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HomeMy WebLinkAbout06-3229d' Doreena Craig Sloan, Esquire Attorney I.D.# 44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 2334101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 Plaintiff, V. CHARLES E. SHAY, Jr. Individually, Power of Attorney Attorney in Fact, Responsible Party and/or Fiduciary for Patricia J. Shay 1926 Longboat Drive Lakeland, FL 33810 NOTICE CIVIL CAUSI YOU HAVE BEEN SUED IN COURT. If you wish to defend al in the following pages, you must take action within twenty (20) and notice are served, by entering a written appearance personally in writing with the court your defenses or objections to the clan You are warned that if you fail to do so the case may proceed wit may be entered against you by the court without further notice fr the complaint or for any other claim or relief requested by the F AW nst the claims set forth Lys after the complaint by attorney and filing set forth against you. ut you and a judgment any money claimed in intiffs. 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. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THUS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIA'T'ION LAWYER REFERRAL SERVICE 213 NORTH FRONT STREET HARRISBURG, PA 17101 TELEPHONE: (717) 232-7536 Le had demandado a usted en la corte. Si usted quiere defenders expuestas en las paginas siguientes, usted tiene viente dias de ply fecha de la demanda y la notificication. Hace falta ascentar una persona o con abogado y entregar a la corte en forma escrita sus objeciones a las demandas en contra de su persona. Se adviso qi defiende, la corte tomara medidas y puede continuer la demanda previo aviso o notificacion. Ademas, la corte puede decidir a faN requiere que usted cumpla con todas las provisions de esta dem, perder dinero o sus propiedades y otros direchos importantes par LLEVE ESTA DEMANDA A SU ABOGADO IMMEDIATAN ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE P VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OF] DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AV: PUEDE CONSEGUIR ASISTENCIA LEGAL. de estas demandas o al particular de la mparencia escrita o en ;tenses o sus si usted no tiene n contra suya sin it del demandante y ida. Usted puede usted. SI NO TIENE TAL SERVICIO, CUYA AR DONDE SE ASOCIACION DE LICENCIADOS DE FIL ELFIA, SERVICIO DE REFERENCIA Y INFORMACI LEGAL, ONE READING CENTER, FILADELFIA, PENNSY VANIA 19107 TELEFONO: (215) 238-1701 ******************* 2 Doreena Craig Sloan, Esq. Attorney I.D.#44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 2334101 Attorneys for Plaintil IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLV) PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 Plaintiff, V. CHARLES E. SHAY, Jr. Individually, Power of Attorney Attorney in Fact, Responsible Parry and/or Fiduciary for Patricia J. Shay 1926 Longboat Drive Lakeland, FL 33810 CIVIL CAUSI COMPLAINT AND NOW, comes Plaintiff, Tracy D. Shay- Snyder, by and Craig Sloan, Esquire, of the law firm Capozzi & Associates, P following complaint, respectfully show the Court the following: 1. Plaintiff, Tracy D. Shay-Snyder is a resident of the Pennsylvania and is the daughter of Patricia J. Shay and E. Shay, Jr. 2. Plaintiff Tracy D. Shay-Snyder currently holds a Power cf Attorney issued in the state of Florida for her mother Patricia J. Shay, the subject of this action. 3. Charles E. Shay, Jr., is the spouse of Patricia J. Shay as t4ey were married on October 25, 1952, in the Commonwealth of AW ot,- 9.27 7 f a 714,- attorney, Doreena and as set-forth in the of 3 4. Charles E. Shay, Jr., is currently a resident of the state of Florida. 5. Patricia J. Shay is a resident at Claremont Nursing and Rehabilitation Center, a long-term care facility located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 6. Patricia J. Shay was admitted to the Claremont Nursing and Rehabilitation Center, a long-term care facility that is licensed to partic#pate in the Medicaid and Medicare programs, on February 4, 2005, with a dia?nosis of, among other things, Alzheimer's Dementia. 7. Defendant Charles E. Shay, Jr., is an adult individual rending at 1926 Longboat Dive, Lakeland, Florida 33810. 8. On information and belief, Defendant Charles E. Shay, ir., is also Power of Attorney, Attorney in Fact, Responsible Party and Fiduc?ary for his wife Patricia J. Shay. ?I 9. On or about April 2003, Plaintiff Patricia J. Shay was li4ng with her husband, Defendant Charles E. Shay, Jr., at the Defendant's residence, when he was hospitalized and underwent a surgical procedure that rendered him unable to continue to care for Plaintiff Patricia J. Shay. 10. Defendant Charles E. Shay, Jr., requested assistance fro Tracy D. Shay- Snyder in taking care of his wife Plaintiff Patricia J. Sha , acknowledged that her condition would soon require nursing home placeme t, agreed to allow her to return to Pennsylvania to live with their daughter Trac D. Shay-Snyder, Power of Attorney, be placed in a nursing home when n essary, and agreed to pay for any current and future expenses related to the car of his wife Plaintiff 4 Patricia J. Shay. 11. Between April 2003 and February 3, 2005, Plaintiff Patricia J. Shay resided with her daughter and Power of Attorney Tracy D. Shay-Snyder and her medical condition deteriorated such that she required 24 hour nursing home care. 12. During that same period, Defendant Charles E. Shay, Jr., did not contribute in any way to the support of his wife Plaintiff Patricia J 13. On or about February 4, 2005, Claremont Nursing and admitted Patricia J. Shay to the facility to receive she has continuously remained there. 14. The Claremont Nursing and Rehabilitation Center has home care services rendered to Patricia J. Shay and Jr., as husband and Power of Attorney, and to Tracy D. Attorney and daughter of Patricia J. Shay. 15. At all times relevant to this action, the nursing care and Center care and services and bills for nursing Charles E. Shay, Power of rendered by Claremont Nursing ad Rehabilitation Center have met all !applicable federal, state and local standards of care. 16. On or about February 4, 2005, the Claremont Nursing presented a promise to provide nursing care and services Shay in exchange for her promise to pay for said care 17. While Defendant Charles E. Shay, Jr., was not in the Pennsylvania at the time of Plaintiff Patricia J. Shay's Nursing and Rehabilitation Center, he had made Shay-Snyder, daughter and Power of Attorney Rehabilitation Center Plaintiff Patricia J. services. monwealth of fission to Claremont ations to Tracy D. J. Shay, as the husband 5 and Power of Attorney of Plaintiff Patricia J. Shay that he would pay for the expenses of her care. 18. Plaintiff Patricia J. Shay, through her Power of Attorney Tracy D. Shay-Snyder, I relied upon the representations of Charles E. Shay, Jr., and signed the contract to admit Patricia J. Shay to Claremont Nursing and Rehabilitation Center. 19. Plaintiff Patricia J. Shay's, average monthly expenses incurred at the Claremont Nursing and Rehabilitation Center total approximately 20. The current bill for nursing home services provided to Claremont Nursing and Rehabilitation center is $23,265 21. Plaintiff Patricia J. Shay's reasonable monthly living Claremont Nursing and Rehabilitation Center has monthly income and were insufficient to adequately ,000.00. tricia J. Shay by 5 and increases daily. mses incurred at the antly exceeded her de for her care, maintenance, and support. 22. Due to the refusal of Defendant Charles E. Shay, Jr., to make any payment for the nursing care and services rendered to Plaintiff Patrici? J. Shay by Claremont Nursing and Rehabilitation Center, the account for currently in arrears in the amount of $23,265.25 and 23. Due to the refusal of the Defendant Charles E. Shay to pharmaceutical supplies and medications furnished to since her admission, her account is currently in arrears. Patricia J. Shay is s daily. payment for ffPatricia J. Shay 6 24. On information and belief, Defendant Charles E. Shay, Ji., individually and as spouse and Power of Attorney for Patricia J. Shay, has not made any payments for the nursing home care of his wife, Plaintiff Patricia J Shay, or for her pharmacy bills. 25. A majority of the income and assets of Plaintiff Patricia 1. Shay were, at all times relevant and material hereto, and currently are accessed and controlled by the Defendant Charles E. Shay, Jr. 26. Confidential personal financial information about Patricia J. Shay, such as, but not limited to: life insurance policy numbers; bank account numbers, income, and real estate data were, at all times relevant and material hereto, accessed and controlled by the Defendant Charles E. Shay, Jr., and de4ied to the Plaintiff Patricia J. Shay and her Power of Attorney Tracy D. 27. Defendant Charles E. Shay, Jr., has substantially refused jail communication from the facility and Plaintiff Tracey Shay-Snyder related to the past due balance. 28. Defendant Charles E. Shay, Jr., refused or neglected to atsist Plaintiff Patricia J. Shay through Tracy D. Shay-Snyder, Power of Attorney, in her efforts to secure Medical Assistance for Plaintiff Patricia J. Shay. 29. On information and belief, Defendant Charles E. Shay, J?., withheld critical information relating to Defendant Charles E. Shay, Jr.'s *nd Plaintiff Patricia J. Shay's finances that are a necessary prerequisite to the Medical Assistance application's approval by the Department of Public 30. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Snyder, and Defendant Charles E. Shay, Jr., as Power of Attorney for Patricia J. Shay had a contractual, legal and fiduciary obligation to the facility 6 assist the facility in qualifying Plaintiff Patricia J. Shay, for Medical Assistance by providing all information necessary to complete Plaintiff Patricia J. Shay's Medical Assistance Application. 31. As a result of Defendant Charles E. Shay's, refusal to Medical Assistance process, Plaintiff was denied Assistance benefits. 32. Defendant Charles E. Shay, Jr, has a legal and fiduciary Patricia J. Shay to pay for the medical, nursing and rendered to his wife for whom he holds a Power of A COUNTI-BREACH Charles E. Shay, Jr. Individually and as Patricia J. Attorney, Attorney in Fact, Responsible Party 33. Plaintiff hereby incorporates paragraphs 1 through 32 forth at length herein. 34. As more fully described herein, on or about February 4, J. Shay, through her Power of Attorney Tracy D. for the admission of Plaintiff Patricia J. Shay to the Rehabilitation Center for ongoing nursing care and Plaintiff in the for Medical to Plaintiff services , Patricia J. Shay. Spouse, Power of Fiduciary Complaint as if set- , Plaintiff Patricia , made application Nursing and with the full knowledge and consent of Defendant Charles E. Shay, Jrj, spouse and Power of Attorney for Patricia J. Shay. 35. Defendant Charles E. Shay, Jr. has not made payments for the medical, nursing or pharmaceutical services rendered to Plaintiff Patricia ?. Shay as agreed to in the oral contract by and between the parties. 36. The Claremont Nursing and Rehabilitation Center is entitled to compensation for the medical and nursing care and pharmaceutical services rendered to Plaintiff Patricia J. Shay. 37. As such, Defendant Charles E. Shay, Jr., is responsible for the outstanding balance owed to Claremont Nursing and Rehabilitation genter for nursing care and services provided to his wife, Plaintiff Patricia J. Shay for whom he also stands as Power of Attorney. 38. It is an implied term of the agreement between Plaintiff Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., Powers of Attorney for Patricia J. Shay, that Defendant Charles E. Shay, Jr., would responsibly use Od safeguard the assets of his wife, Plaintiff Patricia J. Shay for her care. To the extent that he has failed to do this, he should be held personally responsible. 39. It is an implied term of the agreement between Plaintiff Patricia J. Shay, through Tracy D. Shay-Snyder as her Power of Attorney, and Ch*rles E. Shay, Jr., as spouse and Power of Attorney for Patricia J. Shay, that hd would assist financially by providing payment for services and/or by raking arrangements for payment including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 40. Claremont Nursing and Rehabilitation Center has demanded payment from the Defendant Charles E. Shay, Jr., but the Defendant has ref used and continues to 9 refuse to make payment in breach of the oral contract between himself and Plaintiff Patricia J. Shay. 1 41. Plaintiff Patricia J. Shay has been damaged by the failure of the Defendant Charles E. Shay, Jr., to pay for the nursing care and services that have been rendered on her behalf by Claremont Nursing and Rehabilitation Center and could be discharged for non-payment. 42. Plaintiff Patricia J. Shay through her Power of Attorney T Tracy D. Shay-Snyder is incurring attorney fees and costs in prosecuting this matter that should be reimbursed by Defendant Charles E. Shay, Jr. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25 for nursing are, plus 6% prejudgment and post judgment interest per annum, or as etermined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charle E. Shay, Jr, individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. j d. Granting such other relief as the Court deems Charles E. Shay, Jr., individually and as Patricia J. Shay'Spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 43. Plaintiff hereby incorporates paragraphs 1 through 42 of forth at length herein. Complaint as if set 10 44. On or about April, 2003, Defendant Charles E. Shay, Jr.,',agreed to the admission of his wife Plaintiff Patricia J. Shay to a nursing home bTracy D. Shay-Snyder, Power of Attorney for Patricia J. Shay, and to pay the m4sing home bill for providing care and services to her. 45. Between April 2003 and December 2004, Defendant Charles E. Shay, Jr., continued to make representations that he would pay for the costs of nursing home care for Plaintiff Patricia J. Snyder. 46. On or about February 4, 2005, Tracy D. Shay-Snyder, as Power of Attorney for Plaintiff Patricia J. Shay, relied upon the representations made by Charles E. Shay, Jr., and applied for the admission of Plaintiff Patricia J. Shay to Claremont Nursing and Rehabilitation Center; which was granted add the nursing facility began rendering nursing care and services. 47. The facts, as set forth above, establish an implied-in-law ?nd an implied-in-fact contract. 48. Due to the existence of the implied-in-law and implied-irk-fact contract, Defendant Charles E. Shay, Jr., is responsible to pay for the health care services rendered to Plaintiff Patricia J. Shay. 49. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Pow?r of Attorney, Attorney in Fact, Responsible Party and Fiduciary that hd would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that he has failed to do this, he should be held personally 11 50. It is an implied term of the agreement between Plaintiff l atricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary, that he would assist with, including, but not limited to, providing the necessary documentatiors for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 51. Plaintiff Patricia J. Shay through her Power of Attorney 'racy D. Shay-Snyder, has requested payment from Defendant Charles E. Shay, k, under the terms of the implied-in-fact and implied-in-law contract, but Defendant has failed and/or refused to make payment. 52. The Plaintiff Patricia J. Shay has been damaged by the refusal of Defendant to pay for the nursing care and services rendered, in breach pf the implied-in-law and implied-in-fact contract. 53. Plaintiff is incurring attorney fees and costs in prosecutink this matter. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as spouse and Patricia J. Shay's Power o Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at east $23,265.25 plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses plus 6% prejudgment and postjudgment interest per annum, or as determined by he Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasona e attorney fees incurred in connection with this action and costs of court. 12 d. Granting such other relief as the Court deems COUNT 3-QUANTUM MERUIT Charles E. Shay, Jr individually and as spouse, Power of Atto ney, Attorney in Fact, Responsible Party and Fiduciary of Patricia J. hay 54. Plaintiff hereby incorporates paragraphs 1 through 53 of this Complaint as if set forth at length herein. 55. As more fully described herein, Plaintiff's expectation for payment to be made by Defendant Charles E. Shay, Jr., in exchange for rende ing the nursing care and services to his wife Plaintiff Patricia J. Shay was reasonable. 56. It is an implied term of the agreement between Plaintiff atricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually and as spouse and Power of Attorney of Patricia J. Shay that he would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that Defendant Charles E. Shay, Jr., has failed to do this, he should be held personally responsible. 57. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually, and as spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary of Patricia J. Shay that 4e would assist with, including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff 1 atricia J. Shay. 58. Defendant Charles E. Shay, Jr., has retained the benefit or the bargain with Plaintiff Patricia J. Shay through her Power of Attorney "racy D. Shay-Snyder for the provision of nursing care and services to his wife Od has not conferred a 13 similar benefit in return upon the Plaintiff by refusing to make any payment. 59. Defendant has been unjustly enriched at the expense of 60. Due to Defendant's unjust enrichment, Plaintiff is entitled to proper compensation and support for the services rendered by Claremont Nursing and Rehabilitation Center to his wife for whom he is also Power of Attorney, Plaintiff Patricia J. Shay. 61. Defendant's unjust enrichment at Plaintiff's expense has damaged the Plaintiff and could result in her expulsion from the nursing home. 62. Plaintiff Patricia J. Shay through her Power of Attorney 'racy D. Shay-Snyder has requested payment from Defendant, but Defendant h4s refused payment. 63. Defendant has received bills from Claremont Nursing an? Rehabilitation Center and has refused to make payment. 64. Plaintiff is incurring attorney fees and costs related to prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this Hono?able Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charle$ E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% pr Judgment and post judgment interest per annum, or as determined by the Co , inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems 14 I Myl\ 1 Y - Ll\L' Kx MAI xlx"V .l .. L Charles E. Shay, Jr., Individually, as spouse, and as Patrici J. Shay's Power of Attorney, Attorney in Fact, Responsible Party an Fiduciary 65. Plaintiff hereby incorporates paragraphs 1 through 64 of this Complaint as if set forth at length herein. 66. On information and belief and as described more fully herein, the income and assets of Plaintiff Patricia J. Shay were, at all times relevant and material hereto, accessed and controlled by Defendant Charles E. Shay, 67. On information and belief, confidential personal financial information about Plaintiff Patricia J. Shay such as, but not limited to: life i4surance policy numbers; bank account numbers and real estate data wer?, at all times relevant and material hereto, accessed and controlled by Defendant Charles E. Shay, Jr., as the Power of Attorney, Attorney-in-Fact, Responsible 'arty and Fiduciary for Patricia J. Shay, Defendant Charles E. Shay, Jr., had a fiduciary duty to act in the best interests of Plaintiff Patricia J. Shay. 68. On information and belief, Defendant Charles E. Shay, J4, refused to make the income and assets of Plaintiff Patricia J. Shay available to Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, to pay for her nursing care and services or to pay for those services himself. 69. On information and belief, Defendant Charles E. Shay, Jn, despite being requested to do so, failed to inform the facility or Plaintiff Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, of Patr?cia J. Shay's, income and assets and disclose to the facility exactly what incorne and assets the 15 Defendant Charles E. Shay Jr. had available so that Tracy D Shay-Snyder, as Power of Attorney for Patricia J. Shay, or the facility miIht act in the best interests of Patricia J. Shay by assisting in the Medical Assistance application I process for her. I 70. The Claremont Nursing and Rehabilitation Center, by vi4ue of the contract to provide care to Patricia J. Shay, is an intended third party beneficiary of the agency relationship that existed between Defendant Charles E. Shay Jr. and Patricia J. Shay as he is her spouse, Power of Attorney, Ittorney in Fact, Responsible Party and Fiduciary. 71. On information and belief, Defendant Charles E. Shay, J?., owes a fiduciary obligation to Plaintiff Tracy D. Shay-Snyder to use the a*ts of Plaintiff Patricia J. Shay to pay for her nursing care and services when invpiced, to inform the facility and Tracy D. Shay-Snyder, as Power of Attorney when such assets became depleted, if applicable, and to disclose the available income and assets to the facility. 72. Due to the existence of the fiduciary duty between Defendant Charles E. Shay, Jr, and Plaintiff Patricia J. Shay, Plaintiff Patricia J. Shay is entitled to compensation from Defendant Charles E. Shay for the health care services rendered to her. 73. On information and belief, Defendant Charles E. Shay, J4., violated his fiduciary duty to Plaintiff Patricia J. Shay and to Plaintiff Tracey J] Shay-Snyder by refusing to use Plaintiff Patricia J. Shay's, income and as?ets to pay for her nursing care and services, to inform the facility when such assets became 16 depleted, if applicable, and to disclose the available inco e and assets to the facility and thus damaged Plaintiff. 74. On information and belief, Defendant Charles E. Shay, duty to Plaintiff by withholding information required by Public Welfare to qualify Plaintiff Patricia J. Shay for benefits, and by doing so Defendant Charles E. Shay has 75. On information and belief, Plaintiff has been damaged Shay's violation of her fiduciary duty to Plaintiff 76. Plaintiff is incurring attorney fees and costs in WHEREFORE, Plaintiff respectfully requests that this as follows: , violated his fiduciary ie Department of dical Assistance hus damaged Plaintiff. Defendant Charles E. J. Shay. this matter. Court enter an Order a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25 plus 6% prejudgment and post judgment interest per annum, or as determined by the Coup, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including in connection with this action. d. Granting such other relief as the Court deems attorney fees incurred 17 COUNT 5 - NEGLIGENCE Charles E. Shay, Jr, Individually, as spouse and as Patrici J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and iduciary 77. Plaintiff hereby incorporates paragraphs 1 through 76 of this Complaint as if set forth at length herein. 78. Defendant Charles E. Shay, Jr. had a duty to act in Plaintiff Patricia J. Shay's best interest. 79. Defendant Charles E. Shay, Jr., had a duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests, which would be to pay for her nursing care and services. 80. Defendant Charles E. Shay, Jr., had a duty to aid in Patricia J. Shay's application for Medicaid benefits and to notify the facility and TracylD. Shay-Snyder, Power of Attorney, when her assets were becoming depleted. 81. Defendant Charles E. Shay, Jr., breached his duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Sh y's best interests by refusing to make her income and assets available to pay r her nursing care and services. 82. Defendant Charles E. Shay, Jr., breached his duty to aid 0 completing Plaintiff Patricia J. Shay's Medicaid application by refusing to coimnunicate or aid the facility or Tracy D. Shay-Snyder, as Power of Attorney f?r Patricia J. Shay, in any way with respect to Plaintiff Patricia J. Shay's Medial Assistance application and by failing to notify the facility or Tracy q. Shay-Snyder, as Power of Attorney, that Patricia J. Shay's assets had became depleted. 18 83. On information and belief, Defendant Charles E. Shay, J ., breached his duties as Power of Attorney by refusing to be available to the fa ility to act in his role as Power of Attorney for Patricia J. Shay and thus damag?d her and the Claremont Nursing and Rehabilitation Center. 84. Plaintiff has been damaged by the Defendant Charles E. hay, Jr., in violation of his marital and fiduciary duty to Plaintiff Patricia J. Shaylin the amount of at least $23,265.25 for failure to pay for nursing home care ?ervice; said amount increases daily. 85. Plaintiff Patricia Shay has been damaged by Defendant Charles E. Shay, Jr., in violation of his marital and fiduciary duty to Plaintiff Pa#icia J. Shay in the failure to pay for pharmacy supplies. 86. Plaintiff is incurring attorney fees and costs to prosecute his action. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, esponsible Party and Fiduciary in an amount of $854.48 for pharmacy expense plus 6% prejudgment and post judgment interest per annum, or as determined b the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. C. Granting such other relief as the Court deems 19 COUNT 7 - CONVERSION Charles E. Shay, Jr., Individually, as spouse, and as Patrici J. Shay's Power of Attorney, Attorney in Fact, Responsible Party an Fiduciary 87. Plaintiff hereby incorporates by reference paragraphs 1 t ough 86 of this Complaint as if set forth at length. 88. Defendant Charles E. Shay, Jr., had a duty to act in best interest. 89. Defendant Charles E. Shay, Jr., had a duty to use income and assets to serve Plaintiff Patricia J. Shay's be to safeguard her assets and to pay for her nursing care 90. On information and belief, Defendant Charles E. Shay, to the contractual relationship between Plaintiff Patricia Nursing and Rehabilitation Center that Patricia J. Shay's used for her care and, despite this knowledge converted Patricia J. Shay to his own use. 91. Plaintiff has been damaged by Defendant Charles E. Plaintiff Patricia J. Shay's assets in the amount of at 92. Plaintiff is incurring attorney fees and costs in WHEREFORE, Plaintiff respectfully requests that this as follows: iff Patricia J. Shay's 'Patricia J. Shay's : interest, which would and services. was aware that due Shay and Claremont assets needed to be ie assets of the Plaintiff ,'s conversion of $23,265.25. g this action. Court enter an Order a. Granting judgment for Plaintiff and against Charle E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, esponsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; Granting judgment for Plaintiff and against Charle? E. Shay, Jr., 20 individually and as Power of Attorney, Attorney in Fact, esponsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. I d. Granting such other relief as the Court deems appropriate. COUNT 8 - PETITION FOR ACCOUNTING Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party an Fiduciary 93. Plaintiff hereby incorporates paragraphs 1 through 92 of this Complaint as if set- forth at length. 94. Due to Defendant Charles E. Shay, Jr.'s, conduct described herein, Plaintiff is entitled to an accounting of: a. All transactions and dealings with relation o his duties as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Plaintiff Patricia J. Shay; b. All profits and losses gained or lost as a reult of any investments or businesses run during his tenure as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary on behalf of Plai tiff Patricia J. Shay; C. A listing of all of Defendant Charles E. S y Jr's assets and liabilities during the entire time that Defendant Charles E. Shay, Jr., acted as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Plaintiff Patricia J. Shay and had control of the Plaintiff Patricia J. Shay's assets and any actions taken by Defendant Charles E. Shay, Jr., in regard to the assets and property of Plaintiff Patric a J. Shay or held in for the benefit of Patricia J. Shay; d. Defendant Charles E. Shay, Jr., is a const ctive trustee of the funds and assets of Plaintiff Patricia J. Shay ands ould account for any and all of Plaintiff Patricia J. Shay's funds and fun s held for her benefit, and spent for her personal use. d. Moreover, Defendant Charles E. Shay, Jr., should ccount for any wrongful conversion; dissipation and sale of Plain iff Patricia J. Shay's property or the property held for the benefit of Pla ntiff Patricia J. Shay 21 and return the items or their value to pay for obligations. 95. As a party to the power of attorney between Defendant Plaintiff Patricia J. Shay, Plaintiff is also entitled to a ft inspection of any books or records in the possession of Shay, Jr., pertaining to his actions as a power of attorne responsible party and fiduciary for Plaintiff Patricia J. I WHEREFORE, Plaintiff Patricia J. Shay demands judgment Defendant Charles E. Shay, Jr., and for an Order directing E Shay, Jr., to produce all books and records for inspection rel Power of Attorney, Attorney in Fact, Responsible Party and Shay and account for all of the transactions, dealings, assets other relief that the Court may deem just and proper. Date: fir' Q?e Patricia J. Shay's iarles E. Shay, Jr., and and complete Defendant Charles E. attorney in fact, y. n her favor and against endant Charles E. ng to his actions as duciary for Patricia J. id liabilities and such Respectfully su CAVOZ$I AN A. Sloan , Esquire # 44880 rant Street A 17110 Plaintiff By: a' 1,0 rn u Doreena Cr Attorney,Y. 2933 North] Harrisburg, 1 (717) 233-41 Attorneys to 22 P.C. VERIFICATION I, Tracy D. Shay-Snyder, as Power of Attorney for Patric verify that the facts asserted in the foregoing Complaint are true my knowledge, information and belief. I understand that any fal subject to the penalties contained in Title 18 of the Pennsylvania Section 4904, relating to unswom falsification to authorities. By: Tracy D. Power of Shay J. Shay, do hereby d correct to the best of statements therein are onsolidated Statutes L for Patricia J. 23 T CN - } PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, Plaintiff, V. CHARLES E. SHAY, Jr., Defendant. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 06-3229 Civil Action -Law NOTICE TO PLEAD To Plaintiff: You are hereby notified to plead in response to the attached Preliminary Objections within twenty (20) days or a judgment may be entered against you. 41zt3?&4 e_'X? Matthe M.'1Iaar, Esquire ( a. #85688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 7`h Floor Harrisburg, PA 17101 (717) 257-7508 Dated: July 17, 2006 Attorneys for Defendant 12545).2 7I14M6 ??? 1c1 , ? ?,,; ._ ?,, ._ Defendant resides at 1926 Longboat Drive, Lakeland, Florida 33810. Defendant has continuously resided in the state of Florida for the last eleven (11) years. 8. Defendant does not reside in the Commonwealth of Pennsylvania. 9. Defendant does not do business in the Commonwealth of Pennsylvania. 10. Defendant does not own any real or personal property located in the Commonwealth of Pennsylvania. 11. Defendant did not contact anybody in Pennsylvania to arrange for Plaintiff to receive nursing care, nor did he in any other way initiate a contact in Pennsylvania related to Plaintiff's care. 12. Defendant has not consented and does not consent to personal jurisdiction in the Commonwealth of Pennsylvania. 13. Defendant has not had and does not have continuous or substantial contacts with the Commonwealth of Pennsylvania. 14. To the extent that Defendant has had any contacts with the Commonwealth of Pennsylvania in the last several years, those contacts have been random, fortuitous, or attenuated and are not sufficient to establish personal jurisdiction. 15. Defendant has not purposefully availed himself of the privileges of conducting activities in the Commonwealth of Pennsylvania. 16. Defendant is a non-resident who does not have sufficient minimum contacts with this Commonwealth to establish jurisdiction, and any assertion of personal jurisdiction over the Defendant would not comport with fair play and substantial justice. 1254532 7114/06 -2- 17. Defendant is not subject to personal jurisdiction within the Commonwealth of Pennsylvania. 18. This Court has neither general nor specific jurisdiction over the Defendant. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Complaint with prejudice on the basis of lack of personal jurisdiction. SECOND PRELIMINARY OBJECTION - Pa. R.C.P. 1028(a)(5) Nonjoinder Of A Necessary Party 19. Defendant incorporates the averments of paragraphs 1 through 18. 20. Rule 1028(a)(5) permits a party to file a preliminary objection alleging the nonjoinder of a necessary parry. Pa. R. Civ. P. 1028(a)(5). 21. Failure to join an indispensable party deprives the court of subject matter jurisdiction. Polydvne. Inc. v. City of Philadelphia, 795 A.2d 495, 496 (Pa. Commw. Ct. 2002). 22. A party is indispensable when its rights are so connected with the claims of the litigants that no decree can be made without impairing those rights. Id. Pennsylvania courts consider the following criteria in determining whether an absent party is indispensable: (1) whether the absent party has a right or interest related to the claim; (2) if so, the nature of the right or interest; (3) whether that right or interest is essential to the merits of the issue; and (4) whether justice be afforded without violating due process rights of absent parties. Delaware Co. v. J.P. Morgan Chase & Co., 827 A.2d 594, 598 (Pa. Commw. Ct. 2003). 23. Daughter, acting as Power of Attorney for Wife, seeks a judgment against Husband for monies that are allegedly due and owing by Wife to Claremont Nursing and Rehabilitation Center ("Claremont'), See Compl. ¶ 22. 12545} 2 i/IC/% -3- 24. Claremont has a purported right or interest in plaintiff's claim in that Claremont is the alleged ultimate beneficiary of any amount due. 25. Claremont's purported right or interest is essential to the merits of this claim, as the validity of Mother's alleged debt to Claremont is the epicenter of this case. 26. Justice cannot be afforded without Claremont participating in this litigation. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss Plaintiff's Complaint. THIRD PRELIMINARY OBJECTION - Pa R.C.P. 1028 (a)(3) Insufficient Specificity 27. Defendants incorporate the averments of paragraphs 1 through 26. 28. Rule 1028(a)(3) permits a party to file a preliminary objection alleging insufficient specificity in a pleading. Pa. R. Civ. P. 1028(a)(3). 29. Plaintiff makes the conclusory allegation in paragraph 17 of the Complaint that Defendant represented "that he would pay for the expenses of (Wife's] care." Compl. 117. 30. Plaintiffs conclusory allegation does not include any detail regarding what those representations allegedly were or when, where or how such representations were allegedly made. 31. Defendant cannot formulate a proper answer to these allegations based simply on Plaintiff's conclusory allegations. 32. The Complaint should be dismissed for insufficient specificity. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Complaint. FOURTH PRELIMINARY OBJECTION - Pa. R.C.P. 1028(a)(4) Demurrer 33. Defendant incorporates the averments of paragraphs 1 through 32. 12545).211141% -4- 34. Rule 1028(a)(4) permits a party to file a preliminary objection in the nature of a demurrer asserting the legal insufficiency of a pleading. Pa. R. Civ. P. 1028(a)(4). 35. Attorney's fees may only be awarded when explicitly provided for by contract, by statute or by some other recognized exception. Chatham Communications Inc, v. General Press Corp., 463 Pa. 292, 300-301, 344 A.2d 837, 842 (1975). 36. The Complaint seeks, among other things, attorney's fees. See, M, Compl. p. 10. 37. Plaintiff fails to cite any contractual provision that would establish an ability to recover attorney's fees. 38. Plaintiff fails to identify any statutory basis for the award of attorney's fees. 39. Plaintiff fails to identify any other basis for the award of attorney's fees. 40. Plaintiff has failed to state a claim for the recovery of attorney's fees. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Complaint. Failure To Conform With Rule of Court 41. Defendant incorporates the averments of paragraphs 1 through 40. 42. Rule 1028(a)(2) permits a party to file a preliminary objection alleging that a pleading fails to conform with rule of court. Pa. R. Civ. P. 1028(a)(2). 43. Rule 1019(h) requires that "[w]hen any claim .., is based upon an agreement, the pleading shall state specifically if the agreement is oral or written." Pa. R. Civ. P. 1019(h). 44. Plaintiff alleges the existence of an agreement for Daughter and/or Wife to pay Claremont for Wife's nursing home care. See Compl. 116. 45. Plaintiff fails to specifically allege whether the agreement is oral or written. ¢545).2 7A4/0 -5- 46. Rule 1019(i) requires that "[w]hen any claim ... is based upon a writing, the pleader shall attach a copy of the writing." Pa. R. Civ. P. 1019(i). 47. If the agreement pleaded by Plaintiff is written, Plaintiff failed to attach a copy of the writing to the Complaint. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Complaint. Respectfully submitted, Dated: July 17, 2006 atth w . Haar, Esq ire (Pa. #85688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 7`h Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendants Also: Leonard McCall, Certified Legal Intern Nichole Walters, Esquire The Dickinson School of Law of the Pennsylvania State University Elder Law Clinic 150 South College Street Carlisle, PA 17013 (717) 240-5152 125459 2 7/14(0 -6- 1. CbwW S. Shay. )r.. baraby verify that the sti msats conak-ed io the Among PrvAvob vy Objocytom toe hoe and coned to the best of my knowW*. inf motion and belief. [ wAwstmW *at @us Vaffimdoa b made aobjecl m toe petaddoa of 1$ Pa C.S.A. ! 4904, rdathq to Wwworn &Wtlatim to sudw itim DOW: July i7 2006 vv_ L D -2?5?t CERTIFICATE OF SERVICE I hereby certify that on July 17, 20061 served a true and correct copy of the foregoing Preliminary Objections by first class mail, postage prepaid, upon the following counsel of record: Doreena Craig Sloan, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Attorneys far Plaintiffs Dated: July 17, 2006 U5453 27/14/06 Doreena Craig Sloan, Esquire Attorney I.D.# 44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 2334101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 CIVIL ACTION - LAW Plaintiff, V. CHARLES E. SHAY, Jr. Individually, Power of Attorney Attorney in Fact, Responsible Party and/or Fiduciary for Patricia J. Shay 1926 Longboat Drive Lakeland, FL 33810 CAUSE NUMBER: 063229 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 the 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 Plaintiffs. 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. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT REDUCED FEE OR NO FEE. CUMBERLAND COUNTY BAR ASSOCIATION LAWYER REFERRAL SERVICE 213 NORTH FRONT STREET HARRISBURG, PA 17101 TELEPHONE: (717) 232-7536 Le had demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente dias de plazo al particular de la fecha de la demanda y la notificication. Hace falta ascentar una comparencia escrita o en persona o con abogado y entregar a la corte en forma escrita sus defenses o sus objeciones a las demandas en contra de su persona. Se adviso que si usted no tiene defiende, la corte tomara medidas y puede continuar la demanda en contra suya sin previo aviso o notificacion. Ademas, la corte puede decidir a favor del demandante y requiere que usted cumpla con todas las provisioner de esta demanda. Usted puede perder dinero o sus propiedades y otros direchos importantes para usted. LLEVE ESTA DEMANDA A SU ABOGADO IMMEDIATAMENTE, SI NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. ASOCIACION DE LICENCIADOS DE FILADELFIA, SERVICIO DE REFERENCIA Y INFORMACION LEGAL, ONE READING CENTER, FILADELFIA, PENNSYLVANIA 19107 TELEFONO: (215) 238-1701 Doreen Craig Sloan, Esq. Attorney I.D.#44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 2334101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 CIVIL ACTION - LAW Plaintiff, V. CHARLES E. SHAY, Jr. Individually, Power of Attorney Attorney in Fact, Responsible Party and/or Fiduciary for Patricia J. Shay 1926 Longboat Drive Lakeland, FL 33810 CAUSE NUMBER: AMENDED COMPLAINT AND NOW, comes Plaintiff, Tracy D. Shay- Snyder, by and her attorney, Doreena Craig Sloan, Esquire, of the law firm Capozzi & Associates, P.C., and as set-forth in the following amended complaint, respectfully show the Court the following: 1. Plaintiff, Tracy D. Shay-Snyder is a resident of the Commonwealth of Pennsylvania and is the daughter of Patricia J. Shay and Charles E. Shay, Jr. 2. Plaintiff Tracy D. Shay-Snyder currently holds a Power of Attorney issued in the state of Florida for her mother Patricia J. Shay, the subject of this action. 3. Charles E. Shay, Jr., is the spouse of Patricia J. Shay as they were married on October 25, 1952, in the Commonwealth of Pennsylvania, and they resided here until on or about 1995 and received the benefits of residing in the Commonwealth of Pennsylvania. 4. The marriage of Defendant Charles Shay and Plaintiff Patricia Shay produced two children, Tracy Shay-Snyder and Cory Shay, that were born and raised in the Commonwealth of Pennsylvania and who continue to reside here. 5. Defendant Charles Shay has relatives and friends that continue to reside in Pennsylvania that he contacts and visits. 6. On or about 1995 Defendant Charles Shay and Patricia Shay retired to the State of Florida but continued to visit the Commonwealth of Pennsylvania and maintain contact with their children and other family members and friends that live in Pennsylvania. 7. When Defendant Charles Shay experienced health challenges during 2002 and 2003, he contacted his daughter, Tracey Shay-Snyder, asked her to take care of Plaintiff Patricia J. Shay in her home in Pennsylvania, and agreed to assist financially in her care. 8. Defendant Charles E. Shay, Jr., is currently a resident of the state of Florida but does have, has had, and continues to maintain, contact with relatives and friends in Pennsylvania. 9. Plaintiff Patricia J. Shay is a resident at Claremont Nursing and Rehabilitation Center, a long-term care facility located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 10. Patricia J. Shay was admitted to the Claremont Nursing and Rehabilitation Center, a long-term care facility that is licensed to participate in the Medicaid 4 and Medicare programs, on February 4, 2005, with a diagnosis of, among other things, Alzheimer's Dementia. 11. At some point after Plaintiff Patricia J. Shay's admission to Claremont Nursing and Rehabilitation Center, Defendant Charles E. Shay, Jr., assisted in applying for Medical Assistance Benefits for nursing home care for Patricia J. Shay through the Pennsylvania Department of Public Welfare. 12. Defendant Charles E. Shay, Jr., has consented to the personal jurisdiction of the Commonwealth of Pennsylvania by assisting in the Medical Assistance application process to obtain benefits for his wife, Plaintiff Patricia J. Shay. 13. Later in the eligibility determination process, Defendant Charles E. Shay, Jr., failed and/or refused to provide income and resource information to the Department of Public Welfare for them to make an accurate determination on whether Plaintiff Patricia J. Shay is eligible for Medical Assistance Nursing Home benefits from the Commonwealth of Pennsylvania. 14. Defendant Charles E. Shay, Jr., is an adult individual residing at 1926 Longboat Dive, Lakeland, Florida 33810. 15. On information and belief, Defendant Charles E. Shay, Jr., is also Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for his wife Patricia J. Shay. 16. On or about April 2003, Plaintiff Patricia J. Shay was living with her husband, Defendant Charles E. Shay, Jr., at the Defendant's residence, when he was hospitalized and underwent a surgical procedure that rendered him unable to continue to care for Plaintiff Patricia J. Shay. 17. Defendant Charles E. Shay, Jr., requested assistance from Tracy D. Shay-Snyder in taking care of his wife Plaintiff Patricia J. Shay, acknowledged that her condition would soon require nursing home placement, agreed to allow her to return to Pennsylvania to live with their daughter Tracy D. Shay-Snyder, Power of Attorney, be placed in a nursing home when necessary, and agreed to pay for any current and future expenses related to the care of his wife Plaintiff Patricia J. Shay. 18. Between April 2003 and February 3, 2005, Plaintiff Patricia J. Shay resided with her daughter and Power of Attorney Tracy D. Shay-Snyder and her medical condition deteriorated such that she required 24 hour nursing home care. 19. During that same period, Defendant Charles E. Shay, Jr., did not contribute in any way to the support of his wife Plaintiff Patricia J. Shay. 20. During that same period Plaintiff Tracy D. Shay-Snyder kept in contact with her father Defendant Charles E. Shay, Jr., and advised him of the condition of his wife, Plaintiff Patricia J. Snyder. 21. Prior to February 3, 2005, Plaintiff Tracy D. Shay-Snyder contacted Defendant Charles E. Shay-Snyder, and advised him that Plaintiff Patricia J. Shay required more care than she was able to provide in her home. 22. Defendant Charles E. Shay, Jr., agreed to the placement of Patricia J. Shay into a nursing home due to her need for additional care and orally agreed to pay for her care. 23. Defendant Charles E. Shay, Jr., did not and has not requested that Plaintiff Patricia J. Shay be returned to him in Florida so that he could provide or arrange care for her. 24. On or about February 4, 2005, Claremont Nursing and Rehabilitation Center a written agreement was executed admitting Patricia J. Shay to the facility to receive nursing care and services and she has continuously remained there. (See Exhibit "1") 25. The Claremont Nursing and Rehabilitation Center has submitted bills for nursing home care services rendered to Patricia J. Shay and Defendant Charles E. Shay, Jr., as husband and Power of Attorney, and to Tracy D. Shay-Snyder, Power of Attorney and daughter of Patricia J. Shay. 26. At all times relevant to this action, the nursing care and services rendered by Claremont Nursing ad Rehabilitation Center have met all applicable federal, state and local standards of care. 27. On or about February 4, 2005, the Claremont Nursing and Rehabilitation Center presented a promise to provide nursing care and services to Plaintiff Patricia J. Shay in exchange for her promise to pay for said care and services. 28. While Defendant Charles E. Shay, Jr., was not in the Commonwealth of Pennsylvania at the time of Plaintiff Patricia J. Shay's admission to Claremont Nursing and Rehabilitation Center, he had made representations to Tracy D. Shay-Snyder, daughter and Power of Attorney of Patricia J. Shay, as the husband and Power of Attorney of Plaintiff Patricia J. Shay, that he would pay for the expenses of her care. 29. Plaintiff Patricia J. Shay, through her Power of Attorney Tracy D. Shay-Snyder, relied upon the representations of Charles E. Shay, Jr., and signed the contract to 7 admit Patricia J. Shay to Claremont Nursing and Rehabilitation Center. (See Exhibit 1) 30. Plaintiff Patricia J. Shay's, average monthly expenses incurred at the Claremont Nursing and Rehabilitation Center total approximately $7,000.00. 31. The current bill for nursing home services provided to Patricia J. Shay by Claremont Nursing and Rehabilitation center is $23,265.25 and increases daily. (See Exhibit 2) 32. Plaintiff Patricia J. Shay's reasonable monthly living expenses incurred at the Claremont Nursing and Rehabilitation Center has significantly exceeded her monthly income and were insufficient to adequately provide for her care, maintenance, and support. 33. Due to the refusal of Defendant Charles E. Shay, Jr., to make any payment for the nursing care and services rendered to Plaintiff Patricia J. Shay by Claremont Nursing and Rehabilitation Center, the account for Plaintiff Patricia J. Shay is currently in arrears in the amount of $23,265.25 and increases daily. 34. Due to the refusal of the Defendant Charles E. Shay to make payment for pharmaceutical supplies and medications furnished to Plaintiff Patricia J. Shay since her admission, her account is currently in arrears. 35. On information and belief, Defendant Charles E. Shay, Jr., individually and as spouse and Power of Attorney for Patricia J. Shay, has not made any payments for the nursing home care of his wife, Plaintiff Patricia J. Shay, or for her pharmacy bills. 36. A majority of the income and assets of Plaintiff Patricia J. Shay were, at all times relevant and material hereto, and currently are accessed and controlled by the Defendant Charles E. Shay, Jr. 37. Confidential personal financial information about Patricia J. Shay, such as, but not limited to: life insurance policy numbers; bank account numbers, income, and real estate data were, at all times relevant and material hereto, accessed and controlled by the Defendant Charles E. Shay, Jr., and denied to the Plaintiff Patricia J. Shay and her Power of Attorney Tracy D. Shay-Snyder. 38. Defendant Charles E. Shay, Jr., has substantially refused and/or ignored all communication from the facility and Plaintiff Tracey Shay-Snyder related to the past due balance. 39. Defendant Charles E. Shay, Jr., refused or neglected to assist Plaintiff Patricia J. Shay through Tracy D. Shay-Snyder, Power of Attorney, in her efforts to secure Medical Assistance nursing home benefits for Plaintiff Patricia J. Shay. 40. On information and belief, Defendant Charles E. Shay, Jr., withheld critical information relating to Defendant Charles E. Shay, Jr.'s and Plaintiff Patricia J. Shay's finances that are a necessary prerequisite to the Medical Assistance application's approval by the Pennsylvania Department of Public Welfare. 41. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Snyder, and Defendant Charles E. Shay, Jr., as Power of Attorney for Patricia J. Shay had a contractual, legal and fiduciary obligation to the facility to assist in qualifying Plaintiff Patricia J. Shay, for Medical Assistance by providing all information necessary to complete Plaintiff Patricia J. Shay's Medical Assistance Application. 42. As a result of Defendant Charles E. Shay's, refusal to assist Plaintiff Patricia J. Shay in the Medical Assistance process, Plaintiff was denied eligibility for Medical Assistance benefits. 43. Defendant Charles E. Shay, Jr, has a legal and fiduciary obligation to Plaintiff Patricia J. Shay to pay for the medical, nursing and pharmaceutical services rendered to his wife for whom he holds a Power of Attorney, Patricia J. Shay. COUNT 1- BREACH OF CONTRACT Charles E. Shay, Jr. Individually and as Patricia J. Shay's Spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 44. Plaintiff hereby incorporates paragraphs 1 through 43 of this Complaint as if set forth at length herein. 45. As more fully described herein, on or about February 4, 2005, Plaintiff Patricia J. Shay, through her Power of Attorney Tracy D. Shay-Snyder, made application for the admission of Plaintiff Patricia J. Shay to the Claremont Nursing and Rehabilitation Center for ongoing nursing care and services with the full knowledge and consent of Defendant Charles E. Shay, Jr., spouse and Power of Attorney for Patricia J. Shay. 46. Defendant Charles E. Shay, Jr. has not made payments for the medical, nursing or pharmaceutical services rendered to Plaintiff Patricia J. Shay as agreed to in the oral contract by and between the parties. 47. The Claremont Nursing and Rehabilitation Center is entitled to compensation for the medical and nursing care and pharmaceutical services rendered to Plaintiff Patricia J. Shay. 48. As such, Defendant Charles E. Shay, Jr., is responsible for the outstanding 10 balance owed to Claremont Nursing and Rehabilitation Center for nursing care and services provided to his wife, Plaintiff Patricia J. Shay for whom he also stands as Power of Attorney. 49. It is an implied term of the agreement between Plaintiff Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., Powers of Attorney for Patricia J. Shay, that Defendant Charles E. Shay, Jr., would responsibly use and safeguard the assets of his wife, Plaintiff Patricia J. Shay for her care. To the extent that he has failed to do this, he should be held personally responsible. 50. It is an implied term of the agreement between Plaintiff Patricia J. Shay, through Tracy D. Shay-Snyder as her Power of Attorney, and Charles E. Shay, Jr., as spouse and Power of Attorney for Patricia J. Shay, that he would assist financially by providing payment for services and/or by making arrangements for payment including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 51. Claremont Nursing and Rehabilitation Center has demanded payment from the Defendant Charles E. Shay, Jr., but the Defendant has refused and continues to refuse to make payment in breach of the oral contract between himself and Plaintiff Patricia J. Shay. 52. Plaintiff Patricia J. Shay has been damaged by the failure of the Defendant Charles E. Shay, Jr., to pay for the nursing care and services that have been rendered on her behalf by Claremont Nursing and Rehabilitation Center and could be discharged for non-payment. 53. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder is 11 incurring attorney fees and costs in prosecuting this matter that should be reimbursed by Defendant Charles E. Shay, Jr. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25 for nursing care, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems appropriate. COUNT 2-BREACH OF IMPLIED CONTRACT Charles E. Shay, Jr., individually and as Patricia J. Shay's Spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 54. Plaintiff hereby incorporates paragraphs 1 through 53 of this Complaint as if set forth at length herein. 55. On or about April 2003, Defendant Charles E. Shay, Jr., agreed to the admission of his wife Plaintiff Patricia J. Shay to a nursing home by Tracy D. Shay-Snyder, Power of Attorney for Patricia J. Shay, and to pay the nursing home bill for providing care and services to her. 56. Between April 2003 and December 2004, Defendant Charles E. Shay, Jr., continued to make representations that he would pay for the costs of nursing home care for Plaintiff Patricia J. Snyder. 12 57. On or about February 4, 2005, Tracy D. Shay-Snyder, as Power of Attorney for Plaintiff Patricia J. Shay, relied upon the representations made by Charles E. Shay, Jr., and applied for the admission of Plaintiff Patricia J. Shay to Claremont Nursing and Rehabilitation Center; which was granted and the nursing facility began rendering nursing care and services. 58. The facts, as set forth above, establish an implied-in-law and an implied-in-fact contract. 59. Due to the existence of the implied-in-law and implied-in-fact contract, Defendant Charles E. Shay, Jr., is responsible to pay for the health care services rendered to Plaintiff Patricia J. Shay. 60. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary that he would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that he has failed to do this, he should be held personally responsible. 61. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary, that he would assist with, including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 62. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, 13 has requested payment from Defendant Charles E. Shay, Jr., under the terms of the implied-in-fact and implied-in-law contract, but Defendant has failed and/or refused to make payment. 63. The Plaintiff Patricia J. Shay has been damaged by the refusal of Defendant to pay for the nursing care and services rendered, in breach of the implied-in-law and implied-in-fact contract. 64. Plaintiff is incurring attorney fees and costs in prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as spouse and Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25 plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action and costs of court. d. Granting such other relief as the Court deems appropriate. COUNT 3-OUANTUM MERUIT Charles E. Shay, Jr individually and as spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary of Patricia J. Shay 65. Plaintiff hereby incorporates paragraphs 1 through 64 of this Complaint as if set forth at length herein. 66. As more fully described herein, Plaintiff s expectation for payment to be made by Defendant Charles E. Shay, Jr., in exchange for rendering the nursing care 14 and services to his wife Plaintiff Patricia J. Shay was reasonable. 67. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually and as spouse and Power of Attorney of Patricia J. Shay that he would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that Defendant Charles E. Shay, Jr., has failed to do this, he should be held personally responsible. 68. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually, and as spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary of Patricia J. Shay that he would assist with, including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 69. Defendant Charles E. Shay, Jr., has retained the benefit of the bargain with Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay?Snyder for the provision of nursing care and services to his wife and has not conferred a similar benefit in return upon the Plaintiff by refusing to make any payment. 70. Defendant has been unjustly enriched at the expense of Plaintiff. 71. Due to Defendant's unjust enrichment, Plaintiff is entitled to proper compensation and support for the services rendered by Claremont Nursing and Rehabilitation Center to his wife for whom he is also Power of Attorney, Plaintiff Patricia J. Shay. 72. Defendant's unjust enrichment at Plaintiff s expense has damaged the Plaintiff 15 and could result in her expulsion from the nursing home. 73. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder has requested payment from Defendant, but Defendant has refused payment. 74. Defendant has received bills from Claremont Nursing and Rehabilitation Center and has refused to make payment. 75. Plaintiff is incurring attorney fees and costs related to prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems appropriate. COUNT 4 - BREACH OF FIDUCIARY DUTY Charles E. Shay, Jr.,Individually, as spouse, and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 76. Plaintiff hereby incorporates paragraphs 1 through 75 of this Complaint as if set forth at length herein. 77. On information and belief and as described more fully herein, the income and assets of Plaintiff Patricia J. Shay were, at all times relevant and material hereto, 16 accessed and controlled by Defendant Charles E. Shay, Jr. 78. On information and belief, confidential personal financial information about Plaintiff Patricia J. Shay such as, but not limited to: life insurance policy numbers; bank account numbers and real estate data were, at all times relevant and material hereto, accessed and controlled by Defendant Charles E. Shay, Jr., as the Power of Attorney, Attomey-in-Fact, Responsible Party and Fiduciary for Patricia J. Shay, Defendant Charles E. Shay, Jr., had a fiduciary duty to act in the best interests of Plaintiff Patricia J. Shay. 79. On information and belief, Defendant Charles E. Shay, Jr., refused to make the income and assets of Plaintiff Patricia J. Shay available to Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, to pay for her nursing care and services or to pay for those services himself. 80. On information and belief, Defendant Charles E. Shay, Jr., despite being requested to do so, failed to inform the facility or Plaintiff Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, of Patricia J. Shay's, income and assets and disclose to the facility exactly what income and assets the Defendant Charles E. Shay Jr. had available so that Tracy D Shay-Snyder, as Power of Attorney for Patricia J. Shay, or the facility might act in the best interests of Patricia J. Shay by assisting in the Medical Assistance application process for her. 81. The Claremont Nursing and Rehabilitation Center, by virtue of the contract to provide care to Patricia J. Shay, is an intended third party beneficiary of the agency relationship that existed between Defendant Charles E. Shay Jr. and 17 Patricia J. Shay as he is her spouse, Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary. 82. On information and belief, Defendant Charles E. Shay, Jr., owes a fiduciary obligation to Plaintiff Tracy D. Shay-Snyder to use the assets of Plaintiff Patricia J. Shay to pay for her nursing care and services when invoiced, to inform the facility and Tracy D. Shay-Snyder, as Power of Attorney, when such assets became depleted, if applicable, and to disclose the available income and assets to the facility. 83. Due to the existence of the fiduciary duty between Defendant Charles E. Shay, Jr, and Plaintiff Patricia J. Shay, Plaintiff Patricia J. Shay is entitled to compensation from Defendant Charles E. Shay for the health care services rendered to her. 84. On information and belief, Defendant Charles E. Shay, Jr., violated his fiduciary duty to Plaintiff Patricia J. Shay and to Plaintiff Tracey J. Shay-Snyder by refusing to use Plaintiff Patricia J. Shay's, income and assets to pay for her nursing care and services, to inform the facility when such assets became depleted, if applicable, and to disclose the available income and assets to the facility and thus damaged Plaintiff. 85. On information and belief, Defendant Charles E. Shay, Jr., violated his fiduciary duty to Plaintiff by withholding information required by the Department of Public Welfare to qualify Plaintiff Patricia J. Shay for Medical Assistance benefits, and by doing so Defendant Charles E. Shay has thus damaged Plaintiff. 86. On information and belief, Plaintiff has been damaged by Defendant Charles E. 18 Shay's violation of her fiduciary duty to Plaintiff Patricia J. Shay. 87. Plaintiff is incurring attorney fees and costs in prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25 plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and postjudgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems appropriate. COUNT 5 - NEGLIGENCE Charles E. Shay, Jr, Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 88. Plaintiff hereby incorporates paragraphs 1 through 87 of this Complaint as if set forth at length herein. 