Disproportionate Share Incentive Payments for 12‐month MA‐11 Cost Reports Ending December 31, 2015 with Acceptance Letters Mailed on or before August 1, 2016

Chapter 1187.111 describes an incentive payment to nursing facilities based on the overall occupancy percent and MA occupancy percent of the facility during the facility's cost reporting period.

(a) A disproportionate share incentive payment will be made based on MA paid days of care times the per diem incentive to facilities meeting the following criteria for a 12‐month facility cost reporting period:

(1) The nursing facility shall have an annual overall occupancy rate of at least 90% of the total available bed days.

(2) The nursing facility shall have an MA occupancy rate of at least 80%. The MA occupancy rate is calculated by dividing the MA days of care paid by the Department by the total actual days of care.

(b) The disproportionate share incentive payments will be based on the following for Fiscal Year 2015‐16:

MA PerOverall Occupancy DiemOccupancy (y) Incentive

Group A 90% ›= 90% y $4.25

Group B 90% 88%‹= y ‹90% $2.87

Group C 90% 86%‹= y ‹88% $1.71

Group D 90% 84%‹= y ‹86% $1.04

Group E 90% 82%‹= y ‹84% $0.53

Group F 90% 80%‹= y ‹82% $0.39

                         

Disproportionate Share Payments for full year cost report periods ending December 31, 2015:

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

ALTOONA CENTER FOR NURSING CARE 5/10/2016 43,800 40,545 33,150 93% 82% E $0.53 $17,569.50 8/15/2016 AMBLER EXTENDED CARE CENTER 4/1/2016 36,500 33,933 27,101 93% 80% F $0.39 $10,569.39 8/15/2016 ARMSTRONG COUNTY HEALTH CENTER 5/10/2016 41,975 33,621 24,864 80% 74% $0.00 8/15/2016 ASBURY HEALTH CENTER 5/20/2016 50,735 48,085 20,183 95% 42% $0.00 8/15/2016 ATTLEBORO NURSING AND REHAB CENTER 5/24/2016 65,335 61,327 41,120 94% 67% $0.00 8/15/2016 AUDUBON VILLA HEALTH AND REHAB CENTER 6/13/2016 15,330 14,027 8,424 92% 60% $0.00 8/15/2016 AVALON SPRINGS NURSING CENTER 5/10/2016 36,500 33,379 24,903 91% 75% $0.00 8/15/2016 BARCLAY FRIENDS 4/4/2016 35,405 32,126 10,671 91% 33% $0.00 8/15/2016 BEACON RIDGE, A CHOICE COMMUNITY 6/13/2016 43,070 36,954 19,477 86% 53% $0.00 8/15/2016 BEAVER HEALTHCARE AND REHABILITATION CTR 6/13/2016 24,455 21,648 13,265 89% 61% $0.00 8/15/2016 BELLE HAVEN HEALTHCARE & REHAB CENTER 6/13/2016 21,535 20,471 15,926 95% 78% $0.00 8/15/2016 BELLE REVE HEALTH CARE CENTER 6/13/2016 10,950 9,412 3,273 86% 35% $0.00 8/15/2016 BERKS HEIM NURSING & REHABILITATION 6/9/2016 153,300 149,560 115,832 98% 77% $0.00 8/15/2016 BETHANY VILLAGE RETIREMENT CENTER 5/24/2016 25,185 24,408 6,258 97% 26% $0.00 8/15/2016 BETHLEN HM OF THE HUNGARIAN RFRMD FED 5/20/2016 35,040 32,149 17,251 92% 54% $0.00 8/15/2016 BIRCHWOOD NURSING AND REHAB CENTER 6/16/2016 44,165 40,220 27,772 91% 69% $0.00 8/15/2016 BONHAM NURSING CENTER 7/5/2016 28,105 25,244 19,337 90% 77% $0.00 8/15/2016 BRADFORD COUNTY MANOR 6/9/2016 73,000 59,307 37,697 81% 64% $0.00 8/15/2016 BRADFORD ECUMENICAL HOME, INC 5/24/2016 36,500 34,368 21,362 94% 62% $0.00 8/15/2016 BRADFORD MANOR 5/24/2016 41,975 36,947 26,991 88% 73% $0.00 8/15/2016 BRIARCLIFF PAVILION HEALTH AND REHAB CTR 6/13/2016 43,800 39,379 29,067 90% 74% $0.00 8/15/2016 BRIDGEVILLE REHAB AND CARE CENTER 5/20/2016 70,810 62,582 17,212 88% 28% $0.00 8/15/2016 BRIGHTON REHABILITATION & WELLNESS CTR 5/20/2016 214,985 171,082 132,488 80% 77% $0.00 8/15/2016 BROAD ACRES HEALTH AND REHAB CENTER 6/13/2016 43,800 40,889 24,726 93% 60% $0.00 8/15/2016 BROOKLINE MANOR AND REHABILITATIVE SRVCS 6/13/2016 31,025 27,703 16,748 89% 60% $0.00 8/15/2016 BROOKMONT HEALTHCARE CENTER LLC 6/13/2016 43,435 38,244 26,389 88% 69% $0.00 8/15/2016 BROOKSIDE HEALTHCARE AND REHAB CENTER 5/20/2016 43,800 37,062 30,366 85% 82% $0.00 8/15/2016 BROOMALL MANOR 4/1/2016 44,895 28,187 25,731 63% 91% $0.00 8/15/2016 BROOMALL PRESBYTERIAN VILLAGE 6/13/2016 53,290 47,701 25,508 90% 53% $0.00 8/15/2016 BROOMALL REHAB AND NURSING CENTER 6/13/2016 108,770 97,441 70,196 90% 72% $0.00 8/15/2016 BRYN MAWR EXTENDED CARE CENTER 4/1/2016 58,400 48,790 40,682 84% 83% $0.00 8/15/2016 BUFFALO VALLEY LUTHERAN VILLAGE 6/13/2016 37,230 35,919 24,561 96% 68% $0.00 8/15/2016 BUTLER VALLEY MANOR HLTH AND REHAB CTR 6/13/2016 13,505 12,553 8,778 93% 70% $0.00 8/15/2016 CAMBRIA CARE CENTER 5/10/2016 109,865 92,950 77,017 85% 83% $0.00 8/15/2016 CANTERBURY PLACE 6/16/2016 30,730 28,354 17,438 92% 62% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

