Preview
INDEX NO. 161001/2014
FILED: NEW YORK COUNTY CLERK 11/05/2014 02:09 PM
NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 11/05/2014
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
JEWISH HOME LIFECARE
SUMMONS
Plaintiff,
Plaintiff designates
-against- New York County
as the place of trial.
MARK AST, ERNEST AST and
FIDUCIARY for THE ESTATE OF BETTY AST
Defendants. Index No.:
TO THE ABOVE NAMED DEFENDANTS:
YOU ARE HEREBY SUMMONED and required to serve upon Plaintiff's attorney
an Answer to the Compiaint in this action within twenty (20) days after the service of this
summons, exclusive of the day of service, or within thirty (30) days after the service is
complete if the Summons is not personally delivered to you within the State of New
York. In case of your failure to answer, judgment will be taken against you by default for
the relief demanded in the compiaint.
The basis of this venue designated is the residence of Plaintiff, whose principal office is
located at 120 West 106" Street, New York, New York, 10025.
Dated: White Plains, New York
November 5, 2014 LITTMAN KROQKS LLP
a
By:
f
DES
Albérthe Beri
Attorneys for fhié Plaintiff
399 Knollwood Road
White Plains, New York 10603
914-684-2100 (Telephone No.)
914-684-9865 (Fax No.)
Address of Defendants:
Mark Ast Mr. Ernest Ast
3 Peter Cooper Road 1901 1st Ave, #14b
Apartment No. 14-A New York, New York 10029
New York, New York 10010 and
PO Box 231051, NY, NY 10023
This communication is from a debt collector and is sent to you in an attempt to collect this debt.
Any information obtained will be used for that purpose.
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF NEW YORK
meme ete eee cece ene en cece n em em en en nme meme astnnennnrtnttniunsnietete nin nee) Xx
JEWISH HOME LIFECARE
Plaintiff,
VERIFIED COMPLAINT
-against-
MARK AST, ERNEST AST and
FIDUCIARY for THE ESTATE OF BETTY AST
Defendants. Index No.
x
Plaintiff, JEWISH HOME LIFECARE (“JEWISH HOME’), by its attorneys
LITTMAN KROOKS LLP, as and for its Verified Complaint, respectfully alleges as
follows:
PRELIMINARY STATEMENT
4
This is an action sounding in breach of oral and written contract,
seeking redress for Defendants’ failure to make payment to Plaintiff for fees incurred by
Defendants for lodging, board and nursing care services, among other things, rendered
by Plaintiff to BETTY AST, at Defendants’, specific insistence and request, for which no
payment has been received, despite due demand therefor.
THE PARTIES
2 Plaintiff JEWISH HOME is, and at all times relevant hereto was,
corporation organized and existing under the laws of the State of New York, with offices
for the conduct of business located at 120 West 106" Street, New York, New York,
10025, Telephone No. (212) 870-4903.
3 Plaintiff JEWISH HOME conducts business as a skilled nursing
care services provider, whereby patients receive nursing care services, among other
things, at Plaintiff's place of business located at 120 West 106" Street, New York, New
York, 10025.
4 Betty Ast (“RESIDENT”) was a resident of the State of New York
residing at JEWISH HOME located at 120 West 106" Street, New York, New York,
10025 from on or about April 29, 2042 through July 26, 2012. Said RESIDENT died on
June 21, 2013.
5. Defendant MARK AST is, and at all times relevant hereto was, a
resident of the State of New York residing at 3 Peter Cooper Road, Apartment 14-A,
New York, NY 10010.
6. Upon information and belief, Defendant ERNEST AST is, and at all
times relevant hereto was, a resident of the State of New York having a business
address of 1901 1st Ave, #14b, New York, NY 10029 and postal office box address of
P.O. 231051, New York, New York 10023.
7 Upon information and belief, Defendants MARK AST and/or
ERNEST AST are the appointed and/or nominated Fiduciaries of the Estate of BETTY
AST and are the surviving children of BETTY AST.
JURISDICTION AND VENUE
8. This Court has original jurisdiction over this matter in that the
amount of damages ($46,472.00) sought by plaintiff meets the jurisdictional threshold of
this court. Venue is proper in this Court pursuant to CPLR §503{a) et seq.
FACTUAL BACKGROUND
9 During the period of March 30, 2012 through July 26, 2012, Plaintiff
JEWISH HOME provided room, board, and nursing care services (“Services”) to
RESIDENT at their facility located at 120 W. 106" Street, New York, New York, 10025.
10. RESIDENT accepted and received the benefit of such care and
services rendered to him.
11. Upon information and belief, Defendants MARK AST and ERNEST
AST held themselves out at as the attorney-in-fact and/or designated representative for
RESIDENT.
12. On April 3, 2012, Defendants MARK AST and ERNEST AST
entered into a written contract (“AGREEMENT”) with Plaintiff JEWISH HOME, as the
attorneys-in-fact for RESIDENT, wherein JEWISH HOME would provide certain
services to, and on behalf of RESIDENT. (See Admission Agreement annexed hereto
as Exhibit A).
13. Pursuant to the written terms of the AGREEMENT, in consideration
for Services provided to RESIDENT, Defendants MARK AST and ERNEST AST, as the
attorneys-in-fact for RESIDENT, were obligated and agreed to pay JEWISH HOME
certain sums at a specified daily rate. Upon information and belief, Defendants MARK
AST and ERNEST AST were the named beneficiaries and signatories on the financial
accounts of RESIDENT.
14. Pursuant to the AGREEMENT Defendants MARK AST and
ERNEST AST agreed, as the financial agents for RESIDENT, to refrain from using
RESIDENT’s assets in such a way that would place Plaintiff JEWISH HOME in a
position that would preclude JEWISH HOME or RESIDENT from receiving payment
from RESIDENT’s assets and/or Medicaid.
15. Upon information and belief, Defendants MARK AST and ERNEST
AST transferred RESIDENT’s assets to themselves and/or other individuals, Upon
information and belief, Defendants MARK AST and ERNEST AST spent RESIDENT’s
assets and accumulated income for their personal benefit, despite agreeing to use
same, as per the AGREEMENT, for RESIDENT’s unpaid medical bills with JEWISH
HOME.
16. That Plaintiff JEWISH HOME spoke with Defendants MARK AST
and ERNEST AST on numerous occasions and demanded payment in full for services
rendered to RESIDENT, which to date remains unpaid.
17. That JEWISH HOME has repeatedly called, written, and spoken
with Defendants, MARK AST and ERNEST AST, demanding payment of the
outstanding balance, which presently amounts to $46,472.00; however, to date said bill
remains unpaid.
FIRST CAUSE OF ACTION
(Breach of Written Contract)
18. Plaintiff repeats and re-alleges each and every allegation set forth
in paragraphs 1 through 17 above, inclusive, with the same force and effect as though
fully set forth herein.
19. On or about April 3, 2012, Defendants MARK AST and ERNEST
AST reviewed and executed the AGREEMENT, as RESIDENT’s alleged attorneys-in
fact and agreed to be bound by its terms.