89. Defendant Charles E. Shay, Jr. had a duty to act in Plaintiff Patricia J. Shay's best interest. 90. Defendant Charles E. Shay, Jr., had a duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests, which would be to pay for her nursing care and services. 91. Defendant Charles E. Shay, Jr., had a duty to aid in Patricia J. Shay's application for Medicaid benefits and to notify the facility and Tracy D. Sha)-Snyder, Power 19 of Attorney, when her assets were becoming depleted. 92. Defendant Charles E. Shay, Jr., breached his duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests by refusing to make her income and assets available to pay for her nursing care and services. 93. Defendant Charles E. Shay, Jr., breached his duty to aid in completing Plaintiff Patricia J. Shay's Medicaid application by refusing to communicate or aid the facility or Tracy D. Shay-Snyder, as Power of Attorney for Patricia J. Shay, in any way with respect to Plaintiff Patricia J. Shay's Medical Assistance application and by failing to notify the facility or Tracy D. Shay-Snyder, as Power of Attorney, that Patricia J. Shay's assets had become depleted. 94. On information and belief, Defendant Charles E. Shay, Jr., breached his duties as Power of Attorney by refusing to be available to the facility to act in his role as Power of Attorney for Patricia J. Shay and thus damaged her and the Claremont Nursing and Rehabilitation Center. 95. Plaintiff has been damaged by the Defendant Charles E. Shay, Jr., in violation of his marital and fiduciary duty to Plaintiff Patricia J. Shay in the amount of at least $23,265.25 for failure to pay for nursing home care service; said amount increases daily. 96. Plaintiff Patricia Shay has been damaged by Defendant Charles E. Shay, Jr., in violation of his marital and fiduciary duty to Plaintiff Patricia J. Shay in the failure to pay for pharmacy supplies. 97. Plaintiff is incurring attorney fees and costs to prosecute this action. 20 WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in an amount of $854.48 for pharmacy expenses plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. C. Granting such other relief as the Court deems appropriate. COUNT 7 - CONVERSION Charles E. Shay, Jr., Individually, as spouse, and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 98. Plaintiff hereby incorporates by reference paragraphs 1 through 97 of this Complaint as if set forth at length. 99. Defendant Charles E. Shay, Jr., had a duty to act in Plaintiff Patricia J. Shay's best interest. 100. Defendant Charles E. Shay, Jr., had a duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interest, which would be to safeguard her assets and to pay for her nursing care and services. 101. On information and belief, Defendant Charles E. Shay, Jr., was aware that due to the contractual relationship between Plaintiff Patricia J. Shay and Claremont Nursing and Rehabilitation Center that Patricia J. Shay's assets needed to be used for her care and, despite this knowledge converted the assets 21 of the Plaintiff Patricia J. Shay to his own use. 102. Plaintiff has been damaged by Defendant Charles E. Shay's conversion of Plaintiff Patricia J. Shay's assets in the amount of at least $23,265.25. 103. Plaintiff is incurring attorney fees and costs in prosecuting this action. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and post udgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems appropriate. COUNT 8 - PETITION FOR ACCOUNTING Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 104. Plaintiff hereby incorporates paragraphs 1 through 102 of this Complaint as if set-forth at length. 105. Due to Defendant Charles E. Shay, Jr.'s, conduct described herein, Plaintiff is entitled to an accounting of: a. All transactions and dealings with relation to his duties as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Plaintiff Patricia J. Shay; b. All profits and losses gained or lost as a result of any investments or businesses run during his tenure as Power of Attorney, Attorney in Fact, 22 Responsible Party and Fiduciary on behalf of Plaintiff Patricia J. Shay; C. A listing of all of Defendant Charles E. Shay Jr's assets and liabilities during the entire time that Defendant Charles E. Shay, Jr., acted as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Plaintiff Patricia J. Shay and had control of the Plaintiff Patricia J. Shay's assets and any actions taken by Defendant Charles E. Shay, Jr., in regard to the assets and property of Plaintiff Patricia J. Shay or held in for the benefit of Patricia J. Shay; d. Defendant Charles E. Shay, Jr., is a constructive trustee of the funds and assets of Plaintiff Patricia J. Shay and should account for any and all of Plaintiff Patricia J. Shay's funds and funds held for her benefit, and spent for her personal use. d. Moreover, Defendant Charles E. Shay, Jr., should account for any wrongful conversion; dissipation and sale of Plaintiff Patricia J. Shay's property or the property held for the benefit of Plaintiff Patricia J. Shay and return the items or their value to pay for Plaintiff Patricia J. Shay's obligations. 106. As a party to the power of attorney between Defendant Charles E. Shay, Jr., and Plaintiff Patricia J. Shay, Plaintiff is also entitled to a full and complete inspection of any books or records in the possession of the Defendant Charles E. Shay, Jr., pertaining to his actions as a power of attorney, attorney in fact, responsible party and fiduciary for Plaintiff Patricia J. Shay. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment 23 and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Issue an Order directing Defendant Charles E. Shay, Jr., to produce all books and records for inspection relating to his actions as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Patricia J. Shay and account for all of the transactions, dealings, assets and liabilities e. Granting such other relief as the Court deems appropriate. COUNT 9- DUTY TO SUPPORT Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 107. Plaintiff hereby incorporates paragraphs 1 through 106 of this Complaint as if set-forth at length. 108. As the Spouse and Power of Attorney of Plaintiff Patricia J. Shay, Defendant Charles E. Shay, Jr., had a legal duty to provide care, maintenance and assistance and ensure that Plaintiff Patricia J. Snyder received appropriate nursing home care. 109. Plaintiff Patricia J. Shay's average monthly expenses incurred for nursing home care at Claremont is approximately $7,000.00 (seven thousand dollars). 110. Upon information and belief, Defendant Charles E. Shay, Jr., had at all times material and relevant hereto, sufficient financial ability to pay for Plaintiff Patricia J. Shay's maintenance and support. 111. Title 62 of the Pennsylvania Statutes Section 1973, et. seq., (The Support Act) requires spouses with sufficient financial ability to pay for the care and 24 maintenance of their indigent spouse and to provide their spouse with financial assistance. 112. Plaintiff Patricia J. Shay was "indigent" within the meaning of the Support Act. 113. Defendant Charles E. Shay, Jr., is obligated to pay for nursing care and services rendered to Plaintiff Patricia J. Shay pursuant to the Support Act. 114. Defendant Charles E. Shay, Jr., has not paid any portion of the bill for the nursing care and services rendered to Plaintiff Patricia J. Shay and therefore she has been damaged by the violation of the Support Act by Defendant Charles E. Shay, Jr. 115. The Support Act has been held to obligate individuals situated similarly to Defendant to pay for medical and nursing services. This Court may enter a retrospective order for reimbursement and authority for doing so may be found at Albert Einstein Medical Center v. Forman, 212 Pa. Super. 450, 243 A.2d 181 (1968) and at Savoy v. Savoy, 433 Pa. Super. 549, 641 A.2d 596 (1994). 116. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $23,265.25, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% prejudgment and post judgment interest per annum, or as determined by the Court, inclusive of 25 interest and costs; C. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action. d. Granting such other relief as the Court deems appropriate. Respectfully submitted, P.C. r Date: By. Doreena g Sloan, Esquire Attorney I.D. # 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorneys for Plaintiff 26 VERIFICATION I, Doreena Craig Sloan, Esquire, do hereby verify that the facts made in the foregoing Amended Complaint are true and correct to the best of my knowledge, information and belief. This verification is being made as Plaintiff is unavailable and time is of the essence. Counsel will substitute a verification of Plaintiff as soon as available. I understand that any false statements therein are subject to the nalties contained in Title 18 of the Pennsylvania Consolidated Statutes Section 49 , rela ' g to unswfim falsification to authorities. /l Hy: ?. Doreena Cra loan, Esquire Attorney I- D. # 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorney for Plaintiff 27 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 CIVIL ACTION - LAW Plaintiff, V. CHARLES E. SHAY, Jr. Individually, Power of Attorney Attorney in Fact, Responsible Party and/or Fiduciary for Patricia J. Shay 1926 Longboat Drive Lakeland, FL 33810 CAUSE NUMBER: 06-3229 CERTIFICATE OF SERVICE I hereby certify that o August 7, 2006, I served a true and correct copy of the foregoing Amended Complaint by first class mail, postage prepaid, upon the following counsel of record: Matthew M. Haar, Esquire Saul Ewing LLP Penn National Insurance Plaza 2 North 2n1 Street, 7' Floor Harrisburg, PA 17101 Nicole Waters, Esquire Leonard McCall, Certified Legal Intern The Dickinson School of Law of the Pennsylvania State University Elder Law Clinic / 150 South College Street Carlisle, PA 17013 / reena Doreena C g Sloan, Esquire PA Supreme Court ID # 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 28 '0 y1t /vCCrSt?J ?Y Pehabilitation Center- ADMISSION AGREEMENT 1000 Claremont Road Carlisle. PA 17013.8805 . +ain (717) 243-2031 hx (717) 240-1952 As part of admission to Claremont Nursing and Rehabilitation Center, the Resident and the Responsible Party assisting the resident acknowledge and agree to the following: = 1. If Claremont Nursing and Rehabilitation Center detetmtines that the Resident is not appropriate or does not qualifv for nursing home care, the Resident will discharge from Claremont Nursing and Rehabilitation Center following a 30 day notification of the need to make alternate living arrangements. Z. If the Resident cannot qualify for coverage under the Medical Assistance or ivtedicare programs, the Resident will pay daily rate for care at the nursing facility. 3. The Responsible Party (guarantor) assures that the Resident's bill will be paid from the Resident's assets/funds. If the Resident does not have personal funds or when personal funds are exhausted, the Responsible Party will make application to Medical Assistance on behalf of the Resident. If the Resident does not qualify for Medical Assistance funding, the Responsible Party will arrange discharge for the Resident if the bill is not paid in a timely manner. 4. The Resident authorizes Claremont Nursing and Rehabilitation Center to release information concerning their assets, real or personal, to the Cumberland County Board of Assistance. 5. If the Resident is being covered by the Medical Assistance Program, the Resident and Responsible Party recognize that all income the Resident receives during the month of admission, must be paid to the Claremont Nursing and Rehabilitation Center, regardless of the day of admission, unless waived by the Cumberland County Board of Assistance. The Resident and Responsible Party acknowledge that all future income received by the Resident, while covered under the Medical Assistance Program, must be paid to Claremont Nursing and Rehabilitation Center. Income not applied to charges for care will be placed in the Resident Guest Fund or refunded. ?a?• U `/ 4S Date 0,?- 6405 Date 0,? , 0 `?• 05 Date 0"-). Oye5 Date CLAREMONT NI RSING AND REHABILITATION CENT cR Consen d Assigtment Form Q Customer Name S oria Site (/)x SECTION I Consent for Treatment I, the undersigned, authorize Claremont Nursing and Rebabilitation Center, to perform the examinations, tests, treatments that they consider necessary for my care. I agree to work with them to maximize my progress towards mutually established treatment goals which have been aurhorized by my physician. 1, the undersigned, intending to be legally bound, authorize Claremont Nursing and Rehabilitation Center and its representatives to share records and information with third patties participating in my rehabilitation, including any parry which through an insurance program or otherwise is paying for all or part of my rehabilitation. I authorize Claremont Nursing and Rehabilitation Center to as on my behalf with any reasonable and necessary appeals in regard to services provided by Claremont Nursing and Rehabilic-m Center. I, the undersigned, warrant I have read the Consent for Treatment above. I also warrant that I have full authority to authorize the above Consent for Treatment which I have read and approved, intending to be legally bound. Stanature ODate CJ'-? - 6 `- C,ustom onsible P Witness /6 Dace CJ ?? SECTION II Assignment of Benefits to Claremont Nursing and Rehabilitation Center ?e If any of the above is signed by a re* the responsible parry to the customer' parry due to the incapacity D?.og05 ??. ?L4)_5 ?sromer, what is the relationship of 4/99 I authorize payment of medical benefits to be made directly to Claremont Nursing and Rehabilitation Center for the aforementioned services. CLAREMONT NURSING AND REHABILITATION CENTER Medicare Secondary Payor (MSP) Screening Form Dear Customer or Responsible Party: Medicare requires that the Medicare Secondary Payor (i41SP) Screening Form must be completed and signed for all persons to whom we provide care and services and are participants in the Medicare program. In some rare instances, an insurance company or government agency other than Medicare will pay some or all of the cost of therapy. The purpose of this form is to determine whether such a condition exists. If you have any questions, please ask the therapist at your Center for assistance. This form should be completed and signed by the customer or their representative. Name: Medicare Number: 1. Is the illness/injury to be treated covered by Workers' Compensation? Yes_ No If yes, complete the following: Employer Name Workers' Comp. Insurance Carrier Address Claim Number Date of Accident ?. Is the illness/injury to be treated covered by the Black Lung Program? Yes, No If yes, to what address should the billing be sent? Address 3. Is the customer a member of a Health Maintenance Organization (IUVIO)? Yes- NO If yes, complete the following: Name of HMO Address 4. Is the illness/injury to be treated the result of an automobile accident? Yes_ No! If yes, provide the following information about the automobile insurance company: Name Address Claim Number j. Other than the a'oove, was there an accident? Yes_ No / Ifyes, date ofaccident If yes: Type of accident if yes, complete the following: Name of Responsible Parry Name of Insurer,Attpmey Address oflrsurer/Attorney 6. Is the customer or customer's spouse covered by an Employer Group Health Plan? YesNo_ If no, please Lis date(s) of retirement: Customer _ Spouse If yes, move to Question =7. If no, skip to question 49. 7. Is the customer age 65 or older? If yes, move to Question 48. If no, skip to Question 49. Yes / No 8. Is the customer or the customer's spouse actively employed by an employer of 20 or more employes'? Yes- No If yes, provide cite folowing: if no, skip to the signature at the bottom of this form. Name of W"or`.king Person Relationship to Customer Name of Employer Name of Insurance Company Insurance PoHcv a Address of Iaasurance Company 9. Is the customer entitled to Medicare coverage on the basis of a disability? Yes_ No / If yes, move to Question 410. If no, skip to Question 411. 10. Is the customer, customer's spouse or customer's parent actively employed by an employer of 100 1-1 or more employees? Yes- No If yes, provide the following: if no, skip to the signature at the bottom of this forth. Name of Working Person Relationship to Customer Name o f Emp to yer - Na.me of Insurance Company ----- Insurance Policy 4 Address aftnsurance Company - 3- 11. Is the customer entitled to Medicare coverage on the basis of End Stage Renal Disease (ESRD)? Yes_ No If yes, move to Question 412. If no, skip to the signature at the bottom of this form. 12. Please list first date of dialysis treatment. Date: Please list date of kidney transplant. Date: ?Signatur 5 A Witness: If the form is not signed by the customer, what is the relatioashiq of behalf of the customer? e' A Date: /ld • Q • tJ s Date: 0 ?• o Vas person signing on Revised: 11/99 7 n,t Jv GN,C' 4? P,eh,abilitation Center STATEMENT TO PERMIT PAYMENT OF MEDICARE BENEFITS TO PROVIDER, Name of Beneficia HI Claim Number 1000 Claremont Road Carlisle, PA 17013.8805 main (717) 243.2031 4x (717) 240-1952 I request that payment of authorized vledicare benefits be made, either to me or on my behalf for any services furnished me by or in Claremont Nursing and Rehabilitation Center, including physician services. I authorize any holder of medical or other information about me to release to the health care ftnancine administration and its agents a.. information needed to determine these benefits or benefits for related services. Beneficiary Si;nanire Other than Beneficiary , ?. - A) A Relationship ? alm f L41 Reason Beneficiary cannot sign D.?. 6 '? o Date Date signed Dd- 0 Z'/ 0.5 PHYSICIANS AND PATIENT. \C,1"I'01 .t U/s - -ehabilitation Centff NON-MEDICARE Date Resident Name Medicare ?;umber 9/0 - -_?& - 1000 Claremont Roa: Car!-sle. PA 170: 3-88C: main (717) 243.203 I fax (717) 240.19;: We reviewed your medical information available at the time of or prior to your admission and we believe that the services you need do not meet the requirements for coverage under Medicare. The reason is that Medicare covers medically necessary nursing care and rehabilitative physical therapy provided on a daily basis. Since it is anticipated that at this time you do not need these services, you will be admitted to a Non-Medicare bed. This decision has not been made by Medicare. It represents our judgment that the services you need do not meet Medicare payment requirements. Normally, under this situation, a bill is not submitted to Medicare. A bill will only be submitted to Medicare if you request that a bill be submitted. Furthermore, if you want to appeal this decision, you must request that a bill be submitted. If you request that a bill be submitted, the Medicare intermediary will notify you of its determination. If you disagree with that determination, you may file an appeal. Under a provision of the Medicare law, you do not have to pay for noncovered services determined to be custodial care or not reasonable or necessary unless you had reason to know the services were noncovered. You are considered to know that these services were noncovered effective with the date of this notice. If you have questions concerning your liability for payment for services you received prior to the date of this notice, you must request that a bill be submitted to Medicare. We resret that this may be your first notice of the noncoverage of services under Medicare. Our efforts to contact you earlier in person or by telephone were unsuccessful. r ??r &habilitation Center Date c, ?`f. SOUS Veterans Administration Regional Office P 0 Box 7420 Philadelphia, PA 19101 1000 Claremont Road Carlisle, PA 17013.8805 main (717) 243-2031 fax (717) 240-1952 To Whom It ay Concern: Q'J has been admitted as a e} patient to the Claremont Nursing and Rehabilitations Center of Cumberland County on k J06t a cost of $ /4 ?5/ "--?/day. (Date) Sincerely, Jeffre ?Yalteis Administrator Cumberland County Court House Veteran's Affairs 240-6178 697-0371 532-7286 Elaine Regi OR Neal Delisanti ?1 set-vice agency of Cumberland County t I1 i?rs jar rehabilitation Center RESIDENT'S LMAIL 1000 Claremont Road Carlisle, PA 1 70 1 3-8805 main (717) 243-2031 'ax (717) 240-1952 Resident Name J __ /??,1 ?C IGZC, I authorize the Claremont Nursing and Rehabilit n Center of Cumberland County to open mail related to the following checked items: l% Social security and income checks •?51yidend and interest checks Medical bills and statements ja-fnsurance premium notices t! /Explanation of benefits from third party payers //.:any other information required to qualify for and continue to receive /medical assistance and other third party payments !/ Physician appointments -Resident will open/handle all mail Date Signatu of Resident( uardian Powe of At mey or Re onsible Party Date Win s Date Witness NOTE: This authorization does not pertain to personal mail. 71 sri-virr nariiru of r'ten)hrr(nnrl r,,,,,,- jx0 t eJ ? llrs j??? Pvehabilitation Center 1000 Claremont Road Carlisle, PA 1 70 1 3-8805 main (717) 243-2031 fax (717) 240-1952 SUBJECT: RESERVE BED POLICY FOR PRIVATE/VETERAN/MEDICARE (INCLUDING 65 SPECIAL)/ BLUE CROSS AND BLUE SHIELD PAY RESIDENTS SCOPE: As a component part of a resident's total treatment plan, the Physician may indicate admission to an acute care facility. The Cumberland County Commissioners have adopted the following policy relating to the above. DEFINITION: Reserve bed - any bed being held for a resident of the Claremont Nurs- ing and Rehabilitation Center who has been admitted to an acute care facility. POLICY: When a resident is admitted to an acute care facility, their bed will be held subject to the following: 1. Upon leaving the Nursing Home for any extended period of time, the Resident /Responsible party is to be contacted by the Business Office and asked if they want to reserve their bed (unless already indicated when Nursing Home admission occurred). If the Resident/Responsible Party do not reserve a bed, discharge from the Nursing Home will be immediate and instruction to pick-up the resident's belongings will be given. 2. All bed reservations must accompany a ten (10) day payment in advance. 3. If a resident reserves a bed and does not return to the Claremont Nursing and Rehabilitation Center, monies will be refunded from the day the Business Office was notified that the resident is not re- turning. 4. Bed reservations must be updated every ten (10) days and payment must be in advance. 5. The resident will be billed at the full daily rate for the level of care from which the resident was discharged. 6. When a resident/responsible party elects not to hold a bed, the resi- dent will be given priority (above a new admission) for re-admission to the Nursing Home when ready for hospital discahrge, and upon avail- ability of a bed. 7. 'When a Nursing Home bed is being held for a private pay resident, the bed will be included in the daily census. 1 sea rte agency o(C'urnherland Cbrunt y vQ??Ortt J?tcr.Sl?oG' A-ehabilitation Center ADVANCE MEDICAL DIRECTIVES 1000 Claremont Road Carlisle, PA 17013-8805 main (717) 243-2031 fax (717) 240-1952 Claremont Nursing and Rehabilitation Center follows the requirements of the Patient Self-Determination Act of 1990 (Omnibus Reconciliation Act of 1990) and in so doing provides Residents and their legally authorized representative the opportunity to complete an Advance Medical Directive if they wish. PROCEDURE 1. Upon admission the assigned Social Worker will inform the Resident and their Responsible Party of the option to complete an Advance Medical Directive. The Social Worker will document in the admission note that the option was pre- sented. 2. If a Resident or their legally authorized representative (court appointed) Guardian or Durable POA) wishes to complete a Medical Directive, the assigned Social Worker will arrange for the Assessment Nurse or nursing representative to explain medical options. The Social Worker will then coordinate the actual signing of the document with two witnesses present. 3. The Social Worker will document completion of the directive on the Social Services comment sheet. 4. Upon completion of each annual physical, the Attending Physician will document that the Resident has been presented with the option to initiate or update a Medical Directive. 5. CNRC recognizes that in some cases the Physician will determine that a Resident is not capable of understanding and implementing a Medical Directive and that a durable POA will not be in place. If family members wish, however, to indicate advance treatment preferenced, CNRC and Physician will attempt to obtain consensus among available family members, and will have family complete a Medical Directive which the Physician will review and which will be kept on the medical record. 6. Residents or their authorized legal representative may change, update, or void a Medical Directive at any time without regard to the Resident's mental or physical condition. Continued... .211 serriee ngencti ofCuniberland Countu FINANCIAL POLICIES ,e1,10 ?ursi? GEC Q? Pehabilitation Center November 24, 2004 Dear Resident / Responsible Party: main (717) 243.2031 fax (717) 240-1952 As we are all aware, the costs related to many goods and services have increased over the past year. Expenses for heating oil, natural gas, gasoline, transportation, and food are some examples. The trends for some of these costs reflect dramatic increases. In response to rising costs, we find it necessary to increase our rates here at Claremont. Effective January 1, 2005, the following will become our standard daily rates. Semi-Private Room Private Room Nursing Facility Care Complex (Medicare Equivalent Care) $205.00 $215.00 $225.00 $235.00 These are basic charges for room and board and nursing care services. As in the past, the costs for ancillary items like pharmacy, rehabilitative therapy, specialty equipment, oxygen, and physician services are not included in these rates. Ancillary charges are based on the actual fees charged by the providers and will be billed as separate items. The charge for oxygen provided by the facility is $12.00 per day. These new rates will not affect our residents whose care is covered by the Medicare or Medical Assistance programs. These are private pay rates only. As always, providing quality care for our residents is our primary mission. Thank you for allowing us the opportunity to care for your loved one. Very truly yours, 'lz%j 4?t Jeffrey A. Waiters, NHA Administrator 1000 Claremont Road Carlisle, PA 17013-8805 .Z1 serrice agency of Cumberland County SECURITY DEPOSIT POLICY FOR PRIVATE PAY RESIDENTS The Claremont Nursing and Rehabilitation Center requires one (1) month Security deposit for Private Pay Residents only upon admission to the Facility. A Deposit is NOT required for Residents who are admitted with third-party benefits (Medicare, Medicaid, Veterans Administration, etc.). Security Deposits are held without interest by the County. The funds are used for the last month the Resident is in a Private Pay status. In the event of death or discharge of the Resident, the security deposit less any Nursing Rome charges, is refunded to the Resident or the estate. ont JVU, . 1000 Claremont Road ?re Carlisle, PA 1 70 1 3-8805 main (717) 243-2031 fax (717) 240-1952 rehabilitation Center QUARTERLY GUEST FUND STATEMENTS POLICY It is the policy of Claremont Nursing and Rehabilitation Center that nursing home residents be provided, at their request, copies of their quarterly guest fund statements. If the resident is not interested in receiving the statement or. are unable to make a decision, the statement will be sent to the resident's Responsi- ble Person. Resident's Power-of-Attorney and legally appointed Guardian of Estate will routinely be sent copies of the statement. (When a legally appointed Guardian of Estate has been appointed, the resident will not be given the option by the nursing home of receiving a statement). PROCEDURE 1. During the admission process it will be established who (resident, Responsible Party, P.O.A., etc.) is most appropriate to receive the quarterly guest fund statements. 2. Each quarter, Social Services will deliver statements to residents who request them. 3. Social Services will mail all P.O.A.'s and Legal Guardians of Estates a copy of their resident's statement. 4. All remaining statements will be mailed or delivered by Social Services to Responsible Persons of the nursing home residents. 5. Nursing home residents who wish a copy of their statement after the state- ment has already been mailed, may receive a copy from the Business Office. ,;1 serrice agency of Cumberland Courrt y 1 y u 2 NO. TAX ?Z NMIKIM K PAM I 53 111911fltD'$ NANE 1 is PAk oWr. 4 OW. -M-W- .09a so DM'WYMFAA 0 1ua H PWOWPAYMPO 19 W.AW WIYA I s$ et EI/LOMLWATIM a ADA oaa. 61 7B Z A PAIWOORM NO. I 20: 9 FED. TAxR0. 4538 7 wyD 6 R-0D. P DO, 1o LRD. 11 74?G.OIA'i?7 /A7/AA/AR ?I'f'f 7lAC fAnA 14 PATRICIA J SHAY 2713 COLUMBIA AVENUE CAMP HILL, PA 17011 Ew.mm 50 PAYER 51 PRD"=W. ® 64 MDAPAYM My 1 s ME AYO WCM C 57 , x RO11P6gERARE spin m CFAL-39N-NIG-IDNa 6f OflWPNAAE Shay Patrlcia J 01 2102990x9 I U TFEATMENTAUOEIR4K"00DAA Iml 66 EllIRDYFA RARE - ?p i] P16N DKMCa M AD4 WM OO 17 E LADE 3310 53 85 5533 285 9 1 31 4 19 41092 4439 2724 i °.G ,.,,,e At! ..R E 9 PATEMDCMMd.ND. 20: 6 fID.TAX NO. 700VD. IMCD. IM. 100 11 10 PAYER 51 MOM NO. aM"pAyd 14 9 Wr.. AMMW DDE JN 236003119 3 nSUFWSrME MPAB. bDERf.•fiY1-IIC.-IDN6 41 DDDLl NMI RDtl1EUNDENC7lPNG shav Patricia J 01 210269049 ) 77 ES= ,.c. Claremont NUAS ing & Rehab ° 1000 Ciaremart Drive Carlisle PA 7013 ° ?TNO' I PATRICIA J SHAY 12713 COLUMBIA AVENUE CAMP HILL, PA 17011 I 6 REV fd a CE9OpMM 50 PAYER PRIVATE 57 U INSURED'SNANE okay. ,Pa Q TREAnW 07M1 .3310 J sPA mo M REWAW 7 PAifNT00NTA0L N7. R??; icava INCD. IGID. ,pt?¢T,E 31 D o I ...4 a J A, i ., e... 1r .: .: M MMM/RATU 6 SM. MA 6 SERV.ISSia A'T TOTAL 00TAES /l WNCOVMC 0JM 00 2,4 a f 9 2025 00 _ ) ? xa { F ? 9 202s0 ffm ; a +. v In s MWE y j I M Me R; lug'' ?_? I s" r WAN 01 n k ' F E7 P110170Fl1N0. 51 PRIOR PAYMENTS U EST. AMOUR OME fa 77 y LAGLU9MONT.- ., NIPFAIFPIfifFNU1M'. ?-M 01f0 E E C a Q s. y. ??_} ? f ? f ?1`: ? .J : Gt 'V ' ? ? ? s c cw ca PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff, V. No. 06-3229 CHARLES E. SHAY, Jr., Defendant. Civil Action - Law NOTICE TO PLEAD To Plaintiff: You are hereby notified to plead in response to the attached Preliminary Objections within twenty (20) days or a judgment may be entered against you. 04"Izlzl? Matthew . Haar, sq ire (Pa. #85688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 7a' Floor Harrisburg, PA 17101 (717) 257-7508 Dated: August 28, 2006 Attorneys for Defendant 1259512 8/39/% PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff, V. No. 06-3229 CHARLES E. SHAY, Jr., Defendant. Civil Action - Law DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S AMENDED COMPLAINT Defendant Charles E. Shay, Jr., by and through his undersigned counsel, hereby files the following preliminary objections to Plaintiff's Amended Complaint and avers as follows: Plaintiff Patricia J. Shay ("Wife" or "Plaintiff'), acting through her daughter and Power of Attorney Tracy D. Shay-Snyder ("Daughter"), commenced this action by filing the Complaint on June 6, 2006. Defendant Charles E. Shay, Jr. ("Defendant" or "Husband"), received the Complaint on June 27, 2006. On July 17, 2006, Defendant timely filed Preliminary Objections seeking to dismiss the Complaint. Plaintiff filed an Amended Complaint on August 7, 2006. 5. Defendant may file a timely response to the Amended Complaint on or before August 28, 2006. See Pa. R. Civ. P. 1026(a). izsas3.z WSU FIRST PRELIMINARY OBJECTION - Pa. R.C.P. 1028 (a)(1) Lack Of Jurisdiction Over The Defendant 6. Rule 1028(a)(1) permits a party to file a preliminary objection asserting lack of jurisdiction over the person of the defendant. Pa. R. Civ. P. 1028(a)(1). 7. This action may not proceed unless the Court has personal jurisdiction over the defendant. Fidelity Leasing, Inc. v. Limestone County Bd. of Educ., 758 A.2d 1207 (Pa. Super. Ct. 2000). 8. Defendant resides and is domiciled at 1926 Longboat Drive, Lakeland, Florida 33810. 9. Defendant has continuously resided in the state of Florida for the last eleven (11) years. 10. Defendant does not reside in the Commonwealth of Pennsylvania. 11. Defendant does not do business in the Commonwealth of Pennsylvania. 12. Defendant does not own any real property located in the Commonwealth of Pennsylvania. Defendant's personal property in Pennsylvania is limited to a dormant account at New Cumberland Federal Credit Union, which Defendant does not use, but which he has not closed. 13. Defendant did not contact anybody in Pennsylvania to arrange for Plaintiff to receive nursing care, nor did he in any other way initiate a contact in Pennsylvania related to Plaintiff s care. 14. Defendant has not consented and does not consent to personal jurisdiction in the Commonwealth of Pennsylvania. 15. Defendant has not had and does not have continuous or substantial contacts with the Commonwealth of Pennsylvania. 12545] 2 928/% -2- 16. To the extent that Defendant has had any contacts with the Commonwealth of Pennsylvania in the last several years, those contacts have been random, fortuitous, or attenuated and are not sufficient to establish personal jurisdiction. 17. Defendant has not purposefully availed himself of the privileges of conducting activities in the Commonwealth of Pennsylvania. 18. Defendant is a non-resident who does not have sufficient minimum contacts with this Commonwealth to establish jurisdiction, and any assertion of personal jurisdiction over the Defendant would not comport with fair play and substantial justice. 19. Defendant is not subject to personal jurisdiction within the Commonwealth of Pennsylvania. 20. This Court has neither general nor specific jurisdiction over the Defendant. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Amended Complaint with prejudice on the basis of lack of personal jurisdiction. SECOND PRELIMINARY OBJECTION - Pa. R.C.P. 1028(a)(5) Nonjoinder Of A Necessary Party 21. Defendant incorporates the averments of paragraphs 1 through 20. 22. Rule 1028(a)(5) permits a party to file a preliminary objection alleging the nonjoinder of a necessary party. Pa. R. Civ. P. 1028(a)(5). 23. Failure to join an indispensable party deprives the court of subject matter jurisdiction. Polvdyne, Inc. v. City of Philadelphia, 795 A.2d 495, 496 (Pa. Commw. Ct. 2002). 24. A party is indispensable when its rights are so connected with the claims of the litigants that no decree can be made without impairing those rights. Id. Pennsylvania courts consider the following criteria in determining whether an absent party is indispensable: 1254513 8/28/O -3- (1) whether the absent party has a right or interest related to the claim; (2) if so, the nature of the right or interest; (3) whether that right or interest is essential to the merits of the issue; and (4) whether justice be afforded without violating due process rights of absent parties. Delaware Co. v. J.P. Morgan Chase & Co., 827 A.2d 594,598 (Pa. Commw. Ct. 2003). 25. Daughter, acting as Power of Attorney for Wife, seeks a judgment against Husband for monies that are allegedly due and owing by Wife to Claremont Nursing and Rehabilitation Center ("Claremont"). See Am. Compl. ¶¶ 22 - 35. 26. Claremont has a purported right or interest in Plaintiff's claim in that Claremont is the alleged ultimate beneficiary of any amount due. 27. Claremont's purported right or interest is essential to the merits of this claim, as the validity of Mother's alleged debt to Claremont is the epicenter of this case. 28. Justice cannot be afforded without Claremont participating in this litigation. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Amended Complaint. THIRD PRELIMINARY OBJECTION - Pa. R.C.P. 1028 gI 3) Insufficient Specificity 29. Defendant incorporates the averments of paragraphs 1 through 28. 30. Rule 1028(a)(3) permits a party to file a preliminary objection alleging insufficient specificity in a pleading. Pa. R. Civ. P. 1028(a)(3). 31. Plaintiff makes the conclusory allegation in paragraph 17 of the Amended Complaint that Defendant represented that he "agreed to pay for any current and future expenses related to the care of his wife." Am. Compl. ¶ 17. 32. Plaintiffs conclusory allegation does not include any detail regarding what those representations allegedly were or when, where or how such representations were allegedly made. 115453.2 9/281W -4- 33. Defendant cannot formulate a proper answer to these allegations based simply on Plaintiff s conclusory allegations. 34. The Amended Complaint should be dismissed for insufficient specificity. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Amended Complaint. FOURTH PRELIMINARY OBJECTION - Pa. R.C.P. 1028(a)(4) Demurrer 35. Defendant incorporates the averments of paragraphs I through 34. 36. Rule 1028(a)(4) permits a party to file a preliminary objection in the nature of a demurrer asserting the legal insufficiency of a pleading. Pa. R. Civ. P. 1028(a)(4). 37. Attorney's fees may only be awarded when explicitly provided for by contract, by statute or by some other recognized exception. Chatham Communications. Inc. v. General Press Corp., 463 Pa. 292, 300-301, 344 A.2d 837, 842 (1975). 38. The Complaint seeks, among other things, attorney's fees. See, e.g., Am. Compl. p. 12. 39. Plaintiff fails to cite any contractual provision that would establish an ability to recover attorney's fees. 40. Plaintiff fails to identify any statutory basis for the award of attorney's fees. 41. Plaintiff' fails to identify any other basis for the award of attorney's fees. 42. Plaintiff has failed to state a claim for the recovery of attorney's fees. 12545].2 &28/06 -5- WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Amended Complaint. Respectfully submitted, Dated: August 28, 2006 Matthew M. Haar, Es luire (Pa. 485688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 7`h Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendants Also: Rebecca M. Fuhrman, Certified Legal Intern Nichole Walters, Esquire The Dickinson School of Law of the Pennsylvania State University Elder Law Clinic 150 South College Street Carlisle, PA 17013 (717) 240-5152 1354513 V29/06 -6- i, Charles E. Shay, Jr., hereby vedfl foregoing Prefautaary Objecrrmw are um and and belief. I understand that this Verification is wads 4904, rdatiog to tulaworn fels[ticatim to authorities. Dated: Augota 200ti A the the best ofmp knowledge, information to the peoaitics of I S Pa. C.S.A. $ ,b aw CERTIFICATE OF SERVICE I hereby certify that on August 28, 2006 I served a true and correct copy of the foregoing Preliminary Objections by first class mail, postage prepaid, upon the following counsel of record: Doreena Craig Sloan, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Attorneys for Plaintiffs Dated: August 28, 2006 125451 .2 &28/W ' a D T r- CO ca cli J J c_ i 2 _Z) u F- .,cK i:S1:L . . A% PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY Please list the within matter from the next Argument Court. CAPTION OF CASE (entire caption must be stated in full) Patricia J. Shay by Tracy D. Shay-Snyder as POA for Patricia J. Shay, (Plaintiff) V. Charles E. Shay, Jr., 1. (Defendant) No. 2006 Civil 3229 State matter to be argued (i.e., plaintiffs motion for new trial, defendant's demurrer to complaint, etc.): Defendant's Preliminary Objections to Plaintiff s Amended Complaint 2 3 4. Identify counsel who will argue case: (a) for plaintiff. Doreena Craig Sloan, Esquire Address: Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110 (b) for defendant: Matthew M. Haar, Esquire and Rebecca M. Fuhrman, Cert. Leg. Int. Address: Saul Ewing LLP Dickinson School of Law Penn National Insurance Plaza Elder Law Clinic 2 N. Second Street, 7t" Floor 150 South College Street Harrisburg, PA 17101 Carlisle, PA 17013 I will notify all parties in writing within two days that this case has been listed for argument. Argument Court Date: October 25, 2006 Dated: September 20, 2006 Matt ew M. Haar, Esq re Saul Ewing LLP 2 N. Second Street, 7"' Floor Harrisburg, PA 17101 Attorney for Defendant . ""Bw CERTIFICATE OF SERVICE I hereby certify that on September 20, 20061 served a true and correct copy of the foregoing Praecipe for Listing Case for Argument by first class mail, postage prepaid, upon the following counsel of record: Doreena Craig Sloan, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110 Attorneys for Plaintiffs at f1h ew M. Haar Dated: September 20, 2006 rI 0 tl '? z rte. ? ?? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff CIVIL ACTION V. NO. 06-3229 CHARLES E. SHAY, JR. Defendant MOTION TO CONTINUE ARGUMENT And MOTION FOR PERMISSION TO FILE A SECOND AMENDED COMPLAINT AND NOW, comes Doreena Craig Sloan, Esquire, of Capozzi & Associates, P.C., who files this Motion to Continue Argument, and Motion for Permission to File a Second Amended Complaint and in support thereof avers the following: 1. Oral argument is currently scheduled for October 25, 2006 concerning Defendant's Preliminary Objections to the Amended Complaint filed by Plaintiff. 2. Plaintiff Tracy D. Shay-Snyder has been appointed by the Orphans Court as the Permanent Plenary Guardian of the Person and Estate of Patricia J. Shay. 3. The undersigned counsel has received new information that a substantial portion of the underlying bill for nursing home services rendered to Plaintiff Patricia J. Shay, has been paid by the Commonwealth of Pennsylvania Department of Public Welfare through the Medical Assistance Program. The amount of the underlying bill for her care and ongoing support is at issue. 4. Plaintiff has contacted opposing counsel, Matthew Haar, Esquire, and informed him of the partial payment and suggested that the pending argument be continued or in the alternative agree to the filing of a second amended complaint which would significantly reduce the amount claimed. 5. Upon consultation with his client, Attorney Haar advised the undersigned that they declined to continue the case or agree to the filing of a Second Amended Complaint. 6. Plaintiff has also received information that Defendant has an ongoing business relationship in the Commonwealth of Pennsylvania that was unknown at the time of the filing of the Amended Complaint and therefore was not pled therein. 7. The undersigned counsel has a conflict in that she has been scheduled to appear in Federal District Court in Philadelphia on October 25th as well. WHEREFORE, in light of the newly discovered information regarding the Defendant, his contacts with the Commonwealth of Pennsylvania, and payment that reduces the disputed amount, Plaintiff requests this Honorable Court to grant permission to file a Second Amended Complaint and remove the case from the October 25, 2006 Argument List. Respectfully Submitted AND A$WIATES, P.C. trg Sloan, Esquire No. 44880 2933 North Front Street Harrisburg, PA 17110 (717)233-4101 (717) 233- 4103 Attorneys for Petitioner CERTIFICATE OF SERVICE 1, Doreena Craig Sloan, do hereby certify that on this 20th day of October 2006, I served a true and correct copy of the foregoing MOTION TO CONTINUE ARGUMENT And MOTION FOR PERMISSION TO FILE A SECOND AMENDED COMPLAINTupon the following individuals in the manner indicated: VIA: FACSIMILE (717) 25-77581; (717) 240-6462AND FIRST CLASS MAIL Matthew M. Haar, Esquire C/O Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7t' Floor Harrisburg, PA 17101 Rebecca M. Fuhrman Certified Legal Intern Nicole M. Walters, Esquire The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Respectfully submitted, & ASSPCIAJ&S, P.C. Date: d/?20(/ Ord By. Doree raig Sloan, Esquire Attorney ID No. 44880 2933 North Front Street Harrisburg, PA 17110 (717)233-4101 (717)233-4103 ? 1 nz? _,.) ..3r r,.s rsk) 7 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff vi. CHARLES E. SHAY, JR. Defendant CIVIL ACTION NO. 06-3229 OCT 2 3 20? ORDER AND NOW, this V y day of October 2006, upon consideration of the Plaintiff's MOTION TO CONTINUE ARGUMENT And MOTION FOR PERMISSION TO FILE A SECOND AMENDED COMPLAINT, it is hereby ORDERED that the Motion is GRANTED. The case is hereby continued from the October 25, 2006 Argument List and the Plaintiff shall file a Second Amended Complaint within twenty (20) days from the date of this Order. 0' .C Wd SZ 1,10 99OZ `v1C}iJ u 3H I J© P/ Doreena Craig Sloan, Esquire Attorney I.D. # 44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 233-4101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 Plaintiff CIVIL ACTION - LAW V. . CAUSE NUMBER: 06-3229 CHARLES E. SHAY, JR. Individually, Power of Attorney Attorney in Fact, Responsible Party And/or Fiduciary For Patricia J. Shay 1926 Longboat Drive Lakewood, FL 33810 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 the 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 my 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 Plaintiffs. You may lose money or property or other rights important to you. Doreena Craig Sloan, Esquire Attorney I.D. # 44880 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 233-4101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 Plaintiff vi. CIVIL ACTION - LAW CAUSE NUMBER: 06-3229 CHARLES E. SHAY, JR. Individually, Power of Attorney Attorney in Fact, Responsible Party And/or Fiduciary For Patricia J. Shay . 1926 Longboat Drive Lakewood, FL 33810 . SECOND AMENDED COMPLAINT AND NOW, comes Plaintiff, Tracy D. Shay-Snyder, by and her attorney, Doreena Craig Sloan, Esquire, of the law firm of Capozzi & Associates, P.C., and as set- forth in the following amended complaint, respectfully show the Court the following: 1. Plaintiff, Patricia J. Shay is an incapacitated person, who is a resident at the Claremont Nursing and Rehabilitation Center, a long-term care facility located at 1000 Claremont Road, Carlisle, Cumberland County, Pennsylvania. 2. Plaintiff, Tracey D. Shay-Snyder is a resident of the Commonwealth of Pennsylvania and is the daughter of Patricia J. Shay and Charles E. Shay, Jr. 3. Plaintiff Tracy D. Shay-Snyder has been appointed Guardian of the Person and Estate of Patricia J. Shay by this Honorable Court's Order of September 8, 2006. (Exhibit `1') 4. Plaintiff Tracy D. Shay-Snyder also currently holds a Power of Attorney issued in the state of Florida for her mother Patricia J. Shay, the subject of this action. 5. The Defendant, Charles E. Shay, Jr., is an adult individual residing at 1926 Longboat Drive, Lakeland, Florida 33810. 6. The Defendant, Charles E. Shay, Jr., is the spouse of Patricia J. Shay as they were married October 25, 1952, in the Commonwealth of Pennsylvania, and they resided here and received the benefits of residing in the Commonwealth of Pennsylvania until on or about 1995 when they retired to the State of Florida. 7. The marriage of Defendant Charles E. Shay Jr., and Plaintiff Patricia J. Shay produced two children, Tracy D. Shay-Snyder and Cory Shay, that were born and raised in the Commonwealth of Pennsylvania and who continue to reside here. 8. Defendant Charles E. Shay, Jr., has relatives and friends that continue to reside in Pennsylvania that he continues to contact and visit. 9. When Defendant Charles E. Shay, Jr., experienced health challenges during 2002 and 2003, he contacted his daughter, Plaintiff Tracy D. Shay-Snyder, asked her to take care of Plaintiff Patricia J. Shay in her home in Pennsylvania, and orally represented that he would assist financially in her care. 10. Defendant Charles E. Shay, Jr., is currently a resident of the state of Florida but does have, has had, and continues to maintain, contact with relatives and friends in Pennsylvania. 11. Defendant Charles E. Shay, Jr., owns real property located in the Commonwealth of Pennsylvania in the form of two cemetery plots located in the Harrisburg Cemetery, 13th and Liberty Streets, Harrisburg, Dauphin County, Pennsylvania 17103, which he has owned continuously since approximately 1972. (Exhibit "2") 12. Defendant Charles E. Shay, Jr.'s, continuous ownership of said cemetery plots establishes a continuous business relationship with the Harrisburg Cemetery that has existed from 1972 through the filing of this Complaint. 13. Defendant Charles E. Shay, Jr.'s, continuous ownership of these two cemetery plots after relocating to Florida approximately 12 years ago indicates his intention to return to Pennsylvania to avail himself of the final benefit of being buried in and remaining in Commonwealth of Pennsylvania soil after his death. 14. Defendant Charles E. Shay, Jr.'s, continuous ownership of these two cemetery plots reveals that he has availed himself of conducting activities within the Commonwealth of Pennsylvania. 15. Defendant Charles E. Shay, Jr., has maintained personal property in the Commonwealth of Pennsylvania in the form of at least one bank account located at the New Cumberland Federal Credit Union, 345 Lewisberry Road, Fairview, Cumberland County, Pennsylvania, which he opened well before leaving the Commonwealth of Pennsylvania and has kept into 2006. 16. This Honorable Court and both general and specific jurisdiction over Defendant Charles E. Shay, Jr. 17. Patricia Shay was admitted to the Claremont Nursing and Rehabilitation Center, a long-term care facility that is licensed to participate in the Medicaid and Medicare programs, on February 4, 2005, with a diagnosis of, among other things, Alzheimer's Dementia. 18. At some point after Plaintiff Patricia J. Shay's admission to Claremont Nursing and Rehabilitation center, Defendant Charles E. Shay, Jr,. assisted in applying for Medical Assistance Benefits for nursing home care for Patricia J. Shay through the Pennsylvania Department of Public Welfare. 19. Defendant Charles E. Shay, Jr., has consented to personal jurisdiction of the Commonwealth of Pennsylvania by assisting in the Medical Assistance application process to obtain state-paid nursing home benefits for his wife, Plaintiff Patricia J. Shay. 20. Later in the eligibility determination process, Defendant Charles E. Shay, Jr., failed and/or refused to provide income and resource information to the Department of Public Welfare for them to make an accurate determination on whether Plaintiff Patricia J. Shay is eligible for Medical Assistance Nursing Home benefits from the Commonwealth of Pennsylvania. 21. On information and belief, Defendant Charles E. Shay, Jr., currently holds a Power of Attorney, which was issued in the State of Florida for his wife Patricia J. Shay and has been invalidated by this Honorable Court by the Order of September 8, 2006. 22. On or about April 2003, Plaintiff Patricia J. Shay was living with her husband, Defendant Charles E. Shay, Jr., at their joint residence in Florida, when he was hospitalized and underwent a surgical procedure that rendered him unable to continue to care for Plaintiff Patricia J. Shay. 23. Defendant Charles E. Shay, Jr., then verbally requested assistance from Tracy D. Shay-Snyder in taking care of his wife Plaintiff Patricia J. Shay; acknowledged that her condition would soon require nursing home placement; orally agreed, over the course of several telephone conversations and personal visits between he and Plaintiff Tracy D. Shay-Snyder, to allow her to return to Pennsylvania to live with their daughter Tracy J. Shay-Snyder, Power of Attorney; be placed in a nursing home when necessary, and agreed to pay current and future expenses related to the care of his wife Plaintiff Patricia J. Shay. 24. Between April 2003 and February 3, 2005, Plaintiff Patricia J. Shay resided with her daughter and then Power of Attorney, Tracy D. Shay-Snyder and her medical condition deteriorated such that she required 24 hour nursing home care. 25. During that same period, Defendant Charles E. Shay, Jr., did not contribute financially or in any way to the support of his wife Plaintiff Patricia J. Shay. 26. During that same period, Plaintiff Tracy D. Shay-Snyder kept in contact with her father Defendant Charles E. Shay, Jr., by telephone and advised him of the changing condition of his wife, Patricia J. Shay. 27. Prior to February 3, 2005, Plaintiff Tracy D. Shay-Snyder contacted Defendant Charles E. Shay by telephone and advised him that Plaintiff Patricia J. Shay required more care than she was able to provide at her home. 28. Defendant Charles E. Shay, Jr., orally agreed to the placement of Patricia J. Shay into a nursing home due to her need for additional care and verbally agreed to pay for her care. 29. Defendant Charles E. Shay, Jr., did not and has not requested that Plaintiff Patricia J. Shay be returned to him in Florida so that he could provide or arrange care for her. 30. On or about February 4, 2005, a written agreement was executed admitting Patricia J. Shay to the Claremont Nursing and Rehabilitation Center facility to receive nursing care and services and she has continuously remained there. (See Exhibit "3") 31. The Claremont Nursing and Rehabilitation Center has submitted bills for nursing home care services rendered to Patricia J. Shay and Defendant Charles E. Shay, Jr., as husband and Power of Attorney, and to Tracy D, Shay-Snyder, Power of Attorney and daughter of Patricia J. Shay. 32. At all times relevant to this action, the nursing care and services rendered by Claremont Nursing and Rehabilitation Center have met all applicable federal, state and local standards of care. 33. On or about February 4, 2005, the Claremont Nursing and Rehabilitation Center presented a promise to provide nursing care and services to Plaintiff Patricia J. Shay in exchange for her promise to pay for said care and services. 34. While Defendant Charles E. Shay, Jr., was not in the Commonwealth of Pennsylvania at the time of Plaintiff Patricia J. Shay's admission to Claremont Nursing and Rehabilitation Center, he knew of his wife's condition and need for care and made representations to Tray D. Shay-Snyder, daughter and Power of Attorney of Patricia J. Shay, as Mrs. Shay's husband and Power of Attorney, that he would pay for the expenses of her care. 35. Plaintiff Patricia J. Shay, through her Power of Attorney Tracy D. Shay- Snyder, relied upon the representations of Charles E. Shay, Jr., and signed the contract to admit Patricia J. Shay to Claremont Nursing and Rehabilitation Center. (See Exhibit "3") 36. Plaintiff Patricia J. Shay incurs average monthly expenses for nursing home care provided to her at the Claremont Nursing and Rehabilitation Center of approximately $7,000.00. 37. Plaintiff Tracy D. Shay-Snyder, as Power of Attorney and Guardian of the Person and Estate of Patricia J. Shay, has obtained Medical Assistance benefits for Patricia J. Shay which has to date paid a total of $76,731.64 toward a total nursing home bill for services totaling $101,674.50. 38. As a direct result of Plaintiff Tracy D. Shay-Snyder's successful efforts to obtain payment for Plaintiff Patricia J. Shay's nursing home care, the liability for her care at this time has been reduced to $10,358.50 that increases daily. 39. Plaintiff Patricia J. Shay's reasonable monthly living expenses incurred at the Claremont Nursing and Rehabilitation Center has significantly exceeded her monthly income and were insufficient to adequately provide for her care, maintenance, and support. 40. Due to the refusal of the Defendant Charles E. Shay, Jr., to make payment for the nursing care and services rendered to Plaintiff Patricia J. Shay since her admission, the account for to Plaintiff Patricia J. Shay is currently in arrears in the amount of $10,358.50 and increases daily. 41. Due to the refusal of the Defendant Charles E. Shay, Jr., to make payment for the pharmaceutical supplies and medications furnished to Plaintiff Patricia J. Shay since her admission, her account is currently in arrears. 42. On information and belief, a portion of the balance for pharmaceutical supplies and medications furnished to Plaintiff Patricia J. Shay since her admission should be covered by Medical Assistance. ($854.48) 43. On the information and belief, Defendant Charles E. Shay, Jr., individually and as spouse and Power of Attorney for Patricia J. Shay has not made any payments for the nursing home care of his wife, Plaintiff Patricia J. Shay or for her pharmacy bills. 44. A majority of the income and assets of Plaintiff Patricia J. Shay were, at all times relevant and material hereto, and currently are accessed and controlled by the Defendant Charles E. Shay, Jr. 45. Confidential personal financial information about Patricia J. Shay, such as, but not limited to: life insurance policy numbers; bank account numbers, income, cash, and real estate data were, at all times relevant and material hereto, accessed and controlled by the Defendant Charles E. Shay, Jr., and denied to the Plaintiff Patricia J. Shay and her Power of Attorney Tracy D. Shay-Snyder. 46. Defendant Charles E. Shay, Jr., has substantially refused and/or ignored all communication from the nursing home and Plaintiff Tracy D. Shay-Snyder related to the past balance due. 47. Defendant Charles E. Shay, Jr., refused or neglected to assist Plaintiff Patricia J. Shay through Tracy D. Shay-Snyder, Power of Attorney, in her efforts to secure Medical Assistance nursing home benefits for Plaintiff Patricia J. Shay. 48. On information and belief, Defendant Charles E. Shay, Jr., withheld critical information relating to Defendant Charles E. Shay, Jr. and Plaintiff Patricia J. Shay's finances that were a necessary prerequisite to the Medical Assistance application's approval by the Pennsylvania Department of Public Welfare. 49. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay- Snyder and Defendant Charles E. Shay, Jr., as Power of Attorney for Patricia J. Shay had a contractual, legal fiduciary obligation to the facility to assist in the qualifying Plaintiff Patricia J. Shay, for Medical Assistance by providing all information necessary to complete Plaintiff Patricia J. Shay's Medical Assistance Application. 50. As a result of Defendant Charles E. Shay, Jr.'s, failure or refusal to assist Plaintiff Patricia J. Shay in the Medical Assistance process, Plaintiff was originally denied eligibility for Medical Assistance benefits. 51. Defendant Charles E. Shay, Jr., has a legal and fiduciary obligation to Plaintiff Patricia J. Shay to pay for the medical, nursing and pharmaceutical services rendered to his wife, Plaintiff Patricia J. Shay. COUNT 1- BREACH OF CONTRACT Charles E. Shay, Jr., Individually and as Patricia J. Shay's Spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 52. Plaintiff hereby incorporates paragraphs 1 through 51 of this Complaint as if set forth at length herein. 53. As more fully described herein, on or about February 4, 2005, Plaintiff Patricia J. Shay, through her Power of Attorney Tracy D. Shay-Snyder, applied for the admission of Plaintiff Patricia J. Shay to the Claremont Nursing and Rehabilitation Center for the ongoing nursing care and services with the full knowledge and verbal consent of Defendant Charles E. Shay, Jr., spouse and Power of Attorney for Plaintiff Patricia J. Shay. 54. Defendant Charles E. Shay, Jr., has not made payments for the medical, nursing or pharmaceutical services rendered to Plaintiff Patricia J. Shay as agreed to in the verbal contract by and between the parties. 55. On information and belief, the Defendant Charles E. Shay, Jr., has sufficient resources to pay for all, or part, of the nursing home care services that have been, and is being, been received by his wife, Plaintiff Patricia J. Shay. 56. On information and belief, Defendant Charles E. Shay, Jr., is responsible for the outstanding balance owed to Claremont Nursing and Rehabilitation Center for nursing care and services provided to his wife, Plaintiff Patricia J. Shay, $10,358.50; said sum continues to grow daily. 57. It is an implied term of the agreement between Plaintiff, Tracy D. Shay- Snyder and Defendant, Charles E. Shay, Jr., Powers of Attorney for Patricia J. Shay, that Defendant Charles E. Shay, Jr., would responsibly use and safeguard the assets of his wife, Plaintiff Patricia J. Shay for her care. To the extent that he has failed to do this, he should be held personally responsible. 58. It is an implied term of the agreement between Plaintiff Patricia J. Shay, through Tracy D. Shay-Snyder as her Power of Attorney, and Charles E. Shay, Jr., as spouse and Power of Attorney for Patricia J. Shay, that he would assist financially by providing payment for services and/or by making arrangements for payment including, but not limited to, providing the necessary documentation for an application for Medical Assistance on behalf of Plaintiff Patricia J. Shay. 59. Plaintiff Tracy D. Shay-Snyder has presented invoices from Claremont Nursing and Rehabilitation Center to Defendant Charles E. Shay, Jr., for payment for nursing home care services provided to Plaintiff Patricia J. Shay and the Defendant has refused and continues to refuse to make payment in breach of the oral contact. 60. Plaintiff Patricia J. Shay has been damaged by the failure of the Defendant Charles E. Shay, Jr., to pay for the nursing care and services that have been rendered on her behalf by Claremont Nursing and Rehabilitation Center. 61. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay- Snyder is incurring attorney fees and costs in prosecuting this matter that should be reimbursed by Defendant Charles E. Shay, Jr., as spouse, Power of Attorney, Responsible Party and/or Fiduciary. WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in the amount of at least $$10,358.50 for nursing care, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in an amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. COUNT 2 - BREACH OF IMPLIED CONTRACT Charles E. Shay, Jr., individually and as Patricia J. Shay's Spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 62. Plaintiff hereby incorporates paragraphs 1 through 61 of this Complaint as if set forth at length herein. 63. On or about April 2003, Defendant Charles E. Shay, Jr., orally agreed to the admission of his wife, Plaintiff Patricia J. Shay to a nursing home by Tracy D. Shay-Snyder, Power of Attorney for Patricia J. Shay, and to pay the nursing home bill for providing care and services to her. 64. Between April 2003 and December 2004, Defendant Charles E. Shay, Jr., continued to make representations that he would pay for the costs of nursing home care for Plaintiff Patricia J. Shay. 65. On or about February 4, 2005, Tracy D. Shay-Snyder, as Power of Attorney for Plaintiff Patricia J. Shay, relied upon the representations made by Charles E. Shay, Jr., and applied for the admission of Plaintiff Patricia J. Shay to Claremont Nursing and Rehabilitation Center; which was granted and the nursing facility began providing skilled nursing care and services. 