CARBONDALE NURSING AND REHAB CENTER 4/1/2016 41,975 38,876 29,369 93% 76% $0.00 8/15/2016 CARE PAVILION NURSING AND REHAB CENTER 5/24/2016 144,540 135,512 121,489 94% 90% A $4.25 $516,328.25 8/15/2016 CARING HEIGHTS COMMUNITY CARE & REHAB 4/1/2016 43,800 39,927 32,138 91% 80% F $0.39 $12,533.82 8/15/2016 CARLETON HEALTHCARE & REHABILITATION CTR 6/13/2016 9,490 8,638 5,201 91% 60% $0.00 8/15/2016 CEDAR HAVEN HEALTHCARE CENTER 5/24/2016 118,260 111,949 95,950 95% 86% C $1.71 $164,074.50 8/15/2016 CEDARBROOK NURSING HOMES 6/9/2016 244,550 225,039 198,150 92% 88% B $2.87 $568,690.50 8/15/2016 CENTENNIAL HEALTHCARE & REHAB CENTER 5/20/2016 65,700 60,414 50,919 92% 84% D $1.04 $52,955.76 8/15/2016 CENTRE CREST 6/16/2016 87,600 83,030 60,649 95% 73% $0.00 8/15/2016 CHANDLER HALL HEALTH SERVICES INC 6/13/2016 19,345 17,168 5,852 89% 34% $0.00 8/15/2016 CHAPEL POINTE AT CARLISLE 6/13/2016 21,535 21,158 8,514 98% 40% $0.00 8/15/2016 CHERRY TREE NURSING CENTER 5/20/2016 43,800 29,747 23,075 68% 78% $0.00 8/15/2016 CHESTER VALLEY REHAB AND NURSING CENTER 5/20/2016 67,160 59,324 43,711 88% 74% $0.00 8/15/2016 CHESTNUT HILL LODGE HEALTH AND REHAB CTR 6/13/2016 66,065 55,005 48,785 83% 89% $0.00 8/15/2016 CHURCH OF GOD HOME, INC 5/20/2016 39,785 38,184 18,090 96% 47% $0.00 8/15/2016 CLAREMONT NRC OF CUMBERLAND COUNTY 5/24/2016 105,850 96,554 74,822 91% 77% $0.00 8/15/2016 CLARVIEW NURSING AND REHAB CENTER 6/13/2016 43,800 37,068 26,938 85% 73% $0.00 8/15/2016 CLEPPER MANOR 5/10/2016 19,710 17,858 12,926 91% 72% $0.00 8/15/2016 CLIVEDEN NSG & REHAB CTR 5/24/2016 65,700 60,916 49,407 93% 81% F $0.39 $19,268.73 8/15/2016 COLONIAL MANOR NURSING HOME 5/24/2016 98,550 78,507 62,037 80% 79% $0.00 8/15/2016 COLONIAL PARK CARE CENTER 5/10/2016 72,270 68,945 52,109 95% 76% $0.00 8/15/2016 COMMUNITIES AT INDIAN HAVEN 6/13/2016 39,420 36,693 18,202 93% 50% $0.00 8/15/2016 CONCORDIA AT THE CEDARS 5/24/2016 21,535 17,216 9,616 80% 56% $0.00 8/15/2016 CONESTOGA VIEW 6/13/2016 162,790 158,633 138,850 97% 88% B $2.87 $398,499.50 8/15/2016 CONSULATE HEALTH CARE OF CHESWICK 6/16/2016 44,165 37,066 32,527 84% 88% $0.00 8/15/2016 CONSULATE HEALTH CARE OF NORTH STRABANE 6/16/2016 22,630 19,181 12,942 85% 67% $0.00 8/15/2016 CORNWALL MANOR 5/20/2016 36,856 33,902 10,170 92% 30% $0.00 8/15/2016 CORRY MANOR 5/24/2016 44,165 39,648 27,858 90% 70% $0.00 8/15/2016 COUNTRY MEADOWS NURSING CENTER-BETHLEHEM 5/20/2016 25,550 24,306 730 95% 3% $0.00 8/15/2016 COUNTRYSIDE CHRISTIAN COMMUNITY 5/24/2016 12,045 11,650 6,555 97% 56% $0.00 8/15/2016 COURTYARD GARDENS NURSING AND REHAB CTR 5/24/2016 37,230 30,992 18,122 83% 58% $0.00 8/15/2016 COVENTRY MANOR HEALTH AND REHAB CTR 6/16/2016 14,965 13,285 9,359 89% 70% $0.00 8/15/2016 CRAWFORD COUNTY CARE CENTER 4/12/2016 57,305 53,085 39,040 93% 74% $0.00 8/15/2016 CREEKSIDE HEALTH AND REHABILITATION CTR 6/16/2016 29,565 24,647 20,821 83% 84% $0.00 8/15/2016 CUMBERLAND CROSSINGS RETIREMENT COMM 6/16/2016 21,170 20,086 8,551 95% 43% $0.00 8/15/2016 DARWAY HEALTHCARE & REHABILITATION CTR 6/16/2016 24,455 21,990 17,369 90% 79% $0.00 8/15/2016 DENVER HEALTH AND REHABILITATION CENTER 6/16/2016 29,930 28,287 19,654 95% 69% $0.00 8/15/2016 DUNMORE HEALTH CARE CENTER 4/1/2016 33,580 30,218 21,672 90% 72% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