20. That pursuant to said AGREEMENT, Defendants MARK AST and
ERNEST AST undertook the obligation to do the following independent acts:
a guarantee a continuity of payment from RESIDENT's funds and/or from
third party payor(s) to meet RESIDENT's obligations to JEWISH HOME;
arrange for timely and/or continued coverage from third party payor(s),
if such coverage becomes necessary to satisfy RESIDENT's obligations
to JEWISH HOME;
guarantee payment from RESIDENT's funds where a third party payor
denies coverage for services JEWISH HOME.renders to RESIDENT at
the specified daily rate of five hundred and two doilars ($502) per day
for a semi-private room or five twenty five ($525) for a private room,
which private pay rates were subject to change;
timely submit a Medicaid application, if necessary, to ensure
uninterrupted payment to JEWISH HOME;
use RESIDENT’s assets in such a way that would not jeopardize
RESIDENT’s application for Medicaid and would guarantee payment to
JEWISH HOME for services rendered to RESIDENT;
fully document and assist with RESIDENT's Medicaid application to the
appropriate County Department of Social Services Medicaid agency
within the required time;
in the event RESIDENT is approved for Medicaid benefits, remit
payment to JEWISH HOME of RESIDENT’s Net Available Monthly
Income (NAMI) pursuant to RESIDENT's Medicaid budget as
determined by the County Department of Social Services providing
RESIDENT’s Medicaid coverage;
timely notify RESIDENT of the anticipated time when third party benefits
are exhausted and RESIDENT's funds are depleted to the Medicaid
resource level;
if RESIDENT's funds are depleted or not available and third party
benefits are exhausted or unavailable, arrange for the payment of
RESIDENT's monthly income to JEWISH HOME as partial payment of
RESIDENT's private pay rate;
if late payment is made on RESIDENT's account, and RESIDENT's
account is overdue more than 30 days, to be liable for interest at 1.50%
per month;
if JEWISH HOME must refer RESIDENT's outstanding account for
collection, pay for reasonable collection fees, including but not limited to
attorney fees incurred by JEWISH HOME in enforcing the terms of the
AGREEMENT; and
Agent of resident agrees to pay damages to the Facility for any breach
of his/her personal obligations as set forth in the Agreement.
21. That the Defendants MARK AST and ERNEST AST were advised
by Plaintiff to file an application for Medicaid benefits on behalf of resident, so as to
cover the cost of RESIDENT’s care at Plaintiff's facility. That the Defendants
represented to Plaintiff JEWISH HOME that they retained counsel to file said application
for Medicaid benefits. That Plaintiff repeatedly followed up with said counsel, only to be
advised, months later, that the Defendants had changed their minds regarding filing said
Medicaid application.
22. Upon information and belief, Defendants MARK AST and ERNEST
AST had access to RESIDENT’s assets and income and they were sufficient to satisfy
the indebtedness owed to JEWISH HOME.
23. That Defendants MARK AST and ERNEST AST refused and
refrained from turning over payment to JEWISH HOME in consideration for services
rendered to RESIDENT and instead used the funds for their own benefit or the benefit
of other individuals.
24. In breach of the AGREEMENT, and by reason of Defendants
MARK AST and ERNEST AST’s default of same, JEWISH HOME has been damaged in
the amount of $46,472.00 together with the contractually specified finance charges at a
rate of one (1.50%) percent per month, along with reasonable costs for collection,
including attorney’s fees.
SECOND CAUSE OF ACTION
AS AGAINST MARK AST and ERNEST AST
(Breach of Oral Contract)
25. Plaintiff repeats and re-alleges each and every allegation set forth in
paragraphs 1 through 24 above, inclusive, with the same force and effect as though fully
set forth herein.
26. At the time of RESIDENT’S admission to JEWISH HOME,
RESIDENT and Defendants MARK AST and ERNEST AST, as the attorneys-in-fact for
RESIDENT, orally agreed to pay and/or arrange for payment from the assets and
income of RESIDENT, for the cost of nursing care services provided by Plaintiff
JEWISH HOME to RESIDENT.
27. RESIDENT and the Defendants MARK AST and ERNEST AST
breached the parties’ oral agreement by refusing or otherwise failing to pay JEWISH
HOME for the cost of care and services provided by Plaintiff to RESIDENT.
28. That Plaintiff JEWISH HOME has fully performed all of its
obligations under the oral agreement.
29. That RESIDENT and Defendants MARK AST and ERNEST AST
have neither legal justification, nor excuse, for their failure to pay JEWISH HOME the
amount due.
30. By reason of the foregoing, JEWISH HOME has been damaged in
the amount of $46,472.00.
THIRD CAUSE OF ACTION
(Quantum Meruit/Unjust Enrichment)
31. Plaintiff repeats and re-alleges each and every allegation set forth
in paragraphs 1 through 30 above, inclusive, with the same force and effect as through
fully set forth herein.
32. That JEWISH HOME provided services to RESIDENT at
RESIDENT’s and Defendants MARK AST and ERNEST AST's specific insistence and
request, and RESIDENT received and accepted the benefits of the services so
provided.
33. That despite repeated demands for payment by JEWISH HOME
and its representatives, RESIDENT and Defendants MARK AST and ERNEST AST
failed and refused to pay JEWISH HOME for the services provided to RESIDENT.
34. RESIDENT and Defendants MARK AST and ERNEST AST should
not be permitted, in equity and good conscience, to benefit from the services provided
to RESIDENT at their specific request and insistence and promise to pay; without
making payment for same.
35. By reason of the foregoing, RESIDNET and Defendants MARK
AST and ERNEST AST have been unjustly enriched and are liable to JEWISH HOME in
the amount of $46,472.00 or the reasonable value of services provided to RESIDENT at
their request.
FOURTH CAUSE OF ACTION
(Conversion of Assets)
36. Plaintiff JEWISH HOME repeats and re-alleges each and every
allegation contained in paragraphs 1 through 35, inclusive, of this Complaint.
37. RESIDENT was the owner of certain assets and/or received certain
income while he was a resident at JEWISH HOME’ facility.
38. That upon information and belief, Defendants MARK AST and/or
ERNEST AST, individualiy, and/or as attorneys-in-fact for RESIDENT, wrongfully
converted the income and assets belonging to RESIDENT for unfair consideration. or for
no consideration.
39. All income and/or assets of RESIDENT that Defendants MARK
AST and/or ERNEST AST converted should have first been applied to satisfy
RESIDENT’s and the Defendants outstanding payment obligations to Plaintiff JEWISH
HOME.
Ao. That these asset transfers and conversions rendered RESIDENT
and her Estate insolvent by such transfers. The Defendants have therefore wrongfully
converted such income and/or assets.
A. That the Defendants MARK AST and/or ERNEST AST, individually,
and/or as attorneys-in-fact for RESIDENT, intended by their actions that JEWISH
HOME should be defrauded, hindered, delayed and otherwise prevented from collecting
debits due and owing, specifically, the $46,472.00, for care and services rendered to
RESIDENT.
42. Defendants’ fraudulent conduct proximately caused damages to
JEWISH HOME in the amount of $46,472.00.
FIFTH CAUSE OF ACTION
(FRAUDLENT CONVEYANCE UNDER DEBTOR CREDITOR LAW)
43. Plaintiff JEWISH HOME repeats and re-alleges each and every
allegation contained in paragraphs 1 through 42, inclusive, of this Complaint.
44, RESIDENT was, just prior to her admission or during the time she
resided at JEWISH HOME’ facility, the owner of certain assets and/or received certain
income.
45. Upon information and belief, at all applicable times relevant hereto,
Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact
for RESIDENT, had, and/or still have, control over and/or access to income and/or
assets belonging to RESIDENT.
46. Defendants MARK AST and/or ERNEST AST, individually, and/or
as attorneys-in-fact for RESIDENT, wrongfully conveyed and/or transferred all or some
of the income and/or assets away from RESIDENT, without fair consideration or for no
consideration, in order to prevent JEWISH HOME, as a creditor or a future creditor,
from recovering monies due it for nursing care services rendered to RESIDENT.
47, All income and/or assets of RESIDENT that Defendants MARK
AST and/or ERNEST AST converted should have first been applied to satisfy
10
RESIDENT and Defendants’ outstanding payment obligations to Plaintiff JEWISH
HOME.
48, Such transfers were made by Defendants MARK AST and/or
ERNEST AST knowing, intending and believing that RESIDENT and Defendants had a
continuing obligation, under the terms of the AGREEMENT, to pay JEWISH HOME for
services rendered to RESIDENT, and that as a resuit of such actions, payment from the
income and/or assets of RESIDENT would not be forthcoming.
49. Such transfers of assets by Defendants MARK AST and/or
ERNEST AST constitute fraudulent conveyances under Sections 273, 275 and/or 276 of
the New York Debtor and Creditor Law.