66. The facts, as set forth above, establish an implied-in-law and an implied-in- fact contract. 67. Due to the existence of the implied-in-law and implied-in-fact contract, Defendant Charles E. Shay, Jr., is responsible to pay for the health care services rendered to Plaintiff Patricia J. Shay. 68. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party, and Fiduciary that he would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that he has failed to do this, he should be held personally responsible. 69. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder and Defendant Charles E. Shay, Jr., individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary, that he would assist with, including, but not limited to, providing the necessary documentation for an application for medical assistance on behalf of Plaintiff Patricia J. Shay. 70. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay- Snyder has requested payment from Defendant Charles E. Shay, Jr., under the terms of the implied-in-fact and implied-in-law contract, but Defendant has failed and/or refused to make payment. 71. The Plaintiff Patricia J. Shay has been damaged by the refusal of Defendant to pay for the nursing care and services rendered, in breach of the implied-in-law and implied-in-fact contract. 72. Plaintiff is incurring attorney fees and costs in prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows. a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as spouse and Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $10,358.50 plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action and costs of Court; and d. Granting such other relief as the Court deems appropriate. COUNT 3 - QUANTUM MERUIT Charles E. Shay, Jr., individually and as spouse, Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary of Patricia J. Shay 73. Plaintiff hereby incorporates paragraphs 1 through 72 of this Complaint as if set forth at length herein. 74. As more fully described herein, Plaintiff Patricia Shay's expectation for payment to be made by her husband Defendant Charles E. Shay, Jr., to Claremont Nursing and Rehabilitation Center for skilled nursing home care provided to her in her incapacitated condition was reasonable. 75. It is an implied term of the oral agreement between Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually and as spouse and Power of Attorney of Patricia J. Shay that he would responsibly use and safeguard Plaintiff Patricia J. Shay's assets for her care. To the extent that Defendant Charles E. Shay, Jr., has failed to do this, he should be held personally responsible. 76. It is an implied term of the agreement between Plaintiff Patricia J. Shay through her power of Attorney Tracy D. Shay-Snyder, and Defendant Charles E. Shay, Jr., individually, and as spouse, Power of Attorney, Attorney in Fact, Responsible party and Fiduciary of Patricia J. Shay that he would assist with, including, but not limited to, providing the necessary documentation for an application for Medical Assistance on behalf of Plaintiff Patricia J. Shay. 77. Defendant Charles E. Shay, Jr., has retained the benefit of the bargain with Plaintiff Patricia J. Shay through her Power of Attorney, Tracy D. Shay- Snyder for the provision of nursing care and services to his wife and has not conferred a similar benefit in return upon the Plaintiff by refusing to make any payment. 78. Defendant Charles E. Shay has been unjustly enriched at the expense of Plaintiff. 79. On information and belief, Defendant Charles E. Shay has spent significant sums of money and assets belonging to Plaintiff Patricia J. Shay on himself as well as other person(s)s and things that were of no benefit to Plaintiff Patricia J. Shay. 80. Due to Defendant's unjust enrichment, Plaintiff Patricia J. Shay is entitled to proper compensation and support for the skilled nursing home services previously rendered by Claremont Nursing and Rehabilitation Center to her, his wife, as well as for the skilled nursing home services that she will require in the future. 81. Defendant's unjust enrichment at Plaintiff's expense has damaged the Plaintiff and could result in her expulsion from the nursing home. 82. Plaintiff Patricia J. Shay through her Power of Attorney Tracy D. Shay- Snyder has requested payment from Defendant, but Defendant has refused payment. 83. Defendant has received bills from Claremont Nursing and Rehabilitation Center and has refused to make payment. 84. Plaintiff is incurring attorney fees and costs related to prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. COUNT 4 - BREACH OF FIDUCIARY DUTY Charles E. Shay, Jr., individually, as spouse, and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 85. Plaintiff hereby incorporates paragraphs 1 through 84 of this Complaint as if set forth at length herein. 86. On information and belief and as described more fully herein, the income and assets of Plaintiff Patricia J. Shay were, at all times relevant and material hereto, accessed and controlled by Defendant Charles E. Shay, Jr. 87. On information and belief, confidential personal financial information about Plaintiff Patricia J. Shay such as, but not limited to: life insurance policy numbers, bank account numbers, cash and real estate data were, at all times relevant and material hereto, accessed and controlled by Defendant Charles E. Shay, Jr., as the Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Patricia J. Shay, Defendant Charles E. Shay, Jr., had a fiduciary duty to act in the best interests of Plaintiff Patricia J. Shay. 88. On information and belief, Defendant Charles E. Shay, Jr., refused to make the income and assets of Plaintiff Patricia J. Shay available to Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, to pay for her nursing care and services or to pay for those services himself. 89. On information and belief, Defendant Charles E. Shay, Jr., despite being requested to do so, failed to inform the facility or Plaintiff Tracy D. Shay- Snyder, as Power of Attorney for Patricia J. Shay, of Patricia J. Shay's income and assets and disclose to the facility exactly what income and assets the Defendant Charles E. Shay, Jr., had available so that Tracy D. Shay-Snyder, as Power of Attorney for Patricia J. Shay, or the facility might act in the best interests of Patricia J. Shay by assisting in the Medical Assistance application process for her or, alternatively, providing for her ongoing support. 90. The Claremont Nursing and Rehabilitation Center, by virtue of the contract to provide skilled nursing care to Patricia J. Shay, is an intended third party beneficiary of the agency relationship that existed between Defendant Charles E. Shay, Jr., and Patricia J. Shay as he is her spouse, Power of Attorney, Attorney In Fact, Responsible Party and Fiduciary. 91. On information and belief, Defendant Charles E. Shay, Jr., owes a fiduciary duty to his wife, Plaintiff Patricia J. Shay to use their joint and several assets of to pay for her nursing care and services when invoiced, to inform the facility and Tracy D. Shay-Snyder, as Power of Attorney, when such assets became depleted, if applicable, and to disclose the available income and assets to the facility. 92. Due to the existence of the spousal relationship and fiduciary duty between Defendant Charles E. Shay, Jr., and Plaintiff Patricia J. Shay, Plaintiff Patricia J. Shay is entitled to compensation from Defendant Charles E. Shay, Jr., for the health care services rendered to her. 93. On information and belief, Defendant Charles E. Shay, Jr., violated his fiduciary duty to Plaintiff Patricia J. Shay and to Plaintiff Tracy J. Shay- Snyder by refusing to use Plaintiff Patricia J. Shay's income and assets to pay for her nursing care and services, to inform the facility when such assets became depleted, if applicable, and to disclose the available income and assets to the facility and thus damaged Plaintiff. 94. On information and belief, Defendant Charles E. Shay, Jr., violated his fiduciary duty to Plaintiff by withholding information required by the Department of Public Welfare to qualify Plaintiff Patricia J. Shay for Medical Assistance benefits and by doing so Defendant Charles E. Shay, Jr., has thus damaged Plaintiff. 95. On information and belief, Plaintiff has been damaged by Defendant Charles E. Shay, Jr.'s violation of his fiduciary duty to Plaintiff Patricia J. Shay. 96. Plaintiff is incurring attorney fees and costs in prosecuting this matter. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. COUNT 5 - NEGLIGENCE Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 97. Plaintiff hereby incorporates paragraphs 1 through 96 of this Complaint as if set forth at length herein. 98. Defendant Charles E. Shay, Jr., had a duty to act in Plaintiff Patricia J. Shay's best interests. 99. Defendant Charles E. Shay, Jr., had a duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests, which would be to pay for required skilled nursing care and services rendered on her behalf. 100. Defendant Charles E. Shay, Jr., had a duty to aid in Patricia J. Shay's application for Medicaid benefits and to notify the facility and Tracy D. Shay- Snyder, Power of Attorney, when her assets were becoming depleted which he failed to do. 101. Defendant Charles E. Shay, Jr., breached his duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests by refusing to make her income and assets available to pay for her nursing care and services. 102. Defendant Charles E. Shay, Jr., breached his duty to aid in completing Plaintiff Patricia J. Shay's Medicaid application by refusing to communicate or aid the facility or Tracy D. Shay-Snyder, as Power of Attorney for Patricia J. Shay, in any way with respect to Plaintiff Patricia J. Shay's Medical Assistance application and by failing to notify the facility or Tracy D. Shay Snyder, as Power of Attorney, that Patricia J. Shay's assets had become depleted. 103. On information and belief, Defendant Charles E. Shay, Jr., breached his duty as Power of Attorney by refusing to be available to the facility to act in his role as Power of Attorney for Patricia J. Shay and thus damaged her and the Claremont Nursing Rehabilitation Center. 104. Plaintiff has been damaged by the Defendant Charles E. Shay, Jr., in violation of his marital and fiduciary duty to Plaintiff Patricia J. Shay in the amount of at least $10,358.50 for failure to pay for skilled nursing home care service; said amount increases daily. 105. Plaintiff Patricia J. Shay has been damaged by Defendant Charles E. Shay, Jr., in violation of his marital and fiduciary duty to Plaintiff Patricia J. Shay in the failure to pay for pharmacy supplies. ($854.48) 106. Plaintiff is incurring attorney fees and costs to prosecute this action. WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Order as follows. a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. COUNT 7 - CONVERSION Charles E. Shay, Jr., Individually, as spouse, and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 107. Plaintiff hereby incorporates by reference paragraphs 1 through 106 of this Complaint as if set forth at length. 108. Defendant Charles E. Shay, Jr., had a duty to act in Plaintiff Patricia J. Shay's best interests. 109. Defendant Charles E. Shay, Jr., had a duty to use Plaintiff Patricia J. Shay's income and assets to serve Plaintiff Patricia J. Shay's best interests, which would be to safeguard her assets and to pay for her skilled nursing care and services. 110. On information and belief, Defendant Charles E. Shay, Jr., was aware that, due to the contractual relationship between Plaintiff Patricia J. Shay and Claremont Nursing and Rehabilitation Center, Patricia J. Shay's assets needed to be used for her care and, despite this knowledge converted the assets of the Plaintiff Patricia J. Shay to his own use. 111. On information and belief, Defendant Charles E. Shay, Jr., was aware that, due to the contractual relationship between Plaintiff Patricia J. Shay and Claremont Nursing and Rehabilitation Center, a portion of their joint assets needed to be used for her care and, despite this knowledge converted their joint assets to his own use. 112. Plaintiff has been damaged by Defendant Charles E. Shay, Jr.'s, conversion of Plaintiff Patricia J. Shay's assets in the amount of at least $10,358.50, which increases daily. 113. Plaintiff is incurring attorney fees and costs in prosecuting this action. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows. a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. COUNT 8 - PETITION FOR ACCOUNTING Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 114. Plaintiff hereby incorporates paragraphs 1 through 113 of this Complaint as if set forth at length. 115. Due to Defendant Charles E. Shay Jr.'s, conduct described herein, Plaintiff is entitled to an accounting of: a. All transactions and dealings with relation to his duties as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary for Plaintiff Patricia J. Shay; b. All profits and losses gained or lost as a result of any investments or businesses run during his tenure as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary on behalf of Plaintiff Patricia J. Shay; c. A listing of all Defendant Charles E. Shay, Jr.'s assets and liabilities during the entire time that Defendant Charles E. Shay, Jr., acted as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Plaintiff Patricia J. Shay and had control of the Plaintiff Patricia J. Shay's assets and any actions taken by Defendant Charles E. Shay, Jr., in regard to the assets and property of Plaintiff Patricia J. Shay or held in for the benefit of Patricia J. Shay; d. Defendant Charles E. Shay, Jr., is a constructive trustee of the funds and assets of Plaintiff Patricia J. Shay and should account for any and all of Plaintiff Patricia J. Shay's funds and funds held for her benefit, and spent for her personal use. e. Moreover, Defendant Charles E. Shay, Jr., should account for any wrongful conversion, dissipation and sale of Plaintiff Patricia J. Shay's property or the property held for the benefit of Plaintiff Patricia J. Shay and return the items or their value to pay for Plaintiff Patricia J. Shay's obligations. 116. As a party to the Power of Attorney between Defendant Charles E. Shay, Jr., and Plaintiff Patricia J. Shay, Plaintiff, Plaintiff is also entitled to a full and complete inspection of any books or records in the possession of the Defendant, Charles E. Shay, Jr., pertaining to his actions as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary for Plaintiff Patricia J. Shay. WHEREFORE, Plaintiff respectfully requests that this honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Parry and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; d. Issue an Order directing Defendant Charles E. Shay, Jr., to produce all books and records for inspection relating to his actions as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary for Patricia J. Shay and account for all of the transactions, dealings, assets and liabilities; and e. Granting such other relief as the Court deems appropriate. COUNT 9 - DUTY TO SUPPORT Charles E. Shay, Jr., Individually, as spouse and as Patricia J. Shay's Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary 117. Plaintiff hereby incorporates paragraph 1 through 116 of this Complaint as if set forth at length. 118. As the spouse and Power of Attorney of Plaintiff Patricia J. Shay, Defendant Charles E. Shay, Jr., had a legal duty to provide care, maintenance and assistance and ensure that Plaintiff Patricia J. Shay received appropriate nursing home care. 119. Plaintiff Patricia J. Shay's average monthly expenses incurred for nursing home care at Claremont Nursing and Rehabilitation Center is approximately $7,000.00 (seven thousand dollars). 120. Upon information and belief, Defendant Charles E. Shay, Jr., had at all times material and relevant hereto, sufficient financial ability to pay for Plaintiff Patricia J. Shay's maintenance and support. 121. Title 62 of the Pennsylvania Statutes Section 1973, et. seq., (The Support Act) requires spouses with sufficient financial ability to pay for the care and maintenance of their indigent spouse and to provide their spouse with financial assistance. 122. Plaintiff Patricia J. Shay is, and was, "indigent" within the meaning of the Support Act during all relevant periods. 123. Defendant Charles E. Shay, Jr., is obligated to pay for nursing care services rendered to Plaintiff Patricia J. Shay pursuant to the Support Act. 124. Defendant Charles E. Shay, Jr., has not paid any portion of the bill for the nursing care and services rendered to Plaintiff Patricia J. Shay and therefore she has been damaged by the violation of the Support Act by Defendant Charles E. Shay, Jr. 125. The Support Act has been held to obligate individuals situated similarly to Defendant to pay for medical and nursing services. This Court may enter a retrospective Order for reimbursement and authority for doing so may be found at Albert Einstein Medical Center v. Forman, 212 Pa. Super. 450, 243 A. 2d 181 (1968) and at Savoy v. Savoy, 433 Pa. Super. 549, 641 A.2d 596 (1994). WHEREFORE, Plaintiff respectfully requests that this Honorable Court enter an Order as follows: a. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in the amount of at least $10,358.50 plus 6% pre- judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; b. Granting judgment for Plaintiff and against Charles E. Shay, Jr., individually and as Power of Attorney, Attorney in Fact, Responsible Party and Fiduciary in amount of $854.48 for pharmacy expenses, plus 6% pre judgment and post judgment interest per annum, or as determined by the Court, inclusive of interest and costs; c. Granting Plaintiff its expenses, including reasonable attorney fees incurred in connection with this action; and d. Granting such other relief as the Court deems appropriate. Respectfully Submitted, Associates, P.C. Date: By: A24,?- Doreena Cr ' loan, Esquire Attorney I.D. No. 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorneys for Plaintiff VERIFICATION I, Doreena Craig Sloan, Esquire, do hereby verify that the facts made in the foregoing Amended Complaint are true and correct to the best of my knowledge, information and belief. This verification is being made as Plaintiff is unavailable and time is of the essence. Counsel will substitute a verification of Plaintiff as soon as available. I understand that any false statements therein are subject to the penalties contained in Title 18 of the Pennsylvania Consolidated Statutes Section 4904, relating to unsworn falsification to authorities. By: MAN'k Doreena C i Slokf, Esquire Attorney I. No. 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorneys for Plaintiff )d6 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay 2713 Columbia Avenue Camp Hill, PA 17011 Plaintiff vii. CHARLES E. SHAY, JR. Individually, Power of Attorney Attorney in Fact, Responsible Party And/or Fiduciary For Patricia J. Shay 1926 Longboat Drive Lakewood, FL 33810 CIVIL ACTION - LAW CAUSE NUMBER: 06-3229 CERTIFICATE OF SERVICE I herby certify that on November 13, 2006, I served a true and correct copy of the foregoing Second Amended Complaint by first class mail, postage prepaid, upon the following counsel of record: Matthew M. Haar, Esquire Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7d' Floor Harrisburg, PA 17101 Nicole Waters, Esquire Leonard McCall, Certified Legal Intern The Dickenson School of Law of t Pennsylvania State Univers' Elder Law Clinic 150 South College S eet? / Carlisle, PA 171 3 Doreena Craig,$ lKan, Esquire Attorney I.D. o. 44880 2933 North Front Street Harrisburg, PA 17110 (717) 233-4101 Attorneys for Plaintiff /N IN RE: IN THE COURT OF COMMON PLEAS OF PATRICIA J. SHAY CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION An Incapacitated Person NO. 21-06-492 FINAL ORDER OF COURT APPOINTING PLENARY GUARDIAN AND NOW, this 8th day of September, 2006, following hearings held in this case on July 16, 2006, and September 8, 2006, the Court now enters findings as follows, based upon the exhibits and testimony presented: 1. That PATRICIA J. SHAY is an individual, married to Charles E. Shay, Jr., on October 25, 1952, and she has two children, Tracy Shay-Snyder and Cory Shay. 2. That PATRICIA J. SHAY suffers from, among other things, Senile Alzheimer's Dementia, a condition which has now advanced to the point where the condition impairs her capacity to receive and evaluate information.effectively, and now prevents her from making and communicating decisions concerning the management of financial affairs or to meet essential requirements for her physical health and safety. 3. That PATRICIA J. SHAY is now a resident of Claremont Nursing and Rehabilitation Center located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 4. That Daughter Tracy Shay-Snyder and Husband Charles E. Shay, Jr., acknowledge that from this day forward, said nursing facility (or a similar facility) is the most appropriate setting for the care and physical residence of PATRICIA J. SHAY. F" m NOW, THEREFORE, based on the clear and convincing K W evidence supporting the foregoing findings, it is ORDERED, ADJUDGED, AND DECREED: ?waa A. That PATRICIA J. SHAY be and is hereby adjudged a totally incapacitated person. B. That Tracy Shay-Snyder is appointed Plenary Guardian of the Person of PATRICIA J. SHAY and shall have the authority to act on behalf of PATRICIA J. SHAY, to provide for the general care, maintenance and custody of PATRICIA J. SHAY. Further: 1. The Plenary Guardian shall arrange for medical, psychological and psychiatric services and social and vocational opportunities, as appropriate; 2. The Plenary Guardian shall assist PATRICIA J. SHAY in the development of maximum self-reliance and independence; 3. The Plenary Guardian shall have the authority to give consent for and to withhold surgical or medical treatmeht so long as Mr. Shay is notified as soon as practical, but in no event more than 24 hours after a decision is made in regards to providing or withholding such treatment. 4. The Plenary Guardian shall do nothing to interfere with the relationship between Charles Shay, Jr., and PATRICIA J. SHAY. Provided, however, that this provision shall not be construed as preventing the Guardian from pursuing any legal action to enforce or protect the rights of the incapacitated person vis-a-vis her husband or any other person. 5. Charles E. Shay, Jr., shall have the right to visit PATRICIA J. SHAY upon 48 hours notice to the Guardian, and he shall have the unrestricted right to receive full information about her status, care and treatment from all care-givers; and 6. The Plenary Guardian shall file with the Clerk of the Court a report on the social, medical and other relevant conditions, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually thereafter. C. Tracy Shay-Snyder is hereby appointed Plenary Guardian of the Estate of PATRICIA J. SHAY and shall have the authority and responsibility to manage and use PATRICIA J. SHAY'S property for her benefit in accordance with 20 Pa. C.S.A. 5536(a). The Plenary Guardian for the estate shall file a report with the Clerk of the Court about assets, investments, receipts and disbursements, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this order and annually thereafter. The Plenary Guardian shall file an inventory with the Court in accordance with 20 Pa. C.S.A. Sections 5521 and 5142 within three months of this Order. The Plenary Guardian of the estate shall not be required to post a bond. , D. Any existing general power of attorney, limited power of attorney and/or health care power of attorney executed by PATRICIA J. SHAY is hereby specifically revoked-and rendered null and void. E. PATRICIA J. SHAY has the right to appeal this Order by filing exceptions within ten (10) day to petition this Court for a review of hearing terminate the guardianship herein established. Petitioner is directed to have served upon and J. SHAY a copy of this Order and the Statement of which is attached hereto, and to file proof with this Court within, ten (10) days. y? . By the Court, i I .? J I ?..1 s of this date or to modify or Counsel for read to PATRICIA of Rights, a copy of such service Edward E. Guido, J. Rebecca M. Fuhrman, Certified Legal Intern Nichole M. Walters, Esquire THE ELDER LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 Doreena Craig Sloan, Esquire CAPOZZI & ASSOCIATES 2933 North Front Street Harrisburg, PA 17110 srs 4 DATLOF:INTERMEN7 - F_ NAM E.OF?DECEASED LOT SPACE r 1. 2 liki's Elizabeth M Shay' r3r. 2 M 6 -1972 Charles W. Shay Gr. 1 Y PRICE DATE?Or PAYMENT LEDGER - AREAIEl! !f 0A R'E tiEC•. ;,ti06. . , „ . N-A-WE '. L O;T- H OfL'.DE'tt W. ' Y. E. 34 39 Charles E Shay Ei 0?3 q - 966 13" ? d;• G..? S? N 6y , Jan 0 I- x W f 7'e2 C) O CAD 4 co cD cD cD (,j U7 4 W N - 4 -I 00 00 00 a) V 00 cD O N 0) va oa va o? .cn cn M CP CA N -? O co OD CA 4 L4 r-j P -? ? ? cn v, v? cn 01 v, (P cr 0 v, 0) CD O -? N -I, 4- -P ? ? -? W W W W. W W W W U7 -P W N O CD o' S T -A -" -? N N N N 'N N N N W 0) --,1 00 CD O N Cry P CJt v 00 CD O C), -P (A N j O (D h ` -? 00 00 ;OD :QQ 00 00 00 (D W?cna?voocc? O OD v 0) VI -P W N : N r= ; O i i 0 v Cr) U? -P W N 0 i ?oT,t Ju-s. 1ehabihtation Center Resident `Fame 1000 Claremont Road Carlisle, PA 17013-8805 main (717) 243-2031 :ax (717) 240-1952 ADMISSION AGREEMENT As part of admission to Claremont Nursing and Rehabilitation Center, the Resident and the Responsible Party assisting the resident acknowledge and agree to the following: 1. If Claremont Nursing and Rehabilitation Center determines that the Resident is not appropriate or does not qualify for nursing home care, the Resident will discharge from Claremont Nursing and Rehabilitation Center following a 30 day notification of the need to make alternate living arrangements. 2. If the Resident cannot qualify for coverage under the Medical Assistance or Medicare programs, the Resident will pay daily rate for care at the nursing facility. 3. The Responsible Party (guarantor) assures that the Resident's bill will be paid from the Resident's assetsifunds. If the Resident does not have personal funds or when personal funds are exhausted, the Responsible Party will make application to tiledical Assistance on behalf of the Resident. If the Resident does not qualify for Medical Assistance funding, the Responsible Party will arrange discharge for the Resident if the bill is not paid in a timely manner. 4. The Resident authorizes Claremont Nursing and Rehabilitation Center to release information concerning their assets, real or personal, to the Cumberland County Board of Assistance. 5. If the Resident is being covered by the Medical Assistance Pro,am, the Resident and Responsible Party recognize that all income the Resident receives during the month of admission, must be paid to the Claremont Nursinz and Rehabilitation Center, regardless of the day of admission, unless tivaived by the Cumberland County Board of Assistance. The Resident and Responsible Party acknowledge that all future income received by the Resident, while covered under the Medical Assistance Program, must be paid to Claremont Nursing and Rehabilitation Center. Income not applied to charges for care will be placed in the Resident Guest Fund or refunded. Resid ' t ipnature or ,',Ia Les; Respons}tbl Parry Sianatu itness Date 0?. )-5 Date Date Date ,7l RF11-1ce nzellr') of C'1u1r11c 1.1(111(1 C-UmItc1 April 15, 2004 Dear Resident/R.esponsible Party: As you may be aware, Claremont Nursing and Rehabilitation Center recently completed =iaaicucarci'iv_e+?ic3i:1 .CCCci?I catiuii and State Licensure survey. The Facility is responsible for making the results of the survey available for examination and of posting these same survey results in a place readily accessible to the residents and responsible parties. This most recent survey results have been placed in the Facility's Main Lobby, on the bulletin board in the "connecting hallway", outside the entrance to A-Wing, and on the wall in the new Administrative Wing Lobby. Please feel free to review the results of the survey at any time. Assistance will be offered to review the results with any resident/responsible party who would like to have assistance reading the survey and the plan of correction. One of our goals is to keep you informed about the Facility and particularly your loved one. We encourage you to attend care plan meetings and to contact us any time you have a concern. Sincerely, . f1% Jeanne Schwartz, Manager Social Services /ptm NOTICE !i If you have mental retardation, a physical disability or other disability which occurred before the age of 22, you may be eligible to receive support services that would help you to live with your family, in your own apartment or in another community setting. You may also be eligible for specialized services. If you have mental retardation call 717-772-6507 for more information. If you have another disability (other than mental retardation or mental illness) call 717-397-1841 for more information. If you have mental illness (other than dementia) and you do not need nursing facility services; you may be.eligible to receive support services that would help you Live in your own apartment, in a group home or another community setting. For more information call _ _ 717-772-7,66 . If you are not satisfied with the response you receive, C211 the Disabilities Law Project at (215)238-8070. You may call collect. 1\? OT ,t XIl!-'S11? 10 4 Pehabilitatiori Centel- RESIDENT RESPONSIBILITIES 1000 Claremont Road Carlisle, PA 1 70 1 3-8805 main (717) 243-2031 fax (717) 240-1952 The Claremont Nursing and Rehabilitation Center recognizes and informs its residents of their rights as citizens and as nursing home residents. The nursing home recognizes and informs residents of their rights, not only to comply with regulation, but also because of the facility's commitment to these rights and to the dignity of all individuals. In conjunction with this com- mitment to the rights and dignity of all individuals, Claremont Nursing and Rehabilitation Center also emphasizes the respon- sibilities, of its residents to respect the rights of other individuals, including both resident and staff. To emphasize this commitment, specific resident responsibilities are outlined below as part of the Claremont Nursing and Rehabilitation Center Resident Responsibilities. 1, The resident shall recognize the rights of all Claremont Nursing and Rehabilitation Center residents to privacy in receipt of care, privacy in visitation with family and friends, and con- fidentiality of medical care and financial matters: and shall be especially aware of the impact their actions have in this regard. Therefore a resident shall recognize that they have no right to information regarding another resident's medical care, financial transcations, or personal problems and shall not pass this type of information to others if accidentally overheard or shared by others, 2. The resident shall recognize the right of all Claremont Nursing and Rehabilitation Center residents and staff to personal safety and freedom from injury, and to this end will not strike, OVER... _I set-vice Q,2FJ1Ct! Of C?(i))lL?el'InPiCt? County Page 2 Resident Responsibilities push, or aggressively grab another resident even if provoked, ex- cept in justified self defense. If another resident physically abuses a resident, that resident should immediately notify their Charge Nurse; or if the Charge Nurse is unavailable, the resident should notify the closest staff member who will in turn notify the Charge Nurse. 3. The resident shall recognize the right of all Claremont Nursing and Rehabilitation Center residents to be free from verbal abuse and to this end will not speak to another resident or to staff in obscene or vulgar language. 4. The resident is charged with the responsibility for appropriate behavior and dress when in a community setting and therefore will be aware of keeping interaction between themselves and other residents appropriate when in public view, will be alert to appropriate dress, and will be alert to appropriate hygiene. If the resident is cognitively or physically impaired to an extent in which they cannot monitor these aspects of life, the staff will provide assistance, 5. The resident shall recognize the right of all Claremont Nursing and Rehabilitation Center residents to safely maintain, their personal belongings and shall not infringe upon this right by unlawfully taking another resident's possissions. If a lost or a misplaced item is observed it should be returned to the resi- dent's nursing station. 6. The resident shall recognize that it is their responsi- bility to fairly consider the treatment and care recommended and provided by the Attending Physician and professional treatment team and to make any disagreement with these recommendations known to the treatment team, in order that these concerns can be properly and openly addressed. CONTINUED... 1N01-It Jvurs, . 4 rehabilitation Center RESIDENT RIGHTS 1000 Claremont Road Carlisle, PA 1 70 1 3-8805 main (717).243-2031 fax (717) 240-1952 The governing body of this facility maintains its responsibility in the establishment of written policies regarding the rights and responsibilities of residents, and through the administrator is responsible for the development of and adherence to procedures implementing such policies. These policies and procedures are made available to residents, to any guardians, next of kin, sponsoring agency H es), responsible person or representative payees, and to the public. The staff of the facility is trained and involved in the implementation of these policies and procedures. 1. The resident shall be fully informed as evidenced by the resident's written acknowledgement prior to or at the time of ad- mission and during stay, of these rights and of all rules and re- gulations governing resident conduct and responsibilities. 2. The resident or a legally responsible representative or both (in the case of a Medical Assistant recipient, the recipient or the relevant County Board of Assistance in the absence of a legally responsible representative or both) shall be informed verbally and in writing prior to or at the time of admission and during his stay, of services available in the facility and of related charges not covered by the facility's basic per diem rate, 3. The Physician shall inform the resident of his medical con- dition unless it is medically contraindicated, as documented in the medical record, and is afforded the opportunity to participate in the medical treatment. The resident has the right to refuse to participate in expermental research. OVER:.. RESIDENT RIGHTS Page 2 4. The resident shall be transferred or discharged only for medical reasons or for his welfare or that of other residents, or for non-payment for his stay, or for fraud or deception in gaining admission to the facility. The resident is given reasonable advance notice to ensure orderly transfer or discharge. Such actions are documented in the resident's medical record. 5. The resident is encouraged and assisted throughout his period of stay to exercise his rights as a resident and as a citizens and to this end may voice grievances and recommend changes in policies and services to facility staff and/or to outside representatives of his choice. In addition, each resident may address grievances when he feels they will not be properly resolved through the facility's grievances process to the Governor's Action Line (Toll Free 1-800- 932-0784) or the Department's Hot Line (1-800-692-7254), or the County Ombudsman at the Office of Aging (717) 240-6110). 6. The resident shall be free from restraint, interference, coercion, discrimination, or reprisal. 7. The resident may manage his personal financial affairs. 8. If the facility accepts the responsibility for the resi- dent's financial affairs, the resident may designate the transfer of responsibility in writing. Further, the facility must give the resident an accounting of all financial transactions made on the resident's behalf, This accounting must be done at least quarterly. 9. The resident must be free from mental and physical abuse and free from chemical and, except in emergencies, physical re- straints except as authorized in writing by a Physician for a special and limited time or when it is necessary to protect the resident from injury to himself and to others. Continued... RESIDENT RIGHTS Page 3 - 10, The resident shall be assured confidential treatment of his personal and medical records and may approve or refuse their release to any individual outside the facility, except, in case of his transfer to another health care institute or as required by law or third party payment contract. 11. The resident shall be treated with consideration, respect, and full recognition of his dignity and individuality, including privacy in treatment and in care for his personal needs, 12. The resident shall not be required to perform services for the facility that are not included for therapeutic purposes in his plan of care, and agreed to by the resident. 13, The resident shall be permitted to associate and com- municate privately with persons of his choice. The resident shall be permitted to send and receive his personal mail unopened. 14. The resident,shall be permitted to participate in social and religious activities, unless medically contraindicated, as documented by his Physician in the medical record. 15. The resident shall be permitted to meet with community groups at his discretion, unless medically contrindicated, as documented by his Physician in the medical record, 16. The resident shall be permitted to retain and use his personal clothing and possessions as space permits unless to do so would infringe upon the rights of other residents and unless medically contraindicated, as documented by his Physician in his medical record. 17. A resident shall be afforded an opportunity to meet in private with visitors. When a husband and wife are residents in the same facility, they shall be permitted to share a room if they desire to do so, unless it is medically contraindicated, The Attend- RESIDENT RIGHTS Page 4 ing Physician must document in writing the informaion regarding the medical contraindication in the resident's medical record. 18. All rights and responsibilities specified in paragraphs (1), (3), (4), and (5) devolve to such resident's guardian, next of kin, sponsoring agency, or representative payee, except when the facility itself is representative payee, in the following instances; a) A resident adjudicated incompetent in accordance with State law, b) A resident who is found by his Physician to be medically incapable of understanding these rights, c) A resident who exhibits a communication barrier, EMPLOYEE RIGHTS 1. No employee shall be punished or harrassed by the facility or by its agent because of the efforts to avail himself of his/her rights, 2, There shall be written policies that provide for the re- gistration of employee complaints without threat of discharge or other reprisals. 5 S Q r " , " t d -E - (` Page 3 Resident Responsibilities 7. The resident shall recognize that it is their responsi- bility to notify appropriate staff members (professional nursing staff, social worker, or appropriate administrative personnel) of dissatisfaction regarding care or treatment at Claremont Nursing and Rehabilitation Center, in order that these concerns can be properly and efficiently addressed, 8. The resident will at all times exercise respect for staff and their attempts to deliver quality care and provide for the safety of residents and therefore will not physically or verbally abuse staff as they attempt to deliver this care, If verbal or physical abuse is perpetrated by the resident, it will be addressed in a manner agreed upon by the Physician and professional treatment team, will be documented on the medical record, and will follow guidelines approved by Claremont Nursing and Rehabilitation Center. 9. The Claremont Nursing and Rehabilitation Center reserves the right to have residents transfer within the facility based upon medical, psychosocial, and environmental needs, Transfers will occur as outlined under relevant policies and procedures. It is the resident's responsibility to make every effort to adequately adjust to a transfer should the need occur. 10. To maintain a sense of community. it is the resident's responsibility to exercise personal freedoms only up to the point that the exercising of these freedoms does not infringe upon the freedoms and rights of other residents and staff. :alr f1T- i a"' R PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff, V. No. 06-3229 CHARLES E. SHAY, Jr., Defendant. Civil Action - Law NOTICE TO PLEAD To Plaintiff: You are hereby notified to plead in response to the attached Preliminary Objections within twenty (20) days or a judgment may be entered against you. Aewatt M. Haar, Es wire (Pa. #85688) Saul Ewing LLP Dated: December 11, 2006 Penn National Insurance Plaza 2 N. Second Street, 7`h Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendant 125453.2 12/11/06 PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff, V. No. 06-3229 CHARLES E. SHAY, Jr., Defendant. Civil Action - Law DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S SECOND AMENDED COMPLAINT Defendant Charles E. Shay, Jr., by and through his undersigned counsel, hereby files the following preliminary objections to Plaintiff s Second Amended Complaint and avers as follows: 1. Plaintiff Patricia J. Shay ("Wife" or "Plaintiff'), acting through her daughter and Power of Attorney Tracy D. Shay-Snyder ("Daughter"), commenced this action by filing the Complaint on June 6, 2006. 2. Defendant Charles E. Shay, Jr. ("Defendant" or "Husband"), received the Complaint on June 27, 2006. 3. On July 17, 2006, Defendant timely filed Preliminary Objections seeking to dismiss the Complaint. 4. Plaintiff filed an Amended Complaint on August 7, 2006. On August 28, 2006, Defendant timely filed Preliminary Objections seeking to dismiss the Amended Complaint. 125453.2 12/11/06 6. On October 24, 2006, Plaintiff filed a motion to continue argument on Defendant's preliminary objections and for permission to file a second amended complaint. By Order dated October 24, 2006, the Court (Hess, J.) granted Plaintiff's motion. 7. Plaintiff filed a Second Amended Complaint on or about November 13, 2006. 8. Defendant was not served with the Second Amended Complaint until November 20, 2006, and as clarified by agreement of counsel, Defendant may timely file a response to the Second Amended Complaint on or before December 11, 2006. See Pa. R. Civ. P. 1026(a). FIRST PRELIMINARY OBJECTION - Pa. R.C.P. 1028 (a)(1) Lack Of Jurisdiction Over The Defendant 9. Rule 1028(a)(1) permits a party to file a preliminary objection asserting lack of jurisdiction over the person of the defendant. Pa. R. Civ. P. 1028(a)(1). 10. This action may not proceed unless the Court has personal jurisdiction over the defendant. Fidelity Leasing, Inc. v. Limestone County Bd. of Educ., 758 A.2d 1207 (Pa. Super. Ct. 2000). 11. Defendant resides and is domiciled at 1926 Longboat Drive, Lakeland, Florida 33810. 12. Defendant has continuously resided in the state of Florida for the last eleven (11) years. 13. Defendant does not reside in the Commonwealth of Pennsylvania. 14. Defendant does not do business in the Commonwealth of Pennsylvania. 15. Defendant does not own any real property located in the Commonwealth of Pennsylvania. While Defendant may have been willed a cemetary plot in Harriburg by his parents many years ago, Defendant has disclaimed any interest in the plot and has no intention of being buried there. 125453.2 12/11/06 -2- 16. Defendant has no personal property in Pennsylvania. Until recently Defendant had a dormant account at New Cumberland Federal Credit Union, but that account is now closed. 17. Defendant did not contact anybody in Pennsylvania to arrange for Plaintiff to receive nursing care, nor did he in any other way initiate a contact in Pennsylvania related to Plaintiff's care. To the contrary, Defendant provided care to Plaintiff during the entirety of their marriage, until Defendant was unable to do so because he underwent open heart surgery and was being treated for prostate cancer, at which time Daughter moved Plaintiff to Pennsylvania and represented to Defendant that she would take care of Plaintiff. 18. Defendant has not consented and does not consent to personal jurisdiction in the Commonwealth of Pennsylvania. 19. Defendant has not had and does not have continuous or substantial contacts with the Commonwealth of Pennsylvania. 20. To the extent that Defendant has had any contacts with the Commonwealth of Pennsylvania in the last several years, those contacts have been random, fortuitous, or attenuated and are not sufficient to establish personal jurisdiction. 21. Defendant has not purposefully availed himself of the privileges of conducting activities in the Commonwealth of Pennsylvania. 22. Defendant is a non-resident who does not have sufficient minimum contacts with this Commonwealth to establish jurisdiction, and any assertion of personal jurisdiction over the Defendant would not comport with fair play and substantial justice. 23. Defendant is not subject to personal jurisdiction within the Commonwealth of Pennsylvania. 24. This Court has neither general nor specific jurisdiction over the Defendant. 125453.2 12/11/06 _'} _ WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Second Amended Complaint with prejudice on the basis of lack of personal jurisdiction. SECOND PRELIMINARY OBJECTION - Pa. R.C.P. 1028(a)(5) Nonjoinder Of A Necessary Party 25. Defendant incorporates the averments of paragraphs 1 through 24. 26. Rule 1028(a)(5) permits a party to file a preliminary objection alleging the nonjoinder of a necessary party. Pa. R. Civ. P. 1028(a)(5). 27. Failure to join an indispensable party deprives the court of subject matter jurisdiction. Polydyne Inc. v. City of Philadelphia, 795 A.2d 495, 496 (Pa. Commw. Ct. 2002). 28. A party is indispensable when its rights are so connected with the claims of the litigants that no decree can be made without impairing those rights. Id. Pennsylvania courts consider the following criteria in determining whether an absent party is indispensable: (1) whether the absent party has a right or interest related to the claim; (2) if so, the nature of the right or interest; (3) whether that right or interest is essential to the merits of the issue; and (4) whether justice be afforded without violating due process rights of absent parties. Delaware Co. v. J.P. Morgan Chase & Co., 827 A.2d 594, 598 (Pa. Commw. Ct. 2003). 29. Daughter, acting as Power of Attorney for Wife, seeks a judgment against Husband for monies that are allegedly due and owing by Wife to Claremont Nursing and Rehabilitation Center ("Claremont"). See Am. Compl. ¶¶ 22 - 35. 30. Claremont has a purported right or interest in Plaintiff's claim in that Claremont is the alleged ultimate beneficiary of any amount due. 31. Claremont's purported right or interest is essential to the merits of this claim, as the validity of Mother's alleged debt to Claremont is the epicenter of this case. ,25459 .2 12/11106 -4- 32. Justice cannot be afforded without Claremont participating in this litigation. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court sustain his preliminary objection and dismiss the Second Amended Complaint, or in the alternative direct that Plaintiff join Claremont as a party to the case. Respectfully submitted, Dated: December ll, 2006 Mat ew M. Haar, E quire (Pa. #85688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 71h Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendants Also: Rebecca M. Fuhrman, Certified Legal Intern Nichole Walters, Esquire The Dickinson School of Law of the Pennsylvania State University Elder Law Clinic 150 South College Street Carlisle, PA 17013 (717) 240-5152 125453.2 12/11/06 -5- VERIFICATION J, Charles E. Shay, Jr., hereby verify that the statements contained in the foregoing P'reii ni"y Objections are true and correct to the best of my knowledge, information and belief. I understand that this Verification is made subject to the penalties of 18 Pa. C.SA. I 4944, relating to unsworn falsification to authorities. Dented: December ff, , 2006 CERTIFICATE OF SERVICE I hereby certify that on December 11, 20061 served a true and correct copy of the foregoing Preliminary Objections by first class mail, postage prepaid, upon the following counsel of record: Doreena Craig Sloan, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Attorneys for Plaintiffs Dated: December 11, 2006 1254512 12/11105 ^' -s? c_" ? ? - '-i rri ' ?? .?+ ^'7 . '.i ! _1 ..- ? ?'^? X .C, ? - _t i-? -„{ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff V. CHARLES E. SHAY, JR. Defendant CIVIL ACTION NO. 06-3229 PRAECIPE FOR ENTRY OF APPEARANCE To: THE PROTHONOTARY OF CUMBERLAND COUNTY PLEASE NOTE that, pursuant to Pa. R.C.P. No. 1012, Bruce G. Baron, Esquire, appears for Plaintiffs, Patricia J. Shay by Tracy D. Shay-Snyder as Power of Attorney for Patricia J. Shay, in the above-referenced case. Papers should be served on the undersigned at the address set forth below. Respectfully Submitted, CAPOZZI AND ASSOCIATES, P.C. Bruce G. Baron, Esquire Attorney ID No. 28090 2933 North Front Street Harrisburg, PA 17110 (717)233-4101 (717)233-4103 Dated: CERTIFICATE OF SERVICE I, hereby certify that I have, this date, served a true and correct copy of the foregoing Praecipe by U.S. Mail, first class, postage prepaid, addressed to the following individuals: Matthew M. Haar, Esquire C/O Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7h Floor Harrisburg, PA 17101 Rebecca M. Fuhrman Certified Legal Intern Nicole M. Walters, Esquire The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Robin Parker, Paralegal Dated: o n; . c c -0 L' :3 rTl IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff V. CHARLES E. SHAY, JR. Defendant CIVIL ACTION NO. 06-3229 PRAECIPE FOR ENTRY OF APPEARANCE To: THE PROTHONOTARY OF CUMBERLAND COUNTY PLEASE NOTE that, pursuant to Pa. R.C.P. No. 1012, Douglas A. Snyder, Esquire, appears for Plaintiffs, Patricia J. Shay by Tracy D. Shay-Snyder as Power of Attorney for Patricia J. Shay, in the above-referenced case. Papers should be served on the undersigned at the address set forth below. Respectfully Submitted, CAPOZZI AND ASSOCIATES, P.C. Douglas A. Snyder, Esquire Attorney ID No. 204384 2933 North Front Street Harrisburg, PA 17110 (717)233-4101 (717) 233- 4103 (fax) Dated: June 25, 2007 VkV CERTIFICATE OF SERVICE I, Douglas A. Snyder, do hereby certify that on this 25 day of June, 2007, I served a true and correct copy of the foregoing Praecipe for Entry of Appearance, upon the following individuals in the manner indicated: BY FAX AND BY FIRST CLASS MAIL AS INDICATED BELOW: Matthew M. Haar, Esquire (FAX: 717-257-7581) CIO Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7t' Floor Harrisburg, PA 17101 (Attorney for Defendant) Rebecca M. Fuhrman (FAX: 717-240-6462) Certified Legal Intern Nicole M. Walters, Esquire The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Respectfully submitted, CAPOZZI & ASSOCIATES, P.C. By: . Douglas A. Snyder, Esquire Attorney I.D. No. 204384 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) (Attorney for Plaintiff) PC O C=? -TI Fn rr Ln '? co IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as CIVIL ACTION - LAW Power of Attorney for Patricia J. Shay Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant RULE TO SHOW CAUSE AND NOW, this day of , 2007, upon consideration of the foregoing petition, it is hereby ordered that: (1) A Rule is issued upon the Respondent to show cause why the Petitioner is not entitled to the relief requested; (2) The Respondent shall file an Answer to the Petition within days of this date; (3) The Petition shall be decided under Pa. R.C.P. No. 206.7; (4) The depositions shall be completed within days of this date; (5) Argument shall be held on , 2007 in Courtroom of the Cumberland County Courthouse; and (6) Notice of the Entry of this Order shall be provided to all parties by the Petitioner. BY THE COURT: J. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff CIVIL ACTION NO. 06-3229 V. CHARLES E. SHAY, JR. Defendant PETITION TO AMEND CAPTION NOW COMES, Patricia J. Shay by Tracy D. Shay-Snyder as Plenary Guardian of the Person and Estate of Patricia J. Shay (the "Petitioner"), by and through her attorneys, Capozzi & Associates, P.C., and in support of its Petition to Amend Caption avers as follows: 1. Plaintiff Patricia J, Shay, acting through her daughter and Attorney In Fact Tracy D. Shay-Snyder commenced an action in this Court by filing a Complaint on June 6, 2006. 2. The Complaint was captioned: PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff V. CHARLES E. SHAY, JR. Defendant 3. Since the commencement of this action, and by Order of this Court, Patricia J. Shay has been declared an Incapacitated Person. (Order attached as Exhibit A). 4. Tracy D. Shay-Snyder has been named Plenary Guardian of the Person and Estate of Patricia J. Shay. 5. Petitioner prays leave to amend her aforesaid complaint by substituting the caption: PATRICIA J. SHAY An Incapacitated Person by TRACY D. SHAY-SNYDER as Plenary Guardian of the Person and Estate of Patricia J. Shay Plaintiff V. CHARLES E. SHAY, JR. Defendant 6. Defendant will not be prejudiced if relief is granted. 7. Defendant's counsel was contacted and he does not oppose the relief requested. WHEREFORE, the Petitioner, by Capozzi and Associates, her attorney, moves the Court to amend the caption of the Complaint as described above or in the alternative, grant a rule on the above named Defendant, to show cause why the caption of the Complaint filed in the above cause should not be amended as described above. Respectfully submitted, CAPOZZI & ASSOCIATES, P.C. Bruce G. Baron, Esquire Attorney I.D. No. 28090 Dougl A. Snyder, Esquire Attorney I.D. No. 204384 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) Attorneys for Plaintiff VERIFICATION I, Douglas A. Snyder, Esquire, hereby verify that I am the attorney for the Petitioner. I have sufficient knowledge or information based upon the investigation into this matter to make this verification. I hereby verify that the statements in the foregoing Petition are true and correct to the best of my knowledge, information and belief. I understand that false statements contained herein are made subject to the penalties of 18 Pa. C.S.A Section 4904 relative to unsworn falsification to authorities. Date: July 9, 2007 Douglas A. Snyder, Esquire Attorney I.D. No. 204384 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 (717) 233- 4101 (717) 233- 4103 (fax) Attorneys for Plaintiff IN RE: IN THE COURT OF COMMON PLEAS OF PATRICIA J. SHAY CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION An Incapacitated Person NO. 21-06-492 FINAL ORDER OF COURT APPOINTING PLENARY GUARDIAN AND NOW, this 8th day of September, 2006, following hearings held in this case on July 16, 2006, and September 8, 2006,. the Court now enters findings as follows, based upon the exhibits and testimony presented: 1. That PATRICIA J. SHAY is an individual, married to Charles E. Shay, Jr., on October 25, 1952, and she has two children, Tracy Shay-Snyder and Cory Shay. 2. That PATRICIA J. SHAY suffers from, among other things, Senile Alzheimer's Dementia, a condition which has now advanced to the point where the condition impairs her capacity to receive and evaluate information effectively, and now prevents her from making and communicating decisions concerning the management of financial affairs or to meet essential requirements for her physical health and safety. 3. That PATRICIA J. SHAY is now a resident of Claremont Nursing and Rehabilitation Center located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 4. That Daughter Tracy Shay-Snyder and Husband Charles E. Shay, Jr., acknowledge that from this day forward, said nursing facility (or a similar facility) is the most appropriate setting for the care and physical residence of PATRICIA J. SHAY. NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing findings, it is ORDERED, ADJUDGED, AND DECREED: A. That PATRICIA J. SHAY be and is hereby adjudged a m x- W totally incapacitated person. B. That Tracy Shay-Snyder is appointed Plenary Guardian of the Person of PATRICIA J. SHAY and shall have the authority to act on behalf of PATRICIA J. SHAY, to provide for the general care, maintenance and custody of PATRICIA J. SHAY. Further: 1. The Plenary Guardian shall arrange for medical, psychological and psychiatric services and social and vocational opportunities, as appropriate; 2. The Plenary Guardian shall assist PATRICIA J. SHAY in the development of maximum self-reliance and independence; 3. The Plenary Guardian shall have the authority to give consent for and to withhold surgical or medical treatment so long as Mr. Shay is notified as soon as practical, but in no event more than 24 hours after a decision is made in regards to providing or withholding such treatment. 4. The Plenary Guardian shall do nothing to interfere with the relationship between Charles Shay, Jr., and PATRICIA J. SHAY. Provided, however, that this provision shall not be construed as preventing the Guardian from pursuing any legal action to enforce or protect the rights of the incapacitated person vis-a-vis her husband or any other person. 5. Charles E. Shay, Jr., shall have the right to visit PATRICIA J. SHAY upon 48 hours notice to the Guardian, and he shall have the unrestricted right to receive full information about her status, care and treatment from all care-givers; and b. The Plenary Guardian shall file with the Clerk of the Court a report on the social, medical and other relevant conditions, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually thereafter. C. Tracy Shay-Snyder is hereby appointed Plenary Guardian of the Estate of PATRICIA J. SHAY and shall have the authority and responsibility to manage and use PATRICIA J. SHAY'S property for her benefit in accordance with 20 Pa. C.S.A. 5536(a). The Plenary Guardian for the estate shall file a report with the Clerk of the Court about assets, investments, receipts and disbursements, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually thereafter. The Plenary Guardian shall file an inventory with the Court in accordance with 20 Pa. C.S.A. Sections 5521 and 5142 within three months of this Order. The Plenary Guardian of the estate shall not be required to post a bond. D. Any existing general power of attorney, limited power of attorney and/or health care power of attorney executed by PATRICIA J. SHAY is hereby specifically revoked-and rendered null and void. E. PATRICIA J. SHAY has the right to appeal this Order by filing exceptions within ten (10) day to petition this Court for a review of hearing terminate the guardianship herein established. Petitioner is directed to have served upon and J. SHAY a copy of this Order and the Statement of which is attached hereto, and to file proof with this Court with ten (10) days. Al, 1By the Court, 71 V.4 Z l ?' S ? Di V?, s of this date or to modify or Counsel for read to PATRICIA of Rights, a copy of such service Iri l o.•ill l+???.•. (+lf, ? (Iti!?:: ??I?ItO lit lit, YI - ?. jl 111 {:;r)s lr()L{ft Edward E. Guido, J. CERTIFICATE OF SERVICE I, Douglas A. Snyder, do hereby certify that on this 9d' day of July, 2007, I served a true and correct copy of the foregoing Petition to Amend Caption, upon the following individuals by First Class U.S. Mail: Matthew M. Haar, Esquire C/O Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7t` Floor Harrisburg, PA 17101 (Attorney for Defendant) Rebecca M. Fuhrman Certified Legal Intern Nicole M. Walters, Esquire The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Douglas A. Snyder, Esquire Attorney I.D. No. 204384 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) Attorneys for Plaintiff r? C`7 ' ?F+'t IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay Plaintiff, CHARLES E. SHAY, JR., Defendant CIVIL ACTION - LAW NO. 06-3229 ORDER AND NOW, this l? J'Aay of , 2007, upon consideration of the foregoing petition: the Prothonotary is directed to substitute the following caption in the above named case: PATRICIA J. SHAY An Incapacitated Person by TRACY D. SHAY-SNYDER as Plenary Guardian of the Person and Estate of Patricia J. Shay Plaintiff V. CHARLES E. SHAY, JR. Defendant T: J. f ! / J N 4 J i 11 /t1S"1 Bruce G. Baron, Esquire Attorney I.D. #28090 Douglas A. Snyder, Esquire Attorney I.D. # 204384 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 2334101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY-SNYDER As Plenary Guardian of the Person and Estate of Patricia J. Shay, CIVIL ACTION - LAW Plaintiff, V. CHARLES E. SHAY, JR., Defendant NO. 06-3229 PLAINTIFF'S ANSWER TO DEFENDANT'S PRELIMINARY OBJECTIONS TO PLANTIFF_S SECOND AMENDED COMPLAINT. WITH MEMORANDUM OF LAW ATTACHED Plaintiff, by her Guardian Tracey D. Shay-Snyder, in answer and opposition to the Preliminary Objections filed by Defendant, states as to the allegations thereof: 1. Admitted. By way of further answer, Tracey D. Shay-Snyder was appointed the Plenary Guardian of Plaintiff, Patricia J. Shay, by Order of this Court entered on September 8, 2006 with the right to pursue legal action to enforce or protect the rights of Patricia J. Shay vis-a-vis her 2 husband, Defendant (copy of Order attached as Exhibit A). The Caption in this matter was changed to reflect those facts by Order of July 11, 2007. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. Admitted. First Preliminary Objection - Lack of Jurisdiction Over the Defendant 9. Admitted. 10. Admitted. 11. Admitted. 12. Admitted. 13. Admitted. 14. Admitted. 15. Denied. Since Defendant has not produced any evidence that he has sold, released, or otherwise divested himself of property titled in his name in Pennsylvania, but only expresses an intention about its use, Plaintiff considers the allegations of the Second Amended Complaint concerning Defendant's ownership of real property in Pennsylvania admitted. 16. Denied. Since Defendant has not produced any evidence that he closed his bank account(s) in Pennsylvania as of the date on which this Action 3 was commenced and served, Plaintiff considers the allegations of the Second Amended Complaint concerning Defendant's ownership of personal property in Pennsylvania admitted. 