EASTON HEALTH AND REHABILITATION CENTER 6/16/2016 66,065 58,802 50,210 89% 85% $0.00 8/15/2016 EDINBORO MANOR 5/24/2016 44,165 40,693 28,908 92% 71% $0.00 8/15/2016 EDISON MANOR NURSING AND REHAB CENTER 4/1/2016 43,070 35,285 27,897 82% 79% $0.00 8/15/2016 ELMWOOD GARDENS 6/9/2016 18,615 17,281 10,279 93% 59% $0.00 8/15/2016 EMMANUEL CENTER FOR NURSING AND REHAB 6/16/2016 32,850 31,197 16,910 95% 54% $0.00 8/15/2016 EPHRATA MANOR 6/16/2016 43,800 40,618 21,728 93% 53% $0.00 8/15/2016 EPWORTH HEALTHCARE AND REHAB CENTER 6/16/2016 37,230 35,072 26,027 94% 74% $0.00 8/15/2016 EVERGREEN HEALTH AND REHAB CENTER 6/16/2016 41,975 39,599 31,190 94% 79% $0.00 8/15/2016 FAIR ACRES GERIATRIC CENTER 5/20/2016 331,420 288,311 267,669 87% 93% $0.00 8/15/2016 FAIRVIEW MANOR 5/24/2016 44,165 41,033 28,696 93% 70% $0.00 8/15/2016 FORBES CENTER FOR REHAB & HEALTHCARE LLC 6/9/2016 52,090 41,693 33,890 80% 81% $0.00 8/15/2016 FOREST CITY NURSING AND REHAB CENTER 3/15/2016 48,180 35,298 26,152 73% 74% $0.00 8/15/2016 FOREST PARK HEALTH CENTER 6/16/2016 41,610 39,645 28,055 95% 71% $0.00 8/15/2016 FORESTVIEW 5/24/2016 29,200 26,203 9,648 90% 37% $0.00 8/15/2016 FOX SUBACUTE AT CLARA BURKE 6/16/2016 21,900 19,711 16,135 90% 82% E $0.53 $8,551.55 8/15/2016 FOX SUBACUTE CENTER 6/16/2016 21,900 16,634 11,910 76% 72% $0.00 8/15/2016 FREDERICK LIVING - CEDARWOOD 6/16/2016 22,265 21,026 4,820 94% 23% $0.00 8/15/2016 FREY VILLAGE 6/16/2016 49,640 47,594 29,521 96% 62% $0.00 8/15/2016 FRIENDSHIP VILLAGE OF SOUTH HILLS 5/20/2016 32,485 31,842 1,959 98% 6% $0.00 8/15/2016 GARVEY MANOR 5/10/2016 48,180 47,379 32,192 98% 68% $0.00 8/15/2016 GLENDALE UPTOWN HOME 6/16/2016 87,600 81,672 68,769 93% 84% D $1.04 $71,519.76 8/15/2016 GOLDEN LIVINGCENTER-BLUE RIDGE MOUNTAIN 5/24/2016 34,675 30,761 24,133 89% 78% $0.00 8/15/2016 GOLDEN LIVINGCENTER-CAMP HILL 5/24/2016 34,675 30,731 26,182 89% 85% $0.00 8/15/2016 GOLDEN LIVINGCENTER-CLARION 5/24/2016 30,295 20,556 15,185 68% 74% $0.00 8/15/2016 GOLDEN LIVINGCENTER-DOYLESTOWN 5/24/2016 43,800 34,635 30,551 79% 88% $0.00 8/15/2016 GOLDEN LIVINGCENTER-EAST MOUNTAIN 5/24/2016 43,800 41,374 30,245 94% 73% $0.00 8/15/2016 GOLDEN LIVINGCENTER-GETTYSBURG 5/24/2016 37,230 35,391 29,268 95% 83% E $0.53 $15,512.04 8/15/2016 GOLDEN LIVINGCENTER-HAIDA 5/26/2016 35,770 31,822 23,554 89% 74% $0.00 8/15/2016 GOLDEN LIVINGCENTER-HILLVIEW 5/26/2016 48,545 45,608 32,597 94% 71% $0.00 8/15/2016 GOLDEN LIVINGCENTER-KINZUA 5/26/2016 38,690 35,981 26,667 93% 74% $0.00 8/15/2016 GOLDEN LIVINGCENTER-LANCASTER 5/26/2016 45,260 41,789 36,885 92% 88% B $2.87 $105,859.95 8/15/2016 GOLDEN LIVINGCENTER-LANSDALE 5/26/2016 45,990 37,522 33,994 82% 91% $0.00 8/15/2016 GOLDEN LIVINGCENTER-MANSION 5/26/2016 25,550 23,886 20,076 93% 84% D $1.04 $20,879.04 8/15/2016 GOLDEN LIVINGCENTER-MEYERSDALE 5/26/2016 36,135 30,455 24,991 84% 82% $0.00 8/15/2016 GOLDEN LIVINGCENTER-MONROEVILLE 5/26/2016 43,800 40,032 26,442 91% 66% $0.00 8/15/2016 GOLDEN LIVINGCENTER-MT LEBANON 5/26/2016 44,165 37,867 30,248 86% 80% $0.00 8/15/2016 GOLDEN LIVINGCENTER-MURRYSVILLE 5/26/2016 43,800 39,199 29,252 89% 75% $0.00 8/15/2016 GOLDEN LIVINGCENTER-OIL CITY 5/26/2016 34,675 31,222 21,796 90% 70% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

GOLDEN LIVINGCENTER-PHOENIXVILLE 5/26/2016 50,370 38,742 32,371 77% 84% $0.00 8/15/2016 GOLDEN LIVINGCENTER-READING 5/26/2016 45,260 38,857 29,791 86% 77% $0.00 8/15/2016 GOLDEN LIVINGCENTER-RICHLAND 5/26/2016 35,405 31,368 19,947 89% 64% $0.00 8/15/2016 GOLDEN LIVINGCENTER-ROSEMONT 5/26/2016 27,740 22,569 20,597 81% 91% $0.00 8/15/2016 GOLDEN LIVINGCENTER-SCRANTON 6/7/2016 50,735 41,930 34,199 83% 82% $0.00 8/15/2016 GOLDEN LIVINGCENTER-SHIPPENVILLE 6/7/2016 43,800 28,433 20,759 65% 73% $0.00 8/15/2016 GOLDEN LIVINGCENTER-SOUTH HILLS 6/7/2016 37,960 32,300 23,226 85% 72% $0.00 8/15/2016 GOLDEN LIVINGCENTER-STENTON 6/7/2016 34,310 28,282 25,710 82% 91% $0.00 8/15/2016 GOLDEN LIVINGCENTER-STROUD 6/7/2016 46,355 42,798 32,912 92% 77% $0.00 8/15/2016 GOLDEN LIVINGCENTER-SUMMIT 6/7/2016 43,800 37,128 30,770 85% 83% $0.00 8/15/2016 GOLDEN LIVINGCENTER-TITUSVILLE 6/7/2016 28,105 24,509 18,488 87% 75% $0.00 8/15/2016 GOLDEN LIVINGCENTER-TUNKHANNOCK 6/7/2016 45,260 41,362 31,697 91% 77% $0.00 8/15/2016 GOLDEN LIVINGCENTER-UNIONTOWN 6/7/2016 43,800 41,171 27,569 94% 67% $0.00 8/15/2016 GOLDEN LIVINGCENTER-WALNUT CREEK 6/7/2016 41,975 36,179 18,924 86% 52% $0.00 8/15/2016 GOLDEN LIVINGCENTER-WAYNESBURG 6/7/2016 40,515 36,464 25,826 90% 71% $0.00 8/15/2016 GOLDEN LIVINGCENTER-WEST SHORE 6/7/2016 112,785 72,759 58,956 65% 81% $0.00 8/15/2016 GOLDEN LIVINGCENTER-WESTERN RESERVE 6/7/2016 48,545 41,116 32,192 85% 78% $0.00 8/15/2016 GOLDEN LIVINGCENTER-WILLIAM PENN 6/7/2016 44,165 41,960 30,181 95% 72% $0.00 8/15/2016 GOLDEN LIVINGCENTER-YORK TERRACE 6/7/2016 29,200 26,299 19,299 90% 73% $0.00 8/15/2016 GRACEDALE - NORTHAMPTON COUNTY HOME 5/10/2016 264,625 240,730 201,301 91% 84% D $1.04 $209,353.04 8/15/2016 GREEN RIDGE CARE CENTER 4/1/2016 34,675 31,017 16,628 89% 54% $0.00 8/15/2016 GREENERY CENTER FOR REHAB & NURSING 5/10/2016 51,100 35,687 29,082 70% 81% $0.00 8/15/2016 GREENSBURG CARE CENTER 5/10/2016 43,800 39,678 28,479 91% 72% $0.00 8/15/2016 GUARDIAN HEALTHCARE & REHAB CENTER 6/20/2016 40,150 35,459 29,046 88% 82% $0.00 8/15/2016 HANOVER HALL 5/24/2016 55,480 50,919 33,865 92% 67% $0.00 8/15/2016 HARMAR VILLAGE CARE CENTER 5/10/2016 47,450 43,463 29,673 92% 68% $0.00 8/15/2016 HARMON HOUSE CARE CENTER 5/10/2016 39,785 36,442 25,587 92% 70% $0.00 8/15/2016 HARRISON SENIOR LIVING OF CHRISTIANA 6/20/2016 50,735 34,549 30,154 68% 87% $0.00 8/15/2016 HAVEN CONVALESCENT HOME, INC 6/9/2016 33,215 32,549 25,787 98% 79% $0.00 8/15/2016 HEARTHSIDE REHAB AND NURSING CENTER, THE 5/20/2016 57,305 52,164 38,451 91% 74% $0.00 8/15/2016 HEMPFIELD MANOR 6/7/2016 43,800 40,403 23,459 92% 58% $0.00 8/15/2016 HICKORY HOUSE NURSING HOME 4/1/2016 40,150 35,318 16,861 88% 48% $0.00 8/15/2016 HIGHLAND MANOR REHAB & NURSING CENTER 7/5/2016 43,800 38,848 29,122 89% 75% $0.00 8/15/2016 HIGHLAND PARK CARE CENTER 5/10/2016 52,560 46,262 38,800 88% 84% $0.00 8/15/2016 HIGHLAND VIEW HEALTHCARE & REHAB CENTER 6/20/2016 18,250 16,390 11,051 90% 67% $0.00 8/15/2016 HIGHLANDS CARE CENTER, THE 6/20/2016 43,800 40,338 35,627 92% 88% B $2.87 $102,249.49 8/15/2016 HILLSDALE REHABILITATION AND NURSING CTR 5/20/2016 27,010 24,871 17,109 92% 69% $0.00 8/15/2016 HOLY FAMILY HOME 5/20/2016 16,425 15,672 13,602 95% 87% C $1.71 $23,259.42 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

