Department of Public Welfare granting such benefits is attached hereto as Exhibit" A" . 7. The PA-162 grant required Ms. Ritter and Ms. Saliaris to report any changes that would impact Ms. Saliaris's continued eligibility. 8. On or about July 8, 2005, the Pennsylvania Office of Inspector General, working with the Department of Public Welfare, discovered previously undisclosed assets of Ms. Saliaris that, if known at the time of application, would have impacted her eligibility for benefits. Said Assets include to wit: proceeds from transfer and/ or redemption of Capital Life Insurance, Wachovia Securities, and Mellon Investor Services IRA accounts in the amount of $82,366.69. A true and correct copy of the letter issued by the Pennsylvania Office of Inspector General notifying Ritter of its claim is attached hereto as Exhibit "B." 9. As a result of the aforementioned undisclosed assets, the Department of Public Welfare rendered Ms. Saliaris ineligible for all benefits received from October 1, 2003 through August 30, 2004, an overpayment equal to $37,028.64. 10. Ms. Saliaris, to date, continues to reside at ManorCare. 11. If Ms. Ritter does not remit to the Office of Inspector General the aforesaid $37,028.64, Ms. Saliaris will be disqualified from receiving additional Medicaid benefits for her continued stay at ManorCare. 2 12. Upon information and belief, Ms. Ritter received some or all of Ms. Saliaris's aforementioned assets. WHEREFORE, Petitioner requests that this Honorable Court issue a citation directed to Ms. Ritter to show cause, if any there be, why an Order should not be entered requiring her to file a full and complete accounting of all transactions undertaken by her with respect to the redemption and/ or transfer of Capital Life Insurance, Wachovia Securities, and Mellon Investor Services IRA accounts, of Barbara Saliaris from July 1, 2003 to August 1, 2005 in the amount of $82,366.69, and to turn over $37,028.64 of said proceeds from the transactions to the Pennsylvania Office of Inspector General. Respectfully submitted, SCHUTJER BOGAR LLC Dated: '1-). c)- oS By: Cha . 0 At rney J.D. No. 83755 W. Scott Foster Attorney J.D. No. 90266 441 Friendship Road, Suite 102 Harrisburg, PA 17111 (717) 909-5924 Attorneys for Petitioner 3 Hx Date/Time AUG-18-2UU5(THU) 11:11 Rug 18 OS 12:28p R. E. Bo~ne Stouffer '"U "\,l:: I V A......LU\,.:AN I ElIGtBLE EL~JLe PENOING 717249 Ub39 P.U15 717-249-0639 p.IS 1-800-269-0173 717-240-2700 DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE OFFICE 33 WESTMINSTER DRIVE P. O. BOX 599 CARLISLE, PA 17013-0599 O ASSISTANCE CHECK "'" MEDICAL "'" ASSISTANCE x After the first chock Which may be a special amount you will receive $ o Twice a Monlh 0 Once a MonTh D In Ihe Mall 0 At the Bank o You have a pallent pay liability of S lor the period beginning and Boding EUec1ive Oat& 10/1/()3 o FOOD STAMPS You will rcceiv8 $ a month 'rom for the rnoolh(s) of then you will receive food SlM'lps in ttle amcunl of $ to 0 In the Mail 0 AI the Bank .' il r/ n .......~ a month toward yo.r car.. LLL].:.. :..:.:...:: i ( GRvSS v'1l:"IT'.' COSTS1UTfL!TY ST~NOA~D" Level of care authorized ASST. FOOD MED. SOC. CHECK STAMPS ASST. SERVICE &Name Name $ $ $ Name Name $ $ $ TOTAL GROSS IIIIONTHL V INCOME GROSS MONTHL V DEPENDENT CARE COSTS GROSS MEDICAL COSTS 5 $ $ TOTAL GROSS MONTHLY INCOME GROSS MONTHLY DEPENDENT CARE COSTS $ $ Telephone Electric Gas Oil Water/Sew'ge GarbageITrash Utility Installation Other D MEDICAL ASSISTANCE Name RENTIMORTGAGE TAXeS INSURANCE COST ON HOME TOTAL SliELTEA COST S $ $ $ $ Name 'The household may switch between the actual utilliy costs and the standard utility aliowancr; at the lime of reapplication and one additional lime during each twelv"'iTlonth p'iJriod. TOTAL GROSS MONTHLY INCOME NET MONTHL V INCOME/NET SEMI. ANNUAL JliCOIVIE II INCOME ur~1T RECORD NUMBER r I ~&Ioi.