David D. Nesbit

Staff: Dave D. Nesbit


I’m a Baby Boomer nearing what Social Security calls the “full retirement age.”  I’ve shared a bit of my past below, which explains the motivation and purpose of Keystone Elder Law.  My wife and I presently feel “called” to provide a solid foundation for Keystone Elder Law PC to outlive us as our future legacy to serve our community’s long-term care needs.

We were confused and frustrated by a wide variety of unbelievably challenging issues over an eight year period when all four of our parents suffered from Alzheimer’s disease and vascular dementia at the end of their lives.   Dealing with the conflicting regulations and apparent motivations of hospitals, rehab facilities, skilled nursing homes, dementia facilities, continuing care retirement communities, hospices, and individual medical professionals was a remarkably chaotic experience. It nearly drove us crazy!

We had no guide or advisor to give us comprehensive advice to make us feel confident that we weren’t overlooking an opportunity to comfort or assist our parents.  One attorney wrote us a helpful letter to explain the Medicaid process, but did not do the paperwork for us.  We were never advised that our fathers’ World War II service opened the door to receive more than $20,000 per year in a special pension from the Veterans Administration.  No one explained how we could use a Medicaid-compliant annuity to save assets for the spouse who still lived in the community. No one helped us to understand or coordinate facility or care options.  No one came to the facility to help us with advocacy.

Frustration remained, even after the passing of our parents.  I concluded that, although we had met many really fine and kind individuals along our parents’ “journeys,” either the elder care system was badly broken or had not yet been fully invented.  I began seeking “a better way” to serve our community.

I imagined a service that would maximize the quality of independent living for older persons.  Then, if an alternative care arrangement became needed for their safety, or as the only economically viable option to assist with their increased need for help with their activities of daily living, I wanted to reduce the pain of transitioning. Although I had not been practicing law, I realized that my law license could be used to become part of the solution.

Much research led to my strong belief that involving an experienced, non-lawyer professional to focus on care planning could help to anticipate and avoid a crisis.  Clearly, since a lawyer can appear to be intimidating or adversarial, a care provider’s staff would be more comfortable speaking with a similarly licensed professional to coordinate placement, if and when a client would have a need for home care or care in a facility.  Keystone Elder Law P.C. has adopted this approach, and our multi-disciplined team of experienced professionals shares a profound commitment to this service.

As ambassadors to facilitate the best caregiving, we refuse to bring lawsuits against care providers, who have become willing to collaborate with us to get the best care for our clients.   Care providers seem to appreciate that, instead of threatening them with litigation, we have chosen to employ a non-legal professional as our clients’ care coordinator to help our clients and their supportive family members to communicate care needs most effectively to care providers.  When our clients’ families feel frustrated by what they perceive to be deficiencies in a care provider’s services, we are often able to be an empathetic buffer to help to bridge the gap constructively between expectations and standard practices.

Prior to becoming a principal of Keystone Elder Law P.C., I was an executive and shareholder of a multi-state, private corporation which employed more than 1,200 people; and I was a real estate broker-developer who completed transactions worth hundreds of millions of dollars over three decades in many states. I served as a national chair of the Office Condominium Forum and the Private Developers Forum of the National Association of Office and Industrial Properties (NAIOP), and was president of the Greater Harrisburg Association of Realtors Industrial, Commercial and Investment Council.  My professional career began in the non-profit and public sectors, where I initially worked in direct social services with wayward teenagers, and then later in the administration of federal and state grants for housing and community development on a local level in Lancaster County.  As the only member of my family who was not employed as an educator, I was appointed and later elected to serve as a school board member for the urban School District of Lancaster, which had more than 1,000 employees and over 10,000 students.

My formal education includes a Bachelor of Arts degree from Wake Forest University, a Master of Public Administration degree from Penn State University, and a Juris Doctor degree from Widener University School of Law. While attending law school in mid-life to demystify the legal objections of others in the corporate culture to my out-of-the-box creativity, I supported my family with full-time employment.   I was honored to receive the American Jurisprudence Awards for Real Estate Transactions and Education.   My continued professional education includes:  certification in Long Term Care Insurance (CLTC); retaining Pennsylvania licenses as both a real estate broker and a producer of life and health insurance; certification as a CCIM and member of the Commercial Investment Real Estate Institute; and certificated participant in extensive mediation training, including Good Shepherd’s Elder Mediation Course at Temple University.

As one who places a high value on continuing professional education, I have completed hundreds of hours of training in real estate, law, management, mediation, and leadership; and we encourage and assist Keystone colleagues to be similarly committed.   Because “giving back” is important, I have frequently taught accredited continuing education courses to various professionals. Keystone accepts as many invitations as possible to speak to local service and professional organizations about elder law and long-term care issues.

I can’t imagine a better use of my experience and time than the present opportunity to lead a team of experienced and dedicated professionals in offering a fresh and comprehensive approach to guide older adults and their families through the maze of long-term care issues. Keystone is able to stay on top of the latest changes in law and resources through our active membership with a number of national and state organizations.  Although I wish that my parents and in-laws could have benefited from having such a comprehensive service available to them, we feel blessed to have the opportunity to be the first to initiate that level of service in Central Pennsylvania.

Please accept this invitation to call us.  Our care coordinator will spend time to listen to your questions.  We’ll either refer you to a free or more appropriate resources, or we’ll help you to prepare so that an initial appointment with us will clarify how we can help you, and at what cost.  Getting started sooner than later is important!

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Long Term Care Guide