HomeMy WebLinkAbout06-7269a
ALMA HEALTH LLC d/b/a, IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, OF CUMBERLAND COUNTY
Plaintiff
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - 70 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
NOTICE TO DEFEND
You have been sued in court. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this complaint, order 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 money claimed in the complaint or for any other claim or relief
requested by the plaintiff. You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER, OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 South Bedford Street
Carlisle, Pennsylvania 17013
(717) 249-3166
1-800-990-9108
AMERICANS WITH DISABILITIES
Act of 1990
The Court of Common Pleas of Cumberland County is required by law to comply with
the Americans with Disabilities Act of 1990. For information about accessible facilities and
reasonable accommodations available to disabled individuals having business before the court,
please contact our office. All arrangements must be made at least 72 hours prior to any hearing
or business before the court. You must attend the scheduled conference or hearing.
2
CASE NO: 2006-07269 P
SHERIFF'S RETURN - REGULAR
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
ALMA HEALTH LLC ET AL
VS
SHIPPENSBURG HEALTH CARE CTR
SHAWN HARRISON
Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE was served upon
eLTTDDIIATQUTTD('1 uLTaT.7W rnRF rP..NTTP.R TNr the
DEFENDANT , at 1540:00 HOURS, on the 29th day of December , 2006
at 121 WALNUT BOTTOM ROAD
SHIPPENSBURG, PA 17057 by handing to
CINDY HARTMAN, ADMINISTRATOR, ADULT IN CHARGE
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs: So Answers:
Docketing 18.00
Service 16.72 Postage .39
Surcharge 10.00 R. Thomas Kline
.00
45.11 0 01/09/2007
oV MARCUS MCKNI
Sworn and Subscibed to 00 By:
before me this day Depu y Sheriff
of A.D.
SHERIFF'S RETURN - U.S. CERTIFIED MAIL
CASE NO: 2006-07269 P
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
ALMA HEALTH LLC ET AL
VS.
SHIPPENSBURG HEALTH CARE CTR
R. Thomas Kline , Sheriff of Cumberland
County, Pennsylvania, who being duly sworn according to law served the
within named DEFENDANT MAGNOLIA MANAGEMENT COMPANY ,
by United States Certified Mail postage
prepaid, on the 28th day of December 2006 at 0000:00 HOURS, at
1710 UNDERPASS WAY #210
HAGERSTOWN, PA 21740 a true
and attested copy of the attached COMPLAINT & NOTICE Together
with
. The returned
receipt card was signed by LISA SWORD
01/03/2007 .
Additional Comments:
on
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
6.00
6.56
.00
10.00
.00
22.56
So answers:
R. Thomas Kline
Sheriff of Cumberland County
Paid by MARCUS MCKNIGHT
Sworn and Subscribed to before me this
day of ,
on 01/09/2007 .
A. D.
¦ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
¦ Print your name and address on the reverse
so that we can return the card to you.
¦ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Magnolia Management Ccmpany
1710 Underpass Way #210
Hagerstown, MD 21740
X L?? 13 Agent
? Addre
)TaQ .
ed y ( d N C. D
D. Is delivery address different from item 1 ? ? es
If YES, enter delivery address below: ? No
3. Service Type
)=CertiW Mail ? Express Mail
? Registered ? Return Receipt for Merchandise
? Insured Mail ? C.O.D.
4. Restricted Delivery? (Extra Fee) ? Yes
?005 1820 0002 4619 064? 06-7269 civil
2004 Domestic Return Receipt
102595-02-M-1540
UNITED STATES POSTAL SERVICE
• Sender: Please print your name, address, and ZIP+4 in this box •
CUMBERLAND COUNTY SHERIFF'S DEPARTMENT
ONE COURTHOUSE SQUARE
CARLISLE PA 1701,3
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
ALMA HEALTH LLC d/b/a,
MEDSTAFFERS, a Pennsylvania Corporation,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
COMPLAINT
AND NOW comes the Plaintiff, ALMA HEALTH LLC d/b/a MEDSTAFFERS, a
Pennsylvania Corporation, by and through their attorneys, Irwin & McKnight, and makes the
following Complaint against the Defendants, SHIPPENSBURG HEALTH CARE CENTER,
INC. and MAGNOLIA MANAGEMENT COMPANY, as follows:
1.
The Plaintiff is Alma Health Care LLC d/b/a Medstaffers, a Pennsylvania Corporation
with an address of 17 East High Street, Carlisle, Cumberland County, Pennsylvania 17013.
2.
The Defendant is Shippensburg Health Care Center, Inc with an address 121 Walnut
Bottom Road, Shippensburg, Cumberland County, Pennsylvania 17057.
3.
The Defendant is Magnolia Management Company, with an address of 1710 Underpass
Way #201, Hagerstown, Maryland 21740.
4.
The parties entered a contract for services dated April 4, 2006, a copy of which is
attached hereto and marked as Exhibit "A".
3
5.
To date, the Defendants have incurred unpaid services with the Plaintiff in the amount of
Thirty Three Thousand Fifty and 12/100 ($33,050.12) Dollars. Copies of invoices are attached
hereto and marked as Exhibit "B".
6.
The Plaintiff has made numerous demands for payment to which no payments have been
made.
7.
In addition to the amount owed for staffing services, the Defendants owe interest on the
unpaid invoices or invoices which have been paid late as well as reasonable legal fees. A copy of
interest owed is attached hereto and marked as Exhibit "C".
WHEREFORE, the Plaintiff demands judgment against the Defendants in the amount of
$33,050.12 including reasonable legal fees, costs and interest as permitted by law.
Respectfully submitted,
IRWIN & cKNIG
By:
Marcu A. McNsd fit.
Supr ourt I.D. #: 254
60 We Pomfret Street
Carlisle, 13
(717) 249-2353
Date: December 26, 2006 Attorney for the Plaintiff
4
FACILITY STAFFING AGREEMENT
THis AGREEMENT, made and entered into this t-}VV\day of t 2006, by and
between ALMA HEALTH LLC D/B/A/ MEDSTAFFERS., a Pennsylvania corporation (hereinafter referred to as
_- r
MEDSTAFFERS") and its
successors or assigns (hereinafter referred to as "FACILITY").
WHEREAS, the FACILITY requires nursing personnel (hereinafter referred to as "PERSONNEL")
to work various shifts in and for said FACILITY; and
WHEREAS, FACILITY desires that MEDSTAFFERS provide the required nursing personnel; and
WHEREAS, MEDSTAFFERs desires to supply to FACILITY with the required nursing personnel,
subject to the availability of such Personnel by MEDSTAFFERS; and
WHEREAS, MEDSTAFFERS has Or NVill recruit all necessary Personnel iii an effort to rneet the
musing personnel needs of the FACILITY; and
Now. THEREFORE. the parties agree as follows:
r
1. APPLICABLE DEFINITIONS
PERSONNEL - shall be defined as Registered Nurses (RN), Licensed Practical Nurses
(LPN), and Certified Nursing Assistance (CNA) acting within the scope of their respective
license or certification performing tasks assigned by the FACILITY.
FIRM AVAILABILITY - shall be defined as the specific personnel needs which
FACILITY seeks to have MEDSTAFFERS provide. Said FIRM AVAILABILITY shall be
determined by a projected patient census and staffing requirements as determined by the
FACILITY.
GUARANTEED TIME - shall be defined as a request for PERSONNEL which cannot be
canceled for any reason and for which the FACILITY is subject to full billing. The
FACILITY shall designate which shifts are GUARANTEED TIME.
EARLY REQUESTS - shall be defined as requests for PERSONNEL received four (4) to
six (6) weeks before the scheduling need.
EMERGENCY REQUEST - shall be defined as requests for PERSONNEL received less
than twenty (24) hours before the scheduling need.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page I of 12
SUPPLEMENTAL STAFF - shall be defined as the service provided by MEDSTAFFERS
when MEDSTAFFERS PERSONNEL supplements the existing staffing needs of the
FACILITY.
FLOATING - shall be defined as the removal or transfer of MEDSTAFFERS PERSONNEL
to an assignment other than the original assignment.
2. PROCEDURE TO REQUEST SERVICES
a. FACILITY shall notify MEDSTAFFERS, in writing, telephone or via fax, of their
PERSONNEL needs. Any such requests shall be deemed a FIRM AVAILABILITY request.
b. In the event MEDSTAFFERS cannot fttlfill a PERSONNEL request, provided said request has
been placed at least one week in advance of the scheduling need, MEDSTAFFERS shall give FACILITY
notice. via telephone and/or fax verification. of MFDSTAFFERS inability to fulfill the FACILITY's
PERSONNEL request.
C. In the event FACILITY seeks an EMERGENCY REQUEST. FACILITY shall contact
MEDSTAFFERS via telephone as soon as practicable prior to the scheduling need. Within thirty (30) minutes
of receipt of FACILITY's EMERGENCY REQUEST. MEDSTAFFERS shall notify the pre-designated
Scheduling Contact at the FACILITY as MEDSTAFFERS's ability to fulfill the FACILITY's EMERGENCY
REQUEST.
3. MEDSTAFFERS'S GENERAL RESPONSIBILITIES
a. Upon receipt of a request by FACILITY, MEDSTAFFERS shall assign as many such
PERSONNEL as are available for such assignment.
b. MEDSTAFFERS does not CyUarantee at any time that all orders will be tilled.
C. MEDSTAFFERS will require FIRM AVAILABILITY from FACILITY two (2) to six (6)
weeks in advance.
d. Requests for PERSONNEL can be accepted up to twenty six (26) weeks in advance. The
earlier the requests are received the easier to fill the shifts needed. GUARANTEED TIME is defined as
PERSONNEL needs that can not be canceled for any reason and are subject to full billing except for
mutual cancellations.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 2 of 12
A 6
e. EARLY REQUESTS and GUARANTEED REQUESTS will receive top priority.
f. MEDSTAFFERS shall maintain an employee file on each of its PERSONNEL containing the
following:
(1) a completed application which includes skills, specialties and preferences
(2) documentation of special education or training
(?) skills check list for each employee
(4) three recent work references
(5) TB test and evidence of health status in accordance with state regulations
(6) dates hired and oriented
(7) performance evaluation
(8) copy of current license.. registration or certification. as applicable including but not limited
to CPR and ACLS certification
°; INS Form 1-9 and documents establishing :dent. and work authorization
(10) competency verification through NLN testing for RN/LPN's with a score of 85? o or better
(11) CNA's will have current NLN proficiency screening
(12) current negative dnjg screen
(13) complete background checks including but not limited to criminal and the Office of
Inspector General Exclusion Check.
(14) OSHA/JCAHO/HIPPA In-service and testing yearly based on state & federal regulations
Older Adults Protective Services Act (OAPSA)
Medstaffers acknowledges the requirements of the OAPSA. which contain in part the
requirements pertaining to reports of criminal history record information, have application in the
performance of services under this agreement. Medstaffers certifies that prior to assigning any
personnel who have client contact with residents or who may have unsupervised access to personal
living quarters, Medstaffers will obtain a report of criminal history record information, OIG
exclusion verification, all federal and state hiring documentation and other documentation listed
above, and provide a copy of such documentation to FACILITY and/or FACILITY'S regulating
agencies upon request. Medstaffers will indemnify and hold FACILITY harmless from any and all
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 3 of 12
claims, actions, damages, liabilities, costs and expenses, including reasonable attorney's fees and
expenses, arising out of any claim or an actual finding of failing to comply with OAPSA or not
having fulfilled the other documentation requirements herein listed.
g. MEDSTAFFERS shall take all reasonable efforts to match the skills and experience levels as
provided by its PERSONNEL. as set forth in employment applications. licenses and certifications. to the
specific needs of FACILITY.
h. PERSONNEL will perform a variety of services within the scope of their license or
certification which will continuously change based on the needs set forth by the FACILITY.
MEDSTAFFERS will recruit PERSONNEL on an ongoing basis and will provide qualified PERSONNEL
based on the availability at the time of the scheduled need. The placement of qualified PERSONNEL in a
FACILITY is up to the discretion of MFDSTAFFFRs and depends on the availability of PERSONNEL.
i. MEDSTAFFERS PERSONNEL shall report to its designated supervisor at the FACILITY
`?`e?^re Sl:eilie br?'l.s :z1orklna
j. MEDSTAFFERS will be available to FACILITY 24 hours a day. seen days a week.
k. MEDSTAFFERS shall give FACILITY priority service, that is, FACILITY orders will receive
priority over orders of non-contract facilities. however. contract requests will be on a first come first serve
basis.
1. MEDSTAFFERS will provide FACILITY's orientation packet to Medstaffers employees, and
forward to FACILITY, prior to the first work assignment of employee, signed acknowledgment forms from
the employee that he/she has read the information, including FACILITY's code of conduct, and
understand it.
M. All PERSONNEL assigned to FACILITY pursuant to this agreement shall. for the purposes
of this Agreement. be considered employees of MEDSTAFFERS.
n. MEDSTAFFERS is an independent contractor to the FACILITY.
o. MEDSTAFFERS is in compliance with all state and federal laws applicable to the
employment of the PERSONNEL assigned to FACILITY.
P. MEDSTAFFERS agrees not to discriminate in the assignment of its PERSONNEL on the
basis of race, creed, color, national origin, sex, age, disability, or veteran status.
q. MEDSTAFFERS agrees not to at anytime or in any manner either directly or indirectly,
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 4 of 12
divulge, disclose, or communicate to any person, organization, and corporation any information
concerning any matters affecting or relating to the business of the FACILITY, its employees, or patients
except as required by the law.
r. MEDSTAFFERS shall maintain at its sole expense a valid professional liability insurance
policy of One Million Dollars ($1.000,000.00) per occurrence and Five Million Dollars
($5,000,000.00) aggregate during the term of this agreement. Upon signing this agreement,
Medstaffers will supply FACILITY with a Certificate of Liability insurance, and will notify
FACILITY prior to cancellation, reduction or material change in coverage in the future.
MEDSTAFFERS shall maintain required workers compensation insurance for all of MEDSTAFFERS'S
employees placed in FACILITY.
s. MEDSTAFFERS PERSONNEL will abide by FACILITY rules, policies and procedures: and
report to, and be supervised by FACILITY Clinical Managers when on duty at FACILITY.
t_ MFDSTAFFERS will take no step-, to recruit as its own employees tl,nce PERSONNEL
provided by FACILITY during the tern of this Agreement. The !MEDSTAFFERS further acknowledges
the considerable expense incurred by FACILITY to advertise, recruit, interview. evaluate, reference check
and supervise its employees.
4. FACILITY RESPONSIBILITIES
a. FACILITY shall use MEDSTAFFERS as one of its sources of SUPPLEMENTAL
STAFFING.
b. All PERSONNEL provided by MEDSTAFFERS for the term of this contract are the
employees of MEDSTAFFERS.
c. FACILITY %?ill take no steps to recruit as its own employees those PERSONNEL provided
by MEDSTAFFERs during the term of this Agreement. FACILITY understands MEDSTAFFERS is not an
employment agency and that its employees are assigned to the FACILITY to render temporary services and
are not assigned to become employed by the FACILITY. The FACILITY further acknowledges the
considerable expense incurred by MEDSTAFFERS to advertise, recruit, interview, evaluate, reference check
and supervise its employees. Accordingly, the FACILITY may not hire MEDSTAFFERS's Personnel unless
an "Intent to Hire" agreement is met.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 5 of 12
d. "Intent to Hire" - 1) If FACILITY seeks to hire the MEDSTAFFERS employee at the end
of the employee's 90 day GUARANTEED term assignment, the fee for a "buy out" of the services will be
waived, or 2) if FACILITY seeks to hire the MEDSTAFFERS employee prior to the end of the contract
agreement period, a lump sum for the remainder of the guaranteed time will be paid to MEDSTAFFERS.
Once an option is agreed upon, the said MEDSTAFFERS employee employment rights are transferred to the
FACILITY. The beginning of the 90 day period starts from the first day notice is griven for the intent to
hire. Facility agrees to not hire a MEDSTAFFERS employee for a period of 6 months after their
termination of employment with MEDSTAFFERS.
e. FACILITY shall provide sufficient information about its specific needs so that
MEDSTAFFERS can match the skills and experience of its PERSONNEL to those deeds.
f FACILITY shall utilize assigned PERSONNEL only for the specific area/specialty need
requested.
0 PFRCpNNET mar he temnornrily reassigned to a different «unrk nn-n if PERSONNEL
In, - does not have sufficient orientation or experience in the type of work performed in the temporary work
area, PERSONNEL will be required to perform all basic nursing functions, but will not be required to
perform tasks or procedures for which PERSONNEL is not qualified or trained to perform, nor will
PERSONNEL be required to assume sole accountability for patient care assignments. If reassigned
PERSONNEL has sufficient orientation or sufficient experience in the type of work performed in the
temporary work area, PERSONNEL will be required to assume sole accountability for patient care
assignments."
h. FACILITY agrees that MEDSTAFFERS's duty to fill assignments is subject to the availability
of qualified Personnel.
i. FACILITY agrecs to provide orientation necessary for the specific unit assignment. Which
includes physical layout of the unit/facility.
J. FACILITY nursing supervisors will assist MEDSTAFFERS, on a continuing basis, with
evaluation of MEDSTAFFERS PERSONNEL by providing performance information and/or access to clinical
areas for observation by MEDSTAFFERS's Clinical Director.
k. FACILITY shall allow MEDSTAFFERS PERSONNEL (on their own time) to attend
appropriate facility staff development programs.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 6 of 12
1. FACILITY shall notify MEDSTAFFERS immediately of the initiation of any complaint,
inquiry, investigation, or review with or by any licensing or regulatory authority, peer review organization,
FACILITY committee, or other committee, organization which directly or indirectly, evaluates or focuses
on the quality of care provided by MEDSTAFFERS or its PERSONNEL either in any specific instance or in
general.
M. FACILITY will make available to MEDSTAFFERS copies of all documentation about
problems or incidents in which MFDSTAFFERS's employees are involved.
n. If, in the sole discretion of the FACILITY, any person assigned by MEDSTAFFERS is
incompetent, negligent, or has engaged in misconduct, FACILITY may require such person to leave its
premises and shall inform MEDSTAFFERS of this action immediately. The dismissed employee shall not be
assigned to the FACILITY thereafter. The FACILITY's obligation to compensate MEDSTAFFERS for said
services shall be limited to the hours actually worked by such person and FACILITY shall have no further
c'Hi_gation with re-nert to -,11r h ass*
gniiir ntc..
o. FACILITY shall make every effort to request PERSONNEL at least four (4) hours prior to
reporting time. If PERSONNEL are requested less than two (2) hours prior to reporting time every
attempt will be made to fill the request. If the PERSONNEL accepting assignment is unable to arrive at
the exact start time due to the short notice. the FACILITY will be billed for the entire shift if notice of
request was received less then 2 hours before start time.
P. If FACILITY changes or cancels an order less than two (2) hours before reporting time,
FACILITY shall be liable for four (4) hours at the hourly rate for the PERSONNEL involved. FACILITY
then reserves the right to then employ the nurse for four (4) hours.
q. FACILITY agrees not to discriminate in the assignment of MEDSTAFFERS' PERSONNEL
on the basis of race, creed. color. national origin. sex. age, disability. or veteran status.
r. FACILITY shall maintain at its sole expense a valid policy of insurance covering
professional liability arising from the acts or omissions of FACILITY's employees. FACILITY shall
forward a Certificate of Insurance to MEDSTAFFERS upon request and give MEDSTAFFERS prompt, written
notice of any change in FACILITY's coverage.
5. TERM OF AGREEMENT
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 7 of 12
This term of this Agreement shall commence on the day of k 0c, k , 2006, and
shall continue for a period of twelve (12) months from the commencement.
Unless written notice of termination is given by either party to this Agreement thirty (30) days prior
to the end of the aforementioned term, this Agreement shall automatically be extended for an additional
like period and so on until terminated as above set forth.
6. PAYMENTS, INVOICES
a. MEDSTAFFERS will furnish FACILITY with a weekly invoice of services provided. The
rates for its services are attached as Exhibit A to this Agreement. The rates for services established in
Exhibit A can be prospectively amended by MEDSTAFFERS at any time upon thirty (30) days written notice
to FACILITY.
b. FACILITY shall pay MEDSTAFFERS as provided. entitled Payment Terms. Payment due
?Ipon receipt of invoice. Accounts not paid in full xvithin 30 days of billing shall be subject to a 1.5% per
30 days overdue. FACILITY shall also be responsible for any and all counsel fees and costs associated
with the collection of overdue balances.
C. GUARANTEED REQUESTS and bookings for PERSONNEL can not be canceled and are
subject to complete billing whether Personnel are used or not except mutual cancellations.
7. MODIFICATION AND WAIVER OF AGREEMENT
This Agreement shall constitute a full, complete, and total binding Agreement between the parties and
is precluded from amendment or modification EXCEPT if the parties specifically agree to modify this
Agreement.
Any and all imoditications to this Agreement shall only be by written agreement containing the same
formalities as this Agreement and shall exhibit the notarized signatures of both parties. along with two
witnesses.
Any waiver of a breach of any provision of this Agreement shall not constitute an ongoing waiver.
8. TERMINATION OF AGREEMENT
Either party can terminate this Agreement, with or without cause, upon thirty (30) days written
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 8 of 12
notice to the other party. Notices of termination must be sent to the parties as listed within this Agreement.
FACILITY may immediately terminate this agreement if Medstaffers or employee's conduct is
unprofessional, unethical or fraudulent, and if, in the opinion of FACILITY, such action discredits the name
or is detrimental to the reputation, character and standing of FACILITY.
9. PRIOR AGREEMENTS
This Agreement constitutes the entire understanding and agreement beteecn the parties hereto. and
there are no other representations, warranties, covenants, understandings or agreements other than those
expressly set forth herein.
10. BREACH AND ENFORCEMENT
If either party hereto breaches any of the provisions of this Agreement. the other party shall have the
right to bring anv actions or actions in law or equity for such breach.
11. NOTICES
All notices shall be in writing and shall be addressed to the parties as set forth below. Notices shall
be effective upon receipt when delivered personally or sent via US Certified Mail return receipt requested
to the appropriate addresses listed below and shall be effective upon mailing when property addressed with
postage prepaid.
MEDSTAFFERS
ALMA HEALTH D/B/A/ MEDSTAFFERS.
Corporate Headquarters
17 East Hiah Street
PO Box 95
Carlisle, PA 17013
FACILITY
TVA
12. ADDITIONAL INSTRUMENTS
Each of the parties hereto agrees that it will join in the execution, acknowledgment and delivery of
any other document which may be reasonably necessary to carry out the intent of this Agreement, and, in the
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 9 of 12
event either of the parties hereto would not join in the execution, acknowledgment and delivery of such
instrument, then such party does hereby irrevocably appoint the other party hereto as its Attorney-in-Fact to
execute, acknowledge and deliver such instrument hereby ratifying all that such other party hereto may do by
virtue hereof with a copy of this Agreement to be a sufficient Power of Attorney to carry out the intent and
purpose of this paragraph.
13. VOLUNTARY EXECUTION
The provisions of this Agreement and their legal effect have been fully explained to the parties by
their respective legal representatives, and each party acknowledges that the Agreement is fair and
equitable, that it is being entered into voluntarily, with full disclosure and that it is not the result of
any duress or undue influence.
14. ENTIRE AGREEMENT
This Agreement contains the entire understanding of the parties and there are no representations,
warranties, covenants or undertakings other than those expressly set forth herein.
15. CONFIDENTIALITY
The terms of this agreement are confidential, and each party receiving any proprietary or confidential
information from the other party or its clients shall exercise reasonable efforts to preserve the
confidentiality of said information.
16. COMPLIANCE ACKNOWLEDGMENT
Medstaffers and FACILTY represent and warrant that they are and shall remain throughout the tern
of this agreement in compliance with all applicable federal and state laws and regulations related to
this agreement and the services to be provided, including without limitation, statutes and regulations
related to fraud, abuse, false claims/statements, referrals and prohibition of kickbacks.
Medstaffers also represents and warrants, by signing and returning the attached acknowledgment,
that Medstaffers agrees to comply with the compliance protocols that impact ancillary providers
under FACILITY'S corporate compliance plan and/or code of conduct.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 10 of 12
17. ASSIGNMENT
Neither party may assign this agreement without the prior written consent of the other party.
18. APPLICABLE LAW
This Agreement shall be interpreted in accordance with the laws of the Commonwealth of
Pennsylvania. Any and all disputes which arise as a result of this Agreement shall be heard in the
Court of Common Pleas of Cumberland County, Pennsylvania.