{ Dale J.40'~J.739 DIST cIl7.!dA / J.( aYtMCtJ Wor1(or's Signature Telepholle Number OcHCi I{;~t 84R8Afi'A .94L1AR/S' !/ldr:t..y ();re- q4tJ tt'olr.u.i:' &.>fhi7L R(I {'ar/.6!12- PA J 7013 LEGAL HELP IS AVAILABLE AT L LEGAL SERVICES, INC. a IRVINE ROW CARLISLE, PA 17013-3019 717-243-9400 717-766-8475 -1 I CUlENT COpy Rx Date/Time AUG-I~-2UU5[THUI 11:11 Rug 18 OS 12:29p R. E. BQ~ne Stouffer --- 717 249 UbH 717-249-0639 P. U 1 b p.16 . NAME ,..~" 1 r IJ 1.."') 1(' Jrt. I .'7 f'11__'; l)/'rl..n,..", ,'-- ){.r iA..u (A."oo- RECORD NUMBER q1/(jt{ INITIAL )2/03 01 /[JlI MO!YR MO!YR 1!>/.{jb 7(P7.00 3~J, 61 3d i, ,g:; 0 (). lOTi. 31 J(jl!3? 0 () JOT}.8Q i f).fl. 31 . 30.1JO 30 J){) 0 ~ u IOI./~.31 Ja:;Y.31 GROSS S5 10 }U3 MO!rR '751. 0lJ -.......-.. ..- -.- Q,?I1i IOJ'V ., :5;rorJ--krtl<Jo(J)91/)/lt'h;-' Lj3i.3~ iff/.!:iJf/':"K. 91(/''s JI" WiI$. TOTAL ~SS UNEARNED ) 510.'71 3~/,;q ESTIMATED INTEREST 0 TOTAL INCOME USED i5ICV7/ . - PERSONAL CARE ALLOWANCE 3()..()o - COMMUNITY SPOUSE! 0 HOME MAINTENANCE GROSS PATIENT PAY (53) /4J'O. '7/ - MEDICAL EXPENSES 0 (See below) NET PATIENT PAY (57) MtO:7f MEDI~ EXPENSES LISTED LESS MEDICAL EXPENSES PAID MONTHLY MO IYR NO~: Future cbq;a in mediW e~ shouJd be repe;rted to tbe NUl'liol Facility. . MO/YR DRUGS (54) MEDICARE (55) BC/RS/OTHER MEDICAL INS (55) OTHER MEDICAL (56) o o MONTHLY TOTAL r/?;"A r1J k. cblaou; SIGNATURE tL/3/01 DATE .~ REMINDER: The resource limit iS~/$2400. See attached Addendum Rx Date/Time AUG-19-2005(FRI) 13: 51 'AUG. 19.2005 2: 56PM P 002 NO. 0133 P. 2 ;> COMMONWEALTH OF PENNSYLVANIA OFFICE OF INSPECTOR GENERAL July 8, 2005 Niki Ritter RR 2 Box 33-5 Loysville, Pennsylvania 17047 BUREAU Of' FRAUD PReVENTION AND PROSECUTION POST OFFICE BOX 8041 HARRISBURG, PENNSYlVANIA 17105-8041 (717) n2-4935 RE: DPW # 21-0099164 Name: Barbara Saliaris Cairn: $37,028.64 Dear Ms_ Ritter; The Office of Inspector General has established a claim for incorrectly paid Medical Assistance Benefits for Barbara Saliaris. This claim resulted from Barbara Saliaris' unreported ownership and subsequent transfer of Capital Life Insurance, Wachovia Securities and Mellon Investor Services IRA accounts, The enclosed computation sheets show how the Office of Inspector General calculated the claim. Ms. Saliaris was authorized to receive Medical Assistance Benefits on October 1, 2003. To be eligible to receive benefits it is required that all resources and income be disclosed when applying for and while receiving Medical Assistance. On July 2, 2003, Wachovia Securities IRA #OUZ-R04419-36 was valued at $30,478.42; and Wachovia Securities IRA #OUZ-ROO812-36 was valued at $14,458.77, On July 3, 2003, Capitol Life Insurance Company IRA #CI131 073 was valued at $12,192.93 and Capitol Life Insurance Company IRA #C10990456 was valued at $14,458.77. On May 19, 2004, Mellon Investor Services #OO1-750-56501R10 was valued at $7,049.04. The surrender and transfer of these accounts totaled $82,366.69, which resulted in a 14-month period of ineligibility that caused Ms. Saliaris to be ineligible for all benefits received from October 1, 2003 through August 30, 2004. The total amount of benefits paid on behalf of Ms. Saliaris during