HOLY FAMILY MANOR 6/9/2016 75,920 65,673 44,677 87% 68% $0.00 8/15/2016 HOLY FAMILY RESIDENCE 5/24/2016 19,710 19,295 17,279 98% 90% A $4.25 $73,435.75 8/15/2016 HOMETOWN NURSING AND REHAB CENTER 3/15/2016 54,900 48,677 36,335 89% 75% $0.00 8/15/2016 HOMEWOOD AT MARTINSBURG PA INC 5/10/2016 47,085 45,868 21,945 97% 48% $0.00 8/15/2016 HOMEWOOD AT PLUM CREEK 5/10/2016 43,800 42,738 15,299 98% 36% $0.00 8/15/2016 HOSPITALITY CARE CENTER OF HERMITAGE INC 4/1/2016 12,045 10,195 8,087 85% 79% $0.00 8/15/2016 JAMESON CARE CENTER 4/4/2016 28,470 26,462 10,170 93% 38% $0.00 8/15/2016 JEFFERSON HILLS HEALTHCARE & REHAB CTR 6/20/2016 30,295 23,035 16,354 76% 71% $0.00 8/15/2016 JEWISH HOME OF EASTERN PENNSYLVANIA 6/7/2016 63,145 57,382 42,597 91% 74% $0.00 8/15/2016 JOHN J KANE REGIONAL CENTER-GLEN HAZEL 6/20/2016 76,650 69,601 62,870 91% 90% A $4.25 $267,197.50 8/15/2016 JOHN J KANE REGIONAL CENTER-MCKEESPORT 6/20/2016 131,400 104,082 86,437 79% 83% $0.00 8/15/2016 JOHN J KANE REGIONAL CENTER-ROSS TWNSHP 6/20/2016 87,600 82,290 72,960 94% 89% B $2.87 $209,395.20 8/15/2016 JOHN J KANE REGIONAL CENTER-SCOTT TWNSHP 6/20/2016 114,610 100,072 73,084 87% 73% $0.00 8/15/2016 JULIA POUND CARE CENTER 5/20/2016 47,815 38,349 23,294 80% 61% $0.00 8/15/2016 JULIA RIBAUDO EXTENDED CARE CENTER 4/1/2016 43,800 35,725 25,550 82% 72% $0.00 8/15/2016 KADE HEALTH AND REHABILITATION CENTER 6/20/2016 27,010 24,187 20,554 90% 85% D $1.04 $21,376.16 8/15/2016 KEARSLEY REHAB AND NURSING CENTER 5/20/2016 30,660 29,516 20,815 96% 71% $0.00 8/15/2016 KEPLER CENTER FOR NURSING AND REHAB 5/20/2016 14,600 11,103 9,388 76% 85% $0.00 8/15/2016 KINGSTON HEALTH CARE CENTER 4/1/2016 23,725 18,444 10,148 78% 55% $0.00 8/15/2016 KITTANNING CARE CENTER 5/10/2016 43,800 37,657 33,034 86% 88% $0.00 8/15/2016 LAFAYETTE MANOR, INC 6/20/2016 35,770 31,948 22,214 89% 70% $0.00 8/15/2016 LAKESIDE HEALTH AND REHABILITATION CTR 6/20/2016 11,315 10,191 8,017 90% 79% $0.00 8/15/2016 LAKEVIEW HEALTHCARE & REHABILITATION CTR 6/20/2016 12,410 11,558 6,952 93% 60% $0.00 8/15/2016 LANCASHIRE HALL 5/24/2016 87,600 79,065 66,074 90% 84% D $1.04 $68,716.96 8/15/2016 LATROBE HEALTH AND REHABILITATION CENTER 6/20/2016 39,055 35,385 30,318 91% 86% C $1.71 $51,843.78 8/15/2016 LAUREL CARE NURSING AND REHAB CENTER 6/20/2016 33,580 32,673 19,906 97% 61% $0.00 8/15/2016 LAUREL WOOD CARE CENTER 5/10/2016 43,800 40,265 27,567 92% 68% $0.00 8/15/2016 LAWSON NURSING HOME, INC. 6/9/2016 18,250 14,814 6,876 81% 46% $0.00 8/15/2016 LEBANON VALLEY BRETHREN HOME 6/9/2016 36,500 32,676 13,799 90% 42% $0.00 8/15/2016 LEBANON VALLEY HOME THE 6/20/2016 20,075 19,114 9,507 95% 50% $0.00 8/15/2016 LECOM AT PRESQUE ISLE, INC. 5/24/2016 51,465 41,343 34,640 80% 84% $0.00 8/15/2016 LGAR HEALTH AND REHABILITATION CENTER 6/9/2016 43,800 39,527 30,048 90% 76% $0.00 8/15/2016 LITTLE FLOWER MANOR OF DIOCESE SCRANTON 6/20/2016 48,545 45,496 30,515 94% 67% $0.00 8/15/2016 LITTLE SISTERS OF THE POOR 5/10/2016 17,520 16,944 15,820 97% 93% A $4.25 $67,235.00 8/15/2016 LOCUST GROVE RETIREMENT VILLAGE 6/9/2016 37,960 34,497 27,305 91% 79% $0.00 8/15/2016 LOYALHANNA CARE CENTER 6/16/2016 43,800 38,269 25,544 87% 67% $0.00 8/15/2016 LUTHER ACRES MANOR 6/20/2016 38,690 37,715 14,438 97% 38% $0.00 8/15/2016 LUTHER CREST NURSING FACILITY 6/20/2016 21,900 20,782 5,025 95% 24% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