50. By reason of the foregoing, the aforementioned conveyances by
Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact
for RESIDENT, were void as to Plaintiff JEWISH HOME, as defined under Sections
273, 275 and/or 276 of the New York Debtor and Creditor Law, and thus JEWISH
HOME has been damaged in the amount of $46,472.00.
SIXTH CAUSE OF ACTION
(Constructive Fraud)
51. Plaintiff repeats and re-alleges each and every allegation set forth
in paragraphs 1 through 50 above, inclusive, with the same force and.effect as though
fully set forth herein.
52. By reason of the foregoing, Plaintiff JEWISH HOME has suffered
damages in the sum of $46,472 by virtue of the constructive fraud. of Defendants MARK
AST and ERNEST AST.
11
SEVENTH CAUSE OF ACTION
(Account Stated)
53. Plaintiff repeats and re-alleges each and every allegation set forth
in paragraphs 1 through 52 above, inclusive, with the same force and effect as though
fully set forth herein.
54, An account was taken and stated between Plaintiff and Defendants
MARK AST and ERNEST AST for the amount of $46,472.00, which monies remain due
and owing to Plaintiff.
55. Upon information and belief, Defendants MARK AST and ERNEST
AST have received and retained said statements of account.
56. Defendants MARK AST and ERNEST AST, as attorneys-in-fact for
RESIDENT and/or the Fiduciary of the ESTATE OF BETTY AST, have not objected to
said statement of account. The outstanding balance remains due to Plaintiff, despite
several demands for same.
57. By reason of the foregoing, Plaintiff has been damaged in the
amount of $46,472.00.
EIGHTH CAUSE OF ACTION
AS AGAINST THE ESTATE OF BETTY AST
58. Plaintiff repeats and re-alleges each and every allegation set forth
in paragraphs 1 through 57 above, inclusive, with the same force and effect as though
fully set forth herein.
12
59. That all causes of action alleged herein accrued prior to the death
of RESIDENT, and by reason of RESIDENT’s death, such causes of action are herein
made against RESIDENT’s Estate, the ESTATE OF BETTY AST, as valid claims.
60. Upon information and belief, Defendant MARK AST is the
nominated Executor for the ESTATE OF BETTY AST.
61. That during the period of April 29, 2012 through July 26, 2012,
Plaintiff JEWISH HOME provided nursing care services to BETTY AST, now deceased,
at BETTY AST’s and Defendants’ specific insistence and request and promise to pay.
62. That no sum has been paid to Plaintiff JEWISH HOME for the
outstanding amount owed on account, despite Plaintiffs repeated demands to
Defendants MARK AST and ERNEST AST, in their capacity as the nominated Executor
of the ESTATE OF BETTY AST.
63. By reason of the foregoing, Plaintiff JEWISH HOME is owed a
judgment against the ESTATE OF BETTY AST in the amount of $46,472.00, plus
interest and costs from May 29, 2012 through the present.
WHEREFORE, Plaintiff, JEWISH HOME, demands judgment against the
Defendants as follows:
A On the First Cause of Action not less than $46,472.00, together with the
contractually specified finance charge at a rate of one (1.50%) percent per
month, along with reasonable costs for collection, including attorney's
fees;
On the Second Cause of Action not less than $46,472.00, plus interest
and costs from May 29, 2012;
13
On the Third Cause of Action not less than $46,472.00, plus interest and
costs from May 29, 2012;
On the Fourth Cause of Action not less than $46,472.00, plus interest and
costs from May 29, 2012;
On the Fifth Cause of Action not less than $46,472.00, plus interest and
costs from May 29, 2012;
On the Sixth Cause of Action not less than $46,472.00, plus interest and
costs from May 29, 2012
On the Seventh Cause of Action not less than $46,472.00, plus interest
and costs from May 29, 2012; and
On the Eigth Cause of Action not less than $46,472.00, plus interest and
costs from May 29, 2012;
The cost for attorneys’ fees and disbursements incurred for this action,
together with such other and further relief this Court may deem just and
proper.
Dated: White Plains, New York
November 5, 2014 LITTMAN KROOKS LLP
By:
ALBERTHE IER, ESQ
Attorneys for the Plaintiff
399 Knollwood Road
White Plains, New York 10603
(914) 684-2100
This communication is from a debt collector and is sent to you in an attempt to collect this debt.
Any information obtained will be used for that purpose.
14
VERIFICATION
STATE OF NEW YORK )
)ss.:
COUNTY OF NEW YORK )
| am the Director of Patient Accounts at JEWISH HOME LIFECARE NURSING
HOME. | am familiar with the facts and have read the foregoing Verified Complaint and
know the contents thereof to be true to my knowledge, except as to those matters
alleged on information and belief, and that as to those matters, | believe them to be true
as well.
ANNETTE LOBO, Director of Patient
Accounts
Sworn to before
day of SE Tea leek 2014
INOTARY PUBLIC STATE OF NEW YORK
UC. #o1
(COMM, EXP,
EXHIBIT A
142198 Rov 02/12
JeWISIE HOME LIFECARI, MANHATTAN
ADMISSION AGREEMENT
442198 Rov o2fi2
JEWISH HOME LIFECARE, MANHATTAN
ADMISSION AGREEMENT
TABLE OF CONTENTS
Page
NON-DISCRIMINATION ......cssensnesconn rsnseassstgerasnsesies
sHenneddbesanecaneennqsnnsscennsenDittariteeneeeassateenes
SERVICES PROVIDED BY THE FACILITY.
t Services Included Under the Daily Basic Rate. pene
Physician and Ancillary Services
23 ‘Transportation Services.
24 Outsi ye 8
25 Presoription Drugs; Medicare Part D
2.6 lasses, Hearing Aids and Prosthetic Devices
27 Be aoanen Aversannantanene vereeeantansananssaensnencanenn a
3. THE PATIENTRESIDENT'S AGREEMENT TO PAY FOR SERVICES,
Patient/Rosident’s Direction to His/Her Agent
33 ‘The Patient/Resident’s Obligattons ,. 3
33 Third Party Agreements..
34 Seaurity Dopostt., asestesn
35 Payment Obligations Under Medicaid
and Other Third Parly Payots wissen set
‘THE RESPONSIBLE PARTY'S OBLIGATIONS TO THE FACILITY 6
Acknowledgement of Consideration
.... wenn
AL Payment Ontgation fiom Patient/Resident’s fim
43 Medicaid Ob
4A Powers of. atineye 6
45 Transfers by the Patieat/Resident.. ae scene
TRUTHFULNESS OF INFORMATION PROVIDED ee eanenneeansaans
LATE PAYMENTS AND NON-PAYMENT. 08
6.4 Late Charges...
62 Discharge for Ni ate
63 Collection Costs rune D
64 Darnages, .
PATIENT/RESIDENT’S PERSONAL PROPERTY,
AUTHORIZATION FOR PHYSICIAN VISITS
OBLIGATIONS TO ABIDE BY FACILITY RULES AND REGULATIONS; NON-
SMOKING...»