19. VOID CLAUSES
If any term, condition, clause or provision of this Ac-9-cement shall be determined or declared
to be void or invalid in law or otherwise. then only that term. condition, clause or provision shall be
stricken from this Agreement and ir. all other respects, this Agreement shall be valid and continue in
frill force. effect and operation
REMAINDER OF THIS PAGE HAS BEEN INTENTIONALLY LEFT BLANK
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page I 1 of 12
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year first
above written.
WITNESS/ATTEST:
ALMA HEALTH D/B/A/ MEDSTAFFERS.
By:
(SEAL)
Title: !
(SEAL)
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a MedstafPers.
February 2006
Page 12 of 12
EXHIBIT "B"
DEC-26-2006(TUE) 11:17 ALMA MedicalDBA (FAX)l 717 2dl 30211 P.003/031
Bill To:
Please summit invoices to
MedStaffers
PO Box 1300
Suisun City Ca, 94585
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
Attn. Jeff Benevit
Facility Branch Account O Period Ending Invoice #
Shippensburg Health Care Center HC1 174 09/23/2006 7663
Date Shifts Caregiver Title Description Hm/Units Rate Amount Miles Mileage Total
Unit Nam e: LTC
09/17/2006 06:30AM- 03.OOPM Whocler,Earlann L CNA REGULAR WEEKEND 8.50 28.00 238.00 238.00
09/17/2006 03;OOPM - 07:OOPM Wheeler,Earlann L CNA REGULAR WEEKEND 4.00 29.00 116.00 116.00
09/18/2006 06:30AM - 03:OOPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
09118/2006 07:30AM - 03:OOPM Barclay,Jennifer I CNA REGULAR WEEKDAY 7.50 24.00 180.00 180.00
09/18/2006 03;OOPM - 10;30PM Barclay,Jennlrer 1 CNA REGULAR WEEKDAY 7.50 25.00 187.50 187.50
09119/2006 06;30AM - 03:0OPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
09/19/2006 02:30PM- 03:00PM Nace,Nicole R CNA REGULAR WEEKDAY 24.00
09/19/2006 03!OOPM - 10:30PM Nace.Nicole R CNA REGULAR WEEKDAY 7.50 25.00 187.50 187.50
09120/2006 02;30PM - 03;OOPM NacoAlecle R CNA REGULAR WEEKDAY 0.50 24.00 12.00 12.00
09120/2006 03;OOPM - 04:OOPM Nace,Nicole R CNA REGULAR WEEKDAY 1.00 25.00 25.00 25.00
09/2112006 06:30AM - 03!OOPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192,00 192.00
09/21/2006 06,30AM - 02:30PM Barclay,Jennlrer I CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
09/21/2006 02;30PM - 03;OOPM Naco,Nlcole R CNA REGULAR WEEKDAY 0.50 24.00 12.00 12.00
09121/2006 03:OOPM- 08:30PM Rlckrode,Ashley L CNA REGULAR WEEKDAY 5.50 25.00 137.50 137.50
09121/2006 03:OOPM - 10:30PM Nace,Nicole R CNA REGULAR WEEKDAY 7.50 25.00 187.50 187.50
09/22/2006 08:30AM - 03;OOPM Rickrode.Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
09/22/2006 02;30PM - 03;OOPM Frey,Laurle J CNA REGULAR WEEKEND 0.50 28.00 14.00 14.00
09/22/2006 03:00PM - 04:30PM Rickrode,Ashley L CNA REGULAR WEEKEND 1.50 29.00 43.50 43.50
09/2212006 03:OOPM - IODOPM Frey,Laurle J CNA REGULAR WEEKEND 7.00 29.00 203.00 203.00
09122/2006 10:30PM - 11;OOPM Balr,Kathy S LPN REGULAR WEEKEND 0.50 44.00 22.00 22.00
0912212006 11;OOPM - 07:00AM B21r,Kalhy S LPN REGULAR WEEKEND 8.00 46.00 368.00 368.00
09/2312006 07:00AM - 07:15AM Bair,Kalhy S LPN REGULAR WEEKEND 0.25 42.00 10.50 10.50
0912312006 07:OOAM - 02:1OPM Wheeler.Earlann L CNA REGULAR WEEKEND 7.17 28.00 200.76 200.76
TS
A 1.5% finance charge will be added to this Invoice if not paid within 30 days
(FAX)l 717 2dl 3024
I immit invoices to
affers
Ply Loox 1300
Suisun City Ca, 94585
ALMA MedicalOBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
Attn: Jeff Benevit
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
P. OOd/031
Facility Branch Account* Period Ending Invoice #
Shippensburg Health Care Center HC1 174 09/23/2006 7663
DEC-26-2006(TUE) 11:18
Date Shifts Caregiver Title Description Hrs/Units Rate Amount Miles Miloage Total
09/23/2006 02:10PM- 03:OOPM Wheeler.Eariann L CNA OVERTIME WEEKEND 0.83 42,00 34.86 34.86
09/23/2006 03:OOPM - 07:OOPM Wheeler,Earlann L CNA OVERTIME WEEKEND 4.00 43.50 174.00 174.00
Unit SubTotal: 119.75 $3,313.82 $3,313.62
Facility Total: 119.75 $3,313.62 $3,313.62
Please Pav this amount: $3,313.62
IS
A 1.5% finance charge will be added to this invoice if not paid within 30 days
(FRX)l 717 241 3024
RLMR MedicalOBR
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0051031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/07/2006 7730
DEC-26-2006(TUE) 11:18
Date Shifts Caregiver
Unit Name: LTC
10103/2006 06:30AM - 03:0OPM Pyne,Cheryl A
10/0312006 06:30AM - 03:OOPM Rlckrode,Ashley L
10/04/2006' 08:30AM - 03:OOPM Pyne.Cheryl A
10/04/2006 06:30AM - 03:OOPM Rickrode,Ashley L
10/04/2006 03:OOPM - 03:15PM Pyne,Cheryl A
10/06/2005 07:30AM - 03:OOPM Pyno,Cheryl A
10/06/2006 03:OOPM - 03:45PM Pyne.Cheryl A
10106/2006 11:00PM - 07:00AM Bair,Kalhy S
10/07/2006 07:OOAM - 07:15AM Bair,Kalhy S
10/0712006 11:OOPM - 07:ODAM Bair,Kalhy S
1010812006 07:OOAM - 07:30AM Bair.Kalhy S
Title Description Mrs/Unft Rate Amount Mlles Mileage Total
LPN REGULAR WEEKDAY 8,00 36,00 $288.00 5288.00
CNA REGULAR WEEKDAY 8.50 24.00 $204.00 5204.00
LPN REGULAR WEEKDAY 8.50 36.00 5~306.00 5306.00
CNA REGULAR WEEKDAY 8.50 24,00 $204.00 $204.00
LPN REGULAR WEEKDAY 0.25 38.00 $9.50 $9.50
LPN REGULAR WEEKDAY 7.50 36.00 S270.00 $270.00
LPN REGULAR WEEKEND 0.75 44.00 $33.00 533.00
LPN REGULAR WEEKEND 8.00 46.00 5368.00 $368.00
LPN REGULAR WEEKEND 0.25 42.00 510.50 310.50
LPN REGULAR WEEKEND 8.00 46.00 $368.00 $368.00
LPN REGULAR WEEKEND 0.50 42.00 $21.00 $21.00
Unit SubTotal- 56.75 $2,08200 $2.082.00
Facility Total: 58.75 $2,082.00 $2.082.00
Please pay this amount: $ 2,08200
A 1 ROA finanrp r.hamp will hp adelpel fn 4h1le invniro if nnM void %uii-min %n Ae,so
DEC-26-2006(TUE) 11;18
ALMA MedicalDBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
(FAX)l 717 241 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0061031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/0712006 7730
Invoice # : 7730 Check # Amount Paid (S):
Please Return This Form With Your Payment. Thank You.
A 1 .5i°L. finnnrp rh=mp will ho ae1ripA fn fhie inunie-p if nnf nmid within 4n Asue
DEC-26-2006(TUE) 11:18 ALMA Medical08R (FRX)1 717 2dl 3024 P.007/031
Bill To,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Senevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 1011412006 7754
Date Shifts Caregiver
Unit Name: LTC
10/10/2006 08:30AM - 03:OOPM Rickrode.Ashley L
10/102006 03:OOPM - 08!OOPM Rickrodo,Ashley L
10/1112006 06:15AM - OTOOAM Rickrodo.Ashley L
10/112006 07:OOAM - 03:OOPM Rickrode,Ashley L
10/11/2006 03:OOPM - 10:30PM Rickrode,Ashley L
10/132006 06:30AM - 03.OOPM Johnson,Slacy J
10113/2006 06:30AM - 03:OOPM Whealor.Eaflann L.
10/1312006 D3:OOPM - 07:OOPM Wheeler,Earlann L
10/142006 06:30AM - 03:OOPM Wheeler,Earlann L.
101142006 03:OOPM - OPOOPM Whealer,Earlann L
Title Descrlptlon Hrs/Unifs Rate Amount Miles Mileage Total
CNA REGULAR WEEKDAY 8.00 24.00 $192.00 $192.00
CNA REGULAR WEEKDAY 5.00 25.00 $125.00 $125.00
CNA REGULAR WEEKDAY 0.25 26.00 S6.50 $6.50
CNA REGULAR WEEKDAY 8.00 24.00 $192.00 $192.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
CNA REGULAR WEEKDAY 8.00 24.00 $192.00 $192.00
CNA REGULAR WEEKDAY 8.00 24.00 5192.00 $192.00
CNA REGULAR WEEKEND 4.00 29.00 $116.00 $116.00
CNA REGULAR WEEKEND 8.00 28.00 $224.00 $224.00
CNA REGULAR WEEKEND 4.DO 29.00 5116.00 $116.00
Unit SubTotal' 60.75 $1.543.00 $1,543.00
Facility Total: 60.75 $1.543.00 $1,543.00
Please pay this amount. S 1,543.00
A 1 904 finnne-a rharnn urill hn mArld% l 4n *hie In.snlwa IF nw+ m,%IA %.&46:" In A-....-
DEC-26-2006(TUE) 11;18 ALMA MedicalDBA (FAH)l 717 2d1 3024 P.008/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10114/2006 7754
Invoice #, 7754 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 1 S% fin2n" rh.2mo will ho 2ririod fn thle lnvnlro If not nelri within '?n rlmoa
DEC-26-2006(TUE) 11;18
RLMR MedicalDBR
Bill To,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
(FRX)l 717 241 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0091031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/21/2006 7771
Date Shifts Caregiver
Unit Name: LTC
10113/2006 10:30PM - 11:00PM Bair,Kathy S
10113/2006 11:0013M - 06.OOAM Balr,Kathy S
10114/2006 10:30PM - 11:00PM Bair.Kathy S
1011412006 11:OOPM - 06:00AM Beir,Kathy S
1011812006 06:30AM - 02:30PM Rickrode,AShley L
1011912006 06:15AM - 07:OOAM Rickrode,Ashiey L
10/1912006 07:OOAM - 03:OOPM Rickrode,Ashley L
10/19/2006 03:OOPM - 10:30PM Rickrode,Ashley L
10/2012006 06.30AM - 03:00PM Wheeler,Fartann L
1012012006 06:30AM - 03:OOPM Rickrode.Ashley L
10120/2006 06:30AM - 03:00PM Johnscn,Stacy J
10120/2006 07:OOAM - 03:OOPM Pyne,Cheryl A
10120/2006 03:00PM - 07:OOPM Wheeler,Earlann L
10/20/2006 03:OOPM - 10:15PM RickrodeAshley L
1012012006 10:15PM - 10:30PM Rickrode,Ashley L
1012012006 11:00PM - 07:OOAM Bair,KaLhy S
1012112006 06:30AM - 03-OOPM Wheeler,Eadann L
10/2112006 03:OOPM - 07:00PM Wheeler,Eadann L
10121/2006 11:00PM - 06.45AM Myem,Jamie 1
10/21/2006 11:00PM - 07:OOAM Bair,Kathy S
1012212006 07:00AM - 07:15AM Balr,Kathy S
Title Doscription Hrs/Un'lts Rate Amount Miles Mileage Total
LPN REGULAR WEEKEND 0.50 44,00 522.00 $22.00
LPN REGULAR WEEKEND 7.00 46.00 $322.00 S322.00
LPN REGULAR WEEKEND 0.50 44.00 522.00 $22.00
LPN REGULAR WEEKEND 7.00 46.00 $322.00 $322.00
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 0.75 27.00 $20.25 $20.25
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGULAR WEEKDAY 8.50 25.00 $212.50 $212.50
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
LPN REGULAR WEEKDAY 7.50 40.00 S300.00 $300.00
CNA REGULAR WFEKEND 4.00 28.00 $112.00 5112.00
CNA REGULAR WEEKEND 7.25 28.00 $203.00 3203.00
CNA OVERTIME WEEKEND 0.25 42.00 510.50 $10.50
LPN REGULAR WEEKEND 8.00 46.00 $368,00 $368.00
CNA REGULAR WEEKEND 8.50 27.00 $229.50 $229.50
CNA REGULAR WEEKEND 4.00 26.00 $112.00 $112.00
CNA REGULAR WEEKEND 725 29.00 $210.25 $210.25
LPN REGULAR WEEKEND 8.00 46.00 $366.00 $368.00
LPN REGULAR WEEKEND 0.25 44.00 $11.00 $11.00
Unit SubTotal- 119.75 $3,865.00 $3,865.00
Facility Total- 119.75 $3,865.00 $3,865.00
Please pay this amount: S 3,86&00
A 11 SoL flnanro nharnn will ho erideoll fn thie invnie-o if nn? naid nrithin 1n rlasm
DEC-26-2006(TUE) 11:19 RLMR MedicalDBR (FRX)l 717 261 3026 P.010/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/2112006 7771
Invoice # : 7771 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 1 .r.°/. finanra rharnp will ho arlrlpri to Thk invnira if not nairl within ZA rlavc
DEC-26-2006(TUE) 11;19
ALMA MedicalDBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
(FAK)l 717 2d1 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0111031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 1012812006 7796
Date Shifts Caregiver
Unit Name: LTC
10123/2006 06:30AM - 02:30PM Johnson,Slacy J
1012412006 06:15AM - 07:OOAM Rickrode,Ashley L
1012412006 07:OOAM - 03:OOPM Rickrode,Ashley L
1024/2006 03:OOPM - 08:30PM Rlckrode,Ashley L.
1025/2006 06:30AM - 02:30PM Johnson,Stacy J
1012512005 05;30AM - 03:OOPM Rickrode,Ashley L
10/25/2006 03:00PM - 10:30PM Rickrode,Ashley L
10272006 06:30AM - 02,30PM Johnson,Slacy J
10/27/2006 06.30AM - 03:OOPM Wheeler.Earlann L
1012712006 03:OOPM - 07:00PM Wheeler,Eadenn L
1027/2006 11:OOPM - 07:OOAM Belr,Kelhy S
10282006 07:OOAM - 07.30AM Balr,Kathy S
10128/2006 02:30PM - 03:OOPM Myers,Jamie I
10/2812006 03:OOPM - 11:00PM Myers,Jamie I
1028/2006 11:OOPM - 07:OOAM Balr,Kathy S
102912006 07:OOAM - 07:30AM Bair.Kathy S
Title Description Hrs/Units Rate Amount Milos Mileage Total
CNA REGULAR WEEKDAY 7.50 25.00 $167.50 S187.50
CNA REGULAR WEEKDAY 0.75 27.00 $20.25 $20.25
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 5.50 28.00 5143.00 $143.00
CNA REGULAR WEEKDAY 7.50 25.00 5187.50 $187.50
CNA REGULAR WEEKDAY 6.50 25.00 5212.50 $212.50
CNA REGULAR WEEKDAY 7.50 26.00 S195.00 $195.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKEND 4.00 28.00 $11200 $112.00
LPN REGULAR WEEKEND 8.00 48.00 $368.00 $368.00
LPN REGULAR WEEKEND 0.50 44.00 $22.00 $22.00
CNA REGULAR WEEKEND 27.00
CNA REGULAR WEEKEND 8.00 26.00 5224.00 $224.00
LPN REGULAR WEEKEND 8.00 46.00 $368.00 $368.00
LPN REGULAR WEEKEND 0.50 44.00 $22.00 $22.00
Unit SubTotal: 89.75 $2,649.25 $2.649.25
Facility Total: 89.75 $2,649.25 $2.649.25
Please pay this amount: S Z649.25
A 1 A°L. finanrp rhamx& will ho arlelofi M fhie Inunirs If nn* ngilrl wahin 4n rlsve
DEC-26-2006(TUE) 11:19 ALMA MedicalOBA (FAX)l 717 2d1 3024 P.012I031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/28/2006 7796
Invoice #: 7796 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 1.5% finanr_p rhamP will hp added to this invnirp If not nalet within 'tn dnw*
DEC-26-2006(TUE) 11:19 ALMA MedicalDBA (FAX)l 717 2d1 3024 P.013l031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice 0
Shippensburg Health Care Center HC1 174 10/3112006 7852
Date Shifts Caregivor Title Description Hrs/Units Rate Amount Miles Mileage Total
Unit Nam e: LTC
10/27/2006 02:30PM - 10:15PM Frey,Laude J CNA 7.75 28.00 $217.00 $217.00
10/29/2006 02:30PM - 03,OOPM Myerr.,Jamie I CNA REGULAR WEEKEND 0.50 27.00 $13.50 $13.50
10/29/2006 010OPM - 10:30PM Myors.Jamle I CNA REGULAR WEEKEND 7,50 28.00 $210.00 $210.00
10/30/2006 06:30AM - 03:0OPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.50 25.00 $212.50 $212.50
10/3012006 03:OOPM - 08:00PM Rickrode,Ashley L CNA REGULAR WEEKDAY 5.00 26.00 $130,00 $130.00
1013112006 06:1 SAM - 07:OOAM Rlckrode,Ashley L CNA REGULAR WEEKDAY 0.75 27.00 520.25 $2025
10131/2006 06:30AM - OTOOPM Pyne.Choryl A LPN REGULAR WEEKDAY 8.50 40.00 $340.00 $340,00
10/31/2006 07:OOAM - 02:30PM Rickrode,Ashley L. CNA REGULAR WEEKDAY 7.50 25.00 5187,50 $187.50
Unit SubTotal: 46.00 51,330.75 $1,330.75
Facility Total' 46.00 $1,330.75 $1,330.75
Please pay this amount: $ 1,330.75
A 1 ROA fimnro r-harno will ho nrlelArl to thie invnire if not nnirl within 4n firma
DEC-26-2006(TUE) 11:19 ALMA MedicalOBA (FAH)l 717 2d1 3024 P.Oldl031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/31/2006 7852
Invoice # : 7852 Check #
Amount Paid ($):
Please Retum This Form With Your Payment_ Thank You.
A 7 FoL finanro a-harnn ..rill hn oaava to this in%inie-a w not now %aatkin %n A,&%ja
DEC-26-2006(TUE) 11;20 ALMA MediralDBH (FHX)l 717 2d1 3024 P.015/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/04/2006 7870
Date Shifts Caregiver Title Description Hs/Units Rate Amount Miles Mileage Total
Unit Nam e: LTC
11/01/2006 06:20AM - 07:OOAM Rlckrodo,Ashley L CNA REGULAR WEEKDAY 0.67 27.00 $16.09 $18.09
11/01/2006 07:OOAM - 03:OOPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
11/01/2006 02:30PM - 03:OOPM Frey,Laude J CNA REGULAR WEEKDAY 25.00
11101/2006 03:OOPM - 10:30PM Frsy,Laurle J CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
11/01/2006 03:OOPM - 10:30PM Rickrodo,Ashley L CNA REGULAR WEEKDAY 7.50 28.00 5195.00 $195.00
11/02/2006 02:30PM - 03:OOPM Frey,LaOe J CNA REGULAR WEEKDAY 25.00
11/02/2006 03:OOPM - 10!30PM Frey,Leurie J CNA REGULAR WEEKDAY 7.50 26.00 5195.00 $195.00
11/0312006 06:30AM - 02:30PM Johnson,Stacy J CNA REGULAR WEEKDAY 7.50 26.00 $187.50 $187,50
1110312006 06:OOPM - 10;30PM Fullon,Amy M CNA REGULAR WEEKEND 4.60 28.00 $126.00 $126.00
11/0412006 06:30AM - 03:OOPM Wheeler,Eartann L CNA REGULAR WEEKEND 8.00 27.00 $216.00 $216.00
11/04/2006 03!OOPM - 07:001310 Wheeler,Earlann L CNA REGULAR WEEKEND 4.00 28.00 $112.00 $112.00
Unit SubTotal: 55,17 $1.444.59 S1,44a.59
Facility Total: 55.17 $1.444.59 $1,444.59
Please pay this amount. $ 1,444.59
A 4 C% f:nonna r-harna mill he erlAmA M this Insinlna If nn# Hair/
DEC-26-2006(TUE) 11:20 ALMA MedicalOBA (FAX)l 717 241 3024 P.016/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/04/2006 7874
Invoice # : 7870 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($)-
A 1 404 finone-a rharna will ho arlAari M Mh;* lnun?r•a if nnf nairl within in love
DEC-26-2006(TUE) 11:20 ALMR MedicalOBA (FAX)l 717 241 3024 P.017/031
Bill To.,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/11/2006 7891
Date Shifts Caregiver
Unit Name: LTC
1110312006 06:30AM - 04:30PM McCartney,Nicole R
1110512006 06:30AM - 02:30PM Rlckrode,Ashley L
11106/2006 06:30AM - 02.30PM Johnson,Stacy J
11/07/2006 06:30AM - 02:30PM Rickrode,Ashley L
11107/2006 02!30PM - 03,OOPM Slyder,Evs M
1110712006 03:OOPM - 10:30PM Slyder,Eva M
1110812006 06:30AM - 02:30PM Johnson.Stacy J
11/09/2006 06:25AM - 07:00AM Rickrode,Ashley L
11/09/2006 07:OOAM - 03:OOPM Rlckrode,Ashley L
11/0912006 03:OOPM - 08:OOPM Rlckrode,Ashloy L
1111012006 06:30AM - 03:OOPM Rickrode,Ashley L
1111012006 03:OOPM - 05,25PM Rickrode,Ashley L
11/10/2006 05:25PM - 10:30PM Rlckrode,Ashley L
11111/2006 06:30AM - 03:OOPM Wheeler.Earlann L
11/1112006 06:30AM - 02:30PM Fullon,Amy M
Titla Description Has/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKDAY 10.00 25.00 S250.00 $250.00
CNA REGULAR WEEKEND 8.00 27.00 5216.00 $216.00
CNA REGULAR WEEKDAY ?.SO 25.00 $187.50 $187.50
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WkFKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 5187.50
CNA REGULAR WEEKDAY 0.58 27.00 515.66 $15,66
CNA REGULAR WEEKDAY 6.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 5.00 26.00 $130.00 $130.00
CNA REGULAR WEEKDAY 8.50 25.00 $212,50 S212.50
CNA REGULAR WEEKEND 2.42 28.00 567.76 $67.76
CNA OVERTIME WCEKEND 5.08 42.00 $213.36 $213.36
CNA REGULAR WEEKEND 8.00 27.00 $216.00 5216.00
CNA REGULAR WEEKEND 7.50 27.00 $202.50 5202.50
Unit SubTotal• 93.08 $2,481.28 $2,481.26
Facility Total: 93.08 S2,481.28 52,481.28
Please pay this amount: $ 2,481.28
A I COL 41nenna whoarna ue:ll hn -addnrl fn Fhis Cnv?Ci-n if ww& wnia ao;616iw 9n A-
DEC-26-2006(TUE) 11:20 ALMA MedicalDBR (FAX)l 717 2dl 3024 P.0181031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11111/2005 7891
Invoice #: 7891 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 9 COL flonsnwa Awarns will I+a eAAftA M *M& iminiwe i; ~0 ne9d miN6in 2n desoe
DEC-26-2006(TUE) 11:20 ALMA MedicalDBA (FAX)l 717 2111 3024 P.019/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/18/2006 7966
Date Shifts Caregiver
Unit Name: LTC
11/09/2006 03:00PM - 10:30PM Frey,Laurie J
11/10/2006 010OPM- 10!30PM Froy.LaurlaJ
11/12/2006 02:30PM - 03:00PM Myers,Jamie 1
11/12/2006 03:OOPM - 10;30PM Myers,Jamie 1
1111312006 06:30AM - 02:00PM Johnson,$lacy J
11/1312006 06:30AM - 03:00PM Rlckrodo.Ashley L
1111312006 03:00PM - 10:30PM Rickrode,Ashley L
11/1412006 06:30AM - 02:30PM Rickrode,Ashley L
11/15/2006 06:30AM - 03!OOPM Rlckrodo,Ashley L
11115/2006 02:30PM - 03:OOPM Frey,Laurie J
1111512006 03:00PM - 10:30PM Frey,Laude J
11/15/2006 03:00PM - 08:00PM Rickrode,Ashley L
11/16/2006 02:30PM - 03:OOPM Froy,Laurle J
11/16/2006 03:OOPM - 10-30PM Frey,Laurie J
1111712006 06:30AM - 09:OOAM Rickrode,Ashley L
1111712006 09:00AM - 09:45AM Rlckrode,Ashley L
11/17/2006 02:30PM - 03:OOPM Fray,Laurio J
11/1712006 03:OOPM - 11:OOPM Frey.taude J
11/1712006 10:30PM - 11;OOPM Sair,Kathy S
11117/2006 11:OOPM - 07:OOAM Balr,Kathy S
11/18/2006 02:30PM - 03:00PM Myers.Jamle 1
11/182006 03:00PM - 10:00PM Myers,Jamie I
Title Description Hrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WCCKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKEND 7.50 28.00 $210.00 $210.00
CNA REGULAR WEEKEND 0.50 27.00 S13.50 $13.50
CNA REGULAR WEEKEND 7.50 28.00 S210.00 $210.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $167,50
CNA REGULAR WEEKDAY 8.50 25.00 $212.50 $212.50
CNA REGULAR WEEKDAY 7.50 26.00 S195.00 $195.00
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA RCGULAR WCCKDAY 5.00 26.00 $130.00 $130.00
CNA REGULAR WEEKDAY 25.00
CNA REGULARWEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 2.50 25.00 $62.50 $62.50
CNA OVERTIME WEEKDAY 0.75 37.50 $28.13 $2813
CNA REGULARWEEKEND 27.00
CNA REGULAR WEEKEND 8.00 28.00 $224.00 S224.00
LPN REGULAR WEEKEND 0.50 48.00 $24.00 $24.00
LPN REGULAR WEEKEND 8.00 46.00 $368-00 $368.00
CNA REGULAR WEEKEND 0.50 27.00 513.50 $13.50
CNA REGULAR WEEKEND 7,00 28.00 $196.00 $196.00
Unit SubTotal: 110.25 $3,072.13 $3,072.13
Facility Total- 110.25 $3,072.13 $3,072.13
Please pay this amount. $ 3,07213
A 4 !w 61-- -- wr..........111 1.- -ddwd ?w 65.1- ir..,wlww 19 rw6 --IA .s,I?61w 99% A--
DEC-26-2006(TUE) 11:21 ALMA MedicalDBA (FAX)l 717 241 3024 P.0201031
A 4 Gw- F:..-.....I. ??...M.. ??f7?? I- 1A.A-A 6.. &Wl- ?..II..i.... tt ..A6 ...IA 1..165.1- -n .1•....