LUTHER WOODS NURSING & REHAB CENTER 6/7/2016 51,100 41,856 21,306 82% 51% $0.00 8/15/2016 LUTHERAN HOME AT HOLLIDAYSBURG, THE 6/16/2016 32,485 31,752 16,119 98% 51% $0.00 8/15/2016 LUTHERAN HOME AT JOHNSTOWN, THE 6/20/2016 22,995 21,624 10,761 94% 50% $0.00 8/15/2016 LUTHERAN HOME AT KANE, THE 6/9/2016 32,850 31,101 22,224 95% 71% $0.00 8/15/2016 LUTHERAN HOME AT TOPTON 6/29/2016 70,810 68,874 40,468 97% 59% $0.00 8/15/2016 MAHONING VALLEY NURSING AND REHAB CENTER 6/7/2016 51,830 45,621 30,233 88% 66% $0.00 8/15/2016 MAJESTIC OAKS REHAB & NURSING CENTER 6/7/2016 65,700 60,158 48,168 92% 80% F $0.39 $18,785.52 8/15/2016 MANATAWNY MANOR INC 6/29/2016 48,545 46,250 28,615 95% 62% $0.00 8/15/2016 MANCHESTER COMMONS 6/9/2016 28,470 26,652 14,256 94% 53% $0.00 8/15/2016 MANORCARE HEALTH SERVICES - MONTGOMERY 4/1/2016 62,050 52,533 40,849 85% 78% $0.00 8/15/2016 MANORCARE HEALTH SVCS-ALLENTOWN 4/1/2016 60,590 54,205 42,466 89% 78% $0.00 8/15/2016 MANORCARE HEALTH SVCS-BETHEL PARK 5/20/2016 58,400 45,115 31,055 77% 69% $0.00 8/15/2016 MANORCARE HEALTH SVCS-BETHLEHEM (2021) 5/10/2016 82,855 74,835 62,158 90% 83% E $0.53 $32,943.74 8/15/2016 MANORCARE HEALTH SVCS-BETHLEHEM (2029) 5/10/2016 79,205 68,360 56,496 86% 83% $0.00 8/15/2016 MANORCARE HEALTH SVCS-CAMP HILL 5/20/2016 44,895 40,907 26,194 91% 64% $0.00 8/15/2016 MANORCARE HEALTH SVCS-CARLISLE 4/1/2016 54,750 48,590 37,207 89% 77% $0.00 8/15/2016 MANORCARE HEALTH SVCS-CHAMBERSBURG 4/7/2016 76,650 69,105 48,954 90% 71% $0.00 8/15/2016 MANORCARE HEALTH SVCS-DALLASTOWN 4/7/2016 73,730 68,691 55,084 93% 80% F $0.39 $21,482.76 8/15/2016 MANORCARE HEALTH SVCS-EASTON 4/1/2016 82,855 69,348 52,143 84% 75% $0.00 8/15/2016 MANORCARE HEALTH SVCS-ELIZABETHTOWN 4/7/2016 26,645 24,134 17,069 91% 71% $0.00 8/15/2016 MANORCARE HEALTH SVCS-GREEN TREE 5/20/2016 65,700 51,130 27,594 78% 54% $0.00 8/15/2016 MANORCARE HEALTH SVCS-HUNTINGDON VALLEY 4/1/2016 47,450 41,805 32,163 88% 77% $0.00 8/15/2016 MANORCARE HEALTH SVCS-JERSEY SHORE 4/7/2016 43,800 41,675 32,758 95% 79% $0.00 8/15/2016 MANORCARE HEALTH SVCS-KING OF PRUSSIA 5/10/2016 57,305 46,701 33,666 81% 72% $0.00 8/15/2016 MANORCARE HEALTH SVCS-KINGSTON 4/1/2016 64,240 50,466 37,769 79% 75% $0.00 8/15/2016 MANORCARE HEALTH SVCS-LANCASTER 5/10/2016 62,780 59,347 43,558 95% 73% $0.00 8/15/2016 MANORCARE HEALTH SVCS-LAURELDALE 4/7/2016 72,270 67,271 43,776 93% 65% $0.00 8/15/2016 MANORCARE HEALTH SVCS-LEBANON 4/7/2016 58,035 52,233 37,716 90% 72% $0.00 8/15/2016 MANORCARE HEALTH SVCS-MONROEVILLE 4/1/2016 45,807 40,976 22,471 89% 55% $0.00 8/15/2016 MANORCARE HEALTH SVCS-NORTH HILLS 4/1/2016 73,000 62,078 43,954 85% 71% $0.00 8/15/2016 MANORCARE HEALTH SVCS-OXFORD VALLEY 4/1/2016 54,750 47,795 28,597 87% 60% $0.00 8/15/2016 MANORCARE HEALTH SVCS-PETERS TOWNSHIP 4/1/2016 51,100 37,768 26,087 74% 69% $0.00 8/15/2016 MANORCARE HEALTH SVCS-POTTSTOWN 4/1/2016 60,225 48,948 39,532 81% 81% $0.00 8/15/2016 MANORCARE HEALTH SVCS-POTTSVILLE 4/1/2016 65,335 61,264 50,165 94% 82% E $0.53 $26,587.45 8/15/2016 MANORCARE HEALTH SVCS-SINKING SPRING 4/1/2016 78,110 73,378 54,085 94% 74% $0.00 8/15/2016 MANORCARE HEALTH SVCS-SUNBURY 4/1/2016 45,990 42,673 33,715 93% 79% $0.00 8/15/2016 MANORCARE HEALTH SVCS-WEST READING NORTH 4/7/2016 64,240 61,451 53,611 96% 87% C $1.71 $91,674.81 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