17. Admitted in part and denied in part. Admitted that Defendant is no longer able to care for Patricia J. Shay, that Defendant underwent open-heart surgery, and that Defendant is being treated for prostate cancer. Admitted that Patricia J. Shay was moved from Florida to Pennsylvania by her daughter, Tracey D. Shay-Snyder, who represented to Defendant that she would take care of her mother; however, it is denied that she represented that she would do so at her own expense or without support from Defendant for the reasons stated in the Complaint. Denied that Defendant did not consent to and participate in the decision to move his wife to Pennsylvania for care. Denied that Defendant did not contact anyone in Pennsylvania to arrange for his wife's care, as Defendant participated in qualifying his wife to receive Medical Assistance funded nursing facility benefits in Pennsylvania (see Exhibit B, attached) and consulted with his daughter to arrange for the care of his wife in Pennsylvania. Otherwise denied for the reasons stated in the Complaint. By way of further response, Plaintiff notes that, as confirmed in the Order attached as Exhibit A, Defendant has acknowledged that Patricia J. Shay is currently receiving care in the most appropriate place, i.e., the Cumberland County Home ("Claremont"). 4 18. Denied. Defendant has already consented to personal jurisdiction in Pennsylvania through participation in the Guardianship Proceedings for his wife before this Court and is subject to an on-going Order (attached as Exhibit A) entered in that matter concerning his rights as to his wife. 19. Denied. Defendant's wife is receiving on-going nursing facility care in Pennsylvania; his children and grandchild reside in Pennsylvania; and, he is subject to an on-going Order (attached as Exhibit A) entered in the Guardianship Proceedings concerning the care of his wife which terminated his Power of Attorney on behalf of his wife and establishes certain rights as to his continuing relationship with his wife. 20. Denied. Defendant obtained medical care for himself at Holy Spirit Hospital, Cumberland County, Pennsylvania after his wife was moved here for care; is subject to an on-going Order (attached as Exhibit A) entered in the Guardianship Proceedings concerning the care of his wife which terminated his Power of Attorney on behalf of his wife; and participated in seeking Medical Assistance benefits to pay for his wife's care in Pennsylvania (see Exhibit B). 21. Denied. Defendant participated in seeking Medical Assistance benefits to pay for his wife's care in Pennsylvania and is subject to an on-going Order (attached as Exhibit A) entered in the Guardianship Proceedings concerning the care of his wife which terminated his Power of Attorney on behalf of his wife and which established his visitation and other rights with respect to his wife thereafter. 5 22. Denied in part and admitted in part. Admitted that Defendant is a non- resident. Otherwise denied as a conclusion of law and in error. 23. Denied. This is a conclusion of law and is in error. 24. Denied. This is a conclusion of law and is in error. WHEREFORE, the Court should DISMISS Defendant's First Preliminary Objection. A proposed form of Order and Memorandum in Opposition to the relief requested by Defendant is attached hereto. Second Preliminary Objection - Nonjoinder of Necessary Party 25. Plaintiff incorporates its responses for paragraphs 1-24. 26. Admitted. 27. Admitted. 28. Admitted. 29. Admitted in part and denied in part. Plaintiff is seeking support to make payment of unpaid bills due to Claremont and others, including related legal expenses for her to obtain a Guardian, qualify for Medical Assistance, and pursue this support action. Mrs. Shay owes Claremont $13,946.60 through February 28, 2007. The amount due to Claremont is based on the monthly amounts determined by the Pennsylvania Medical Assistance Program to be due from Mrs. Shay's income; and, neither Mr. Shay nor Mrs. Shay appealed that determination. The legal expenses incurred on behalf of Mrs. Shay total $18,361 through January 31, 2007, 6 against which $12,263.31 from Mrs. Shay's income was applied to date and not paid against her bills to Claremont. Mr. Shay has paid none of the $18,361 expenses incurred on behalf of his wife or any of the amount remaining due to Claremont that are the result of actions to obtain her guardianship and qualify her for Medical Assistance, and now to obtain support that he refused to provide to her. Mr. Shay instead transferred all assets in which Mrs. Shay had an ownership interest in Florida into his own name. Otherwise denied. 30. Admitted in part and denied in part. Plaintiff is seeking support to make payment of unpaid bills due to Claremont and others, including related legal expenses for her to obtain a Guardian, qualify for Medical Assistance, and pursue this support act. Otherwise denied as a conclusion of law that requires no response. 31. Denied. This is a conclusion of law that requires no response and is in error. 32. Denied. This is a conclusion of law that requires no response. Creditors are not required as parties to this action in order to do justice in this support action since the issue in this matter is Defendant's ability to provide for his wife's necessary expenses as otherwise required by law, there being no dispute as to what those expenses are, that Defendant has paid for none of them, or that his wife is unable to pay for any of them. By way of further response, Claremont has notice of this action and has not chosen to intervene or join as a party plaintiff. 7 WHEREFORE, the Court should dismiss Defendant's Second Preliminary Objection. A proposed form of Order and Memorandum of Law in Opposition to the relief requested by Defendant is attached hereto. Date: YIIPI`?all?? Respectfully Submitted CAPOZZI AND ASSOCIATES, P.C. By: 0?1 ,. Bruce G. Baron, Esquire Attorney I.D. No. 28090 Douglas A. Snyder, Esquire Attorney I.D. No. 204384 2933 North Front Street Harrisburg, PA 17110-1250 (717) 233- 4101 (717) 233- 4103 (fax) Attorneys for Plaintiff 8 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY-SNYDER As Plenary Guardian of the Person and Estate of Patricia J. Shay, CIVIL ACTION - LAW Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant VERIFICATION I, Tracy D. Shay-Snyder, do hereby depose and state that the facts contained in the foregoing Answer to Defendant's Preliminary Objections to Plaintiff's Second Amended Complaint are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4094, relating to unworn falsification to authorities. Date: 9110107 9 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated . Person, by TRACY D. SHAY-SNYDER : CIVIL ACTION - LAW As Plenary Guardian of the Person and . Estate of Patricia J. Shay, Plaintiff, v. CHARLES E. SHAY, JR., Defendant NO. 06-3229 COMPLAINT STATMENT OF QUESTIONS PRESENTED 1. DOES THE COURT HAVE PERSONAL JURISDICTION OVER THE SUPPORT AND RELATED CLAIMS OF A WIFE RESIDING IN PENNSYLVANIA AGAINST HER HUSBAND, A RESIDENT OF FLORIDA, WHERE: (a) THE SPOUSES WERE MARRIED AND FORMERLY RESIDED TOGTHER IN PENNSYLVANIA; (b) THE SPOUSES' CHILDREN LIVE IN PENNSYLVANIA; (c) THIS COURT APPOINTED A GUARDIAN FOR THE WIFE, INVALIDED THE HUSBAND'S POWER OF ATTORNEY AND GRANTED THE HUSBAND VISITATION RIGHTS IN A PROCEEDING IN WHICH THE HUSBAND PARTICIPATED; (d) WITH THE HUSBAND'S KNOWLEDGE, THE WIFE IS CURRENTLY RECEIVING ON-GOING MEDICAL CARE IN PENNSYLVANIA; AND (e) THE HUSBAND PARTICIPATED IN THE WIFE'S APPLICATION FOR MEDICAL ASSISTANCE PROGRAM BENEFITS IN PENNSYLVANIA THAT THE WIFE IS CURRENTLY RECEIVING? Suggested Answer -YES 2. IS THE FACILITY PROVIDING THE ON-GOING MEDICAL SERVICES TO PLAINTIFF AN INDISPENSIBLE PARTY TO THIS SUPPORT ACTION? Suggested Answer - NO 10 PROCEDURAL STATUS efendant (hereinafter "Mr. Shay") has filed Preliminary Objections in this matter, o jetting that this Honorable Court lacks personal jurisdiction over him and lacks subject matter jurisdiction for failure to join Cumberland County, which is providing care to Plaintiff, Mrs. Shay, at the county home, Claremont Nursing and Rehabilitation Center of Cumberland County ("hereinafter, Claremont), in Carlisle. Since all Preliminary Objections must be asserted at one time, Pa. R.Civ.P. Rule 1028(b), Mr. Shay has waived all other Preliminary Objections at this preliminary stage of the proceedings. Lexington Insurance Co. v. Insurance Department, 541 A.2d 834 (Pa. Cmwlth. 1988); Ellenbogen v. PNC Banc, NA, 731 A.2d 175 (Pa. Super. 1999). STANDARD OF DECISION A ]preliminary objection asserting lack of personal jurisdiction may be sustained only in the clearest of cases. Hall-Woolford Tank Co., Inc. v. R.F. Kilns, Inc., 698 A.2d 80, 82 (Pa. Super. 1997); Scordato v. Dyess, 73 Pa. D.&C.0' 360, 364 (Court of Common Teas, Centre County, 2005) ("only if it is quite clear that no jurisdiction exists") (citing Hall-Woolford Tank Co, Inc.). Preliminary Objections must be denied unless it is clear and free from doubt from all the facts pleaded and all reasonable inferences] therefrom that Plaintiff will be unable to prove facts sufficient to establish or a right to relief. Hospital Healthsvstem Association of Pennsylvania v. 585 Pa. 106, 116 at FN 12, 888 A.2d 601, 607 at FN 12 (2005); WOrner v. Zazyczny, 545 Pa. 470, 578, 681 A.2d 1331, 1335 (1996). Where any doubt exists, a Preliminary Objection must be overruled. R.W. v. Manzek. 585 Pa. 335, 11 351-352,'I888 A.2d 740, 749 (2005); Scooggins v. Scoggins, 555 A.2d 1314, 1317 (Pa. Super. 1589). Tie party raising the preliminary objection to personal jurisdiction must come forward with evidence, beyond the bare allegations of the preliminary objections, in support of his objections. Scoggins v. Scoggins. Where the evidence before the court is conflictinjg or insufficient to determine the question, the court must permit the parties a reasonable period of time to present evidence by deposition, interrogatories or otherwise prior to determining the preliminary objections. Scoggins v. Scoguins. Since Mr. Shay has not came forward with any evidence other than the bare allegations of his preliminary objections and the he has had sufficient time to come forward with additional evidence to support them since filing them on December 11, 2006, his objections should be dismissed, The reasonableness of asserting jurisdiction over a non-resident of Pennsylvania is not susceptible to mechanical application and the sufficiency of the affiliating circumstances to support personal jurisdiction must be determined by weighing the specific facts of each case. Kulko v. Superior Court of California in and for the County of San Francisco 436 U.S. 849 92 (1978) (hereinafter, Kulko ; Rogers v. Rogers, 441 A.2d 398 (Pa. Super. 1982). In this case, the undisputed facts clearly support jurisdiction over Mr. 12 ARGU NT 1i The Court has personal jurisdiction over Defendant, Mr. Shay The uncontested facts of this case establish that Mr. Shay has sufficient contacts with Pennsylvania for this Court to exercise personal jurisdiction over him in this case. Having pkeviously invoked the jurisdiction of this very Pennsylvania Court to establish his rightsl to continuing contact with his wife while she is receiving care in Pennsylvania at Claremont, which Mr. Shay himself acknowledged to this Court is the most appropriate setting for Mrs. Shay's care and residence (Finding No. 4 in Final Order of Court Appointing Plenary Guardian, Exhibit A, attached), Mr. Shay's assertion of lack of sufficient' contacts with Pennsylvania to support this Court's personal jurisdiction over him is without merit. The law is well-settled in Pennsylvania that where spouses were married in Pennsylvania, had residence in Pennsylvania, and the wife is a resident of Pennsylvania, the other spouse, even if domiciled in a different State, has sufficient contacts with Pennsylvania by reason of the marriage itself for personal jurisdiction to perfect upon service of: a complaint by wife involving the obligations of the out-of-state husband to the Pennsylvania-domiciled spouse, especially where, as here, the spouses are parties to an on-going order of a Pennsylvania court (here, the Order appointing a Plenary Guardian for Mrs. Shay, providing for Mr. Shay's visitation rights, and voiding his power of attorney f om his wife) (copy of Order attached as Exhibit A). Carney v. Dahlmann, 624 A.2d 197,1199 (Pa. Super. 1993); Novich v. Novich, 42 Pa. D.&C.4' 548 (Court of Common Pleas, Lawrence County, 1999). The test for personal jurisdiction in such actions is Scogains v. Scoggim 555 A.2d at 1319-1320 (Pa. Super. 13 1989); Nf ovich v. Novich. The mere fact of prior residence in Pennsylvania can be to sustain personal jurisdiction. Scoggins v. Scoggins, 555 A.2d at 1322. In this case,l the relevant facts are uncontested and Mr. Shay's Preliminary Objection must be denied as without merit. This Honorable Court has previously exercised jurisdiction with respect to the relationship between Mr. and Mrs. Shay in the Order of September 8, 2006, entered in the guardianship proceedings for Mrs. Shay, at Orphans' Court Division No. 21-06-492 (Exhibit A attached), in which Mr. Shay's power of attorney from Mrs. Shay was nullified and Mr. Shay was granted specific visitation, information and notice rights relating t4 his wife. The need for a guardian for Mrs. Shay arose both from Mrs. Shay's physical and mental condition and from testimony that Mr. Shay was not exercising his power of attorney from Mrs. Shay in her best interests and may have diverted Mrs. Shay's assets to his own use without any accounting. Inlthis case, Mr. and Mrs. Shay were married and domiciled in Pennsylvania prior to relocating to Florida. As alleged in the Second Amended Complaint, Mr. Shay agreed to the relocation of Mrs. Shay back to Pennsylvania for care and to provide support for that care in Pennsylvania. As alleged in the Second Amended Complaint, Mr. Shay also to have property interests in Pennsylvania. Mr. Shay and Mrs. Shay previously received care in Cumberland County, Pennsylvania, near the current domiciles of their children, even after their move to Florida. After an inpatient stay in Florida, Mr. Shay came to Holy Spirit Hospital in County, Pennsylvania, to receive care near his wife and family prior to his wife's admission to Claremont. 14 all times relevant to this complaint, Mr. Shay's wife has been receiving care in with his knowledge. When Mr. Shay and Mrs. Shay were married in Mr. Shay assumed the legal obligation to make payments for his wife's care and other needs; and, that obligation is imposed as an incident of their marriage and cannot be relieved by separation. Porter v. Karivalis, 718 A.2d 823, 827 (Pa. Super. 1998), cuing Samuels v. Hirz, 151 A.2d 640, 641 (Pa. Super. 1959). Shay was purposefully moved to Pennsylvania because Mr. Shay, her power of attorney and husband, as admitted in his Preliminary Objections at ¶17, could no longer care for her in Florida. She was moved to Pennsylvania with his knowledge and consent in order to continue to provide for her care, the same kind of care that Mr. Shay alleges he provided as long as he was able to do so, as stated in his Preliminary Objection at 117. As demonstrated by the Record in Mrs. Shay's guardianship proceedings, Mr. Shay continued to have and exercise a power of attorney from his wife prior to her relocation to Pennsylvania and thereafter until it was nullified by this Honorable Court. Shay has contacts in Pennsylvania related to his family (his two children and his grandchild reside here) and specifically with respect to his wife. Mr. Shay icipated in his wife's application for Medical Assistance Program benefits, for which his wife h s qualified (Exhibit B, attached). The Cumberland County Assistance Office wrote to P aintiff specifically noting that Mr. Shay had provided verification of his and Mrs. Shay s resources as part of the application process (Exhibit B, attached). Mr. Shay was a party before this Honorable Court in his wife's guardianship proceeding and requested and obtained on-going visitation rights as part of that proceeding 15 (Exhibit ?k). Exhibit A also invalidated Mr. Shay's power of attorney from Mrs. Shay, thereby asserting this Honorable Court's on-going jurisdiction over Mr. Shay's exercise of that power of attorney. Having invoked the jurisdiction of this Honorable Court to obtain visitation rights to maintain his contacts with his wife in Pennsylvania and being subject to the on-going supervision of this Honorable Court, Mr. Shay, under the isputod facts of this case, has sufficient contacts with Pennsylvania for his wife to seek support from him in Pennsylvania where she now resides subject to those same visitation rights. Carney v. Dahlmann; Scogains v. Scog ig ns; Novich v. Novich. mice Mr. Shay plainly has continuing and significant contacts with Pennsylvania, including with respect to his wife's care in Claremont, Mr. Shay's First Preliminary is without merit and should be overruled. 2. That is not an party in that spouse's support action under 23 Pa. C.S. § 4603 against the other spouse to have those services paid by the other spouse. See, for example: lavoy v. Savoy. 641 A.2d 596 (Pa. Super. 1994) (Support payments ordered toward unpaid bills due to mother's prior medical providers without requiring them to be joined as i*dispensable parties, determined under prior uncodified version of the statute at 62 P.S. § 1973). Plaintiff's Nursing Home Is Not an Indispensable Party Defendant asserts that Claremont is an indispensable party to this litigation. correct. A creditor that provided services to one spouse that remains unpaid is 16 Mr. Shay wishes to join Cumberland County as a party to this matter or to limit not an and has cause of action that the Home might bring against him, he is free to do so, isgle, 3 Pa. D.&C.4t` 1989 (Court of Common Pleas, Erie County, 1989) i?g joinder of health insurance company in support dispute, even though it was party); Pa. R.Civ.P. 2232(a). Claremont has notice of this action chosen to intervene or join as a party to date. if this Honorable Court were to determine that Claremont is an party, this Honorable Court must order the Home's joinder and hold this matter in that the idi also: until it is joined and not dismiss the action, since there is no allegation of the Home is impossible. Pa. R.Civ.P. Rules 1032(b), 2232(c); see 25 Phila. Co. Rptr. 320 (1993) (ordering joinder). however, is not an indispensable party. is case involves the support obligation of Mr. Shay to his wife, who happens to be a resid expenses guardian exercisin husband f resulting f fund these obtain Me for care at of Claremont. The expenses involved are the amount of Mrs. Shay's legal obtaining Medical Assistance benefits to pay for her care, obtaining a her husband was no longer able to provide for her care and was his power of attorney contrary to her interests, and in seeking support from her her expenses, as well as the unpaid portion of Mrs. Shay's bill at Claremont her using her funds intended to pay her share of the bill at Claremont to necessary legal services. The related legal expenses were required for her to Assistance Program coverage for most of her past and on-going charges thereby reducing her own and Mr. Shay's liability for such 17 charges; to obtain a guardian to be free from Mr. Shay's authority over her care and assets; and, to obtain Mr. Shay's contribution to these necessary expenses. amount of Mrs. Shay's obligations to Claremont cannot be in dispute because those amounts are established by the Pennsylvania Medical Assistance Program as part of Mrs. Shay's eligibility determination, a process in which Mr. Shay participated. Mrs. Shay owes Claremont $13,946.60 through February 28, 2007. The legal expenses incurred on behalf of Mrs. Shay total $18,361 through January 31, 2007, against which $12,263.1 from Mrs. Shay's income has been applied to date and not paid against her bills to Claremont. Mr. Shay has paid none of the $18,361 expenses incurred on behalf of his wi or any of the amount remaining due to Claremont that are the result of actions to obtain er guardianship and qualify her for Medical Assistance, and now to obtain support that he was refusing to provide to her. Mr. Shay instead transferred all assets in which Mrs. Shay had an ownership interest in Florida into his own name. . Shay's only payment obligations to Claremont involved in this matter, as amended, arise from her duty to pay for a part of the Medical Assistance Program payment to Claremont for her care, also referred to as the "patient pay amount." 55 Pa. Code § § 181.451 et seq. The patient pay amount is set by the County Assistance Office in its dete coverage, for her ca W Shay's pa amount o of Mrs. Shay's eligibility. By qualifying for Medical Assistance Shay substantially reduced her liability and that of Mr. Shay to Claremont both Mr. and Mrs. Shay had a right to contest the determination of Mrs. pay amount by the County Assistance Office, neither has appealed the Mrs. Shay's share of the cost of care; and, therefore, Mr. Shay cannot contest 18 those amounts in this matter. See: 55 Pa. Code § 181.452(d)(2); 62 P.S. § 423(a), 42 U.S.C. § ?1396r-5(e), Davis v. Department of Public Welfare, 776 A.2d 1026 (Pa. Cmwlth. 2001) (all relating to Mr. Shay's right to appeal the determination of Mrs. Shay's patient pay amount); see also: Potratz v. Department of Environmental Protection, 897 A.2d 16, 20 (Pa. Cmwlth. 2006) (failure to pursue or exhaust statutory remedy later dispute with issues that could have been determined through that process). There is no dispute between Mrs. Shay and Claremont over the amount that Mrs. Shay owes to Claremont for her patient pay amount. Since that amount is established by law and is now final as a matter of law, Mr. Shay cannot contest here what he left uncontested before. Pennsylvania Medical Assistance Program has paid for all of the rest of the charges for Mrs. Shay's stay at Claremont and is paying its share of the charges for her on-going care there. The Pennsylvania Medical Assistance Program is precluded by law from seeking reimbursement from Mr. Shay for its payments to Claremont on behalf of Mrs. Shay's care. 42 U.S.C. § 1396p(b); 62 P. S. § 447(a). *. Shay's responsibility to assist Mrs. Shay, as needed, with the payment of her necessary expenses is established by law. 23 Pa. C.S. §§ 4102, 4603. Nothing involved in this support action can affect Claremont's rights to receive the patient pay amount owed to Claremont by Mrs. Shay as established by the County Assistance Office. Mrs. Shay is paf ying her patient pay amount to Claremont for the month of March, 2007 and on-going hereafter. In this matter, as amended, Mrs. Shay is seeking contribution from Mr. Shay only for her necessary expenses incurred prior to March, 2007, as permitted by law. 19 Shay, in addition, has the right to obtain her Medical Assistance covered nursing *cility services from the provider of her choice. 42 U.S.C. § 1936a(a)(23)(A); 62 P.S. §? 444.1, 1405(a); 42 CFR § 431.51(b)(1); 55 Pa. Code § 1101.51(a) (all relating to recipient freedom of choice of providers of services). As found by this Court in the Order of September 8, 2006 (Exhibit A) at 14, Mr. Shay has acknowledged that is the most appropriate setting for the care and physical residence of Mrs. Shay. He should not be heard to contest in this matter that it is not or that Mrs. Shay should be receiving care somewhere else. Federal regulations require Mrs. Shay to pay a portion of the cost of her care (the patient pay amount) whether she receives Medicaid services in Pennsylvania or in Florida. 42 CFR §§ 435.700 et seq. While Federal law permits Mrs. Shay's patient pay amount to be reduced if needed to support Mr. Shay, 42 U.S.C. § 1396r-5(d)(1); 42 CFR §§ 435.7 =to (2) (which results in the amount paid by the Pennsylvania Medical Claremont making up the difference), Mr. Shay did not seek or establish the need for such maintenance support from Mrs. Shay's income as part of establishing her eligibility for Medical Assistance in Pennsylvania. Since Mr. Shay could hav6, but has failed to exhaust the mandated statutory remedy provided by 62 P.S. § 423(a) a?d 42 U.S.C. § 1396r-5(e) before the Department of Public Welfare on the question of permitted reductions of Mrs. Shay's patient pay amount, Mr. Shay cannot contest the amount of that obligation before this Court or require the joinder of Claremont to reach s? ch questions. Potratz v. Department of Environmental Protection. support obligation of Mr. Shay was established when the parties were married m re than fifty years ago and has not changed. The right to receive support from 20 Mr. Shay is the right that Mrs. Shay has asserted. Mr. Shay is required to support his wife's necessary legal expenses in obtaining Medical Assistance Program benefits, ining the guardianship, and otherwise obtaining support that he has been unwilling to provide by making up the difference in her patient pay payments to Claremont left unpaid because 1 e left her to fund those expenses from the only income and resources he left her with, which was intended to be used to pay Claremont. See: U.S. v. O'Neill, 478 F.Supp. 176 (E.D? Pa. 1979) (Cost of legal representation of indigent husband must be paid by able wife); In re: Sharpless' Estate, 39 Pa. D.&C.3d 217 (Chester County Orphans' Court, 1980) (Estate of incompetent father may be charged for legal expenses incurred on behalf of child); 23 Pa. C.S. § 4603. A determination of the amount of Mr. Shay's obligation to support his wife's legal expenses does not involve any issues related to A does not i 's rights to receive payment from Mrs. Shay. on the question of Mr. Shay's support obligation for such expenses also it Claremont's rights. See: Powell v. Shepard, 381 Pa. 405, 412, 113 A.2d 261, 265 1955) (Indispensable party is one whose rights are so connected with the claims of the litigants that no decree can be made between the parties without impairing those rights); Sharkus v. Blue Cross of Greater Philadelphia, 494 Pa. 336, 431 A.2d 883 (1981), and on remand at 8 Phila. Co. Rptr. 656, 667 (1983) (Where meaningful relief can be grated without joinder of another party and without affecting that party's rights to relief, that party is not indispensable). Support actions have never required the joinder of the creditors of the party seeking support as indispensable parties. See: Savoy v. Savoy. Claremont's contract is with Mrs. Shay and her guardian, not with Mr. Shay, as p inted out in Mr. Shay's own Preliminary Objections. While Claremont may 21 have separate causes of action against Mr. Shay if Mrs. Shay in unable to pay her bills to 23 Pa. C.S. §§ 4102 (relating to Mr. Shay's duty to pay Claremont for her unpaid " ecessaries"), 4603 (relating to Claremont's right, as well as Mrs. Shay's to seek support om Mr. Shay for her care), 4605 (relating to Claremont's right to sue on behalf of Mrs. S ay for moneys due to her, if required), those causes of action are not impaired by Mrs. Shay's support action against Mr. Shay. In addition, Claremont's interests are isq protected by statute and court supervision of the management of Mrs. Shay's support moneys by Mrs. Shay's court-appointed guardian. Legislature has expressly provided protection for Claremont's interests by that Claremont may be substituted as the plaintiff in any money judgment obtained by Mrs. Shay (23 Pa. C.S. § 4605(b), "If the amount due has been reduced to a the public body or public agency may be substituted as a plaintiff in the Here, however, as in Savoy v. Savoy, Mrs. Shay's complaint already seeks to direct payment to satisfy Claremont's bills, as well as those of her other unpaid creditors. Therefore, the joinder of Claremont in this case is not required to protect s rights. While the Legislature has also expressly provided that, to the extent another r4ative or friend, such as Mrs. Shay daughter, Tracey Shay-Snyder (who is also her guardian), is providing support for her pending the liquidation of money due to Mrs. Shay, any recovery beyond that required to reimburse Claremont and Mrs. Shay's other creditors i to go to that person (23 Pa. C.S. § 4605(c)), Mrs. Shay-Snyder is not seeking such relie in this matter and is only seeking support sufficient to pay off Mrs. Shay's unpaid obligations and not any future support. to the Order of September 8, 2006 appointing Mrs. Shay's guardian, the 22 guardian ?is required to manage and use Mrs. Shay's property for her benefit and to file annual reports with the Clerk of this Court concerning same. See: In re Easly, 771 A.2d 844, 852 (Pa. Cmwlth. 2001) (Guardian is officer of the court and always under the court's control and direction); In re: Hill's Estate 64 Pa. D.&C.2d 94 (Philadelphia Orphans' Court, 1974) (Property received by guardian is within the custody of the court). This cannot protected supervision also provides sufficient protection of Claremont's interests in the use of the proceeds of this support action to conclude that Claremont's rights impaired by determining Mr. Shay's support obligations in this matter. Since 's right to relief is separate and distinct, not subject to dispute, and otherwise law, Claremont is not an indispensable party; and, Mr. Shay's Second Objection should be overruled. Plaintiff respectfully submits that Defendant's Preliminary Obi dismissed are without merit as a matter of law and that they should therefore be overruled. Respectfully Submitted Date: CAPOZZI AND ASSOCIATES, P.C. By: /6 ?QG Bruce G. Baron, Esquire Attorney I.D. No. 28090 Douglas A. Snyder, Esquire Attorney I.D. No. 204384 2933 North Front Street Harrisburg, PA 17110-1250 (717) 233- 4101 (717) 233- 4103 (fax) Attorneys for Plaintiff 23 . gPI?.006 IN IN THE COURT OF COMMON PLEAS OF PATRICIA J. SHAY CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION An In apacitated Person NO. 21-06-492 FINAL ORDER OF COURT APPOINTING PLENARY GUARDTJM AND NOW, this 8th day of September, 2006, follo ing hearings held in this case on July 16, 2006, and Sept er 8, 2006,. the Court now enters findings as follows, based upon the exhibits and testimony presented: 1. That PATRICIA J. SHAY is an individual, married to Ch rles E. Shay, Jr., on October 25, 1952,.and she has two child en, Tracy Shay-Snyder and Cory Shay. 2. That PATRICIA J. SHAY suffers from, among other thing , Senile Alzheimer's Dementia, a condition which has now advanced to the point where the condition impairs her capacity to rec ive and evaluate information.effectively, and now preven s her from making and communicating decisions concerning the ma agement of financial affairs or to meet essential requir ents for her physical health and safety. 3. That PATRICIA J. SHAY is now a resident of Clarem nt Nursing and Rehabilitation Center located at 1000 Clarem nt Road, Carlisle, Pennsylvania 17013. 4. That Daughter Tracy Shay-Snyder and Husband Charle E. Shay, Jr., acknowledge that from this day forward, said n rsing facility (or a similar facility) is the most approp late setting for the care and physical residence of PATRICI J. SHAY. NOW, THEREFORE, based on the clear and convincing evident supporting the foregoing findings, it is ORDERED, ADJUDG AND DECREED: EXHIBIT A A. That PATRICIA J. SHAY be and is hereby adjudged a totally incapacitated person. B. That Tracy Shay-Snyder is appointed Plenary an of the Person of PATRICIA J. SHAY and shall have the autho ity to act on behalf of PATRICIA J. SHAY, to provide for the g neral care, maintenance and custody of PATRICIA J. SHAY. r: 1. The Plenary Guardian shall arrange for medic 1, psychological and psychiatric services and social and vocational opportunities, as appropriate; 2. The Plenary Guardian shall assist PATRICIA J. SHAY i the development of maximum self-reliance and independence; 3. The Plenary Guardian shall have the authority to giv consent for and to withhold surgical or medical treatment so lon as Mr. Shay is notified as soon as practical, but in no event re than 24 hours after a decision is made in regards to provid ng or withholding such treatment. 4. The Plenary Guardian shall do nothing to interf re with the relationship between Charles Shay, Jr., and PATRIC A J. SHAY. Provided, however, that this provision shall not be construed as preventing the Guardian from pursuing any legal ction to enforce or protect the rights of the incapa itated person vis-a-vis her husband or any other person. 5. Charles E. Shay, Jr., shall have the right to visit TRICIA J. SHAY upon 48 hours notice to the Guardian, and he shal have the unrestricted right to receive full information about h r status, care and treatment from all care-givers; and 6. The Plenary Guardian shall file with the Clerk o the Court a report on the social, medical and other relevan conditions, as required by 20 Pa. C.S.A. Section 5521(c) within twelve months of this Order and annually then after. C. Tracy Shay-Snyder is hereby appointed Plenary Guar ian of the Estate of PATRICIA J. SHAY and shall have the autho ity and responsibility to manage and use PATRICIA J. SHAY' property for her benefit in accordance with 20 Pa. C.S.A. 5536( ). The Plenary Guardian for the estate shall file a repor with the Clerk of the Court about assets, investments, recei is and disbursements, as required by 20 Pa. C.S.A. Section 5521( ), within twelve months of this Order and annually there fter. The Plenary Guardian shall file an inventory with the C urt in accordance with 20 Pa. C.S.A. Sections 5521 and 5142 ithin three months of this Order. The Plenary Guardian of the a tate shall not be required to post a bond. D. Any existing general power of attorney, limited power of attorney and/or health care power of attorney executed by PA RICIA J. SHAY is hereby specifically revoked-and rendered null d void. E. PATRICIA J. SHAY has the right to appeal this Order y filing exceptions within ten (10) days of this date or to petition this Court for a review of hearing to modify or termin to the guardianship herein established. Counsel for Petiti ner is directed to have served upon and read to PATRICIA J. of whi with a copy of this order and the Statement of Rights, a copy is attached hereto, and to file proof of such service is Court with' ten (10) days. By the Court, _ iI C CI:?I , Z I S 1 ??! !!?. CC)r :1:.)i`A HEGU1RD Ire l'I ?f. i fitt0 ;J6 illw 14T, . : i j? ? u 1::ar?S ?,:uVCt,?p Edward E. Nich THE 45 N Carl 2933 Harr a M. Fuhrman, Certified Legal Intern e M. Walters, Esquire DER LAW CLINIC th Pitt Street le, PA 17013 a Craig Sloan, Esquire I & ASSOCIATES orth Front Street burg, PA 17110 srs Commonwealth of Pennsylvania Department of Public Welfare CUMBERLAND COUNTY ASST OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, PA 17013-0599 Telephone 240-2744 OR 1-800-269-0173 ext 3744 FAX: 249-0919 April 27, 2005 Tracy Snyd 2713 Colum is Ave Camp Hill, A 17011 Re: Patricia Shay CNRC Case 97630 Dear Mrs. Enclosed p ,ease find the Results of the Resource Assessment for Mrs. Shay. Mr. Charles Shay provided v fication that he has several bank accounts which when combined with Mrs. Shay's accounts to $37464.85. According to Nursing Home regulations, Mr. Shay is able to keep $19020.00 o the total resources. He can either complete the enclosed Income Assessment Worksheet t see if he can keep additional resources to maintain himself in the community, or he can use the a cess to pay Nursing Home or other medical expenses and provide this office with verification. ee attached Manual Regulation, if neither of these options apply to your situation, the resources must be reduced before she can be determined eligible for Nursing Home Medical Assistance. I have encl sed a new application which needs to be completed listing the reduced resources when you ready to reapply. Call me if you have any questions. I have sent a copy of this notice and th Results of the Resource Assessment to Mr. Shay. Sincerely, Lynne Gordon IMC Copy: Mr. Charles Shay 8 Commonwealth of Pennsylvania Department of Public Welfare CUMBERLAND COUNTY ASST OFFICE 33 Westminster Drive P.O. Box 599 Dear MR: The Del APRIL resources is _$ 3746 -----------u Carlisle,--PA--l7O13-Q59-2 Telephone 240-2744 OR 1-800-269-0173 FAX: 249-0919 RESULTS OF RESOURCE ASSESSMENT PATRICIA J. SHAY, ulment of Public Welfare has completed the Resource Assessment received on ;6, 2005. Based on the information you provided, the total value of the countable wned by you and your spouse as of the date of your admission to the nursing facility .85 _. A copy of the Resource Assessment Form is enclosed purp se of the assessment was to determine what portion of the total resources owned by you and yo spouse may be protected for the spouse at home. This portion is called the "protected ,pousal. share" and is not considered available to pay for nursing facility care. This protected usal share is generally one-half of your joint resources, up to a maximum, set by federal la urrently $95,100) and not less tan h a minimum (currently $19,020). Based on that formula, ;u"r protected spousal share is $19020.00 . Except described below, you should apply for Medical Assistance when the total countable resources you and your spouse are reduced to an amount approximately equal to the protected spousal s e (above) plus $2,400. In some , more resources may be protected for the spouse at home. In order to be able to protect mo a resources, you must apply for Medicaid sooner and request a hearing. Information describing when you are permitted to protect more resources for your spouse at home was included ' Part 3 of the Admissions Notice Packet you received from the Nursing facility when you were admitt You should refer to this information if the income of the spouse at home is less than $ 378 per month. If you need another copy of Part 3, contact the admission office of your nuns' g facility. It is im rtant for you to calculate the monthly income allowance and actual monthly income needs of th spouse at home in order to appropriately protect resources and provide income to your spous at home as permitted by federal law. The enclosed worksheet will help you in making thi determination, Once yo have applied for Medicaid benefits, either you or your spouse may request a fair hearing if you are dissatisfied with the Department's det in 'on of the community spouse's share of r urces or monthly income allowance, or to establish that your spouse should receive a higher in me or resource allowance. If you have any questions about this letter, youmay contact me by telephone at 240-2744.or I- 800-269-01.73 or by writing to the address above. LYNNE GORDON Copies: N *sing Home INCOME ASSESSMENT WORKSHEET You, the s use living at home, are entitled to a minimum protected monthly income level. Currently, t level is $1562, plus shelter costs over $469, up to no more than a total of $2378. The folio g chart will enable you to compute your own protected monthly income level and your actual onthly income. The allowances for utility costs are based on a set standard, not on your actual costs. If you pay separately (for example, not included in rent) for heating and/or cooling and for other utilities you should ter $374.00 in the appropriate space in the chart below. If you do not pay for heating or cooling, but pay for other utilities (besides telephone service), your should enter $201. If you do not have any utility costs, but pay only for telephone service, you should enter $29. For all oth shelter items, compute and enter your actual monthly cost, even if you pay on another time basis (for example, quarterly or annually). If you do not make payments for a specific item leave that item blank. MONTHLY EXPENMURES (1) UTIL S ($374, $201, OR $29) (1) (2) RENT (2) (3) MORTG AGE (PRINCIPAL & INTEREST) (3) (4) REAL E STATE TAXES (MONTHLY) (4) (5) HOME ER'S INSURANCE (MONTHLY) (5) (6) CONDO WINIUM FEES (6) (7) SUB T AL (ADD LINE 1-6) (7) (8) LESS $4 59 (8) :-469.00 (9) YOUR HELTER COSTS ____ (9) (10) C NT FEDERAL BASE LEVEL (10) 1562.00 (11) PLUS OUR SHELTER COSTS (LINE 9) (11)+ (12) TOTAli - MONTHLY INCOME ALLOWANCE (12) This total i the minimum monthly income amount which you are entitled to as a community spouse, and Federal Medicaid law. If your total is greater than $2378, the Department of Public Welfare will use the figure of $2378, because that is the maximum allowance under federal law. -2- TO DETER?M YOUR ACTUAL MONTHLY INCOME, USE THE FOLLOWING MONTHLY INCOME OF SPOUSE AT HOME (13) SOC SECURITY (13) (14) PENSIONS (14) (15) OTHER (15) (16) INTER ST OR DIVIDENDS FROM PROTECTED SHARE OF RESOURCES* (FRO RESULTS OF RESOURCE ASSESSMENT(16) (17) TOT MONTHLY INCOME (17) * Actual r to of return OR reasonable rate of return on a 1 year C.D. whichever is larger. Example: if 1-year C.D. currently earns 3.% /yr. and you have your standard spousal share of resources invested at a rate of only 3.5%, the Department of Public Welfare will use 3.% as the rate of return or interest. If the total n line 17 (your income) is less than the total on line 12 (your monthly income allowance) u are permitted to have more monthly income. For Exampl : if your protected monthly income level (line 12) is $2019 and your total monthly income (line 17) is : 1200 you may seek additional income of : $ 819 If you want to protect additional resources for the purpose of producing this income, your spouse should apply for Medicaid now and request a hearing to establish that you need a greater share of the resources in order to bring your income up to the protected level. In the alt five, your spouse in the nursing facility can give you some of his or her income each month. Your spouse does not have to apply for Medicaid or have a hearing to do this. You should make sure that the total of your combined incomes is enough to provide the monthly income allowance. If you and our spouse choose to supplement your income through a monthly income contribution m your spouse in the nursing facility instead of protecting a greater share of your resources, th n your spouse does not have to apply for Medicaid until the total resources are reduced to a ximately your protected share (indicated on the Results of Resource Assessment) plus $2400. REMINDER: The maximum protected amounts for both resources and income for the spouse at home is re sed annually. NU 1 IL -4 1 V AF'F'LICAN 1 1-800-269-0173 717-240-2700 DEPARTMENT OF PUBLIC WELFARE CUMBERLAND COUNTY ASSISTANCE OFFICE IP; CE ' 33 WESTMINSTER DRIVE ' P. O. BOX 599 BENEFIT EuGi R TT' CARLISLE, PA 17013-0599 ASSISTANCE CHECK After the first check which may be a spadai amount you vAl rsoaivs S ? Twim a Month ? Once a Month ? In the MtA ? Al the Banc ? MEDICAL ASSISTANCE gg ? You have a patient pay bobpiry of S for the period beginning and ending ? Efhctive Data ? FOOD STAMPS You wig receive i for the month(s) of than you will reoshre food stamps in the amount of $ a month from to ? In"Map ? At the Bank ? NURSING HOME CARE Level of can authorized you are expected to pay i a monk toward your care. ? S ? rs, IN _ LINE NAME NO. AB CH E U MED. SOC LINE CK ST S SERVICE ASST. NAME CH STAMPS A G1-- 6 t EF request for resource limit urces owned sep sal share (dete MMMWMIM R'- 178.121 Reason C0d° 079 sing Facility Services Nedica7. Assistance is being denied due to excess res $2400.00. The amount of your resources vas determined by evaluating all rately and jointly as of the date of admission to the home and subtracting t d to be $ ,37 `I44,"minus spousal share $ iQ020 a se $ 184-44 rs av 41A1? Name )MRO Mj T Name GROSS MO NTHLY $ $ N $ $ Name UNREAARS D INCOME Name UGNEA Y Is Is $ Is TOTAL GROSS MONTHLY INCO ME $ TOTAL GROSS MONTHLY INCOME I s GROSS MONTHLY DEPENDENT ARE COSTS Is GROSS MONTHLY DEPENDENT CARE COSTS I s GROSS MEDICAL COSTS Is Telephone water/sewage MFkitCUaA8S1rSTl l CE Number ta f Pe r3otrs Electric Garbage/Trash Name EARN MO D IN NTHLY COME Gas Utility Installation $ Oil Other $ GROSS UTILITY COSTSAMLITY STANDARD' $ $ RENT/MORTGAGE $ Name UNEARNED I NCOME TAXES $ $ INSURANCE COST ON HOME $ $ TOTAL SHELTER COST $ $ the. household may: swft .:between. standard utility allowance at, the: Lime: ,addiflonal time daring each, verve-month Doi CO RECORD NUMBER CAT CTR DIG 21 coq %&, AtJ TOTAL GROSS MONTHLY INCOME $ 3! t?tilrty. ocstS, and the eapplication and ' one. NET MONTHLY INCOMEMET SEMI-ANNUAL INCOME $ INCOME LIMIT $ DIST \- lAyt- 4117103 2 L/D 2 7 LN \ `X Worker's Signature Date Telephone Number -? F.3" t CNRC L YI yS+j ab n6f unorstand our on`c LEGAL SERVICES, INC. 8 IRVINE ROW CARLISLE, PA 17013-3019 717-243-9400 717-766-8475 ny quest J carted yox worker. CUENT COprlf I: u CERTIFICATE OF SERVICE I, served a Law Matthew C/O Saul Penn Nat 2 North 2 Rebecca Certified Nicole N The Elde The Penr The Dick 45 North Carlisle, G. Baron, do hereby certify that on this 10th day of September, 2007, I and correct copy of the foregoing Plaintiff's Answer to Defendant's Objections to Plaintiff's Second Amended Complaint, with Memorandum of upon the following individuals in the manner indicated: Haar, Esquire (FAX: 717-257-7581) nine. LLP )nal Insurance Plaza d Street, 70' Floor PA 17101 for Defendant) v1. Fuhrman (FAX: 717-240-6462) Legal Intern Walters, Esquire and Consumer Protection Clinic Sylvania State University mson School of Law Pitt Street 'A 17013 Respectfully submitted, CAPOZZI & ASSOCIATES, P.C. By: (Z4? '' Bruce G. Baron, Esquire Attorney I.D. No. 28090 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) (Attorneys for Plaintiff) 24 ?: r.m -? --, a•? ?'?` __., cn ?-_ ?' ?.. .. --? ;? tv t.? PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in full) PATRICIA J. SHAY by TRACY D. SHAY-SNYDER as Power of Attorney for Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR. Defendant No. 06-3229, Term 1. State matter to be argued (i.e. Plaintiff's motion for new trial, Defendant's demurrer to complaint, etc): Defendant's Preliminary Objections to Plaintiff's Second Amended Complaint 2. Identify counsel who will argue cases: a. For Plaintiff. Bruce G. Baron, Esquire, Capozzi & Associates, P.C., 2933 North Front Street, Harrisburg, PA 17110 b. For Defendant: Matthew M. Haar, Esquire, Saul Ewing, LLP, 2 North 2nd Street, 7"' Floor, Harrisburg, PA 17101 I will notify all parties in writing within two days that this case has been listed for argument by First Class Mail: Matthew M. Haar, Rebecca Fuhrman, and Nicole M. Walters of the Dickinson School of Law. 4. Argument Court Date: November 21, 2007 _&M40M7A9_1_ Signature Print your name ?)el,A ? Attorney for Date: October 5, 2007 rv V CO [ d C-? ?? C, CD PATRICIA J. SHAY, An IN THE COURT OF COMMON PLEAS OF Incapacitated Person, by CUMBERLAND COUNTY, PENNSYLVANIA TRACY D. SHAY- SNYDER, as Plenary Guardian of the Person And Estate of Patricia J. Shay, Plaintiff V. CIVIL ACTION - LAW CHARLES E. SHAY, JR., Defendant NO. 06-3229 CIVIL TERM IN RE: DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S SECOND AMENDED COMPLAINT BEFORE OLER and EBERT, JJ. ORDER OF COURT AND NOW, this II`h day of March, 2008, upon consideration of Defendant's Preliminary Objections to Plaintiff's Second Amended Complaint, and it appearing that disputed factual issues exist with respect to the preliminary objection relating to personal jurisdiction over Defendant, it is ordered and directed as follows: 1. Depositions shall be completed within 28 days of the date of this order, establishing a factual record upon which the issue of personal jurisdiction may be determined; and 2. Argument shall be held on Wednesday, May 14, 2008, at 1:30 p.m., in Courtroom No. 1, Cumberland County Courthouse, Carlisle, Pennsylvania; supplemental briefs shall be submitted to the court at least five days prior to the argument, with citations to the deposition record in support of the positions advanced. BY THE COURT, I I :C "'c, Z1 my gool 3,,HJ Jo AI /Bruce G. Baron Esq. 2933 North Front Street Harrisburg, PA 17110-1250 Attorney for Plaintiff ZMatthew A Haar, Esq. Penn National Insurance Plaza 2 North Second Street, 7`h Floor Harrisburg, PA 17101 Attorney for Defendant 1. BLS M:2 [LECL 1 C.1 PATRICIA J. SHAY, an incapacitated person by TRACY D. SHAY-SNYDER as plenary guardian of the person and estate of Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR., Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA No. 06-3229 Civil Action - Law PRAECIPE TO FILE DEPOSITION TRANSCRIPTS TO THE PROTHONOTARY: Please file of record the attached documents as directed by the Court's Order of March 11, 2008: 1) Deposition of Tracy Shay-Snyder (April 7, 2008) with exhibits; and 2) Deposition of Charles E. Shay, Jr. Dated: May 9, 2008 Respectfully submitted, Matthew M. Haar, EsquirK(Pa. #85688) Saul Ewing LLP Penn National Insurance Plaza 2 N. Second Street, 7t' Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendant i SHAY-SNYDER TR • SHAY VS April 7, 2008 SHAY IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, AN INCAPACITATED: PERSON BY TRACY D. SHAY-SNYDER AS : PLENARY GUARDIAN OF THE PERSON AND: ESTATE OF PATRICIA J. SHAY, PT.ATNTT FF VS CHARLES E. SHAY, JR., DEFENDANT NO. 06-3229 DEPOSITION OF: TRACY D. SHAY-SNYDER TAKEN BY: DEFENDANT BEFORE: DAWN YOUNG DIETRICH, REPORTER NOTARY PUBLIC DATE: APRIL 7, 2008, 3:40 P.M. PLACE: CAPOZZI & ASSOCIATES, PC 2933 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAM • SHAY VS April 7, 2008 SHAY { } t 2 4 1 APPEARANCES: 1 TRACY D. SHAY-SNYDER, called as a 2 CAPOM & ASSOCIATES, PC 2 witness, being sworn, testified as follows: BY: BRUCE G. BARON, ESQUIRE 3 3 FOR - PLAINTIFF 4 DIRECT EXAMINATION 4 5 SAUL EWING, LLP 6 BY MR HAAR: 5 BY: MATTHEW M. HAAR, ESQUIRE 7 Q Good afternoon. Do you prefer to go by 6 FOR - DEFENDANT 8 Ms. Shay-Snyder or - ALSO PRESENT: 9 A Tracy. 8 10 Q By Tracy, okay. CORY L. SHAY 11 A Uh-huh 9 10 KEPPH SNYDER 12 Q Tracy, my name is Matt Haar. I'm an 11 13 attorney representing your father, Charles E- Shay, 12 14 Jr. We had the opportunity to meet briefly before 13 15 this deposition, correct? 14 16 A Correct. 15 16 17 Q Before we get started, I want to give you 17 18 some basic instructions or ground niles just so we're 18 19 on the same page as we go forward today. Is that all 19 20 right? 20 21 A Sure. 21 22 22 Q My first instruction is that you please 23 23 listen to my questions. Is that okay with you? 24 24 A Uh-huh, 2 5 2-5 Q If you answer m on, I'll assume 3 5 1 TABLE OF CONTENTS 1 that you heard it and understood the question Is 2 WITNESS 2 that all right? 3 3 A Fine. FOR DEFENDANT DIRECT CROSS 4 Q Okay. If a question is unclear or you 4 5 don't understand it, would you please ask me to 5 Tracy D. Shay-Snyder 4 36 6 either repeat it or clarify it? 6 7 A I will. 7 8 Q Thank you. If you need to speak with EXHIBITS 9 your attorney at any time, would you please just let 8 9 PLAINTIFF PRODUCED 10 11 me know that? A I will EXHIBIT NO. AND MARKED . 10 12 Q If you need a break, please let me know 22 - Durable Power of Attorney 49 13 as well. Is that okay? 11 12 14 A I will. 13 15 Q Is there any reason why you cannot give 14 16 truthful testimony under oath today? 15 17 A No. I will be giving MWnU testimony 16 18 under oath today. 17 1 s 19 Q Did you speak with anybody to prepare for 19 20 today's deposition? 20 21 A I've had correspondence with my attorney, 21 22 Q Anybody other than your attorney that you 2 3 23 spoke with to prepare for today's deposition? 2 4 24 A What do you mean by prepare? 25 25 Q Well, did you talk to anybody about 2 (Pages 2 to 5) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAO • SHAY VS April 7, 2008 SHAY S f 6 1 gathering any documents, about finding out any facts, 1 2 anything that would help you be ready for today? 2 3 A Pm not sure what you're asking. With 3 4 the information that is in the exhibits, I had to 4 5 talk to various people to get those. 5 6 Q Well talk about those exhibits at some 6 7 point in time here. But, for example, your brother's 7 8 here. 8 9 A Uh-huh. 9 10 Q Did you talk with your brother about the 10 11 deposition? 11 12 A Yes. 12 13 Q Okay. And what did you talk with him 13 14 about? 14 15 A Asking if he could recall the dates when 15 16 Charles visited he, Cory, and his daughter Dana. 16 17 Q Other than your brother Cory, who did you 17 18 speak with about today's deposition? 18 19 A Bruce. 19 20 Q Anybody other than Cory and Bruce? 20 21 A If Pm understanding your question, Pve 21 22 gathered information from the credit union. Is that 22 23 what you're referring to? 23 24 Q Well, let me rephrase the question. 24 25 Other than the people that you spoke with to et the 25 7 1 documents in the packet that your attorney's 2 provided, your attorney and your brother, did you 3 speak with anybody else? 4 A No. My husband is aware of the 5 information, so of course in the house we have 6 conversations. 7 Q I assume you spoke with your husband. 8 Tracy, are you an attorney9 9 A No. 10 Q Do you hold any professional licenses? 11 A As... 12 Q As anything. 13 A No. 14 Q Do you have any formal medical training? 15 A No. 16 Q Would you agree with me that your father 17 is now a resident of Florida? 18 A Yes. 19 Q And just to keep this moving when we go 20 forward, would you prefer that I refer to him as your 21 father, Charlie? 22 A Charles. 23 Q Charles? 24 A Uh-huh. 25 Q And do you have a recollection as to when 8 Charles moved to Florida? A Do you mean full-time or part-time? Q Well, let's start with full-time. A He was down there full-time somewhere in the years of 1996 -'95,'96 full-time. Q And you said that he was down there part-time before that. A Uh-huh. Q Approximately when did he start residing in Florida part-time? A I really can't remember that. Q Can you approximate it; five, ten, twenty years prior to that? A Pm going to estimate, guessing, five years. Q Okay. A He would spend three, four months. Q I don't want you to guess, but if you can approximate or give me the best of your recollection, Pll take that. So just so Pm clear, to the best of your recollection, Charles started residing in Florida part-time in perhaps the 1990, 1991 time frame? A He was never considered a resident there while he was going three to four months because he 9 1 would just rent a house and his legal residency was 2 in Pennsylvania. 3 Q Would you agree with me, though, that as 4 of 1996 he removed himself permaiienfly to Florida? 5 A Yes. 6 Q Why don't we take a look at these 7 documents that your attorney has assembled and marked 8 for us. 9 Exhibit P-1 is a thre&1mge document Do 10 you recognize this document9 11 A I do. 12 Q And what is it? 13 A It is the official record held by 14 Harrisburg Cemetery that Charles Shay, who is my 15 father, has two cemetery plots. 16 Q And did you obtain this document? 17 A No. Charles actually gave it to me. He 18 asked me to hold it since at that time he was telling 19 me that I would be responsible to handle his estate 20 and that upon his death I would have the document to 21 have hire buried. 22 Q And you still have the document as it was 23 given to you by Charles? 24 A Yes. 25 Q Do you remember approximately when it was 3 (Pages 6 to 9) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAI • SHAY VS April 7, 2008 SHAY 10 1 that he gave you this document? 1 2 A I don't remember. 2 3 Q Can we approximate it? Has it been 3 4 within the last ten years? 4 5 A Yes. 5 6 Q Was it within the last five years? 6 7 A I don't remember. 7 8 Q Why don't we try and agree on a date and 8 9 perhaps we can use that as kind of a guidepost as to 9 10 whether things happened before or after. 10 11 Do you recall when it was that your 11 12 mother moved from Florida to Pennsylvania? 12 13 A Permanently - 13 14 Q Permanently. 14 15 A - with me? 15 16 It was right after Easter, April 2003. 16 17 Q And when I refer to your mother, do you 17 18 prefer - 18 19 A Mother. 19 20 Q Mother? 20 21 A Uh-huh. 21 22 Q Do you remember whether Charles gave you 22 23 what has been marked as P-1 before or after Mother 23 24 moved back to Pennsylvania in 2003? 24 25 A It was before. 25 11 1 Q Do you remember approximately how much 1 2 before? 2 3 A I do not, but I can tell you that on this 3 4 document here (indicating) it was during the period 4 5 that he lived at this address and they have 5 6 miswritten that. It is actually Florida; Davenport, 6 7 Florida. 7 8 Q And just so we're clear for the record 8 9 about what we're talking about, you're looking at the 9 10 second page of what we've marked as Exhibit 1, P-1, 10 11 correct? 11 12 A Right, correct. 12 13 Q And there's three addresses on here. 13 14 You're looking at the bottom of the three, correct? 14 15 A Correct. 15 16 Q And you're indicating that this reflects 16 17 his address as Davenport, Pennsylvania, but it's 17 18 actually Davenport, Florida? 18 19 A Correct. 19 20 Q And that would probably be reflected in 20 21 that zip code, the 33837? 21 22 A Correct. 22 23 Q All right. So is it your testimony then 23 24 that Charles was residing at Davenport, Florida at 24 25 the time that he provided this to you? 25 12 A Correct. Q Since you moved your mother to Pennsylvania in 2003, have you had any subsequent conversations with Charles about where he wants to be buried? A No. Q Now, if you would, please, look at ExWbit P-2. And this is a four-page document. Can you identify this for us? A This is the headstone that Charles had prepared for himself and my mother and this is located at Harrisburg Cemetery. Q And who took these pictures? A I did. Q Do you recall approximately when you took them? A Two weeks ago. Q Tracy, you were here earlier when Charles testified that he had an account at New Cumberland Federal Credit Union, correct? A Correct. Q Did he ever discuss that account with you? A No. Q Since - 13 A Although I used to do - years ago, before he moved to Florida, he would have me reconcile his checking accounts, so I was aware that at one time when I was in high school that he had those accounts Q And after this litigation was commenced which I believe was in approximately June 2006, did you have any contacts with New Cumberland Federal Credit Union about this account? A Yes. Q Okay. And could you tell me, please, about those contacts? A Within two weeks I went down to see what the status was of my mother's account and the teller told me that Charles' name was there with my mother's name on and my mother's name was therewith my father's name on. So they told me that Charles closed his account on August 31 st, 2006 under the recommendation of his attorney and then they gave me information on my mother's account and her balance. Q Do you recall the name of the person you spoke with at NCFCU? A No, I do not Q Was it a male or a female? 4 (Pages 10 to 13) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAO • SHAY VS April 7, 2008 SHAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 A Female. Q Do you recall any physical attributes about her that might help us identify her at this point in time? A I don't, no. Q Did you make a transaction on that day with your mother's account? A I did. Q Okay- A I closed it and I took that money and I made a payment at Claremont Nursing Home on my mother's accounts. Q Just so I'm clear on timing, you said within two weeks you checked with NCFCU. Is that within two weeks of filing the lawsuit? A Of today, two weeks of today. Q Do you recall when you were talking with this female at NCFCU what you asked her when you went in there? A I asked her for information on Patricids 14 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 account. Q Did you ask her specifically for information about Charles' account? A Yes. I asked her if she had information on his and she told me that it was close& so she could not provide anything for me other than that he closed it on August 31 st, 2006. Q Did she offer any other information about Charles' account? A No. Q You said earlier that it was closed on the reconmrendation of attorney. Did she tell you that? A Yes, she did. Q Did she say whether or not that was reflected in the notes of their computer or - A Yes, yes. She was looking at a computer screen. Q Did you see that computer screen? A No. Q Now, your attorney provided me on Friday with an Exhibit P4 which is one page and today he provided a two-page exhibit which looks to be just the cover sheet to P11. MR. BARON: You also have the other side of R4. It's two-sided- MR- HAAR: Oh, okay. BY MR. HAAR: Q Can you identify R4? A Yes. 1 Q What is it? 2 A It's a letter that was sent to me when 3 information, financial information, needed to be 4 supplied for Mom to be eligible for the Waiver 5 Program, and that's through the Pennsylvania 6 Department of Aging. 7 And since I had to provide any type of 8 insurance information, I recall Charles saying that 9 there was a $1,000 policy at the credit union and I 10 also have a document in Charles' handwriting telling 11 me what type of insurance Mom has. 12 Q Let's just keep on this document for a 13 moment so I understand it. 14 A The reason that I had to get this 15 document was to provide to the Waiver Program for 16 financial information. 17 Q And this relates to information on your 18 mother, correct? 19 A Correct. 20 Q It does not relate to information on 21 Charles, correct? 22 A Correct. 23 Q And this letter wasn't sent to you by 24 Charles, was it? 25 A No, it wasn'k 15 17 1 Q Now, you indicated to me that Charles 2 told you that there was this policy. 3 A Uh-huh. 4 Q Do you recall when it was that he told 5 you about the policy? 6 A This is information that Charles provided 7 to me on - upon the death of him or Mom, that this 8 is the information that I needed to take care of the 9 estates (indicating). l 0 MR. BARON: Do you want a copy of that? 11 MR- HAAR: Not right now. 12 BY MIL HAAR.- 13 Q Do you recall when it was that he 14 provided this information to you? 15 A Yes. It was shortly after the incident 16 in 1998 where Charles held a loaded gun to Mom's head 17 and said he was going to blow her head off and then 18 kill himself. 19 So after we went through getting 20 treannent for Charles and he stayed with me two to 21 three months - he and my mom stayed with me for two 22 to three months until Charles felt as though he was 23 mentally stable enough to go back to Pennsylvania, I 24 told him he needed to get this information in order, 25 so this is the information that he provided. 5 (Pages 14 to 17) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAO • SHAY VS April 7, 2008 SHAY 18 20 1 Q All right. I just want to make sure rm 1 frame here. August 29, is the date Charles 2 clear on kind of the focus of my question, thars 2 called you and you flew to Florida? 3 when he gave this to you. You said it was after an 3 A Correct. 4 incident you recall in'98,'99? 4 Q Until he goes through the hospital in 5 A Uh-huh. 5 Florida, you guys drive him to Pennsylvania, he goes 6 Q So did you receive this information from 6 through time at Holy Spirit, then he stays with you 7 Charles prior to the year 2000? 