DEC-26-2006(TUE) 11:21 ALMA MedicalDBR (FAX)) 717 2d1 3024 P.021/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #.
Shippensburg Health Care Center HC1 174 11/18/2006 7966
Invoice # : 7966 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 1.5% finance charge will bp added to this invnira if nnf naiel within An elava
DEC-26-2006(TUE) 11:21
RLMR MedicalOBR
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
(FHX)1 717 2d1 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0221031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/2512006 7967
Data Shifts Caregiver
Unit Name: LTC
11119/2006 06:30AM - 02:30PM Rlckrodo,Ashloy L
11120/2006 06:30AM - 03:OOPM Rickrode,Ashley L
1112112006 06:30AM - 03:OOPM Rickrode,Ashley L
11/2112006 07:OOAM - 02:30PM Wheeler,Eailann L
11/21/2006 02:30PM - 03:OOPM Smith,Tlna A
11/21/2006 03:OOPM - 11:00PM Smith.Tina A
11121/2006 03:00PM - 06:30PM Rickrode,Ashley L
11/21/2006 06:OOPM - 10:30PM Fukon,Amy M
11/22/2006 03:00PM - 10:30PM Fulton,Amy M
11123/2006 03:OOPM - 08:OOPM Smilh,Tina A
1112312006 11:OOPM - 07:00AM Sair,Kethy S
11/2312006 06:30AM - 03:OOPM SmILh,Tlna A
11/2412006 03:00PM - 11:00PM Smlth.Tina A
11/2412006 06:OOPM - 10:30PM Fullon,Amy M
11124/2006 10:30PM - 11:OOPM Balr,Kaihy S
11/24/2006 1100PM - 07:OOAM Balr.Kathy S
11/2412006 11:00PM - 01:30AM Sm11h.T1n3 A
1112512006 07:OOAM - 02:30PM Wheeler,Earlann L
11/2512008 11:OOPM - 07:OOAM Bair,Kathy S
Title Description Hrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKEND 8.00 27.00 $216.00 $216.00
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGUI.AR WEEKDAY 8.50 25.00 $212.50 $212.50
CNA REGULAR WEEKDAY 7.50 25.00 $197.50 $187.50
LPN REGULAR WEEKDAY 0.50 40.00 $20.00 $20.00
LPN REGULAR WEEKDAY 8.00 42.00 $336.00 5336.00
CNA REGULAR WEEKDAY 3.50 26.00 $91.00 $91.00
CNA REGULAR WEEKDAY 4.50 26.00 $117.00 $117.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
LPN WEEKDAY HOLIDAY 5.00 63.00 $315.00 $315.00
LPN WEEKDAY HOLIDAY 8.00 66.00 $628,00 $528.00
LPN WEEKDAY HOLIDAY 6.50 60.00 $510.00 $510.00
LPN REGULAR WEEKEND 8.00 48.00 $384.00 $364.00
CNA REGULAR WEEKEND 4.50 26.00 $126.00 $126.00
LPN REGULAR WEEKEND 0.50 48.00 $24.00 524.00
LPN REGULAR WEEKEND 8.00 46.00 $368.00 $368.00
LPN REGULAR WEEKEND 2.50 46.00 3115.00 $115.00
CNA REGULAR WEEKEND 7.50 27.00 5202.50 $202.50
LPN REGULAR WEEKEND 6.00 46.00 $368-00 $368.00
Unit SubTotal: 117.00 $4,526.00 54.529.00
Facility Total: 117.00 54,528.00 $4,528.00
Please pay this amounC $ 4,528.00
A 4 e0/ s:..-.,... -6-......,,:11 6- -..1.1wd sw 46- :...,....... w --* --.*A PA-.-
DEC-26-2006(TUE) 11:21 RLMR MedicalOBR (FRO 717 2d1 3024 P.023/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/25/2006 7987
Invoice # : 7987 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 1.5% finance charoe will be added to this invnien if not nald within in riavc
DEC-26-2006(TUE) 11:21
9 6
ALMA MedicalDBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
(FAH)l 717 2d1 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 024/031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/30/2006 8057
Date Shifts Carogiver Title Description Ftrs/Units Rate Amount Miles Mileage Total
Unit Name: LTC
11126/2006 02:30PM - 03:OOPM Smilh,Tina A LPN REGULAR WEEKEND 44.00
11/26/2006 02!30PM - 03:OOPM Myers,Jamie I CNA REGULAR WEEKEND 27.00
1112612006 OTOOPM - 11:00PM Smlth,Tlna A LPN REGULAR WEEKEND 8.00 48,00 S384.00 $384.00
11126/2006 03:OOPM - 10:30PM Myers,Jamie I GNA REGULAR WEEKEND 7.50 28.00 5210.00 $210.00
1112612006 11:OOPM - 11:15PM Smilh,Tina A LPN REGULAR WEEKEND 0.25 46.00 $11.50 511.50
1112712006 02!30PM - 03:OOPM Smilh,Tina A LPN REGULAR WEEKDAY 0.50 40.00 S20.00 $20.00
11/2712006 03:OOPM - 11:OOPM Smlth.Tlna A LPN RCGUiAR WEEKDAY 6.00 42.00 S336.00 $336.00
1112712006 11:OOPM - 11:30PM Smilh,Tina A LPN REGULAR WEEKDAY 0.50 44.00 $22.00 $22,00
11/2812006 06!30AM - 02:30PM Wheeler,Earlenn L CNA REGULAR WEEKDAY 7.50 25.00 5187.50 $187.50
11/2812006 02:30PM - 03!OOPM Smllh,Tina A LPN REGULAR WEEKDAY 40.00
1112812006 03:00PM - 11:OOPM Smlth,Tlna A LPN REGULAR WEEKDAY 8,00 42.00 $336.00 $336.00
11/28/2006 11:OOPM - 11:30PM Smilh,Tina A LPN REGULAR WEEKDAY 0.50 44.00 $22.00 522,00
11/29/2006 02:30PM - 03!OOPM Fulion,Amy M CNA REGULAR WEEKDAY 25.00
11/29/2006 03:OOPM - 10:30PM Fulton,Amy M CNA aEGULAR WEEKDAY 7.50 26.00 S19S.00 $195.00
1112912006 10:30PM - 11:OOPM Bair.Kalhy S LPN REGULAR WEEKDAY 0.50 42.00 $21.00 521.00
11/29/2006 11:OOPM - 07:OOAM Bair,Kathy S LPN REGULAR WEEKDAY 8.00 44.00 $352.00 $352.00
11/30/2006 06,30AM - 02:30PM Wheeler,Earlann L CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
1113012006 02:30PM - 03:OOPM SmI1h,Tina A LPN REGULAR WEEKDAY 40.00
11/3012006 03:OOPM - 11:OOPM Smith.Tina A LPN REGULAR WEEKDAY 8.00 42.00 $336.00 $336.00
11130/2006 OWOOPM - 10:30PM Fullon,Amy M CNA REGULAR WEEKDAY 4.50 26.00 $117.00 $117.00
Unit SubTotal: 76.75 $2,737.50 $2,737.50
Facility Total: 76.75 $2,737.50 $2,737.50
Please pay this amount S Z737.50
A 1 404 finant-n t-harnn u,;11 do OAAO l F n +k1a invnii-a if nn4 nA;A w1+h1n In A-Selo
DEC-26-2006(TUE) 11;21 ALMA MedicalDBA (FAX)l 717 2d1 3024 P.025/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account $ Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/30/2006 8057
Invoice # . 8057 Check # Amount Paid ($):
Please Return This Form With Your Payment Thank You.
A 4 COI fIM4N/.A wh.srnea ...ill 1%^ ? 01A ftd 6n 4140 9..... ---- .0 --I...- A ...7F1.i.. 4A d...,..
DEC-26-2006(TUE) 11:22 ALMA MedicalDBR (FRX)l 717 2d1 3024 P.026I031
Bill To:
Shippensburg Health Can; Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/02/2006 8075
Date Shifts Caregiver
Unit Name: LTC
12/01/2006 02:30PM - 010OPM Fulton,Amy M
12101/2006 03;OOPM - 10:30PM FultonAmy M
12/02/2008 06:30AM - 03:OOPM Wheeler.Eadann L
12102/2006 06:30AM - 02:30PM Jchnson,Stacy J
1210212006 03,OOPM - 07,OOPM Wheeler,Eerlenn L
Title Description Hrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKEND 0.50 27.00 $13.50 $13.50
CNA REGULAR WEEKEND 7.50 28.00 $210.00 S210.00
CNA REGULARWEEKEND 8.00 27.00 $216.00 $216.00
CNA REGULAR WEEKEND 7.50 27.00 $202.50 5202.50
CNA REGULAR WEEKEND 4.00 28.00 $112.00 $112.00
Unit SubTotal: 27.50 $754.00 $754.00
Facility Total: 27.50 5754.00 $754.00
Please pay this amount: $ 754.00
A , CG/- fin-an..e whowmn %.411 ke .aAAd A 4n th1a- :.......?.. ii ....& --.A ...:?L.1.. 9fl d+..?
DEC-26-2006(TUE) 11;22
ALMA MedicalDBP
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
(FAX)] 717 241 3024
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0271031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12102/2006 8075
Invoice 9: 8075 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
0 1 J;°/. finanra rhamv will ha arirlerl fn Ehie Inunirw If nnf nairl uu?thin Qn rlnvc
DEC-26-2006(TUE) 11:22 RLMR MedicalDBR (FRX)l 717 241 3024 P.028/031
z
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Senevit
Services Provided For:
Shippersburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account* Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12109/2006 8118
Date Shifts Careglver Title Description HrslUnits Rato Amount Miles Mileage Total
Unit Name: LTC
12/01/2006 06:30AM - 03:OOPM Barclay,Jennlfer I CNA REGULAR WEEKDAY 8.50 25.00 S212.50 $212.50
12101/2006 03:OOPM - 08:30PM Barclay.Jennifer I CNA REGULAR WEEKEND 3.50 28.00 $98.00 $98,00
12/0312006 02,45PM - 03:00PM Smith,Tina A LPN REGULAR WF.rKEND 0.25 44,00 511.00 $11.00
12/03/2008 03;OOPM - 10:30PM Smlth,Tina A LPN REGULAR WEEKEND 7,50 48.00 $360.00 5360.00
12/06/2006 02:30PM - 03:OOPM Fulton,Amy M CNA REGULAR WEEKDAY 25.00
12/06/2006 03:OOPM - 10:30PM Fulton.Amy M CNA RCGULAR WEEKDAY 7.50 26.00 5195.00 $195.00
17/07/2006 06:30AM - 02!30PM Wheeler,Earlsnn L CNA REGULAR WEEKDAY 7.50 25.00 $187.50 8187.50
12/08/2006 06:30AM - 02:30PM Jchnson,Stacy J CNA REGULAR WEEKDAY 7.50 25.00 5187.50 5187.50
12/09/2006 06:30AM - 03;OOPM Wheeler.Earlann L CNA REGULAR WEEKEND 8.00 '27.00 $216.00 $216.00
12/09/2006 03:DOPM - 07:OOPM Wheeler,Eadann L CNA REGULAR WEEKEND 4.00 28.00 5112.00 $112.00
12109/2006 10:30PM - 11:OOPM Beir,Kalhy S LPN REGULAR WEEKEND 0.50 48.00 524.100 $24.00
12/0912006 11:OOPM - 06:45AM Balr,Kathy S LPN REGULAR WEEKEND 7.75 46.00 S356.50 $356.50
Unit SubTotal: 62.50 $1,960.00 $1,980.00
Facility Total: 62.50 $1,960.00 51,960.00
Please pay this amount: S 1,960.00
A 1.5% finance charoe will be added to thin invnir-P if not nairl within 3n rlavc
DEC-26-2006(TUE) 11;22 ALMA MedicaID13A (FAX)l 77 2d1 3024 P.029/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/09/2006 8118
Invoice # : 8118 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 1.5911. flnanr_p r_harna will hp aririad to thine invnir_a if not nail within in riave
DEC-26-2006(TUE) 11:22 ALMA MedicalOBA (FAX)l 717 241 3024 P.030/031
r ,
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn_ Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/16/2006 8138
Date Shifts Caregiver
Unit Name: LTC
12/12/2006 0710AM - 02:30PM Wheeler,Earlann L
12/13/2006 06:30AM - 03;OOPM Johnson,Stacy J
1211312006 02:30PM - 03:00PM Frey,Laurie J
12/13/2006 03;OOPM - 10:30PM Frey,Laude J
12114/2006 06:30AM - 02:00PM Wheeler,Earlann L
12/15/2006 06:30AM - 02:30PM Johnson.Stacy J
12/1512006 10:30PM - 11:00PM Bair,Kathy S
12/15/2006 11:OOPM - 06:30AM Bair,01hy S
Title Description Hrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKDAY 6.50 25.00 5162.50 S162.50
CNA REGULAR WEEKDAY 6.00 25.00 5200.00 5200.00
CNA REGULAR WEEKDAY 25.00
CNA REGUI.AR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 7.00 25.00 $175.00 5175.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
LPN REGULAR WEEKEND 0.50 48.00 524.00 524.00
LPN REGULAR WEEKEND 7-50 46.00 $345.00 5345.00
Unit SubTotal: 44-50 $1,289.00 $1,289.00
Facility Total; 44.50 $1,289.00 $1,289.00
Please pay this amount: S 1,289.00
A 1.6% finance charge will be added to this Invoice if not paid within 30 davr.
DEC-26-2006(TUE) 11;22 ALMA MedicalDBA (FAX)l 717 2d1 3024 P.031/031
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/1612006 8138
Invoice #: 8138 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 1.5% finance charge will be added to this invalce It not paid within in rinwot
DEC-26-2006(TUE) 11:17 ALMA MedicalOBA
µ. ;
(FAX)l 717 2d1 3026 P.001/031
Interest due in
addition to
Total Invoice Date Pald unpaid balance
06/3012006
174 Shippensburg Health Care 1 7270 848.00 9.26 30.75
Total For: 6/3012006 S848.00
07108/2006
174 Shippensburg Health Care 1 7303 396.00 9.28 15.04
Total For: 7/8/2006 $396.00
0711512006
174 Shippensburg Health Care 1 7325 217.50 9.26 6.49
Total For: 7/1512006 S217.50
07/22/2006
174 Shippensburg Health Care 1 7348 413.23 9.26 11.1
Total For: 712212006 $413.23
0712912006
174 Shippensburg Health Care 1 7400 1,085.00 9.26 25.01
Total For: 7/2912006 $1,085.00
07/3112006
174 Shippensburg Health Care 1 7421 473.00 9.26 10.9
Total For: 7/3112006 $473,00
08/0512006
174 Shippensburg Health Care 7438 2,104.00 11.1 76.3
Total For: 8/5/2006 S2.104.00
08/12/2006
174 Shippensburg Health Care 1 7481 2,672.50 11.1 88.92
Total For: 8!1212006 $2,672.50
08/1912006
174 Shippensburg Health Caro 1 7508 2,666.60 11.1 80.75
Total For: 8/1912006 $2,666.60
08/26/2006
174 Shippensburg Health Caro 1 7547 2,456.50 11.1 67.04
Total For: 812612006 62,456.50
08/3112006
174 Shippensburg Health Care 7566 756.50 11.1 19.53
Total For., 813112006 $756.50
09/0212006
174 Shippensburg Health Care t 7579 1.351.00 11.28 48.99
Total For: 912!2006 $1.351.00
09/0912006
174 Shippensburg Health Care 1 7594 4,938.50 11,26 164.31
Total For: 91912006 54,938.50
0911612006
174 Shippensburg Hoaith Care 1 7636 3,000.00 11.28 90.85
Total For: 9116/2006 53,000.00
09/23/2006
174 Shippensburg Health Care 1 7663 3,313.62 128.69
Total For: 9123/2006 53,313.62
09/30/2006
174 Shippensburg Health Care 1 7705 2,279.25 11.28 57.34
Total For. 9/30/2006 S2,279.25
10107/2006
174 Shippansburg Health Care 1 7730 2,082.00 70.16
Total For: 1017/2006 52,082.00
10/14/2006
174 Shippensburg Health Care 1 7754 1,543.00 46.07
Total For. 1011412006 S1,543.00
1002112006
174 Shippensburg Health Care 1 7771 3,865.00 103.83
Total For: 10121/2006
A AI.,n.nnnn $3,865.00
Paid Unpaid Invoice Balance
848.00
5846.00 $0.00
396.00 0.00
$396.00 50.00
217.50 0.00
$217.50 50.00
413.23 0.00
$413.23 S0:00
11085.00 0.00
$1,086.00 S0.00
473.00 0.00
S473.00 S0.00
2.104.00 0.00
52,104.00 50.00
2,672.50 0100
$2.672.50 S0.00
2.666.60 0.00
52,666.60 S0.00
2,456.50 0.00
S2,466.50 50.00
756.50 0.00
$756.60 S0.00
1,351.00 0.00
$1,351.00 $0.00
4,938.50 0.00
S4,938.50 S0.00
3,000.00 0.00
S3,000.00 S0.00
3,313.62
$3,313.62
2,279.25 0.00
$2,279.25 $0.00
2,082.00
$2,082.00
1,543.00
$1,543.00
3,865.00
53,865.00
DEC-26-2006(TUE) 11:17 RLMA MedicalOBR
' 90 . Total For: 1 012 812 0 0 6 $2,649.25
1013112006
174 Shippensburg Health Care 1 7852 1,330.75
Total For. 1013112006 $1,330.75
1110412006
174 Shippensburg Health Care 1 7870 1,444.59
Total For: 11/412006 $1,444.59
1111112006
174 Shippensburg Health Care 1 7891 2,481.28
Total For: 11111/2006 $2,481.28
1111812006
174 Shippensburg Health Care 1 7966 3,072.13
Total For., 11118/2006 $3,072.13
1112512006
174 Shippensburg Health Care 1 7987 4,528.00
Total For: 1112512006 S4,528.00
11/3012006
174 Shippensburg Health Care 1 8057 2,737.50
Total For: 1113012006 52,737.50
12/02/2006
174 Shippensburg Health Care 1 8075 754.00
Total For., 1212/20D6 S754.00
12/0912006
174 Shippensburg Health Caret 8118 1,960.00
Total For, 121912006 S1,960.00
1211612006
174 Shippensburg Health Caro 1 8138 1,289.00
Total For, 1211612006 51,289.00
Total For: Weekly 558,707.70
(FRO 717 2dI 3024 P.0021031
S2,649.25
31.23 1,330.75
$1,330.75
30.96 1,444.59
$1,444.59
46.72 2,481.28
52,481.28
47.47 3,072.13
S3,072.13
56.6 4,528.00
54,529.00
2,737.50
S2,737.50
754.00
$754.00
1,960.00
$1,960.00
1,289.00
S1,289.00
$33,050.12
$58.707.70 2843.4 $33,050.12
H ! % k
VERIFICATION
The foregoing document is based upon information which has been gathered by counsel
and myself in the preparation of this action. I have read the statements made in this document
and they are true and correct to the best of my knowledge, information and belief. I understand
that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904,
relating to unworn falsification to authorities.
STA K. KREBS
On behalf of ALMA HEALTH LLC
d/b/a MEDSTAFFERS
Date: December 26, 2006
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O' EN, BARIZ&SCIH
David A. Baric, Esquire
I.D. 44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
I I
ALMA HEALTH, LLC d/b/a
MEDSTAFFERS, a
Pennsylvania Corporation,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE
CENTER, INC. and
MAGNOLIA MANAGEMENT
COMPANY,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2006-7269 CIVIL TERM
CIVIL ACTION-LAW
PRAECIPE FOR ENTRY OF APPEARANCE
TO THE PROTHONOTARY:
Please enter my appearance on behalf of the Defendants, Shippensburg Health Care
Center, Inc. and Magnolia Management in the above matter.
Respectfully submitted,
dab.dir/shcc/almahealth/entryofappearance.pra
lqlk?
CERTIFICATE OF SERVICE
I hereby certify that on January 17, 2007, 1, David A. Baric, Esquire of O'Brien, Baric &
Scherer, did serve a copy of the Praecipe For Entry of Appearance, by first class U. S. mail, postage
prepaid, to the party listed below, as follows:
Marcus A. McKnight, III, Esquire
Irwin & McKnight
60 West Pomfret Street
Carlisle, Pennsylvania 17013
V <,?/l
David A. Baric, Esquire
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ALMA HEALTH, LLC d/b/a
MEDSTAFFERS, a
Pennsylvania Corporation,
Plaintiff
V.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2006-7269 CIVIL TERM
SHIPPENSBURG HEALTH CARE
CENTER, INC. and
MAGNOLIA MANAGEMENT
COMPANY,
Defendant
CIVIL ACTION-LAW
PRELIMINARY OBJECTIONS OF DEFENDANTS
NOW, come Defendants, Shippensburg Health Care Center, Inc. and Magnolia
Management Company, by and through their attorneys, O'BRIEN, BARIC & SCHERER, and
file the within Preliminary Objections and, in support thereof, set forth the following:
1. Failure to Conform to Law or Rule of Court
1. When any claim of defense is based upon a writing the document is to be attached
to the pleading. Pa.R.C.P. 1019(I).
2. Plaintiff has failed to attach any writing to its complaint which references, reflects
or relates to any contract between Plaintiff and Magnolia Management Company.
3. The Facility Staffing Agreement appended as an exhibit to Plaintiff's complaint
references an "Exhibit A" which purportedly sets forth the rates for services to be rendered. No
such "Exhibit A" has been attached to the complaint.
4. When any claim or defense is based upon an agreement, the pleadings shall state
specifically whether the agreement is oral or written. Pa.R.C.P. 1019(h). Plaintiff has failed to
state whether its contract with Magnolia Management Company is oral or written.
5. Pa.R.C.P. 1019(a) requires all material facts upon which a cause of action is based
to be stated in a concise and summary form. Plaintiff's complaint fails to identify any contract
between Plaintiff and Magnolia Management Company.