MANORCARE HEALTH SVCS-WHITEHALL BOROUGH MANORCARE HEALTH SVCS-WILLIAMSPORT

5/10/2016 60,590 53,658 19,763 89% 37% $0.00 8/15/2016

NORTH 5/10/2016 55,480 45,755 36,330 82% 79% $0.00 8/15/2016 MANORCARE HEALTH SVCS-WILLIAMSPORT SOUTH 5/10/2016 42,340 37,930 31,310 90% 83% E $0.53 $16,594.30 8/15/2016 MANORCARE HEALTH SVCS-YEADON 4/1/2016 72,270 68,110 61,576 94% 90% A $4.25 $261,698.00 8/15/2016 MAPLE WINDS CARE CENTER 5/24/2016 18,250 13,589 6,431 74% 47% $0.00 8/15/2016 MAPLEWOOD NURSING AND REHABILITATION CTR 6/7/2016 65,700 62,027 55,754 94% 90% A $4.25 $236,954.50 8/15/2016 MASONIC VILLAGE AT ELIZABETHTOWN 6/29/2016 165,345 155,372 88,747 94% 57% $0.00 8/15/2016 MASONIC VILLAGE AT LAFAYETTE HILL 6/29/2016 21,900 21,145 13,697 97% 65% $0.00 8/15/2016 MASONIC VILLAGE AT SEWICKLEY 6/29/2016 46,720 45,354 15,940 97% 35% $0.00 8/15/2016 MASONIC VILLAGE AT WARMINSTER 6/29/2016 14,105 13,829 9,703 98% 70% $0.00 8/15/2016 MAYBROOK HILLS REHAB & HEALTHCARE CENTER 7/5/2016 87,600 71,079 59,621 81% 84% $0.00 8/15/2016 MEADOW VIEW HEALTHCARE & REHAB CENTER 6/29/2016 22,995 22,007 15,929 96% 72% $0.00 8/15/2016 MEADOWVIEW REHAB & NURSING CENTER 7/5/2016 89,060 75,201 61,037 84% 81% $0.00 8/15/2016 MENNO-HAVEN, INC. 7/5/2016 55,480 49,042 20,992 88% 43% $0.00 8/15/2016 MERCY CENTER NURSING UNIT, INC 6/29/2016 21,535 20,732 12,942 96% 62% $0.00 8/15/2016 MID VALLEY HEALTH CARE CENTER 4/1/2016 13,870 11,907 5,983 86% 50% $0.00 8/15/2016 MILFORD SENIOR CARE AND REHAB CENTER 6/29/2016 29,200 27,422 18,742 94% 68% $0.00 8/15/2016 MILLVILLE HEALTH AND REHABILITATION CTR 6/29/2016 40,150 31,121 28,238 78% 91% $0.00 8/15/2016 MILTON NURSING AND REHABILITATION CENTER 6/7/2016 50,370 44,731 35,637 89% 80% $0.00 8/15/2016 MISERICORDIA NURSING & REHAB CENTER 6/29/2016 18,250 16,383 6,449 90% 39% $0.00 8/15/2016 MON VALLEY CARE CENTER 6/29/2016 21,900 18,942 7,938 86% 42% $0.00 8/15/2016 MORAVIAN MANOR 5/24/2016 46,355 42,559 12,547 92% 29% $0.00 8/15/2016 MORRISONS COVE HOME 6/9/2016 45,260 42,981 31,116 95% 72% $0.00 8/15/2016 MOUNT CARMEL NURSING AND REHAB CENTER 3/15/2016 44,286 41,265 30,307 93% 73% $0.00 8/15/2016 MOUNTAIN TOP HEALTHCARE AND REHAB CTR 6/29/2016 38,690 35,251 26,970 91% 77% $0.00 8/15/2016 MOUNTAIN VIEW, A NURSING AND REHAB CTR 6/29/2016 98,915 72,583 59,021 73% 81% $0.00 8/15/2016 MOUNTAINVIEW SPECIALTY CARE CENTER 5/20/2016 50,005 39,124 29,042 78% 74% $0.00 8/15/2016 MULBERRY HEALTHCARE & REHAB CTR 6/29/2016 27,375 24,198 17,578 88% 73% $0.00 8/15/2016 NESHAMINY MANOR HOME 7/5/2016 131,400 129,632 97,333 99% 75% $0.00 8/15/2016 NORMANDIE RIDGE 5/24/2016 23,360 21,894 9,860 94% 45% $0.00 8/15/2016 NOTTINGHAM VILLAGE 6/7/2016 44,165 38,978 23,652 88% 61% $0.00 8/15/2016 NUGENT CONVALESCENT HOME 5/20/2016 38,325 34,945 24,871 91% 71% $0.00 8/15/2016 OAKMONT CENTER FOR NURSING AND REHAB 5/20/2016 31,025 27,252 21,573 88% 79% $0.00 8/15/2016 OAKWOOD HEIGHTS 6/9/2016 38,690 36,728 25,943 95% 71% $0.00 8/15/2016 OHESSON MANOR 6/29/2016 48,910 47,227 32,361 97% 69% $0.00 8/15/2016 OLD ORCHARD HEALTH CARE CENTER 4/7/2016 65,700 61,509 42,524 94% 69% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

ORANGEVILLE HEALTH AND REHAB CENTER 6/29/2016 43,800 38,317 29,848 87% 78% $0.00 8/15/2016 OVERLOOK HEALTH AND REHAB CENTER 6/29/2016 41,975 34,539 29,030 82% 84% $0.00 8/15/2016 OXFORD HEALTH CENTER 5/20/2016 50,005 48,125 28,340 96% 59% $0.00 8/15/2016 PALMYRA HEALTH AND REHABILITATION CTR 6/29/2016 14,235 12,218 8,967 86% 73% $0.00 8/15/2016 PARK AVENUE REHAB AND NURSING CENTER 5/20/2016 63,145 49,963 39,531 79% 79% $0.00 8/15/2016 PARKHOUSE NURSING AND REHABILITATION CTR 6/9/2016 170,455 149,498 124,367 88% 83% $0.00 8/15/2016 PAUL'S RUN 7/5/2016 43,800 41,168 17,082 94% 41% $0.00 8/15/2016 PEMBROOKE HEALTH AND REHAB CENTER 6/29/2016 65,700 57,089 47,599 87% 83% $0.00 8/15/2016 PENN HALL AT MENNO HAVEN 6/16/2016 21,900 20,992 7,602 96% 36% $0.00 8/15/2016 PENNKNOLL VILLAGE 6/13/2016 47,450 47,002 35,674 99% 76% $0.00 8/15/2016 PHILADELPHIA NURSING HOME 4/1/2016 146,730 142,657 134,619 97% 94% A $4.25 $572,130.75 8/15/2016 PHILADELPHIA PROTESTANT HOME 6/13/2016 45,990 44,908 21,643 98% 48% $0.00 8/15/2016 PLATINUM RIDGE CTR FOR REHAB & HEALING 5/24/2016 35,405 32,714 22,665 92% 69% $0.00 8/15/2016 PLEASANT ACRES NURSING AND REHAB CENTER 5/20/2016 136,875 129,538 113,860 95% 88% B $2.87 $326,778.20 8/15/2016 PLEASANT RIDGE MANOR WEST 5/24/2016 124,988 111,363 99,041 89% 89% $0.00 8/15/2016 PLEASANT VALLEY MANOR, INC 5/20/2016 63,510 59,680 45,605 94% 76% $0.00 8/15/2016 PLEASANT VIEW RETIREMENT COMMUNITY 4/1/2016 48,545 43,343 17,045 89% 39% $0.00 8/15/2016 POCOPSON HOME 6/13/2016 100,375 92,682 80,076 92% 86% C $1.71 $136,929.96 8/15/2016 PRAXIS ALZHEIMER'S FACILITY 6/29/2016 41,975 40,287 34,694 96% 86% C $1.71 $59,326.74 8/15/2016 PRESBYTERIAN HOMES-PRESBYTERY-HUNTINGDON 5/20/2016 24,455 21,796 11,669 89% 54% $0.00 8/15/2016 PROSPECT PARK HEALTH AND REHAB CENTER 6/29/2016 65,700 59,475 46,245 91% 78% $0.00 8/15/2016 PROVIDENCE CARE CENTER 5/10/2016 65,700 62,368 51,452 95% 82% E $0.53 $27,269.56 8/15/2016 QUINCY RETIREMENT COMMUNITY 5/20/2016 48,910 46,108 26,849 94% 58% $0.00 8/15/2016 REFORMED PRESBYTERIAN HOME 5/24/2016 21,170 16,718 13,562 79% 81% $0.00 8/15/2016 REHAB & NURSING CTR GREATER PITTSBURGH 5/24/2016 43,800 36,899 14,380 84% 39% $0.00 8/15/2016 RICHFIELD HEALTHCARE AND REHAB CENTER 6/29/2016 14,600 13,236 9,365 91% 71% $0.00 8/15/2016 RIDGEVIEW HEALTHCARE & REHAB CENTER 5/20/2016 40,515 29,104 21,814 72% 75% $0.00 8/15/2016 RIDGEVIEW HEALTHCARE & REHAB CENTER 6/29/2016 47,815 44,774 34,335 94% 77% $0.00 8/15/2016 RIVER RUN REHAB AND NURSING CENTER 5/20/2016 52,925 34,142 25,297 65% 74% $0.00 8/15/2016 RIVER'S EDGE NURSING AND REHAB CENTER 7/5/2016 43,800 38,326 25,036 88% 65% $0.00 8/15/2016 RIVERSIDE CARE CENTER 5/10/2016 43,800 41,321 35,533 94% 86% C $1.71 $60,761.43 8/15/2016 RIVERSIDE REHABILITATION AND NURSING CTR 5/20/2016 58,765 50,984 40,762 87% 80% $0.00 8/15/2016 RIVERWOODS 5/24/2016 82,490 54,767 32,689 66% 60% $0.00 8/15/2016 ROCHESTER MANOR 5/24/2016 44,530 31,632 22,575 71% 71% $0.00 8/15/2016 ROLLING FIELDS, INC 5/20/2016 66,065 60,715 45,220 92% 74% $0.00 8/15/2016 ROLLING HILLS HEALTHCARE & REHAB CENTER 6/29/2016 20,805 18,762 15,823 90% 84% D $1.04 $16,455.92 8/15/2016 ROUSE WARREN COUNTY HOME 5/20/2016 64,240 62,394 40,433 97% 65% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