10. RELOCATION. ase
i GENERAL PROVISIONS RELATING TO THIS AGREEMENT
JEWISH HOME LAFECARE, MANHATTAN
ADMISSION AGREEMENT
Agreoment entered on wo, 20 f2ostveen JEWISH HOME LIFECARE,
MANHATTAN (also reforred fo as “Hacility”) and
ad
Ae
ven
{Patient ident)
and Ernst Ast | Mak
(Responsible Party)
THE PARTIES TO THIS AGREEMENT AGREE AS FOLLOWS:
i NON-DISCRIMINATION
‘THE FACILITY DORS NOT DISCRIMINATE BECAUSE OF RACE,
CREED, COLOR, NATIONAL ORIGIN, SEXUAL PREF
GENDER, BLINDNESS, DISABILITY, SPONSORSHIP IN ADMISSION,
SOURCE OF PAYMENT, AGE, OR AS OTHER WISE PROHIBITED BY
LAW WITH RESPECT TO THE ADMISSION, RETENTION AND CARE
OF PATIENT/RESIDENTS,
2, SERVICES PROVIDED BY THE FACILILY
2 ervices Inchided Under The Daily Basic Rate, The following sorvices are provided
by the Facility cu the daily basic rate:
@ Lodging it anou-private room;
®) Board, excluding artificial hydration and nutritlon;
{) Twenty-four (24) hour per day nursing care;
@ Fresh bed linens as required;
©) Hospital gowns or pajamas as required and regular non-dry cleaning laundry
services for these and other launderable potsonal clothing items;
® Genel household medicinc cabinet supplics, including non-prescription
medications, material for routine skin cave, oral hygiene, care of hair, except for
specific items-that are medically indicated and needed fb r exceptional nse fora
specific Patient/Resident;
Assistance and/or supervision when required with activitios of daily living,
including toileting, bathing, feeding and ambulation assistance;
J4zi98 Rev 02/12
® Services of members of the Facility staff performing their daily assigned patient
care duties;
@ The vse of customarily stocked equipment, including orutches, walters,
wheelchairs, or other supportive equipmont, and training in theit use wher
ry, unless such item is prescribed by a physician for the regular and sole
hecesss fa
use by a specific Patient/Resident;
@ The use of all ipment, medical supplies and modalities usually used in the
ovory day care of the Patlent/Resident, Including catheters, hypodermic syxingos
and needles, irrigation outfits, dressings and pads;
«) An_aclivilies progtam, including a planned schedule for reoreatlonal,
motivational, , social and other activities, together with the necessary materials
atid supplies;
Q Social services as needed; and
(a) Physical, ocenpationat and speech therapies, provided in acvordanes with a
maintenance program (but stot such therapies provided in accordance with a
restorative program).
22 Physician And. Ancillary Servises
Charges for physician visits and physician-ordered ancillary services are not included in the
i
daily basic rate. Charges may be billed v the Facility or directly by the provider’
of the service, The
Patient/Rosident is not obligated to pay r services paid for by Medicaid, Medicare (or other third
patty payor) except for deductibles aud co-payments. Medicaid eligible Paticnt/Resident’s physioian
services are normally covered by Medicaid,
A listing of charges for ancillary services and prescription drugs which are provided by the
Facility but whieh are not included in the daily basic rate iy available to the Pation/Resident at the
office of the Facifity's administrator.
is
The Facility will artange for hi ysician visits as authorized under this Agreement and for
aneillary services 0 be available to ¢ Patieni/Resident when proscribed by a physician, These
services will he administered or supervised by practitioners affiliated with and/or approved by the
Facility who meet the applicable New York licensing, registration and certification requirements,
The following ancillary services are normally covered by Medicare or Medicaid:
(2) Restorative Physical Therapy
&
@
Restorative Audiology Services
Restorative Occupational Therapy
Speech Therapy
Podiatry Servicos
Psychiatric or Psychological Treatment
:
Optometric Services
Laboratory Services
Radiology Services
Eleotroonrdiography Services
&) Oxygen Therapy
Dental Services
“Re
M2198 Roy 02/12
23 Tranmertaion. Services,
ives, Medicare will usually cover ambulance services that are
sncdically necessary while Mediesid will ysually cover ambulette services. In addition, some (although
not many) managed care plans and third party insurance polictes may provide coverage for certain
transportation cosis, The Pailent/Residont will be responsible for payment of transportation costs that
ate not covered by Medicare, Medicaid or insurance cartier.
2.4 Qutside Services, If the Patient/Resident desires to engage the services of an outside
dentist, physician or other consultant, and the use of that consultant was not ordered by a Facility
cian, Paticni/Resident is responsible for all costs associnted with thoso services, including
professional fees to the extent those fees are not covered by Medicaid, Medicare or ats insarence cartier
and accompanying Facility personal when transportation off-site with supervision is required, The
Patient/Resident agrees to hold Facility harmless for any and all harm, inj , damage or loss the
Patien!/Resident inight incur while away ftom, the Facility unaccompanied by any Facility staff
members.
25 Charges tor drugs prescribed by a physician
are not included in resctiption drug ol pes are not covered by
Medicaid, Medicare or insurance cartier, they mustb
for Medicare Part D coverageagrees to enroll,in a Me fone attD ti i
re by the Resident, A Patlont/Resident eligible
ctiplion drug plan which has a
contract with the Facility’s vendor pharnaacy at or prior to the date of admission, if gligible at such time
or during the month the Resident first becomes aligiblo for Medicare Patt D coverage, if such clipibility
oceuts after the date of admission. All prescription drugs must be administered to the Resident by the
Facility,
26a gE es, Hey
prostheses othe aAN eee ae osthetic Devices,
availa!
Eyeglasses, hearing aides, dental
¢ Factily but aro tot covered nnder the
y
daily basic rate, ‘To the extent that they are not paid for by Medicaid, Medicare or insurance carrier,
they must be paid for or charged against the Patient/Resident’s account when the cost is Incurred.
27 Personal Jems, Certain items and gervices, such as those listed below, are not cove:
under the daily basic rate nor are they normally paid for by Medicaid, Medicare or insurance o: atrIOKs,
Such items are wade available by the’ Facility but must be pald for or charged agaist the
Patient/Resident’s account when the cost is incurred.
BathesBeanty Parlor
Private telephone inxoom including installation, maintenance and fees
Private TV in room including installation,mainienanee and monthly cable fees
a) Newspal
Shoes (non-prescription) and clothing
Dry cleanin,
Speolal transportation for porsonal use
0 Non-toutine porsonal hygione items and services
Computer, including installation, maintenance and internet connection fees
3. THE PATIENT/RESWENT’S AGREEMENT TO PAY FORSERVICES
34 Patient/Resident’s Dixcation To His Het Ags ents. The Pationi/Resident hereby directs
the Re
Patient esident’s assets and to cooperate in
noible Party, to ensure that all p inet obligations under this Agreement are met from the
obtaining Medicaid covaage if nece: onary to meet the
Patient/Resident’s obligations under this Agreement,
Petientesid
KationtResident’s_Obgntions
‘The Subject to Section 3.3 below, the
all services provided by the Facility under h
ent agrees to pay for, or arrange fo haye paid for by Medicaid, Medicare or other insurers,
is Agreement as follows:
-3-
142198 Rev 02/12
a) Medionce ot Medicaid Coverage, , Hf the Pationt/Residont qualifies for Medionid
or Medicare covera: ty agrees to accept the payment from these programs, plus any related
coinsurance, deductible and Medicaid. surplus antonnts owed by the Patient/Resident, as payment in
fill for the items and services covered by Medicaid or Medicave. Patlent/Residents are responsible for
payment of services not covered by Medicate or Medicaid. Patient{Residents elf for Medicaid
are also required fo pay over thelr net available monthly income as detailed im Section 3.5(¢)
below.
Private pay Status, If the Patient/Resident does not qualify for Medicaid or
Medicare coverage, the Patient/Resident agrees to pay the Facility (i) the daily basic rate of $502.0
for a Semi Private Room and $525 for a Private Roow (as may be increased on thirty (30) days
wiitten notice to the Patient/Rosident or the Responsible Party); and (ii) items and services not covered
under the daily basic rate pursuant to section 2.1 above (including tion drugs and other
}
ancillary services) (the fotel of the charges set forth in Subsections 3.2 Ab) (it) referred to as the
“Private Pay Rate”). ‘The Pationt/Resident agreos fo pay the Private Pay Rato to the Facility after other
coverage has beon applied or exhausted until the month in which the Paticnt/Resident’s Medionid
eligibility covers such charges, The Private Fay Rate payable for a month shall be paid in full by the
fiflgenth (15th) day of that month, In addition, a Resident paying the Privaic Pay Rate is responsible for
aying the amount of the New York State assessment levied on the Resident’s payments to the Facility,
including the base assessment, as may be adjusted, aud any additional temporary assessments imposed,
(As of September 1, 2011, the current combined assesament rate is 7.2%).