WHEREFORE, Defendants request that said objections be sustained and Plaintiff's
complaint be dismissed with prejudice.
II. Insufficient Specificity
6. When any claim or defense is based upon a writing the document is to be attached
to the pleading. Pa..R.C.P. 1019(I).
7. Plaintiff has failed to attach any writing to its complaint which references, reflects
or relates to any contract between Plaintiff and Magnolia Management Company.
8. The Facility Staffing Agreement appended as an exhibit to Plaintiff's complaint
references an "Exhibit A" which purportedly sets forth the rates for services to be rendered. No
such "Exhibit A" has been attached to the complaint.
9. Pa.R.C.P. 1019(a) requires all material facts upon which a cause of action is based
to be stated in a concise and summary form. Plaintiff's complaint fails to identify any contract
between Plaintiff and Magnolia Management Company.
WHEREFORE, Defendants request that said objections be sustained and Plaintiff s
complaint be dismissed with prejudice.
III. Legal Insufficiency (Demurrer)
10. No exhibits or averments in the Complaint of Plaintiff establish any basis for a
claim of breach of contract by Magnolia Management Company.
11. The lack of "Exhibit A" to the Facility Staffing Agreement is a fatal defect in the
claim of Plaintiff as there exists no averments establishing a contractual right to payment as
demanded by Plaintiff.
WHEREFORE, Defendants request that said objections be sustained and Plaintiff's
complaint be dismissed with prejudice.
Respectfully submitted,
RIEN, BARIC & SCH R
r
David A. Baric, Esquire
I.D. 44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
Attorney for Defendants
da b. dir/shcc/almahealth/preliminary. obi
CERTIFICATE OF SERVICE
I hereby certify that on January 17, 2007, 1, David A. Baric, Esquire of O'Brien, Baric &
Scherer, did serve a copy of the Preliminary Objections Of Defendants, by first class U.S. mail,
postage prepaid, to the party listed below, as follows:
Marcus A. McKnight, III, Esquire
Irwin & McKnight
60 West Pomfret Street
Carlisle, Pennsylvania 17013
David A. Baric, Esquire
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ALMA HEALTH LLC d/b/a, IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, OF CUMBERLAND COUNTY
Plaintiff
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - 7269 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY,
Defendants
NOTICE TO DEFEND
You have been sued in court. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this complaint, order 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 money claimed in the complaint or for any other claim or relief
requested by the plaintiff. You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER, OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 South Bedford Street
Carlisle, Pennsylvania 17013
(717) 249-3166
1-800-990-9108
AMERICANS WITH DISABILITIES
Act of 1990
The Court of Common Pleas of Cumberland County is required by law to comply with
the Americans with Disabilities Act of 1990. For information about accessible facilities and
reasonable accommodations available to disabled individuals having business before the court,
please contact our office. All arrangements must be made at least 72 hours prior to any hearing
or business before the court. You must attend the scheduled conference or hearing.
2
ALMA HEALTH LLC d/b/a, : IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, . OF CUMBERLAND COUNTY
Plaintiff
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - 7269 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
AMENDED COMPLAINT
AND NOW comes the Plaintiff, ALMA HEALTH LLC d/b/a MEDSTAFFERS, a
Pennsylvania Corporation, by and through their attorneys, Irwin & McKnight, and makes the
following Amended Complaint against the Defendants, SHIPPENSBURG HEALTH CARE
CENTER, INC. and MAGNOLIA MANAGEMENT COMPANY, as follows:
1.
The Plaintiff is Alma Health Care LLC d/b/a Medstaffers, a Pennsylvania Corporation
with an address of 17 East High Street, Carlisle, Cumberland County, Pennsylvania 17013.
2.
The Defendant is Shippensburg Health Care Center, Inc with an address 121 Walnut
Bottom Road, Shippensburg, Cumberland County, Pennsylvania 17057.
3.
The Defendant is Magnolia Management Company, with an address of 1710 Underpass
Way #201, Hagerstown, Maryland 21740.
4.
The parties entered a contract for services with Shippensburg Health Care Center, Inc.
dated April 4, 2006, a copy of the Facility Staffing Agreement with billing rates are attached
hereto and marked as Exhibit "A".
3
5.
Shippensburg Health Care Center, Inc. is a subsidiary of Defendant Magnolia
Management Company which is bound by the contract of its subsidiary with the Plaintiff, Alma
Health, LLC d/b/a Medstaffers.
6.
To date, the Defendants have incurred unpaid services with the Plaintiff in the amount of
Thirty Three Thousand Fifty and 12/100 ($33,050.12) Dollars. Copies of invoices are attached
hereto and marked as Exhibit "B".
7.
The Plaintiff has made numerous demands for payment to which no payments have been
made.
8.
In addition to the amount owed for staffing services, the Defendants owe interest on the
unpaid invoices or invoices which have been paid late as well as reasonable legal fees. A copy of
interest owed is attached hereto and marked as Exhibit "C".
WHEREFORE, the Plaintiff demands judgment against the Defendants in the amount of
$33,050.12 including reasonable legal fees, costs and interest as permitted by law.
Respectfully
By:
Supreme (court I.D. #: 2547
60 West Naffret Street
Carlisle, PA 1
Date: January 19, 2007 (717) 249-2353
4
I ' {
EXHIBIT "A"
t
FACILITY STAFFING AGREEMENT
THIS AGREEMENT, made and entered into this '-4; "-dav of Pat 2 0,06- by and
between ALMA HEALTH LLC D(B/A;'N1EDSTAFFERS., a Pennsylvania corporation (hereinafter referred to as
MEDSTAFFERS") and l i_ ' ` 1 t - - its
i.
successors or assigns ( hereinafter refc--ed -c as -F3 C !LIT Y
WHEREAS, the FACILITY requires nursi 7g personnel (i, ereiilafter referred to ;a '•FERSGN?DEL ';
to work various shifts in and for said FACILITY; and
WHEREAS, FACILITY desires that MEDSTAFFERS provide the required nursing personnel; and
WHEREAS, MEDSTAF_FERS desires to supply to FACILITY with the required nursing personnel.
subject to the availability of such Personnel by NIEDSTAFFERS: and
WHEREAS, NIEDST-JFERS has or :-C:-Ult all n cos ar, PCrsoni-lei ail ? flirt 70 ;iieet rile
nursing personnel needs of the FACILITY. and
Now. THEREFORE. the parties agree as 'b lcows.
1. APPLICABLE DEFINITIONS
PERSONNEL - shall be defined as Registered Nurses (RN ). Licensed Practical Nurses
(LPN). and Certified Nursing Assistance (CNA) acting within the scope of their respective
license or certification performing tasks assigned by the FACILITY.
FIRM AVAILABILITY - shall be defined as the specific personnel needs which
FACILITY seeks to have MEDSTAFFERS provide. Said FIRM AVAILABILITY shall be
determined by a projected patient census and staffing requirements as determined by the
FACILITY.
GUARANTEED TIME - shall be defined as a request for PERSONNEL :,1:ich cannot be
canceled for any reason and for which the FACILITY is subject to full billing. The
FACILITY shall designate which shifts are GUARANTEED TIME.
EARLY REQUESTS - shall be defined as requests for PERSONNEL received four (4) to
six (6) weeks before the scheduling need.
EMERGENCY REQUEST - shall be defined as requests for PERSONNEL received less
than twenty (24) hours before the scheduling need.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 1 of 12
SUPPLEMENTAL STAFF - shall be defined as the service provided by MEDSTAFFERS
when MEDSTAFFERS PERSONNEL supplements the existing staffing needs of the
FACILITY.
FLOATING - shall be defined as the rcmo%al or transfer of MEDSTAFFERS PERSONNEL
to an assignment other than the o: zinal 's?z -?nmeni.
2. PROCEDURE TO REQUEST SERVICES
a, FACILITY shall notify MEDSTAFFERS, in writing, telephone or Lia fax, of their
PERSONNEL needs. Any such requests shall be deemed a FIRM AVAILABILITY request,
b. In the event MEDSTAFFERS cannot fttifill a PERSONNEL request. provided said request has
been placed at least one week in advance of the schedulinc reed. NIEDST.-.PEERS shall give F ACILlTY
notice. via telephone and'or fax ,efitication. of N,-IEDST.A.FFFRS inability to tidfill *,he FACJILITY's
PERSONNEL request.
C. In the event FACILITY seeks an E;NIERGENCY REQUEST. FACILITY Shall ci aituCt
MEDSTAFFERS via telephone as soon as practicable prior to the scheduling need. Within thirty (30) minutes
of receipt of FACILITY's' ENIERGE\CY REQUEST. ':MEDSTAFFERS shall notffti the pre-designated
Scheduline Contact at the FACILITY as N1EDSTAFF ERS's ability to fulfill the FACILITY'S EMERGENCY
REQUEST.
3. MEDSTAFFERS'S GENERAL RESPONSIBILITIES
a. Upon receipt of a request by FACILITY, MEDSTAFFERS shall assign as many such
PERSONNEL as are available for such assignment.
b. IF.DST.-FFERS iOC? iillt `Tuaral,tee ai ai?+ tln]e -hat all ordel-s `.4111 b-- illlClc.
C. MEDSTAFFERS will require FIRM AVAILABILITY from FACILITY t%No (_'i to six (6)
weeks in advance.
d. Requests for PERSONNEL can be accepted up to twenty six (26) weeks in advance. The
earlier the requests are received the easier to fill the shifts needed. GUARANTEED T1110E is defined as
PERSONNEL needs that can not be canceled for any reason and are subject to full billing except for
mutual cancellations.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 2 of 12
e. EARLY REQUESTS and GUARANTEED REQUESTS will receive top priority.
f. MEDSTAFFERS shall maintain an employee file on each of its PERSONNEL containing the
following:
(1) a completed application which inciLides skills. specialties and preferences
(2) documentation of special eLucaiic,n c•r,raininq
( 3) skills check list for .ach Z:i'!) lG vi C
(4) three I_tCCiII es
(5) TB test and evidence of health status in accordance with state regulations
(6) dates hired and oriented
(7) performance evaluation
($) copy of current license- registration cr certification. as applicable ir.cludina but not liniited
to CPR and ACLS certification
(9) tNS Form I-U _--d 'jCCt le..._ ._t3blizl:ln` ident' r ." kj.1":l authCl'z'ti.--
(l0) C1JIl]peTZI1Cy %Zrltil'3I1h1) till"ough NL?1 testing fo," RN LPN s kith a se
(1 1) CNA's will have current NLN proficiency screening
(12) current ne_ative d111a screen
(13) complete background checks includili2 but rot limited to c-rietinal and the Office of
Inspector General Exclusion Check,
(14) OSHA/JCAHO/HIPPA In-service and testing yearly based on state & federal regulations
Older Adults Protective Services Act (OAPSA)
Medstaffers acknox ledges the reciuirernents of the OAPSA. xhich contaili in part tiic
requirements pertaililn` to rC? of vt C lSiillial lilJtlll'd record IiIIUI"IilallOii_ 3i i\ ? applic itil?ll ill fl-'e
performance of services under this agreement. Medstaffers certifies that prior to assigning any
personnel who have client contact with residents or who may have unsupervised access to personal
living quarters, Medstaffers will obtain a report of criminal history record information, OIG
exclusion verification, all federal and state hiring documentation and other documentation listed
above, and provide a copy of such documentation to FACILITY and/or FACILITY'S regulating
agencies upon request. Medstaffers will indemnify and hold FACILITY harmless from any and all
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 3 of 12
claims, actions, damages, liabilities, costs and expenses., including reasonable attorney's fees and
expenses. arising out of any claim or an actual finding of failing to comply with OAPSA or not
having fulfilled the other documentation requirements herein listed.
9. MEDSTAFFERS shall take all reasonable efforts to match the skills and experience levels as
provided by its PERSONNEL. as sct `'orth in e?.:cl+:?:ment applications. 'icenscs and ?c,tlf Kati tip- !0 the
specific needs of F_aCILI T Y
Jrt?i 3 icellse +Ar
ii, PE?.?(_#'y?`tiEL '.viii pc
certification which will continuously change based on the needs set forth by the FACILITY.
MEDSTAFFERS will recruit PERSONNEL on an ongoing basis and will provide qualified PERSONNEL
based on the availability at the time of the scheduled need. The placement of qualified PERSONNEL in a
FACILITY is up to the discretion of ;,1FDSTA.FFFRS and depends on the availability of PERSONNEL.
i. IMEDSTAFFFRS PERSONNEL 4hall report to its designated superv,aor at ti-,e FACILITY
before she, hebc:gns
j. MEDSTAFFERS voll be mailable to FACILITY 24 huurs a dav- se-1ea dati, a week.
k. MEDSTAFFERS shall Qive FACILITY priority service. that is. FACILITY orders will receive
priority over orders of non-contract facilities. ho~?e?er. contract requests will be ori-a first come first serve
basis.
L MEDSTAFFERS will provide FACILITY's orientation packet to Medstaffers employees, and
forward to FACILITY, prior to the first work assignment of employee, signed acknowledgment forms from
the employee that he/she has read the information, including FACILITY's code of conduct, and
understand it.
m. All PERSONNEL assigned to FACILITY pursuant t this agrzcnient sliail. for tlic p?srposes
11 of thli Asrecmtn nt. be consldcrcd C[iiplG,,'C0S C,f 1IED'STAFFERS.
D. MEDSTAFFERS is an independent contractor to the FACILITY.
o. MEDSTAFFERS is in compliance with all state and federal la,,A,-s applicable to the
employment of the PERSONNEL assigned to FACILITY.
p. MEDSTAFFERS agrees not to discriminate in the assignment of its PERSONNEL on the
basis of race, creed, color, national origin, sex, age, disability, or veteran status.
q. MEDSTAFFERS agrees not to at anytime or in any manner either directly or indirectly,
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 4 of 12
? r
divulge, disclose, or communicate to any person, organization, and corporation any information
concerning any matters affecting or relating to the business of the FACILITY. its employees, or patients
except as required by the law.
r. N4EDST?FFERS shall maintain at its sole expense a valid professional liability insurance
policy of One >\ .lhoi Dollars aper vcctirre!ice rF'V.e Nliliiotl Dailars
i55.O00.0(O- '0) ag rc a,e d-i ini3 -h1 'err, . i t111 ?le:nhellt. 1_p?!h _ _ " c - `rCCi:iC'.ht.
:J.
7edstafre s ?iil st!ppl FACILITY • .T:. r C.rtit;c4.e of Liabil _... T.c:. d .iil n ti±;
FACILITY prior to cancellation. reduction or material change in coverage in the future.
MEDSTAFFERS shall maintain required workers compensation insurance for all of MEDSTAFFERS'S
employees placed in FACILITY.
S. MEDSTAFFERS PERSONNEL Fill abide by FACILITY rules, policles and procedures: and
report to. and be supersised by FACILiTY° Clinical %lana`Ters Ahen on dur,,at FAA ILITY.
r. ;tlE}c T AFFF S ;, ..( ri4e ,,:? c?epc a? =- =lit tc _,un .nlpl:?jy, PEQS -NN-1EL
provided by FACILITY during the term of this .-11grcement. Tlhe %IEDSTAFFE2S further acknowledges
the considerable expense incurred:by FACILITY to advertise. recruit. interview. evaluate: reference check
and supervise its employees.
4. FACILITY RESPONSIBILITIES
a. FACILITY shall use MEDSTAFFERS as one of its sources of SUPPLEMENTAL
STAFFING.
b. All PERSONNEL provided by MEDSTAFFERS for the term of this contract are the
employees of MEDSTAFFERS.
C. r:?i?1L1 I't `.'.Iii iaKC .1:) jtl}?j - !1: ]'e? O\,I e;l?},lUV?e? tiiG?c PERSONNEL !'C??'?!ded
by MEDST.-,FFERS during the term of this Agreement. FACILITY understands MEDSTAFFERS is not an
employment agency and that its employees are assigned to the FACILITY to render temporary services and
are not assigned to become employed by the FACILITY. The FACILITY further acknowledges the
considerable expense incurred by MEDSTAFFERS to advertise, recruit, interview, evaluate, reference check
and supervise its employees. Accordingly, the FACILITY may not hire MEDSTAFFERS's Personnel unless
an "Intent to Hire" agreement is met.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 5 of 12
d. "Intent to Hire" - 1) If FACILITY seeks to hire the MEDSTAFFERS employee at the end
of the employee's 90 day GUARANTEED term assignment, the fee for a "buy our" of the services will be
waived, or 2) if FACILITY seeks to hire the :MEDSTAFFERS employee prior to the end of the contract
agreement period. a lump sum for the remainder of The guaranteed time will be paid to \-IEDSTAFFERS.
Once an option Is agreed llpen. The said ME?STA: emplo%ee en'?1OV117eI1t I"i 1}Tc ar ti-11.1 -.,- rcd Ip t!_e
FACILITY. Til: c?ginnir,? of Tile "t(J day pc:- cd _?arts front the first dav nogee _; L ea T'c'r i e _.ltc }t to
hire. Facilitl, ,`rees o _,; t hire •. ". r
IcDSTS.F!-Eir.S -m,1'?,eG =1i1 a rcrl':u
termination of employment with MEDSTAFFERS.
e. FACILITY shall provide sufficient information about its specific needs so that
MEDSTAFFERS can match the skills and experience of its PERSONNEL to those needs.
f FACILITY shall utilize assigned PERSONNEL only for the specific area' pecialty need
requested.
v pFH C(Iti`yFi mu i?r tamnnrarii?.- ,-aacc:vn,?.i *,? p it1 .1?.A,-nr ?-I?_? i± p:?';;I-! 'N N E y _ L
does not hay ,e stlfflClellt 0I'IentatI0I or experience in the type of work pe!'fOI'I}led in tl}e teIi"flair !4 'ti\Grk
area, PERSONNEL will be required to perform all basic nursing functions. 'but will not be required to
perform tasks or procedures, for which PERSONNEL is not qualified or Trained 'to perform. nor
PERSONNEL be required to assume sole accountability for patient care assignments. If reassigned
PERSONNEL has sufficient orientation or sufficient experience in the type of work performed in the
temporary work area, PERSONNEL will be required to assume sole accountability for patient care
assignments."
h. FACILITY agrees that MEDSTAFFERS's duty to fill assignments is subject to the availability
of qualified Personnel.
1. F A C ILI T j rCC's, !o pru-, Ric crnent3Tl,,'n ',C,Ce5?aI' fill" The spe, i i" iL1Cl1
includes physical layout of the unit, facility.
J. FACILITY nursing supervisors will assist MEDSTAFFERS, on a continuing basis, with
evaluation of MEDSTAFFERS PERSONNEL by providing performance information and/or access to clinical
areas for observation by MEDSTAFFERS's Clinical Director.
k. FACILITY shall allow MEDSTAFFERS PERSONNEL (on their own time) to attend
appropriate facility staff development programs.
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 6 of 12
1. FACILITY shall notify MEDSTAFFERS immediately of the initiation of any complaint,
inquiry. investigation, or review with or by any licensing or regulatory authority, peer review organization.
FACILITY committee. or other committee. organization which directly or indirectly. evaluates or focuses
on the quality of care provided by MEDSTAFFERs or its PERSONNEL either in any specific instaric or in
general.
r aL1LIT`T x'11 i_l k_' ljpl.e?5 C1 111 IJIt_'_t1iiC_; a.?V ^_ ;(
problem; --,r ilncidenf la 111 Ch 1I
n. If, in the sole discretion of the FACILITY. any person assigned by )"IEDSTAFFERS is
incompetent, negligent, or has engaged in misconduct, FACILITY may require such person to leave its
premises and shall inform MEDSTAFFERS of this action immediately. The dismissed employee shall not be
assigned to the FACILITY thereafter. The FACILI T Y's obligation to compensate MEDSTAFFFRS for said
services shall be limited to the hours actually vvc.rked by Such person and FACILITY shall flak no further
Ohliasitlon v,th 1'rr,?nrr'i to jIjrl :a jCl ull Jllt'fltC,
o. FACILITY shall make evei, effort to request PERSONNEL at least four (4) 1;OU1'S ;prior to
reporting time. If-PERSONNEL are requested less than two (2) hours prior to reporting time every
attempt will be made to fill the request. If the PERSONNEL accepting assignment is unable ro. arrive at
the exact start time due to the short notice.. the FACILITY will be billed for the entire shift if notice of
request was received less then 2 hours before start time.
P. If FACILITY changes or cancels an order less than two (2) hours before reporting time,
FACILITY shall be liable for four (4) hours at the hourly rate for the PERSONNEL involved. FACILITY
then reserves the right to then employ the nurse for four (4) hours.
q. FACILITY agrees not to discriminate in the assignment of MEDS T aFFERS' PERSONNEL
gill the baSIS Ott .:LG. freed, colui-. 1?:1ril? ::1 tl?lii. _?t:, i`C'. di?ablllt? Ul •Ct?lall Staiii?.
r. FACILITY shall maintain at its sole expense a valid policy of insurance Covering
professional liability arising from the acts or omissions of FACILITY's employees. FACILITY shall
forward a Certificate of Insurance to MEDSTAFFERS upon request and give MEDSTAFFERS prompt, written
notice of any change in FACILITY's coverage.
5. TERM OF AGREEMENT
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 7 of 12
,•,
This term of this Agreement shall commence on the ?4` day of 2006, and
shall continue for a period of twelve 02) months from the commencement.
Unless written notice of te:-rnination is given b% either party to this Agreement thirty i li) days prior
to the end of the aforementioned tern. ti:is Agreement shall autornatically be exter:ded for an additional
like period and c;, cn until terminated as sbc-:e sit fclih.
6. PAYMENTS. INVOICES
a. iMEDSTAFFERS will furnish FACILITY with a weekly invoice of services provided. The
rates for its services are attached as Exhibit A to this Agreement. The rates for services established in
Exhibit A can be prospectively amended by MEDSTAFFERS at any time upon thil-ty (-'0) days written notice
to FACILITY.
b. FACILITI' _hall pa% N1EDST,%FFERS as provided. entitled P a'; ient Tc, is. Pa,,ment due
upon receipt of im-clice. Accounts not njid "m Rill viThin 36 dabs of biding shalt he _'_1?1?rl.t '<l ?i 1 ??•-
r
10 davs overdue. FACILITY -hail also be responsible fcr ay and all cc:it,sci id cl_:ts associated
with the collection of overdue balances.
C. GUAR --NTE1=D REQUESTS and bookings for PERSONNEL can 1w t"-,e c-,nceted and are
subject to complete pilling whether Pe;-om.7el are used or not except mutual carceliatio:is
7. MODIFICATION AND WAIVER OF AGREEMENT
This Agreement shall constitute a full, complete, and total binding Agreement between the parties and
is precluded from amendment or modification EXCEPT if the parties specifically agree to modify this
Agreement.
Ally a1:d ;1 iodltl?'3tiu:1- i(" ti7i- :? rC?.i2CIL ;bail ':iilw
formalities as this Agreement and shall exhibit the norarized signanires of both pal-ties. along with two
witnesses.
Any waiver of a breach of any provision of this Agreement shall not constitute an ongoing waiver.
8. TERMINATION OF AGREEMENT
Either party can terminate this Agreement, with or without cause, upon thirty (30) days written
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 8 of 12
notice to the other party. Notices of termination must be sent to the parties as listed within this .Agreement.
FACILITY may immediately terminate this agreement if Medstaffers or employee's conduct is
unprofessional. unethical or fraudulent. and if. in the opinion of FACILITY. such action discredits the name
or is detrimental to the reputation. character and standil;a of FACILITY-.
9. PRIOR AGREEMENTS
i!ll? A` eCnal eft loriStltUtcS the er.tl:e undo-srandl:i
La.
there are no other representations. warranties.. covenants. understandings or agreements other than those
expressly set forth herein.
14. BREACH AND ENFORCEMENT
If either party i;ereto breaches any of the provisions of this Agreement. the other par-. shall have the
right to bring any actions cr actions in late or cgUIN' for SuCli breach.
11. NOTICES
All notices shall be in writing and shall be addressed to the parties as set forth belo« Notices shall
be effective upon receipt xh'en delivered personally or sent pia US Certified Mail return receipt requested
to the appropriate addresses listed below and shall b' cff11to r upon mailing when property addressed with
postage prepaid.
MEDSTAFFERS
ALMA HEALTH D/B/A/ MEDSTAFFERS.
Corporate Headquarters
17 East High Str et
PO Bost 95
Carlisle, PA 17013
FACILITY
- J t-?
.fir .