7 for some amount of time - 8 A Yes. 8 A Right. 9 Q Now, you also just mentioned an incident 9 Q - what time was it approximately that he 10 where Charles held a gun to your mother's head. 10 returned to Florida? 11 A Uh-huh. 11 A It was before Christmas. 12 Q Were you present for that incident? 12 (Discussion held off the record.) 13 A No. He called me on the phone and told 13 BY MR. HAAR. 14 me he was standing there with a loaded gun at her 14 Q Tracy, other than the cemetery plot that 15 head, she was sitting there crying and he was going 15 you talked about earlier, do you believe Charles owns 16 to blow her head off. 16 any other real estate in Pennsylvania? 17 Q Where was he when this incident happened? 17 A Not that rm aware of. 18 A He was telling me he was in their house. 18 Q Other than the NCFCU account that we 19 Q In Florida? 19 talked about earlier, are you aware of any other 20 A In Florida, Longboat Drive. 20 personal property that Charles owns in Pennsylvania? 21 Q Do you remember approximately when this 21 A rm not aware of any other. 22 was? 22 Q At some point in time you through counsel 23 A Uh-huh, I do. 23 sought to be appointed as the guardian of your 24 What rm looking for is my credit card 24 mother, correct? 25 receipt that Keith and I flew down that same day to 25 A Correct. 19 21 1 take care of Charles and also my mom. 2 We flew down to Florida the day he called 3 me. That was August 29th, 1998. 4 Q You indicated after that he and your 5 mother came to Pennsylvania to live with you and your 6 husband for some time? 7 A Yes, because my mother wasn't capable of 8 taking care of herself So after Charles was taken 9 to the emergency room at Lakeland, the doctor 10 admitted trim to a locked psych unit where he stayed 11 for two weeks and that's where Keith heard Charles 12 tell the doctor that he was going to kill his wife 13 and himself. 14 And then my brother carne down on a bus, 15 because Keith had to come back to Pennsylvania to 16 take care of my children, and Cory came down on a bus 17 to help drive back Charles, my mom, Cory and I and 18 Charles' car because I now needed to get back to 19 Pennsylvania since I was down there for two weeks and 20 we had taken Charles to the emergency room at Holy 21 Spirit Hospital and he was admitted there for further 22 treatment. Once he was discharged from Holy Spirit, 23 Charles and Pat stayed with me for two to three 24 months. 25 Q I'm trying to place together the time 1 Q And do you recall approximately when you 2 started that proceeding? 3 A I do. According to the first bill that 1 4 have from Capom & Associates, they started vrvrk on 5 November 18th, 2005. 6 Q And that ultimately led to an order of 7 September 8, 2006 that was marked as Exhibit P-21, 8 correct? 9 A Let me see what P-21 is. It ultimately 10 got to there, but this was a three-step process. 11 Because Charles would not release my 12 mothers assets to Claremont Nursing Home, which he 13 knew she was in because he completed the paperwork to 14 support financial documents and he also had telephone 15 calls with the nursing home saying that he would not 16 pay,1 had to get attorneys to get an exception made 17 with MA to get my mother on that program. That was 18 the first step. 19 The second step is that I've learned 20 after the fact that Charles had my mother sign two 21 power of attorneys when she was incompetent on the 22 same day, one to him, one to me, and I was told by 23 that attorney in Florida that since they were married 24 Charles' power of attorney would override mine. 25 So knowing that Charles - and Charles 6 (Pages 18 to 21) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA • SHAY VS April 7, 2008 SHAY 22 1 does not have an interest in my mothers health, and 1 2 knowing that - because he was telling me when my mom 2 3 lived with me for two years not to get medical 3 4 attention for her and then when a pacemaker was put 4 5 in my mom he talked to Keith and I on the phone and 5 6 was just irate that we were keeping her alive. 6 7 Knowing that he didn't care for her welfare, I went 7 8 after the legal guardianship so he could not pull her 8 9 out of that nursing home, nor did I want him to visit 9 10 her because he did not have her best interest in 10 11 mind. So I stopped visitation to protect my mother 11 12 from mental and physical harm from him. 12 13 (Cory Shay confers with the witness.) 13 14 MIL HAAR: Bruce, I appreciate that Cory 14 15 might want her to know something, but no prompting 15 16 during the deposition. 16 17 MR. BARON: Right. 17 18 BY MR. HAAR. 18 19 Q Just so I'm clear, you said there was a 19 20 three-step process here. 20 21 A Uh-huh. 21 22 Q I think that the second was when you 22 23 learned about the two POAs, powers of attorney in 23 24 Florida. Was there what you believed to be a third 24 25 distinct step here? 25 23 1 A Is what we're doing here right now. I )m 2 trying to recover some of my mother's assets so that 3 attorney bills can be paid. 4 The other piece of that is that when 5 Medical Assistance permitted her to go onto MA, they 6 backdated her to the very first day that she was 7 admitted to eliminate a $ 100,000 debt that was 8 sitting at the nursing home at that point. Because 9 Charles would not release the money, she could not 10 get on MA. 11 So they told me upon my mothers death I 12 should keep in mind for my mothers estate that money 13 could go back to MA to help reimburse for the money 14 that Charles should have paid and did not. So when 15 Charles was saying that she was denied, she was 16 denied because he would not release her assets. 17 Q After you filed or your attorney filed 18 the papers that ultimately led to P-21, did you have 19 any discussions with Charles about the proceeding? 20 A No. You're saying this is dated 21 September 12th, 2006? 22 Q No. P-21 is dated September 8, 2006, at 23 least it is on the front. I think there's another 24 date on the top which might be when it was received 25 by somebody. 24 A No. The last time that I had any communication with Charles is when he tried to visit my mother at the nursing home and I had him on the do-not-visit list and he caused quite a commotion there where the nursing staff had to bring in maintenance crew and warn Charles if he didn't settle down he was going to be removed by the police. Q And just to be clear, you weren't at the home when that took place, connect? A No. Q Your account of it is what the nursing home staff told you? A Right. Q Okay. A But while Charles was there, Amy Walker who was the - I don't know what her exact title is - head nurse in A Wing at Claremont, she called me three times on my cell phone and asked me to speak with Charles. And the third time I did speak with him and he told me that I bit off more than what I could chew and that I was no longer his daughter and he - I did not hang up. He gave the phone back to the nurse. Charles was stating that when he calls me I hang up. That was the only time I had anv 25 1 conversations with him. 2 Q Just so I'm clear on this one point, the 3 last time you've actually spoken with your father is 4 the day of this incident in Claremont Nursing Home? 5 A Correct 6 Q There are actually two days I think Why 7 don't we turn to those notes real quick just so were 8 clear on this. 9 A That's November I 1 th, 2005. 10 MR. BARON: November or July? 11 A I'm sorry. It is July 11th, 2005. 12 MR BARON: It's P-14. 13 MR. HAAR: Thank you. 14 BY MR. HAAR: 15 Q We're looking at P-14. Why don't we 16 start off by identifying what this is. Can you 17 identify what this is for us, please? 18 A I do not prepare this document, but it 19 was a document that I requested a copy of, any 20 documentation from Claremont Nursing Home recording 21 the outburst from Charles at the nursing home, and 22 they had documented that event and this is the 23 documentation they provided 24 Q Okay. So none of this is your 25 handwriting? 7 (Pages 22 to 25) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAO SHAY VS April 7, 2008 SHAY 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 A None of it. Q This is just what Claremont gave to you - A Correct Q - when you asked for - did you ask specifically for documentation about this event or - A Yes. Q - did you just ask for documentation generally? A No. 1 asked for this event to prove that he was in Pennsylvania. Q And as far as you know, this is the last time he was physically in the Commonwealth of Pennsylvania? A No, I don't know that. I understand from his Uncle Dick and Aunt Betty that Charles has been in Pennsylvania after I've discontinued a relationship with Charles which ended in 2004. Q Let's try and break this down just a little bit. This P-14 identifies July 10 and 11, 2005 as the date where there was an incident involving Charles at Claremont Nursing, correct? A Correct- Q And that's the last date that you spoke directly with him correct? 28 1 visit my mother and I would not allow Alma to come to 2 my house to visit my ream, but on that visit Keith and 3 I took Alma and Charles to bnmch at the Hershey 4 Hotel. 5 MR. BARON: P-12. 6 A That was on 7/13/2003. 7 BY MR. HAAR: 8 Q And I see you're looking at what appears 9 to be an original receipt. But if you look at the 10 packet of documents that your attorney turned over to 11 me and turn to Exhibit P-12, the packet of 12 domunents - do you have Exhibit P-12 in front of 13 you? It should be just a couple pages before what we 14 had been looking at, the interdisciplinary notes. 15 A Okay. 16 Q Can you identify P-12 for the record? 17 A Yes. This is a statement of the credit 18 card that Keith and I held and the line that is 19 circled to the Hotel Hershey restaurant was for four 20 Sunday brunch tickets where Keith and I took Ahm and 21 Charles. 22 Q And July 13th of 2003 then is the last 23 date you recall physically seeing Charles in 24 Pennsylvania? 25 A No. This is the date I purchased the 29 1 tickets. Whatever that Sunday is. 2 Q So it was within a week of July 13th, 3 2003? 4 A Correct 5 Q Just so I understand, it was you, your 6 husband Keith, Charles - 7 A And Ahma. 8 Q - and his companion Alma who were at 9 that brunch? 10 A Correll. 11 Q And you and your husband paid for the 12 brunch, correct? 13 A Correct 14 Q Now, if we could please go back to 15 Exhibit P-14. If you look on the first page of this 16 two-page document about one-third of the way down - 17 A Second page? 18 Q No, first page. About one-third of the 19 way down, it starts the sentence I believe, Tracy 20 Shay-Snyder daughter POA carded and stated that 21 husband can't visit with resident. 22 A Uh-huh. 23 Q Did you tell Claremont that Charles was 24 not allowed to visit with his wife? 25 A Yes, I did. 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 A Correct. Q And you could ascertain from that conversation that he was in Pennsylvania, specifically at Claremont, correct? A Yes. Q Other than what other people might have told you, do you know any other date after this where Charles was in Pennsylvania? A I had no contact with Charles from this date, 7/11/2005, until today, so he would not inform me of any of that, but my - well, Charles' Uncle Dick has told me that Charles did not want people to know when he was in Pennsylvania because he was afraid that he would be picked up for owing money to Claremont. Q When is the last time that you actually saw your father in person? I m song, the last time you saw Charles in person. A I'd have to think about that. I can't give you a date off the top of my head. Q Well, let's go back to our one guidepost. You believe you moved your mother from Florida to - A I know exactly. I know exactly when it is now. He and Ahna, his girlfriend, came up to 8 (Pages 26 to 29) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA SHAY VS April 7, 2008 SHAY 30 1 Q Was there any condition on that such as 1 2 he could if you came over or - 2 3 A No, because this was prior to any type of 3 4 me getting legal guardianship and I was concerned 4 5 about my mother's safety knowing that Charles already 5 6 held a loaded gun to her head to kill her and advised 6 7 me many times not to seek medical treatment for her. 7 8 Q Here it identifies you as POA which I 8 9 take to be power of attomey. 9 10 A That's correct. 10 11 Q Did you identify yourself to Claremont as 11 12 the power of attorney? 12 13 A I have a document from my mother that I'm 13 14 power of attorney. 14 15 Q And that's the same document that you 15 16 discussed with the lawyer in Florida and he said it 16 17 would probably be underneath Mr. Shay's power of 17 18 attorney? 18 19 A That was after I provided power of 19 20 attorney to Claremont. The only way that I found out 20 21 that Charles had her sign two when she was 21 22 incompetent is that I called that attorney to find 22 23 out what my power of attorney gave me, what areas 23 24 could I decide for my mother, and that's when the 24 25 attorney told me are you aware that there's two power 25 31 1 of attorneys. 1 2 Q So the power of attorney that designated 2 3 you as the POA for your mother, you thought it was 3 4 executed at the same time as one in favor of Charles, 4 5 correct? 5 6 A That's what the attorney in Florida told 6 7 me, that they were dated the same day. 7 8 Q And you said that that was at a time when 8 9 your mother was incompetent, correct? 9 10 A Correct. 10 11 Q But you believe that your own POA was 11 12 viable, correct? 12 13 A Yes, I do. Yes, I do. 13 14 Q But you believe the one in favor of 14 15 Charles isn't? 15 16 A That's correct. 16 17 Q And why is that? 17 18 A Just because of past behavior that 18 19 Charles had exhibited on not having any concern about 19 20 my mother's well-being. Somebody had to make 20 21 decisions for my mother because she wasn't capable of 21 22 doing it. Charles was going to kill her. 22 23 When I got my mother from Charles and 23 24 took her to an Alzheimer's specialist, Dr. Hal 24 25 Fineburg who has now died - Charles was 25 32 overmedicating my mother where she could not speak, she could not walk and he was giving her medications that were toxic when mixed, so Dr. Fineburg took her off of all of that medication and got her back on the proper mods and got her to a fiunctioning capacity. Q Now, do you believe that you're currently part of Charles' support network? A Explain what you mean by support network. Q Well, do you believe that you currently offer any support to Charles? A No. Q When is the last time that you believe you did offer support to Charles? A Support in what manner? Mental, physically, financially, spiritually, how? Q Any support at all. A In all of those areas? Q In all of those areas. A Financially I was taking care of my mother for two years. My mother got her Social Security check and that was it from Charles. Q rm trying to put a time frame on this. A I've also paid for all of my mother's medical bills. I paid for a 51,000 root canal for 33 her because she did not have dental coverage. I bought her eye glasses, had her eye exam I provided her a home. Q So you believe that by caring for your mother you're caring for Charles? A Because when - Charles was in the hospital when I talked to Charles about me caring for my mother because Charles was in for a heart replacement valve and Charles agreed that I could care for my mother because Charles had the girlfriend, Alma, and was parading her around and putting her with a lady known to be an alcoholic in the park so Charles and Alma could go out of town on little vacations. So the alcoholic was not watching my mom and she was found to be roaming in the park and was found by somebody who knew who she was. And then when I heard that this lady was known to be an alcoholic, that was another reason why I wanted to take my mom and give her proper care. Charles would also put my mother in bed at night and go and stay with the girlfriend. Charles was turned in twice for that to Social Services. Charles' pastor also talked to me about that, that the church was in an uproar because they 9 (Pages 30 to 33) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA1 • SHAY VS April 7, 2008 SHAY i 34 1 knew that my dad was leaving my mother alone and 1 2 spending time with Ahna. 2 3 My mom, when left alone, caught the house 3 -4 on fire. 'Mere was afire in the kitchen. So 4 5 those - the people at the church vice very agitated 5 6 because they knew that he was not caring for her 6 7 poly. 7 8 Q Let's kind of go back to my question. I 8 9 understand that you feel that you've supported your 9 10 father by supporting your mother. 10 11 A I've also taken care of him when he 11 12 needed any type of healthcare. 12 13 Q When is the last time that you helped 13 14 provide healthcare to Charles? 14 15 A When he stayed with me for two, three 15 16 months after he came out of Holy Spirit Hospital. 16 17 Q Okay. We decided I believe that was - 17 18 A No, that's not correct, that's not 18 19 correct. It was when he was in the hospital with his 19 20 heart valve because that's when he and I agreed that 20 21 Man would stay with me and Charles said that he would 21 22 provide anything I needed financially, if I needed a 22 23 break caring for my mother that he would take care of 23 24 it. 24 25 Q I'm trying to put a time frame on that. 25 35 1 A When he was in the hospital? 1 2 Q For the heart valve. 2 3 A Well, it was when I brought my mother 3 4 with me in April 2003. 4 5 So just to give you more detail on that 5 6 event, Charles was in the hospital, had his heart 6 7 valve replaced, Keith and I were down there That 7 8 was over Easter. We came home, his girlfriend called 8 9 me two days later and said he has to go back in the 9 10 hospital because he was acting irrationally and it 10 11 was frightening her, so I had to fly back down and 11 12 get him admitted again. 12 13 At that point I Trade arrangements for him 13 14 upon leaving the hospital the second time that he 14 15 went into a rehab center. 15 16 Q This is ail in the April 2003 time frame? 16 17 A Uh-huh. 17 18 Q Since that have you been involved in any 18 19 way in helping your father with medical care? 19 20 A No. 20 21 Q Okay. You've talked about you supporting 21 22 Charles through supporting your mother and this 22 23 assistance with medical care that you provided in 23 24 April of 2003. 24 25 Other than that, since April of 2003 have 25 36 you provided any support to your father, to Charles? A I had no relationship with him after 2004, so no, I had next to nothing in contact other than the incident at the nursing home. And at the nursing home, remember that he told me that I was no longer his daughter, so why would I? Q When is the last time that Charles saw his grandchildren? A We went down to visit him when we learned he had cancer and we drove - no, we flew down. I would have to look back on records to find that date. But I even took my mom down with us. Q So it would have been after Easter of 2003 when you moved your mother? A Yes. It would have been between 2003 and 2005 because my mom was not in the nursing hone at that point. MR HAAR: I don't have any more questions. MR. BARON: I just want to identify some documents. CROSS-EXANIINAMN BY MR. BARON: 37 Q Can you look at P-5 in the material. A Uh-huh. I have it. Q And can you tell me what this is? A This was a letter sent to me by Cumberland County Assistance Office informing me that Charles was - now wait. Let me read this if you don't mind. It's stating that the - Q Let me interrupt you just to maybe save some time. It says what it says. Did you receive this letter? A Yes, I did. Q Can you look at P-8. A P-8? Q I'm sorry, P-6. A Yes. Q Can you tell me what that is? A This is a request from Cumberland County Assistance Office to get my mother eligible for the Waiver Program and these are the financial documents that they requested that be provided. Q And did you undertake to get those documents? A I provided the ones that I could. The ones that I didn't have I requested from Charies that he provide them and he mailed those to me. 10 (Pages 34 to 37) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA • SHAY VS April 7, 2008 SHAY 38 1 Q Okay. Can you look at P-7. 1 2 A Yes. 2 3 Q What is this? 3 4 A It's a 2002 tax return. It's a 1040 that 4 5 was filed by Charles and my mother, Patricia. This 5 6 document - 6 7 Q Hold on. This is a copy of that 7 8 document? 8 9 A Correct. 9 10 Q Did you make this copy? 10 11 A No, I didn't. It was sent to me in this 11 12 envelope (indicating) with the original bank 12 13 statements. 13 14 Q And when you say this envelope, are you 14 15 referring to an envelope that has the cover that's 15 16 depicted on P-82 16 17 A That's correct. 17 18 Q And do you have the original of that 18 19 envelope with you today? 19 20 A I do. 20 21 Q And did we make the copy of P-8 from that 21 22 original? 22 23 A Yes, we did. 23 24 Q And what else was in that envelope? 24 25 A It's all of these bank statements and it 25 39 1 was this tax return (indicating). 1 2 Q And when you say all of these bank 2 3 statements, whose bank statements are we talking 3 4 about? 4 5 A There's also a checkbook that Charles 5 6 sent. Not a checkbook, but his check register. 6 7 These are bank statements in the name of 7 8 Charles and Patricia Shay from August 1999 through 8 9 August of 2003. 9 10 Q Okay. So just to piece together the 10 11 events - 11 12 A I'm sorry. It's through July of 2003. 12 13 Q To piece together the events, you 13 14 received something from the County Assistance Office 14 15 requesting you to get verification data This is 15 16 dated August the 18th, 2003. 16 17 A Right 17 18 Q And you requested that your father assist 18 19 you with assembling this information? 19 20 A This document - my mother was on two 20 21 programs in Pennsylvania. 21 22 Q No, I know that 22 23 In response to getting this document, did 23 24 you request information from your dad to help you 24 25 gather the information that the County Assistance 25 40 Office wanted? A Yes. MR HAAR- Can we just be a little more precise about this document? MR. BARON: Okay. The document P-6, okay? A P-6? BY MR. BARON: Q P-6 is the August the 18th. A Yes. Q Okay. And you requested your dad to help you out. Did you call him on the phone? How did you communicate with him? A On the phone. Q And he sent you some material? A Yes. Q And one of the pieces of material he sent you is P-7, the tax return? A That's correct. Q And he sent it to you in an envelope that was labeled P-8? A That's correct. Q And he sent you additional information. And did you subsequently get your mother qualified for the Waiver Proeram? 41 A Yes, I did. Q As a result of having that information? A Yes. Q Now, I want to ask you to look at P-16. Can you identify the contents of P-16? A I didn't get to it yet. Q Okay. It's a series of invoices. The fast one is Pinnacle Health FirstPlace Health Care, Seidle Hospital. A Yes. Q Okay. Can you tell us what the contents of P-16 is? Are these copies that you have? Are these documents you have in your possession that we made copies of? A Yes. Q And what are these documents generally? A The Seidle? These are - the first one, the Seidle Hospital, is getting Morn a physical to go into the day care program. Q Would I be correct that each of these documents is an invoice for services to your mother in Pennsylvania? A That's correct Q And I want to address your attention to the document that is from the hospital that says This 11 (Pages 38 to 41) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAI • SHAY VS April 7, 2008 SHAY 42 1 Is Not A Bill and its an itemized listing of various 2 charges. 3 A Uh-huh. 4 MR. HAAR: Is this within P-1 6? 5 MR. BARON: Yes, it is. 6 BY MR. BARON: 7 Q Its the fourth page. 8 A What is the date here where it says 9 statement covered period? 10 Q The statement covered period it looks 11 like to me is January the 29th, 2005 to February 12 the 4th, 2005. 13 A Okay. 14 Q Is this an invoice for services for your 15 another? 16 A Yes. 17 Q Can you tell me who the insurances are 18 that are covering this care in block 58? 19 A Its Patricia J. Shay, my mother, and the 20 second is Charles E. Shay, Jr. 21 Q And during this period of time in 2005, 22 do you know whether part of your mother's care was 23 paid for by insurance carried by your father, Charles 24 Shay? 25 A Yes, it was. 43 1 Q And how do you know that? 2 A Charles sent me a letter stating that he 3 was getting invoices and that he was making sure that 4 they were paid under his insurance. 5 Q And I want to address your attention to 6 P-17. What kind of prescription coverage did your 7 mother have during the period that she's been in 8 Pennsylvania? 9 A This was under her husband Charles under 10 what I've known to be as mail handlers prescription 11 coverage and that was running through Medco Health. 12 Q And what are the documents in P-17 as far 13 as you know? Can you identify them? 14 A Yes. It's an order foam for me to order 15 the prescriptions for my mother while she was living 16 with me. The Rite Aid is showing that my mother was 17 on the Waiver Program using an ACCESS Card which is a 18 part of Welfare to get her prescriptions paid for. 19 So prior to my mother going onto the 20 Waiver Program, her prescriptions were paid under 21 Charles' prescription plan. 22 Q Who filled out the Medical Assistance 23 application for your mother? 24 A Can you tell me what that looks like? 25 Q When your mother applied for Medical 44 1 Assistance, somebody had to fill out an application 2 and run it through the County Assistance Office. Who 3 handled that? 4 A I did. 5 Q And did you have to list the various 6 kinds of insurance that your mother had available to 7 her on that application? 8 A I don't remember. 9 Q Do you remember if you had to list the 10 health insurance coverage that she already had? 11 A I don't remember. 12 Q Since your father moved to Florida, has 13 your father told you anything about his plans for 14 your mother's burial? 15 A Both my parents told me that they wanted 16 to be cremated and that my mother was to be buried 17 beside him in the cemetery lots that are shown in 18 this exhibit. 19 Q And did your father at any time tell you 20 that there was any change in those plans? 21 A No. 22 MR. HAAR- You mean other than today in 23 the deposition? 24 MR. BARON: I don't believe today in the 25 deposition he said anvthine about the Glans for her 45 1 mother. 2 BY MIL BARON: 3 Q I want to address your attention to P-4. 4 A Okay. 5 Q And let me make sure you have a P4 with 6 all of the sides. Do you have one that has all of 7 the sides? 8 A This one (indicating,)? 9 Q Yeah. I want to direct your attention to 10 the beneficiary of the policy. Who is the 11 beneficiary? 12 A Unless you tell us otherwise, the 13 beneficiary will be your spouse, so my mother, 14 Patricia Shay, her beneficiary would be Charles Shay. 15 Q And am I correct that your statement is 16 this policy's no longer in effect because you have 17 now canceled - 18 A I closed the account. 19 Q - this account? 20 And just to clarify your testimony, when 21 did you cancel your mother's account? 22 A Within two weeks. 23 Q Within two weeks of today, that is two 24 weeks prior to today? 25 A Within two weeks of today. 12 (Pages 42 to 45) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA4 • SHAY VS April 7, 2008 SHAY i 46 48 1 Q During the conversation that you 1 Q Now, I want to clan fY your testimony as 2 mentioned in 1998, did your father ask you to come to 2 to the powers of attorney that existed When did you 3 Florida? 3 fast get a power of attorney that indicated that you 4 A 1998? 4 were a power of attorney on behalf of your mother? 5 Q Yes, when there was the incident that 5 A I have that document with me. I received 6 led - 6 this shortly after it was - I would have received 7 A He called me and said that he was going 7 that in September of '01. 8 to kill my mother and himself and that he needed 8 Q Who gave it to you? 9 help, so I told him that I would fly to Florida 9 A Charles. 10 immediately to be there to help him. So I think we 10 Q Did you have anything to do with the 11 had - well, I know we had a layover. 11 execution, signing or notarization of that document? 12 I called him from Middletown Airport 12 A No. 13 telling him what time my flight was leaving and when 13 Q What did Charles tell you when he gave it 14 it was to arrive and I also called him from our 14 to you? 15 layover and I also called him when we arrived in 15 A This is what he sent to me; this packet 16 Florida because I did not know what I was going to 16 of information (indicating), and it had last wills 17 walk into when I got to his home, if I was going to 17 and power of attorney coming from Michael Johnson who 18 find them alive or dead. 18 prepared the documents and he said that I would be 19 Q And when you arrived there they were 19 taking care of both of their estates and if they were 20 alive? 20 not able to make decisions for themselves that I 21 A They were alive. 21 would be their durable power of attorney. 22 Q And was them an ambulance or any police 22 Q Is there a durable power of attorney for 23 there at that time? 23 you both for your mother and for Charles? 24 A No. But Charles had me up for 36 hours 24 A Yes. 25 because he couldn't get settled and that's when I .25 Q And have you ever received anything in 47 49 1 called an ambulance to come and take him to the I 1 2 hospital because he had very little strength. 2 3 And when they arrived, they sent the 3 4 police, the ambulance and the fire department, and 4 5 then after they examined Charles in bed the ambulance 5 6 told me that they could not take him because they 6 7 felt as though that his vitals were enough that I 7 8 could get him to the hospital. 8 9 Q And did you take him to the hospital? 9 10 A Yes, immediately. 10 11 Q Okay. And did you sign him in at the 11 12 hospital? 12 13 A He signed himself in. 13 14 Q Now, you answered one of Mr. Haar's 14 15 questions about the visit when he was being 15 16 readmitted after the problem with his heart valve in 16 17 2003- 17 18 A Correct. 18 19 Q - where Alma called you and you came and 19 20 rm trying to - 20 21 A She requested that I come. 21 22 Q I understand that. Who admitted him to 22 23 the hospital that second time? 23 24 A I don't know. He was in the hospital 24 25 when I got back down there. 25 writing from Charles revoking your power of attorney? A No, I haven't. MR. HAAR: Just to be clear, when you say revoking, meaning as to him or as to Mother? BY MR. BARON: Q Did you ever receive anything from Charles - well, let me see the document that is - A Their wills are also in there. (Brief pause.) (Durable Power of Attorney marked as Plaintiffs Exhibit Number 22.) BY MR. BARON: Q Okay. I want you to look at a document I'm identifying as P-22. Is this something Charles sent to you? A Yes. It was in this packet with both my mother's and Charles' power of attorney and their wills. Q And with respect to the - let's finish our conversation with respect to your mother's. When was the first time after you received the power of attorney as to your mother that you became aware that there was a second power of attorney? A It was when my mother was in Claremont and Charles attempted to visit. 13 (Pages 46 to 49) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRA N • SHAY VS April 7, 2008 SHAY f { 1 50 1 Q So we've established earlier that the 1 2 attempt to visit was in 2005. 2 3 A Right, and the nurse - 3 4 Q Let me stop you. When your mother was 4 5 admitted to Claremont, did Claremont ask you whether 5 6 or not your mother had a power of attorney? 6 7 A Yes, and they have this on file. 7 8 Q And the power of attorney that you gave 8 9 them was the one that your father had sent to you in 9 10 2001? 10 11 A Correct. 11 12 Q And that was the power of attorney on 12 13 file when she was admitted? 13 14 A Correct. 14 15 Q And that was the power of attorney on 15 16 file on the date that your father visited in 2005? 16 17 A Yes, yes. 17 18 Q And prior to that date were you aware 18 19 that there was any other power of attorney to anyone 19 20 else other than yourself for your mother? 20 21 A No. 21 22 Q On the date your father arrived in July 22 23 of 2005, was that the date you contacted the attorney 23 24 in Florida about the powers of attorney? 24 25 A It was within a couple days. 25 51 1 Q A couple days after or a couple of days 1 2 before? 2 3 A A couple days after Charles visited the 3 4 nursing home. 4 5 Q Okay. So sometime after July the I l th 5 6 you contacted the attorney in Florida whose card was 6 7 on the material that your father had sent you in 7 8 2001? 8 9 A Correct. 9 10 Q And what did the attorney tell you then? 10 11 A He told me that there were two power of 11 12 attorneys dated the same day, one to Charles, one to 12 13 me, and since they are married, Charles' power of 13 14 attorney would override mine. 14 15 The reason I called inquiring about what 15 16 the durable power of attorney would give me is 16 17 because I was afraid - Charles had made the 17 18 statement to Amy Walker that when he got lack to 18 19 Florida I would no longer be power of attorney, so I 19 20 needed to know if he could change that, and if he 20 21 could, I therefore needed to put actions in place to 21 22 stop Charles from pulling my mother out of a nursing 22 23 hone. 23 24 Q When you admitted your mother to the 24 25 nursing home with the power of - this power of 25 52 attorney is notarized on August the 29th, 2001. A Okay. Q And it says its signed on August the - well, this is your father's. Let me look at your mother`s for a minute. A This is my mother's (indicating). Q Your mother's says it was signed on August the 29th and that it was notarized on August the 29th. What was your mother's condition - do you know what your mother's medical condition was on August the 29th, 2001? A She was already diagnosed with Alzheimer's at age sixty, so she was probably in the mid stages of Alzheimer's when she signed this. Q So did you ever obtain or do you know whether any physician has documented that on August the 29th, 2001 your mother was competent or incompetent to sign a power of attorney9 A Ask your question again. Q Did you ever obtain a medical opinion as to whether your mother was competent or incompetent on August the 29th, 2001 to sign a power of attorney? A I never asked a medical doctor if she was commetent to sign on August 29th, 2001. 53 Q Did the attorney who prepared these documents when he spoke to you give you any information on that? A No. Q Now, to go back to my earlier question, with respect to P-22, the power of attorney for Charles - A Okay. Q Its not in the set, its this (indicating). A I have it here. Q Okay. This is something Charles sent to you? A Yes. Q And my question is has he ever sent you in writing a document revoking this power of attorney? A No. Q During the guardianship proceeding which commenced in - I think it was settled sometime in 2006, although you started what you referred to as step one in November of 2005. During the guardianship proceeding, did you have any conversations or correspondence with your father? A Charles sent me the letter saying tbat he 14 (Pages 50 to 53) Geiger & Loria Reporting Service - 800-222-4577 SHAY-SNYDER TRAO • SHAY VS April 7, 2008 SHAY 54 1 was receiving medical bills and that's in one of your 2 exhibits. 3 Q When you say the letter, you're talking 4 about the letter of November 15th? 5 A Yeah. It's Exhibit P-15. 6 Q That was November 4th, 2005, so that was 7 prior to your commencing the proceedings. 8 MR HAAR: rm sorry. Which exhibit are 9 we talking about? 10 MR. BARON: P-15 she was referring to. 11 A You are correct. 12 BY MR. BARON: 13 Q After November 18th, 2005, did you have 14 any conversations or correspondence with your father 15 about the guardianship proceedings? 16 A Not that I recall. 17 MR. BARON: Nothing else. 18 MR HAAR- Nothing from me. Thank you. 19 (The deposition was concluded at 4:54 20 p.m.) 21 22 23 24 25 55 1 STATE OF PENNSYLVANIA : ss 2 COUNTY OF DAUPHIN 3 4 1, Dawn Young Dietrich, a Reporter 5 Notary-Public, authorized to administer oaths within 6 and for the Commonwealth of Pennsylvania and take 7 depositions in the trial of causes, do hereby 8 certify that the foregoing is the testimony of 9 TRACY D. SHAY-SNYDER. 10 I fiuther certify that before the taking 11 of said deposition, the witness was duly sworn; that 12 the questions and answers were taken down 13 stenographically by the said reporter, Dawn Young 14 Dietrich, a Reporter Notary-Public, approved and 15 agreed to, and afterwards reduced to typewriting 16 under the direction of the said Reporter. 17 I fiuther certify that the proceedings 18 and evidence are contained fully and acamately in 19 the notes taken by me on the within deposition, and 20 that this copy is a correct transcript of the same. 21 In testimony whereof, I have hereunto 22 subscribed my hand this 21 st day of April, 2008. 23 24 Dawn Young Dietrich 125 My commission expires: 15 (Pages 54 to 55) Geiger & Loria Reporting Service - 800-2224577 .7 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated . Person by TRACY D. SHAY-SNYDER as : CIVIL ACTION - LAW Plenary Guardian of the Person and Estate of Patricia J. Shay, Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant LIST OF EXHIBITS FOR DEPOSITION OF CHARLES E. SHAY, JR. MONDAY, APRIL 7, 2008 - STARING AT 3:00 P.M. BY TELEPHONE CONFERENCE WITH COUNSEL PRESENT AT 2933 NORTH FRONT STREET, HARRISBURG, PA 17110 1. Exhibits related to ownership of real property in Pennsylvania P-1 Ownership card on file with Harrisburg Cemetery for Section 34 Lot No. 39. P-2 Photographs of headstone site engraved with name of Charles E. Shay, Jr. and Patricia J. Shay. 2. Exhibits related to bank accounts in Pennsylvania prior to September 8, 2006: P-3 [TO BE SUPPLIED BY DEFENDANT] Showing of his NCFCU account was closed on August 31, 2006, after this litigation was filed on June 6, 2006. P-4 CUNA Mutual Group Insurance Society policy for Credit Union Members Health Insurance Trust naming Defendant as the beneficiary of the insurance on the account at NCFCU set up in the name of his wife and not closed until 2008. • 0 3. Exhibits related to Contacts with State Medicaid Program P-5 April 27, 2005 letter from Cumberland County Assistance Office, with copy to Defendant, concerning verification of assets provided by Defendant and providing additional information. P-6 August 18, 2003 transmittal from Cumberland County Assistance Office to Tracy Snyder requesting Defendant's tax returns and bank statements. P-7 2002 Federal Tax Return filed by Defendant transmitted by Defendant in response to P-6. P-8 August 18, 2003 Parcel Post sent by Defendant to Tracy Snyder with bank statement information in support of Medicaid Application and in response to P-6 4. Exhibit related to Defendant's continuing contacts in Pennsylvania P-9 Withdrawal during 9/24/1999 visit from Camp Hill MAC machine confirmation P-10 Checks for 1999, 2000, and 2001 West Fairview School Association reunions in Pennsylvania. P-11 Charge Entry for Dinner with family on 6/17/2000 at Peppermill Restaurant in Mechanicsburg, PA P-12 Charge Entry for Dinner with family on 7/13/2003 at Hotel Hershey in Hershey, PA P-13 Defendant's insurance policy card covering his wife while she was receiving care in Pennsylvania - R02028811 (effective 1/1/1989) - BCBS Federal Employee Program PPO Government-Wide Service Benefit Plan. P-14 Interdisciplinary Notes from Claremont concerning Defendant's efforts to visit his wife there on July 10-11, 2005 P-15 November 4, 2005 letter from Defendant to Tracy Snyder concerning Bills he received for care of his wife in Pennsylvania that were paid under P-13. P-16 Billing invoices for Mrs. Shay's care in Pennsylvania listing Defendant's insurance as a payment source. P-17 Letter from Medco Health to Defendant at address in Camp Hill, PA related to FEPCARD insurance in his name and related RX invoices paid by such insurance. P-18 Letter of June 21, 2006 from counsel for Tracy Snyder, Attorney Sloan, in Guardianship proceedings to counsel for Defendant, Attorney Irwin, concerning Defendant's demands for visitation rights to see his wife at Claremont. P-19 Letter of September 5, 2006 from Rebecca M. Fuhrman, CLI and Nichole Walter, Supervising Attorney, Dickinson Elder Law and Consumer Protection Clinic, indicating they were "representing Mr. Shay in the guardianship action filed by Tracy D. Shay-Snyder," to Attorney Doreena Craig Sloan (then representing the Petitioner in the Guardianship proceedings for Mrs. Shay) concerning Defendant's desire, as part of any resolution of the Guardianship proceedings, to have "the right to visit his wife without the discretion of his daughter" with notice to "Claremont Nursing Center [sic] at least 48 hours in advance of his visits, but he will not contact his daughter and seek permission before making the trip from Florida to Pennsylvania to see his wife." P-20 September 6, 2006 letter from Attorney Doreena Craig Sloan to Nicole Waters, Esq. and Becky Furhman with counteroffer on visitation rights. P-21 Order of September 8, 2006 in Guardianship Proceeding. k 4?XA? e A"?' -2 34- 9(v (a/ r3-4 of-e-4 14 A, - m8 rr E- • • Vt' ^} . ((d ?s.*.-f 5'?hf+, wLQ i•a7dvFf4 r z 4r ,r,F, °.r ,? ? ?la?y .`?? d .. • r- O •- N M d- to O 0) ao f- cD: to It, M N O O 00 n tD M NNNN?NNN N N i s N M sF N 0 1? 00 M M M M M M M- M M M M M M M IN to U-) to e? d- d' d- O rn ? a0 00 ? t? ?O c0 '3 ?! ?t M M N ?- O ? 00 t? c0 t0 ? ? to to to to to NM??t?000O?NM?t? r-- N 1? d- t('); :cOj h QO O O ?- N M ?t ? cD cD co cD co co co (0 co 1- ? f`- 1- r-- i- 7 O) 00 ? (Or M N r- O 01) 00 1? tD 31 00 00 , OD b0: .GO, 00 00. 00 ? 00 t- f? 1, I- ?t ? t0 1? 00 N M ?- Nr--?.-.- - N M Ifi U) d' CYD Z O W U? t, i. R ?f_ L ti rte.:: IM 1. f•? s?' ? r. ?J rt C I } r ? x Y- a `_Z t y1-z<; tt r c ? 'r r _ •7. ? L 44 177- Y . ? 1 wl: J ZRl a ,4 f •?0 9 •ta'' .ti?s. ' :??i 1 A s ?i { z1? - J 'y7?y 7' .t y ? f. 'S a^S o J ? r l I _a kx i N ?t *yy 1 ?.y ? a ? t ?!;.-: , ':ter: .rSe•.!S ! 1 k^Y?iY <F _v ? ? 1 ? I t li 4 i SEPTEMBER 15, 2003 Patricia J Shay C/O Tracy Snyder 2713 Columbia Ave Camp Hill PA 17011 RE: Dear Patricia J Shay: Enclosed is the insurance document you requested. 24 We are pleased to be providing you with insurance coverage. If we may be of further assistance, please contact our Service Center at 1-800-779-5433. Our business hours are 6 a.m. to 9 p.m., Monday through Friday, and 8 a.m. to 6 p.m., Saturday, Central time. We do have other insurance products available to help meet your financial needs. For more information, contact our Credit Union Member Services at 1-800-356-6006. Sincerely, Diana Beschorner Supervisor - Policy Service Credit Union Member Services Enclosure 7JC-ROLS/ZA115 i . CUNA MUTUAL GROUP CUNA Mutual Inmrancc Soddy ?kti;b,-F P- P,o. Box 61 ¦ Waverly, IA 50677-0061 Business 800/779-5433 a Fax 319!352.6132 ft cutup MUTUAL GOUP CUNA Mutual Insurance Society Group Accidental Deat Administrative Office and Dismembermer P.O. Box 61 • Waverly, IA 50677-0061 Phone: 800/779-5433 (called WE, US or OUR) POLICYHOLDER: CREDIT UNION MEMBERS HEALTH INSURANCE TRUST SCHEDULE: BASIC AMOUNT While Under Age 70 Age 70 and Over $1,000 $500 We have issued a Group Accidental Death and Dismemberment Policy to the Policyholder to insure Eligible Members of the Participatiln< Association. RIGHT TO EXAMINE THE CERTIFICATE FOR 30 DAYS. You may return the Certificate for any reason and get a refund within 30 day: of (1) the date You received the Certificate or; if later, (2) the date the first premium is paid. We will refund any premiums paid. The Certificate will be void from the start. No benefits will be paid for any Loss. EFFECTIVE DATE OF INSURANCE. This insurance on an Insured Member (also called "You," "Your" or "Yours" under this Certificate) Will become effective on the Entry Date following Our acceptance of Your completed enrollment form. DEFINITIONS. As used in this Certificate, these words have the following meaning: Basic Amount means the non-contributory amount provided to the Insured Member only. Eligible Member means a natural person who is a member of a Participating Association and who is over 18 and under 70 years of age. Entry Date means the date on which an Insurance Period begins. Insurance Period means the three-month period beginning on each Entry Date selected by the Participating Association. Insured Member means an Eligible Member who has: 1. completed an enrollment form; and 2. not been terminated from coverage under the Policy in accordance with the Termination Provisions. Injury means any bodily harm caused by an accident occurring while the Policy is in force as to the Insured Member and resulting directly and independently of all other causes of Loss. Loss means injury which results in Loss of life or bodily injury of an Insured Member and occurs while the Policy is in force. Loss with reference to hand or hands, foot or feet, means severance at or above the wrist or ankle joint. (For South Carolina residents, loss of hand or hands also means loss of four fingers.) Loss with reference to eye or eyes means total and irrevocable loss of the entire sight of the eye or eyes. Loss of speech or hearing means total and irrevocable loss of speech or hearing. Loss with reference to thumb and index finger means total loss of the thumb and index finger on the same hand. BENEFITS. While this Certificate is in effect, an Insured Member is covered 24 hours a day, 365 days a year against accidents in the course of business or pleasure. Coverage includes (but is not limited to) accidents whether on or off the job, occurring in the home, traveling as a passenger by train, airplane, automobile or other public or private transportation. The benefits provided under the Policy are payable in addition to any other insurance which may be in effect at the time of the accident. If an Insured Member sustains a Loss within 365 days after the date of an accident, We will pay in one sum, the following indicated percentage of the Basic Amount shown in the Schedule for: LOSS OF Life 100% Both Hands or Both Feet 100% Sight of Both Eyes 100% One Hand and One Foot 100% One Hand and Sight of One Eye 100% One Foot and Sight of One Eye 100% One Hand or One Foot or Sight of One Eye 100% Speech or Hearing 100% Thumb and Index Finger of Same Hand 1000/0 EXHIBIT P7Y Only one benefit, the largest to which the Insured Member is entitled to, is payable for all losses resulting from one accident. ISCERTIFICATE OF INSURANC El Oc-008-689-4 . ? CUNA MUTiJAL GOUP CUNA Mutual Insurance Society Administrative office P.O. Box 61 • Waverly, IA 50677-0061 Phone- 8001 7 79-5 4 3 3 Group Accidental Death and Dismemberment (called WE, US or OUR) POLICYHOLDER: CREDIT UNION MEMBERS HEALTH INSURANCE TRUST SCHEDULE: BASIC AMOUNT While Under Age 70 Age 70 and Over $1,000 $500 We have issued a Group Accidental Death and Dismemberment Policy to the Policyholder to insure Eligible Members of the Participating Association. RIGHT TO EXAMINE THE CERTIFICATE FOR 30 DAYS. You may return the Certificate for any reason and get a refund within 30 days of (1) the date You received the Certificate or; if later, (2) the date the first premium is paid. We will refund any premiums paid. The Certificate will be void from the start. No benefits will be paid for any Loss. EFFECTIVE DATE OF INSURANCE. This insurance on an Insured Member (also called "You," "Your" or "Yours° under this Certificate) will become effective on the Entry Date following Our acceptance of Your completed enrollment form. DEFINITIONS. As used in this Certificate, these words have the following meaning: Basic Amount means the non-contributory amount provided to the Insured Member only. Eligible Member means a natural person who is a member of a Participating Association and who is over 18 and under. 70 years of age. Entry Date means the date on which an Insurance Period begins. Insurance Period means the three-month period beginning on each Entry Date selected by the Participating Association. Insured Member means an Eligible Member who has: 1. completed an enrollment form; and 2. not been terminated from coverage under the Policy in accordance with the Termination Provisions. Injury means any bodily harm caused by an accident occurring while the Policy is in force as to the Insured Member and resulting-drectly and independently of all other causes of Loss. Loss means injury which results in Loss of life or bodily injury of an Insured Member and occurs while the Policy is in force. Loss with reference to hand or hands, foot or feet, means severance at or above the wrist or anide joint. (For South Carolina residents, loss of hand or hands also means loss of four fingers.) Loss with reference to eye or eyes means total and irrevocable loss of the entire sight of the eye or eyes. Loss of speech or hearing means total and irrevocable loss of speech or hearing. Loss with reference to thumb and index finger means total loss of the thumb and index finger on the same hand. BENEFITS. While this Certificate is in effect, an Insured Member is covered 24 hours a day, 365 days a year against accidents in the course of business or pleasure. Coverage includes (but is not limited to) accidents whether on or off the job, occurring in the home, traveling as a passenger by train, airplane, automobile or other public or private transportation. The benefits provided under the Policy are payable in addition to any other insurance which may be in effect at the time of the accident. If an Insured Member sustains a Loss within 365 days after the date of an accident, We will pay in one sum, the following indicated percentage of the Basic Amount shown in the Schedule for: LOSS OF Life 100% Both Hands or Both Feet 100% Sight of Both Eyes 100% One Hand and One Foot 100% One Hand and Sight of One Eye 100% One Foot and Sight of One Eye 100% One Hand or One Foot or Sight of One Eye 100% Speech or Hearing 100% Thumb and Index Finger of Same Hand 100% Only one benefit, the largest to which the Insured Member is entitled to, is payable for all losses resulting from one accident. OCERTIFICATE OF INSURANCE E10c-00A-689-4 EXCLUSIONS. We will not pay a benefit rr any Loss to an Insured Member caused by orresulting from: 1. suicide while sane or insane (for Colorado and Missouri residents: suicide while sane), or 2. intentionally self-inflicted injury, or 3. declared or undeclared war or any act thereof, or 4. air travel as a pilot or crew member, or 5. operating a motor vehicle while intoxicated, or 6. riding or driving in any kind of race as a professional, or 7. cMmitt V or attempting to commit a felony, or 8. voluntary use of any drug, medicine, or sedative, except as prescribed by a physician. BENEFIT PAYMENTS. The benefit for Loss of life will be paid in accordance with the Beneficiary designation and the provisions regarding such payments which may be in effect at the time of payment. All other benefits will be paid to You. BENJEFICIARY. Unless You tell Us otherwise, Your Beneficiary under the Policy for insurance payable for Loss of life on Your death will be Your spouse, if living, otherwise Your estate. CHANGE OF BENEFICIARY. Unless You indicate that Your Beneficiary cannot be changed (irrevocable Beneficiary), You can change Your-Beneficiary at any time. The Beneficiary's consent is not needed. We will make the change only if We first acknowledge receipt of Your notice. It will take effect on the date Your notice was signed. You do not .have to be alive on the date of Our acknowledgement. The change is subject to: (1) the rights of Your spouse if living in a community or marital property state; and (2) any payment made or action taken by Us before Our acknowledgement. TERMINATION OF INSURANCE. This insurance will terminate on the earliest of the following dates: 1. the date the Policy or the Participating Association's coverage under the Policy terminates; or 2. the end of the Insurance Period during which You are no longer a member of the Participating Association; or 3. the date of Your death; or 4. the premium due date following Your request termination. Temlination of Your insurance will be without prejudice to any benefit payable for Loss which occurred prior to termination. HOW TO FILE A CLAIM. You must write Us about a claim within 20 days after the occurrence of any Loss or as soon as You can. We will provide You with claim forms or We will send them to You within 15 days after You tell Us about the claim. If We don't send the forms in 15 days, You can simply send Us written proof of loss. The proof must show the date, the character and extent of the Loss. You must send proof to Us within 90 days after the date of such Loss. If You cannot send proof to Us within 90 days, You must do so as soon as You can. Unless You have been legally incapable of filing the proof of loss, We won't accept it if it is filed after one year from the time it should have been filed. You can't start any legal action against Us until 60 days after You send Us proof of loss and You can't start any legal action against Us more than three years (six years for South Carolina residents) after You have sent the proof. MISSTATEMENT OF AGE. If You misstated Your age, all amounts payable under the Policy will be such as the premium paid would have purchased at Your correct age. STATEMENTS OF INSURABILITY. The Policy and the Application for the Policy are the complete contract of insurance. All statements made by You are considered to have been made to the best of Your knowledge and belief. No statement can be used to void this insur- ance or deny a claim unless that statement is signed by You. After two years from the Effective Date of Insurance on any Insured Member, no statement made by You can be used to void this insurance or deny a claim. PHYSICAL EXAMINATIONS AND AUTOPSY. We, at Our own expense, have the right to examine an Insured Member as often as is reasonably required while a claim is pending and to make an autopsy in case of death where it is not forbidden by law. CONFORMITY WITH STATE STATUTES. Any part of the Policy which, on the Effective Date of the Policy, conflicts with the statutes of the state where the Policy was delivered is changed to conform to the minimum standards of those statutes. This Certificate replaces and supersedes any Certificate previously issued to You E10c-008-689-4 Commonwealth of Pennsylvania Department of Public Welfare CUMBERLAND COUNTY ASST OFFICE 33 Westminster Drive P.O. Box 599 Carlisle, PA 17013-0599 Telephone 240-2744 OR 1-800-269-0173 ext 3744 FAX: 249-0919 April 27, 2005 Tracy Snyder 2713 Columbia Ave Camp Hill, PA 17011 Re: Patricia Shay CNRC Case 97630 Dear Mrs. Snyder, Enclosed please find the Results of the Resource Assessment for Mrs. Shay. Mr. Charles Shay provided verification that he has several bank accounts which when combined with Mrs. Shay's accounts total $37464.85. According to Nursing Home regulations, Mr. Shay is able to keep $19020.00 of the total resources. He can either complete the enclosed Income Assessment Worksheet to see if he can keep additional resources to maintain himself in the community, or he can use the excess to pay Nursing Home or other medical expenses and provide this office with verification. See attached Manual Regulation, if neither of these options apply to your situation, the resources must be reduced before she can be determined eligible for Nursing Home Medical Assistance. I have enclosed a new application which needs to be completed listing the reduced resources when you are ready to reapply. Call me if you have any questions. I have sent a copy of this notice and the Results of the Resource Assessment to W. Shay. Sincerely, Lynne Gordon IMC Copy: Mr. Charles Shay EXHIBIT Commonwealth of Pennsylvania Department of Public Welfare CUMBERLAND COUNTY ASST OFFICE 3 3 Wesbninster Drive P.O. Box 599 ------ ---__ ---Carlisle,.-PA-.11O13_O59-9 ----_ --------- Telephone 240-2744 OR 1-800-269-0173 FAX: 249-0919 RESULTS OF RESOURCE ASSESSMENT Dear MRS. PATRICIA J. SHAY, The Department of Public Welfare has completed the Resource Assessment received on- -APRIL 26, 2005. Based on the information you provided, the total value of the countable resources owned by you and your spouse as of the date of your admission to the nursing facility is _$ 37464.85 _. A copy of the Resource Assessment Form is enclosed. The purpose of the assessment was to determine what portion of the total resources owned by you and your spouse may be protected for the spouse at home. This portion is called the "protected spousal share" and is not considered available to pay for nursing facility care. This protected spousal share is generally one-half of your joint resources, up to a maximum, set by federal law (currently $95,100) and not less than a minimum (currently $19,020). Based on that formula, your protected spousal share is $19020.00 . Except as described below, you should apply for Medical Assistance when the total countable resources of you and your spouse are reduced to an amount approximately equal to the protected spousal share (above) plus $2,400. In some cases, more resources may be protected for the spouse at home. In order to be able to protect more resources, you must apply for Medicaid sooner and request a hearing. Information describing when you are permitted to protect more resources for your spouse at home was included in Part 3 of the Admissions Notice Packet you received from the Nursing facility when you were admitted. You should refer to this information if the income of the spouse at home is less than $2378 per month. If you need another copy of Part 3, contact the admission office of your nursing facility. It is important for you to calculate the monthly income allowance and actual monthly income needs of the spouse at home in order to appropriately protect resources and provide income to your spouse at home as permitted by federal law. The enclosed worksheet will help you in making this determination, Once you have applied for Medicaid benefits, either you or your spouse may request a fair hearing if you are dissatisfied with the Department's determination of the community spouse's share of resources or monthly income allowance, or to establish that your spouse should receive a higher income or resource allowance. If you have any questions about this letter, yowmay contact me by telephone at 240-2744 or 1- 800-269-0173 or by writing to the address above. LYNNE GORDON Copies: Nursing Home • • INCOME ASSESSMENT WORKSHEET You, the spouse living at home, are entitled to a minimum protected monthly income level. Currently, that level is $1562, plus shelter costs over $469, up to no more than a total of $2378. The following chart will enable you to compute your own protected monthly income level and your actual monthly income. The allowances for utility costs are based on a set standard, not on your actual costs. If you pay separately (for example, not included in rent) for heating and/or cooling and for other utilities you should enter $374.00 in the appropriate space in the chart below. If you do not pay for heating or cooling, but pay for other utilities (besides telephone service), your should enter $201. If you do not have any utility costs, but pay only for telephone service, you should enter $29. For all other shelter items, compute and enter your actual monthly cost, even if you pay on another time basis (for example, quarterly or annually). If you do not make payments for a specific item, leave that item blank. MONTHLY EXPENDITURES (1) UTILITIES ($374, $201, OR $29) (2) RENT (3) MORTGAGE (PRINCIPAL & INTEREST) (4) REAL ESTATE TAXES (MONTHLY) (5) HOMEOWNER'S INSURANCE (MONTHLY) (6) CONDOMINIUM FEES (7) SUB TOTAL (ADD LINE 1-6) (8) LESS $469 (9) YOUR SHELTER COSTS (1) (2) (3) (4) (5) (6) (7) (8) -469.00 (9) (10) CURRENT FEDERAL BASE LEVEL (10) 1562.00. (11) PLUS YOUR SHELTER COSTS (LINE 9) (11)!+ (12) TOTAL -MONTHLY INCOME ALLOWANCE (12) This total is the minimum monthly income amount which you are entitled to as a community spouse, under Federal Medicaid law. If your total is greater than $2378, the Department of Public Welfare will use the figure of $2378, because that is the maximum allowance under federal law. 0 • -2- TO DETERMINE YOUR ACTUAL MONTHLY INCOME, USE THE FOLLOWING PROCEDURE: MONTHLY INCOME OF SPOUSE AT HOME (13) SOCIAL SECURITY (13) (14) PENSIONS (14) (15) OTHER (15) (16) INTEREST OR DIVIDENDS FROM PROTECTED SHARE OF RESOURCES* (FROM RESULTS OF RESOURCE ASSESSMENT(16) (17) TOTAL MONTHLY INCOME (17)_ * Actual rate of return OR reasonable rate of return on a 1 year C.D. whichever is larger. Example: if a 1-year C.D. currently earns 3.% /yr. and you have your standard spousal share of resources invested at a rate of only 3.5%, the Department of Public Welfare will use 3.% as the rate of return or interest. If the total on line 17 (your income) is less than the total on line 12 (your monthly income allowance) you are permitted to have more monthly income. For Example: if your protected monthly income level (line 12) is $2019 and your total monthly income (line 17) is : 1200 you may seek additional income of : $ 819 If you want to protect additional resources for the purpose of producing this income, your spouse should apply for Medicaid now and request a hearing to establish that you need a greater share of the resources in order to bring your income up to the protected level. In the alternative, your spouse in. the nursing facility can give you some of his or her income each month. Your spouse does not have to apply for Medicaid or have a hearing to do this. You should make sure that the total of your combined incomes is enough to provide the monthly income allowance. If you and your spouse choose to supplement your income through a monthly income contribution from your spouse in the nursing facility instead of protecting a greater share of your resources, then your spouse does not have to apply for Medicaid until the total resources are reduced to approximately your protected share (indicated on the Results of Resource Assessment) plus $2400. REMINDER: The maximum protected amounts for both resources and income for the spouse at home is revised annually. PA , . _ NOTICE TO APPLICW NT e y ? ,r ?4 A.R. f BENEFIT ELIGIBLE NOT ELIGIBLE PENDING CAR!- ISLE, P,-,. 