3.3 Third Par
a) Menaged Care Agteoment, . Notwithstandin, anything in this Agreement to the
Agreement”) is in effect between the Facili and a managed care company (the “ Nan
contrary but subject fo Section 3.3(c) below, during such time as (i) a vweltten agreem ent (the “Provider
i ined Care
Company”) for the reimbursement to the Paoil ty for certain servicas (“Covered Services”) to enrolled
members of the Managed Cate Company's plan; and (ii) the Patient/Resident continues as an enrolled
Member of the Managed Care Company's plan, the Patient/Resident will not be responsible to the
Facility for the
services for whi ic
yinent of any Covered Services, The Patient/Resident will remain Mable for
the Vactlity is not entitted to reimbursement wider the Provider Agreement,
including deductibles, co-payments, co-ingurance and/or pay
Preview
INDEX NO. 161001/2014 FILED: NEW YORK COUNTY CLERK 11/05/2014 02:09 PM NYSCEF DOC. NO. 1 RECEIVED NYSCEF: 11/05/2014 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NEW YORK JEWISH HOME LIFECARE SUMMONS Plaintiff, Plaintiff designates -against- New York County as the place of trial. MARK AST, ERNEST AST and FIDUCIARY for THE ESTATE OF BETTY AST Defendants. Index No.: TO THE ABOVE NAMED DEFENDANTS: YOU ARE HEREBY SUMMONED and required to serve upon Plaintiff's attorney an Answer to the Compiaint in this action within twenty (20) days after the service of this summons, exclusive of the day of service, or within thirty (30) days after the service is complete if the Summons is not personally delivered to you within the State of New York. In case of your failure to answer, judgment will be taken against you by default for the relief demanded in the compiaint. The basis of this venue designated is the residence of Plaintiff, whose principal office is located at 120 West 106" Street, New York, New York, 10025. Dated: White Plains, New York November 5, 2014 LITTMAN KROQKS LLP a By: f DES Albérthe Beri Attorneys for fhié Plaintiff 399 Knollwood Road White Plains, New York 10603 914-684-2100 (Telephone No.) 914-684-9865 (Fax No.) Address of Defendants: Mark Ast Mr. Ernest Ast 3 Peter Cooper Road 1901 1st Ave, #14b Apartment No. 14-A New York, New York 10029 New York, New York 10010 and PO Box 231051, NY, NY 10023 This communication is from a debt collector and is sent to you in an attempt to collect this debt. Any information obtained will be used for that purpose. SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF NEW YORK meme ete eee cece ene en cece n em em en en nme meme astnnennnrtnttniunsnietete nin nee) Xx JEWISH HOME LIFECARE Plaintiff, VERIFIED COMPLAINT -against- MARK AST, ERNEST AST and FIDUCIARY for THE ESTATE OF BETTY AST Defendants. Index No. x Plaintiff, JEWISH HOME LIFECARE (“JEWISH HOME’), by its attorneys LITTMAN KROOKS LLP, as and for its Verified Complaint, respectfully alleges as follows: PRELIMINARY STATEMENT 4 This is an action sounding in breach of oral and written contract, seeking redress for Defendants’ failure to make payment to Plaintiff for fees incurred by Defendants for lodging, board and nursing care services, among other things, rendered by Plaintiff to BETTY AST, at Defendants’, specific insistence and request, for which no payment has been received, despite due demand therefor. THE PARTIES 2 Plaintiff JEWISH HOME is, and at all times relevant hereto was, corporation organized and existing under the laws of the State of New York, with offices for the conduct of business located at 120 West 106" Street, New York, New York, 10025, Telephone No. (212) 870-4903. 3 Plaintiff JEWISH HOME conducts business as a skilled nursing care services provider, whereby patients receive nursing care services, among other things, at Plaintiff's place of business located at 120 West 106" Street, New York, New York, 10025. 4 Betty Ast (“RESIDENT”) was a resident of the State of New York residing at JEWISH HOME located at 120 West 106" Street, New York, New York, 10025 from on or about April 29, 2042 through July 26, 2012. Said RESIDENT died on June 21, 2013. 5. Defendant MARK AST is, and at all times relevant hereto was, a resident of the State of New York residing at 3 Peter Cooper Road, Apartment 14-A, New York, NY 10010. 6. Upon information and belief, Defendant ERNEST AST is, and at all times relevant hereto was, a resident of the State of New York having a business address of 1901 1st Ave, #14b, New York, NY 10029 and postal office box address of P.O. 231051, New York, New York 10023. 7 Upon information and belief, Defendants MARK AST and/or ERNEST AST are the appointed and/or nominated Fiduciaries of the Estate of BETTY AST and are the surviving children of BETTY AST. JURISDICTION AND VENUE 8. This Court has original jurisdiction over this matter in that the amount of damages ($46,472.00) sought by plaintiff meets the jurisdictional threshold of this court. Venue is proper in this Court pursuant to CPLR §503{a) et seq. FACTUAL BACKGROUND 9 During the period of March 30, 2012 through July 26, 2012, Plaintiff JEWISH HOME provided room, board, and nursing care services (“Services”) to RESIDENT at their facility located at 120 W. 106" Street, New York, New York, 10025. 10. RESIDENT accepted and received the benefit of such care and services rendered to him. 11. Upon information and belief, Defendants MARK AST and ERNEST AST held themselves out at as the attorney-in-fact and/or designated representative for RESIDENT. 12. On April 3, 2012, Defendants MARK AST and ERNEST AST entered into a written contract (“AGREEMENT”) with Plaintiff JEWISH HOME, as the attorneys-in-fact for RESIDENT, wherein JEWISH HOME would provide certain services to, and on behalf of RESIDENT. (See Admission Agreement annexed hereto as Exhibit A). 13. Pursuant to the written terms of the AGREEMENT, in consideration for Services provided to RESIDENT, Defendants MARK AST and ERNEST AST, as the attorneys-in-fact for RESIDENT, were obligated and agreed to pay JEWISH HOME certain sums at a specified daily rate. Upon information and belief, Defendants MARK AST and ERNEST AST were the named beneficiaries and signatories on the financial accounts of RESIDENT. 14. Pursuant to the AGREEMENT Defendants MARK AST and ERNEST AST agreed, as the financial agents for RESIDENT, to refrain from using RESIDENT’s assets in such a way that would place Plaintiff JEWISH HOME in a position that would preclude JEWISH HOME or RESIDENT from receiving payment from RESIDENT’s assets and/or Medicaid. 15. Upon information and belief, Defendants MARK AST and ERNEST AST transferred RESIDENT’s assets to themselves and/or other individuals, Upon information and belief, Defendants MARK AST and ERNEST AST spent RESIDENT’s assets and accumulated income for their personal benefit, despite agreeing to use same, as per the AGREEMENT, for RESIDENT’s unpaid medical bills with JEWISH HOME. 16. That Plaintiff JEWISH HOME spoke with Defendants MARK AST and ERNEST AST on numerous occasions and demanded payment in full for services rendered to RESIDENT, which to date remains unpaid. 17. That JEWISH HOME has repeatedly called, written, and spoken with Defendants, MARK AST and ERNEST AST, demanding payment of the outstanding balance, which presently amounts to $46,472.00; however, to date said bill remains unpaid. FIRST CAUSE OF ACTION (Breach of Written Contract) 18. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 17 above, inclusive, with the same force and effect as though fully set forth herein. 19. On or about April 3, 2012, Defendants MARK AST and ERNEST AST reviewed and executed the AGREEMENT, as RESIDENT’s alleged attorneys-in fact and agreed to be bound by its terms. 