12. ADDITIONAL INSTRUMENTS
Each of the parties hereto agrees that it will join in the execution, acknowledgment and delivery of
any other document which may be reasonably necessary to cant' out the intent of this Agreement, and, in the
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 9 of 12
event either of the parties hereto would not join in the execution, acknowledgment and delivery of such
instrument, then such party does hereby irrevocably appoint the other party hereto as its Attorney-in-Fact to
execute, acknowledge and deliver such instrument hereby ratifying all that such other parry- hereto may do by
virtue hereof with a copy of this agreement to be a sufficient Power of Attorney io caiTv out the intent and
purpose of this paragrapl;.
13. VOLUNTARY EXECUTION
The provisions of this Agreement and their legal effect have been fully explained to the parties by
their respective legal representatives, and each party acknowledges that the Agreement is fair and
equitable. that it is being entered into voluntarily. with full disclosure and that it is not the result of
any duress or undue influence.
14. ENTIRE AGREEMENT
This Agreement contains the entire Understanding of the paliCCs gild there are nc) reprCSCritatil;nS.
warranties. covenants or undertakings other than those expressly set forth herein.
15. CONFIDENTIALITY
The terms of this agreement are confidential, and each party receiving any proprietary or confidential
information from the other party or its clients shall exercise reasonable efforts to preserve the
confidentiality of said information.
16. COMPLIANCE ACKNOWLEDGMENT
Medstafters and FaC- 1x71 i-epresent and `A arra;li Uiat tliC`a WIC alld ?Ilall remalll thrclw hoot the tcrill
of this agreement in compliance with all applicable federal and state laws and regulations related to
this agreement and the services to be provided, including without limitation, statutes and regulations
related to fraud, abuse, false claims/statements, referrals and prohibition of kickbacks.
Medstaffers also represents and warrants, by signing and returning the attached acknowledgment,
that Medstaffers agrees to comply with the compliance protocols that impact ancillary providers
under FACILITY'S corporate compliance plan and/or code of conduct.
FACILITY STAFFING AGREEMENT
Alma Health LLC dlbla Medstaffers.
February 2006
Page 10 of 12
17. ASSIGNMENT
Neither party may assign this agreement witheut the prior -A ritten consent of the other party.
18. APPLICABLE LAW
This Agreement sllall be _ntel-preted ':1 :Ci _iuailC. witi the la,.vs of the Conlmonblealth of
Pennsylvania. Any and all disputcs 'which alist as a es, of t11is Awl"ct'n:eilt shall be
iie[ird 111 the
Ilir Court of Common Pleas of Cumberland County, Pennsylvania.
19. VOID CLAUSES
If any tern;. condition, clause or rro? ision of this Agreement shall be determined or declared
to be void or invalid in law or otheiv; Ise. then 'Only that terns. condition. clause or provision shall be
str;cken front tills Agreen ent and in all other .eSpee.S.. tk u ..
. , T"?. ?.? i'. ii Jl1 all b: ??- aiid 1. Vfiii liV
hill force. effect and operation
REMAINDER OF TINS PAGE HAS BEEN LVTENTIONALL F LEFT BLANK
FACILITY STAFFING AGREEMENT
Alma Health LLC dfb/a Medstaffers.
February 2006
Page 11 of 12
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the day and year first
above written.
WITNESS/ATTEST: ALMA HEALTH D/13/.A/ MEDSTAFFERS.
B}: ` - (SEAL)
Title:
FACILITY
By - s.SEAL
Title:
FACILITY STAFFING AGREEMENT
Alma Health LLC d/b/a Medstaffers.
February 2006
Page 12 of 12
01/19/2007 15:06 7172433658 MEDSTAFFERS
RATES: 7.3
RN Weekday $52.50
Weekend $60.00
LPN Weekday $40.00
Weekend $44,00
CNA Weekday $25.00
Weekend $27.00
3.77 11-7
$54.50 $56.50
$62.00 $64.00
$42.00 344.00
$48.00 346.00
$26.00 527,00
$28.00 $29.00
HOLIDAYS: Holidays are billed at one and one half of the hourly rate. Weekends begin at 3pm Friday and end lam Monday.
PAGE 01
New Years Eve (3.11, 11-7) Labor Day (shift starting prior to the holiday 11-7,7-3, 3.11, 11-7)
New Year's Day (7-3, 3.11, 11.7) Thanksgiving (shift starting on the holiday eve 11.7, 7.3,3-11,11-7)
Memorial Day (shirt starting prior to holiday 11-7, 7-3, a-1 1, 11-7) Christmas Eve (3.11, 11-7)
Independence Day (shift starting prior to holiday 11-7, 7-3, 3-11, 11-7) Christmas Day (7-3, 3-11. 11.7)
TERMS: Invoices are mailed weekly and are payable upon receipt Accounts not paid within 30 days will be subject to a 1.6% surcharge
per 30 days overdue,
CHARGE RATES: LPN Charge rates are an additional 34 per hour. RN Campus Charge rates are an additional $10 per hour.
DISCOUNTS:
2% discounts given for.
• EZ Pay program, whereby payment Is automatically captured within 10 days of invoicing through electronic transfers.
Guaranteed nME-
Guaranteed tlme is defined as Personnel needs that cannot be canceled for any reason and are subject to full billing except for mutual
cancellations, Early requests and guaranteed requests will receive top priority. Guaranteed requests and bookings for Personnel cannot
be canceled and are subject to complete billing whether Personnel are used or not except for mutual cancellations, Emergency Requests
are requests that are made two hours prior to starting time and are subject to full shift billing even If the personnel Is not able to arrive at
the desighated start of the shift
CANCELLA710NS:
If facility changes or cancels an order less then two (2) hours before reporting time, facility shall be liable for four (4) hours at the hourly
rate for the Personnel Involved. Facility then reserver; the right to then employ the nurse for four (4) hours.
KQ9'1
'sy
DEC-26-2005(7JE; ";'
Bill To:
HLMR Medica!DSH
Please summit invoices to
MedStaffers
PO Box 1300
Suisun City Ca, 94585
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
Attn_ Jeff Senevit
;FHX;i 71 21i 3021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
P 01]3;'031
Facility Branch Account $ Period Ending Invoice #
Shippensburg Health Care Center HC1 174 09/23/2006 7663
Date Shifts Caregiver Title Description Hrs/Units Rate Amount Miles Mileage Total
Unit Name: LTC
09/17/2008 06:30AM- 03:OOPM Whcoler,Farlann L CNA REGULAR WEEKEND 8.50 28.00 238.00 238.00
09/17/2006 03:OOPM- 07:OOPM Wheet8r,Eartenn L CNA REGULARWEEKGND 4,00 29.00 118.00 116.00
09/18/2006 06:30AM - 03:OOPM Rickrode,Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
09/1812006 07:30AM - 03:OOPM Barclay.Jonnifer 1 CNA REGULAR WEEKDAY 7.50 24.00 180.00 180.00
09/18/2008 03:OOPM - 10:3OPM Barclay,Jennlrer I CNA REGULAR WEEKDAY 7.50 25.00 187.50 187.50
OSIIW2006 06:30AM- 03:OOPM Rlckrode,Ashley L. CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
0911912006 02:30PM - 03:OOPM Nace,Nicole R CNA REGULAR WEEKDAY 24.00
09119/2006 03*OOPM - 10:30PM Nace.Nicolo R CNA REGULAR WEEKDAY 7.SO 25.00 187.50 187.50
09120/2008 02:30PM - 03:OOPM Noco.N ecle R CNA REGULAR WEEKDAY 0.50 24.00 12.00 12.00
09120/2006 03:OOPM - 04:OOPM Nace,Nlcole R CNA REGULAR WEEKDAY 1.00 25.00 25.00 25.00
09212006 06,30AM - 03:OOPM Rickrode,Ashley L CNA REGULAR WEEKDAY 6.00 24.00 192.00 192.00
09/21/2006 06:30AM - 02:30PM Barclay.Jonnlfer I CNA REGULAR WEEKDAY B.00 24.00 192.00 192.00
09121/2008 02:30PM - 03:OOPM Naco,Nlcole R CNA REGULAR WEEKDAY 0.50 24,00 12.00 12.00
09121/2006 03:OOPM - 08:30PM Rlckrode,Ashley L CNA REGULAR WEEKDAY 5.50 25.00 137.50 137.50
091212006 03:0013M - 10:30PM Neee,Nicoie R CNA REGULAR WEEKDAY 7.50 25.00 187.50 187.50
09122/2006 08:30AM - 03:OOPM Rickrode.Ashley L CNA REGULAR WEEKDAY 8.00 24.00 192.00 192.00
0922/2008 02:30PM - 03:OOPM Frey,Laurle J CNA REGULAR WEEKEND 0.50 28.00 14.00 14.00
0912212006 03:OOPM - 04:30PM Rickrode,Ashley L CNA REGULAR WEEKEND 1.50 29.00 43.50 43.50
0922/2006 03:OOPM - 10:OOPM Frey,Laurle J CNA REGULAR WEEKEND 7.00 29.00 203.00 203.00
0912212006 10:30PM - 11:OOPM Balr,Karhy S LPN REGULAR WEEKEND 0.50 44.00 22.00 22.00
09=2006 11:OOPM - 07:OOAM Balr,Kathy S LPN REGULAR WEEKEND 8.00 46.00 368.00 368.00
0912312006 07:00AM - 07:15AM Sair,Kalhy S LPN REGULAR WEEKEND 0.25 42.00 10.50 10.50
09/23/2006 07:100AM - 02:1 OPM Wheeler.Earlann L CNA REGULAR WEEKEND 7.17 28.00 200.75 200.76
A 1.5% finance charge will be added to this Invoice if not paid within 30 days
E?-c5-?005( 7!,! 13
immit invoices to
_ .r11'ers
PU A;ox 1300
Suisun City Ca, 94585
RLMR Medica!OBR
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
Attn: Jeff Benevit
30c1
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd,
Shippensburg, PA 17257
P J04/r 31
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 09/23/2006 7663
Date Shifts Caregiver
09/23/2006 02:11 OPM- 03:OOPM Wheeler,Eadann L
09123/2008 03:0012M - 07:00PM Wheeler,Earlsnn L
Title Description HmMnits Rate Amount Miles Miloage Total
CNA OVERTIME WEEKEND 0.83 42.00 34.86 34.86
CNA OVERTIME WEEKBNO 4.00 43.50 174.00 174.00
Unit SubTotal: 119.75 53,313.82 $3.313.62
Facility Total: 119.75 33,313.62 53,313.62
Please pay this amount: 5 A 1.6% finance charge will be added to this invoice If not paid within 30 days
?E--26-2005-, E; 3
r .
a,
HLMH MedicalDSH
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
(r--; N! l 1 - 21 3021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 001: 03'
Facility Branch Account # Period Ending • Invoice #
Shippensburg Health Care Center HC1 174 10/07/2006 7730
Oate Shifts Caregiver
Unit Name: LTC
101=006 06:30AM - 03:OOPM Pyne, Cheryl A
10/03/2006 06.30AM - 03:OOPM Rlckrods,Ashley L
10/04/2006 06:30AM - 03;OOPM Pyne.Cheryl A
10/04/2006 06:30AM - 03:00115M Rickrode,Ashley.L
1010412006 03:0012M - 03:1513M Pyne,Cheryl A
1OW2005 07:30AM - 03:0013M Pyno, Cheryl A
1010612006 03:OOPM - 03:45PM Pyne,Cheryl A
10/06/2006 11:00PM - 07:OOAM Sair,Kathy S
10/07/2006 07.ORAM - 07:15AM Balr,Kathy S
10/07/2006 11:OOPM - 07;OOAM Balr.Kathy S
10108/2008 07.OOAM - 07:30AM SairAnthy S
Title Description Hrs/Unlts Rate Amount Mlles Mileage Total
LPN REGULAR WEEKDAY 8.00 36.00 $288.00 5286.00
CNA REGULAR WEEKDAY 8.50 24.00 $204.00 $204.00
LPN REGULAR WEEKDAY 8.50 36.00 5306.00 5306.00
CNA REGULAR WEEKDAY 8.50 24,00 5204.00 $204.00
LPN REGULAR WEEKDAY 0.25 38.00 59.50 S9.50
LPN REGULAR WEEKDAY 7.50 36.00 $270.00 $270.00
LPN REGULAR WEEKEND 0.75 44.00 $33.00 533.00
LPN REGULAR WEEKEND 8.00 46.00 5388.00 $368.00
LPN REGULAR WEEKEND 0,25 42.00 510.50 510.50
LPN REGULAR WEEKEND 8.00 46.00 $368.00 $368.00
LPN REGULAR WEEKEND 0.50 42.00 $21.00 521.00
Unit SubTotal- 58.75 $2,082.00 52.082.00
Facility Total: 58.75 $2,082.00 $2.082.00
Please pay this amount: $ 2,08200
A 1 Sai. finAnro rhamv will hab MAtIOA to #hie iraun7e-n if nr%o noirl wiMfn+n in 4%ue
P 0051031
7EC-26-?006 f "'JE ;' ' 3 R? IA '4ed i :.a 1788 (FR,t; l -17 ILd i 302,1
Bill To,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/07/2006 7730
Invoice #: 7730 Check # Amount Paid (S):
Please Return This Form With Your Payment. Thank You.
A 1 M finanro rha?no will ho nolAPA to thie inunire if nn+ nsiri within zn .isua
,a;?)': '1 2tl '021 ? JO 17 ,03
5-2BCb ?UEi .S gLMR MediCaIOBA C
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Senevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending - Invoice #
Shippensburg Health Care Center HC1 174 10/1412006 7754
Date Shifts Caregiver
Unit Name: LTC
10/10/2006 00:30AM - 03:OOPM Rickrode,Ashley L
10/10/2006 03:0013M - 08:00PM Rlckrode,Ashley L
10111/2006 06:15AM - 07:OOAM Rickroda Ashley L
10/1112006 07:00AM - 03:0OPM Rickrode,Ashley L
1011172006 03,00PM - 10:30PM Rickrode,Ashley L
10/132006 06:30AM - 03:OOPM Johnscn,Slacy J
10/13/2006 06:30AM - 03.OOPM Whealar.Earlann L
10/13/2006 03:OOPM - 07:OOPM Wheeler.Earlann L
10/14/2006 06:30AM - OTOOPM Wheeler,Earfann L
101148006 03:0OPM - 07:OOPM Whoalor,Earlann L
Title Description Mrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKDAY 8.00 24.00 $192.00 $192.00
CNA REGULAR WEEKDAY 5.00 25.00 $125.00 5125.00
CNA REGULAR WEEKDAY 0.25 26.00 56.50 56.50
CNA REGULAR WEEKDAY 8.00 24.00 $192.00 $192.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 5187.50
CNA REGULAR WEEKDAY 8.00 24.00 5192.00 5192.00
CNA REGULAR WEEKDAY 8.00 24,00 5192.00 5192.00
CNA REGULAR WEEKEND 4,00 29.00 $116.00 3116.00
CNA REGULARWEEKEND 8.00 28.00 $224.00 $22x.00
CNA REGULAR WEEKEND 4.00 29.00 S116.00 $116.00
Unit SubTotal: 60.75 $1,543.00 31,sa3.oa
Facility Total: 60.75 $1,543.00 $1,543.00
Please pay this amount: $ 1,543.00
A 4 GO/_ S:--- -n -I.ore+n wvll I%- mrfAm 'l 4n 0%;i In?inlPa If nn+ r ftl,l 41% .1......
tiEC-26-2305( iUEi i3
ALMR MedicalOBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
(?R(;i 1 ? l ? 211 3021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
D 008/031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/14/2006 7754
Invoice #: 7754 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
0 1 Ca/_ fimmnna rhsrnn will hs aelr/ael tee thle InunMs If not nftlA within *an rleve
5'J5 J5 O
PLM:IP MediCalOBR
Bill To,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Fa,)1 i; ?1; 021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 009/1331
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/21/2006 7771
Date Shifts Caregiver
Unit Name: LTC
10113/2006 10:30PM - 11:OOPM Bair,Kathy S
10/13/2006 11:OOPM - 06:OOAM Balr,Karhy S
10/1412006 10:30PM - 11:OOPM Sair.Kathy S
10/1412006 11:00PM - 08:00AM Bair, Kathy S
1011812006 06:30AM - 02:3OPM Riekrode,AShtey L
1011912006 06-ISM - 07:OOAM Rickrode,Ashley L
10/1912006 07:00AM - 03:OOPM Rickrode,Ashley L
10/1912006 03:00PM - 10:30PM Rickrode,Ashley L
10/20/2006 06:30AM - 03:OOPM Whesler,Eartann L
101208006 06:30AM - 03:00PM Rlckrode,Ashley L
101208006 06:30AM - 03:OOPM Johnson,Stacy J
IOreW006 07:OOAM - 03:0OPM Pyne,Cheryl A
1012012006 03:0OPM - 07:00PM Wheeler,Eadann L
10/208006 03:OOPM - 10:15PM RickrodeAshley L
10120!2006 10:1513M - 10:30PM Rickrode,Ashley L
10/2012006 11:OOPM - 07:OOAM Balr,Kathy $
1012112006 06:30AM - 03:00PM Whaeler,Earlann L
101218006 03:OOPM - 07:00PM Wheeler,Earlann L
1012112006 11:OOPM - 06:45AM Myer%Jamie I
10/21!2006 11:OOPM - 07,00AM Balr,Karhy S
10/2212006 OTOOAM - 07:15AM Balr,Karhy S
Title Doscription Hrs/Units Rate Amount Miles Mileage Total
LPN REGULAR WEEKEND 0.50 44,00 $22.00 522.00
LPN REGULAR WEEKEND 7,00 46.00 $322,00 S322.00
LPN REGULAR WEEKEND 0.50 44.00 3122.00 $22,00
LPN REGULAR WEEKEND 7.00 46.00 $322.00 $322.00
CNA REGULAR w5FKDAY 8.00 25.00 5200.00 3200.00
CNA REGULAR WEEKDAY 0.75 27.00 $2025 $20.25
CNA REGULAR WEEKDAY 8.00 25.00 $200.00 $200.00
CNA REGULAR WEEKDAY 7.50 26,00 $195.00 5195.00
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGULARWEEKDAY 8.50 25.00 $212.50 $212.50
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212,50
LPN REGULAR WEEKDAY 7.50 40.00 S300.00 $300.00
CNA REGULAR WFEKEND 4,00 28.00 $112.00 5112.00
CNA REGULAR WEEKEND 7.25 28.00 $203.00 5203.00
CNA OVERTIME WEEKEND 0.25 42.00 S10.50 $10.S0
LPN REGULAR WEEKEND a,00 4$.00 $368.00 $368.00
CNA REGULAR WEEKEND 8.50 27.00 $229.50 5229.50
CNA REGULAR WEEKEND 4.00 28.00 5112.00 5112.00
CNA REGULAR WEEKEND 725 29.00 5210.25 $210.25
LPN REGULAR WEEKEND 8.00 48.00 $368.00 5388.00
LPN REGULAR WEEKEND 0.25 44.00 $11,00 $11.00
Unit SubTotal: 119.75 $3,865.00 $3,865.00
Facility Total: 119.75 53,885.00 $3,865.00
Please pay this amount: $3,865.00
A 1 904 flnanr•e eharnn will he arldarl }n fhie invnsre if "FO. naid %ariH•sin 9n An%m
ALMA MedicalDBH
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
f;=T-01 71 22d1 3021
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 0'. 0/,731
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/21/2006 7771
Invoice #: 7771 Check #
Please Return This Form With Your Payment_ Thank You.
Amount Paid ($):
A -4 GeL rlnnne = e-h%MO w*111 ho oAACA to thi¢ invnirn if not nairl within '%n rinv-.
DEC-26-2006(_UE) 11:19
9LIR Med:_a'_78fl
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For-
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P JiI,031
Facility Branch Account # Period Ending -Invoice #
Shippensburg Health Care Center HC1 174 10/2812006 7796
Data Shifts Caregiver
Unit Name- LTC
10232006 06:30AM - 02:30PM Johnson, Stacy J
1 0/2412006 06:15AM - 07:OOAM Rickrode,Ashley L
1012412006 07:OOAM - 03:OOPM Rickrode,Ashley L
10/24/2006 03:00PM - 08:30PM Rlckrode,Ashley L.
1025!2006 06:30AM - 02:30PM Johnson,Stacy J
101252008 06:30AM - 03:OOPM Rickrode,Ashley L.
10/2512006 03:OOPM - 10:30PM Rickrode,Ashley L
10272006 06:30AM - 02:30PM Johnson,Stacy J
10/27/2006 06:30AM - 03:OOPM Wheeler,Earlann L
10/2712008 03:OOPM - 07:OOPM Wheeler,Earlann L
1012712006 11:OOPM - 07:OCAM 8olr,Kathy S
10/282006 07:OOAM - 07:30AM Salr,Kathy S
10r282006 02,30PM - 03:00PM Myers,Jarnie 1
10/2812006 03:OOPM - 11:OOPM Myers,JAmie 1
10128/2006 11:00PM - 07:00AM Balr,Kathy S
10/292006 07:OOAM - 07:30AM Bair,Kathy S
Title Description Iits/Units Rate Amount Milos Mileage Total
CNA REGULAR WEEKDAY 7.50 25.00 $167.50
CNA REGULAR WEEKDAY 0.75 27.00 520.25
CNA REGULAR WEEKDAY 8.00 25.00 $200.00
CNA REGULAR WEEKDAY 5.50 26.00 $143.00
CNA REGULAR WEEKDAY 7.50 25.00 5187,50
CNA REGULAR WEEKDAY 8.50 25,00 $212.50
CNA REGULAR WEEKDAY 7.50 26,00 S195.00
CNA REGULAR WEEKDAY 7.50 25.00 5187.50
CNA REGULAR WEEKDAY 8.00 25.00 $200.00
CNA REGULAR WEEKEND 4.00 28.00 $112.00
LPN REGULAR WEEKEND 8.00 48.00 $368.00
LPN REGULAR WCCKEND 0.50 44.00 $22.00
CNA REGULAR WEEKEND 27.00
CNA REGULAR WEEKEND 8.00 28.00 $224.00
LPN REGULAR WEEKEND 8,00 48.00 $368.00
LPN REGULAR WEEKEND 0.50 44,00 S22.00
Unit SubTotal: 89.75 $2,649.25
Facility Total: 89.75 62,849.25
S187.50
$20.25
5200.00
$143,00
S187.50
$212.50
$195.00
$187.50
5200.00
$112.00
$368,00
522.00
$224.00
S36B.00
522.00
$2,649,25
$2,649.25
Please pay this amount: S 2,849.25
A 1 ROIL finnnro rhmmo will ho 9lfrlatl M thla Inunle-a If not meld within 4n Amwa
IEE-26-2006 ( 71JE ) ' ' : 1 9
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ALh9 ;ded:r-3'_39A
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
qX 1 2d -302d
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 0"!19 31
Facility Branch Account # Period Ending Invoice 9
Shippensburg Health Care Center HC1 174 10/28/2006 7796
Invoice #: 7796 Check # Amount Paid ($):
Please Return This Form With Your Payment. Thank You.
A 1.5% finanr_n c_haraP will hp addPrl to this invnlae If nnt n2let within -%n A:xu*
1 l A 1
%
19 RLMH Med raIHR
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 01 31-1,031
Facility Branch Account # Period Ending Invoice 0
Shippensburg Health Care Center . HC1 174 10/3112006 7852
Date Shifts Caregivor Title Description HrslUnits Rate Amount Miles Mileage Total
Unit Name: LTC
10/2712000 02:30PM - 10:15PM Frey,LauOe J CNA 7.75 28.00 $217,00 5217.00
10/29/2006 02,30PM - 03:OOPM Myer6,Jamie I CNA REGULAR WEEKEND 0.50 27.00 $13.50 $13.50
101292006 03:OOPM - 10:30PM Mycrs,Jamie I CNA REGULAR WEEKEND 7.50 28.00 S210.00 $210.00
10/30/2000 06:30AM - 03:OOPM Rickrode.Ashley L CNA REGULAR WEEKDAY 8.50 25.00 $212.50 $212.50
10/3012008 03,OOPM - 08:00PM Rickrode,Ashley L CNA REGULAR WEEKDAY 5.00 26.00 $130.00 5130.00
10/3112006 06:15AM - 07:OOAM Rlckrade,Ashley L CNA REGULAR WEEKDAY 0.75 27.00 $20.25 $20.25
10/312006 06:30AM - 03:OOPM Pyne.Choryl A LPN REGULAR WEEKDAY 6.50 40.00 $340.00 5340,00
10/31120OO 07:00AM - 02:30PM Rickrode,Ashley L CNA REGULAR WEEKDAY 7.50 25.00 $187.50 5197.50
Unit SubTotal: 46.00 51,330.75 $1,330.75
Facility Total: 46.00 $1,330.75 $1,330.75
Please pay this amount: $ 1,330.75
A 1 A0 fi anra rha?na will ha arlrlarl in thie invnira if not nald within In rime-a
DEC-26-2006(TUE) 11:19
PLMR Med__a')9P
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
SPX,, -4! 3Cc1
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P Oiflr031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 10/31/2006 7852
Invoice # : 7852 Check # Amount Paid ($):
Please Return This Form With Your Payment Thank You.