170 F`v59Y-' ASSISTANCE CHECK After the first check which may be a special amount you will receive $ 0 Twice a month [:] Once a Month [3 In the Mail 0 At the Bank Ei MEDICAL ASSISTANCE [J you have a patient pay liability of $ for the period beginning and ending Effective Date STAMPS You will receive $ for the month(s) of a month from to E] In the Mail then you will receive food stamps in the amount of $ At the Bank 0 NURSING HOME CARE Level of care authorized you are expected to pay $ a month toward your care. SOLI ALES ? OTHER THE FOLLO1NiNdPERSONS ARE INCLUDED LINE NO. NAME CAST ECK FOD STAMPS MED. ASST. SOC. LINE SERVICE NO. NAME ASS . CHECK FOOD STAMPS MED. ASST SO SERI ,5o V F Your reoufast for llsursin4 Facil • Regu4ttion 178.121 Reason Code 079 ity Services Medical Assistance is beinp- denied due to excess rl The resource limit is $2400.66. The amouvt of your -tesources was leteimf6ed by evaluating all resources awned separately and jointly as of the date of admission to the borne and subtr' tir_? $ .9 ac 19,E I4 S avail.- spousal share {detest ed to be $ 37`(6-`Ng56inus spousal share $ igo2o,00 _ Name GROSS MONTHLY EARNEDINCOME Name GROSS MO EARNED IN NTHLY COME $ $ $ $ Name GROSS MONTHLY UNEARNED INCOME Name GROSS MO UNEARNED I NTHLY NCOME $ ZYZL $ $ $ TOTAL GROSS MONTHLY INCOME i s TOTAL GROSS MONTHLY INCOME $ GROSS MONTHLY DEPENDENT CARE COSTS I s GROSS MONTHLY DEPENDENT CARE COSTS Is GROSS MEDICAL COSTS I s Telephone Water/Sewage Q MEDICAL ASSISTANCE. Number of Persons` Electric Garbage/Trash Name EARNEDMIN COME Gas Utility Installation $ Oil Other $ GROSS UTILITY COSTS(UTILITY STANDARD` $ $ RENTIMORTGAGE $ Name GROSS MO UNEARNED I NTHLY NCOME TAXES $ $ INSURANCE COST ON HOME $ $ TOTAL SHELTER COST is $ switch between the actual utilit costs and the eh ld ma 'Th h TOTAL GROSS MONTHLY INCOME I s y y ous o e standard utility allowance at the time of reapplication and one NET MONTHLY INCOME/NET SEMI-ANNUAL INCOME $ additional time during each twelve-month period. INCOME LIMIT Is CO RECORD NUMBER CAT CTR DIG DIST ` r \ ?J](s? 1 o? ` f } ,? -7 `t 1 2 , .21 000 /t PAtJ U Worker's Signature Date Telephone Number U r" YJ R C I LEGAL HELP IS AVAILABLE AT tZsIrld_ SER:nCES.14C. e*WKE ROW 0 7RUSLE PA-1701-3-3019 ?i'-T3 S,`T? 71, . -"rxi E'M'S L_ J If you do not understand our decision or have any questions, contact your worker. i;suut<?t f?1?JtJJMtfy I t: U WION 511EET PAGE ONE OF TWO Completed By: ?-yf?n?? CaR???: Ins6tuEionalized Spouse: n ODE 01 County. Date of Admission: TYPE cash on Hand • Area: z y C LOCATION OF RESOURCE - COMMENTS Soc. Sec. Number: ountable Amount IP yea 02 ftyings Account CC o - as ,? Savl Account 'Incilovia-, 7 y .i Savi Account 03 Checld Account - , - s ' S AV Account , 1,g .4 r, 7.4 a ? Account CtwmM Account 04 CINIshnasNacation Ciub Chfkbwwfflo? Club 05 sbmkseon& i StockslBonds StocksiSonds Stoclcsi601ds - - StodtsiBonds Trust Fund s Trust Fund T Burial Reserve Irrevocable? ss No Burial Reserve Irrevocable? Yes No s 08 surw Plot Exemp t? Yes No Burial Plot ] Examp t? Yes No We Insurance 4JU4 kC - Cu Facet o `_' Cash $ Q Life Insurance O Face = O °O Cash t u We Insurance 2 - LT Face t oG GO Cash f = L ik Insurance Facet Cash Life Insurance Face t Cash t t Non•itesident Property $ Motor Vehicle -o l Exemp t? Yes No $ Motor Vehicle Exem Yes No s Other Vehicle(s) Other Vehicle(s) Other Vehicle(s) _ 13 cem of Deposit i f l O J > F 7 c Cert of Deposit $ Cert of Deposit Cent of Deposit Cert. of R?Lmlt Cert. of It SUBTOTAL VEMFIED COUNTAB LE R $ $ 7 6 ,CIS RESOURCE ASSESSMENT COMP ON SHEET TWO OF TWO CODE TYPE LOCATION OF RESOURCE - COMMENTS Countable Amount VeirtRed yes Nc 14 Annuities $ Annuities Annuities 15 Savings Bonds $ Savings Bonds S Savings Sonds $ Saving Bonds $ Savings Bonds $ Savings Bonds $ 16 Mutual Funds $ Mutual Funds $ Mutual Funds $ l Funds $ 7 Sole Proprietorship $ Joint Partnership $ 18 ute Interest $ 19 Other $ Other $ Other $ Other SUBTOTAL VERIFIED COUNTABLE RESOUitCES (D WONO) $ # SUBTOTAL VERIFIED COUNTABLE RESOURCES (o TOTAL COUNTABLE m om S $ -7 4 a744.4 : T S ': Notliioatlo? 8snt Data EnWvd Veon/Docunarftlio W D ? - SPOUSAL SHARE n Needed: $ - o ot > I DEPARTMENT OF PUBLIC WELFARE ' ° • • ' ° • • KLSUru wsUN I T A,bl* IANGIZ OFFICE 33 WESTMINSTER DRIVE P. 0. BOX 599 BENEFIT ELIGIBLE Et"reTLE vErroaac CARLISLE, PA 17013-0599 ASSISTANCE CHECK After the first check which may be a special amoum you will receive $ Twice a Month ? Once a Month to the Mai 0 At the Bank Ei MEDICAL ASSISTANCE xx ? You have a patiem pay liability of $ for the period beginning and ending ? Effective Date FOOD STAMPS You wit receive $ for the month(s) of ? ftten you wig receive ft food stamps in the amount of $ a month from to In tfkMai At Bank NURSING HOME CARE Level of care authorized you are effected to pay $ a mom toward your care. ? SERIES ? O R '?J T?,!!fa"?11-Wr Y'f;"! .'•.. ? ...?.!4 '.•,}r' 'Y-Yr2}.t<)'.'?? J.: ?.t ?2 1 +4 t}-+ '. vi>'F,? }-3. ?, 1L ?,"ql?. .c#,?4 NO. NAME CHE CK STAMPS ASST. SESOC NO. NAME CHECK STAMPS ASST. S Rk G i- our request for Nursina • Re0'?°b°" 178.121 Reaacn Code 079 Facility Services Medical Assistance is beinfa denied due tn P_vd-pmla rp f f resource limit is $2400.00. The mount of your resources was determined by evaluating all urces owned separately and jointly as of the date of admission to the home and subtracting sal share (determined to be $.37 H64,'?5minus spousal share $ P020100° _ $ 18f-144 gs availa ,???yp}?? ¦? L:.I?iVVa/,,P!? ?.?b.. ..i.• u INTO e • _7J}O% a ?y(]r/ :'.Y.?d?s'?i Y.. `-?{'y?`w ?.^.'. Name REARNED INCOME New EA I OME $ $ N $ $ Name UNEARNED INMON Y Name lR RfIED I NCOI fE $ $ $ $ TOTAL GROSS MONTHLY INCOME $ TOTAL GROSS MONTHLY INCOME $ GROSS MONTHLY DEPENDENT CARE COSTS $ GROSS MONTHLY DEPENDENT CARE COSTS I s GROSS MEDICAL COSTS I s - Telephone Water/Sewage []-$ AEOICALASSWANCE`` NutnTsel of Pe lofts : Electric Gaftg&7rash Name GROSS MO EAARRNE IN NTHLY COME Gas Utility Installation $ Oil Other $ GROSS UTILITY COSTS/UTILITY STANDARD` $ $ RENT/MORTGAGE $ Name UNEARNED I tVC011E TAXES $ $ INSURANCE COST ON HOME $ $ TOTAL SHELTER COST $ $ housB60ld 'De mik switchbetween a actual utility costs and )rie TOTAL GROSS MONTHLY INCOME $ . . ., , standard utility allowance at, tfie time. of reappWcabon and.` one NET MONTHLY INCOMMET SEMI-ANNUAL INCOME $ -additional time during each twelve-month period.. INCOME LIMIT $ Workers Signature Date Telephone Number (- LEGAL'HELP IS AVAILABLE AT C:JNRC LEGAL SERNACES, INC. 8 IRVINE ROW CARLISLE, PA 17013-3019 717-243-9400 717-766-8475 L J if. do not understand but decision or have an ....you y questions contact your worker. E?! t1Gfs?t' r?,f•et?v CO RECORD NUMBER CAT GTR DIG DUST 21 ??Q 730 ?,J COPMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF PUBLIC WELFARE ?V CUM RLAND COUNTY ASSISTANCE OFFICE 33 Westminster Drive P.Q. $pg 599 TELEPHONE NUMBER. C b le, Pennsylvania 17013-0599 h°7) 240-2700 q13 3 I-C q14163 _ ., 7 el 1 3 0o Urat??. ? ?Ahtp H., ? _P fl ; -700 Dear - .J ?llLt &t4de_i1_ ff ?aA PG?.4-1-cta_ S We have received your application for WPr)Vela, Medical? ? Assistance. -?fJ In, order to determine eligibility we will need the following items as idicated. Photo copies are acceptable. Please send the information to Please call if you have any q stions or need help in obtaining the required information. 1.) Social Security Card(s) 2.) Proof of date of birth 3.) Medical coverage membership cards a.) Medicare (red/white/blue card(s) b.) Blue Cross/Blue Shield card(s) c.) Any other health insurance plan(s) 4.) Work histories (if any in the past 5 years) _ 5.) Verification of assets/resources for the past 3 ears Vv - eUVLkLIct 7.) (acceptable types of verifications are: ec oo , ank statement, copies of,item(s) statement(s) from source of resource/asset). This verification is essential. Photostatic -Copies are available from the financial institution. a.) Bank accounts (checking/savings/money market, etc.) b.) Stocks, Bonds, or Certificates -of. Deposit C.) Christmas Club(s), Vacation Club(s), etc. d.) Trust Funds .) IRA or KEOGH f Tax returns, including 1099(s for last 3 years a"C ?o-3 4 X.e . Verification e titles, vehicle registration (if more than one vehicle provide value of each vehicle). All life insurance policies (verificatInn Al6rwil i +nr•lnda s name, volicv number amount of •.u.- aaa.a aLaa.=EMUL vU current caSII value). X 9.) Deed to burial plots or statement from cemetary 10.) Copy of burial Trust/Reserve/or Pre-Paid Agreement (Include Irrevocable Statemen _?=11.) Deed to all property (if transferred or sold within the t 36 months a copy of the new deed and the settlement sheet for all sold property). 12.) Title to mobile home 13.) Verification of any resource/asset that has been sold, traded,el.osed, cashed in or given away over the last 36 mopthg 14.) Any medical bills you wish to have a determination made, to see if Medical Assistance could cover A 15.) Verification of all GROSS income a.) Interest income b.). Current award letter D'F &OM c.) Written statement from source of check ) Copy of checkstub ? e.) All deductions from gross amount of check must be verifiP(d {{j _. EXHIBIT I I _? .6 -2- 16.) Health insurance premiums (frequency and amount) 17.) Power of Attorney or guardianship papers, (if available) 18.) If there is a spouse living in the community the following must also be provided for the spouse a.) Verification of rent, mortgage b.) Tax on property only c.) Insurance on home/property d.) Utility bills e.) Resource assessment form if completed by department before application 19. Signature on enclosed affidavit. 20.) Other, By waiving the interview, you are certifying to this office, under- penalty of fraud; that all information you have provided is true, correct, and p ete.to the best of your knowledge. You agree to report all changes in 15 circumstances to this office within seven (7) days. If determined eligible there will be 'a Medicaid card i-eatted to the mow' which will cover hospital, doctor, and prescription drug expenses. if <rou eeetrv- -- wed! e-3 LJ39f- bhe ---L-' _tz see efgiee at the-im*9ing home 1?^ thPU will ba -ossesazn'm of Crh - edie *+d card. You will receive a PA 162 (Notice to Applicant) form when the case has either been- authof zed or-denied. --The .9-r-- ?.?.. ?- •. This material.is due in this office by if infornatiou is not received by the date listed the _application could be discontinued and reapplication would be necessary. If you,have any questions regarding this notice, please call r'?IMG? at 1-800-269-0173. If you live in the Carlisle area ee call 240- 2715. Sincerely, 12o.ris_ ,I. Rlingensmi-th 'Income Maintenance Caseworker Form Department of the Treasury-Intemal Revenue Service 1040A U.S. Individual Income Tax Return 2002 IRS Use Only--Do not write or staple in this space. Label Your first name and initial Last name OMB No. 1545-1085 (See page 21.) LL Your social security number - r Use the b !RS l l E L If a iomt , spouse's first name and initial - U- Last name ! Spouse's social security number --jl a . e Otherwise, Please P t H E E E Home addr (number and street). ff you have a P.O. box, see page 22. l 4 f R?. -n 4 •`, Apt. no. A Important! A or type. - Cily, town or post office, state, and ZIP code. If you have a foreign address, see page 22. You must enter your SSN(s) above. Presidential Election Campaign' Note. Checking "Yes" will not change your tax or reduce your refund. You Spouse (See page 22.) bo you, or your spouse if filing a joint return, want $3 to go to this fund? ? ? Yes 2440 ? Yes 0 No Filing 1 El Single 4 El Head of household (with qualifying person). (See page 23) status - 21 Married filing jointly (even if only one had income) If the walifying person is a child but not your dependent, 3 ? Married filing separately. Enter.spouse's SSN above and enter this chtd's.name here. r Check only full name here. ? s ? ouaiff' Vng widow(er) with dependent child one box. - - (Year spouse Bled b. ) (See page 24.) rzr Exemptions If more than six dependents, see page 24. 6a Yourself. If your parent (or someone else) can claim you as a dependent on his or her tax retum, do not check box 6a . b ?. Se ic Dependents. (2) Dependent's social (3) Dependent's (4) ii/if qualifying chili for child (1) First name Last name security number relationship to you tax credit (see page 25) No. of boxes checked on 6a and tab No. of children on 6c who: • lived with You 9 did not h" with you due to divoroe or separation (see page 26) Dependents on 6c not entered above Add numbers d Total number of exemptions claimed. above lines Z Income Attach Form(s) W-2 here. Also attach Form(s) 1099-R if tax was withheld. If you did not get a W-2, see page 27. Enclose, but do not attach, any payment. Adjusted gross income 7 Wages, salaries, tips, etc. Attach Form(s) W-2. 8a Taxable interest. Attach Schedule f if required b' Tax?xempt interest. Do not include on line 8a. 9 Ordinary dividends. Attach Schedule 1 if required 10 Capital gain distributions (see page 27). 11a IRA distributions. 11a 12a Pensions and annuities. 12a 13 Unemployment compens 14a Social security benefits. 14a 15 Add lines 7 through 14b (f 16, Educator expenses (see p, 17, IRA deduction (see page I, IS Student loan interest dedu 19 20` Tuition and fees deduction Add fires 16 through 19. 21 Subtract line 20 from line 15. 1 For Disclosure, Privacy Act, and Paperwork Reduction . 8a 8b 9 10 l l b Taxable amount (see page 27), 11b 12b Taxable amount (see page 28). 12b :`' --` ? 14b Taxable amount 1 see a 30. 14b ` in). This is your total income, 10" 15 i 16 17 e 33). 18 3. 19 20 EXHIBIT _ ,? . 21 7 Cat. No. 17166F Form 1040A (2002) torlm 1044A (2002) ? • Page ,2 22 Enter the amount from line-21 (adjusted gross income) 22 cy ?9 Tam credits, and 23a Check You were 65 or older ? Blind i Enter number of © t if. Spouse was 65 or older ? Blind j boxes checked ? 23a payments If you are _frtarried filing separately crate! and Y_ 9 p y your spouse itemizes. Standard Deduction for- • People who checked any box on line 23a or 23b or who can be claimed as a dependent, see page 34. • All others: Single, $4,700 Head of household, $6,900 Married filing jointly or Qualifying widow(er), $7,850 Married deductions, see page 34 and check here ? 23b ? ,h trrlxer our etandai d deduction see left margin . 4 ; 26 " Subtract tine 24: from line 22. If line 24 is more than line 22, enter -0-. N1utf " $31000 b the total number of exemptions claimed on`fine 6d. 25 /00 26 ?t3 27 Subtract line 26 from (ire 26. If line 26 is more than line 25, enter -0-. This s our.taxable income. - ? 27 910 28 Tax includin ` an alternative minimum tax see page 35). 28+ 7-0 k 29 Credit for child and".dependent care expenses. Attach Schedule 2. 29 30 " . Credit for the elderly or .the disabled. Attach Schedule 3, 30 Education credits. Attach Form. 8863. 31 32 Retirement saviligs'contributions credit. Attach Form' 8880. 32 _ 43. Ghild'tax credit seek. a e 38). 33 34 Adoption credit: Attach Form 8839. 34 filing 55 Ada lines 29 through 34. These are your total credits separately, Subtract line 35 f prlr line 28. If dine 35 is more than line 28, enter -0-:so $3,925 37 Ldyance earned income credit payments from Forms W-2. - 37 38 Add ljries 36 and 37. This is your total tax. ? 38 39 Federal income tax withheld from Forms W-2 t and 1099. 39 f P C:1 l 40 2002 estimated tax payments and amount if you have app lied from 2001 return. 40 ild, attar ild, attach 41 Earned income credit lC . 41 hedule 42 Additional child tax credit. Attach Form 8812. 42 43 Add lin 39 th h 42 T es roug . hese are our total p ayments. ? 43 OD I Refund 44 If line 43 is more than line 38, subtract line 38 from line 43. This is the amount you overpaid. 44 Direct 45a Amount. of line 44 you want`refunded to you. ? 45a deposit? See page 52 ? b Routing e: ? n b 0- c T Ch ki ? S i and fill in yp um er ec ng av ngs 45b, 45c, ? d Account and 45d. number 46 Amount of line 44 you want applied to your 200:1 estimated tax. 46 Amount 47 Amount you owe. Subtract line 43 from tine 38 . For details on how you owe to pay, see page 53. ? 47 wurnuac? aun 2fJG11G11Ly JOUZ PCIWVS JJJ. c}ty designee party Do you want to allow another person to discuss this return with the IRS (see page 54)? ? Yes. Complete the following. ? No designee Designee's Phone Personal identification name ? no. ? ( ) number (PIN) ? Sign Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and accurately list all amounts and sources of income 1 received during the tax year. Declaration here of preparer (other than the taxpayer) is based on all information of which the preparer has, any knowledge. Joint return? Your signature Date Your occupation Daytime phone number See page 22. . Keep a copy Spouse's signature. If a joint return, both must sign. Date Spouse's upation for your ? records. f A/TCE l site code: ® Printed on recycled paper Form 1 e Benefit Checking 01 031 40 5 13 13,125 CHARLES E SHAY JR PATRICIA J SHAY 1926 LONG BOAT DRIVE LAKELAND FL 33810 PB Benefit Checldng 9/21/1999 thru 10/19/1999 Account number: Account holder(s): CHARLES E SHAY JR PATRICIA J SHAY Account Summ Opening balance 9/21 $3,185.00 Deposits and other credits 2,289.97+ Interest paid 1.10+ Checks 1,080.44- Other withdrawals and service fees 908-50- Closing balance 10/19 $3,487.13 Deposits and Other Credits Date Amount Description 10/01 339.00 AUTOM TED IT US TREASURY 303 SOC SEC CO. ID. PPD MISCUPKINNIft SSA 10101 733.00 AUTOMAT€D_CRED US TREASURY 303 SOCSEC CO. ID. MISOdWIIIIIIIIIIIIIIIII? $SA 10101 1,217.97 AUTOMAT DIT US TREASURY 307 CIVIL SERV GO. ID.10 PPD MIS CSA 10/19 1.10 INTEREST FROM 09/21/1999 THROUGH 10/19/1999 Total $2,291.07 Interest Number of days this statement period 29 Annual percentage yield earned 0.39% Interest earned this statement period $1.10 Interest paid this statement period $1.10 Interest paid this year $8.42 Checks Date Date Date Number Amount posted Number Amount Posted Number Amount Hosted 0907 106.15 10/04 0909 82.50 10/04 0911 71.00 10112 0908 20.79 10/04 0910 800.00 9/30 Total $1,W.44 EXHIBIT ?,- 7 F ?{ Benefit CheAng 02 , 031 40 5 13 13,126 Other Withdrawals and Service Fees .:..Date. A?rount Gescrip6tjn -- 9/24 401.00 WITHDRAWAL MAC 09124 2148 MARKET ST CAMP HILL PA 5027H004713 10/15 WE T IDE 2105 NEW TAMPA HW LAKELAND FL 5027F004365 10(18 6.00 ` 'DEP69iteD ITEM RETURNED FEE 10118 100.00 DEPOSITED ITEM RETURNED ADV 1I: 585848 10119 V 1.50 SERVICE CHARGE owl 50 Service Fees Description Quantity Amount Total NON-FUNS WITHDRAWALS 1 1.50 1.50 Total s1.5o balance S3,562.70 Minimum balance $11,984-00 Benefit Banlang Balance Summary Checking & Investments No. of AccouniTs) Account Minimum balance Average balance 1 BENEFIT CHECKING $1,984.00 $ 3,562.70 1 CHECKING ACCOUNT(S) $29,099.41 29,160.91 Total 537.08341 532,723.62 JOIN THE MORE THAN ONE MILLION CUSTOMERS BANKING ONLINE WITH FIRST UNION. ONLINE BANKING ON THE INTERNET LETS YOU CHECK ELIGIBLE ACCOUNT BALANCES, SEE WHEN CHECKS CLEAR AND DEPOSITS ARE MADE, AND MORE..ANYWHERE, ANY TIME. IT'S EASY TO SIGN UP AND THERE'S NO ADDITIONAL COST! CALL 1-800-731-6736 TO SIGN UP. fiRST UNION NATIONAL BANK, WESTSIDE frN Benefit Checrrng W 03 031 40 5 13 13,127 Customer Service Information For questions about your statement or WkV errors, contact us at Chedmig & Investment Accounts TDD (For the Hearing Impaired) Consumer Loan Accounts 24 Hour Banking Card & Check Card credit card & Other Lines of credit En Espanol Para Cuentas De Depositos Y Ahorros Phone number Address 1-800-275-3862 FIRST UNION NATIONAL BANK 1-800-735-1012 P.O. BOX 2870 1-800-388-2234 JACKSONVILLE FL 32231 1-800-829-0192 FIRST UNION NATIONAL BANK P.O. BOX 13327 ROANOKE VA 24040 1-800-359-3862 FIRST UNION CARD PRODUCTS POST OFFICE BOX 563966 CHARLOTTE NC 28256-3966 24 HOURS A DAY, 365 DAYS A YEAR 1-800-326-8977 To Balance Your Account 1. Compare your account register to your account statement for List Outstanding C hecks and Wi thdrawals unrecorded transactions (such as ATM, CheckCard, Interest earned, fees, etc.) Your new account register total should match the Ck. No. Amount Ck. No_ Amount adjusted balance in fine 6 below. 2. Write in the closing balance shown on the front of account statement. 3. Write in any deposits you have made since the date of this statement. 4. Add together amounts listed above in steps 2 and 3. 5. In the section to the right, list and total all checks and withdrawals that you have made that are not reported on your account statement. Write in the total here. 6. Subtract the amount in line 5 from the amount in line 4. This is your adjusted balance and should match the balance in Step 1 above. Total In Case of Errors or Questions About Your Electronic Transfers: Telephone us at 1-800-359-3662 or Write us at FIRST UNION CARD PRODUCTS, POST OFFICE BOX 563966, CHARLOTTE NC 28256-3966, as soon as you can, if you think your statement or receipt is wrong or if you need more information about a transfer on the statement or receipt. We must hear from you no later than 60 days after we sent you the FIRST statement on which the error or problem appeared. 1. Tell us your name and account number (if any). 2. Describe the error or the transfer you are unsure about, and explain as clearly as you can why you believe there is an error or why you need more information. 3. Tell us the dollar amount of the suspected error. We will investigate your complaint and will correct any error promptly. If we take more than 10 business days to do this, we will credit your account for the amount you think is in error. You will have use of the money during the time it takes us to complete our investigation. FIRST UNION NATIONAL BANK, WESTSIDE PAY TO T Lf; c?iL?4 OFD • CHARLES E. SHAY, JR. PATRICIA J. SHAY 1926 Long Boat Dr. 941-815-8754 Lakeland, FL 33810 I _ _ F-e 64 s4 !,Y' F/st Union Kahan Bank RIT 063107513 oV/ i 'ru 091 ??±± 63-751/63 DAME BRANCH 007 T " Ar .? genefu Banc{ fCR- ?8 20u- 0 90 1 ,10000 1500 CHARLES E. SHAY, JR. PATRICIA J. SHAY 0971 1926 Long Boat Dr. 941-8QQ15-8754 _ . jl akelanc IL7 v _ RANCH/007 ',ZAT_ ? BRANCH 00721 3 7 PAYTOTHE ORD9}7OF i 3© UV J0 - as 1 Oa/ _ Fist Union National Bank RIT 063107513 Benefit BankMn FCA; F, 78 20N' _ 09 ? 6 •1'000000 t 011 CHARLES E. SHAY, JR. fi PATRICIA j, SHAY 1926 Long Boat Dr. 941-815-8754 Lakeland, FL 33810 v PAYToTHE ORDER OF_ ?r Del / /7J A n r! , / PAD ???/ F-Irst F ??Unio NaHouat Bank Ora- 003 RIT 063107513 1122 63-751/631 DATE _ BRANCH 00721 DOLLARS 1 o.n.,:, .. Benefit Bankirlge 1P 8 20ir 1122 1'0000 700,,: E EXHIBIT ? o C)4 C1?? C - x M I XET 04.026-426.c Cj9-c,1C?99q-?; -.-MrQ?30001 C-49 .isis r = 71363 jam 2-99 f RE PHILL;, 20 0 1 UUCa6C;=,?U31 C, I xL'L) 4 - Ca U6C)56 U- OS-00 F7z t t D 12z i c ? n a?-?0G3 6 Cyr U = 1 1 002,82 1 1 CC}g _ 128 c +y ! 3 Aim. 031 Q - 0004 - 0 03=2.0-01 1 1 6 x'16 03-21-01 215 t'3 I H_ -C31 -AA amZ- a f5 ?. i r, t CHARLES E. SHAY, IR. p 11 1926 LonTRIM(h(Sft&& 3 i 3 3 t O 05, 1,544 1031 Long Boat Dr. 941-815-8754 63-751/631 Lakeland, FL 33810 DATE , BRANCH 0072 PAYTOTHE ORDER OF W V? MW U Nm I WffwW Bank firsba"n.com Benefit Bank Org 003 RIT 063107513 FOR ?8 20r 1176 .14000000 , 001 O C: i T m * _? DODjO? ? I_ !i n 7 ? pa ??a na G ' 05f ??.. 07-2 m s l j4 - 1 V 1t .Y If N72R 'WO 6-0 - I . - }JvN_s.. ? W M V. al, O _ ] z? CUSTOMER SERVICE BUIING INQUIRY PAYMENTADDRESS 1-333-371-4714 (INSIDE US) P.O. BOX 8650 P.O. BOX 15153 n 1-302-594-3200 (OUTSIDE US) call collect WILMINGTON, DE 19899-8650 WILMINGTON DE 19886-5153 1-SS3-446-3308 (en Espanol) www.fustusa.com ACCOUNT NUMB ER TOTAL EDIT L[NE 510,500 CASH ADVANCE CREDIT LINE t $81500 AVAILABLE CREDIT $9,558 AVAIL.ABLEPORTION FOR CASH ADVANCES $8,500 PAYMENT DUE DATE 07/15/00 a6-s- G DATE 06/20/00 TRANS POST REFERENCE NUMBER MERCHANT NAME OR TRANSACTION DFSMPMON AMOUNT DATE DATE 0519 0520 9154186GY13WSLRT BPS WHOLESALE €125 WOX HARRISBURG PA 339 47- 0520 0520 9154186GY13VVVYLW BPS WHOLESALE #25 WOX HARRISBURG PA . 12 25 0523 0523 8044681HIOOE2G6BY WAYNE S AUTO REPAIR do HARRISBURG PA . 18 02- 0525 0525 7054186H309FQ95FO HOME DEPOT 4113 HARRISBURG PA . 35 92- 0526 0526 9154186H513VVSX4P BPS WHOLESALE #25 WOX HARRISBURG PA . 92AS 0529 0529 8045079H63E80E5RR BEN FRANKLIN CRAFTS 43 MECHANICSBURG PA 59 26 0529 0529 704464111709Q3886 RITE AID CORP 1074 LEMOYNE PA . 18 30 0531 0531 8043218H90BQ37006 BOSCOV DEPARTMENT STOR CAMP HILL. PA . 54 98- 0601 0601 7042950HALYXPWL7E STEPHENSON S FLOWER CAMP HQL PA . 24 33- 0601 0601 8554453H9013Y46Y7 PAYMENT - THANK YOU . 824 59- 0603 0603 8045385HQQIKYNIPS CHUCK E. CHEESE #%4 HARRISBURG PA . 31 25 0605 0605 7054136HE25DKNVEW BLOCKBUSTER VIDEO #420 LEMOYNE PA . 20 00- 0606 0606 7041019HF09WYK17H PAYLESSSHOESOU 0063537 CAMP HILL PA . 30 97 0606 0606 7054186HGOGHA6PX7 MARRIOTT HOTELS CITY C PITTSBURGH PA . 67 04 0610 0610 7044641HK60P5Q5P0 COAKLEY'S RSTR do PUB NEW CUMBERLAN PA . 30 78-- 0614 0614 8043213HPOBBY9FT7 BOSCOV DEPARTMENT STOR CAMP HILL PA . 22 26-- 0615 0615 7541019HPHOV49ZQ5 PIZZA HUT 06050728 MECHANICSBURG PA . 13 83- 0615 0615 7044641HR02TDBPE2 WINE & SPIRITS 2107 CAMP HILL PA . 27 35 0617 0617 8020700HSWH7SA4ZR THE PEPPERMILL RESTAUR MECHANICSBURG PA . 43.35 • M Ora O Q ~ O c. a ¢ r o W oco M Jos i-'a ?<nm u c W CL L.) CK _ Q J = J Lai ¢ ~ w c. Q N CJ7 ?... W Y oa?rerr - Statement Date: dew _. , r nwla .. -06/20/03 - 07121!03 - 07/21/03 M^ N ? CUSTOMER SERVICE Payment Due Date: 08/10/03 , In U.S. 1-886-871 4714 cr, Minimum Payment Due: $75.00 Espanol 1-888-446-3308 TDD 1-800-955-8060 Outside U.S. call collect MASTERCARD ACCOUNT SUMMARY Account Number 1-302-594-8200 Previous Balance $3,952.47 Total Credit Line $2370 ACCOUNT INQUIRIES Payments, Credits -$1,938.72 Avatlable Crept $19,382 P.0. Box W50 Purchases, Cash, Debits +$1,715-80 Cash Access Line $8,500 Wdmsngfon, DE 19899-8650 Finance Charges +$44-85 Available for Cash $8,500 PAYMENT ADDRESS New Balance ,774.40 P.U. Box 15153 W1knkOcn, DE 19886-5153 VwSwwTaU'dS meAmTb: erservices -com REWARDS SUMMARY POINTS EARNED THIS PERIOD: PURCHASES 1,377 FINANCE CHARGES 45 BONUS POINTS 0 TOTAL POINTS EARNED THIS PERIOD 1,422 PREVIOUS POINT BALANCE 12,403 POINTS REDEEMED THIS PERIOD 0 TOTAL POINTS. -- 13,825 POINTS DUE TO EXPIRE ON 12-2004 3,141 POINTS EXPIRED THIS PERIOD e Trans I Amount Date Reference Number Merchant Name or Transaction Description Credit Debit 8620 23444005DJ3QH6SZH BJS FUEL_09025 WOX HARRISBURG PA 06120 70431785OWPH60ME HECHT CO. I.E. LADIE CAMP HILL PA _.g ._ 0620 704464150039378WG HOSS'S STEAK 8 SEA #18 MECHANICSBURG PA .per„ 06120 9MG06605EHF238H FUDDRUCKERS 148 BALTIMORE MD -4I8,z9-- 06120 70541WS023291487 ESPN ZONE-BALTIMORE AR BALTIMORE MD 0626 23444005JJ5RSR1P7 BJS FUEL#9025 WOX HARRISBURG PA q?yl. 0626 91444005JJ5F1N4E1 BJ WHOLESALE 00025 WOX HARRISBURG PA 0626 88418735MWGT7RH3S PINNACLE FOPC GIFT SHO MECHANICSBURG PA .yg..Ie. 0626 70499676JKSRABJYD RITE AID STORE 1981 HARRISBURG PA 40.97 0629 78432865LO0J2KVME AOL"ONLINE SERVICE 060 800-827-6364 VA 23.;0 06130 23444005NJ7JJEKVX BJS FUEL #9025 WOX HARRISBURG PA 442* 07105 85544595V0159SVE9 PAYMENT - THANK YOU -- 1600 00. 07107 91444005XJADGQLVB BJ WHOLESALE #0025 WOX HARRISBURG PA 07108 78541865Y03TGDOE9 QVC'3032988679 800-367-9444 PA„ 07/08 80469175XMOLAOJOK WAYNE S AUTO REPAIR SE HARRISBURG PA ....? ,?„ 07109 80416015Z5H7ZJ31D SUPERPETZ 0227 MECHANICSBURG PA 07109` 7049%75Z58HRW6EH SUMMERDALE DINER ENOLA PA _Og.88. 07110 23444006WBZSZQVJ BJS FUEL #9025 WOX HARRISBURG PA 07110 8141601605J6J823E THE HEALTHY GROCER SRF CAMP HILL PA 07/10 W5027860ETNKYPS1 THE GIFT BOX ENOLA PA 07111 705480761EM1602L9 THE BOMBAY COMPANY #69 CAMP HILL PA - 5630 :0811 U5D 880 7 14 830721 ¦ R 6801 7030 enc--- U<n6 r3432a%5000G67D6 AOL`ONLINE SERVICE ORE 800-827-6364 VA .;ra scy 07117 234440067JF33L7MB BJS FUEL #9025 WOX HARRISBURG PA 3g- L81HX3 mo G? V co rn c m C H ? ?Hm ? nn r? Z r A m n D rn cn '< CD >' -; x ?-?- Q.rr rn m r., ww b rn OD OD 'W W • 3 s n rn Oz -1 A = in oyp D n Hemp m?n2 0 " -, ^ D -i r= m T L r? N r 1'17 < m .-.? U) D D :0 T ODDrn N x -- m m m a y w w In t-- J J • ? 't t W W h' -4-4 i i ". ,i f A ?' ,•., as r? JIQ v m A n ep n? N u A O V O 7yC? S $ n 29 A p yA O ? o? r O ,9 3 A 'Z A ..? b CD "b Revem, S-de , INTERDISCIPLINARY- NOTES A INTERDISCIPLINARY NOTES 5199 !A J DATE TIME DISCI- PLINE SIGNATURE kU6 C v C. 7 {\ r J S(v a o T 'A j( a / 4 i _ ?1 f EX HIBIT ??. mew l`?- P I , INTERDISCIPLINARY 'NOTES DATE TIME DlSCI- PLINE c SIGNATURE It qC Q ?j ( CIL, 1 G Y? V ` r ek 1 n /U- CA ?p I a -? ?? ?? 2 n o+rC? i.S TPA 0ab f f hAkm 2b2cf l . SLAP INTERDISCIPLINARY NOTES . .. !? 1. - ti ? - ? .J 1 5199 CNRC Y? 9LLLA Swma;4A-4np .9agzu3usaM - 9400 two 1.1044ns X ol dWS r?F Leo-aca 4099520034680 flail???ll6l?Il?lgill?IRlq?l???!!l??lllll??lidl?l??lhlhh?111??!!li ?`r. L7 S. 4a-;I-y ??? / zpa k` \? .n t 4 .....-- _ - I tit tip -- Blu*ross® Service Benefit Plan BlueShield® ey PO Box 52080 Phoenix, Az 85072-2080 e Attention: Prior Approval Feder Employee Plrogr m Clinical Services Fax : 1-877-378-4727 February 10, 2005 PATRICIA SHAY 1926 LONG BOAT DR LAKELAND, FL 33810-2773 Re: Dear Service Bene;it Plan Member: We have received your Prior Approval request for ARICEPT. At this time we are unable to make a decision based on the information provided. Therefore, we are requesting additional information from your physician. Once we have received the requested information, we will contact you with the results of our review. If no additional information is received within 60 days, we will make our benefit decision based on the information at hand. Enclosed is a copy of the. letter we will be sending your physician. In order for us to obtain all records relevant to your case, we would like to make sure that your physician has your personal authorization to release medical information. You may also want to contact your physician to make sure he or she responds promptly to our request for additional information. We will be requesting copies of your medical records including the history, clinical exam, progress notes, and the results of certain tests, which are important parts of the work-up for your disease. In addition, we may also be asking a series of questions to help determine the staging of your disease process. Please note, reimbursement for expenses related to the completion of forms by physicians and/or duplication of medical records are not covered under the Blue Cross and Blue Shield Service Benefii Plan. Thank you for your cooperation and patience. If you have any questions, please call the Customer Service Unit at 1-800-624-5060. Sincerely, Director of Patient Safety & Quality Monitoring Program Service Benefit Plan Pharmacy Program Prior Approval Program /LA r g:\clnc1ops\reviz03\general information\more infoirnation.doc 0 0 B1ueCross. B1ueShield. ,-Fedw& iployee Pmgmn April 11, 2005.. Patricia Shay 1926 Long Boat Dr Lakeland, FL 33810-2773 Re: Dear Service Benefit Plan Member: Service Benefit Plan PO Box 52080 Phoenix, AZ 85072-2080 Attention: Prior Approval Clinical Services We have received your Prior Approval re 'cept. Your request has been approved fr 02/04/2005 0210312006. We will keep the Prior Approval on file to speed up pr en y r prescription filled. The Preferred pharmacy will give you the Preferred price for the drug, and you will pay only your copayment, or coinsurance, if applicable. If you paid for this medication out-of-pocket while waiting for Prior Approval, you will need to file a claim for reimbursement. Be sure to include the original receipt with the claim. Claim forms can be obtained from our web site. Visit www.fepblue.org and dick Pharmacy Programs. Select Standard or Basic Option Retail Pharmacy Program then select Download Forms. Claim forms are also available by calling the Pharmacy Program Customer Service Unit at 1-800-624-5060. If you have any questions regarding the Prior Approval Program or the Prescription Drug Benefit, please contact the Customer Service Unit at 1-800-624-5060. Thank you for your cooperation. Sincerely, Director of Patient Safety & Quality Monitoring Program Service Benefit Plan -Pharmacy Program Prior Approval Program BlueCrosso . BlueShielde Federal Employee Program Date: 6,12/20/2005 Service Benefit P.a. Box 5 Phoenix, AZ 85072- Attention: Prior Appr Clinical Ser% P 1926 ATRICIA J SHAY T LAKELANDGFB0338i0-2773 ? - RENEWAL NOTICE Identification Number: Dear Service Benefit Plan Member: This letter is to inform you that your Prior Approval will expire on 02103/2006 for COGNEX/AR ICEPT/EXELON/R EMINYL. Please remember that Prior . Approval is necessary for you to obtain this medication. If you do not get Prior Approval, the medication will not be covered under the Service Benefit Plan. In order for you to continue to process paperless claims, we must have adequate time to review your Prior Approval request. It is important that you act upon this matter as soon as possible to avoid an interruption of your Prior Approval authorization. If you are to continue therapy with this medication, have your physician contact our Clinical Call Center at 1-877-727-3784 between the hours of 8:00 a.m. and 8:00 p.m. EST Monday through Friday. Please note that this phone number is for physicians only. Clinical information provided by your physician will ensure quick and accurate processing of your record. The Service Benefit Plan recognizes that some members and physicians prefer to use a paper-based process to obta; . Prior Approval. Paper-based requests may be initiated by having your physician contact the Clinical Call Center at 1-877-727-3784 to obtain FAX forms. Or, members may contact our Customer Service Unit at 1-SM-624-5060 to request Prior Approval forms. Your Prior Approval request will be reviewed according to the terms of your Service Benefit Plan coverage (see page 15 in your 2005 Blue Cross and Blue Shield Service Benefit Plan brochure RI 71-005). If coverage for the prescription drug is approved, we will keep the Prior Approval on file to speed up processing when you have your prescription filled. i • If the drug Is approved, the Preferred pharmacy will give you the Preferred price for the drug, and you will pay only your copayment, or coinsurance, If applicable. Thank you for your prompt attention In this matter. If you have any questions about the Prior Approval process, please call us at 1-800-624-5060. Sincerely, Director of Patient Safety and Quality Monitoring Service Benefit Plan Pharmacy Program Prior Approval Program 450ey'05 • a? PI N NACLE HEALTI-i ` FirstPlace Health Care Received from for the Account of: Seide tfaspW 120 South Fdbot Sued Medwvcadxg, PA 17055 1717) 795-6650 $# .Y PA 4. 27t3 M91-61 A AYE 1701.1 chair' 1411. PA 717--714-004 210269044 ROBE R7 5-0 EXHIBIT P-4- FP DEPT IV, PRIVATE AMBULATORY ? DATE g3 /1S v'? WR!T AMOUNT '- 00 DOLLARS LABS CENTS CURRENCY MONEY ORDER CHE K d F-1 ED i? f? V C ECK NOJAMT MISC. OTHER Thank You GENERAL LEDGER NO. h V 4!?? PER Form 0666-63 (07101) IormeAy INV 2963 Y J } PINNACLEHfALTH 9 F C FirstPlam 2" ;? e 1 4 A E 1' ,' 3 1 th Care Ner>ae, (717) 795-6656 INSTR E PATIENT • FustPlace #t: The examination and treatment you have received in the FustPlace Center has been rendered on an urgent basis only, and are riot intend to be a substitute for, or an effb0*46triW aomplete medical care. IF YOU DEVELOP NEW PROBLEMS OR COMPLICATIONS, CONTACT YOUR PHYSICIAN OR THIS FIRSTPLACE HEALTH CARE. FOLLOW THE INSTRUCTIONS BELOW AS INDICATED FOR YOU. LACERATION, ABRASIONS OR BURNS - EYE INJURIES 1. Keep wand dean and dry 24-46 tours. 21. Wear eye patch for hours. 2. After 24-46 hours wash with soap and water or peroxide. 22. Do not drive or operate machinery u rm 3. Watch for signs of swelling, tenderness, redness, had or 23. Return to FirstPlaoe Health Care or family physician drainage - return to FrstPlace if any of these signs occur , -Wftsurqlmm. 4. Return to FindPface to have your sutures removed 24. Avoid bright fights. T.Y. and Prolonged reeding for houi _ 25. Eye medication 5. Tetanus Twdod/Tetanus diphtheria given yes. HEAD INJURIES SPRAINS, BRUISES AND FRACTURES 26. Avoid strenuous physical activity for at least 24 hays. 6. Elevate on 2 pillows and rest. 27. Use for headed* every 4 hours as needed. 26 L -tours 7. Use ice for minutes . . times a 8. Ace wrap for days. CALL DOCTOR M?OIATELY IF. . Use spirts 9 for 9. A. UnaMe to arouse patient, confused or Irritable 10. Use Rdue s for use cp B. Patie nt continues b be naueeabd and/or vomi t 11. to bear weight Begin weight C. Pad" lraa ta+orrbta with balance O. Patient conq**w of any visual difficulty 12. St wens casks on for minutes times a day unfit rec heck or no E ? 24 hours or if it symptom present- bsaomN avirs l? 13. Wear cervical Coker F. Convulsions 14. No heave It" for 15. Use aft for NOSEBLEEDS MEDICAL INSTRUCTIONS 29. Do not blow your nose. 16. Bed rest for 30. If bleeding occurs through nasal packing or in throat call FmdPlace or family physician. 17. Take aspirin of Tylenol S every tours. 18. If a ci iii has fever: FOLLOW UP CARE A. dress lightly - don't cover with blankets; S. place in tub of kikewarm water and sponge for 30 minutes. 31. Return to FirstPlako It temperature is higher than and won't 32. Fallow-up with family physiasn come down with aspirin or Tylenol@ 33. an Dr. C. give plenty of fluids - offer small amounts frequently, on at AM/PM D. give baby aspirin or TyWKOS if temperature higher than EMPLOYMENT E. DO NOT use ice packs. cold water enemas or alcohol bath. 34. Radum to normal duty on 19. Clem liquid diet - advance as tolerated. 35. Umited duty from until 20. Drink plenty of liquids. Limitation 36. S ee Ooaupatonal lnstruconal Sheet 37. OTHER X-RAY INSTRUCTIONS: Your x-rays have been read by the FirstPlace Hearth Care Physician. For your added protection, your x-ray will be reread by our Radiology Department. If any abnormalities are found that have not been called to your attention, you and your doctor will be caked immediately. Sometime frmdures or abnormalities may not show up on x-rays for several days. If symptoms persist or get worse, call your Physician or return to this FkstPlace Health Care Carder More x-rays may have to be taken. LABORATORY INSTRUCTIONS: Cal PestPlace for results of your pending lab tests. SK3NATURES R.N. Finn rdVALA1 Irw"I1 f-.... 1 HEREBY A004OWLEDGE RECEIPT OF THESE INSTRUCTIONS AND UNDER- STAND THEM. I UNDERSTAND THAT 1 HAVE HAD URGENT TREATMENT ONLY AND THAT 1 MAY BE RELEASED BEFORE ALL OF MY MEDICAL PROBLEMS AR KNOWN OR TREATED. I WILL ARRANGE FOR FOLLOW-UP CARE AS I HAVE BEEN INSTRUCTED. X?i?Cccr Date Doctor S Code 10/2612004 ANJALI G BHATT,MD 88312 10126/2004 ANJALI G BHATT,MD 88305 10/26/2604 HENRY J VENBRUX, MD 88112 11/22/2004 1199 11/22/2004 1100 rage Desc n A no SPECIAL STAINS GROUP 1 SURG PATH SINGLE COMP (2 Times) CYTOPATHOLOGY SMEARS W IN MEDICARE CONTRACTUAL ADJUSTMENT -? MEDICARE PAYMENT ??. 11,41 n 13-3 THESE SERVICES WERE PERFORMED BY THE PATHOLOGIST AT HOLY SPIRIT HOSPI tAL. Billing questions call: 800/238-3614 ACCMW MUMWR DATE OF STAMWEW PAYMeM AFIER TM BAL/NNM AMOUNT DUE 01!2812005 GATE WALL APPFM ON YWR NEXT STATEMENT 34.68 PATENT NAM WE FILED YOUR INSURANCE BUT HAVE NOT RECEIVED PAYMENT. THE BALANCE IS YOUR RESPONSIBILITY. PLEASE CONTACT YOUR INSURANI PATRICIA J SHAY OR MAIL PAYMENT IN FULL TODAY. BILLING HOURS ARE 10AM TO 4PM Place of Service: HOLY SPIRIT HOSP 1P Referring Doctor: DAVID J PETERS DO MAKE CHECKS PAYABLE TO: WEST SHORE PATHOLOGY PO BOX 750 SCRANTON PA 18501 8001238-3614 SEE REVERSE SIDE FOR IMPORTANT BILLING INFORMATION k5o. TAX 12 PATIENT NAME 1 14 BIRTHOATE 15 SE y 16 MS ADMISSION 17 DATE 12 IM 19 TYPE 2n ? 1210 OWE oAtf cooE DATE 3 rAI MRI WNIm l1v 0. 6 STATEMENT FROM 7NR0UGH 7 COV D. 8 N-C 0. 9 C-1 D. 10 L-R D. 1 I 3 PATIENT ADDRESS HR 22 STA 23 MEDICAL RECORD NO C DI nON C OD) E 36 • CODE =RRENCIE FROM SPAN 37 .. TMip11p11 q 7 1- N 42 REV. CO. 43 DESCRIPTION 44 NCPCS / RATES ;'M T V _'1.. UT I ONS 859 DRUGB/30THE MED-- UR SUPPLIES _ 66'72 S t E? ILE SUF LTr . 300 LA80R 4TORY X20 . 0X X-PAY .324 DX X-7RAWCHEST- .. 3= ; ; -?CAt'.! RHEA 430 0t CUfATl]Q'd,THER .. :: , 440 SPEECH F ATHO+_ 450 EMERG ROOM 46Cl F-ULM.sNAR.'i F NI 480 C,ARD10L.?Y 637 DR fGiS SEL -F ADMI -EC .'40 EEG F E D TO BE US ? n 7 C.' D I_ - INS p ?y ? RANCE [f "1 7 T C 3N 1i Ei'.f is I_, _' +'DTH ti TV Jv; 50 PAYER 51 PROVIDER NO. Ai L. Lj 1 .?-i `? 4 L if ? i ?1 7J1 • ?: l`??? JG 1.J C'?tT' BLim lf, R.11? -. 3? s 39.0004 i 3t-f ?' i?c i`i Y ? i :n'1J a. •?t i e G -L 00 7 !188 10013 3 r 57 _j-iC1L,1: 59INSURED'S NAME 59 P.REL 60 CERT. - SSN . HIC. - ID NO. 63 TREATMENT AUTHORIZATION CODES 44 ESC 65 EMPLOYER NAME tk . iPEI_` L7f, RETIRED_ 67 PRIN. DIAG. CD. CODE z r; -f -- 70iOp >n.r 79 P.C 180 PRINCIPAL PRQCEOURE 81 'OTHER PROCEDURE 84 REMARKS ..._.._? ! '_ :. -.. f j°.i;' •, 08-92 HCFA-1450 b c d 31 45 SERV. DATE 46 SERV. UNITS 47 TOTAL CHARGES 48 NON-COVERED CHARGES 49 1 29 60-300 1 G-; 3so Z, Q 34 - _ 1-66 Pq 4413 56 .. E98400 _ 1 0-9$00 2 46®00 1 . 137900 .27f# trjo. 1 541-00 J. ? ?t3?171y` 1 "?l?l1 1 010 469o o 54 PRIOR PAYMENTS 55 EST. AMOUNT DUE 56 J y -r .1 9;i _., y y T H 1, 14 'N' 4r "T A ILL 61 GROUP NAME 162 INCIIRAWT r•RrHrP un 66 EMPLOYER LOCATION (7t ^ 74 CODE 76 ADM. DIAG. CO. 77 E-CODE _•1 82 ATTENDING PHYS. ID OTHER PHYS. ID OTHER PHYS. ID f,nDv 1 85 PROVIDER REPRESENTATIVE 86 DATE 78 h,* . 3 PATIENT CONTROL NO 1 = . N .=_ TPy2T 5 FED. TAX NO, - b STA MELT COVE RS 7 COV D. 8 N-C 0. 9 C4 D 10 L-R D. 11 _RIOD :12 PATOENT NA;AE 13 PATIENT ADDRESS !=:-i .'1 1=rsTR'ii:iA i i1Ai>._.; Ai;: u7t t 14 BIATHDATE to SF 16 M 17 DATE ADMISSION B HP 19 YP£ 20 8AC 21 D 22 STAT 23 MEDICAL RECORD NO. cot fift dots T• - 31 . 1 24 ., 26 LT',-!l 29 F s l '22304 J. c 14 0 1 1 07113 .+ ? ry IL CC7' CAT'E " '. '. 34 CODE DATE -= 36 , - t cODE OCCURREAl FROM AN t11RD11Gt1 37 A j 8 r r, 1 t, • 39 AL CODE A "mT x ?: 41 VALUE CODE ANCNM 2 7_1 3 1121 _LIMB i A AV a _. C 1 d 42 REV. CD. 43 DESCRIPTKN4 44 HCPCS i RATES 45 SERV. DATE 46 SERV. UNITS 47 TOTAL CHARGES 48 NON-COVERED CHARGES 49 2J?. 1'"WINI= sf20It1""sE 525.CCi 5 2f7 r O ' 2 SG IV SOLUTIONS 5 91 po 2S9 DRUGS/OTHER 132 1314b'` 270 MED-SUP; SUPPLIES 20 loll i s 272 STERILE SUPPLY 4 56-94 275 PACEMAKER i 5169PS 300 LABORATORY 22 1117??Ci 320 DX X-RAY i 5a8Do 451 CT SCAN/HEAD 1 137900 li 360 OR SERVICES 3 609600 I 421 P HYS THERP /'t IL SI T 1 27601-D 450 E l2PC ROOM 1 b93bCs 461 PULMONARY FUN 2 480 CARDIOLOGY 3 106800" 621 M-ED-SUR SURP/ II NC IDNT PAD i ti 00 ::40 EEG 1 ?c,"ii'JCt Q-'AL CHARGES 50 PAYER 51 PROVIDER NO. 54 PRIOR PAYMENTS 55 EST. AMOUNT DUE 56 i N -DI C +RE !/P HOS:P MED 39Ci:: 04 Y u 2383674 t iE C Jk ; 3• 61 a 39'0(304 y IPA M-ED ASSIST IP 100771SS100 7-t,'22_- :. 0 -.ate- .? j 58 INSURED'S NAME NO. 59 P 60 CERT. SSN _ NIC. 6 INSU G S=-3A Y. P TF 1 C 1:r,`; _t 1 S IS?•-AY jR> C±-(ARLES U1 iGS 63 TREATMENT AUTHORIZATION CODES 6; ESC 6 5 EMPLOYEER NAME 66 EMPLOYER LOCATION 1 ' : 1 PET :.R1_D FIX I f i 'f i?..^,. RETIRED 67 P: In:. DI AC. CC- f N CODE 4 21 79 P.C 30 y PRINCIPAL PROC CODE 311. 3 /dam 84R&A4RKSiCARr- -i;''.s if3I Gr",3'iii-- S 1 R 'z)5.92 HCFA•1afiG - _- :=i l MOV t Wutb Dfi i = ., 6 76 ADM. MG. CD, 77 E"CODE 72 4` >•' !L ATTENDING PHYS. ID 83 OTHER PHYS. ID A R ?S OTHER PHYS. ID % PROVIDER REPRESENTATIVE 86 DAT= 4- -,a - *PATIENT DISCHAW INSTRUCTIO W- This form serves as your discharge instructions and if necessary, provides orders for any home health agency follow- Follow-up appointment -- Name of Doctor hid v4 Phone. Date / Time of Appointment Call your Doctor's office within the next few days to make an appointment days(?om now. If you have any questions before your appointment, calf your doctor. [] Home Care Agency Phone Other Important Numbers [j You may resume your Regular Diet. [] Special Diet Q PEG/Feeding Tube: RATE You may resume normal activities as tolerated n You may return to work: FORMULA You should esi" ' vur activities as follow r L 01% ke' 0'1?- s aer SURGIC L WOUND CARE -- If you ave increased pain, redness or drains ura rslstenf temperas over 100 degrees, call your doctor. r??/ ! use. K ?? /t c Q Your incision may be gently cleansed with soap and water. -PAIN MANAGEMENT: For management of pain, follow your doctor's instructions Hg ME CARE ORDERS/SPECIAL INSTRUCTIONS: 1L'" DISCHARGE MEDICATIONS -- Include dose, frequency, instructions (' indicates prescriptions given to patient) [-] Nc t=Rt Umw , t-R6("NCYL 4AME• OF .DRUG DOSE NAME OF DRUG DOSE INM, UGTIONS (NStRUCTIONS LIT 1 (:Q ru?rt , J 1 rr rf y I I G LA, r , -A re Ah l??,fi ,• 1 I F] Med`cards with food/drug interaction guide given After review and discussion, patient / family / significant other verbalizes understanding of instructions a ' receives copy. Signature of Patient / Sig ' icant,141her? c? ,- i ? c`'`? , y,0a A - -- HOLY SPIRIT HOSPITAL. Camp Hill, PA DISCHARGE INSTRUCTIONS Form No. 182 (2/01) SHAY PATRICIA J 1 F ED GROUP ERl 071138 12/21/04 24592271 MS7W PA T LENT COPY 14 BIRTHRATE 15 SEA '6 MS ADMLSSION 17 GATE td19t 18 TYPc 20 9iC 210 STAT 23 MEDICAL RECORD NO. r 2s - . ? - ! - t, , O 31 j N 1 3 734 22 2 7 Ib 01 07i--- =c. CODE DATE cm DATE 3s CODE OCCUIWENC FROM E AN 37 THROUGH A 1 71 t f- _S04 r2: 4 B =s Y" ' i A , I isi 39 CDOE AL + AMOUNT MEN + 41 E cm AU(ANTT h)l a 42 REV, CO, SCR IP7 10N 43 DE 44 HCPCS I RATES 45 SERV. DATE 46 SERV. UNITS 47 TOTAL CHARGES 48 NON-COVERED CHARGES 49 L`. `06 ( i (!7? J j i I?1 IL.s etI L#I 1 '?f ATE /? sets.00 J 1?i 'r1S. ?4?i 258 ?'+{ '?( ` ' 1e; SOLUTIONS T I { F 1 641 0 255- DRUGS/0THER 2 44400, 1 270 MED-SUR SUPPLIES is 4891)6 2 7-= 'S'TERILE SUPPLY i "D 3010 LABORATORY 47 , 1645 . 39c; s?,1-0 iifST?3'r-PF 3 2 6K)O j 421 P HYS. THERP/VISIT 1 27004 4 30 0l' GUP'ATIW"; THER . tom; 604 1 i 450 EMERG:.,ROOM, 2 377bO o PULMONARY F UNC 2 C?orjo 637 DRUG-8/SELF ADM IN s 65iO 7370 EKG/ECG ? i 1300 750 GASTR-- I.NTS SV5 1 $07 3G t ADMIT KITS 9 60 99 P-1 CC3NVEP.fCEiGTH' 3 1700 • T2 ? c1 )3 itil + , 3 t• t of ?? + .. n' ' * . _ . . . A '?' a P ? ? ? < ? ? :4 ? t ? I 1 " If"5 y r 50 PAYER 51 PROVIDER NO. 54 PROR PAYMENTS 55 EST. AMOUNT DUE 56 'i t_.Er•?t, %?ft .L ..: ? t.J,.f ey f 'a?i'? j GLUE CROSS 361 0004 Y Y { I ] 56 INSURED'S NAME L I CERT. - SSN • NIC. - D p, 61 GROUP NAME 62 INSURANCE GROUP NO. _, T . f-i 1 f 1 i. SHAY JR, CHARLES .E Cry. 105 63 TREATMENT AUTHOWATION CODES R ESC 6: EMPLOYER NAME 66 EMPLOYER LOCATION KE 1 1Ev- i CIil Y+ RET IR.ED 67 PRIN. DIAG. CD. p CODE x , .. 74 CODE IS ADM. DIAG. CO. R E•COOE 78 ^i' 1' .3J 79 P.C. 80 PRNCIPAL PR OCEDUREE DAT OTHER.PRICEOURE 81 COOS ..DATE : • • t , ?!, . , ., 82 ATTENDING PHYS. ID OTHER 000E CEDURE DATE .: OTHER CODE OURE DATE 83 OTHER PHYS. I) =--l .... iJ-,f tt!Y 1. t.r f. ?.:? (1..1? i'i fem.. %84 REMARKS' . -_ _,- z •_, . _. ; v. ._ f .. .-f + _ _.. : Fr _._. T nm-o-) acre-iAsm cncv i OTHER P1tYS.10 a5 PROVIDER REPRESENTATIVE 86 DATE X JAMES L JONES a ? ? ??, Cann Hill Fire Company No P 1 Biging Office P.O. Box 726 New Cumbedand, PA_ 17070 Local TEL: (717) 214-6018 TIN: 23-6266703 Toll Free TEL: (877) 214-6018 FAX: (717) 214-6020 email: info0ambulancebitlingoffice.com PATRICIA J. SHAY 2713 COLUMBIA AVE CAMP HILL, PA 17011 PLEASE MAKE ANY CORRECTIONS TO ADDRESS ABOVE. LWIJ, 11/17/2004 ° 11 DISCOVER V°IS, 04-50498 $621.0( Patient Name. SHAY, PATRICIA J. Patient SSN: Date of Service: 10/2512004 10.00 From: RESIDENCE To: Holy Spirit Hospital Primary Payor. Bill Patient Secondary Payor. DETACH AND RETURN TOP PORTION WITH YOUR PAYMENT 10/25/04 Basic Life SuppoWEmergency A0429 _ 1 505.00 505.00 10125104 Mileage A0425 ?- 2 13.00 - -- ---- 26.00 ------ ---- 1- 5/04 Oxygen _----_---- -- - A0422 1 90.00 90.00 - --- Total 621.00 0.00 0.00 1J„ y In order fora claim to be submitted to Medicare, we need the enclosed form completed, signed and retumed to our office. if you do not have Afedicare, please contact us. Failure to provide this information could result in further collection action. Camp Nil Fire Company No 1, 877 214-6018 PAY THIS AMOUNT 11* SHAY, PATRICIA J. 04-50498 y 205 GRANDVIEW AVE • • SUITE 211 CAMP HILL, PA 17011 Phone #: (800) 367-0512 Federal Tax ID: 23-2463002 VVM SHC EMERGENCY MEDICAL SE PATIENT NAME: PATRICIA SHAY PATIENT NUMBER: 31410 MDEN CALL NUMBER: 3032960A MDIP INSURANCE: MEDICARE B DATE OF CALL: 10/25/2004 DEPARTMENT OF PUBLIC TIME OF CALL: CALLER: 3032960A FROM: 2713 COLUMBIA AVE TO: HOLY SPIRIT HOSPITAL PATRICIA SHAY 2713 COLUMBIA AVE REASON(S) ALTERED LEVEL OF CONSCIOU CAMP HILL, PA 17011 FOR TRANSPORT INVOICE DESCRIPTION OF CHARGE QUANTITY UNIT PRICE AMOUNT PARAMEDIC INTERCEPT A0999 1.0 512.49 512.49 OP SITE A0394 1.0 4.70 4.70 EKG ELECTRODES A0396 1.0 4.23 4.23 GLUCOSE BLOOD A0394 1.0 5.82 5.82 ANGIOCATH (14-24) A0394 1.0 4.99 4.99 3CC SYRINGE A0394 1.0 1.54 1.54 Total Charges 533.77 DESCRIPTION OF PAYMENT FIECEIPiT PAYMENT DATE AMOUNT ? wf C, Total Credits 0.00 PLEASE PAY THIS AMOUNT $533.77 DETACH ALONG PERFORMATiON AND RETURN STUB WITH PAYMENT 533.77 AMOUNTDUE PATIENT NAME: SHAY, PATRICIA CALL NUMBER 3032960A AMOUNT $ PATIENT NUMBER: 31410 BILLING DATE: 11/2912004 ENCLOSED THIS ACCOUNT IS PAST DUEI Send your payment now or contact fAwbd1K our office to make payment arrangements. VISA AND MASTER CARD ACCEPTED WEST SHORE EMS - ALS 205 GRANDVIEW AVE CAMP HILL, PA 17011 . MEDICAL EVALUATION LiWow I I undated 1. MAR-ECIPIENT NUMBER 2. NAME OF APPLIW (Last, fast, middle initial) SECURfiYNO. 4. BIRTH DATE 5 i . n- 7. ATTENDING PHYSICIAN a. PHYSICIAN LICENSE NUMBER 9. EVALUATION AT (Description and code) L 10. For the purpose of determining my need for TITLE XIX INPATIENT CARE, and d applicable, my need fa 01 Hospital shelter deduction, I authorize rile release of any medical intormatiorm by the physician to the County Assistan 02 W Office. State Department of Public Welfare or its agents. 03 Personal Care/Dom Care ^ 04 Own House/Aparwnert 06'o « t >, r .o't• .? _ _ ,i.r:_,+ _ °..... 'J ther (Si dY) t } L Si nature ?Ap ficant w Pe s A hi f A li g p r on c ng or pp cant Date 11. HEIGHT WEIGHT _ BLOOD PRESSURE 7 7 PEM EM TU?E t PULSE RATE ? CARDIAC flHYTI , a i f7 ?yc ; f'i 12. MEDICAL SUMMARY _ r 1A l , _VJ 13. In evert of an emergency the Patient can vacate the budding 1. Independently E] 2. Wth Minimal Assistance 3. With Total Assistance 14. Patient is Capable of odminiiftrfrg What own rrnedicaliorn Ej 1. son E32. Under Supervision 3. No 15. LCD 9-CM DUGNOSTIC CODES l ~? 41 !.3 Primary( 4-4-0 j1 Secondary -dary ,[B: f'rq?earsana) and TecMical Care Needed - Check J each category that is applicable [I`PhysicatTherapy 0 Speech Therapy C] Occupational Therapy Inhalation Therapy 0 Special Dressings Irrigations C] Special Skin Care 0 Parenteral Fluids . Q Suclionemg ? Ol er (Spey) 17. PHYSICIAN ORDERS Medications , 3 } Treatment !• , r Rehabilitative and Restorative Services Therapies Diet :. ' Activities socialServices Special Procedures for Health and Safety w to Meet Objectives 18. PROGNOSIS - Check of only one 19. REK401UTATION POTENTIAL - Check / only one Q 1. Stable 2. Improving C] 3. Deteriorating 1. Good I,1. Limited M 3. Pow rrlran.IMa To the best of m RECOMMENDATION y knowledge, the patient's medical condition and related needs are essentially as indicated as above. 2DA. On the basis of the present medical findings the patient Y. a. no If yes, check of only one wilt eventually be able to return home or be discwged. E] 1. Within 180 days E) 2, Over 180 days 208. 1 recommend that the services and care to meet these needs can be provided at the level of care indicated - deck J only one f?'NF Services In HomWCommunity Services Personal Care/Residential El 1CF/MR Care Inpatient Psychiatric Care + f'} ? other (Specify) Physician (Printed Name) Phone Physic' S fur ` Date' r FOR DEPARTMENT USE 1 Medical and other professional personnel of" Medicaid agency or its designee MUST evaluate each apploaWs or recipient's need for admission by reviewing and assessing the evakJ- ations required by regulations. Medically 21A- Medically Eligtmile Yes No for Waiver Appropriate 218. Length of Stay O Within 180 bays ? Over 180 Days 22. Comments Reviewer's Signature and Tile Date gq?!)ICAL RECORD FOP.) 92-S.t'41 "Pv "v=-_ Nu, c??.. ,0--, - ma=r.`?a H4? e f? A7'.'ze? v ? may / r1?C3 n:e?Q 7-20- Pennsylvania BlueShield ,M'4«MMewt lia?w of IM OW Gass ,ad Mw SWW Assoc abo • CLAIM NOTICE - THIS IS NOT A BILL Member. ID Number. Grout information: CHARLES E SHAY JR Provider: CENTRAL PENN NRI CTR C?-7S - O 4 4 y Total Provider's Charge: $875.00 For Claim Number(s): 02535021124 Covered benefit amount we paid you: Covered benefit amount we paid this provider: If not already paid, the provider may bill you: Page 1 of 3 FEBRUARY 16, 2002 $0.00 $0.00 5875.00 J f P ?-?6G '7?3 Pennsylvania o BlueShield Camp Hill, PA 17089 - == ?.- 2L BBMNDBQH BOCSR979711889130i CHARLES E SHAY JR 1926 LONG BOAT OR LAKELAND FL 33810-2773 NN1388F • N ' M O O N C ? M A} 09 Q Oi so 0. W LL .5 1 0.0 2 Z f n Y! L 41 L ? O h O ? 5 m ? O ? O c W ? 4-0 c u ? C >1 CL .?C cc 41 w ° L c w f- u u L w va o > o = L ? CL v- ev o u m CL a a? *' a 44 c •C 4 U N O ? L O L .C CL O ? v pp L L .5 0 v ? O O c 41 0 .04 V> a L O O a w 3 N +,,, u a? N z 0 0 A P?4 A !L-. M co OD OD M 2 Z 2 ?d: I --?nl-*7 Medco Health P.O. Box 2031 Pine Brook, NJ 07058 2936M FEPCARD CH III ARLES E. SHAY JR 2713 COLUMBIA AVE CAMP HILL, PA 17011-5312 Dear CHARLES E. SHAY JR: is Enclosed are the materials that you requested from Medco Health. Medco Health is th Merck-Medco and PAID Prescriptions. the new name for "You need more information, please contact Member Services. Thank you. Sincerely, Medco Health FORM SCSLTRI A i Medco Health a Delivery 'Pharmacy Servi M Order Form Benefits Provided by the Service Benefit Plan For Refills To order from our websire: www.fepblue.org. Have your Member 10 number and Prescription (Rx) number on hand. Your 12-digit Prescription or Rx number can be found on your refill slip. To order by phone: Call 1 877 FEPFILL (1 877 337-3455) to use the automated refill system. Have your Member 1D number and your refill slip with the prescription information ready. To order by mail: Include your refill slip(s) with this form. Do not complete the Patient information section for refills. For New Prescriptions Fill out one line of the Patient Information Section for each new prescription you send. Be sure to include the patient's full name, • date of birth, and address, along with the doctor's name phone number. For All Home Delivery Orders Place all prescriptions and refill slips together with this completed order form and your co-payment in the enclose return envelope. Be sure to fold the form as indicated so 1 address on the bottom right shows through the window. If You Need Additional Help Call Member Services at 1 800 262-7890. Best times to ca are Tuesday through Friday afternoons. See the back of this form for additional instructions. Member Information Member ID: Shipping address if different from your mailing address Group: FEPMAIL Check if ? Temporary ? Permanent Name: Street Address: Street Address: Street Address: City, ST, ZIP: Daytime telephone F Evening telephone FM = You authorize release of all information to the plan administrator underwriter, sponsor, policyholder, employer, and their agents for use in connection with the benefit plan programs. Information m also be used for other reporting and analysis purposes without identification of you or your family members. Patient Information-Complete one line for each new prescription (Do not complete for refills) Does patient Patient name and Medicare B Patient's relation to plan Birth date Doctor name have any othe number (if applicable) member (fill in one) Sex M/D/YYYY and phone number prescription pl 1 Self Spouse Dependent ? M / ? Yes ? ? '? ?F ?No 2 Self Spouse Dependent ? M ? Yes ? ? ? ?F ?No 3 Self Spouse Dependent ? M j ? Yes ? ? ? ?F ?No Order Information Paying by Credit Card? Ovisa ?MC ODiscmovuS OAMEx ODif Total number of medications in this order a (including all refills and new medications) CREDIT CARD NUMBER Subtotal of this order MM Y1 1 X EXPIRATION DATE CARDHOLDER SIGNATURE Optional expedited shipping ?.? $9.00 (subject to change) Total enclosed (do not send cash) s[[T]!Zl Check here to have all orders billed to your credit card. By doing so, you authorize Medco Health to keep your card number on file and bill all future orders directly to your credit card. To enroll by phone, please call 1 800 948-8779. Paying by check? Write Your Member 0 on your check or money order made payable to Medco Health. MEDCO HEALTH PO SOX 30492 TAMPA FL 33633-1112 FORM fFEP10 {..11...11..11_. 11 11 .. •• - Medco Health a Delivery Pharmacy Servi TM Order Form Benefits Provided by the Service Benefit Plan For Refills To order from our website. www.fepblue.org. Have your Member ID number and Prescription (Rx) number on hand. Your 12-digit Prescription or Rx number can be found on your refill slip. a 4 two ro order by phone. Call 1 877 FEPFILL (1 877 337-3455) to use the automated refill system. Have your Member ID number and your refill slip with the prescription information ready. To order by mait Include your refill slip(s) with this form. Do not complete the Patient information section for refills. For New Prescriptions Fill out one line of the Patient Information Section for each new prescription you send. Be sure to include the patient's full name, 0 date of birth, and address, along with the doctor's name phone number. For All Home Delivery Orders Place all prescriptions and refill slips together with this completed order form and your co-payment in the enclose return envelope. Be sure to fold the form as indicated so tl address on the bottom right shows through the window. If You Need Additional Help Call Member Services at 1 800 262-7890. Best times to cal are Tuesday through Friday afternoons. See the back of this form for additional instructions ber Information to. Warne: FEPMAIL Street Address: Street Address: Street Address: City, ST, ZIP: _ Daytime telephone 1110 Fff] Evening telephone I Shipping address if different from your mailing address Check if ? Temporary ? Permanent You authorize release of all information to the plan administrator underwriter, sponsor, policyholder, employer, and their agents for use in connection with the benefit plan programs. Information m also be used for other reporting and analysis purposes without identification of you or your family members. Patient Information--Complete one line for each new prescription (Do not complete for refills) Does patient Patient name and Medicare 8 Patient's relation to plan Birth date Doctor name have any othe number (if applicable) member (fill in one) Sex M/D/YYYY and phone number prescription pl, t Self Spouse Dependent ? M ? Yes ? ? ? ? F ? No 2 Self spouse Dependent ? M ? Yes ? ? ? ? F ? No 3 Self Spouse Dependent ? M ? ? ? ?F ? Yes ? No Order Information Total number of medications in this order (including all refills and new medications) Subtotal of this order Optional expedited shipping $9.00 (subject to change) Total enclosed (do not send cash) O m 1111-00 sCL[]Fln Paying by Credit Card? ?visa ?MC ?DWNOVUS ?AmEx ?Din 'f'CREDDppIT CAT'RD NUMBER ?/ MU-1 Y X EXPIRATION DATE CARDHOLDER SIGNATURE ? Check here to have all orders billed to your credit card. By doing so, you authorize Medco Health. to keep your card number on file and bill all future orders directly to your credit card. To enroll by phone, please call 1 800 948-8779. Paying by check? Write your Member ID on your check or money order made payable to Medco Health. MEDCO HEALTH PO BOX 30492 TAMPA FL 33633-1112 i 11 it is I. MEMO TO: REQUESTOR • SUBJECT: MAILING ADDRESS AND TELEPHONE NUMBER FOR UBH CLAIMS UBH CLAIMS MAIL SERVICES PO BOX 744925 HOUSTON, TX 772744925 TELEPHONE NUMBER- 1-800-888-2998 EXT 6815 5l()"-/ rmarIST. sexual ability/interest, unusual or severe mentallmood changes. odor immodiately i f any of these unlikely but serious side effects k stools, "coffee ground" vomit, easy bruisingNeedin& Males - :ience a painful and prolonged erection, stop using this drug and diate medical attention, An allergic reaction to this drug is it seek immediate medicid attention if it, occurs. Symptoms of an action include: rash, itching, swelling, severe dizziness, trouble .f you notice other effects not listed above, contact your doctor or (CONS odor your medical history,. especially of. liver problems, kidney Wires, heart problems, other mentallmood disorders (e.g., rider), thyroid-problems, atineral (electrolyte) problems (e g., iia, SIADH), any allergies. This drub may snake you dizzy or caution engaging in activities requiring alertness such as tmg machinery. Limit alcoholic beverages. Though depression can lead to thoughts or attempts of suicide. Tell immediately if you have any suicidal thoughts, worsening or any other mentallmood changes (including new or worsening tation, panic attacks, trouble sleeping, irritability, hostile(angry pulsive actions, severe iesdessums, rapid speech). Keep all mintments so your healthcare professional can monitor your )sely and ad}usUchange your medication if needed. Caution is m using this dnig is the elderly because they may be more the effects of the drug. This medication should be used only y needed during pregnancy. Discuss the risks and benefits with . If this medication is used during the last 3 months of in"ttentl your newborn may develop symptoms including ireathmg difficulties, seizures, muscle stiffness, ptteriuess, or ing. However, do not stop taking this medication unless your is you to do so. Report any such symptoms to your doctor his drug passes into breast milk Because of the potential risk , breast-feeding while using this drug is not recommerided. r doctor before breast-fending. 'FRACTIONS 6cations taken with this product could result in serious, even iterachons. Avoid taking MAO inhibitors (e g., fiuazolidone, id, linezohd, moclobemide, phenelzine, procarbazi ne, selegiline, nine) within 2 weeks before or after treatment with this .Rite ADVICE" RITE AID PH?p 1074 1137 MARKI LEWYNE PA 17043 R: 01074 0766612 SHAY, PATRICIA Date of B l" 2713 COL CAMP HILL PA 17011 (717) 737-3359 Store DEA: AR9609807 RPH: WF Date Filled: 10/04/2004 (717.)730-0650 LEXAPRO G TABLET 20 M ? S N DC.. 2t1 1 s ..? ,F U&C: PAY: REFILL RX $73.79 (our iteAid.com. ORDER NO. 460574 'QV i'i'1aC15t. 'EMS diarrhea, nausea, vomiting or stomach/abdominal pain may 1y of these effects persist or worsen, notify your doctor or promptly. Tell your doctor immediately if any of these unlikely side effects occur: signs of increased blood sugar levels (ehg., hirst, increased urination, confusion). Tell your doctor y if any of these highly unlikely but very serious side effects s of vitamin B-12 deficiency with long-terns (over 3 years) e.g., unusual weakness, sore tongue, numbness or tingling of the . A serious allergic reaction to this drug is unlikely, but seek medical attention if it occurs. Symptoms ofa serious allergic Jude: rash, itching, swelling, dizziness, trouble breathing. If you r effects not listed above, intact your doctor or pharmacist. [IONS ug pantoprazole, tell your doctor or pharmacist if you are allergic amilar drugs (e.g., lansoprazole, omeprazole); or if you have any ies. Before using this medication, tell your doctor or pharmacist al history, especially of. severe liver disease, diabetes (poorly other stomach problems (e.g., tumors). Some symptoms may signs of a more serious condition. Tell your doctor immediately : heartburn combined with lightheadedness/sweating/dizziness, r shoulder/jaw pain (especially with trouble breathing), pain arms/neck/shoulders, unexplained weight loss. This should be used only when clearly needed during pregnancy. risks and benefits with your doctor. It is not known whether sses into breast milk Breast-feeding while using this drug is tended. Consult your doctor before breast-feeding. [FRACTIONS wuld not be used with the following medication because a very ruction may occur: atazanavir. If you are currently using this tell your doctor or pharmacist before starting pantoprazole. e can decrease the effectiveness of certain drugs which require d in order to be absorbed. Before using this medication, consult or pharmacist on how to manage such a potential interaction if ng the following drugs: ampicillin, azole antifungals (e.g., .e,ltraconazole), iron supplements. Before using this medication, ctor or pharmacist of all prescription and nonprescription/herhal u may use, especially digoxin. Based on information for similar ?prazole may increase the amount of digoxin that is absorbed Rite ADVICE` our RITE AID PH CY S 1074 1137 NCARK?