the period of ineligibility was $37,028.64. As the amount of Medical Assistance was less than the amount of resources, our claim is for the amount of benefits paid on her behalf. The legal authority for seeking restitution for the amount of Medical Assistance paid by the Department of Public Welfare during the period in question can be found at 62 P.S. 1408 (c)(6)(i) which states the following: Rx Date/Time AUG-19-2DD5(FRI) 13:51 AUG. 19, 2005 2: 56PM P. 003 NO. 0133 P,3 Niki Ritter ~2. July 8, 200S "If it is found that a recipient or member of her/his family or household who would have been ineligible for medical assistance, possessed unreported real or personal property in excess of the amount permitted by law, the amount collectible shall be limited to an amount equal to the market value of such unreported property Or the amount of medical assistance granted during the period it was held up to the date of the unreported excess real or personal property is identified, whichever is less. Repayment of the overpayment shall be sought from the recipient, the person receiving or holding such property, the recipient's estate and/or the survivors benefiting from receiving such property. Proof of date of acquisition of such property must be provided by the recipient or person acting on herlhis behalf. , ," Please make your check or money order in the amount of $37,028.64 payable to the Commonwealth of Pennsylvania and forward it to my attention, A self-addressed envelope has been enclosed for your convenience. Please be sure to have the DPW case identification number, 21-0099164, written on your payment. Payment is expected within 20 days from the date of this letter. If you do not agree with this overpayment, you have the right to appeal and request a fair hearing. To appeal, see the page titled "Your Right to Appeal and to Request a Fair . Hearing." If you have any questions or would like to set up a conference, I may be reached in Harrisburg at (717) 705-4638. Enclosures Rx Oate/Time AUG. 19.2005 AUG-19-2005(FRI) 13:51 2:56PM P. 00 d NO.0133 P. 4 YOUR RIGHT TO APPEAL AND TO REQUEST A FAIR HEARING co. Rl3CORD NO. CLAIM NO, DATE OJ? LEtTER 7/8/05 21 0099164 PJN 01 You as a medical assistance recipient, or you acting on behalf of a medical assistance recipient, have the right to appeal and request a fair hearing. You may use this form or call me at (717) 705-4638 to appeal. You lDIlst appeal this ovelpayment claim in writing within 30 days from the date of this letter or your appeal will not be accepted. If you call [0 appeal, you must also submit a written request to this office within 3 work days of the call. At the heating, you may explain Why you disagree with this oVeIpayment claim. You may present evidence and witllesse& on YOW' behalf. You may represent yourself or have an attorney represent you. If you cannot afford an attorney and you qualify. free legal help may be available at the address llited in the block on the right. Legal Service Inc. 8 Irvine Row Carlisle, PA 17013 (717) 243-9400 HOW TO SUBMIT A WRITTEN RE UEST TO APPEAL AND ASK FOR A FAlRBEARlNG: 1. Explain why you are appealing. 2. Sign and date this appeal and fair hearing request foxm. I am appealing and Want a fair hearing because: XUUR SJUNA.I. Uilh J)4J....