A 1 CO/ finoni n z-ho?ne will ha oAded #n thie inuni?e Cf nno now voaldn 4n wus
?L;MR 1e 1 i ca' 7®R
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
`A;t ? ? .7 ?1' X021
P 9i5/031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center • HC1 174 11/04/2006 7870
Date Shifts Caregiver
Unit Nam e: LTC
11101/2006 06:20AM - 07:OOAM Rlckrodo,Ashley L
11101/2008 07:00AM - 03:OOPM Rickrode.Ashley L
11/01/2006 02:30PM - 03:10OPM Frey,Laurie J
1110112006 03:OOPM - 10:30PM Frey,Laurle J
1110112006 03:0010M - 10:30PM Rickrodo,Ashley L
1110212006 02:30PM - 03:0OPM Frey,Laude J
11/02/2006 03:0015M - 10:30PM Frey,Laurie J
11/03/2006 06:30AM - 02:30PM Johnson,Stacy J
11103/2006 06:OOPM - 10:30PM Fullon,Amy M
11/002006 06:30AM - 03:0OPM Wheeler,Eariann L
11/0412006 03:OOPM - 07:OOPM Wheeler,lEarlann L
Title Description Hrs/Unlts Rate Amount Miles Mileage Total
CNA REGULAR Wrr-KDAY
CNA REGULAR WEEKDAY
CNA REGULAR WEEKDAY
CNA RFGUTAR WEEKDAY
CNA REGULAR WEEKDAY
CNA REGULAR WEEKDAY
CNA REGULAR WEEKDAY
CNA REGULAR wErKDAY
CNA REGULAR WEEKEND
CNA REGULAR WEEKEND
CNA REGULAR WEEKEND
0.67 27.00 518.09
8.00 25.00 $200.00
25.00
7.50 26.00 5195.00
7.50 26.00 $195.00
25.00
7.50 26.00 5195.00
7.50 25.00 $187.50
4.50 28.00 $126.00
8.00 27.00 $218.00
4.00 28.00 $112-00
55.17 $1.444.59
55.17 $1.444.59
$18.09
$200.00
S195.00
$195.00
$195.00
$167.50
$126.00
$216.00
$112.00
S1,444.59
Unit SubTotal:
Facility Total:
S1,444.59
Please pay this amount: $ 1,444.59
A 4 C% fiv% n" -O rherna tarill Ise M0401e.1 fn +kIa In1lni^s If nn! nft:d ...:!{.:.. 4A dom....
OEC-26-2005(7`- '':20
AL1A ledi?-a108A
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
(FA`„)i 7' 21? 5021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P O15i0?1
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/04/2006 7870
Invoice #: 7870 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 9 Riof finanra rhm ma will ha off larl to fhia in%#n?rn if nnf nairi within An An%am
OED-'S-?005 "JE; "''0
A! AMA 1ed:,_a:J'BA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
? iJ I 10"
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/11/2006 7891
Date Shitts Caregiver
Unit Name: LTC
11/0312006 06:30AM - 04:30PM McCartney, Nicole R
1110512006 06:30AM - 02:30PM Rlckrode,Ashley L
11106/2006 06:30AM - 02:30PM Johnson.Slacy J
11/07/2006 06:30AM - 02:30PM Rickrode,Ashley L
1110712006 02:30PM - 03:0015M Slyder,Eve M
1110712006 03:00PM - 10:30PM Slyder,Eva M
I VOW= 06:30AM - 02:30PM Johnson.Stacy J
11109!2006 06:25W - 07:00AM Rickrode,Ashley L
11109/2006 07:OOAM - 03:0013M Rlckrode,Ashley L
1110912006 03:OOPM - 08:OOPM Rlckrode,Ashloy L
11/1012006 06:30AM - 03:0OPM Rickrode,Ashley L
11/1012006 03:0015M - 05:25PM Rickrode,Ashiey L
1111012006 05:25PM - 10:30PM Rlckrode,Ashley L
11111/2006 06:30AM - 03:OOPM Wheeler,Earlann L
11111 /2006 06:30AM - 02:30PM Fullon,Amy M
Titlo Description Hrs/Units Rate Amount Miles Mileage Total
CNA REGULAR WEEKDAY 10.00 25.00 5250.00 $250,00
CNA REGULAR WEEKEND 8.00 27.00 S216.00 $216.00
C,NA REGULAR WEEKDAY 7.50 25.00 5187.50 5187.50
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 $187.50
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 5187.50
CNA REGULAR WEEKDAY 0.58 27,00 $15.68 $15.66
CNA REGULAR WEEKDAY 8.00 25,00 $200.00 $200,00
CNA REGULAR WEEKDAY 5.00 26.00 $130.00 5130.00
CNA REGULAR WEEKDAY 8.50 25.00 $212.50 S212.50
CNA REGULAR WEEKEND 2.42 28.00 $67.78 $67.76
CNA OVERTIME WEEKEND 5.08 42.00 5213.36 $213.36
CNA REGULAR WEEKEND 6.00 27.00 $216.00 5216.00
CNA REGULAR WEEKEND 7.50 27.00 5202.50 5202.50
Unit SubTotal• 93.08 52,481.28 $2,481.28
Facility Total: 93.08 $2,481.28 $2,481.28
L Please pay this amount. $ 2,481.28
A .1 CoL FI„?r.ws wh?rns .-.:11 hn addnrl •w rl.:s :w...-:.?..:F __& --*..1 ...:a.1-:- 9A .1-
DEC-26-2005(?JE1 '':'0
ALMA Medca:JBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
7 l- 24? _702-
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
N 3 i 8,," OJ 1
Facility Branch Account # Perlod Ending Invoice #
Shippensburg Health Care Center HC1 174 11/11/2006 7891
Invoice # : 7891 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
a 4 COL fonsnws A.hsrns mill tis siidsrl #n N+if ii nn# ns'sA uric-Mn an Assoc
0EC-25-2005(T!JE) I' ?0
RLMR 4ed:Ca10BR
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
PRX,, 17 21' :1'21
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 119i1'?1
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/18/2006 7966
Date Shifts Caregiver
Unit Name: LTC
1110912006 03:00PM - 10:30PM Frey,Laurie J
11/10/2006 03:DOPM - 10:30PM Froy.Laurlo J
11/12/2006 02:30PM - 03:001010 Myers.Jamie 1
11/12/2006 03:OOPM - 10:30PM Myers,Jamie 1
1111312006 06:30AM - 02:OOPM Johnscn,Slacy J
11/1312006 06:30AM - 03:OOPM Mckrodo,Ashley L
1111312006 03:00PM - 10:30PM Rickrode,Ashley L
1111412006 08:30AM - 02:30PM Rickrode,Aahley L.
11/15/2006 06:30AM - 03:OOPM Rlckrodo,Ashley L
11/152006 02:30PM - 03:00PM Frey.1.3ude J
1111512006 03.OOPM - 10:30PM Frey.Laude J
11/1512006 03:OOPM - 08:00PM Rickrods,Ashley L
11116!2006 02:30PM - 03:OOPM Froy,Laurfo J
1111612006 03:OOPM - 10:30PM Frey,Laude J
11/17/2006 06:30AM - 09:OOAM Rickrode,Ashley L
11/17/2006 09:00AM - 09:45AM Rlckrode,Ashley L.
11/17/2006 02-30PM - 03:00PM Frey,Laurio J
11/1712006 03:OOPM - 11:00PM Frey.Laude J
1111712005 10:30PM - 11.OOPM Bsir,Kethy S
11/17/2006 11:OOPM - 07:00AM Balr,Kathy S
11/16/2006 02:30PM - 03:OOPM Myers,Jamie 1
11/18/2006 03:OOPM - 10:00PM Myers,Jamie I
Title Description HrsNnits Rate Amount Miles Mileage Total
CNA REGULAR WCCKDAY 7,30 26.00 5195.00 $195.00
CNA REGULAR WEEKEND 7.50 28.00 $210.00 $210.00
CNA REGULAR WEEKEND 0.50 27.00 S1150 $13.50
CNA REGULAR WEEKEND 7,50 28.00 8210.00 $210.00
CNA REGULAR W EEKDAY 7.50 25.00 5187.50 $187.50
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGULAR WEEKDAY 7.50 25.00 5195.00 $195.00
CNA REGULAR WCCKDAY 8.00 25.00 $200.00 $200.00
CNA REOULAR WEEKDAY 8.50 25.00 5212.50 $212.50
CNA REGULAR W EEKDAY 25.00
CNA REGULARWEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WCCKDAY 5.00 26.00 $130.00 5130.00
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 2.50 25.00 $62.50 562.50
CNA OVERTIME WEEKDAY 0.75 37.50 $28.13 $28.13
CNA REGULARWEEKEND 27,00
CNA REGULAR WEEKEND 8.00 28.00 $224.00 5224.00
LPN RCGULAR WEEKEND 0.50 48.00 $24.00 $24.00
LPN REGULAR WEEKEND 8.00 46.00 S368.00 5368.00
CNA REGULAR WEEKEND 0.50 27.00 $13.50 $13.50
CNA REGULAR WEEKEND 7.00 28.00 5196.00 $198.00
Unit SubTOtal: 110.25 $3,072.13 $3,072.13
Facility Total: 110.25 $3,072.13 53,072.13
Please pay this amount: $ 3,07213
A 4 CO/ 61-w--- wM+.-.w ---111 1-w +.d.Jww1 •w 61-i- 1---wlww is -w* -+Id ..-z6kim 9n A-.,w
,OEG-25-2006(TUE 11;21 ALMA MedicalDBA
(FAX)l 717 2Q1 302x1 P 020/031
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UtL-26-2005?;TUEi ll,Ll
RLMR Medi_aIOBA
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
?1 3021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
°.02:1031
Facility Branch Account # Period Ending Invoice #.
Shippensburg Health Care Center HC1 174 11118/2006 7966
Invoice #: 7966 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 1.5% finance charge will be added to thin invnlra if not nairi within An riava
`JEt-26-2006;-UF) '':21
HLMH Medi._a 399
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
FHX 7,.. =1i ,C21
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P 0221031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/25/2006 7987
Date Shifts Caregiver
Unit Name: LTC
11119/2006 06:30AM - 02:30PM Rlckrodo,Ashloy L
11120/2006 06:30AM - 03:OOPM Rickrode,Ashley L
11/21/2006 06:30AM - 03:OOPM Rickrode,Ashley L
11/2112006 07:00AM- 02:30PM Wheeler,Eadann L
11/2112006 02:30PM - 03:00PM Smlth,Tlna A
11/212006 03:00PM - 11:00PM Smith,Tina A
1112112005 03:001PM - 06:30PM Rickrode,Ashley L
'11121/2006 06:OOPM - 10:30PM Fulton,Amy M
11/2212006 03:00PM - 10:30PM Fulton,Amy M
11/23/2005 03:001PM - 08:OOPM Smilh.Tina A
11/23/2006 11:001PM - 07:00AM Bair,Kalhy S
11/2312006 06:30AM - 03:OOPM Smlth,Tlna A
11/2412006 03:00PM - 11:00PM Smith,Tina A
111242006 06:OOPM - 10:30PM Fullon,Amy M
11124/2006 10:30PM - 11:00PM Bair,Kathy S
11/242006 11:00PM - 07:00AM 8alr.Kathy S
11/2412006 11:00PM - 01:30AM Smlth.Tina A
1112512006 07:00AM- 02:30PM Wheeler,EarlannL
1112512006 11:00PM - 07.OOAM Bair,Kathy S
Title Description Hrs/Units Rate Amount Mlles Mileage Total
CNA REGULAR WEEKEND 8.00 27.00 5216.00 5216.00
CNA REGULAR WEEKDAY 8.50 25.00 S212.50 5212.50
CNA REGULAR WEEKDAY 8,50 25.00 $212.50 $212.50
CNA REGULAR WEEKDAY 7.50 25.00 5187.50 $187.50
LPN REGULAR WEEKDAY 0.50 40.00 520.00 $20.00
LPN REGULAR WEEKDAY 8.00 42.00 $336.00 5336.00
CNA REGULAR WEEKDAY 3.50 26.00 $91.00 $91.00
CNA REGULAR WEEKDAY 4.50 26.00 $117.00 $117,00
CNA REGULAR WEEKDAY 7.50 26,00 $195.00 5195.00
LPN WEEKDAY HOLIDAY 5,00 63.00 5315.00 $315.00
LPN WEEKDAY HOLIDAY 8.00 66.00 $528.00 $528.00
LPN WEEKDAY HOLIDAY 8.50 60.00 $510.00 5510.00
LPN REGULAR WEEKEND 8.00 48.00 $384.00 5384.00
CNA REGULAR WEEKEND 4,50 28.00 $126.00 $126.00
LPN REGULAR WEEKEND 0.50 48.00 524.00 524.00
LPN REGULAR WEEKEND 8.00 46.00 5368.00 $368.00
LPN REGULAR WEEKEND 2.50 46.00 5115.00 $115.00
CNA REGULAR WEEKEND 7,50 27.00 520Z,50 $20250
LPN REGULAR WEEKEND 8.00 46.00 5368.00 $368.00
Unit SubTOtal: 117.00 34,528.00 54,528.00
Facility Total: 117.00 54,528.00 54,528.00
L Please pay this amount $ 4,528.00
A 4 GO/ ?:w?www w6w?ww u,7/1 S.w .-AA-A &w 46C_ :! w.-& .--:A 2n ate...
OEC-26-2006 TUE`
RLMR Medirall9q
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
=,,q- ''' 21' '021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/25/2006 7987
Invoice # : 7987 Check #
Please Return This Form With Your Payment. Thank You_
Amount Paid ($):
A 1.5% finance charge will be added to this invninp if not nald within In riavc
ULL-fib-dM (TUEi 11,21
RLMR Medicai08R
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Senevit
.-Rrii1 'r Ed! -U21
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
? 021;'031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11/30/2006 8057
Date Shifts Carogiver
Unit Name: LTC
11128/2008 02:30PM - 03:OOPM Smilh,Tina A
11126/2006 02:30PM - 03:00PM Myers,Jamie 1
112612006 03:00PM - 11:OOPM Smllh,Tlna A .
11/2812006 03:00PM - 10:30PM Myers,Jamie I
1126/2008 11:OOPM - 11:15PM Smilh,Tina A
1112712006 02,30PM - 03:OOPM Smilh,Tina A
1112712006 03TOPM - 11:OOPM Sml0,11na A
11/2712008 11:OOPM - 11:30PM Smilh,Tina A
1112812006 06:30AM - 02:30PM Wheeler,Earlann L
11282006 02:30PM - 03:00PM SmllVina A
11282006 03:00PM - 11:OOPM Smlth,Tlna A
11/282006 11:00PM - 11:30PM Smilh,Tina A
11/2912006 02:30PM - 03:00PM Fullan,Amy M
11292006 03:OOPM - 10:30PM Fultan,Amy M
111292006 10:30PM - 11;OOPM Bair.Kathy S
11/2912006 11:OOPM - 07:00AM 8air,Kathy 5
11/302006 06:30AM- 02:30PM Wheeler,EartannL.
11/302006 02:30PM - 03:OOPM Sm11h, nna A
1113012008 03:OOPM - 11:OOPM Smith,Tina A
11/3012008 06:OOPM - 10:30PM Fullan,Amy M
Title Descriptlon "/Units Rate Amount Miles Mileage Total
LPN REGULARWEEKEND 44.00
CNA REGULAR WEEKEND 27.00
LPN REGULAR WEEKEND 8.00 48,00 5384.00
CNA REGULAR WEEKEND 7.50 28.00 $210.00
LPN REGULAR WEEKEND 0.25 46.00 $11.50
LPN REGULAR WEEKDAY 0.50 40.00 S20.00
LPN REGULAR WEEKDAY 8.00 42.00 5336.00
LPN REGULAR WEEKDAY 0.50 44.00 $22.00
CNA REGULAR WEEKDAY 7.50 25.00 $187.50
LPN REGULAR WEEKDAY 40.00
LPN REGULAR WEEKDAY 8.00 42.00 5336.00
LPN REGULAR WEEKDAY 0.50 44.00 $22.00
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 S195.00
LPN REGULAR WEEKDAY 0.50 42.00 $21.00
LPN REGULAR WEEKDAY 8.00 44.00 $352.00
CNA REGULAR WEEKDAY 7.50 25.00 5187.50
LPN REGULAR WEEKDAY 40.00
LPN REGULAR WEEKDAY 8.00 42.00 $336.00
CNA REGULAR WEEKDAY 4.50 26.00 $117.00
Unit SubTotal: 76.75 52,737.50
Facility Total: 76.75 $2,737.50
$384.00
$210.00
s11.50
520.00
$336.00
S22.00
$187.50
$336.00
S22.00
$195.00
S21.00
5352.00
S187.50
$336.00
$117.00
$2,737.50
$2.737.50
Please pay this amount: $ 2,737,5[1
A 1 rob finanea r•harna will ho ar4dar4 M thle tmrniwa if n^# r%%;A uii+htn 'In rlaue
7EC-25-2CC6(T1JE; ":2
AL,IR :Medic.31J50
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
=A ,,, c1' :?21
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
3. ,3E5i'J5
Facility Branch Account* Period Ending Invoice #
Shippensburg Health Care Center HC1 174 11130/2006 8057
Invoice #: 8057 Check # Amount Paid ($):
Please Return This Form With Your Payment Thank You.
A '7 GOI_ FIN?JN/.A ..I?9MA ...:II ??n .aAdA?1 ?w ?I?:e :....w.....:i ..wF ..•.:.? ...:t/.:.. 4A d-....-
,DEC-2?-2005iTUE;? 1' 2?
ALMA 4ediC310EA
Bill To.,
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
'17 21 302$
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 3215.. '" J3 I
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/02/2006 8075
Daft Shifts Caregiver
Unit Name: LTC
12/01/2006 02:30PM - 03:0012M Fulton, Amy M
12/01/2006 03:OOPM - 10:30PM Fulton.Amy M
12/=006 06:30AM - 03:OOPM Wheeler.Eadann L
12XW2006 06:30AM - 02:30PM Johnson•Slacy J
'1210212006 03:0013M - 07:00PM Wheeler,Eerlann L
Titlo Description HrsAJnits Rate Amount Miles Mileage Total
CNA REGULAR WEEKEND 0.50 27.00 $13.50 S13.50
CNA REGULAR WEEKEND 7.50 26.00 5210.00 5210.00
CNA REGULAR WEEKEND 8.00 27.00 $216.00 $216.00
CNA REGULAR WEEKEND 7.50 27.00 $202.50 5202.50
CNA REGULAR WEEKEND 4.00 28.00 $112.00 $112.00
Unit SubTotal: 27.50 5754.00 $754.00
Facility Total: 27.50 5754.00 $754,00
Please pay this amount: $ 754.00
A 1 Ca/- finbnwa wh?..+n 1.0:11 hn -%AA,%A In Ikl. :......•?...a w..& --.A ...i?1.:.. 9n .1?..?
_ ?? ,?•, I uL CC
ii 3
HLMH 4e1:r-a108H
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
?2 /03
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/0212006 8075
Invoice #: 8075
Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid {$}:
A 1 A°/ finanra rhama will ha arWorl tet thie Invnira if nett nsirl within zn rlavc
ALMA Medir-a129A
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff Benevit
Services Provided For:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
J '
Facility Branch Account # Period Ending Invoice
Shippensburg Health Care Center HCl 174 12/09/2006 8118
Date Shifts Careglver
Unit Nam e: LTC
10012006 06:30AM - 03:0013M Barclay, Jennifer 1
121012006 03:OOPM - 06:30PM Barclay, Jennifer 1
121032006 02:45PM - 03:OOPM Smith, Tina A
12/032006 03;00PM - 10:30PM Smlth, nna A
12MM008 02-30PM - 03:00PM Fulton,Amy M
121062006 03:OOPM - 10:30PM Fulton,Amy M
12/072006 06:30AM - 02:30PM Wheeler,Eadenn L
121082006 06:30AM - 02:30PM Johnson,SLacy J
121092006 06:30AM - 03;OOPM Wheeler.Earlann L
12/092006 03:00PM - 07:0015M Wheeler,Earlann L
12!0912006 10:30PM - 11:00PM Bair,Kalhy 5
12/OW2006 11:OOPM - 06:45AM Balr,Kathy S
Title Description Hrs/Units Rato Amount Miles Mileage Total
CNA REGULAR WEEKDAY 8.50 25.00 5212.50 5212.50
CNA REGULAR WEEKEND 3.50 28.00 $98.00 $98.00
LPN REGULAR WEEKEND 0.25 44.00 $11.00 511.00
LPN REGULAR WEEKEND 7.50 48.00 S360.nO S360.00
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 $195.00
CNA REGULAR WEEKDAY 7.50 25.00 5187.50 $187.50
CNA REGULAR WEEKDAY 7.50 25.00 $187.50 5187.50
CNA REGULAR WEEKEND 8.00 27.00 $216.00 $216.00
CNA REGULAR WCEKEND 4.00 28.00 5712.00 5112.00
LPN REGULAR WEEKEND 0.50 48.00 524.10 $24.00
LPN REGULAR WEEKEND 7.75 46.00 5356.50 $356.50
Unit SubTOtal: 62.50 $1,960.00 $1,960.00
Facility Total' 62.50 $1,960.00 $1,980.00
Please pay this amount: S 1,960.00
A 1.5% finance charoa will be added to this invnir_P if nest nairi within in rlavc
DEC-26-2006(TUE) 11:?2
• r r
PLMR Medica:OSP
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
F;?X; - ( 2d i 3021
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
P. 029, 031
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 1210912006 8118
Invoice # : 8118 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A I -xi%finanep r_harna will hp arldod to thise inunina if not nAm within zn riavc
?IECy-26-20061; TUE) I I ; 22 RLMA Med i ca i DBA i FqX 717 21' 302:1 P. J30 ? 031
-, w 4 A .
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Attn: Jeff 8enevit
Services Provided For.
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12/16/2006 8138
Date Shifts Caregiver
Unit Nam e: LTC
12/12/2006 07:30AM - 02:30PM Wheeler,Earlann L
12/132006 06:30AM - 03:OOPM Johnson,Stacy J
12/13/2006 02:30PM - 03:DOPM Frey, Laurie J
12113/2006 03:OOPM - 10:30PM Frey,Laurie J
12114/2006 06:30AM - 02:OOPM Wheeler,Earlann L
12/152006 06:30AM - 02:30PM Jahnson.Stacy J
12/15/2006 10:30PM - 11:OOPM Bair,K3thy S
12/15/2006 11:00PM - 06:30AM 9air,Kalhy S
Title Description FkvUnits Rate Amount Miles Mileage Total
CNA• REGULAR WEEKDAY 6.50 25.00 5162.50 S162.50
CNA REGULAR WEEKDAY 8.00 25.00 5200.00 $200.00
CNA REGULAR WEEKDAY 25.00
CNA REGULAR WEEKDAY 7.50 26.00 $195.00 5195.00
CNA REGULAR WEEKDAY 7.00 25.00 $175.00 5175.00
CNA REGULAR WEEKDAY 7.50 25.00 $197.50 $187,50
LPN REGULAR WEEKEND 0.50 48.00 $24.00 524.00
LPN REGULAR WEEKEND 7.50 46.00 $345.00 S345.dO
Unit SubTotal: 44.50 51,289.00 $1,289.00
. Facility Total: 44.50 $1,289.00 $1,289.00
Please pay this amount: S1,289.00
A I se/ finanrn r_harnp will be added to this Invoice if not paid within 30 davs
,D;4C-M-2006 (TUE) 1' 22 RLMA Medical06H I Z. Rit;! 717 ?dl 30c1 P 03':?`0?1
Bill To:
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Services Provided For
Shippensburg Health Care Center
121 Walnut Bottom Rd
Shippensburg PA 17257
Facility Branch Account # Period Ending Invoice #
Shippensburg Health Care Center HC1 174 12116/2006 8138
Invoice #: 8138 Check #
Please Return This Form With Your Payment. Thank You.