RYDAL PARK OF PHILADELPHIA PRSBYTR HOMES 6/29/2016 41,610 36,881 6,550 89% 18% $0.00 8/15/2016 SAINT JOHN XXIII HOME 4/1/2016 32,850 30,420 21,055 93% 69% $0.00 8/15/2016 SAINT MARY'S AT ASBURY RIDGE 6/7/2016 29,200 25,942 12,113 89% 47% $0.00 8/15/2016 SAINT MARY'S EAST 6/7/2016 50,735 48,588 27,520 96% 57% $0.00 8/15/2016 SAINT MARY'S VILLA NURSING HOME, INC 7/5/2016 40,880 38,039 23,709 93% 62% $0.00 8/15/2016 SAINT PAUL HOMES 5/24/2016 70,080 67,620 38,530 96% 57% $0.00 8/15/2016 SARAH A TODD MEMORIAL HOME 7/5/2016 42,705 40,500 29,099 95% 72% $0.00 8/15/2016 SAXONY HEALTH CENTER 7/5/2016 24,820 22,014 13,194 89% 60% $0.00 8/15/2016 SCENERY HILL HEALTHCARE & REHAB CENTER 7/5/2016 20,440 17,669 11,486 86% 65% $0.00 8/15/2016 SCOTTDALE HEALTHCARE & REHAB CENTER 7/5/2016 12,775 11,985 4,316 94% 36% $0.00 8/15/2016 SCRANTON HEALTH CARE CENTER 4/1/2016 16,060 13,431 7,411 84% 55% $0.00 8/15/2016 SENA-KEAN MANOR 7/5/2016 55,480 46,106 35,844 83% 78% $0.00 8/15/2016 SHENANDOAH MANOR NURSING CENTER 3/15/2016 45,384 40,509 32,046 89% 79% $0.00 8/15/2016 SHENANGO PRESBYTERIAN SENIORCARE 7/5/2016 9,125 8,663 1,579 95% 18% $0.00 8/15/2016 SHIPPENSBURG HEALTH CARE CENTER 7/5/2016 45,625 39,350 30,658 86% 78% $0.00 8/15/2016 SHOOK HOME, THE 6/7/2016 23,725 22,811 12,863 96% 56% $0.00 8/15/2016 SIEMONS' LAKEVIEW MANOR NSG AND REHAB 6/13/2016 43,800 40,873 31,873 93% 78% $0.00 8/15/2016 SILVER OAKS HEALTH AND REHAB CENTER 7/5/2016 22,630 19,898 17,358 88% 87% $0.00 8/15/2016 SIMPSON HOUSE, INC 7/5/2016 56,210 54,598 43,459 97% 80% F $0.39 $16,949.01 8/15/2016 SNYDER MEMORIAL HEALTH CARE CENTER 5/24/2016 36,500 33,649 29,635 92% 88% B $2.87 $85,052.45 8/15/2016 SOUTHMONT OF PRESBYTERIAN SENIORCARE 4/1/2016 56,575 51,480 26,246 91% 51% $0.00 8/15/2016 SOUTHWESTERN NURSING CARE CENTER 7/5/2016 43,070 39,579 23,224 92% 59% $0.00 8/15/2016 SPANG CREST MANOR 7/5/2016 38,325 36,673 20,174 96% 55% $0.00 8/15/2016 SPIRITRUST LUTHERAN VLG @ SHREWSBURY 7/5/2016 36,500 33,617 16,996 92% 51% $0.00 8/15/2016 SPIRITRUST LUTHERAN VLG @ GETTYSBURG 7/5/2016 36,500 32,615 16,299 89% 50% $0.00 8/15/2016 SPIRITRUST LUTHERAN VLG @ SPRENKLE DRIVE 7/5/2016 37,960 35,532 19,068 94% 54% $0.00 8/15/2016 SPIRITRUST LUTHERAN VLG @ UTZ TERRACE 6/13/2016 14,600 14,067 8,016 96% 57% $0.00 8/15/2016 SPRINGS AT THE WATERMARK, THE 5/24/2016 39,785 34,313 13,367 86% 39% $0.00 8/15/2016 SQUIRREL HILL CTR FOR REHAB AND HEALING 5/24/2016 64,970 51,904 45,604 80% 88% $0.00 8/15/2016 ST. BARNABAS NURSING HOME 7/5/2016 62,780 35,485 18,612 57% 52% $0.00 8/15/2016 STONERIDGE POPLAR RUN 5/20/2016 21,900 21,021 9,623 96% 46% $0.00 8/15/2016 STONERIDGE TOWNE CENTRE 5/20/2016 55,480 45,718 29,505 82% 65% $0.00 8/15/2016 SUGAR CREEK STATION SKILLED NSG & REHAB 6/13/2016 58,400 44,592 34,539 76% 77% $0.00 8/15/2016 SUNBURY COMMUNITY HEALTH & REHAB CENTER 3/15/2016 10,585 9,266 5,381 88% 58% $0.00 8/15/2016 SUNNYVIEW NURSING AND REHABILITATION CTR 5/24/2016 80,300 77,752 56,964 97% 73% $0.00 8/15/2016 SUSQUE VIEW HOME, INC 5/20/2016 53,290 49,332 35,597 93% 72% $0.00 8/15/2016 SWAIM HEALTH CENTER 5/20/2016 28,835 26,077 14,461 90% 55% $0.00 8/15/2016 SWEDEN VALLEY MANOR 6/7/2016 44,165 37,663 30,834 85% 82% $0.00 8/15/2016