20. That pursuant to said AGREEMENT, Defendants MARK AST and ERNEST AST undertook the obligation to do the following independent acts: a guarantee a continuity of payment from RESIDENT's funds and/or from third party payor(s) to meet RESIDENT's obligations to JEWISH HOME; arrange for timely and/or continued coverage from third party payor(s), if such coverage becomes necessary to satisfy RESIDENT's obligations to JEWISH HOME; guarantee payment from RESIDENT's funds where a third party payor denies coverage for services JEWISH HOME.renders to RESIDENT at the specified daily rate of five hundred and two doilars ($502) per day for a semi-private room or five twenty five ($525) for a private room, which private pay rates were subject to change; timely submit a Medicaid application, if necessary, to ensure uninterrupted payment to JEWISH HOME; use RESIDENT’s assets in such a way that would not jeopardize RESIDENT’s application for Medicaid and would guarantee payment to JEWISH HOME for services rendered to RESIDENT; fully document and assist with RESIDENT's Medicaid application to the appropriate County Department of Social Services Medicaid agency within the required time; in the event RESIDENT is approved for Medicaid benefits, remit payment to JEWISH HOME of RESIDENT’s Net Available Monthly Income (NAMI) pursuant to RESIDENT's Medicaid budget as determined by the County Department of Social Services providing RESIDENT’s Medicaid coverage; timely notify RESIDENT of the anticipated time when third party benefits are exhausted and RESIDENT's funds are depleted to the Medicaid resource level; if RESIDENT's funds are depleted or not available and third party benefits are exhausted or unavailable, arrange for the payment of RESIDENT's monthly income to JEWISH HOME as partial payment of RESIDENT's private pay rate; if late payment is made on RESIDENT's account, and RESIDENT's account is overdue more than 30 days, to be liable for interest at 1.50% per month; if JEWISH HOME must refer RESIDENT's outstanding account for collection, pay for reasonable collection fees, including but not limited to attorney fees incurred by JEWISH HOME in enforcing the terms of the AGREEMENT; and Agent of resident agrees to pay damages to the Facility for any breach of his/her personal obligations as set forth in the Agreement. 21. That the Defendants MARK AST and ERNEST AST were advised by Plaintiff to file an application for Medicaid benefits on behalf of resident, so as to cover the cost of RESIDENT’s care at Plaintiff's facility. That the Defendants represented to Plaintiff JEWISH HOME that they retained counsel to file said application for Medicaid benefits. That Plaintiff repeatedly followed up with said counsel, only to be advised, months later, that the Defendants had changed their minds regarding filing said Medicaid application. 22. Upon information and belief, Defendants MARK AST and ERNEST AST had access to RESIDENT’s assets and income and they were sufficient to satisfy the indebtedness owed to JEWISH HOME. 23. That Defendants MARK AST and ERNEST AST refused and refrained from turning over payment to JEWISH HOME in consideration for services rendered to RESIDENT and instead used the funds for their own benefit or the benefit of other individuals. 24. In breach of the AGREEMENT, and by reason of Defendants MARK AST and ERNEST AST’s default of same, JEWISH HOME has been damaged in the amount of $46,472.00 together with the contractually specified finance charges at a rate of one (1.50%) percent per month, along with reasonable costs for collection, including attorney’s fees. SECOND CAUSE OF ACTION AS AGAINST MARK AST and ERNEST AST (Breach of Oral Contract) 25. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 24 above, inclusive, with the same force and effect as though fully set forth herein. 26. At the time of RESIDENT’S admission to JEWISH HOME, RESIDENT and Defendants MARK AST and ERNEST AST, as the attorneys-in-fact for RESIDENT, orally agreed to pay and/or arrange for payment from the assets and income of RESIDENT, for the cost of nursing care services provided by Plaintiff JEWISH HOME to RESIDENT. 27. RESIDENT and the Defendants MARK AST and ERNEST AST breached the parties’ oral agreement by refusing or otherwise failing to pay JEWISH HOME for the cost of care and services provided by Plaintiff to RESIDENT. 28. That Plaintiff JEWISH HOME has fully performed all of its obligations under the oral agreement. 29. That RESIDENT and Defendants MARK AST and ERNEST AST have neither legal justification, nor excuse, for their failure to pay JEWISH HOME the amount due. 30. By reason of the foregoing, JEWISH HOME has been damaged in the amount of $46,472.00. THIRD CAUSE OF ACTION (Quantum Meruit/Unjust Enrichment) 31. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 30 above, inclusive, with the same force and effect as through fully set forth herein. 32. That JEWISH HOME provided services to RESIDENT at RESIDENT’s and Defendants MARK AST and ERNEST AST's specific insistence and request, and RESIDENT received and accepted the benefits of the services so provided. 33. That despite repeated demands for payment by JEWISH HOME and its representatives, RESIDENT and Defendants MARK AST and ERNEST AST failed and refused to pay JEWISH HOME for the services provided to RESIDENT. 34. RESIDENT and Defendants MARK AST and ERNEST AST should not be permitted, in equity and good conscience, to benefit from the services provided to RESIDENT at their specific request and insistence and promise to pay; without making payment for same. 35. By reason of the foregoing, RESIDNET and Defendants MARK AST and ERNEST AST have been unjustly enriched and are liable to JEWISH HOME in the amount of $46,472.00 or the reasonable value of services provided to RESIDENT at their request. FOURTH CAUSE OF ACTION (Conversion of Assets) 36. Plaintiff JEWISH HOME repeats and re-alleges each and every allegation contained in paragraphs 1 through 35, inclusive, of this Complaint. 37. RESIDENT was the owner of certain assets and/or received certain income while he was a resident at JEWISH HOME’ facility. 38. That upon information and belief, Defendants MARK AST and/or ERNEST AST, individualiy, and/or as attorneys-in-fact for RESIDENT, wrongfully converted the income and assets belonging to RESIDENT for unfair consideration. or for no consideration. 39. All income and/or assets of RESIDENT that Defendants MARK AST and/or ERNEST AST converted should have first been applied to satisfy RESIDENT’s and the Defendants outstanding payment obligations to Plaintiff JEWISH HOME. Ao. That these asset transfers and conversions rendered RESIDENT and her Estate insolvent by such transfers. The Defendants have therefore wrongfully converted such income and/or assets. A. That the Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact for RESIDENT, intended by their actions that JEWISH HOME should be defrauded, hindered, delayed and otherwise prevented from collecting debits due and owing, specifically, the $46,472.00, for care and services rendered to RESIDENT. 42. Defendants’ fraudulent conduct proximately caused damages to JEWISH HOME in the amount of $46,472.00. FIFTH CAUSE OF ACTION (FRAUDLENT CONVEYANCE UNDER DEBTOR CREDITOR LAW) 43. Plaintiff JEWISH HOME repeats and re-alleges each and every allegation contained in paragraphs 1 through 42, inclusive, of this Complaint. 44, RESIDENT was, just prior to her admission or during the time she resided at JEWISH HOME’ facility, the owner of certain assets and/or received certain income. 45. Upon information and belief, at all applicable times relevant hereto, Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact for RESIDENT, had, and/or still have, control over and/or access to income and/or assets belonging to RESIDENT. 46. Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact for RESIDENT, wrongfully conveyed and/or transferred all or some of the income and/or assets away from RESIDENT, without fair consideration or for no consideration, in order to prevent JEWISH HOME, as a creditor or a future creditor, from recovering monies due it for nursing care services rendered to RESIDENT. 47, All income and/or assets of RESIDENT that Defendants MARK AST and/or ERNEST AST converted should have first been applied to satisfy 10 RESIDENT and Defendants’ outstanding payment obligations to Plaintiff JEWISH HOME. 48, Such transfers were made by Defendants MARK AST and/or ERNEST AST knowing, intending and believing that RESIDENT and Defendants had a continuing obligation, under the terms of the AGREEMENT, to pay JEWISH HOME for services rendered to RESIDENT, and that as a resuit of such actions, payment from the income and/or assets of RESIDENT would not be forthcoming. 