- ET UMOYNE PA 17043 Rx 01074 0807096 SHAY, PATRICIA Date of Birth; 2713 COL CAMP HILL PA 17011 (717) 737-3359 Stom DEA AR%09307 RPH: MOF Date Filled: 11/24/200.3 (717) 730-0650 PROTONIX 44 MG TABLET EC ,. D SIJPP ' :30 0 E ?? > U&C: $226.79 PAY: REFILL RX !Aid.com. ORDER NO. 460574 -macist. ®.? ;ore throat, muscle stiffcims, coufusion, sweating, uncontrolled vements (e.g., tongue or facial muscles), one-sided muscle cold sensitivity, trouble urinating, black stools, unusual moods. nay infrequently make your blood sugar level rise, therefore worsening diabetes. This high blood sugar can rarely cause metimes fatal) conditions such as diabetic coma. Tell your doctor iy if you develop syuiptoms of high blood sugar, such as unusual hirst and urination, or vision changes. If you already have e sure to check your blood sugar level regularly. This drug may significant weight gain and a rise in your blood cholesterol (or levels. These effects, along with diabetes, may increase your teloping heart disease. Discuss the risks and benefits of treatment toctor. (See also Notes section.) If you notice other effects not e, contact your doctor or phannacist. LIONS rig quetiapine, tell your doctor or pharmacist if you are allergic to have any other allergies. Tell your doctor your medical history, & liver problems, blood vessel disease, very- low blood pressure, )rders. (See also Side Effects section.) Also tell your doctor or if either you or a family Manber has a history of the following: !art disease, high blood cholesterol/triglyceride leveb, high ure, obesity. To avoid dizziness and lightheadedness when a seated or lying position, get up slowly. This is more likely to first few days after starting or restarting the drug, or after dosag his dnig may snake you dizzy or drowsy; use caution engaging : requiring alertness such as driving or using machinery. Avoid averages. This drug might hinder body temperature c mtrol. It is to exercise strenuously, and to avoid extreme beat while using bon. Caution is advised when using this drug in the elderly y may be more sensitive to its effects. This medication Mould y when clearly needed during pregnancy. Discuss the risks mid h your doctor. It is not known whether this drug is excreted into Because of the potential risk to the infant, breast-feeding while rug is not recommended. Consult your doctor before ng. "ERACTIONS xxor of all nonprescription and prescription medication you may lly of: dopainme-like drugs (e.g., dopamine, bromocriptine, ), levodopa, anti-seizure drugs (e.g., phenytoin, phenobarbital), .Rite ADVICE` RITE AID PRACY *! 1074 (717) 737-3359 1137 MARKET STP EE Store DEA: AR9609807 RPH: JES L.EWYNE PA 17043 Rx 01074 0819538 Date Filled: 17/1(112404 SHAY, PA Date of 13iith: (717)730-0650 2713 COLLUMSIA CAMP NILE, PA 17011 SEROQUEL 25 MG TABLET trey ?? ?3, f k?";: t .:.'S'i`;ti _t';,,• '.. .?..A k42 Y ?:?, l?',? .x U&C: $531.89 PAY: ?1- NEW RX )Ur eAid.com. ORDER NO. 460574 a?: -rr adst. i activities requiring alertness such as driving or using machinery. olic beverages. This medication should be used only when clearly ing pregnancy. Discuss the risks and benefits with your doctor. It is whether this drug passes into breast milk. Consult your doctor ;t-feeding. fERACTIONS g this medication, tell your doctor or pharmacist of all prescription lption/hertW products you may use, especially of amantadme, hydtase inhibitors (e.g., acetaaolamide, methawlamide), orphan, ketamine, sodium bicarbonate. Do not start or stop any ithout doctor or pharmacist approval. iE is suspected, contact your local poison control center or emergency diately. US residents can call the US national poison hotline at -1222. Canadian residents should call their local poison control dy_ Symptoms of overdose may include restlessness, personality :ucmations, drowsiness, or loss ofconsciousness. e this medication with others. OSE a dose, use it as soon as you remember. If it is near the time of the next re missed dose and resume your usual dosing schedule. Do not lose to catch up. n temperature at 77 degrees F (25 degrees C) away from light and -ief storage between 5"6 degrees F (15-30 degrees C) is permitted in the bathroom. Keep all medicines away from children and pets. ALERT ion can cause complications in a medical emergency. For enrollment mll MedicAlert at 1-800-854-1166 (USA) or 1--800--668-1507 m in this leaflet may be used as an educational aid. TNsinfonnation does not bk uses, actions, precautions, side effects, ocintecactiom of fts medicine. This not intended as medical advicefor individual problemm t Databank - The Hearst Co"ration ® Rite ADVICE our teAid.com. ORDER NO. 460574 RITE AID PHICY # 1074 1137 MARKET STREET LEWYNE PA 17043 R: 01074 0819531 SHAY, ofB' Date e of Butte: 2713 COL CAMP HULL PA 17011 U&C: $105.29 PAY: NEW RX (717)737-3359 Store DEA: AR9609807 RPH: TES Date Filled: 11/1012004 (717) 730--0650 S }tf Medeohealth Information for patients concerning the use of: No. 317 ' live life well Version 6.01 proton pump inhibitors (oral) PRO tahn PUMP in HIH bih torz PAT SHAY Your prescription is for. OMEPRAZOLE(PRILOSEC) CAPS 20MG 08-07-2003 Rx# 0321910734-20 Standard drug name: OMEPRAZOLE Dr. FINESURG Directions: TAKE 1 CAPSULE DAILY To manage your prescription online, visit our website at www.feoWue.ora where you can order and track your prescription, view your prescription history and related expenses, and check pricing online. Not Online? You can also inquire about your prescription order and other questions by contacting us at the toll-free number on your prescription label. What are proton pump inhibitors? Proton pump inhibitors decrease the amount of acid produced in the stomach. Proton pump inhibitors are used to treat and prevent stomach and intestinal ulcers, gastroesophageal reflux disease (also known as GERD or heartburn), damage to the esophagus from stomach acid, Zollinger Ellison syndrome, and other conditions that involve excessive stomach acid production. Proton pump inhibitors may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking a proton pump inhibitor? Before taking a proton pump inhibitor, tell your doctor if you have ever had any type of liver disease. You may not be able to take the proton pump inhibitor, or you may require a dosage adjustment or special monitoring during treatment. The 15 mg and 30 mg Prevacid SoluTabs contain 2.5 mg and 5.1 mg phenylalanine respectively per tablet. Individuals with phenylketonuria may need to monitor their intake of this additive. Esomeprazole (Nexium), lansoprazoie (Prevacid), pantoprazole (Protonix), and rabeprazole (Aciphex) are in the FDA pregnancy category B. This means that they are not expected to be harmful to an unborn baby. Omeprazole (Prilosec) is in the FDA pregnancy category C. This means that it is not known whether omeprazole will be harmful to an unborn baby. Do not take a proton pump inhibitor without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is not known whether proton pump FP itthibitnrc naqc intn hi c?act rrvlk nn Writ faire o if you have difficulty swallowing, the lansoprazoie (Prevacid), esomeprazole (Nexium), or omeprazole (Prilosec) capsules can be opened and the contents sprinkled onto a tablespoonful of applesauce. The pellets should be mixed with the applesauce and then swallowed immediately. The applesauce should not be hot and should be soft enough to be swallowed without chewing. The pellets should not be chewed or crushed. The pellettapplesauce mixture should not be stored for later use. The lansoprazoie (Prevacid) capsules can also be mixed with ENSURE pudding, cottage cheese, yogurt, strained pears, or apple, orange, tomato juice and consumed immediately. If the pellets are mixed with juice, after consuming the mixture the glass should be rinsed with an additional two ounces of juice and the contents swallowed immediately. The granules must not be chewed or crushed. For patients who have a nasogastric tube in place, the Prevacid capsules can be opened and the intact granules mixed in 40 mL of apple juice and injected through the nasogastric tube into the stomach. After administering the granules, the nasogastric tube should be flushed with additional apple juice to clear the tube. Each packet of Prevacid for Delayed-Release Oral Suspension should be emptied into a container containing 2 tablespoons of water. Stir well and drink the mixture immediately. Do not crush or chew the granules. After drinking the mixture, add more water to the glass, stir, and drink immediately. Do not use other liquids or foods to mix the contents of the package. The Prevacid SoluTabs should be placed on the tongue and allowed to disintegrate with or without water until the particles can be medeohealth , Information for patients cuncerninz dic use of'. • lit, Weil tricyclic antidepressants try SICK: lik AN tec de press untz No. 338 Version 1.04 PAT SHAY Your prescription is for: AMITRIPTYUNE TABS SOMG 06-02-2003 Rx# 0315310117-20 Standard drug name: AMITRIPTYLINE Dr. GALLAGHER Directions: TAKE 1 TABLET EVERY MORNING A TABLET AT BEDTIME To manage your prescription online, visit our website at www.Aeoblue.om where you can order and track your prescription, view your prescription history and relatad expenses, and check pricing online. Not Online? You can also inquire about your prescription order and other questions by contacting us at the toll-free number on your prescription label. What are tricyclic antidepressants? Tricyclic antidepressants affect chemicals in your brain that may become unbalanced and cause depression. Tricyclic antidepressants are used to relieve symptoms of depression such as feelings of sadness, worthlessness, or guilt; loss of interest in daily activities; changes in- appetite; tiredness; sleeping too much; insomnia; and thoughts of death or suicide. Some tricyclic antidepressants are also used to reduce anxiety and to treat obsessive- compulsive di%order (OCD). Tricyclic antidepressants may also be used for purposes other than those listed in this medication guide. What should I discuss with my healthcare provider before taking tricyclic antidepressants? Do not take a tricyclic antidepressant without first talking to your doctor if you have taken a AIN monoamine oxidase inhibitor (MAGI) such as Ik 7" J isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) within the last 14 days. Before taking a tricyclic antidepressant, tell your doctor if you have kidney disease; -liver disease; -asthma; -thyroid disease; -diabetes; -stomach or intestinal problems; -high blood pressure, an irregular heartbeat, or other heart disease; -had a heart attack in the last 6 weeks; seizures or epilepsy; -an enlarged prostate or difficulty urinating; or -glaucoma. You may not be able to take a tricyclic antidepressant, or you may require a dosage adjustment or special monitoring during X '. How should 1 take tricyclic antidepressants? Take this medication exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you. _. • ° Take each dose with a full glass of water. :? rA B Tricyclic antidepressants may be taken several times a day or in one daily dose (usually at bedtime). Follow your doctor's instructions. Do not stop taking this medication without first talking to your doctor. It may take several weeks for you to start feeling better. Grapefruit and grapefruit juice may interact with clomipramine (Anafranil). The interaction could lead to potentially adverse effects. You should discuss the use of grapefruit and grapefruit juice with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor. r =< Store tricyclic antidepressants at room temperature away from moisture and heat. What happens if 1 miss a dose? Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed by your doctor. What happens if I overdose? © Seek emergency medical attention. Symptoms of an overdose include seizures; rnnfrecirin• .•irnt?l._irnac• ?r+i4a}i!.n• rnarmacyatatemenx www.fepblue.org Customer Service: 1 800 262-7890 I I IIIQ%d %xW i1CCaI Ll I r K Plan Member PATRICIA SHAY Invoice # 20-012928122 ( This package is part of an order shipped in multiple packages. Billing information for this package is included with another package associated with this order. SECTIO Important Member Information About Your Order What You May Need To Know • This package contains only part of your prescription order. The • Tip: An online visit to balance of your order will be delivered separately and within www.fepblue.org lets you the usual delivery timeframe. refill or request new • The quantity of the medication was reduced either because the prescriptions and track order prescription was written for more than your plan allows or status 24 hours a day. You because of state restrictions. (RX#-0305518479) can also review your account summary and check and pay balances. (Additional information on the back) SECTIO In This Package * This package is part of an order shipped in multiple packages. Rx* 0306518479-20 Strength 50MG Quantity 180 National Drug Code (NDC): 6348-1007-670 Prescribed for PATRICIA SHAY Refills Remaining 1 $35.00 -TEAR HERE ----------------------------------------------------------------- SEalPayment Statement . Plan Member PATRICIA SHAY Member ID XXXXX8811 Group Number PD1 FEPMAIL Invoice Number 20-012928122 'f. $0.00 St_ l,l I ( f•W Paying by credit card? ovjae• o once o oixo/Navus• o Ameo o otmrs- a Credit Cwd Number ¦ ¦acar /aaua.y ?awaca>,acaaa www.fepblue.org -- 203981577600017 , Customer Service: 1 800 262-7890 o Plan Member PATRIC!A SHAY < Al Invoice # 20-012928122-A MIKAE Mal Previous balance $20.00( Total of this package $4S.( Total of other package $35.( Shipping charges FRI Payments received $60.00 C SERIO Important Member Information About Your Order • This package contains only part of your prescription order. The balance of your order will be delivered separately and within the usual delivery timetrame. • The quantity of the medication was reduced either because the prescription was written for more than your plan allows or because of state restrictions. (RX#-0305509117) • Tip: An online visit to www.fepblue.org lets you retell or request new prescriptions and track order status 24 hours a day. You can also review your account summary and check and pay balances. (Additional information on the back) SECT104D In This Package Y This package is part of an order shipped in multiple packages. Rx# 0315310117-20 Strength 50MG Quantity 90 National Drug Code (NDC): 0078-1148-801 Prescribed for PAT SHAY Refills Remaining 2 $10.00 Rx# 0305509117-20 $35.00 Strength 10MG Quantity 90 National Drug Code (NDC): 0000-6073-554 Prescribed for PATRICIA SHAY Refills Remaining 1 -TEAR HERE ----------------------------------------------------------------- SECTIO_ Payment Statement Plan Member Member ID Group Number PATRIC IA SHAY XXXXX8811 PQ1 FEPMAIL Invoice Number 20-012928122-A What You May Need To Know s, k $0.00 $LJrt ! ! !dWj Paying by credit card? ovsa- O Mr q om- Narus- o Mroa- C] Dimis- ( I 1 I I 1 1 1 1 I I 1 I I 1 credit Gxd Number f locu /11Au.y LALC111C11L www.fepblue.org Customer Service: 1 800 262-7890 20452701550001 N D t o ( PATRICIA SHAY Invoice # 20-013655933-A Previous balance Total of your order Shipping charges Payments applied $15.C $70.C FIRE ($85.0( 5ECT1o : Im ortant Member Information p About Your Order What You.May Need To Know There is no critical information to communicate to you • Tip: An online visit to regarding tho status and contents of this prescription www.fepblue.org allows you order. Be sure to check this area of your Account to quickly and easily order Statement with each order from the Medco Home Delivery refills, request new Pharmacy Service. prescriptions, check order status, and review your account summary. (Additional information on the back) SECTIO ; In This Package Rx# 0328303667-20 $35.00 Strength 10MG Quantity 30 National Drug Code (NDC): 0045-6201-001 Prescribed for PAT SHAY Refills Remaining 6 Rx# 0325818486-20 Strength 25MG Quantity 60 National Drug Code (NDC): 0031-0027-510 Prescribed for PATRICIA SHAY Refills Remaining 5 $ 35.00 -TEAR HERE ----------------------------------------------------------------- 'SECTIO Payment Statement Plan Member PATRICIA SHAY Member ID XXXXX8811 Group Number PD1 FEPMAIL Invoice Number 20-013655933-A $0.00 $L-J, ? , I•LW L I Paying by credit card? ? visa- ? MC• 0 ois A].,,Vus• 0 Amex- 0 Diners- t I I 1 I ..I I i 1 1 1 1 I 1 1 1 f Credit Card Number • •maust. G® d changes (depression), slowfuregular heartbeat, fainting, vision pre frequent or trouble with urination, weight loss. Tell your xhately if any of these highly unlikely but very serious side r black stools, vomit that looks like coffee grounds, severe bZal pain, seizures. If you notice other effects not listed ict your doctor or pharmacist. IONS g donepezil, tdl your doctor or pharmacist if you are allergic to iave any other allergies. Before using this medication, tell your armacist your medical history, especially of: breathing problems % chronic obstructive pulmonary disease), heartdisease (heart lisorders), seizures, stomachlintestinal disease (eg., ulcers, ouble urinating (e.g., enlarged prostate). This drug may make or cause vision ppnn , use caution engaging in activities stress such as my ng or using machinery. Limit alcoholic Before having surgery, tell your doctor or dentist that you are uedication. This medication should be used only when clearly 19 pregnancy. Discuss the risks and benefits with your doctor. It 1 whether this drug pores into breast milk Consult your breast-feeding. FRACTIONS this medication, tell your doctor or pharmacist of all and nonprescription/ herbal products you may use, especially 2ergdc medications (e.#., benztropine, diphenhydramine), doses used for arthritis), c hotinerglc drugs (e.g., bethanechoi), ce inhibitors (e.g., ueostigmine), long-tenor use of non-steroidal . ry dnlgs or MAIDS (e g., ibuprofen, naproxeu), ire, drugs affectiuug the removal of donepezil from your system ad 2136 inducers such as carbamazepineti dexamethasone, 11, phenytoin, rifampin). Do not start or stop any medicine or or pharmacist approval. s suspected, contact your local poison control center or oom immediately. US residents can call the US national poison 800-222-1222. Canadian residents should call their local poison r directly. Symptoms of overdose may include severe or usea/vomiti & excessive sweating, very slow heartbeat, slow reathing, seizures. m Rite ADVICE your iteAid.com. ORDER NO. 460574 L' RITE AID PHARMACY N 1074 1137 MARKET STREET LEMOYNE PA 17043 Rx 01074 0800697 SHAY, PATRICIA Date of Birth: 2713 COLUA CAMP H91 PA 17011 ARICEPT 10 MG TABLET (717) 737-3359 Stone DEA: AR%09807 RPH: BMD Date Filled: 10/0412004 (717) 730--0650 Q Y UPPLY 30 ?q 35 U&C: 5152.09 PAY: NEW RX 1? s A LI irrnacist. w o • on= activities requiring alertness such as driving or using machinery. alit beverages. This medication should be used only when clearly ag pregnancy. Discuss the risks and benefits with your doctor. It is Whether this drug passes into breast mills. Consult your doctor t-feeding. 'FRACTIONS S this medication, tell yourdoctor or pharmacist of all prescription 1?ptroniherbal products you may use, especially of. amantadme, iydmse inhibitors (e.g., aeetazolamide, methazolamide), nphan, ketamme, sodium bicarbonate. Do not start or stop any ithout doctor or pharmacist approval. -E is suspected, contact your local poison control center or emergency irately. US residents can call the US national poison hotline at -1222. Canadian residents should call their local poison control ly. Symptoms of overdose may include restlessness, personality acinations, drowsiness, orloss ofconsciousness. this medication with others- OSE i dose, use it as soon as you remember. If it is near the time of the next e missed dose and resume your usual dosing schedule. Do not ose to catch up. a temperature at 77 degrees F (25 degrees C) away from light and ief storage between 59-86 degrees F (15-30 degrees C) is permitted. in the bathroom. Keep all medicines away from children and pets. ALERT on can cause complications in a medical emergency. For enrollment all MedicAlert at 1-800-854-1166 (USA) or 1-800--668-1507 m in this leaflet may be used as an educational aid. Thisinfomutioa does not -)k uses, actions, precautions, side effects, orinteractions of this medicine. This not intended as wodical advk4lor individual problems. t Databank - The Hearst Corporation -Rite ADVICE' 0 RITE AID PHARMACY # 1074 (717) 737-3359 1137 MARKET STREET Store DEA. AR9609807 RPIU ASB L.EMOYNE PA 17043 Its 01074 0793379 Date Filled: 09108/2004 SHAY, PATRICIA. Date of Birth: (717) 730-0650 2713 COL CAMP HELL PA 17011 NAMENDA 5MG.TABLET U&C: $109.78 PAY: NEW RX * Price may not include all applicable discounts. See register receipt for actual amount p n your -AiteAid.com. ORDER NO. d6057A 0 kID PHARMACIST. 4W r worsening diabetes. This high blood sugar can rarely cause Nueltimes fatal) conditions such as diabetic coma. Tell your doctor Jy if you develop symptoms ofhigh blood sugar, such as unusual thirst and urination, or vision changes. If you already have 1e sure to check your blood sugar level regularly. This drug shay significant weight gain and a rise in your blood cholesterol (or le) levels. These effects, along with diabetes, may increase your veloping heart disease. Discuss the risks and benefits of treatment doctor. (See also Notes section.) If you notice other effects not m, contact your doctor or pharmacist. TIONS ing quetiapine, tell your doctor or pharmacist if you are allergic to u have any other allergies. Tell your doctor your medical history, of: liver problems, blood vessel disease, very low blood pressure, orders. (See also Side Effects suction.) Also tell your doctor or t if either you or a family member has a history of the following: eart disease, high blood cholesterothriglyceride levels, high .ire, obesity. To avoid dizziness and lightheadedness when t a seated or lying position, get up slowly. This is more likely to .e first few days after starting or restarting the dmg,-or after dosag Ibis drug may make you dizzy or drowsy; use caution engaging s requiring alertness such as driving or using machinery. Avoid leverages. This drug might hinder body temperature control. It is t to exercise strenuously, and to avoid extreme heat while using sition.. Caution is advised when using this drug in the elderly y may be more sensitive to its efl^ects. This medication should ly when clearly needed during pregnancy. Discuss the risks and .th your doctor. It is not known whether this drug is excreted into Because of the pottwial risk to the infant, brtast-feeding while hug is not recommended. Consult your doctor before ing. rERACTIONS octor of all nonprescription and prescription medication you may ally of dopamine--like drugs (e.g., dopamine, bromocxiptiney :), levodopa, anti-seizure drugs (e.g., phenytoin, phenobarbital), fabutin, drugs for high blood pressure, other antipsychotic drugs dazine), azole antifungals (e.g., fluconazole, itraconazole), in, thyroid medicine (e.g., thyroxine). Also report use of drugs howsiness, such as: drugs used for slt:ep, sedatives, RIHMADVICE' RITE AID PHARMACY # 1074 1137 MARKET STREET LEMOYNE PA 17043 Ri 01074 0767803 SHAY, PATRICIA (717)737-3359 Store DEA: AR9609807 RPH: MOF Date Filled. 06107/2004 Date ofBitth. (717) 730-0650 2713-CO) L CAMP HILL PA 17011 SEROQUEL 25MG TABLET NDC:00310-0275-10 QTY: 300 DAYS SUPPLY: 30 DAW: 0 HAL S FINEBURG MD 356 E PENN DR ENOLA PA 17025 REFILL 6 TIMES UNTIL 06/0612005 PRIM # 1 PRVD # 27456 NAME: ACCESS PENNSYLVANIA ACCESS CAR CLM REF: 2504161573398 U&-C: PAY: NEW RX $531.89 rompts. ORDER NO. 460574 .ID PHARMACIST. IM 1W e amount of certain medications in your bloodstream. Consult r or pharmacist for more details. If you also take certain other Ner your cholesterol (bile acid-bindmg resins such as nine or c:olestipol), take sirnvastatin at least 1 hour before or at rs after these medications. Use this medication regularly in order u)A benefit from it. Remember to use it at the sauce time each take up to 4 weeks before the full benefit of this drug takes important to continue taking this medication even if you feel people with high cholesterol or triglycerides do not fed sick. ECTS >sd may occur. If this effect persists or worsens, notify your harmacist promptly. This drug may infrequently cause muscle hick can rarely lead to a very serious, possibly fatal, condition domyolysis). Seek immediate medical sawtion if you develop: iltenderness/weakness (especially with fever or unusual cell your doctor immediately if any of these highly unlikely but s side effects occur: yellowing eyes and skin, dark urine, severe mach/abdominal pain, persistent nausea, change in the amount of rious allergic reaction to this drug is unlikely, but seek medical attwtion if it occurs. Symptoms of a serious allergic :hide: rash, itching, swelling, dizziness, trouble breathing. If you r effects not listed above, contact your doctor or pharmacist. 'IONS ag siurvastatin, tell your doctor or pharmacist if you are allergic other "statins"; or if you have any other allergies. This should not be used if you have certain medical conditions. g this medicine, consuk your doctor or pharmacist if you have: disease. Before using this medication, tell your doctor or your medical history, especially of heart disease, history of liver ney disease, underactive thyroid: (hypothyroidism), diabetes trolled), alcohol use. The rare development ofsevere muscle e Side Effects) can "neatly lead to serious kidney problem. ition is usually temporarily stopped if you have any condition acrcase your risk of developing kidney problems. Before ur medication, notify your doctor immediately if you have any wing conditions: major surgery, trauma, serious illness (e.g., re me tabohcleudocrirtelelectrolyle disorders), very low blood icontmlled seizures. Limit alcoholic beverages. Daily use of increase your chance for serious side effects. Caution is advised -Rite ADVICE" 0 RITE AID PHARMACY .". 1074 1137 MARKET STREET LEMOYNE PA 17043 Rs 01074 0713986 SHAY, PATRKIA Date of Birth. 2713 COLT A CAMP HILL PA 17011 T ZOCOR 10MG TABLE NDC:00006-0735-31 QTY: 30 DAYS HAL S FINEBURG MD 356 E PENN DR ENOLA PA 17025 (717) 737-3359 Store DEA: AR9609807 RPH: MOF Date Filled: 06/0512004 (717) 730--0650 UPPLY:30 DAW:0 SUPPLY: REFILL 1 TIMES UNTIL-.12/19/20N PRVD # 1 PRVD 92741+ NAME: ACCESS PENNSYLVANIA ACCESS CAR CIA RF.F.2504157529576 U&C: PAY: REFILL RX $95.39 ompts. ORDER NO. 460303 medeohealth:o Information fior patients concerning the use of No. 514 live 'ife wil quetiapine Version 3.03 K WE F eve all peen PATRICIA SHAY Your prescription is for: SEROQUEL TABS 25MG 09-15-2003 Rx# 0325818486-20 Standard drug name: QUETIAPINE Dr. FINEBURG Directions: TAKE 1 TABLET TWICE A DAY To manage your prescription online, visit our website at www.feabiue.ora where you can orderand track your prescription, view your prescription history and related expenses, and check pricing online. Not Online? You can also inquire about your prescription order and other questions by contacting us at the toll-free number on your prescription label. What is quetiapine? Quetiapine is an antipsychotic medication. It works by changing the actions of chemicals in the brain. Quetiapine is used to treat the symptoms of psychotic conditions, including hallucinations, delusions, and confusion. Quetiapine may also be used for purposes other than those listed in this medication guide. What should 1 discuss with my healthcare provider before taking quetiapine? Before taking quetiapine, tell your doctor if you have -liver disease or other problems with your liver; -heart disease or other heart problems such as high blood pressure, a previous heart attack, or irregular heartbeats; -high levels of cholesterol or triglyceddes (types of fat) in your blood; -Alzheimer's disease; -seizures or epilepsy; or -hypothyroidism. You may not be able to take quetiapine, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above. Quetiapine is in the FDA pregnancy category C. This means that it is not known whether quetiapine will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant or could become pregnant during treatment. It is also not known whether quetiapine Passes into breast milk. Do not take quetiapine without first talking to your doctor if you are breast-feeding a baby. How should I take quetiapine? What happens if I miss a dose? Take the missed dose as soon as you remember. However, if it is almost time for the next regularly scheduled dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication. What happens if I overdose? © Seek emergency medical attention. Symptoms of a quetiapine overdose include drowsiness, increased heart rate, and low blood pressure. What should I avoid while taking quetiapine? Use caution when driving, operating machinery, or performing other hazardous activities. Quetiapine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Dizziness may be more likely to occur when you rise from a sitting or lying position. Rise slowly to prevent dizziness and a possible fall. Avoid alcohol during treatment with quetiapine. Alcohol may increase drowsiness ` and dizziness caused by quetiapine. Use caution in hot weather and during exercise to avoid becoming overheated during treatment. It is easy to become dangerously dehydrated while taking quetiapine. What are the possible side effects of quetiapine? Stop taking quetiapine and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives) to quetiapine. Hat S. Fir! e-burg, MD INTERNAL MEDICINE PROGRESS NOTES Patient Name t' <S Date LZ? &?2 - v ?z X o ab /0 1?1 a"l f o aal ?.? U?- Nil loc W _ Z . W U Z U c6 z A r w O CO r DU N Op C) CA a N f-- Z n Q W N iQ°z 0a'x,- QZc o QOD o ? o w ? 0 L i 0 ?S s SECTIOi UPDATE your 1 information here if necessary ORDER FORM Member ID XXXXX8811 Group PD1 FEPMAIL Member PATRICIA SHAY ORDER REFILLS 2713 COLUMBIA AVE Detach and include order slip(s) for the CAMP HILL, PA medications you wish to refill with this 17011-5312 Order Form (717) 730-0550 medcohea Ith ' live life well Shipping address and phone number if different V Phone ( ) ORDER NEW PRESCRIPTION(S) Fill out Patient Information chart below and enclose new prescription(s) FILL OUT THIS and payment with this Order Form. Complete one line for each patient. CHART FOR NEW Our pharmacists will review the drug information from your submitted PRESCRIPTIONS prescription(s) for you - no need to include drug name. ONLY ? Self OM OYes 1. 0 Spouse ( 1 # 1 1 1 1 1 1 OF ? Dependent 0No ? Self U rd O Yes 2. 0 Spouse I # 0 Dependent O F 1 1 1_ I I ONO 0 Self 3. 0 Spouse M ? Yes # ?Dependent OF L I I i I l 1 1 I ?No TOTAL YOUR ORDER AND INCLUDE PAYMENT Invoice Number: 20-010418205 Total number of refills and new prescriptions ordered 1 1 I Total co-payment due for prescriptions $",I I i 1 I 1 I Standard shipping is FREE (add $4.00 for expedited shipping) ".1 1 (See payment instructions on back) Medco.Health is your provider of home delivery pharmacy services. Expedited shipping available For an additional fee, your order will be shipped by expedited carrier. This option must be chosen when you make the order, and cannot be applied after an order is already processed. Choose expedited shipping for this order by including the appropriate amount in the order information section on the front of this form. If you elect to have this and all future orders billed to your credit card by checking the box below or by enrolling by phone, bear in mind that the AutoCharge feature will apply to all Home Delivery Pharmacy Service orders and any outstanding balances, whether or not they are covered by your plan. Also note that we can only keep one credit card on file. I?r1 State law allows a less expensive, generically equivalent drug to be substituted for certain brand name drugs unless you or your. physician direct otherwise- - -- --------- FOLD HERE Order Payment information Paying by credit card? ? Visa® ? MC® ? DisO/NOVUS® ? Amee ? Diners® >>` ::w: , w- w. ? Check here to have all orders billed to your credit card. By doing so, you authorize Medco Health to keep your card number on file and bill future orders and any outstanding balances directly to your credit card. To enroll by phone, please call toll-free 1 800 948-8779, S `q Paying by check? %-u d t Card Number Write your member ID on your check. N. Make check payable to Medco Health. Y Expiration Date x Cardholder's Signature Group: PD1 FEPMAIL MEDCO HEALTH PO BOX 30492 TAMPA FL 33633-1112 3333 ----_--_-- --- ---_--_- --? - t 0 • ' ouis apozzi, Jr., Esquire* Dan K. Natirboff, Esquire Donald R. Reavey. Esquire Doreen C. Sloan, Esquire Michael B. Volk, Esquire Joseph F. Murphy, Esquire Bruce G. Baron, Research Coordinator Robert G. Sobanski, Reimb. Analyst Adam Solander, Law Clerk Karen L. Fisher, Paralegal Amy Reavey, Paralegal Ca 2933 North Front Street Harrisburg, PA 171 i 0 • (licensed in PA N) and A4Dl June 21, 2006 VIA FACSIMILE TO (717) 243-9200 Harold S. Irwin, III Irwin & Bayley 64 South Pitt Street Carlisle, PA 17013 Telephone: (717) 233-4101 Fax: (717) 233-4103 w ww.capozziassociates.com Victor J. Bierman', lii Esq. Dennis A. Roth', Esq. Vincent E. Fisher'. Esq. Of Counsel 1 l.icci'Sed in Ohio Liceawd in OR. PA. FL Re: Petition for Appointment of Permanent Guardian of the Person and Estate of An Alleged Incapacitated Person - Patricia J. Shay Our Matter No.: 399-05 Dear Attorney Irwin: After our discussion yesterday, I contacted my client and discussed Mr. Shay's comment that she had prevented him from visiting Mrs. Shay in the past. I also confirmed the nursing home's concern with his inappropriate actions during one visit in 2005. Additionally, during another visit to the facility, Mr. Shay brought his girlfriend with him to visit his wife which disturbed her immensely. The negative effects of his visit(s) lasted for a significant period of time. It is against her best interests for him to walk in and then immediately out of her life as it has devastating effects on her mentally and emotionally. While we recognize that they are still legally married, Mr. Shay has not acted as a concerned or loving husband for an extended period of time, nor has he provided for any of her needs. For these reasons, we must decline his request. :Sincerely, l Doreena`Cp ig S"ioan, Esquire DCS/klf Enclosures cc: Tracy D. Shay-Snyder E ocHierr P./P I Qep UZI Uo Ua:Iar PENNSTATE UJL c-rU-DIUC i p.c The Dickinson School of Law September 5, 2006 Doreena Craig Sloan, Esq. Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Tel: (717) 233-4101 Re: Shay v. Shay Dear Mrs. Craig Sloan: 131der Law and Consumer Protection Clinic A smicc 14) the own tinily by students I'mm 71x: Dickinstxt CIMI of Law of 71x; Pennsylvania Soto University Please allow this letter to first serve as an introduct and I am the new law student assigned to represent Law Clinic. As you know we are representing Mr. by Tracy D. Shay-Snyder. As the September S, 2006 guardianship hearing nu Shay's wishes with respect to his rights if Ms. Shay we do not oppose Ms. Shay-Snyder's appointment that Mr. Shay's interests are protected. We are will Ms. Shay-Snyder as guardian without challenge if I Mr. Shay desires the right to visit his wife without 1 be sure to notify Claremont Nursing Center at least he will not contact his daughter and seek permissio; to Pennsylvania to see his wife. If you and your client are willing to accept these to appointment of Ms. Shay-Snyder as Patricia Shay' If you have any questions or concerns, please 240-5152. Sincerely, Rebecca. M. Fuhrman Certified Legal Intern The Dale F. Shughari Cmununity Law Center 45 North Pitt Sirmt Carlisle, PA 17013 Office. 717-240-5152 or 717-240-5102 Fax: 717-241-35% My name is Rebecca Fuhrman files E. Shay, Jr. through the Elder in the guardianship action filed >, we wanted to communicate Mr. Snyder is appointed guardian. While I guardian, we also want to ensure rg to consent to the appointment of our client will agree to the following. e discretion of his daughter. He will 8 hours in advance of his visits, but before making the trip from Florida we will not challenge the me at the Elder Law Clinic at 717- ?` Nichole Walters Supervising Attorney An Equal Opportunity University ..cr VJ VV VJ• iVr+ PENNSTATE qP THE Di TO: Fax Number S Name y Firm City/State/ZIP LJ4 0 183# THE DICKINSON S '1tL.YGu c FROM: Name ?:X-C,jL,4 r\A,]C !(Wj2 tV/n Phone Number 1q[)-6N0)' Fax Number 241 655, (4- Date-1 Number of pages including this cover sheet 2 Comments: zc V6 c-?V-16) luc of LAw SCHOOL OF LAW r-1 The information contained in this transmission is confidential an intended only for the use. of the individual or entity to whom it is addressed. If you have received this transmission in error, please notify us immediately and mail the original transmission to us. THE DICKINSON SCHOOL OF LAW OF THE P SYLVANIA STATE UNIVERSITY 150 SOUTH COLLEGE STREET, CARLISLE, PENNSYLVANIA 17013-2899 (717) 240-5000 Capozzi & Assoc. i i Fax:717-233-4103 *-w Transmit Confirmation Report ww P.1 Sep 6 2006 05:06pm Name/Fax No. Mode Start Time Page Result Note 2413596 Normal 06.05:06pm 0'42" 0 T.1.1 T Transmission failed Send the document(s) from page 1 tams I. c ozd. h., Esgwm* l wjW K. Natkbo$ EKWM 2"M 1K. BOW- UOM Dateeua G 51oa0. Esquire WXbVj B. VOW. BUF&C liritux Z;emer, Ee1e wt-ftrs. Baca, l O-Ch 13=ft2l*a; Remo- KaimI..lrWW'Pankid 7emitaKok, P'w4e d •pi...r:?wxr? 2933 Not* PMW Strew Nwrisbo v- pA 17110 Tdapbow: (717) 233-AIOI Fm=(7t7)233-4103 -Dorn !=nW Was victor I. DWra w', M Esq_ Denou?s A Rotd', Esq Yioawt E. Fut?, Esq. Olcowwl j u..w wai. at;.s++:acstin VIA FACSDWZ to (717) 241-35% Dickinson School of Law AM: Nicole Waters, Esquire acrd W. B= y Fuhmman, Certified Legal Intern 150 South. College sued Carlisle, PA 17013-2899 Re: h Y. Cnmbetland County Guardianship out Matter No.: 339-05 Dear Mss. Waters and Fuhtman: I did receive your letter and spoke with my cluml after talking with Ms. Fubamaa. MY Chem is willing to resolve ibis [natter on the following MIMS: I . NU. Shay will make planned regular lx-mod Y visits; 2. Mr. Shay will advise ?racy Shay-Snyder at least 48 torus in advaucc of his visitation plan(s); 1 Tracy Shay-Snyder will be Phi dMing the visits, and 4. Andy W. Slay =y .• sit with his wik. Patricia Shay, on his visits. He may not bring anyone else with him (i.e., gir}fricad, de...)- please discuss these tams with your client and advise the whather he is willing to accept them. g Sloan t DCS ce- Tracy Sbow-Snyder Septen?ba 6, 2006 { J) 'I 05 IN RE: IN THE COURT OF COMMON PLEAS OF PATRICIA J. SHAY CUMBERLAND COUNTY, PENNSYLVANIA I ORPHANS' COURT DIVISION An Incapacitated Person NO. 21-06--492 FINAL ORDER OF COURT APPOINTING PLENARY GUARDIAN AND NOW, this 8th day of September, 2006, following hearings held in this case on July 16, 2006, and September 8, 2006,. the Court now enters findings as follows, based upon the exhibits and testimony presented: 1. That PATRICIA J. SHAY is an individual, married to Charles E. Shay, Jr., on October 25, 1952, and she has two children, Tracy Shay-Snyder and Cory Shay. 2. That PATRICIA J. SHAY suffers from, among other things, Senile Alzheimer's Dementia, a condition which has now advanced to the point where the condition impairs her capacity to receive and evaluate information.effectively, and now prevents her from making and communicating decisions concerning the management of financial affairs or to meet essential requirements for her physical health and safety. 3. That PATRICIA J. SHAY is now a resident of Claremont Nursing and Rehabilitation Center located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 4. That Daughter Tracy Shay-Snyder and Husband Charles E. Shay, Jr., acknowledge that from this day forward, said nursing facility (or a similar facility) is the most appropriate setting for the care and physical residence of PATRICIA J. SHAY. NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing findings, it is ORDERED, ADJUDGED, AND DECREED: A. That PATRICIA J. SHAY be and is hereby adjudged a totally incapacitated person. B. That Tracy Shay-Snyder is appointed Plenary Guardian of the Person of PATRICIA J. SHAY and shall have the authority to act on behalf of PATRICIA J. SHAY, to provide for the general care, maintenance and custody of PATRICIA J. SHAY. Further: 1. The Plenary Guardian shall arrange for medical, psychological and psychiatric services and social and vocational opportunities, as appropriate; 2. The Plenary Guardian shall assist PATRICIA J. SHAY in the development of maximum self-reliance and independence; 3. The Plenary Guardian shall have the authority to give consent for and to withhold surgical or medical treatment so long as Mr. Shay is notified as soon as practical, but in no event more than 24 hours after a decision is made in regards to providing or withholding such treatment. 4. The Plenary Guardian shall do nothing to interfere with the relationship between Charles Shay, Jr., and PATRICIA J. SHAY. Provided, however, that this provision shall not be construed as preventing the Guardian from pursuing any legal action to enforce or protect the rights of the incapacitated person vis-a-vis her husband or any other person. 5. Charles E. Shay, Jr., shall have the right to visit PATRICIA J. SHAY upon 48 hours notice to the Guardian, and he shall have the unrestricted right to receive full information about her status, care and treatment from all care-givers; and b. The Plenary Guardian shall file with the Clerk of the Court a report on the social, medical and other relevant conditions, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually thereafter. C. Tracy Shay-Snyder is hereby appointed Plenary Guardian of the Estate of PATRICIA J. SHAY and shall have the authority and responsibility to manage and use PATRICIA J. SHAY'S property for her benefit in accordance with 20 Pa. C.S.A. 5536(a). The Plenary Guardian for the estate shall file a report with the Clerk of the Court about assets, investments, receipts and disbursements, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually thereafter. The Plenary Guardian shall file an inventory with the Court in accordance with 20 Pa. C.S.A. Sections 5521 and 5142 within three months of this Order. The Plenary Guardian of the estate shall not be required to post a bond. D. Any existing general power of attorney, limited power of attorney and/or health care power of attorney executed by PATRICIA J. SHAY is hereby specifically revoked-and rendered null and void. E. PATRICIA J. SHAY has the right to appeal this Order by filing exceptions within ten (10) days of this date or to petition this Court for a review of hearing to modify or terminate the guardianship herein established. Counsel for Petitioner is directed to have served upon and read to PATRICIA J. SHAY a copy of this order and the Statement of Rights, a copy of which is attached hereto, and to file proof of such service with this Court witti ten (10) days. By the Court, ift! I F C;c)?' 's `A REGIRD { ',) Ire ! ,•,ii?f ?; f. ?n'::;1k0 ?(' •"?' ?:f 5 I Z iA t'?l? V •y r Edward E. Guido, J. 'y Wof, Rebecca M. Fuhrman, Nichole M. Walters, THE ELDER LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 Certified Legal Intern Esquire Doreena Craig Sloan, Esquire CAPOZZI & ASSOCIATES 2933 North Front Street Harrisburg, PA 17110 • srs s • DURABLE POWER OF ATTORNEY Charles E. Shay, Jr. of 1926 Long Boat Drive, City of Lakeland 33810, County of Polk, a legal resident of the State of Florida, has made, constituted, and appointed Tracy Shay Snyder, my daughter of 2713 Columbia Avenue, City of Camp Hill 17011, County of Cumberland, State of Pennsylvania, my attorney in fact to act in, manage, and conduct any and all of my personal and business affairs, in my name, place and stead, and for my use and benefit. Granting to my attorney in fact full power and authority to do and perform every act requisite and necessary in and about my estate, property, and affairs as fully and effectually to all intents and purposes as I might or could do in my own proper person if personally present, and ratifying and confirming all that my attorney in fact shall lawfully do or cause to be done by virtue of this Durable Power of Attorney. I declare any act or thing lawfully done by my attorney in fact by virtue of this Durable Power of Attorney shall be binding on myself, my heirs, my legal or personal representatives, and my assigns. This Durable Power of Attorney shall not be affected by my disability, incompetency, or incapacity, except as provided by statute. Property subject to this Durable Power of Attorney shall include but not be limited to all real and personal property owned by myself, my interest in all property held in joint tenancy, my interest in all non- homestead property held in tenancy by the entirety, and all property over which I hold a power of appointment. In witness to the above, i have signed this Durable Power of Attorney on August 29, 2001, at Lakeland, Polk County, Florida. [Signature] kdz . --IN R. [Printed Name] We, the undersigned, certify that Charles E. Shay, Jr. Signed the above instrument in our presence and at the time published and declared the same to be Charles E. Shay, Jr.'s Durable Power of Attorney, and that we, in Charles E. Shay, Jr.'s presence and at Charles E. Shay, Jr.'s request, and in the presence of each other, have- subscribed our names to this instrument as attesting witnesses to its execution, at Lakeland, Polk County, Florida, ob August 29, 2001. P6 AA M-0 [Signature of'itne ] ^ [Signature of Witness] A tb • 1-Ct u 2k1 --rA is o y [Printed Name] [Printed Name] The State of Florida, Polk County. Subscribed and sworn to before me by COMW , who is personally known to me or who has produced a Florida Driver's license as i4ptifipation, and .-6y 641=A&rW A eI 1OVa witness who is personally known to me or who has.,-produced a Florida Driver's license as identification, and „)AAIE t7Oi "aJAY , a witness'Ah6 is ersonally known to me or who has produced a Florida Driver's license as i¢entificatiop, nq, S? 1'L9 10 I [date]. JC%4AC-1- ti taignaiu i ice; 1 Sow [Printed name] Owilu Mkhoel Alan Johnson M' COMMIN" * CCOM14 EXPIRES My Commission No.: _ member 141003 ? My Commission Expires: ?;,. AoNOEO1N TWYFARIN EMC (/ 0 0 CHARLES SHAY • April 7, 2008 • SHAY VS SHAY IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, AN INCAPACITATED: PERSON BY TRACY D. SHAY-SNYDER AS : PLENARY GUARDIAN OF THE PERSON AND: ESTATE OF PATRICIA J. SHAY, PLAINTIFF VS NO. 06-3229 CHARLES E. SHAY, JR., DEFENDANT TELEPHONE DEPOSITION OF: CHARLES E. SHAY, JR. TAKEN BY: PLAINTIFF BEFORE: DAWN YOUNG DIETRICH, REPORTER NOTARY PUBLIC DATE: APRIL 7, 2008, 3:00 P.M. PLACE: CAPOZZI & ASSOCIATES, PC 2933 NORTH FRONT STREET HARRISBURG, PENNSYLVANIA Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • • April 7, 2008 SHAY VS SHAY 2 4 1 APPEARANCES: 1 EXH ns (CONTD.) 2 CAP02ZI & ASSOCIATES, PC 2 BY: BRUCE G. BARON, ESQUIRE PLAINTIFF PRODUCED 3 3 EXHIBIT NO. AND MARKED FOR - PLAINTIFF 4 16 - Billing invoices 5 4 5 17 - Prescription documents 5 SAUL EWING, LLP 6 18 - Letter from Capazi & Associates to 5 BY: MATTHEW M. HAAR, ESQUIRE Irwin & Bayley dated June 21, 2006 5 6 FOR - DEFENDANT 7 7 19 - Dickinson School of law documents 5 ALSO PRESENT: 8 8 20 - Facsimile from Doreena Craig Sloan TRACY D. SHAY-SNYDER 9 to Dickinson School of Law dated 9 CORY L. SHAY September 6, 2006 5 KEITH SNYDER 10 10 21 - Final Order of Court Appointing 11 11 Plenary Gum-dim 5 12 12 13 13 14 14 15 15 16 16 17 17 18 18 19 19 20 20 21 21 22 22 23 23 24 24 25 25 3 5 1 TABLE OF CONTENTS 1 (Plaintiff Exhibit Nos. 1-2 and 421 were 2 wiTNESS 2 marked for identification.) 3 ' 3 CHARLES E. SHAY, JR., called as a 4 FOR PLAINTIFF DIRECT CROSS 4 witness, being sworn, testified as follows: Charles R Shay, Jr. 5 33 5 5 6 DIRECT EXAMINATION 7 7 a mns 8 BY MR. BARON: 9 F1.A11,171F PRODUCED 9 Q Mr. Shay, as I said, rm Bruce Baron. to rrNO' AND MARKED 10 I'm the attorney for your wife and Tracy Shay-Snyder 1- Hwrwxng cemetery documents 5 11 who's the guardian in the matter that's before the 11 2 - Headstone photographs s 12 Cumberland County Court. Today we're trying to get 12 13 your testimony on questions only related to the 13 4 - CUNA Mutual Grorq documeds 5 14 jurisdiction of the court over you and I don't think 5 - Cunhertard Cody Assistance office 15 the deposition will be too long. 14 6 - Cdocurnents uria 5 County Ass;stanoe Office 16 If you don't understand something I ask documert dated August 18, 2003 5 17 you, please tell me you don't understand and Pll try 16 7 - 2002 tax return 5 18 to make it clearer. If you don't know the answer to 17 19 something, say you don't know. And if you want to 1 velope from ClarleS* l 9 - Copy of en 20 say something more in answer to the question that's e 19 nv 9- Benefit Checking documents 5 21 , fine. 20 10 - Copes of checks 5 22 1 sent a set of exhibits to Matt to et g 21 22 11- FirstUSA Wfing iogimy 5 12 - MaonCard accocmt summary 5 23 to you. Have you received that set of exhibits? 23 13 - Copies of medical cards 5 - - 24 A I sure have. 24 125 14 - Into 1 4 1 Notes 5 15 - Blue Cross Blue swdd documents s 25 Q Okay. And does your set have 21 tabs in 2 (Pages 2 to 5) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • • SHAY VS April 7, 2008 SHAY 6 8 1 it? 1 It was given to me. 2 A I don't know how nays in it, but I read 2 Q Okay. 3 them all. 3 A And I had a cemetery stone put an it 4 Q Okay. And does it have a cover sheet 4 because my mother died when I was born and my 5 that says List of Exhibits for Deposition of Charles 5 stepmother would not let my father put a stone on her 6 E. Shay, Jr. Monday, April 7th, 2008? 6 grave, so I put a stone on her and my father's grave 7 A Let me look here. 7 and the other side I put Pat's name and my name. 8 Q It should be the first page. 8 Now, I do not plan on using it. I 9 A Yes. 9 already have a lot down here in Florida. I will be 10 Q Okay. I'm going to try to just go 10 buried in Florida. But the other one is available to 11 through the exhibits in order. There are some of 11 Pat. 12 them that I won't have any questions for you at all, 12 Q And on the card that exists in P- 1, 13 so don't worry about that. It's just that I wanted 13 there's a statement that says that you have the 14 to make sure Matt had a set and you had a set of 14 deed. Do you in fact have the deed? 15 documents that we were going to discuss at the 15 A I do. I do have the deed. 16 deposition. 16 Q Okay. 17 There's also going to be a deposition of 17 A Absolutely. 18 Tracy after yours, so Thai's why we have some 18 Q Okay. And is the deed in your name or is 19 exhibits that I won't ask you about. 19 it - 20 A Uh-huh. 20 A Well, you know, I don't know. I kind of 21 Q Okay? 21 think it's the same as it was when my father had it. 22 A I understand. 22 Q Do you know where - 23 Q Okay. Can you hear me okay? 23 A He wrote something on the back of the 24 A Not quite - not quite real clear. 24 card for the cemetery people to give me to make sure 25 Okay, I'm going to turn - 25 I of that lot. 7 9 1 A - turn it up a little louder rd 1 Q Okay. 2 appreciate it. 2 A And I don't think anything else has been 3 Q I'm going to turn the phone closer to 3 changed. My father's name is the same as mine. 4 me. 4 Q Right. 5 A Okay. 5 A So I can't really tell you if it is in my 6 Q Okay. Is that any better? 6 name or his name. 7 A Yes, it is. 7 Q Okay. Who paid to have the headstone 8 Q Okay. The first Exhibit I want to ask 8 engraved? 9 y9? about is the one that's marked P-1 which is 9 A I did. 1, "tled in my summary ownership card on file with 10 Q And do you remember about when you did 11 Harrisburg Cemetery. 11 that? 12 A Yes. 12 A Yeah, the year he died Tracy would 13 Q Did you find that one? 13 probably know. I don't remember dates very well. 14 A Yes. 14 Q Okay. 15 Q Do you recognize that exhibit? 15 A I have short-time memory and I don't 16 A Yes. 16 remember things like that. 17 Q Have you seen it before? 17 Q Okay. 18 A Oh, many times. 18 A But I know when he died I had the stone 19 Q Can you tell us for the record what it 19 put on right away for him and my mother. 20 is? 20 Q And do you still have the deed in your 21 A Well, its a cemetery lot that my father 21 possession? 22 gave me when he died because he did not want his 22 A Yes, I do. 23 ex-wife to be buried beside him, so he gave it to my 23 Q And is that in Florida somewhere? 24 wife and I - he gave it to me for my wife and I, 24 A Yes. 25 Patricia, and that's how I got it. I didn't buy it. 25 Q Is it in a safe deposit box or where is 3 (Pages 6 to 9) Geiger & Loria Reporting Service - 800-222.4577 CHARLES SHAY • • SHAY VS April 7, 2008 SHAY 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 it? A No. Its in my desk I believe. Q Okay. A I haven't - every now and then I run across it. Q Okay. A But I know I still have it Q Can you look at what is marked Exhibit P-2 and tell me as far as you can tell today if those are pictures of what you remember the stone you put up on that cemetery plot looks like? A Yes, its exactly lice I put up. Q Okay- A Exactly. Q And that's in the Harrisburg cemetery in Harrisburg, Pennsylvania? A Yes, it is. Q Okay. All right A At the time I had that done I didn't know I was going to come to Florida, I thought I was going to stay in Pennsylvania. So that's why I had my name put on and Pat's name put on. Q Okay. A But things have changed since. Q Okay. I want you to take a look at the 11 exhibit that's marked P-5 which is - at the top of the letter it has Cumberland County Assistance Office and the letter's dated April 27th, 2005. A Yes. Q Did you get a copy of that letter? A Let me see. Pm not sure. I'm not sure. I got some paperwork and I applied for some paperwork to have Pat get Medicare. If thats one of them, I could have possibly gotten it And I know I filled them all out and sent them in and they all came back that she wasn't qualified for Medicare. And I don't keep records. In the trash can it went Q When you say Medicare, do you mean Medicare or do you mean Medicaid? A Medicaid. I'm sorry. I get them mixed up. Q Yeah. A lot of people do. Okay. Can you take a look at Exhibit P-6. A Yes. Q Now, this is something that was not sent to you, but it asked for some things with respect to Mrs. Shay's qualifications for medical assistance. A Okay. Q And the next exhibit is Exhibit R7. Do 12 1 you see that one which is a tax return? 2 A Yeah. 3 Q Do you recognize that? 4 A No, not really. I don't know what 5 they're talking about there. 6 Q Do you remember what kinds of documents 7 you sent to the County Assistance Office in response 8 to those letters? 9 A No, I don't They were all questions 10 about how much money I had made and things like that 11 and I filled it out and sent it in and later on I got 12 letters back saying that she didn't qualify and I 13 just left it go at that 14 Q Do you recall whether or not one of the 15 things you might have sent was copies of your tax 16 returns? 17 A 1 don't If they would have asked for 18 it, I certainly would have given it to them. 19 Q Do you remember whether or not in 2005 20 you sent some materials to Tracy to help with 21 qualifying Mrs. Shay for Medical Assistance in 22 Pennsylvania? 23 A I don't remember of it, but I probably 24 did if Tracy asked for it 25 Q I want you to take a look at Exhibit P-8 13 1 which is the top of an envelope that was mailed 2 sometime in 2005, the date's on the postage stamp, 3 and in the left there's an address label. 4 Can you identify that address label? 5 A I don't know what you're talking about 6 Q I'm talking about in the left-hand comer 7 there's a return address label that has the letter S 8 on it. 9 A On what, sir? 10 Q On Exhibit P-8. 11 MR. HAAR: Charlie, I don't mean to 12 interject, but on my set of copies the exhibit tab is 13 at the top of the page rather than the bottom 14 A I don't see that 15 BY MR. BARON: 16 Q Okay. Do you see - 17 A I don't think I have that 18 Q Okay. Do you see something that says 19 Parcel Post? 20 A Yes, sent by defendant to Tracy Shay. 21 But that's all there. I don't see anything else. 22 Q You don't see the exhibit itself P-8? 23 A No. 24 Q You don't have something that has Exhibit 25 Number P-8 on it? 4 (Pages 10 to 13) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • SHAY VS April 7, 2008 SHAY 14 1 A Yeah, it has P-8, Number P-8; P-7, P-8. 1 2 Q Okay. No, not on the cover letter, 2 3 Mr. Shay, but actually the exhibits in back of the 3 4 cover letter. 4 5 A In back? 5 6 Q Do you have one that has written on it on 6 7 a tab on the exhibit Exhibit P-8? 7 8 A No, I don't think I have that. 8 9 Q 'All right 9 10 A I don't think I have that, what you're 10 11 talking about. 11 12 Q All right Do you have one that looks 12 13 like your tax return, the one we were talking about 13 14 earlier that has federal tax return - 14 15 A No, I don't have anything that looks like 15 16 my tax return. 16 17 Q Do you have the one that looks like the 17 18 pictures of the cemetery stone? 18 19 A Yeah. 19 20 Q Okay. 20 21 A Are you talking about - 21 22 Q The one that has your and Mrs. Shay's 22 23 headstone, the three pictures. 23 24 A Yes, I have those. 24 25 Okay, Do you see on - 25 15 1 A I have all three of them 1 2 Q Do you see on the very first one there's 2 3 a tab that says Exhibit P-2? 3 4 A Oh, yes, yes. 4 5 Q Okay. 5 6 A It says Exhibit P-2, yes. 6 7 Q Now, I want you to go back through the 7 8 other exhibits and see if you can find one that has a 8 9 label like that that says Exhibit P-8. 9 10 A Are you talking about the pictures of the 10 1 I cemetery stone on those? 11 12 Q No, no, further down in the exhibits. 12 13 A Oh, further down. 13 14 Q Yeah- Just keep going until you find one 14 15 that says Exhibit P-8. 15 16 A PA or H? 16 17 Q No. P, as in Paul, and then a dash and 17 18 the number 8 lace 1, 2, 3, 4, 5, 6, 7, 8. 18 19 A And an 8, okay. Let me look here. 19 20 There's p-5. 20 21 Q Keep going. 21 22 A Well, the numbers quit all of a sudden. 22 23 MR. HAAR- There are a couple of pages 23 24 without that sticker on it Keep going and you'll 24 25 find it. 25 16 A There's P-7. MR. HAAR: Keep going. BY MR. BARON: Q After P-7, after the one that looks like a tax rehim. A I'm getting all my papers messed up here now. Q Okay. A There's P-8. Okay, I got it. Q Do you see it now? Do you see it has a stamp on the right-hand side that says Parcel Post? A Yeah. Q In the top left-hand side there's a return address label with the letter S. Do you see that? A On the left-hand side. There's my name - Q Okay. A - and address. Q Right Is that an address label that you used? A Yes, it is. Q Okay. A Yes. O And do you know - 17 A That is the label I used. Q Right. And do you have any memory of sending a parcel post package to Tracy in 2003? This was postmarked August the 18th, 2003. It's evidently from you to Tracy in which you sent her a lot of financial informatiion like copies of your bank statements and things lice that. A You know, I don't remember, no. Q Okay. A But again, if she asked for it, I'm sure I sent it Q Okay. W. Shay, do you remember having a bank account with the New Cumberland Federal Credit Union? A Absolutely, absolutely. Q And do you know about how long you had that bank account? A I had that for lice fifty years. And let me tell you a little story about that Q Okay. MR. HAAR: Charlie, Charlie - Charlie, this is Matt You've answered the question. If he wants to hear the story, he'll ask for it. A Okay. BY MR. BARON: 5 (Pages 14 to 17) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • • SHAY VS April 7, 2008 SHAY 18 1 Q Okay? 1 2 A Okay. 2 3 Q Do you remember when you closed the bank 3 4 ;ant? 4 5 A I remember closing k yes. 5 6 Q Do you remember when? 6 7 A I thought I had that the other day. Not 7 8 exactly, no, I don't 8 9 Q Do you remember whether you closed it 9 10 before or after the lawsuit was filed in Cumberland 10 11 County? 11 12 A It was probably after. I didn't know 12 13 there was any problem with that. 13 14 Q rm just trying to establish when it 14 15 was. Theres no problem with it I just want to 15 16 find out the date. That's a fact that were arguing 16 17 abo uL 17 18 A Well, I - 18 19 MR. HAAR: Charlie, there's no question. 19 20 Hey, Charlie - 20 21 BY MR BARON: 21 22 Q Charlie, your lawyer wants you to be 22 23 careful about answering questions. 23 24 A Okay. 24 25 Q Okay? 25 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 A I don't remember. Q Now, about when did you move to Florida from Pennsylvania? A Oh, golly. I have that for you. Hold on. Did you say when I moved? Q Yes, to Florida from Pennsylvania. A I don't have that date. All I know is I sold my house at 6:00 at night and I had my car loaded and I drove straight through to Florida that night I really cannot tell you the date. Q And after you moved to Florida do you remember whether you came back to Pennsylvania on different occasions after that? A Absolutely I did. Q Okay. A Absolutely. I came back to visit my family and my grandchildren. Q Can you find Exhibit P-l 0 which is some canceled checks? A Ten. Yeah, I have it. Q Okay. You got them? There are three checks made out to the West Fairview School Association. A Yes. 20 Q Do you remember what those were for? A Sure. Q What were they for? A Well, I went to a small school in West Fairview and we only had ten grades and we had - when you got to tenth grade, at the end of the year we had a graduation the same as all other schools, so we had a prom and we had a graduation and everything and you would go to another school for 11th and 12th. Well, they decided that they were going to meet once a year and get together, have a dinner at the firehouse and just kind of get together. So what I did, when they would send me a letter to come to this, I would schedule a week with Tracy to visit Tracy and the grandkids and my son and I would go see an uncle and I would go see my aunt and that's what that was for. Q And do you remember the last one of these that you attended? This is for'99. A Well, I imagine it's the one here with the last check. I think I attended about four. I'm not sure about that. But I haven't been there in the last four years since Tracy's refused to let me see my wife. 21 1 I don't core to Pemrsylvania anymore. 