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

THE MANOR AT PENN VILLAGE 6/13/2016 58,035 56,014 42,816 97% 76% $0.00 8/15/2016 THE MANOR AT PERRY VILLAGE 6/13/2016 44,895 39,431 29,085 88% 74% $0.00 8/15/2016 THE MANOR AT ST LUKE VILLAGE 6/13/2016 37,960 34,825 26,373 92% 76% $0.00 8/15/2016 THE MANOR AT SUSQUEHANNA VILLAGE 6/13/2016 70,810 65,809 48,397 93% 74% $0.00 8/15/2016 THE PATRIOT, A CHOICE COMMUNITY 7/5/2016 36,500 32,744 22,422 90% 68% $0.00 8/15/2016 THE PAVILION AT ST LUKE VILLAGE 6/13/2016 43,800 38,616 26,468 88% 69% $0.00 8/15/2016 THORNWALD HOME 7/5/2016 30,295 29,753 16,314 98% 55% $0.00 8/15/2016 TIMBER RIDGE HEALTH CENTER 7/5/2016 65,700 61,295 46,230 93% 75% $0.00 8/15/2016 TOWNE MANOR EAST 6/13/2016 43,800 38,029 33,586 87% 88% $0.00 8/15/2016 TOWNE MANOR WEST 6/13/2016 43,435 40,244 33,931 93% 84% D $1.04 $35,288.24 8/15/2016 TRANSITIONS HEALTHCARE GETTYSBURG 6/13/2016 49,275 46,447 35,250 94% 76% $0.00 8/15/2016 TRANSITIONS HEALTHCARE NORTH HUNTINGDON 6/13/2016 43,800 36,429 22,917 83% 63% $0.00 8/15/2016 TRANSITIONS HEALTHCARE WASHINGTON PA 7/5/2016 43,800 38,018 23,533 87% 62% $0.00 8/15/2016 TUCKER HOUSE NSG & REHAB CTR 6/7/2016 65,700 62,624 53,543 95% 85% D $1.04 $55,684.72 8/15/2016 TWIN OAKS HEALTH AND REHAB CENTER 7/5/2016 19,345 17,082 8,909 88% 52% $0.00 8/15/2016 TWIN PINES HEALTH CARE CENTER 4/1/2016 43,800 37,532 28,841 86% 77% $0.00 8/15/2016 UNITED ZION RETIREMENT COMMUNITY 7/5/2016 21,535 20,214 9,465 94% 47% $0.00 8/15/2016 VALENCIA WOODS AT ST BARNABAS 6/13/2016 17,155 11,486 3,302 67% 29% $0.00 8/15/2016 VALLEY VIEW HAVEN, INC 5/10/2016 47,450 43,935 26,485 93% 60% $0.00 8/15/2016 VALLEY VIEW NURSING CENTER 5/24/2016 63,145 52,207 30,587 83% 59% $0.00 8/15/2016 VILLAGE AT LUTHER SQUARE 7/5/2016 40,150 36,204 32,521 90% 90% A $4.25 $138,214.25 8/15/2016 WARREN MANOR 6/9/2016 44,165 38,032 21,064 86% 55% $0.00 8/15/2016 WASHINGTON COUNTY HEALTH CENTER 6/9/2016 105,120 94,161 76,748 90% 82% E $0.53 $40,676.44 8/15/2016 WATSONTOWN NURSING AND REHAB CENTER 6/9/2016 45,625 41,408 28,938 91% 70% $0.00 8/15/2016 WEATHERWOOD HEALTHCARE AND REHAB CTR 7/5/2016 73,000 69,151 53,805 95% 78% $0.00 8/15/2016 WESBURY UNITED METHODIST COMMUNITY 5/10/2016 76,650 69,247 41,313 90% 60% $0.00 8/15/2016 WESLEY ENHANCED LIVING MAIN LINE REHAB 5/24/2016 21,900 20,456 4,630 93% 23% $0.00 8/15/2016 WESLEY ENHANCED LIVING PENNYPACK PARK 5/24/2016 43,800 41,599 26,458 95% 64% $0.00 8/15/2016 WESLEY ENHANCED LIVING-DOYLESTOWN 5/24/2016 21,900 20,429 9,122 93% 45% $0.00 8/15/2016 WESLEY VILLAGE 7/5/2016 66,795 63,013 40,996 94% 65% $0.00 8/15/2016 WESTGATE REHABILITATION AND NURSING CTR 5/20/2016 40,150 37,763 24,813 94% 66% $0.00 8/15/2016 WESTMINSTER VILLAGE 5/20/2016 40,515 38,225 27,975 94% 73% $0.00 8/15/2016 WESTMINSTER WOODS AT HUNTINGDON 5/20/2016 23,360 21,615 10,151 93% 47% $0.00 8/15/2016 WESTMORELAND MANOR 5/20/2016 148,920 139,910 120,440 94% 86% C $1.71 $205,952.40 8/15/2016 WESTON REHABILITATION AND NURSING CENTER 7/5/2016 17,885 14,785 8,223 83% 56% $0.00 8/15/2016 WHITE CLIFF HEALTH AND REHAB CENTER 7/5/2016 56,210 52,421 43,596 93% 83% E $0.53 $23,105.88 8/15/2016 WHITESTONE CARE CENTER 4/1/2016 32,850 28,575 18,821 87% 66% $0.00 8/15/2016 WILLIAM PENN CARE CENTER 7/5/2016 56,575 49,309 27,695 87% 56% $0.00 8/15/2016

 

Cost

Name

Report Acceptance Letter Date

Reported Available

Days

Reported Actual Days

12/31/2015 MA Days of Care

Overall Occupancy

MA Occupancy Group

Per Diem

Total Payment RA Date

WILLIAMSPORT HOME, THE 7/5/2016 47,085 44,094 22,857 94% 52% $0.00 8/15/2016 WILLOW TERRACE 5/20/2016 65,700 59,994 47,369 91% 79% $0.00 8/15/2016 WILLOWBROOKE COURT AT BRITTANY POINTE 7/5/2016 33,580 31,224 2,380 93% 8% $0.00 8/15/2016 WILLOWS OF PRESBYTERIAN SENIORCARE, THE 4/1/2016 73,508 67,304 28,026 92% 42% $0.00 8/15/2016 WINDY HILL VILLAGE OF PRESBYTERIAN HOMES 5/20/2016 43,800 41,884 30,284 96% 72% $0.00 8/15/2016 WOODHAVEN CARE CENTER 5/10/2016 43,800 39,429 30,271 90% 77% $0.00 8/15/2016 YORK NURSING AND REHABILITATION CENTER 6/9/2016 87,600 82,718 69,625 94% 84% D $1.04 $72,410.00 8/15/2016