49. Such transfers of assets by Defendants MARK AST and/or ERNEST AST constitute fraudulent conveyances under Sections 273, 275 and/or 276 of the New York Debtor and Creditor Law. 50. By reason of the foregoing, the aforementioned conveyances by Defendants MARK AST and/or ERNEST AST, individually, and/or as attorneys-in-fact for RESIDENT, were void as to Plaintiff JEWISH HOME, as defined under Sections 273, 275 and/or 276 of the New York Debtor and Creditor Law, and thus JEWISH HOME has been damaged in the amount of $46,472.00. SIXTH CAUSE OF ACTION (Constructive Fraud) 51. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 50 above, inclusive, with the same force and.effect as though fully set forth herein. 52. By reason of the foregoing, Plaintiff JEWISH HOME has suffered damages in the sum of $46,472 by virtue of the constructive fraud. of Defendants MARK AST and ERNEST AST. 11 SEVENTH CAUSE OF ACTION (Account Stated) 53. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 52 above, inclusive, with the same force and effect as though fully set forth herein. 54, An account was taken and stated between Plaintiff and Defendants MARK AST and ERNEST AST for the amount of $46,472.00, which monies remain due and owing to Plaintiff. 55. Upon information and belief, Defendants MARK AST and ERNEST AST have received and retained said statements of account. 56. Defendants MARK AST and ERNEST AST, as attorneys-in-fact for RESIDENT and/or the Fiduciary of the ESTATE OF BETTY AST, have not objected to said statement of account. The outstanding balance remains due to Plaintiff, despite several demands for same. 57. By reason of the foregoing, Plaintiff has been damaged in the amount of $46,472.00. EIGHTH CAUSE OF ACTION AS AGAINST THE ESTATE OF BETTY AST 58. Plaintiff repeats and re-alleges each and every allegation set forth in paragraphs 1 through 57 above, inclusive, with the same force and effect as though fully set forth herein. 12 59. That all causes of action alleged herein accrued prior to the death of RESIDENT, and by reason of RESIDENT’s death, such causes of action are herein made against RESIDENT’s Estate, the ESTATE OF BETTY AST, as valid claims. 60. Upon information and belief, Defendant MARK AST is the nominated Executor for the ESTATE OF BETTY AST. 61. That during the period of April 29, 2012 through July 26, 2012, Plaintiff JEWISH HOME provided nursing care services to BETTY AST, now deceased, at BETTY AST’s and Defendants’ specific insistence and request and promise to pay. 62. That no sum has been paid to Plaintiff JEWISH HOME for the outstanding amount owed on account, despite Plaintiffs repeated demands to Defendants MARK AST and ERNEST AST, in their capacity as the nominated Executor of the ESTATE OF BETTY AST. 63. By reason of the foregoing, Plaintiff JEWISH HOME is owed a judgment against the ESTATE OF BETTY AST in the amount of $46,472.00, plus interest and costs from May 29, 2012 through the present. WHEREFORE, Plaintiff, JEWISH HOME, demands judgment against the Defendants as follows: A On the First Cause of Action not less than $46,472.00, together with the contractually specified finance charge at a rate of one (1.50%) percent per month, along with reasonable costs for collection, including attorney's fees; On the Second Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; 13 On the Third Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; On the Fourth Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; On the Fifth Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; On the Sixth Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012 On the Seventh Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; and On the Eigth Cause of Action not less than $46,472.00, plus interest and costs from May 29, 2012; The cost for attorneys’ fees and disbursements incurred for this action, together with such other and further relief this Court may deem just and proper. Dated: White Plains, New York November 5, 2014 LITTMAN KROOKS LLP By: ALBERTHE IER, ESQ Attorneys for the Plaintiff 399 Knollwood Road White Plains, New York 10603 (914) 684-2100 This communication is from a debt collector and is sent to you in an attempt to collect this debt. Any information obtained will be used for that purpose. 14 VERIFICATION STATE OF NEW YORK ) )ss.: COUNTY OF NEW YORK ) | am the Director of Patient Accounts at JEWISH HOME LIFECARE NURSING HOME. | am familiar with the facts and have read the foregoing Verified Complaint and know the contents thereof to be true to my knowledge, except as to those matters alleged on information and belief, and that as to those matters, | believe them to be true as well. ANNETTE LOBO, Director of Patient Accounts Sworn to before day of SE Tea leek 2014 INOTARY PUBLIC STATE OF NEW YORK UC. #o1 (COMM, EXP, EXHIBIT A 142198 Rov 02/12 JeWISIE HOME LIFECARI, MANHATTAN ADMISSION AGREEMENT 442198 Rov o2fi2 JEWISH HOME LIFECARE, MANHATTAN ADMISSION AGREEMENT TABLE OF CONTENTS Page NON-DISCRIMINATION ......cssensnesconn rsnseassstgerasnsesies sHenneddbesanecaneennqsnnsscennsenDittariteeneeeassateenes SERVICES PROVIDED BY THE FACILITY. t Services Included Under the Daily Basic Rate. pene Physician and Ancillary Services 23 ‘Transportation Services. 24 Outsi ye 8 25 Presoription Drugs; Medicare Part D 2.6 lasses, Hearing Aids and Prosthetic Devices 27 Be aoanen Aversannantanene vereeeantansananssaensnencanenn a 3. THE PATIENTRESIDENT'S AGREEMENT TO PAY FOR SERVICES, Patient/Rosident’s Direction to His/Her Agent 33 ‘The Patient/Resident’s Obligattons ,. 3 33 Third Party Agreements.. 34 Seaurity Dopostt., asestesn 35 Payment Obligations Under Medicaid and Other Third Parly Payots wissen set ‘THE RESPONSIBLE PARTY'S OBLIGATIONS TO THE FACILITY 6 Acknowledgement of Consideration .... wenn AL Payment Ontgation fiom Patient/Resident’s fim 43 Medicaid Ob 4A Powers of. atineye 6 45 Transfers by the Patieat/Resident.. ae scene TRUTHFULNESS OF INFORMATION PROVIDED ee eanenneeansaans LATE PAYMENTS AND NON-PAYMENT. 08 6.4 Late Charges... 62 Discharge for Ni ate 63 Collection Costs rune D 64 Darnages, . PATIENT/RESIDENT’S PERSONAL PROPERTY, AUTHORIZATION FOR PHYSICIAN VISITS OBLIGATIONS TO ABIDE BY FACILITY RULES AND REGULATIONS; NON- SMOKING...» 10. RELOCATION. ase i GENERAL PROVISIONS RELATING TO THIS AGREEMENT JEWISH HOME LAFECARE, MANHATTAN ADMISSION AGREEMENT Agreoment entered on wo, 20 f2ostveen JEWISH HOME LIFECARE, MANHATTAN (also reforred fo as “Hacility”) and ad Ae ven {Patient ident) and Ernst Ast | Mak (Responsible Party) THE PARTIES TO THIS AGREEMENT AGREE AS FOLLOWS: i NON-DISCRIMINATION ‘THE FACILITY DORS NOT DISCRIMINATE BECAUSE OF RACE, CREED, COLOR, NATIONAL ORIGIN, SEXUAL PREF GENDER, BLINDNESS, DISABILITY, SPONSORSHIP IN ADMISSION, SOURCE OF PAYMENT, AGE, OR AS OTHER WISE PROHIBITED BY LAW WITH RESPECT TO THE ADMISSION, RETENTION AND CARE OF PATIENT/RESIDENTS, 2, SERVICES PROVIDED BY THE FACILILY 2 ervices Inchided Under The Daily Basic Rate, The following sorvices are provided by the Facility cu the daily basic rate: @ Lodging it anou-private room; ®) Board, excluding artificial hydration and nutritlon; {) Twenty-four (24) hour per day nursing care; @ Fresh bed linens as required; ©) Hospital gowns or pajamas as required and regular non-dry cleaning laundry services for these and other launderable potsonal clothing items; ® Genel household medicinc cabinet supplics, including non-prescription medications, material for routine skin cave, oral hygiene, care of hair, except for specific items-that are medically indicated and needed fb r exceptional nse fora specific Patient/Resident; Assistance and/or supervision when required with activitios of daily living, including toileting, bathing, feeding and ambulation assistance; J4zi98 Rev 02/12 ® Services of members of the Facility staff performing their daily assigned patient care duties; @ The vse of customarily stocked equipment, including orutches, walters, wheelchairs, or other supportive equipmont, and training in theit use wher ry, unless such item is prescribed by a physician for the regular and sole hecesss fa use by a specific Patient/Resident; @ The use of all ipment, medical supplies and modalities usually used in the ovory day care of the Patlent/Resident, Including catheters, hypodermic syxingos and needles, irrigation outfits, dressings and pads; «) An_aclivilies progtam, including a planned schedule for reoreatlonal, motivational, , social and other activities, together with the necessary materials atid supplies; Q Social services as needed; and (a) Physical, ocenpationat and speech therapies, provided in acvordanes with a maintenance program (but stot such therapies provided in accordance with a restorative program). 