HomeMy WebLinkAbout09-22-05
IN THE COURT OF COMMON PLEAS - CUMBERLAND COUNTY
ORPHANS' COURT DIVISION
IN RE: BARBARA SALIARIS
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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.
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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
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Dale
J.40'~J.739
DIST
cIl7.!dA / J.( aYtMCtJ
Wor1(or's Signature
Telepholle Number
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84R8Afi'A .94L1AR/S'
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{'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
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CUlENT COpy
Rx Date/Time AUG-I~-2UU5[THUI 11:11
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717 249 UbH
717-249-0639
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. NAME
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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
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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
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SIGNATURE
tL/3/01
DATE
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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
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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
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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 .
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P 006
NO. 0133 P. 6
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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
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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, ,
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Paralegal
Enclosures
441 Friendship Road, Suite 102, Harrisburg, PA 17111 . Fax (717) 909-5925 . www.schutjerbogar.com
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