~~ UAJb J.m..e.rnUNJSNUM.HbK. Ai lu.tU'1Ul :s S.lJJNAJ UK~ (,U' UN.ti .I.S aHP.lt..t..'S.bNliNu IUU) .1M.'1: AIJUKNH)";) lAL.J.:lt'HONbNUMHbK 3. You may choose the type of fair hearing you want from the follOwing. You may have either a telephone or face-to-face hearing. If you want a telephone hearing but do 1\ot have a telephone and cannot get one, we will schedule the t81ephone hearing at your local County assistance office. If you want a face-ta-face hearing, we will schedule one for you at One of the following cities: Erie, Harrisburg, Philadelphia, Pittllburgh, R.eading, or Scranton. 0 I want a face-to-face heating. 0 I want a telephone hearing. Call me at 0 I need lUl interpreter. What language do you speak? 4. holail this form to; Office of Inspector General BFPP, Cenn-aJ Regional Office Attention: Jana M. Parsons 101 S. Second St, P.O. Box 8041 Harrisburg, PA 17105-8041 OIG 614 . 9/03 . Rx OotelTime . AUG. 19.2005 .... lIol lIol ~ ~ ~ _t:I.l c;+ol t ~ ~ ~ r..~ oS lIol c:.l .. Q,l ~ ~i,.) ~ ~ eo... Q,l o~ ~ CJl ~ Cl O~ - &'0 &: ,s bll .. =...., ~o 00 'C ~ ..- ~ ~ E!.<> .; .9 ..... <.l !;JO 0.0 .. 0 e~ ell ~ 2: 0 ~> u~ ~~ ~~ ~~ ~~ ~g . , 0_ !;IN Q ::s 'fJ i:; ..s ~; .. .0 .. l;I ~~ ~ :~ !;J~ RUG-19-2005(FRI) 13:51 2:56PM ..., ro5..t ...,8 ON .... . "'0 ~...., e ~ .- aQ 5< ~ o lt~ ... .- ~a .S u t~ !5 IS ~ 18 tlQ;:g = ~ ...., ~ .... Irs .c B oJ o ~ ell Cl S ::: ell ... t~ '5 ~ ~ .8 Q OIl = 'I;; o o ~ l') ~~~~~~~~~~~g~1888ggg8888gg ~ ~ ~~~~~~~~~~~dldddddddddcidd~.~ . ~;;;;,~~:q~~~;.~~~\"'''''''~~<fl<fl{t7IA'''l~~ '~~ .... NN........,"''''''''''f'1t'l<''1 . .' r-- ::! _1A~~"'l"'l..,..,"'l<fl..,~ ~~ ~ .s ," it~;~ t-' ~ ~~. ,.~o , .......... 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AUG. 19.2005 2: 57PM P 006 NO. 0133 P. 6 i Office of Inspector General Long Tenn Care Transfer Computation Case Name: (Last, First MI) Saliaris, Barbara CoJR<<ordlCat.: 21-0099164lPJN MA Authorization Date: October 1, 2003 Nursing FacilitylWaiver Program: Manor Care Carlisle MA Closing Date: lMCW Name: Holly V Ogels01lg Asset Descril)tion Transfer Date EauitV' Value Caoitol ute Xnsurance Co. lull' 8, 2003 $12,192.93 Capitol ute Insurance Co. July 8, 2003 $18,187.53 Wachovia Securities luly 2, 2003 $30478.42 Wachovia Secwjties July 2, 2003 $14,458,77 Mellon Investor Services May 19,2004 $7.049.04 Total Equity Value: $82,366,69 Avernge Private Pay 'Rate at Application: $5,559.25 IneJigible Months: 14 Ineligible Period Begin: July 1,2003 Ineligible Period End: August 30, 2004 ClaDn Period Begin: October 1, 2003 Claim Period End: August 30, 2004 TotalMA Paid: Total Equity Value of Asset: $37,028.64 $82,366.69 Claim Amount: $37,028.64 Agent Name: Agent Signature: Date: OIG 612.4- 3/03 SCHUT dER I BOGAR LLC attorneys & consultants Email: clong@schutjerbogar.com Direct Dial: (717) 909-5923 September 20, 2005 f'...) Glenda Farner Strasbaugh, Register of Wills Cumberland County Courthouse 1 Courthouse Square Carlisle, P A 17013 ~~ ".J C:.1 co In Re: Barbara Saliaris Dear Ms. Strasbaugh: Enclosed for filing please find an original and two (2) copIes of a Petition for Accounting and Turn Over of Assets in the above-referenced matter. Kindly time- stamp the extra copy and return same along with the respective Citation so that we may serve the Respondent in a proper and timely manner. Additionally, we are enclosing a check in the amount of $.50.00 for the r~quired filing and Citation fees. If you should have any questions or require anything further, please do not hesitate to contact me at the number above. Thank you for your attention and assistance in this matter. 0\ .,' S,..ince,rel,y, , ':-- a) ~ . _ ~\.c ~Lng Q Paralegal Enclosures 441 Friendship Road, Suite 102, Harrisburg, PA 17111 . Fax (717) 909-5925 . www.schutjerbogar.com :.?; ,"--.) ,.,,,,