Amount Paid ($):
A 1.5% finance charge will he added to this invoice If not uaid within 3n riavsa
IV r
%V a a 4r
EXHIBIT "C"
•JEC-36-2006( 7 UE i : l7 RLMR Medica108R
,FRX) ' 717 21i 3021 P 00i/031
Interest due in
addition to
Total Invoice Date Pald unpaid balance Paid Unpaid Invoice Balance
06/3012006
174 Shippensburg Health Care 7270 848.00 9.26 30.75 648.00
Total For: 6/3012006 S848.00 5848.00 $0.00
07108!2006
174 Shippensburg Health Care 7303 396.00 9.28 15.04 396.00 0.00
Total For: 718/2006 $396.00 $396.00 50.00
07115/2006
174 Shippensburg Health Care 7325 217.50 9.28 6.49 217.50 0.00
Total For: 711512006 5217.50 $217.50 S0.00
07/22!2006
174 Shippensburg Health Care 1 7348 413.23 9.26 11.1 413.23 0.00
Total For, 712212006 5413.23 $413.23 S0:00
07/29/2006
174 Shippensburg Health Caret 7400 1,085.00 9.26 25.01 1,085,00 0.00
Total For: 712912006 $1,085.00 $1,085.00 SO.00
07/31/2006
174 Shippensburg Health Care 1 7421 473.00 9.26 10.9 473.00 0.00
Total For: 7/3112006 5473,00 S473.00 50.00
0810512006
174 Shippensburg Health Care 1 7438 2,104.00 111 76.3 2,104.00 0.00
Total For, 8/5/2006 52.104,00 S2,104,00 50.00
08112/2006
174 Shippensburg Health Care 1 7481 2,672.50 11.1 88.92 2,672.50 0.00
Total For, BA2,12006 52,672.50 52.672.50 S0.00
08/19/2006
174 Shippensburg Health Caro 1 7508 2,666.60 11.1 80.75 2.666.60 0.00
Total For: 8119!2006 $2,666.60 S2,666,60 S0.00
0 812 612 0 0 6
174 Shippensburg Health Cara 1 7547 2,456.50 11.1 67.04 2,456.50 0.00
Total For: 8126/2006 52,456.50 52,456.50 SO.00
08/3112006
174 Shippensburg Health Care 1 7566 756.50 11.1 19.53 756.50 0.00
Total For, 813112006 $756.50 $756.60 50.00
09/02/2006
174 Shippensburg Health Carer 7579 1,351.00 11.28 48.99 1,351.00 0.00
Total For: 9/212006 51,351.00 $1,351.00 $0.00
0910912006
174 Shippensburg Health Care 1 7594 4,938.50 11,28 164.31 4,938.50 0.00
Total For: 919/2006 $4,938.50 S4,938.50 50100
09116/2006
174 Shippensburg Hoaith Care 1 7636 3,000.00 11.28 90.85 3,000.00 0.00
Total For. 911612006 53,000.00 $3,000.00 $0.00
09/23/2006
174 Shippensburg Health Care 1 7663 3,313.62 128.69 3,313.62
Total For: 9/2312006 $3,313.62 53,313.62
09/30/2006
174 Shippensburg Health Caret 7705 2,279.25 11.28 57.34 2,279.25 0.00
Total For. 9/3012006 52,279.25 S2,279.2S 50.00
10/0T/2006
174 Shippensburg Health Care t 7730 2,082.00 70.16 2,082.00
Total For: 101712006 S2,082.00 $2,082.00
10/14/2000
174 Shippensburg Health Care 1 7754 1,543.00 46.07 1,543.00
Total For, 10114/2006 S1,543.00 $1,543.00
10121/2006
174 Shippensburg Health Care 1 7771 3,865,00 103.83 3,865.00
Total For: 10121/2006 $3,865.00 $3,865.00
IS El?-2F-200o(TUE; 11; 17 RLMR Medica!OBR
`" 'r Total For 1012812006 52,649.25
10/3112006
174 Shippensburg Health Care 7652 1,330.75
Total For. 10131/2006 $1,330.75
1110412006
174 Shippensburg Health Care 1 7870 1,444.59
Total For, 1v4)2006 51,444.59
11/11/2006
174 Shippensburg Health Care 1 7891 2,481.28
Total For: 11/1112006 $2,481.28
11/1812006
174 Shippensburg Health Care 1 7986 3,072.13
Total For: 11118/2006 53,072.13
11/2512006
174 Shippensburg Health Care 7987 4,528.00
Total For: 11125/2006 54,528.00
11/30/2006
174 Shippensburg Health Care 1 8057 2,737.50
Total For: 11/3012006 S2,T37.50
12/02/2006
174 Shippensburg Health Care 8075 754.00
Total For: 121212006 S754.00
12109/2006
174 Shippensburg Health Caro 1 8118 1,960.00
Total Far: 1219/2006 51,960.00
12/16/2006
174 Shippensburg Health Caro 8138 1,289.00
Total For., 1211512006 S1,289.00
Total For Weekly •558,707.70
(FRS}''; 717 21i 3021 P.002 031
S2,649.25
31.23 1,330.75
S1,330.75
30.96 1,444.59
S1,444.59
46.72 2,481.28
52,481.28
47.47 3,072.13
S3,072.13
56.6 4,528.00
54,528.00
2,737.50
52,737.50
754.00
5754. DO
1,960.00
$1,960.00
1,289.00
S1,289.00
$33,050.12
558,707.70 2843.4 $33.050.12
w r r
VERIFICATION
The foregoing Amended Complaint is based upon information which has been gathered
by counsel and myself in the preparation of this action. I have read the statements made in this
document and they are true and correct to the best of my knowledge, information and belief. I
understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section
4904, relating to unsworn falsification to authorities.
di "? / (' ?'
STA K. KREBS
On behalf of ALMA HEALTH LLC
d/b/a MEDSTAFFERS
Date: , 2.001
ALMA HEALTH LLC d/b/a,
MEDSTAFFERS, a Pennsylvania Corporation,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE CENTER, INC. :
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
CIVIL ACTION - LAW
NO. 2006 - CIVIL TERM
CERTIFICATE OF SERVICE
I, Marcus A. McKnight, III, Esquire, hereby certify that a copy of attached document was
served upon the following by depositing a true and correct copy of the same in the United States
mail, First Class, postage prepaid in Carlisle, Pennsylvania, on the date referenced below and
addressed as follows:
David A. Baric, Esquire
19 West South Street
Carlisle, PA 17013
Attorney for Defendants
By:
Date: January 19, 2007
IRWIN &
60 est Pomfret Street '
C isle, PA 17013
(71V) 249-2353
Sup e Court I.D. No. 25476
5
lid 61 N'C LG13I
'3 :SQ
1? 4?F Ui v
i"?.1_? ?.T77_.J{
ALMA HEALTH LLC d/b/a : IN THE COURT OF COMMON PLEAS OF
Medstaffers, a Pennsylvania Corporation, : CUMBERLAND COUNTY,
Plaintiff, : PENNSYLVANIA
V.
NO. 2006-7269 CIVIL TERM
SHIPPENSBURG HEALTH CARE : CIVIL ACTION-LAW
CENTER, INC.and MAGNOLIA
MANAGEMENT COMPANY, : JURY TRIAL DEMANDED
Defendants.
NOTICE TO PLEAD
TO: Alma Health, L.L.C. d/b/a
Medstaffers, a Pennsylvania Corporation
c/o Marcus A. McKnight, III, Esquire
Irwin & McKnight
60 West Pomfret Street
Carlisle, Pennsylvania 17013
You are hereby notified that you have twenty (20) days in which to plead to the enclosed
Answer and New Matter to Amended Complaint or a default judgment may be entered against
you.
Date: February J '2007
'BRIEI4, B C & S R
r
David A. Baric, Esquire
I.D. No. 44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
ALMA HEALTH LLC d/b/a : IN THE COURT OF COMMON PLEAS OF
Medstaffers, a Pennsylvania Corporation, : CUMBERLAND COUNTY,
Plaintiff, : PENNSYLVANIA
V.
NO. 2006-7269 CIVIL TERM
SHIPPENSBURG HEALTH CARE
CENTER, INC.and MAGNOLIA
MANAGEMENT COMPANY,
Defendants.
CIVIL ACTION-LAW
: JURY TRIAL DEMANDED
ANSWER AND NEW MATTER TO AMENDED COMPLAINT
NOW, come Defendants, Shippensburg Health Care Center, Inc. ("Shippensburg") and
Magnolia Management Company ("Magnolia"), by and through their attorneys, O'BRIEN,
BARIC & SCHERER, and file the within Answer and New Matter and, in support thereof, set
forth the following:
1. After reasonable investigation, Shippensburg and Magnolia are without
knowledge or information sufficient to form a belief as to the truth of these averments and they
are, therefore, denied.
2. Admitted in part. It is admitted only that Shippensburg has a business address of
121 Walnut Bottom Road Shippensburg, Cumbeland County, Pennsylvania. The remaining
averments are denied.
3. Admitted in part. It is admitted only that Magnolia has a business address of 1710
Underpass Way #201, Hagerstown, Maryland. The remaining averments are denied.
4. Denied. To the contrary, Shippensburg entered into a contract with Plaintiff
referenced as a "Facility Staffing Agreement" which contract is a writing which speaks for itself.
5. To the extent these averments constitute conclusions of law, no response is
required. To the extent a response may be required, the averments are denied. To the contrary,
Magnolia is not bound by the "Facility Staffing Agreement" appended to Plaintiff's Amended
Complaint.
6. Denied. It is denied that Plaintiff is entitled to this sum of money. To the
contrary, Plaintiff has failed to calculate its fees for services rendered in accordance with the
terms of the Facility Staffing Agreement.
7. Admitted in part. It is admitted only that Plaintiff has made demand for payment.
It is denied that no payments were made to Plaintiff by Shippensburg.
Denied. To the contrary, the referenced document is a writing which speaks for
itself. Magnolia owes no sum of money to Plaintiff. Further, Plaintiff has failed to calculate its
fees for services rendered in accordance with the terms of the Facility Staffing Agreement.
WHEREFORE, Defendants request that judgment be entered in their favor and against
Plaintiff together with costs and expenses.
NEW MATTER
9. Defendants incorporate their answers set forth in paragraphs one through eight as
though set forth at length.
10. Plaintiff has failed to calculate the fees it charged for services rendered in
accordance with the terms of the Facility Staffing Agreement.
11. Plaintiff has failed to state a cause of action against Magnolia.
12. Plaintiff has produced no writing which reflects or references Magnolia.
13. Defendants were justified in refusing to pay money to Plaintiff.
14. Shippensburg has paid money to Plaintiff for services rendered and believes
Plaintiff may not have properly accounted for payments made.
15. Plaintiff has billed Shippensburg for work it was not permitted to bill for under
the terms of the Facility Staffing Agreement.
WHEREFORE, Defendants request judgment be entered in their favor and against
Plaintiff together with costs and expenses.
Respectfully submitted,
O'BRIEN, BARIC & SCHERER
David A. Baric, Esquire
ID No. 44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
Attorney for Defendants
ALMA HEALTH LLC d/b/a : IN THE COURT OF COMMON PLEAS OF
Medstaffers, a Pennsylvania Corporation, : CUMBERLAND COUNTY,
Plaintiff, : PENNSYLVANIA
V. : NO. 2006-7269 CIVIL TERM
SHIPPENSBURG HEALTH CARE : CIVIL ACTION-LAW
CENTER, INC.and MAGNOLIA
MANAGEMENT COMPANY, : JURY TRIAL DEMANDED
Defendants.
VERIFICATION
I verify that the statements made in the foregoing Answer and New Matter to Amended
Complaint are true and correct to the best of my knowledge, information and belief. This
verification is signed by David A. Baric, Esquire, Attorney for Defendants and is based upon the
statements provided by Defendants, as well as documents reviewed by the undersigned as
attorney for Defendants. I understand that false statements herein are made subject to penalties
of 18 Pa.C.S. §4904, relating to unsworn falsifications to authorities.
David A. Baric, Esquire
1
Dated: February S , 2007
ALMA HEALTH LLC d/b/a : IN THE COURT OF COMMON PLEAS OF
Medstaffers, a Pennsylvania Corporation, : CUMBERLAND COUNTY,
Plaintiff, : PENNSYLVANIA
V. : NO. 2006-7269 CIVIL TERM
SHIPPENSBURG HEALTH CARE : CIVIL ACTION-LAW
CENTER, INC.and MAGNOLIA
MANAGEMENT COMPANY, : JURY TRIAL DEMANDED
Defendants.
CERTIFICATE OF SERVICE
I hereby certify that on February 5, 2007, I, David A. Baric, Esquire, of O'Brien, Baric &
Scherer, did serve the Answer and New Matter to Amended Complaint by first class U.S. mail,
postage prepaid, to the parties listed below, as follows:
Marcus A. McKnight, III, Esquire
60 West Pomfret Street
Carlisle, Pennsylvania 17013
L
David A. Baric, Esquire
-._,
.- _?
?,,
--1
L _
_
[..,?
___
?? f., :7
"
?,- `
"
ALMA HEALTH LLC d/b/a,
MEDSTAFFERS, a Pennsylvania Corporation,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE CENTER, INC. :
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
CIVIL ACTION - LAW
NO. 2006 - 7269 CIVIL TERM
ANSWER TO NEW MATTER
AND NOW comes the Plaintiff, ALMA HEALTH LLC d/b/a MEDSTAFFERS, a
Pennsylvania Corporation, by and through its attorneys, Irwin & McKnight, and makes the
following Answer to New Matter against the Defendants, SHIPPENSBURG HEALTH CARE
CENTER, INC. and MAGNOLIA MANAGEMENT COMPANY, as follows:
9.
The Averments of Fact contained in Paragraphs One (1) through Eight (8) of the
Complaint are incorporated herein by reference in response to the Defendants' New Matter.
10.
The Plaintiff has calculated its fees based upon the contract as well as the time records
made by its employees. If there are any errors they are beyond the knowledge of the Plaintiff.
They are therefore denied and proof of any calculation errors is demanded.
11.
The Plaintiff's action against Magnolia is based upon the control it maintains over the
actions of key personnel at Magnolia Management Company.
12.
The Plaintiff's action against Magnolia is based upon its ownership and control of its
subsidiary, Shippensburg Health Care Center, Inc.
13.
The Averments of Paragraph Thirteen (13) of the New Matter are specifically denied. On
the contrary, the Defendants have never objected to the billings made by the Plaintiff. Proof of
any basis for failing to pay for the services provided is demanded from the Defendants.
14.
The Averments of Fact contained in Paragraph Fourteen (14) of the New Matter are
specifically denied. On the contrary, the Plaintiff has correctly applied all payments made by the
Defendants to the accounts of the Defendants.
15.
The Averments of Fact contained in Paragraph Fifteen (15) of the New Matter are
specifically denied. On the contrary, the Defendants were seeking more service from the Plaintiff
and proposed to make regular payments for the services it needed to adequately staff its facility.
WHEREFORE, Plaintiff demands judgment against the Defendants in the amount of
Thirty-Three Thousand Fifty and 121100 ($33,050.12) Dollars plus reasonable legal fees and
interest as permitted by law.
Respectfully submitted,
By:
Date: February 20, 2007
IRWINA McKNIGHT
qs us cKnight, III, Esquire
me Co i?t I.D. #25476
est P ret Street
e, PA 17013
(717) 249-2353
Attorney for the Plaintiff
2
VERIFICATION
The foregoing document is based upon information which has been gathered by counsel
and myself in the preparation of this action. I have read the statements made in this document
and they are true and correct to the best of my knowledge, information and belief. I understand
that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904,
relating to unworn falsification to authorities.
A K. KREBS
On behalf of ALMA HEALTH LLC
d(b/a MEDSTAFFERS
v 7
Date: 2L
ALMA HEALTH LLC d/b/a,
MEDSTAFFERS, a Pennsylvania Corporation,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE CENTER, INC. :
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
CIVIL ACTION - LAW
NO. 2006 - 7269 CIVIL TERM
CERTIFICATE OF SERVICE
I, Marcus A. McKnight, III, Esquire, hereby certify that a copy of attached document was
served upon the following by depositing a true and correct copy of the same in the United States
mail, First Class, postage prepaid in Carlisle, Pennsylvania, on the date referenced below and
addressed as follows:
David A. Baric, Esq.
O'Brien, Baric & Scherer
19 West South Street
Carlisle, PA 17013
IRWIN & McKNIGHT
By: acus A. cKnight, III, Esquire
6 est Po fret Street
Carlis e, A 17013
(717) 249-2353
Supreme Court I.D. No. 25476
Date: February 20, 2007
3
n r-
?
Q
cl
N G
C.W
ALMA HEALTH LLC d/b/a
MEDSTAFFER, A PENNSYLVANIA CORPORATION,
PLAINTIFF '
SHIPPENSBURG HEALTH CARE CENTER, INC.
and MAGNOLIA MANAGEMENT COMPANY,
DEFENDANT.
IN THE COURT OF COMMON PLaAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2006-7269 CIVIL 19
RULE 1312-1. The Petition for Appointment of Arbitrators shall be substantially
in the following form:
PETITION] FOR APPOINTNIENT OF ARBITRATORS
TO THE HONORABLE, THE JUDGES OF SAID COURT:
MARCUS A. McKNIGHT, III , counsel for the plaintiff/defendant in
the above action (or actions), respectfully represents that:
1. The above-captioned actior. (or actions) is (are) at issue.
2. The claim of the plaintiff in the action is $ 33,050.12
The counterclaim of the defendant in the action is n_()n .
The following attorneys are interested in the case(s) as counsel or are other-
wise disqualified to sit as arbitrators: ALL ATTORNEYS AT IRWIN & McKNIGHT
AND O'BRIEN, BARIC & SCHERER.
WHEREFORE, your petitioner prays your Honorable Court to appoint three (3)
arbitrators to whom the case shall be submitted.
ORDER OF COURT
Respec
AND NOW1 , 19 , in co
foregoing petition, Esq.,
Esq., and
of the
,Esq., are appointed arbitrators in the
above-captioned action (or actions) as prayed for.
By the Court,
P. J.
LP
ky as -' r.-
tr? to co
ALMA HEALTH LLC d/b/a
MEDSTAFFER, A PENNSYLVANIA CORPORATION,
PLAINTIFF
SHIPPENSBURG HEALTH CARE CENTER, INC.
and MAGNOLIA MANAGEMENT COMPANY, .
DEFENDANT.
IN THE COURT OF COMMON PL&AS OF
CL'PIBERL.w,ND COUNTY, PENNSYI-VA141A
NO. 2006-7269 CIVIL 19
RULE 1312-1, The Petition for Appointment of Arbitrators shall be substantialiv
in the following form;
PrTI TON FOR APPOINTMENT OF ARBITRATORS
TO THE HONORABLE, THE JUDGES OF SAID COURT:
MARCUS A. McKNIGHT, III , counsel for the plaintif/defendant in
the above action (or actions), respectfully represents that:
1. The above-captioned action (or actions) is (are) at issue.
2. The claim of the plaintiff in the action is $ 33,050.12
The counterclaim of the defendant in the action is -n_00
The following attorneys are interested in the case(s) as counsel or are other-
wise disqualified to sit as arbitrators: ALL ATTORNEYS AT IRWIN & McKNIGHT
AND O'BRIEN, BARIC & SCHERER.
WHEREFORE, your petitioner prays your Honorable Court to appoint three (3)
arbitrators to whom the case shall-be submitted.
ORDER OF COURT
i
AND NOW, in cons' on of the
foregoing petition, Ld,&a aee Esq., d6na'?'
Esq., and are appointed arbitrators in the
above-captioned action (or actions) as prayed for.
By t our ,
J.
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ALMA HEALTH LLC d/b/a
MEDSTAFFER, A PENNSYLVANIA
CORPORATION,
PLAINTIFF
V.
SHIPENSBURG HEALTH CARE
CENTER, INC., AND MAGNOLIA
MANAGEMENT COMPANY,
DEFENDANTS
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
06-7269 CIVIL TERM
ORDER OF COURT
AND NOW, this '' day of March, 2007, the appointment of Joseph J.
Notarianni, Jr., Esquire, to the Board of Arbitrators in the above-captioned case, IS
VACATED. John C. Oszustowicz, Esquire, is appointed in his place.
By the Cou
Edgar B. Bayle ,
/H. Anthony Adams, Esquire
Chairman
,/John C. Oszustowicz, Esquire
104 South Hanover Street
Carlisle, PA 17013
Court Administrator
o?
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C. _? _
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C`+!
A" ICI Lc,L ?
M0 S ?-?.r Plaintiff 1
e
?Ne . o l i e,? Defendant
In The Court of Common Pleas of Cumberland
County, Pennsylvania No. 200? - ?fig
Civil Action - Law.
Oath
We do solemnly swear (or affirm) that we will support, obey and defend the Constitution of the United
States and the Constitution of this Commonwealth and that we will discharge the duties of our office
with fidelity.
i
t
Signature
MA C-
Name (Cha' )
4ue*?bk??
Signature
???'a.aC G
Name
ShIM?- ??jAk 6'J 6el' ?r
Law Firm Law Finn
. o 5. ?t
Address Address
S11 7a S> jn?!? A?7a?13
Lip City, zip
? I1431
3 Award
i
r
t 1
S--'??-- tore
Jo H ?S?-c-? l?y Gv l t Z
Name
Jy1 n,l r a?UJ/VLvl c Z
Law Firm
11 aV .f= /-X?M 47 s
Address
City, zip
# I ao
We, the undersigned arbitrators, having been duly appointed and sworn (or affirmed), make the
fo wing award: (Note: a es for delay are awarde , th shall b separately stated.
Q
Date of Hearing: all) -7
Date of Award:
Notice of Entry of Award
F t
M W.
WAR
Now, the ash day of a , 20_pl_, at a : „ , _.M., the above award was
entered upon the docket and notice thereof given by mail to the parties or their attorneys.
Arbitrators' compensation to be paid upon appeal: $ 350.00
iz a ?-- By:
dode
P thonotary Deputy
?„'r) r) f-VArbitrator, dissents. (Insert name if
C6
n ? sC?
L
-75
C76
;DO ?.o
,? _.
A " ?"(Lc,L
Q
N)011 S ?-Pks- Plainti
C e (e-44t
.9Ne . o i c.%. Defendant
Oath
In The Court of Common Pleas of Cumberland
County, Pennsylvania No. Zed - "7
Civil Action - Law.
We do solemnly swear (or affirni) that we will support, obey and defend the Constitution of the United
States and the Constitution of this Commonwealth and that we will discharge the duties of our office
with fidelity.
<< ??x? ;?
Signature
Name (Ch )
4&ee
Signature
Wkk G
Name
Law Firm Law Firm
0 L 5?.
Address Address
t City, Zip
? 11431 : Award
S' tore
Name
,..Jv k I'l r a2' U J 1/u u. i c Z
Law Firm
tlav -j- f-i-
Address
city, zip
# 1 dog
We, the undersigned arbitrators, having been duly appointed and sworn (or aTarmed), make the
foURwing award: (Note: I?f ages for delay are awarded, they sha11 bey separately stated.)
Q
Date of Hearing:
Date of Award: '
bn it
Notice of Entry of Award
Now, the o?5`?h day of Mav20_pl_, at a :11 , P.M., the above award was
entered upon the docket and notice thereof given by mail to the parties or their attorneys.
A bitrators' cnmi)ensation to be paid upon appeal: $ 350.00
By:
P thonotary
Deputy
& `r,&r?Arbitrator, dissents. (Insert name if
ih
C?
moo i q ??
M ~d A. 1
Do
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6
ALMA HEALTH LLC d/b/a, IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, OF CUMBERLAND COUNTY
Plaintiff
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC. : NO. 2006 - 7269 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY,
Defendants
PRAECIPE TO ENTER JUDGMENT AND ASSESS DAMAGES
To Curtis R. Long, Prothonotary:
Kindly enter judgment in favor of the Plaintiff and against the Defendant on the attached
Order of Court dated May 25, 2007, rendered following arbitration, and no timely appeal has
been filed.
Please assess judgment in favor of the Plaintiff as follows:
Amount of Judgment $36,976.00
Costs of Suit 137.57
Costs of Suit and Legal Fees 2,001.75
Total $39,115.32
IRWIN & McKNIGHT
By: -NI/ ( L
Marcu A. McKffi-e'ht. III, squire
Supreme ourt I.D. #25476
60 Wes omfret Street
Carlisle, PA
(717) 249-2353
Attorney for the Plaintiff
Date: December 19, 2007
DAMAGES ARE HEREBY ASSESSED ON THE JUDGMENT AS INDICATED.
Date: /?s/ 4';t
PROTHONOTARY ?,
A tyn I Aea (4? LL.L aq
("G? S kv 4Te r Plain
,L l#, Cie
'>-C. a l Defendant
In The Court of Common Pleas of Cumberland
County, Pennsylvania No. 200? ---7 2,G7
Ca?v
Civil Action - Law.