1 2 haven't carne to Pennsylvania since Tracy refused to 3 let me see my wife. There's no reason to come. 1 4 can't visit my grandchildren, so I just don't corm to 5 Pennsylvania no more and I don't go to school 6 functions. I got a letter every year, but I can't 7 go. 8 Q I want to direct your attention now to 9 P-13 which is some insurance cards. 10 A Okay, yes. They're my cards. 11 Q And on the top right-hand side there's a 12 Blue Cross Blue Shield insurance card. 13 A Yes. 14 Q Is that one - 15 A That's through the federal government. 16 Q Right. That's one you got from your work 17 and you still have it as a retiree, correct? 18 A Yes, I do. 19 Q And is that still in force? 20 A Oh, yeah. 21 Q And do you recall whether that policy 22 covered Mrs. Shay's care for a period of time? 23 A Absohdely. It would still cover her, 24 but Tracy told me that I didn't need to cover her 25 anymore because she was taken care of under Medicare, 6 (Pages 18 to 21) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • SHAY VS April 7, 2008 SHAY 22 1 so it cut my insurance in half. 2 Q Okay. 3 A So I only have myself only, but - 4 Q And do you remember when you made that 5 change? 6 A Yeah. Probably eight months ago. 7 Q Okay. 8 A But, you know, if she needs it I can put 9 her back on it in January. 10 Q Okay. 11 A No problem 12 Q Okay. 13 A No problem at all. 14 Q Do you remember the last time you visited 15 your wife in Pennsylvania? 16 A No, I don't. I think it was'02 or 17 '05. 105 maybe. 18 Q Do you remember a visit to your wife in 19 '05? 20 A Well, I went to visit her, but they 21 wouldn't let me in. They would let me in to the 22 reception desk, but they wouldn't let me go any 23 further. I've never got to see my wife. 24 Q And do you recall when that was in '05, 25 whether it was in Julv? 24 1 and ifs dated and it has handwriting on it. And can 2 you tell us - 3 A Looks like the fowth of something. 4 Q Yeah. Can you tell us if that's your 5 handwriting? 6 A Absolutely. Absolutely it is. 7 Q And do you remember writing this letter? 8 A Yes. I was concerned I was getting - 9 what was happening there, when something would happen 10 to Pat, she would have an accident or something they 11 would pay the bill, my insurance would pay the bill. 12 But evidently they didn't send it to Tracy, they sent 13 it to me. And I started getting these bills with her 14 having these accidents and Tracy, wasn't telling me 15 about it, so 1 was concerned about what was going on, 16 so I wrote her that little note. 17 Q Do you remember after you got this note 18 whether you continued to get copies of the bills for 19 services to Mrs. Shay? 20 A Yes. I got them all. I don't think 21 Tracy got them I think they sent them to me because 22 the insurance was in my name. 23 Q I want you to look at P-16 which is a lot 24 of billing invoices. 25 A Okay. I have it. 23 1 A No, I don't. 1 2 Q Okay. 2 3 A I just came up, drove up - I decided to 3 4 come up and see her and I came up to see her and she 4 5 wasn't where she was supposed to have been and I 5 6 found out that Tracy had put her in a home I didn't 6 7 know about. 7 8 Q Okay. 8 9 A And when I went to the home they refused 9 10 to let me in. They said Tracy refuses to let me see 10 11 her. 11 12 Q Okay. Now, there's an exhibit that's 12 13 marked P-14. Do you have that? At the top of the 13 14 page it has Interdisciplinary Notes. 14 15 A Yes. 15 16 Q This is from the nursing home and it has 16 17 a date of approximately - the dates on it are July 17 18 10th and July 11th. 18 19 A Yes. They were both days that I went to 19 20 visit her. 20 21 Q Okay. I want you to look at P-15 which 21 22 is a letter and an envelope. 22 23 A Okay. 23 24 Q And ifs again one page followed by some 24 2-5 other things, but the letter is addressed to Tracy 25 25 Q Are these the kinds of things you got in the mail or did you get things that looked different from these? A No. They looked different. Q Okay. A They looked like regular bills like you get from a regular hospital. Q Okay. I want you to take a look at P-17. A Okay. Q And this is a thick thing, but I want you to try to find the third - well, no. I'm sorry. I'm having problems finding it myself. One of the pages in this is addressed to you and I'm trying to find out which page it is. Do you remember ever getting any mail from the phvmacy benefits program? A I don't think so. Q Its called Merck Medco. A I might have from Medco because I have that - I have that medicine. Q Okay. Is Merck Medco the insurance carrier for your Blue Cross Blue Shield benefit program - A Yes. Yes, it is. 7 (Pages 22 to 25) Geiger & Loria Reporting Service - 800-222-4677 CHARLES SHAY • SHAY VS April 7, 2008 SHAY 26 1 Q - that you got from retirement? 1 2 A It's my mail order. I mail order my 2 3 medicine to Medco. 3 4 Q And do you recall whether you - excuse 4 5 me. It's the second page of that exhibit. It's 5 6 Exhibit 17, the second page. 6 7 A Yes, I have it. 7 8 Q Okay. And for some reason it's addressed 8 9 to you at Columbia Avenue in Camp Hill. 9 10 A Oh, yes, it is. Yes, it is. I just 10 11 noticed that. But I must not have gotten that. 11 12 Tracy must have gotten that. It would have went to 12 13 the address. 13 14 Q Okay. The last few questions I have for 14 15 you, Mr. Shay, are about when Tracy was trying to get 15 16 a guardian for Mrs. Shay. Do you remember when that 16 17 started? 17 18 A When she wanted to become the guardian? 18 19 Q Yes. 19 20 A Yes, absolutely, and I was all for it. 20 21 Q Okay. 21 22 A Because Pat was with her and if she 22 23 needed a fast decision Tracy was there to do it and I 23 24 felt as though - that's why I didn't fight it. I 24 25 felt as though she should be. 25 27 1 Q Okay. One of the exhibits is P-18. Can 1 2 you find that one? It's toward the end of the 2 3 packet. 3 4 A Sure, I have it. 4 5 Q Okay. Its a letter of June 21. It's by 5 6 an attomey who was representing Tracy in that 6 7 proceeding to an attorney named Harold Irwin. 7 8 A Yes, I see that. 8 9 Q Do you recall who Harold Irwin was? 9 10 A No, I don't. I don't know the gentleman. 10 11 Q Did you in the course of Trxy's getting 11 12 a guardian express any views about visitation rights 12 13 that you wanted? 13 14 MR. HAAR: Hold on a second. 14 15 A Yes. 15 16 MR- HAAR: Hold on a second, Charlie. 16 17 I'm going to object to the question to the extent 17 18 that you're asking about concerns or facts he may 18 19 have provided to an attorney for the purpose of 19 20 obtaining legal advice. 20 21 MR. BARON: No, Pm not. 21 22 BY MR. BARON: 22 23 Q The letter to Mr. Irwin talks about 23 24 getting visitation rights for you with respect to 24 25 being able to see Mrs. Shay after she got a 25 28 guardian. A Yes. Yes, I did want - I wanted to visit her. There's no question about it. Q Okay. A I wanted to visit my wife and I didn't want to have to go through anybody. I didn't see any need for that. She's my wife for fifty-six years. Q Okay. A And I didn't nndwAand why I would have to get permission from Tracy or anybody else to see my wife. Q Okay. Can you look at P-19. A Sure. Q Okay. This is a letter from two people at the Dickinson School of Law Elder Law and Consumer Protection Clinic, okay, in which they say, and 171 quote from the letter, my name is Rebecca Fuhnnan and I'm a new law student assigmed to represent Charles E. Shay, Jr. through the Elder Law Clinic Program. Do you recall being represented by people at the Elder Law Clinic Program at the Dickinson School of Law? A Yes, many, many of them. They didn't last very long and I'd get another one, but somehow, somewhere Mr. Haar kind of took over and I really 29 didn't bother with those people anymore. I didn't write to them I didn't do anything. They weren't doing me much good - Q Okay. A - to be honest with you. They're only there a little while and they're gone. Q Do you recall the period of time that they represented you? A It was at the beginning of this whole mess, I know that, and they're still doing it. They're still trying to take care of me I guess. Q Do you know if you were ever sent a copy of either P-18 or P-19 that is the letter to attorney - A Yeah, I think so. I got copies like this. Q Do you recall getting a copy of P-18? That is the - A No, I don't recall of one particular copy, no. Q Okay. Do you recall getting a copy of P-199 A No. But I probably did and I read them and in the trash can they go. Q Do you know whether there's also a P-20? 8 (Pages 26 to 29) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • SHAY VS April 7, 2008 SHAY t 30 1 A I have 20. 1 2 Q Okay. 2 3 A What was your question now? 3 4 Q I didn't ask a question yet. First I 4 5 wanted to find out whether you had the exhibit. 5 6 A I do have the exhibit, yes. 6 7 Q You have it in front of you, okay. 7 8 This is a letter from the attorney who's 8 9 representing Tracy in the guardianship proceeding to 9 10 the Dickinson School of Law people. It's a fax copy 10 11 of the letter. Do you recall receiving a copy of 11 12 this? 12 13 A No, I can't say that I do. I could have. 13 14 Q One of the things in this letter that is 14 15 proposed is that Tracy is agreeing that you'll advise 15 16 her at least forty hours in advance of any visitation 16 17 plans to see Mrs. Shay. 17 18 A I remember reading that very well. 1 18 19 must have got a letter because I remember reading 19 20 that and of course that didn't make me happy. Tracy 20 21 doesn't talk to me. In the first place, if I call 21 22 Tracy, she hangs up. 22 23 Q Do you also have a copy of P-21? P-21's 23 24 the last exhibit. 24 25 A Yes, I do. I do have it. 25 31 1 Q It's an order from the court. Do you 1 2 recall receiving a copy of that? 2 3 A No, I don't. 3 4 Q Okay. 4 5 A But like I say, I probably did. 5 6 Q Okay. 6 7 A I don't remember too much. I read these 7 8 things and I don't keep records. I just throw them 8 9 away. If they don't look like they're doing me any 9 10 good, I figure there's no sense in keeping it. And 10 11 if it didn't change - if Pm asking to see my wife 11 12 without calling Tracy and it didn't change, then this 12 13 is no good to me. I throw it away. 13 14 Q Okay. Can you go to the paragraph that's 14 15 number five that begins Charles I- Shay, Jr. shall 15 16 have the right to visit Patricia J. Shay? 16 17 A I'm looking for it. Yes, I have that. 17 18 Q It's on the second page. Do you have 18 19 that one? 19 20 A Yes. 20 21 Q And it's upon 48 hours' notice to the 21 22 guardian. 22 23 A Yeah, yes, absolutely. 23 24 Q And that's what the court finally decided 24 25 in this action. 25 32 A Yes, I understand that. And it didn't suit me, so I didn't come to visit. Q Okay. Mr. Shay, can you tell us - you mentioned earlier that you had been coming to Pennsylvania to visit an aunt, an uncle and relatives and grandchildren. Can you tell us, who is the aunt and uncle that you came to visit? A The aunt and uncle is Richard Shay who lives in Paxtang, and I would visit - normally I would get out to visit Cory and his family and of course I would stay with Tracy, so I would visit with her family, and I would also make it a point to go see my sister (inaudible) who lives in Camp Hill. That's about the extent of it. Now, I would go out and eat dinners and I would meet some people in the restaurant where I eat. The restaurant where I eat is pretty famous for the people in the town that went to school with me and they come there to eat pretty regular, so I would meet people there and I would talk to them. Q Is that the Peppermill Restaurant in Mechanicsburg? A Well, that's one of them, yes. The other one is in Summerdale. (Discussion held off the record.) 33 BY MR. BARON: Q Mr. Shay, can you repeat your sister's name because the phone broke up when you said it. A Anna Mary Bowers, B-0-w-e-r-s. TRACY SHAY: There's no S. A She and I are very, very close. MR. BARON: That's all the questions I have, Mr. Shay. Thank you. A Okay. MR. HAAR: Charlie? A I hope I was helpful. MR. BARON: Your lawyer may have some questions. Hold on. CROSS-EXAMINATION BY MR HAAR: Q Charlie, I just have a few questions for you so were on the record. Can you hear me? A Yes, I can. Q When is the last time that you were physically in the Commonwealth of Pennsylvania? A The day that Tracy refused me. I was really on my way home the last day I tried to visit Pat and I had my girlfriend with me, Alma, and I had 9 (Pages 30 to 33) Geiger & Loria Reporting Service - 800-222-4577 CHARLES SHAY • • SHAY VS April 7, 2008 SHAY 34 1 her in the car. She never got out of the car. She 1 2 never got into the building. 2 3 I got into the building and asked to 3 4 visit Pat and they refused me, so I went right back 4 5 to Florida. I left there. I wasn't going to drive 5 6 back to Harrisburg thirty miles, so I left from there 6 7 and went back to Florida. 7 8 Q After that - 8 9 A And that's the reason my girlfriend was 9 10 with me. 10 11 Q Charlie, after you were not allowed to 11 12 see your wife at the nursing home, is that the last 12 13 time you were in the Commonwealth of Pennsylvania? 13 14 A Yes. 14 15 Q When is the last time you spoke with your 15 16 daughter Tracy on the telephone? 16 17 A The second day that I tried to visit my 17 18 wife and she hung up on me. Of course I wasn't very 18 19 nice. I was hollering at her. 19 20 Q Charlie - 20 21 A I was mad. I wanted to see my wife. 21 22 Q Charlie, when is the last time that you 22 23 actually saw your daughter in person? 23 24 A Mercy. I can't answer that. 24 25 Q Was it before or after you tried to see 25 35 1 your wife in the nursing home? 1 2 A Before. 3 Q Do you know approximately how long 2 4 before; a month, a year, several years? 3 5 A Might have been six months. 4 6 Q When is the last time you spoke with your 5 7 grandchildren by phone? 6 7 8 A About the same time. 8 9 Q And that's about six - 9 10 A I wrote my grandsons a letter and I told 10 11 them that me and mommy, your mother, isn't getting 11 12 along, but there's no reason why you can't call me on 12 13 your cell phone and talk to me or write me a letter 13 14 once in a while and see how rm doing, but they 14 15 never - they never did. 15 16 Q I'm not sure you answered my question. 16 17 When is the last time that you actually spoke with 17 18 those gmAdds by phone? 18 19 A Golly. I imagine about the same time I 19 20 haven't talked to Tracy. 20 21 Q And when is the last time that you saw 21 22 your grandchildren in person? 22 23 A Oh, golly. Couple years. 23 24 Q And Charlie, are you currently seeing any 24 25 doctors down in Florida? 25 36 A Yes, I am. Q Approximately how many? A Well, as you know, Matt, I have a lot of cancer and I see all kinds of doctors. I see my medical doctor - there's about five of them that I see. I see my medical doctor, I see my cancer doctor, I see my radiation doctor. Just the other day I was over to see an ear, nose and throat doctor. Pm seeing doctors all the time. Q In the course of a month approximately how many doctors' appointments do you have? A Some months I might have eight, some months I might only have five. Some doctors I don't see often like my medical doctor. He only sees me - every three months I think he sees me. My cancer doctor sees me once a month. MR HAAR. I have no further questions, but Tracy's lawyer may have some follow-up for you based on what I just asked you. A Okay. MR BARON: I have nothing. MR. HAAR- We're done. (The deposition was concluded at 3:38 P.M.) 37 STATE OF PENNSYLVANIA : ss COUNTY OF DAUPHIN 1, Dawn Young Dietrich, a Reporter Notary-Public, authorized to administer oaths within and for the Commonwealth of Pennsylvania and take depositions in the trial of causes, do hereby certify that the foregoing is the testimony of CHARLES E. SHAY, JR. I further certify that before the taking of said deposition, the witness was duly sworn; that the questions and answers were taken down stenographically by the said reporter, Dawn Young Dietrich, a Reporter Notary-Public, approved and agreed to, and afterwards reduced to typewriting under the direction of the said Reporter. I further certify that the proceedings and evidence are contained fully and accurately in the notes taken by me on the within deposition, and that this copy is a correct transcript of the same. In testimony whereof, I have hereunto subscribed my hand this 21 st day of April, 2008. Dawn Young Dietrich My commission expires: 10 (Pages 34 to 37) Geiger & Loria Reporting Service - 800-222-4577 0 0 CERTIFICATE OF SERVICE I hereby certify that on May 9, 2008, I served a true and correct copy of the foregoing Praecipe to File Deposition Transcripts by first class mail, postage paid, upon the following counsel of record: Bruce G. Baron, Esquire Douglas A. Snyder, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Attorneys for Plaintiffs 41JIW4 Dated: May 9, 2008 2 o c. CIO fy. r .7 ::. 1 Ck Mz .. m ' 1 _. j Bruce G. Baron, Esquire Attorney I.D. #28090 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 Tel: (717) 233-4101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY-SNYDER CIVIL ACTION - LAW As Plenary Guardian of the Person and Estate of Patricia J. Shay, Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant NOTICE OF DEATH The death of Patricia J. Shay, a party to the above action, during the pendency of this action is noted upon the record. By: Date: May 9, 2008 Bruce G. Baron, Esquire Attorney I.D. No. 28090 CAPOZZI & ASSOCIATES, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) Attorneys for the Deceased Party 1 CERTIFICATE OF SERVICE I, Bruce G. Baron do hereby certify that on this 9th day of May 2008, 1 served a true and correct copy of the foregoing NOTICE OF DEATH upon the following individuals in the manner indicated: BY FIRST CLASS MAIL AS INDICATED BELOW: Matthew M. Haar, Esquire Tracy Shay-Snyder CIO Saul Ewing, LLP 2713 Columbia Avenue Penn National Insurance Plaza Camp Hill, PA 17011 2 North 2nd Street, 71h Floor Harrisburg, PA 17101 (Attorney for Defendant) (Guardian for the Deceased Person) Rebecca M. Fuhrman Certified Legal Intern Nicole M. Walters, Esquire The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Respectfully submitted, CAPOZZI & ASSOCIATES, P.C. B ;:PAP Y'-?/ gy_tee? • Bruce G. Baron, Esquire Attorney I.D. No. 28090 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) (Attorneys for the Deceased Party) 2 -n -mac rr Bruce G. Baron, Esquire Attorney I.D. #28090 Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 Tel: (717) 233-4101 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated . Person, by TRACY D. SHAY-SNYDER : As Plenary Guardian of the Person and . Estate of Patricia J. Shay, CIVIL ACTION - LAW Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant PETITION FOR SETTLEMENT OF SMALL ESTATE ON PETITION AND FOR SUBSTITUTION OF TRACY D. SHAY-SNYDER AS PLAINTIFF IN THIS MATTER AND NOW COMES, Petitioner Tracy D. Shay-Snyder, by her attorneys, pursuant to 20 Pa. C.S.A. § 3102, relating to settlement of small estates on petition, and Pa. R.Civ.P. Rules 2352 and 2355, to seek an award of distribution of the personal property, including all chose in action, belonging to Patricia J. Shay, deceased; to deem Tracy D. Shay-Snyder, individually and on behalf of the creditors of Patricia J. Shay, as the successor in interest to Patricia J. Shay, deceased, with respect to the claims in this matter; and, to substitute Tracy D. Shay-Snyder, individually and on behalf of the creditors of Patricia J. Shay, as Plaintiff in this matter; and, in support of such relief states: 4 Patricia J. Shay died on April 9, 2008 and a Notice of Death has been filed of record in this matter. 2. Patricia J. Shay died domiciled in the Commonwealth of Pennsylvania while living at the Cumberland County Home and subject to the a guardianship established by Order of this Court, a copy of which Order is attached hereto as Exhibit A. 3. Charles E. Shay, Jr., Defendant in this matter is the husband of Patricia J. Shay. 4. Patricia J. Shay had two children: Tracy D. Shay-Snyder, her daughter and Plaintiff in this matter, and Cory L. Shay, who resides at 328 Ridge Road, Grantville, PA 17028. 5. When Patricia J. Shay died, she through her guardian Tracy D. Shay-Snyder, who is also her daughter, was a party to the causes of action in this matter, which seek payment of an amount not exceeding $25,000.00. 6. When Patricia J. Shay died she was a Medical Assistance recipient with no other personal property of value. 7. The amounts at issue in this matter all relate to payment of debts of Patricia J. Shay incurred prior to her death that are alleged to be the obligation of her husband, Charles E. Shay, Jr., the defendant in this matter, which debts are owed to the Cumberland County Home and to the attorneys hired on behalf of Patricia J. Shay by Tracy D. Shay-Snyder in order to qualify Patricia J. Shay for Medical Assistance benefits in Pennsylvania, to obtain a guardianship to protect the interests of Patricia J. Shay, and to seek contribution for the support of Patricia J. Shay in this matter. 8. At the time of her death, the only obligations of Patricia J. Shay that remain unpaid are those due to: (a) Claremont Nursing and Rehabilitation Center, the Cumberland County Home located at 1000 Claremont Road, Carlisle, PA 17013; and (b) to Tracy D. Shay- Snyder, individually, for legal services and other expenses incurred as Guardian for Patricia J. Shay and, as alleged in the Complaint in this matter, otherwise incurred on behalf of Patricia J. Shay, which debts in the aggregate do not exceed $25,000.00. 9. When Patricia J. Shay died, Tracy D. Shay-Snyder had in her possession a Will executed by Patricia J. Shay, a copy of which is attached as Exhibit B, which, on information and belief, was executed by Patricia J. Shay when she was not competent to do so. 10. This matter is a chose in action which is personal property of the Estate of Patricia J. Shay. See: 73 C.J.S. 175, § 9; Rodriguez Estate, 6 Pa. D.&C.2d 521 (Philadelphia O.C. 1956); Hack v. Hack, 495 Pa. 300, 307, 433 A.2d 859, 862 (1981) ("Clearly a claim for unliquidated tort damages falls within the language, "property of any kind...."), citing O'Grady v. Potts, 193 Kan 644, 396 P.2 285, 289 (1964)("chose in action is personal property"). 11. As the guardian appointed by this Court for the person and estate of Patricia J. Shay and the child of Patricia J. Shay, Tracy D. Shay-Snyder is entitled to distribution of this cause of action as both a creditor of the Estate of Patricia J. Shay and as an agent of Patricia J. Shay liable to reimburse the other creditors that on behalf of Patricia J. Shay provided services to Patricia J. Shay upon the authorization of Tracy D. Shay-Snyder of behalf of her mother. 12. While Charles E. Shay, Jr. is named as executor in the attached will of Patricia J. Shay, he cannot serve as her executor because of his clear conflict of interest with those of her creditors as demonstrated by this matter and because the will so naming him is invalid. See: Estate of Westin, 874 A.2d 139 (Pa. Super. 2005) (Clear conflict of interest warrants removal of executor); Estate of Fritz v. Fritz, 798 A.2d 243, 245 (Pa. Super. 2002) (Court may disqualify executor for an interest antagonistic to Estate). 13. If the Court directs distribution of this chose in action to Tracy D. Shay-Snyder for distribution to the creditors of Patricia J. Shay, then Tracy D. Shay-Snyder, for herself 6 individually and on behalf of the creditors of Patricia J. Shay, may be substituted as Plaintiff in this matter. WHEREFORE, Petitioner Tracy D. Shay-Snyder requests the Court to issue a Citation on Charles E. Shay, Jr., Cory L. Shay, and the County of Cumberland on behalf of Claremont Nursing and Rehabilitation Center, as interested parties, to Show Cause why this cause of action should not be distributed to Tracy D. Shay-Snyder, for herself individually and on behalf of the creditors of Patricia J. Shay and why Tracy D. Shay-Snyder, for herself individually and on behalf of the creditors of Patricia J. Shay, should not be substituted as Plaintiff in this matter as the successor to Patricia J. Shay, deceased, and that the Plaintiff in the Caption of this matter be amended to be: "Estate of Patricia J. Shay, deceased, by Tracy D. Shay- Snyder, individually and on behalf of the creditors of Patricia J. Shay." A proposed form of Citation and proposed form of Order are attached hereto. Date: May 14, 2008 By: Bruce G. Baron, Esquire Attorney I.D. No. 28090 CAPOZZI & ASSOCIATES, P.C. 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) Attorneys for Tracy Shay-Snyder 7 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY-SNYDER As Plenary Guardian of the Person and Estate of Patricia J. Shay, CIVIL ACTION - LAW Plaintiff, V. NO. 06-3229 CHARLES E. SHAY, JR., Defendant ORDER OF SETTLEMENT, DISTRIBUTION AND AMENDING CAPITION AND NOW, this day of 2008, having received Record Notice of the Death of Patricia J. Shay and upon the Petition of Tracy D. Shay-Snyder pursuant to 20 Pa. C.S.A. 3102, relating to settlement of small estates upon petition, after notice to all interested parties and review of any answers and arguments thereof, finding that: (1) the Estate of Patricia J. Shay, deceased, who was domiciled at the time of her death at Claremont Nursing and Rehabilitation Center, the Cumberland County Home, pursuant to a prior Order of this Court in guardianship proceedings with respect to her incapacity, contains personal property with a gross value not exceeding $25,000; (2) that such property includes the causes of action in this matter; (3) that such causes of action were brought on behalf of Patricia J. Shay by her guardian and daughter, Tracy D. Shay-Snyder, the Petitioner, in order to obtain payment from Defendant, the husband of Patricia J. Shay, deceased, for necessary expenses incurred on behalf of Patricia J. Shay, including expenses for her care at the Cumberland County Home; (4) that such expenses remain unpaid debts of the Estate of Patricia J. Shay; (5) that the causes of action in this matter are the only asset of the Estate of Patricia J. Shay available to pay the debts of the Estate of 8 Patricia J. Shay; and, (6) that the causes of action in this matter are chose in action that are personal property subject to distribution under 20 Pa. C.S.A. § 3102, it is hereby ORDERED and DECREED that the Petition is GRANTED and that: (1) All personal property in the Estate of Patricia J. Shay, deceased, is hereby directed to be distributed to Petitioner, Tracy D. Shay-Snyder without administration of the Estate, including the causes of action in this matter; (2) This decree of distribution shall constitute sufficient authority to all transfer agents, registrars, and others dealing with the property of the Estate of Patricia J. Shay, deceased, to recognize Tracy D. Shay-Snyder as entitled to receive the property without administration and shall in all respects have the same effect as a decree of distribution after an accounting by a personal representative; (3) Within one year after this decree of distribution has been entered, any party of interest may file a petition to revoke it because an improper distribution has been ordered; and, if the Court shall find that an improper distribution has been ordered, it shall revoke the decree and shall direct restitution as equity and justice shall require; (4) Petitioner is hereby recognized as the successor to Plaintiff in this matter pursuant to Pa. R.Civ.P. Rules 2352(a) and 2354. (5) The name of the Plaintiff in the Caption in this matter shall be amended by the Clerk to read, effective as of the date of this Order, as follows: "Estate of Patricia J. Shay, deceased, by Tracy D. Shay-Snyder, individually, and on behalf of the creditors of Patricia J. Shay." (5) Petitioner is directed to file and serve an Amended Complaint in this matter, using the new Caption and specifying the amounts claimed by Petitioner individually and those on 9 behalf of the County of Cumberland on behalf of Claremont Nursing and Rehabilitation Center, within twenty (20) days of the date of this Order. Jurisdiction retained. BY THE COURT: J. 10 A 5 f= P 2000 IN RE: IN THE COURT OF COMMON PLEAS OF PATRICIA J. SHAY CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION An Incapacitated Person NO. 21-06--492 FINAL ORDER OF COURT APPOINTING PLENARY GUARDIAN AND NOW, this 8th day of September, 2006, following hearings held in this case on July 16, 2006, and September 8, 2006, the Court now enters findings as follows, based upon the exhibits and testimony presented: 1. That PATRICIA J. SHAY is an individual, married to Charles E. Shay, Jr., on October 25, 1952, and she has two children, Tracy Shay-Snyder and Cory Shay. 2. That PATRICIA J. SHAY suffers from, among other things, Senile Alzheimer's Dementia, a condition which has now advanced to the point where the condition impairs her capacity to receive and evaluate information effectively, and now prevents her from making and communicating decisions concerning the management of financial affairs or to meet essential requirements for her physical health and safety. 3. That PATRICIA J. SHAY is now a resident of Claremont Nursing and Rehabilitation Center located at 1000 Claremont Road, Carlisle, Pennsylvania 17013. 4. That Daughter Tracy Shay-Snyder and Husband Charles E. Shay, Jr., acknowledge that from this day forward, said nursing facility (or a similar facility) is the most appropriate setting for the care and physical residence of PATRICIA J. SHAY. NOW, THEREFORE, based on the clear and convincing evidence supporting the foregoing findings, it is ORDERED, ADJUDGED, AND DECREED: A. That PATRICIA J. SHAY be and is hereby adjudged a Exhibit A totally incapacitated person. B. That Tracy Shay-Snyder is appointed Plenary Guardian of the Person of PATRICIA J. SHAY and shall have the authority to act on behalf of PATRICIA J. SHAY, to provide for the general care, maintenance and custody of PATRICIA J. SHAY. Further: 1. The Plenary Guardian shall arrange for medical, psychological and psychiatric services and social and vocational opportunities, as appropriate; 2. The Plenary Guardian shall assist PATRICIA J. SHAY in the development of maximum self-reliance and independence; 3. The Plenary Guardian shall have the authority to give consent for and to withhold surgical or medical treatment so long as Mr. Shay is notified as soon as practical, but in no event more than 24 hours after a decision is made in regards to providing or withholding such treatment. 4. The Plenary Guardian shall do nothing to interfere with the relationship between Charles Shay, Jr., and PATRICIA J. SHAY. Provided, however, that this provision shall not be construed as preventing the Guardian from pursuing any legal action to enforce or protect the rights of the incapacitated person vis-a-vis her husband or any other person. 5. Charles E. Shay, Jr., shall have the right to visit PATRICIA J. SHAY upon 48 hours notice to the Guardian, and he shall have the unrestricted right to receive full information about her status, care and treatment from all care-givers; and b. The Plenary Guardian shall file with the Clerk of the Court a report on the social, medical and other relevant conditions, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this Order and annually Exhibit A thereafter. C. Tracy Shay-Snyder is hereby appointed Plenary Guardian of the Estate of PATRICIA J. SHAY and shall have the authority and responsibility to manage and use PATRICIA J. SHAY'S property for her benefit in accordance with 20 Pa. C.S.A. 5536(a). The Plenary Guardian for the estate shall file a report with the Clerk of the Court about assets, investments, receipts and disbursements, as required by 20 Pa. C.S.A. Section 5521(c), within twelve months of this order and annually thereafter. The Plenary Guardian shall file an inventory with the Court in accordance with 20 Pa. C.S.A. Sections 5521 and 5142 within three months of this Order. The Plenary Guardian of the estate shall not be required to post a bond. D. Any existing general power of attorney, limited power of attorney and/or health care power of attorney executed by PATRICIA J. SHAY is hereby specifically revoked-and rendered null and void. E. PATRICIA J. SHAY has the right to appeal this Order by filing exceptions within ten (10) day to petition this Court for a review of hearing terminate the guardianship herein established. Petitioner is directed to have served upon and J. SHAY a copy of this Order and the Statement of which is attached hereto, and to file proof with this Court wit1jjp ten (10) days. . . -.1110 i ? .11 F J' By the Court, .4 1`/i ICJ Edward E. Guido, J. s of this date or to modify or Counsel for read to PATRICIA of Rights, a copy of such service Pt! IF (;O?" )iVl FtiGGUi1D nEj!';itiito N; Li i.19 V"Exhi?i A Rebecca M. Fuhrman, Certified Legal Intern Nichole M. Walters, Esquire THE ELDER LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 Doreena Craig Sloan, Esquire CAPOZZI & ASSOCIATES 2933 North Front Street Harrisburg, PA 17110 srs Exhibit A Last Will and Testament of Patricia J. Sham I, Patricia J. Shay, a resident of Polk County, Florida, being of sound and disposing mind and memory, now revoke any and all wills and codicils previously made by me, and 1 make, publish and declare this to be my Last Will and Testament. 1. Debts and Expenses. I direct that any debts for which my estate becomes legally obligated to pay, including funeral expenses and costs of administration, be paid as soon as practicable after my death. 2. Confirmation of Joint Ownership with Spouse, I confirm that my spouse, Charles E. Shay, Jr. and I own certain real and personal property as tenants by the entirety. I also confirm that, if my spouse survives me, he shall, by operation of law, become the sole owner of all property owned as tenants by the entirety on my death. If any passbook, certificate or other document evidencing that property is found among my effects, I direct my personal representative to deliver the same to my spouse. If we die under circumstances that there is not sufficient evidence to determine the order of our deaths, then one-half of that property shall pass under this will and one-half shall pass under my spouse's will. 3. Memorandum of Tangible Personal Property. I give, devise and bequeath: a. All my guns and pistols to my son, Cory Lynn Shay. b. All my jewelry to my daughter, Tracy Shay Snyder. If any person named predeceases one, then the gift to that person shall lapse and pass as part of the tangible personal property residue below. 4. Tangible Personal Property Residue. I give, devise and bequeath all of the rest of my tangible personal property, which is not disposed of under the Memorandum of Tangible Personal Property, which tangible personal property may include automobiles, jewelry, clothing, household goods and personal effects, and insurance policies on the tangible personal property, and insurance proceeds of them, to my spouse Charles E. Shay, Jr., if my spouse survives me; but if my spouse predeceases me, then to my daughter Tracy Shay Snyder, if she survives me; but if she predeceases me, then to her lineal descendants who survive me; but if none of her lineal descendants survive me, then this gift shall lapse and pass as part of the residue in Paragraph 5 below. The cost of delivery of each item shall be paid by my estate. 5. Residue. I give, devise and bequeath all of the rest, residue and remainder of my estate, real, personal or mixed, as follows: A. Spouse, If my spouse Charles E. Shay, Jr. survives me, my personal representative shall distribute all of my residuary estate to my spouse. If my spouse does not survive me, then this gift shall lapse. If my spouse and I die under such circumstances that there is not sufficient evidence to determine the order of our deaths, then it shall be presumed that my spouse did not survive me. B. Children. But if the above residue provision fails, my personal representative shall distribute all of my residuary estate to my daughter, Tracy Shay Snyder, if she survives me. If she predeceases me, then her share shall pass, per stirpes, to her lineal descendants, natural or adopted, if any, who survive me; but if there are none, her share shall lapse. C. Intestate Heirs. But if the above residue provisions fail, my personal representative shall distribute all of the residuary estate, according to the order of intestate succession in the State of Florida, one-half to those persons who would have been my heirs if I had died intestate and distributed in the same shares those persons would have received in that case, and one-half to those persons who would have been heirs of my spouse if my spouse had died intestate immediately after my death and distributed in the same shares those persons would have received in that case, 6. Powers of Appointment Not Exercised. If, at the time of my death, I have the right to exercise any power of appointment by will or otherwise, I declare that nothing in this will shall be deemed to be an exercise of that power. 7. Estate Tax Apportionment. I direct that estate taxes shall be apportioned in accordance with Florida law. 8. Personal Representative. I appoint my husband, Charles E. Shay, Jr., as my personal representative, my daughter, Tracy Shay Snyder, as my first alternate personal representative, my son, Cory Lynn Shay, as my second alternate personal representative, each to serve in the order indicated on the death, resignation, incapacity of, or failure to qualify and serve as to, the prior personal representative or alternate. I direct that my personal representative or named alternate shall serve without bond and shall have general power of sale of all property at both public and private sale in any jurisdiction. copy hibit B In witness, I have here set my hand and seal to this, my Last Will and Testament, on August 29, 2001, at 225 North Florida Avenue, Lakeland, Polk County, Florida. [ tgnature o tator We, the undersigned, certify that Patricia J. Shay signed and sealed the above instrument in our presence and at the time published and declared the same to be his or her Last Will and Testament, and that we, in Patricia J. Shay's presence and at Patricia J. Shay's request, and in the presence of each other, have here subscribed our names as attesting witnesses to the testator's execution of this instrument, at 225 North Florida Avenue, Lakeland, Polk County, Florida, on August 29, 2001. [Names, addresses, and sip-natures of two witnesses] . -FIB // RI &hj 'te %4y a ??? (Witness] [Printed Nam [Witness] [Printed Name]' 1100 p-Af•SreaG44 ODRkwH. *(3 S3 ! LAKEcoKD ?>=•C 33Bc3 ??? l.Ph.1? ?L 33 ?? State of Florida Polk County We, Patricia J. Shay, ?A mes B. &W M MY and Q Q I AM i5V6RH A KT the testator and the witnesses, respectively, whose names are signed to the attached or above instrument, having been sworn, declared to the undersigned officer that the testator, in the presence of witnesses, signed the instrument as his or her last will, that he or she signed, and that each of the witnesses, in the presence of the testator and in the presence of each other, signed the will as a witness. Subscribed and sworn to before me by Patricia J. Shay, the testator who is personally known to me or who has produced a Florida driver's license as identification, and by -34M65 14au-oway , a witness who is personally known to me or who has produced a Florida driver's license as identification, and &tAU 15?SRNART , a witness who is personally known to me or who has produced a Florida driver's license as identification, on August 29, 2001. Not4Pb jSO o a : SignPrinC, My commission No.: My commission expires: MkMel n)ohnson Y: j PA I CplvltMli8Si01V tCB!!00 t 4 EXPIRES November 14 2003 BONDED TW TROY FAIN INWRAMM {NC .. 2 Exhibit B 44. VERIFICATION I, Tracy D. Shay-Snyder, the Petitioner, do hereby depose and state that the facts contained in the foregoing Petition are true and correct to the best of my knowledge, information and belief I understand that false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4094, relating to unworn falsification to authorities. Date: May 12, 2008 v ' T cy D. Shay-Sny r 12 CERTIFICATE OF SERVICE I, Bruce G. Baron do hereby certify that on this 14th day of May 2008, I served a true and correct copy of the foregoing PETITION FOR SETTLEMENT OF SMALL ESTATE ON PETITION AND FOR SUBSTITUTION OF TRACY D. SHAY-SNYDER AS PLAINTIFF IN THIS MATTER upon the following individuals in the manner indicated: BY FIRST CLASS MAIL AS INDICATED BELOW: Matthew M. Haar, Esquire C/O Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street, 7th Floor Harrisburg, PA 17101 (Attorney for Defendant) COUNTY OF CUMBERLAND for CLAREMONT NURSING AND REHABILITATION CENTER c/o Edward L. Schorpp, Esquire COUNTY SOLICITOR c/o Commissioners' Office - Suite 200 1 Courthouse Sq. (New Courthouse) Carlisle, PA 17013 Rebecca M. Fuhrman COREY L. SHAY Certified Legal Intern 328 Ridge Road Nicole M. Walters, Esquire Grantville, PA 17028 The Elder and Consumer Protection Clinic The Pennsylvania State University The Dickinson School of Law 45 North Pitt Street Carlisle, PA 17013 Respectfully submitted, CAPOZZI & ASSOCIATES, P.C. By: Bruce G. Baron, Esquire Attorney I.D. No. 28090 2933 North Front Street Harrisburg, PA 17110-1250 (717)233-4101 (717) 233- 4103 (fax) (Attorneys for Tracy D. Shay-Snyder) 12 P C Cxa n PATRICIA J. SHAY, an Incapacitated Person, by TRACY D. SHAY-SNYDER as Plenary Guardian of the: Person and Estate of Patricia J. Shay, Plaintiff v CHARLES E. SHAY, JR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW No. 06-3229 CIVIL TERM IN RE: PRELIMINARY OBJECTIONS ORDER OF COURT AND NOW, this 14th day of May, 2008, upon consideration of Defendant's Preliminary objections to Plaintiff's Second Amended Complaint, and it appearing that a "Notice of Death" with respect to Plaintiff Patricia J. Shay has been filed, and it appearing that no personal representative can presently be substituted for the Plaintiff in this case, and pursuant to an agreement of counsel for the Plaintiff in the person of Bruce G. Baron, Esquire, and counsel for the Defendant in the person of Matthew M. Haar, Esquire, the argument scheduled for today's date on the said preliminary objections is continued generally, and counsel are requested to notify the Court at such time as they deem the case in a proper posture to continue with the argument. By the Court, Bruce G. Baron, Esquire 2933 North Front Street Harrisburg, PA 17110-1250 For Plaintiff (2O is enaltrz , : mae P f J. re'sl-ey Ol r, Jr., J. Matthew M. Haar, Esquire C/O Saul Ewing, LLP Penn National Insurance Plaza 2 North 2nd Street 7th Floor Harrisburg, PA 17101 For Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA PATRICIA J. SHAY, An Incapacitated . Person, by TRACY D. SHAY-SNYDER : CIVIL ACTION - LAW As Plenary Guardian of the Person and . Estate of Patricia J. Shay, Plaintiff, V. CHARLES E. SHAY, JR., Defendant NO. 06-3229 IMPORTANT NOTICE / CITATION WITH NOTICE TO: CHARLES E. SHAY, JR. (Defendant and husband of Patricia J. Shay), c/o Matthew M. Haar, Esquire, Saul Ewing, LLP, Penn National Insurance Plaza, 2 North 2°d Street (7th Floor), Harrisburg, PA 17101 (Attorney for Defendant) CORY L. SHAY, 328 Ridge Road, Grantville, PA 17028 (son of Patricia J. Shay) COUNTY OF CUMBERLAND on behalf of Claremont Nursing and Rehabilitation Center, c/o Edward L. Schorpp, Esquire, County Solicitor, 1 Courthouse Square (2d floor), New Courthouse (Suite 200), Carlisle, PA 17013 (a creditor of Patricia J. Shay, deceased). A PETITION HAS BEEN FILED WITH THIS COURT TO DISTRIBUTE THE ASSETS OF PATRICIA J. SHAY, deceased, THROUGH SETTLEMENT AS A SMALL ESTATE WITHOUT FURTHER ADMINISTRATION OR ACCOUNTING AND TO DISTRIBUTE HER ASSETS TO TRACY D. SHAY-SNYDER, the daughter of and, prior to the death of Patricia J. Shay, the Court- appointed guardian of the estate and person of Patricia J. Shay, ON BEHALF OF HERSELF INDIVIDUALLY AND ON BEHALF OF THE CREDITORS OF PATRICIA J. SHAY, INCLUDING THE CAUSES OF ACTION IN THIS MATTER. A COPY OF THE PETITION, WHICH HAS BEEN FILED BY ATTORNEY BRUCE G. BARON, ESQUIRE, IS ATTACHED. AND NOW, this i? PA' day of , 2008, upon consideration of the aforementioned Petition, it is hereby ordered that: (1) (2) (3) (4) (5) Charles E. Shay, Jr.; Cory L. Shay, and the County of Cumberland Respondents, shall Show Cause why the Petitioner, Tracy D. Shay-Snyder, is not entitled to the relief requested; the Respondents, Charles E. Shay, Jr.; Cory L. Shay; and the County of Cumberland, -?? shall file an answer to the Petition within , AQ days of this date; d ate; 1 a , ' room 7 ...p + IATT-MI nrovi P ev for pefiTtmMr- ?a eol? BY E COUR 2 40 4va W ?t1'd d??• ? ire W? 10 .Zl IId ZZ ? vw SQOZ PATRICIA J. SHAY, an incapacitated person by TRACY D. SHAY-SNYDER as plenary guardian of the person and estate of Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR., Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA No. 06-3229 Civil Action - Law DEFENDANT'S ANSWER IN OPPOSITION TO PETITION FOR SETTLEMENT OF SMALL ESTATE AND FOR SUBSTITUTION OF TRACY D. SHAY-SNYDER AS PLAINTIFF IN THIS MATTER Defendant, Charles E. Shay, Jr. ("Mr. Shay"), by and through his undersigned counsel, without prejudice to his pending Preliminary Objections to Plaintiff's Second Amended Complaint filed December 11, 2006, responds to the Petition for Settlement of Small Estate on Petition and for Substitution of Tracy D. Shay-Snyder as Plaintiff in this matter filed by Tracy Shay-Snyder on or about May 14, 2008 and the Court's Order dated May 21, 2008: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted to the best of Defendant's knowledge and belief. 7. Admitted in part and denied in part. Mr. Shay admits that Plaintiff seeks sums allegedly owed to Claremont Nursing Home and an attorney who allegedly helped obtain medical assistance benefits for Patricia J. Shay ("Mrs. Shay"). Mr. Shay denies that Plaintiff is entitled to any such recovery. To the contrary Mr. Shay owes nothing. By way of further response, the averments set forth in Paragraph 7 represent the ultimate issue in the above- captioned action; that is, whether Mr. Shay owes any additional money for the support of Mrs. Shay. 8. Denied. Mr. Shay is without knowledge or information sufficient to form a belief as to the truth of the averments set forth in Paragraph 8 and, therefore, they are denied. By way of further response, Tracy Shay-Snyder ("Daughter"), who acted as the Court appointed guardian of Mrs. Shay, should be required to provide an accounting for all income received and expenses paid on behalf of Mrs. Shay. 9. Admitted in part and denied in part. Mr. Shay admits that to the best of his knowledge and belief, the document attached to the Petition as Exhibit "B" is a true and correct copy of Mrs. Shay's Last Will and Testament. Mr. Shay specifically denies that Mrs. Shay was not competent to execute the Will when she did so. By way of further response, Mr. Shay believes and therefore avers that the Will was executed on the same date (August 29, 2001) as a Power of Attorney executed by Mrs. Shay in favor of Daughter. Mr. Shay does not have a copy of the Power of Attorney in favor of Daughter, but Daughter testified under oath in this matter that she provided a copy of the Power of Attorney to Claremont. Mr. Shay therefore believes and avers that Daughter and Claremont have a copy of Mrs. Shay's Power of Attorney. Daughter also testified in this matter that she used the Power of Attorney, among other things to instruct Claremont that Mr. Shay should not be permitted to visit his wife, Mrs. Shay. Daughter now appears to be talking out of both sides of her mouth - on one hand using an August 29, 2001 Power of Attorney executed by Mrs. Shay thereby acknowledging its validity, but on the other hand alleging that a Will executed by Mrs. Shay at the exact same time is void because Mrs. Shay lacked testamentary capacity. 2 10. Denied as a conclusion of law to which no responsive pleading is required. By way of further response the Probate, Estates and Fiduciaries Code does not include a definition of "personal property" that would help to determine whether an ongoing civil action falls within that category of property subject to distribution as part of a small estate. It is clear, however, that although a civil claim is considered personal property in a variety of contexts, it is not the property contemplated by Section 3102. The cases cited by Daughter do not discuss whether ongoing litigation is property for purposes of Section 3102 and are not even analogous to this situation. To the contrary, In re Rodriguez' Estate, 6 Pa. D.&C. 2d 521 (Philadelphia O.C. 1956), addresses the question of whether a tort action for personal injuries constitutes an asset under the Incompetent Estates Act sufficient to confer jurisdiction. Hack v. Hack, 433 A.2d 859 (1981), and O'Grady v. Potts, 396 P.2d 285 (Kan. 1964), both discuss a married woman's right to maintain a tort action. Interestingly, however, the court in O'Grady noted that there are situations in which the purpose of a particular statute will require that causes of action not be considered property, which is certainly the case with regard to Section 3102. O'Grady, 396 P.2d at 289. 11. Admitted in part and denied in part. It is admitted that Daughter was the daughter of Mrs. Shay and that she was the court-appointed guardian of Mrs. Shay. By way of further response, any authority conferred by that appointment ceased upon Mrs. Shay's death. The averment that Daughter is a creditor of Mrs. Shay's estate and potentially liable to reimburse other creditors on behalf of the estate are denied as conclusions of law to which no responsive pleading is required. To the extent that a response is required, Mr. Shay is without knowledge as to the truth of those averments and they are therefore denied. Mr. Shay denies that Daughter is entitled to any distribution from Mrs. Shay's estate. To the contrary, based upon the assets 3 identified in the estate by Daughter, Mr. Shay is entitled to receive all of the assets of the estate based upon Mrs. Shay's will. See Petition Exh. B. Even if the Will is invalid, Pennsylvania's intestacy statute does not permit the entire estate to be handed to Daughter when she has acknowledged that Mrs. Shay's husband and son were alive at the time of Mrs. Shay's passing. See 20 Pa. C.S.A. § 2102. 12. Denied as a conclusion of law to which no responsive pleading is required. To the extent that a response is required, Mr. Shay admits that he is the executor named by Mrs. Shay, but denies that the Will is invalid or that he is precluded from serving as executor due to a conflict of interest. To the contrary, the Will is valid. Further, Mr. Shay is not conflicted, and any alleged conflict regarding Mr. Shay exists as well for the Daughter. Daughter has alleged that Mr. Shay is liable for support under 23 Pa. C.S.A. § 4603(a)(1), but this section identifies "a child of the indigent person" as equally responsible for any support obligation. Therefore any conflict that exists for Mr. Shay based upon an alleged support obligation exists equally for Daughter. Daughter is further conflicted because (1) she has identified herself as a creditor of Mrs. Shay's estate and therefore has a personal stake in the estate and the litigation beyond that as a representative of the estate, and (2) she should be required to provide an accounting for her activities as Mrs. Shay's guardian. 13. Denied as a conclusion of law to which no responsive pleading is required. By way of further response, Mr. Shay specifically denies (1) that Mrs. Shay's estate is subject to settlement in accordance with 20 Pa. C.S.A. § 3102, and (2) that Daughter can use 20 Pa. C.S.A. § 3102 as a means to have herself named as Mrs. Shay's personal representative and, thereafter, have herself substituted as the Plaintiff in this action-not as Mrs. Shay's representative, but in her individual capacity. 4 Pennsylvania's Probate, Estates and Fiduciaries Code includes a mechanism for the expedited settlement of small estates, allowing qualifying estates to be settled without the expense and complication of producing a formal accounting. This option is available only when a "person dies domiciled in the Commonwealth owning property ... of a gross value not exceeding $25,000." 20 Pa. C.S.A. § 3102. Any party in interest may petition the Omhans' Court for such a settlement. In the case at bar, Daughter's reliance on Section 3102 is misplaced. Rather than using this provision to settle this estate-as, by its clear language, is its purpose-she is attempting to use it to have herself named as Mrs. Shay's personal representative and, thereafter, to have herself substituted as the Plaintiff in this action-not as the estate's representative, but in her individual capacity. This misapplication of Section 3102 and attendant circumvention of the litigation process is illustrated by the fact that Daughter filed the instant Petition not in Orphans' Court, but in the above-captioned civil action, which was commenced prior to Mrs. Shay's death. Daughter acknowledges that, other than this litigation, Mrs. Shay had no personal property of value at the time of her death. See Petition ¶¶ 6 & 10. There is not, therefore, any tangible property subject to distribution, and this lawsuit does not lend itself to settlement as part of a small estate under Section 3102. A settlement under Section 3102 has the same effect as a decree of distribution entered after an accounting. In other words, the possibility of settlement is based on the assumption that there is an understanding of exactly what comprises the estate. By its very terms, Section 3102 is used to settle a small estate. Its purpose is not to identify the executor of an estate, and it certainly is not a vehicle to be used for the complicated determination of who is entitled to be the plaintiff in a civil lawsuit. That is, however, exactly what Daughter is attempting to accomplish. Daughter has not followed the appropriate Orphans' Court channels to seek identification as Mrs. Shay's personal representative. This is likely so because she recognizes that Mrs. Shay's Will is valid and that it names Mr. Shay as executor. If she is appointed personal representative, Daughter can then seek to be substituted as the Plaintiff in this action in accordance with Pa. R.C.P. 2355 and 2352. Again, however, her status at that point would be as the representative of the estate, not as the individual to whom the lawsuit was distributed as "personal property" via the settlement of the estate and the de facto beneficiary of any favorable award in the litigation. In essence, Daughter is asking this Court to render a premature determination that she personally is entitled to the amounts claimed in the Amended Complaint. Before the Orphans' Court can properly distribute this estate to Daughter or, for that matter, anyone else, it has to determine what personal property is included within the estate. It will not be able to do so until after the litigation is concluded. A central issue in the litigation is whether Decedent's estate is entitled to further support from Mr. Shay, including those sums allegedly owed by the estate to Daughter. Daughter cannot circumvent the Orphans' Court procedures and, in fact, the civil suit itself, by using Section 3102 to deem herself the individual beneficiary of the estate. WHEREFORE, Defendant Charles E. Shay, Jr. respectfully requests that the Court deny the Petition filed by Tracy D. Snyder-Shay and grant such further relief as the Court deems just and equitable. Respec ly u i ed, Dated: June 6, 2008 Matth w . Haar, E uire (Pa. #85688) Amy C. Foerster, Esquire (Pa. #77986) Saul Ewing LLP 2 N. Second Street, 7d' Floor Harrisburg, PA 17101 (717) 257-7508 Attorneys for Defendant 6 1, Charles E. Shay, Jr., hereby veaify that I have reed the foregoing Ansvrer to Petition and that the averments of fact dwrcin are trac and con0ct to the bast of my knowledge, infonnadon and belief. I make this veaitiicati(m subjca to the penalties of I S Pa. C.S.A. § 4904 relatiug to unworn falsifiaadon to aatiwrities. Datod: June 4 2008 Charles E. Shot:, Jr. CERTIFICATE OF SERVICE I hereby certify that on June 6, 2008, I served a true and correct copy of the foregoing Answer to Petition by first class mail, postage paid, upon the following counsel: Bruce G. Baron, Esquire Douglas A. Snyder, Esquire Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Attorneys for Plaintiffs Edward L. Schorpp, Esq. County Solicitor 1 Courthouse Square, 2"d Floor Carlisle, PA 17013 Attorney for Alleged Creditor County of Cumberland/Claremont Nursing Home Mr. Cory L. Shay 328 Ridge Road Grantville, PA 17028 Pro Se - Son of Patricia J. Shay, Deceased Matthew . Haar C7 r7l c? PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY-SNYDER As Plenary Guardian of the Person and Estate of Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION-LAW No. 06-3229 ANSWER OF THE COUNTY OF CUMBERLAND TO PLAINTIFF'S PETITION FOR SETTLEMENT OF SMALL ESTATE AND NOW, comes the County of Cumberland, through its Solicitor, Edward L. Schorpp, Esq., and answers Plaintiffs Petition as follows: 1-13. Admitted. By way of further Answer, and should This Honorable Court grant the prayer of the Petition, the County of Cumberland seeks a further order directing the Plaintiff to make priority payment out of any recovery from the Defendant, Charles E. Shay, Jr., to the account of the decedent with Claremont Nursing and Rehabilitation Center Dated: June oZ 7 , 2008 , Edward L. chore , E quire Cumberland County Solicitor Attorney ID No. 17495 1 Courthouse Square Carlisle, PA 17013 (717) 240-5444 VERIFICATION I verify that the statements contained herein are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unsworn falsification to authorities. We e Wible, CNRC Director Dated: */01- CERTIFICATE OF SERVICE I, Janet Walter, paralegal, do hereby certify that on the date set forth below, I did serve a true and correct copy of the Answer of Cumberland County upon the following parties at the addresses indicated below: Bruce G. Baron, Esq. Douglas A. Snyder, Esq. Capozzi & Associates, P.C. 2933 North Front Street Harrisburg, PA 17055 Matthew M. Harr, Esq. Amy C. Forester, Esq. Saul Ewing LLP 2 North Second Street, 7th Floor Harrisburg, PA 17101 Cory L. Shay 328 Ridge Road Grantville, PA 17028 Date: G-av-os' By: Janet Walter, Paralegal Office of Cumberland County Solicitor C-.. v X -3 . _ x - g „ rl) L PATRICIA J. SHAY, An incapacitated person by TRACY D. SHAY-SNYDER: As plenary guardian of the Person and estate of Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR., Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2006 - 3229 CIVIL TERM CIVIL ACTION - LAW ORDER OF COURT AND NOW, this 25TH day of JUNE, 2008, a conference is scheduled for WEDNESDAY, JULY 23, 2008, at 3:30 p.m. in Courtroom # 3 of the Cumberland County Courthouse, Carlisle, Pa. The purpose of the conference shall be to decide on the procedure for disposition of the "Petition for Settlement of Small Estate on Petition and for Substitution of Tracy D. Shay-Snyder as Plaintiff in this Matter". /Bruce G. Baron, Esquire 2933 North Front Street Harrisburg, Pa . 17110 /Matthew M. Haar, Esquire 2 North Second Street 7t' Floor arrisburg, Pa. 17101 Edward L. Schorpp, Esquire County Solicitor 1 Courthouse Square Carlisle, Pa. 17013 Edward E. Guido, J. : l _ aC-i Fps 4Y.! = C " Mr. Cory L. Shay 328 Ridge Road Grantville, Pa. 17028 Ad ?o c ?..s' mac L?aslo ? PATRICIA J. SHAY, An Incapacitated Person, by TRACY D. SHAY- SNYDER, as Plenary Guardian of the Person And Estate of Patricia J. Shay, Plaintiff V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW CHARLES E. SHAY, JR., Defendant NO. 06-3229 CIVIL TERM IN RE: DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S SECOND AMENDED COMPLAINT ORDER OF COURT AND NOW, this 17'h day of July, 2008, a status conference on the above- captioned matter is scheduled in chambers of the undersigned judge for Thursday, August 14, 2008, at 10:15 a.m. 'Bruce G. Baron Esq. 2933 North Front Street Harrisburg, PA 17110-1250 /Attorney for Plaintiff Matthew M. Haar, Esq. Penn National Insurance Plaza 2 North Second Street, 7`" Floor Harrisburg, PA 17101 Attorney for Defendant 0-o P ec M ?i-t Lr rj.___ x/.7/00 BY THE COURT, tsley Ole r., J. a ^ r' ,,f LO, --Z d L ,Rr COOZ n ? Lt ,x, t '!Hi G PATRICIA J. SHAY, an incapacitated person, by TRACY D. SHAY-SNYDER as Plenary Guardian of the Person and Estate of Patricia J. Shay, Plaintiff V. CHARLES E. SHAY, JR., Defendant agreement of the continued genera scheduled before We will schedule forward upon the IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2006-3229 CIVIL TERM CIVIL ACTION - LAW ORDER OF COURT AND NOW, this 23rd day of July, 2008, by parties, all proceedings in this matter are Lly. This includes the status conference Judge Oler on August 14, 2008, at 10:15 a.m. another status conference to move this matter request of any party. By tlje9. Court , E. Guido, J. ;JBruce G. Baron, Esquire Attorney for Plaintiff j./atthew M. Haar, Esquire Attorney for Defendant Edward L. Schorpp, Esquire County Solicitor The Honorable J. Wesley Oler, Jr. srs A f 4 SZ Ind' aal PATRICIA J. SHAY, An IN THE COURT OF COMMON PLEAS OF Incapacitated Person, by CUMBERLAND COUNTY, PENNSYLVANIA TRACY D. SHAY- SNYDER, as Plenary Guardian of the Person And Estate of Patricia J. Shay, Plaintiff V. CIVIL ACTION - LAW CHARLES E. SHAY, JR., Defendant NO. 06-3229 CIVIL TERM IN RE: DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S SECOND AMENDED COMPLAINT ORDER OF COURT AND NOW, this 6 h day of August, 2008, the above-captioned preliminary objections are hereby transferred to the Honorable Edward E. Guido for disposition in conjunction with the matters regarding the estate that are currently pending before him. The Honorable Edward E. Guido -AawiJ, Ace G. Baron, Esq. 2933 North Front Street Harrisburg, PA 17110-1250 Attorney for Plaintiff Matthew M. Haar, Esq. Penn National Insurance Plaza 2 North Second Street, 7t' Floor Harrisburg, PA 17101 Attorney for Defendant Court Administrator -hAnd,4,?, 81610 r 4c_, BY THE COURT, ? l