22 Physician And. Ancillary Servises Charges for physician visits and physician-ordered ancillary services are not included in the i daily basic rate. Charges may be billed v the Facility or directly by the provider’ of the service, The Patient/Rosident is not obligated to pay r services paid for by Medicaid, Medicare (or other third patty payor) except for deductibles aud co-payments. Medicaid eligible Paticnt/Resident’s physioian services are normally covered by Medicaid, A listing of charges for ancillary services and prescription drugs which are provided by the Facility but whieh are not included in the daily basic rate iy available to the Pation/Resident at the office of the Facifity's administrator. is The Facility will artange for hi ysician visits as authorized under this Agreement and for aneillary services 0 be available to ¢ Patieni/Resident when proscribed by a physician, These services will he administered or supervised by practitioners affiliated with and/or approved by the Facility who meet the applicable New York licensing, registration and certification requirements, The following ancillary services are normally covered by Medicare or Medicaid: (2) Restorative Physical Therapy & @ Restorative Audiology Services Restorative Occupational Therapy Speech Therapy Podiatry Servicos Psychiatric or Psychological Treatment : Optometric Services Laboratory Services Radiology Services Eleotroonrdiography Services &) Oxygen Therapy Dental Services “Re M2198 Roy 02/12 23 Tranmertaion. Services, ives, Medicare will usually cover ambulance services that are sncdically necessary while Mediesid will ysually cover ambulette services. In addition, some (although not many) managed care plans and third party insurance polictes may provide coverage for certain transportation cosis, The Pailent/Residont will be responsible for payment of transportation costs that ate not covered by Medicare, Medicaid or insurance cartier. 2.4 Qutside Services, If the Patient/Resident desires to engage the services of an outside dentist, physician or other consultant, and the use of that consultant was not ordered by a Facility cian, Paticni/Resident is responsible for all costs associnted with thoso services, including professional fees to the extent those fees are not covered by Medicaid, Medicare or ats insarence cartier and accompanying Facility personal when transportation off-site with supervision is required, The Patient/Resident agrees to hold Facility harmless for any and all harm, inj , damage or loss the Patien!/Resident inight incur while away ftom, the Facility unaccompanied by any Facility staff members. 25 Charges tor drugs prescribed by a physician are not included in resctiption drug ol pes are not covered by Medicaid, Medicare or insurance cartier, they mustb for Medicare Part D coverageagrees to enroll,in a Me fone attD ti i re by the Resident, A Patlont/Resident eligible ctiplion drug plan which has a contract with the Facility’s vendor pharnaacy at or prior to the date of admission, if gligible at such time or during the month the Resident first becomes aligiblo for Medicare Patt D coverage, if such clipibility oceuts after the date of admission. All prescription drugs must be administered to the Resident by the Facility, 26a gE es, Hey prostheses othe aAN eee ae osthetic Devices, availa! Eyeglasses, hearing aides, dental ¢ Factily but aro tot covered nnder the y daily basic rate, ‘To the extent that they are not paid for by Medicaid, Medicare or insurance carrier, they must be paid for or charged against the Patient/Resident’s account when the cost is Incurred. 27 Personal Jems, Certain items and gervices, such as those listed below, are not cove: under the daily basic rate nor are they normally paid for by Medicaid, Medicare or insurance o: atrIOKs, Such items are wade available by the’ Facility but must be pald for or charged agaist the Patient/Resident’s account when the cost is incurred. BathesBeanty Parlor Private telephone inxoom including installation, maintenance and fees Private TV in room including installation,mainienanee and monthly cable fees a) Newspal Shoes (non-prescription) and clothing Dry cleanin, Speolal transportation for porsonal use 0 Non-toutine porsonal hygione items and services Computer, including installation, maintenance and internet connection fees 3. THE PATIENT/RESWENT’S AGREEMENT TO PAY FORSERVICES 34 Patient/Resident’s Dixcation To His Het Ags ents. The Pationi/Resident hereby directs the Re Patient esident’s assets and to cooperate in noible Party, to ensure that all p inet obligations under this Agreement are met from the obtaining Medicaid covaage if nece: onary to meet the Patient/Resident’s obligations under this Agreement, Petientesid KationtResident’s_Obgntions ‘The Subject to Section 3.3 below, the all services provided by the Facility under h ent agrees to pay for, or arrange fo haye paid for by Medicaid, Medicare or other insurers, is Agreement as follows: -3- 142198 Rev 02/12 a) Medionce ot Medicaid Coverage, , Hf the Pationt/Residont qualifies for Medionid or Medicare covera: ty agrees to accept the payment from these programs, plus any related coinsurance, deductible and Medicaid. surplus antonnts owed by the Patient/Resident, as payment in fill for the items and services covered by Medicaid or Medicave. Patlent/Residents are responsible for payment of services not covered by Medicate or Medicaid. Patient{Residents elf for Medicaid are also required fo pay over thelr net available monthly income as detailed im Section 3.5(¢) below. Private pay Status, If the Patient/Resident does not qualify for Medicaid or Medicare coverage, the Patient/Resident agrees to pay the Facility (i) the daily basic rate of $502.0 for a Semi Private Room and $525 for a Private Roow (as may be increased on thirty (30) days wiitten notice to the Patient/Rosident or the Responsible Party); and (ii) items and services not covered under the daily basic rate pursuant to section 2.1 above (including tion drugs and other } ancillary services) (the fotel of the charges set forth in Subsections 3.2 Ab) (it) referred to as the “Private Pay Rate”). ‘The Pationt/Resident agreos fo pay the Private Pay Rato to the Facility after other coverage has beon applied or exhausted until the month in which the Paticnt/Resident’s Medionid eligibility covers such charges, The Private Fay Rate payable for a month shall be paid in full by the fiflgenth (15th) day of that month, In addition, a Resident paying the Privaic Pay Rate is responsible for aying the amount of the New York State assessment levied on the Resident’s payments to the Facility, including the base assessment, as may be adjusted, aud any additional temporary assessments imposed, (As of September 1, 2011, the current combined assesament rate is 7.2%). 3.3 Third Par a) Menaged Care Agteoment, . Notwithstandin, anything in this Agreement to the Agreement”) is in effect between the Facili and a managed care company (the “ Nan contrary but subject fo Section 3.3(c) below, during such time as (i) a vweltten agreem ent (the “Provider i ined Care Company”) for the reimbursement to the Paoil ty for certain servicas (“Covered Services”) to enrolled members of the Managed Cate Company's plan; and (ii) the Patient/Resident continues as an enrolled Member of the Managed Care Company's plan, the Patient/Resident will not be responsible to the Facility for the services for whi ic yinent of any Covered Services, The Patient/Resident will remain Mable for the Vactlity is not entitted to reimbursement wider the Provider Agreement, including deductibles, co-payments, co-ingurance and/or pay