Oath
We do solemnly swear (or affirm) that we will support, obey and defend the Constitution of the United
States and the Constitution of this Commonwealth and that we will discharge the duties of our office
with fidelity.
Signature
II a. M
Name (Cha' )
-31* ?el
Law Firm
0?
Address
urol
7a s>
S ;
city, Zip
Zw?W?
Signature
Name
Q fG 'r-
Law Firm
J(
Address
J?ln? ?A--?7oW3
City, zip
\f
S, g&ture
24m o CJ,t c c It.., I (-L-
Name
jyhi'r C• ?szu.i/vt."I c z
Law Firm /
?a f ? ? ayP? 1
Address
/70
city, zip
Award
We, the undersigned arbitrators, having been duly appointed and sworn (or affirmed), make the
Date of Hearing:
Now, the ash day of a , 20 , at a :1, .M., the above award was
entered upon the docket and notice thereof given by mail to the parties or their attorneys.
thonotary Notice of Entry of Award
Arbitrators' compensation to be paid upon appeal: S 350. 00 SIC C )M RE(XW
whlfgOf, I hone Uft so 1W hat
80 of saki rt at Qd*, Pa.
By:
ALMA HEALTH LLC d/b/a, IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, OF CUMBERLAND COUNTY
Plaintiff
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - 7269 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
CERTIFICATE OF SERVICE
I, Marcus A. McKnight, III, Esquire, hereby certify that a copy of attached document was
served upon the following by depositing a true and correct copy of the same in the United States
mail, First Class, postage prepaid in Carlisle, Pennsylvania, on the date referenced below and
addressed as follows:
David A. Baric, Esq.
O'Brien, Baric & Scherer
19 West South Street
Carlisle, PA 17013
By:
Marcus
PA 17013 McKni
Carlisle, A.
(717) 249-2353
Supreme Court I.D. No. 25476
IRWIN & McKNIGHT
, Esquire
60 West Pomfret S t
Date: December 19, 2007
c
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
PRAECIPE FOR WRIT OF EXECUTION
Caption:
ALMA HEALTH LLC d/b/a
MEDSTAFFERS, a Pennsylvania Corp.,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE CENTER,INC•
121 Walnut Bottom Road
Shippensburg, PA 17257
? Confessed Judgment
? Other
File No. 2006 - 7269 CIVIL TERM
Amount Due $36, 976.00
Interest 2,767.74
Atty's Comm
Costs 750.00
TO THE PROTHONOTARY OF THE SAID COURT:
The undersigned hereby certifies that the below does not arise out of a retail installment sale,
contract, or account based on a confession of judgment, but if it does, it is based on the appropriate original
proceeding filed pursuant to act 7 of 1966 as amended; and for real property pursuant to Act 6 of 1974 as
amended.
Issue writ of execution in the above matter to the Sheriff of Cumberland
County, for debt, interest and costs, upon the following described property of the defendant (s)
you are directed to levy upon all personal property of the defendant,
Shippensburg Health Care Center, Inc., including but not limited to
furniture and equipment.
PRAECIPE FOR ATTACHMENT EXECUTION
Issue writ of attachment to the Sheriff of Cumberland County, for debt, interest
and costs, as above, directing attachment against the above-named garnishee(s) for the following property
(if real estate, supply six copies of the description; supply four copies of lengthy personalty list)
You are directed to levy upon all personal property of the defendant,
including but not limited to furniture and equipment.
and all other property of the defendant(s) in the possession, custody or control of the said garnishee(s)
? (Indicate) Index this writ against the garnishee (s) as a lis
defendant(s) described in the attached exhibit.
Date _ January 10, 2008 Signature:
Print Name
Address
Attorney for:
pen
dens gainst re estate of the
. McKnight, III
IRWIN & McKNIGHT
60 Pomfret Street
Carlisle, PA 17013
Alma Health, LLC
, ESq.
Telephone: 717.2 4 9.2 3 5 3
Supreme Court IDNo: 25476
W?
1
rZ? /f
V
N
"'b4
+" S? 5
WRIT OF EXECUTION and/or ATTACHMENT
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND)
TO THE SHERIFF OF CUMBERLAND COUNTY:
To satisfy the debt, interest and costs due ALMA HEALTH LLC DB/A MEDSTAFFERS, A
PENNSYLVANIA CORP., Plaintiff (s)
From SHIPPENSBURG HEATLH CARE CENTER, INC., 121 WALNUT BOTTOM ROAD,
SHIPPENSBURG, PA 17257
(1) You are directed to levy upon the property of the defendant (s)and to sell YOU ARE DIRECTED
TO LEVY UPON ALL PERSONAL PROPERTY OF THE DEFENDANT, SHIPPENSBURG
HEALTH CARE CENTER, INC., INCLUDING BUT NOT LIMITED TO FURNITURE AND
NO 06-7269 Civil
CIVIL ACTION - LAW
EQUIPMENT.
(2) You are also directed to attach the property of the defendant(s) not levied upon in the possession
of
GARNISHEE(S) as follows:
and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from
paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant
(s) or otherwise disposing thereof;
(3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession
of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a
garnishee and is enjoined as above stated.
Amount Due $36,976.00
L.L. $.50
Interest $2,767.74
Atty's Comm %
Atty Paid $178.67
Plaintiff Paid
Due Prothy $2.00
Other Costs $750.00
Date: JANUARY 10, 2008
(Seal)
Curtis W Long, Prothon
By:
Deputy
REQUESTING PARTY:
Name MARCUS A. MCKNIGHT, III, ESQUIRE
Address: IRWIN & MCKNIGHT
60 POMFRET STREET
CARLISLE, PA 17013
Attorney for: PLAINTIFF
Telephone: 717-249-2353
Supreme Court ID No. 25476
ALMA HEALTH, LLC d/b/a
MEDSTAFFERS, a
Pennsylvania Corporation,
Plaintiff
V.
SHIPPENSBURG HEALTH CARE
CENTER, INC. and
MAGNOLIA MANAGEMENT
COMPANY,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2006-7269 CIVIL TERM
CIVIL ACTION-LAW
PETITION TO STAY/SET ASIDE EXECUTION PURSUANT TO PaRCP 3121
AND NOW, comes Defendants, Shippensburg Health Care Center, Inc. and Magnolia
Management Company, by and through their attorneys, O'BRIEN, BARIC & SCHERER, and
files the within Petition to Stay Execution and, in support thereof, sets forth the following:
1. This matter relates to a debt for services rendered by Plaintiff at the Shippensburg
Health Care Center.
2. An award in arbitration was issued on April 13, 2007, a true and correct copy of
the award is attached hereto as Exhibit "A" and is incorporated by reference.
3. Since the issuance of the award, Shippensburg Health Care Center has made
payments against the award in the amount of $32,500.00 to Plaintiff as reflected in the checks
attached hereto as Exhibit "B" and incorporated by reference.
4. On December 21, 2007, counsel for Plaintiff entered a judgment on the award
against Shippensburg Health Care Center, Inc. in the amount of $39,115.32. A true and correct
copy of the praecipe to enter judgment is attached hereto as Exhibit "C" and is incorporated by
reference.
5. Upon information and belief, the Plaintiff has failed to give proper credit for
payments made against the debt which forms the basis for the judgment.
6. Plaintiff has undertaken to execute upon the judgment so entered.
7. The praecipe for the writ is defective in that it fails to properly account for
payments made by Shippensburg Health Care Center to Plaintiff since the date of the arbitration
award.
8. Counsel for the Plaintiff does not concur in this Petition.
9. No Judge has issued any prior Orders in this matter.
WHEREFORE, Defendants request that execution on the judgment be stayed and/or set
aside to permit an accounting for the payments made to determine the debt remaining due under
the original award and that the Plaintiff be enjoined from further execution on the judgment until
a determination is made as to the remaining amount due.
Respectfully submitted,
'BRIEN, BARIC
David A. Baric, Esquire
ID#44853
19 West South Street
Carlisle, Pennsylvania 17013
(717) 249-6873
CERTIFICATE OF SERVICE
I hereby certify that on January 18, 2008, 1, David A. Baric, Esquire, did serve a copy of
the Petition to Stay/Set Aside Execution Pursuant to PaRCP 3121, by first class U.S. mail,
postage prepaid, to the party listed below, as follows:
Marcus A. McKnight, III, Esquire
Irwin and McKnight
60 West Pomfret Street
Carlisle, Pennsylvania 17103
Sheriff
Cumberland County Courthouse
One Courthouse Square
Carlisle, Pennsyl 17013
l
David A. Baric
M@ s k.??- ply.-. _ Y
C e (a4r
t l o' ?Dee?fe-a-daa=
h! COL:. C. l.o'^r J" ?:eas o' 1? -`=
County, ?e.?syly? 'a tic- Zap- 72.49
C.v,.l Action - Law.
-..-% Oath
We do solemnly swear (or affirm) the. we vr'li support, obey and defend t;^.e Constita,'d on off the United
States and the Constitution of this Commonwealth and that we will discharge the duties of our office
with fidelity. , .I
Sipatttre
LL A.. M6
Naaze ( )
Sd N)e-
Law Fnm
O
Address
S ? c ?7a Sa
city,
Sig-m:ze f I
85 (unit k (s G u
Nom-
?A' AJIJ& ?J K7e, ? D;* -
Law Firm
Jt W4
Address
r,l? ? A--E7cg3
city, zip
Award
w
S?:tsre
oti k 0. !'x ?Lt J7<T? G.,I L
Name
JU < 4-)f1vJA ICS
Laaw/Firm
Addrou
C G v?.1 1i?- 17e / 3
Ciry. zip
We, the undersigned arbitrators, having been duly appointed and sworn (or affirmed}, make the
P\T-4- 71`.1w.a &R 4,-e A&1,5-tt 7rP -intarAM f%&-i ihs;ll }h P. germ-ratPlZJ eratpA
Date of Hearing:
Date of Award:
Now, the o?5a1day of f 4ay , 20-P-7--, at 9! IL , . --M-, the above awa d was
entered upon the docket and notice then of given by mail to the parties or their attorneys.
Arbitrators' compensation to be paid upon appeal: S Z5Q . DO
TR PE COPY FROM RECOR
ea ? f, l Pere Ul ft My K, I -
1121. ?@ Sit of said '?; ,I at tarit?a, Pa.
.8y:
tconotary1
Exhibit "A"
Nodicz ofFztry of AM,2rd
SHIPPENSBURG HEALTH CARE CTR
c/o 1710 UNDERPASS WAY
HAGERSTOWN, MD 21740-6979
(717) 530-8300
PAY Five Thousand And 00/100 dollars
TO THE
ORDER OF
Medstaffers
P.O. Box 1300
Suisun City, CA. 94585
VO L L84 Liie 403L30941,04 L 5580 2iis
Check Date 05/22/2007
First National Bank of Greencastle
40 Centre Street
GREENCASTLE, PA 17225
60-944/313
DATE
05/22/2007
Check # 11841
11841
AMOUNT
$ 5,000.00
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bat.
7730 $2,082.00
7754 $1,543.00
7771 $1,375.00 $2,490.00
MED101 Medstaffers
$5,000.00
$2,490.00
Check Date 05/22/2007
Check # 11841
Invoice No. Reference Check Notes Amount Paid Discount Invoice But.
7730 $2,082.00
7754 $1,543.00
7771 $1,375.00 $2,490.00
MED101 Medstaffers $5,000.00 $2,490.00
Exhibit "B"
SHIPPENSBURG HEALTH CARE CTR Flrst National Bank of Greencastle 11846
c/o 1710 UNDERPASS WAY 40 Centre Street
HAGERSTOWN, MD 21740-6979 GREENCASTLE, PA 17225
(717) 530-8300 60-944/313
PAY Two Thousand Five Hundred And 00/100 dollars
TO THE
ORDER OF
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
DATE
05/23/2007
AMOUNT
$ 2,500.00
P 'r K.ja up 5?-f
11001L&4601 1:0 3 i 3094401: i 5 560 2118
Check Date 05/23/2007
Check # 11846
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bai.
7771
7796 $2,490.00
$10.00
$2,639.25
MED101 Medstaffers
$2,500.00
$2,639.25
Check Date 05/23/2007
Check # 11846
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
7771
7796 $2,490.00
$10.00
$2,639.25
MED101 Medstaffers $2,500.00 $2,639.25
SHIPPENSBUR CTR
c%o 1710 UNDERPA S !CARE
Y
HAGERSTOWN, MD 2 740-6979
(717) 530-8300
PAY Five Thousand And 00/100 dollars
TO THE
ORDER OF
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
First National Bank of Greencastle
40 Centre Street
GREENCASTLE, PA 17225
60-944/313
DATE
06/13/2007
11912
AMOUNT
$ 5,000.00
na0 L L9 L 2ua 1:0 3 L 3094401: L S S80 2111
SHIPPENSBURG BEALTH CARE CTR
Check Date 06/13/2007
Check # 11912
Invoice No. Reference Check Notes Amonnt Paid Discount Invoice Bal.
7796
7891
STAFFING $2,639.25
$2,360.75
$120.53
MED 101 Medstaffers
$5,000.00
$120.53
SHIPPENSBURG HEALTH CARE CTR
Check Date 06/13/2007
Check # 11912
Invoice No. Reference Check Notes Amount Paid Discount Invoice BaL
7796
7891
STAFFING $2,639.25
$2,360.75
$120.53
MED101 Medstaffers $5,000.00 $120.53
SHIPPENSBURG HEALTH CARE CTR First National Bank of Greencastle 11948
c/o 1710 UNDERPASS WAY 40 Centre Street
HAGERSTOWN, MD 21740-6979 GREENCASTLE, PA 17225
(717) 530-8300 60-944/313
PAY Five Thousand And 00/100 dollars
TO THE
ORDER OF
DATE
06/25/2007
AMOUNT
$ 5,000.00
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
1110 L L948ua 1:03 L3094401: L 5580 2115
SHIPPENSBURG HEALTH CARE CTR
Check Date 06/25/2007
Check # 11948
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
7891 STAFFING $120.53
7852 STAFFING $1,330.75
7966 $3,072.13
8118 STAFFING $476.59 $1,483.41
JUN 2 9 2007
SfIC?-
t
MED101 Medstaffers
$5,000.00
$1,483.41
SHIPPENSBURG HEALTH CARE CTR
Check Date 06/25/2007
Check # 11948
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
7891 STAFFING $120.53
7852 STAFFING $1,330.75
7966 $3,072.13
8118 STAFFING $476.59 $1,483.41
MED101 Medstaffers $5,000.00 $1,483.41
SHIPPENSBURG HEALTH CARE CTR
c/o 1710 UNDERPASS WAY
HAGERSTOWN, MD 21740-6979
(717) 530-8300
PAY Five Thousand And 00/100 dollars
TO THE
ORDER OF
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
First National Bank of Greencastle
40 Centre Street
GREENCASTLE, PA 17225
60-944/313
DATE
07/26/2007
12043
AMOUNT
$ 5,000.00
non
iia0 L 2043ii¦ 1:0 3 1 3094401: 1 5580 2111
SHIPPENSBURG HEALTH CARE CTR
Check Date 07/26/2007
Check # 12043
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
8118
7987 STAFFING
STAFFING $1,483.41
$3,516.59
$1,011.41
MED 101 Medstaffers
$5,000.00
$1,011.41
SHIPPENSBURG HEALTH CARE CTR
rhPrlc Tate 0726/2007
Check # 12043
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
8118
7987 STAFFING
STAFFING $1,483.41
$3,516.59
$1,011.41
MED101 Medstaffers $5,000.00 $1,011.41
SHIPPENSBURG HEALTH CARE CTR
Go 1710 UNDERPASS WAY
HAGERSTOWN, MD 21740-6979
(717) 530-8300
PAY Five Thousand And 001100 dollars
TO THE
ORDER OF
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
First National Bank of Greencastle
40 Centre Street
GREENCASTLE, PA 17225
60-944/313
DATE
09/04/2007
u101211.0na 1:0313094401: 1 5580 2111
SHIPPENSBURG HEALTH CARE CTR
Check Date 09/04/2007
12147
AMOUNT
$ 5,000.00
Check # 12147
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bel.
7987 STAFFING $1,011.41
8057 STAFFING 52,737.50
8075 STAFFING $754.00
8159 $497.09 5873'1
SI P ' 0 2107
MED 101 Medstaffers
$5,000.00
$872.41
SHIPPENSBURG HEALTH CARE CTR
rI,An>< natA n9io4n_nm
Check # 12147
Invoice No. Reference Check Notes Amount Paid Discount Invoice Rai.
7987 STAFFING $1,011.41
8057 STAFFING $2,737.50
8075 STAFFING $754.00
8159 $497.09 $872.41
MED101 Medstaffers $5,000.00 $872.41
First National Bank of Greencastle 12210
.-,.nrvt l ASS WAY 40 Centre Street
HAGERSTOWN, MD 21740-6979 GREENCASTLE, PA 17225
(717) 530-8300 60-944/313
PAY Five Thousand And 00/100 dollars
TO THE DATE AMOUNT
ORDER OF 10/04/2007 $ 5,000.00
Medstaffers
P.O. Box 1300
Suisun City, CA 94585
C
11x0 i 2 2 i011a 1:0 3 L 309440: L S580 21P
SHIPPENSBURG HEALTH CARE CTR
Check Date 10/04/2007 Check # 12210
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bal.
8159 5872,41
8138 $1,289.00
9135 =.64-
996
I4
$1,41
MED 101 Medstaffers
$5,000.00
$1,418.91
SHIPPENSBURG HEALTH CARE CTR
Check Date 10/04/2007
Check # 12210
Invoice No. Reference Check Notes Amount Paid Discount Invoice Bel.
8159 $872.41
8138 $1,289.00
9135 $2,648.75
91.7 $184 $1,41/91
MED101 Medstaffers
$5,000.00
$1,418.91
11:3TAM FROM-IRWIN i McKNIGHT LAW OFFICES +7172496354 T-077 P.003/005 F-240
ALMA HEALTH LLC d/b/a, L\ THE COURT OF COXNION PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, OF CLN.IBERLAN-D COUNTY
Plaintiff n rv
v. CIVIL ACTION - LAw ?` r? ?
•
4: ?•. t? 7 T
j`I
SMPPENSBURG HEALTH CARE CENTER, DiC.:
NO. 2006 - 7269 CVIM FFbRM f
and MAGNOLIA MANAGEtiIENT COMPANY,
Defendants L= ?a
-,' O
PRAFrTPF. Tn F.NTFR n nry1vlFNT AND ASSESS DAMAC.FS CD -C
To Curtis R. Long, Prothonotary:
Kindly enter judgment in favor of the Plaintiff and against the Defendant on the attached
Order of Court dated May 25, 2007, rendered following arbitration, and no timely appeal has
been filed.
Please assess judgment in favor of the plaintiff as follows:
Amount of Judgment $36,976.00
Costs of Suit 137.57
Costs of Suit and Legal Fees 2,001.75
Total $39,11532
IRWLN & McKNIGHT
By:
Marcu A.1V i'ht.I . sctuire
Supreme ourt T.D. ##25476
60 Wes omfret Street
Carlisle, FA
(717) 249-2353
Attorney for the Plaintiff
Date: December 19, 2007
DAMAGES ARE HEREBY ASSESS: D ON THE .1UDG>VIENT AS LNDICATLD.
Date: 4&u Ica (? -21.,20-07 , /1&,
PROTHONOTARY
Exhibit "C"
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ALMA HEALTH, LLC d/b/a
MEDSTAFFERS, a
Pennsylvania Corporation,
PLAINTIFF
V.
SHIPPENSBURG HEALTH CARE
CENTER, INC., and MAGNOLIA
MANAGEMENT COMPANY,
DEFENDANTS
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: 06-7269 CIVIL TERM
ORDER OF COURT
AND NOW, this day of January, 2008, a hearing shall be
conducted in Courtroom Number 2, Cumberland County Courthouse, Carlisle,
Pennsylvania at 9:30 a.m., Thursday, February 21, 2008, to determine the amount
unpaid and still owing in the judgment entered against defendants. Execution of the
judgment is stayed pending an order following that hearing.
By the _Co rt,
Edgar B. Bayley, J.
?Marcus A. McKnight, III, Esquire
For Plaintiff
L--'David A. Baric, Esquire
For Defendants
Sheriff
y
:sale £._
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11+ Z5
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.
ALMA HEALTH LLC d/b/a,
MEDSTAFFERS, a Pennsylvania Corporation,
Plaintiff
: IN THE COURT OF COMMON PLEAS
: OF CUMBERLAND COUNTY
V. CIVIL ACTION - LAW
SHIPPENSBURG HEALTH CARE CENTER, INC.: NO. 2006 - 7269 CIVIL TERM
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants .
PRAECIPE TO SETTLE AND DISCONTINUE
To the Prothonotary:
Please mark the above-captioned case settled and discontinued. 4_a 'Toi
Respectfully submitted,
IRWIN &
By:
Marcus 1k. McKnight, III, Esquire
60 West Pomfret Street
Carlisle, Pennsylvania 17013
(717) 249-2353
Date: February 21, 2008
1
ALMA HEALTH LLC d/b/a, : IN THE COURT OF COMMON PLEAS
MEDSTAFFERS, a Pennsylvania Corporation, . OF CUMBERLAND COUNTY
Plaintiff
V.
SHIPPENSBURG HEALTH CARE CENTER, INC. :
and MAGNOLIA MANAGEMENT COMPANY, .
Defendants
CIVIL ACTION - LAW
NO. 2006 - 7269 CIVIL TERM
CERTIFICATE OF SERVICE
I, Marcus A. McKnight, III, Esquire, hereby certify that a copy of attached Praecipe to
Settle and Discontinue was served upon the following by depositing a true and correct copy of
the same in the United States mail, First Class, postage prepaid in Carlisle, Pennsylvania, on the
date referenced below and addressed as follows:
David A. Baric, Esq.
O'Brien, Baric & Scherer
19 West South Street
Carlisle, PA 17013
IRWIN &
By: Marcus jk. McK, III, Esquire
60 West Pomfret Street
Carlisle, PA 17013
(717) 249-2353
Supreme Court I.D. No. 25476
Date: February 21, 2008
rv
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R. Thomas Kline, Sheriff, who being duly sworn according to law, states
this writ is returned STAYED.
Sheriff's Costs: Advance Costs: 200.00
Sheriff's Costs: 82.13
Docketing 18.00 117.87
Poundage 1.61
Advertising
Law Library .50
Prothonotary 2.00 Refunded to Atty on 02/26/08
Mileage 19.20
Surcharge 20.00
Levy 20.00
Certified Mail
Post Pone Sale
Garnishee
Postage 82
TOTAL $ 82.13 ? 3/os?6 io'Inswers;
R. Thomas Kline, Sheriff
By laudia A. Brewbaker
d I I Ndf 8001 k Y.
bd'AINS3H1? .
.40 301.4-40
do` 2/2-
0
WRIT OF EXECUTION and/or ATTACHMENT
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND)
NO 06-7269 Civil
CIVIL ACTION - LAW
TO THE SHERIFF OF CUMBERLAND COUNTY:
To satisfy the debt, interest and costs due ALMA HEALTH LLC D/B/A MEDSTAFFERS, A
PENNSYLVANIA CORP., Plaintiff (s)
From SHIPPENSBURG HEATLH CARE CENTER, INC., 121 WALNUT BOTTOM ROAD,
SHIPPENSBURG, PA 17257
(1) You are directed to levy upon the property of the defendant (s)and to sell YOU ARE DIRECTED
TO LEVY UPON ALL PERSONAL PROPERTY OF THE DEFENDANT, SHIPPENSBURG
HEALTH CARE CENTER, INC., INCLUDING BUT NOT LIMITED TO FURNITURE AND
EQUIPMENT.
(2) You are also directed to attach the property of the defendant(s) not levied upon in the possession
of
GARNISHEE(S) as follows:
and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from
paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant
(s) or otherwise disposing thereof;
(3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession
of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a
garnishee and is enjoined as above stated.
Amount Due $36,976.00
Interest $2,767.74
Atty's Comm %
Atty Paid $178.67
Plaintiff Paid
Date: JANUARY 10, 2008
(Seal)
L.L. $.50
Due Prothy $2.00
Oth&r Costs $750.00
Al*
Curti. Long, otary
By:
Deputy
REQUESTING PARTY:
Name MARCUS A. MCKNIGHT, III, ESQUIRE
Address: IRWIN & MCKNIGHT
60 POMFRET STREET
CARLISLE, PA 17013
Attorney for: PLAINTIFF
Telephone: 717-249-2353
Supreme Court ID No. 25476