supplemental ventilator care and tracheostomy care payments
TRANSCRIPT
Supplemental Ventilator Care and Tracheostomy Care Payments
Supplemental Ventilator Care and Tracheostomy Care payments will be made to qualifying MA nonpublic and county nursing facilities each calendar quarter effective July 1, 2014 based on the following:
A nonpublic and county nursing facility will qualify for the payment if both of the following criteria are met based on each Picture Date:
(A) The facility has a minimum of ten MA-recipient residents who receive medically necessary ventilator care or trachestomy care; and
(B) The facility has a minimum of 10% of their MA-recipient resident population receiving medically necessary ventilator care or tracheostomy care.
The determination of medically necessary ventilator care is based on whether there is a positive response to MDS 3.0 Section O0100F1 or O0100F2 on the MDS assessment identified on the Picture Date CMI Report. The determination of medically necessary tracheostomy care is based on whether there is a positive response to MDS 3.0 Section O0100E1 or O0100E2 on the MDS assessment identified on the Picture Date CMI Report.
The Supplemental ventilator care and tracheostomy care per diem shall equal ((number of MA-recipient residents who receive necessary ventilator care or tracheostomy care/total MA-recipient residents) x $69) x (the number of MA recipient residents who receive necessary ventilator care or tracheostomy care/total MA-recipient residents). The quarterly payment shall equal the supplemental ventilator care and tracheostomy care per diem multiplied by the number of paid MA facility and therapeutic leave days.
Paid Facility and
Picture Date Authorization
Schedule Therapeutic Leave Day
Quarter February 1 September January 1 – March 31 May 1 December April 1 – June 30 August 1 March July 1 – September 30 November 1 June October 1 – December 31
Supplemental Ventilator Care and Tracheostomy Care
Payments for September:
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date ABINGTON CREST HEALTH AND REHAB CENTER 0 55 0% 5,146 $0.00 12/7/2015 ABINGTON MANOR 0 62 0% 6,056 $0.00 12/7/2015 ABRAMSON RESIDENCE 0 183 0% 16,953 $0.00 12/7/2015 ALLIED SERVICES SKILLED NURSING CENTER 21 229 9% 21,253 $0.00 12/7/2015 ALTOONA CENTER FOR NURSING CARE 1 74 1% 7,169 $0.00 12/7/2015 AMBLER EXTENDED CARE CENTER 1 73 1% 6,497 $0.00 12/7/2015 ARBUTUS PARK MANOR 0 71 0% 7,027 $0.00 12/7/2015 ARISTACARE AT MEADOW SPRINGS 53 96 55% 9,491 $198,077.17 12/7/2015 ARMSTRONG COUNTY HEALTH CENTER 0 62 0% 5,997 $0.00 12/7/2015 ARTMAN LUTHERAN HOME 0 14 0% 1,409 $0.00 12/7/2015 ASBURY HEALTH CENTER 0 42 0% 4,754 $0.00 12/7/2015 ATTLEBORO NURSING AND REHAB CENTER 0 102 0% 8,478 $0.00 12/7/2015 AUDUBON VILLA HEALTH AND REHAB CENTER 0 22 0% 2,044 $0.00 12/7/2015 AVALON NURSING CENTER 0 63 0% 5,805 $0.00 12/7/2015 AVALON SPRINGS NURSING CENTER 0 55 0% 5,433 $0.00 12/7/2015 BALA NURSING AND RETIREMENT CENTER 3 138 2% 12,633 $0.00 12/7/2015 BALANCED CARE BLOOMSBURG 0 37 0% 3,671 $0.00 12/7/2015 BALDWIN HEALTH CENTER 0 85 0% 9,710 $0.00 12/7/2015 BALL PAVILION, THE 0 56 0% 5,192 $0.00 12/7/2015 BAPTIST HOMES OF WESTERN PENNSYLVANIA 0 80 0% 8,014 $0.00 12/7/2015 BARCLAY FRIENDS 0 28 0% 2,769 $0.00 12/7/2015 BARNES‐KASSON COUNTY HOSPITAL SNF 0 42 0% 3,589 $0.00 12/7/2015 BEACON RIDGE, A CHOICE COMMUNITY 0 51 0% 4,630 $0.00 12/7/2015 BEAVER ELDER CARE AND REHAB CENTER 0 38 0% 3,387 $0.00 12/7/2015 BEAVER VALLEY HEALTH AND REHAB CENTER 0 59 0% 5,375 $0.00 12/7/2015 BELAIR HEALTH AND REHABILITATION CENTER 0 49 0% 4,990 $0.00 12/7/2015 BELLE HAVEN SKILLED NURSING & REHAB CTR 0 40 0% 4,051 $0.00 12/7/2015 BELLE REVE HEALTH CARE CENTER 0 9 0% 751 $0.00 12/7/2015 BERKS HEIM NURSING & REHABILITATION 0 296 0% 28,184 $0.00 12/7/2015 BERKSHIRE CENTER 0 64 0% 6,205 $0.00 12/7/2015 BERWICK RETIREMENT VILLAGE NRSNG HOME I 0 41 0% 3,871 $0.00 12/7/2015 BERWICK RETIREMENT VILLAGE NRSNG HOME II 0 58 0% 5,710 $0.00 12/7/2015 BETHANY VILLAGE RETIREMENT CENTER 0 15 0% 1,527 $0.00 12/7/2015 BETHLEN HM OF THE HUNGARIAN RFRMD FED 0 47 0% 4,374 $0.00 12/7/2015 BIRCHWOOD NURSING AND REHAB CENTER 1 77 1% 7,149 $0.00 12/7/2015 BLOOMSBURG HEALTH CARE CENTER 0 85 0% 8,291 $0.00 12/7/2015 BONHAM NURSING CENTER 0 50 0% 4,527 $0.00 12/7/2015 BRADFORD COUNTY MANOR 0 109 0% 9,520 $0.00 12/7/2015 BRADFORD ECUMENICAL HOME, INC 0 60 0% 5,238 $0.00 12/7/2015 BRADFORD MANOR 1 73 1% 6,988 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date BRANDYWINE HALL 0 126 0% 12,222 $0.00 12/7/2015 BRETHREN VILLAGE 0 36 0% 3,489 $0.00 12/7/2015 BRIARCLIFF PAVILION HEALTH AND REHAB CTR 0 77 0% 7,023 $0.00 12/7/2015 BRIARLEAF NURSING AND CONVAL CENTER 0 141 0% 12,570 $0.00 12/7/2015 BRIGHTON REHABILITATION & WELLNESS CTR 2 353 1% 32,528 $0.00 12/7/2015 BRINTON MANOR 1 53 2% 4,795 $0.00 12/7/2015 BROAD ACRES HEALTH AND REHAB CENTER 0 63 0% 6,134 $0.00 12/7/2015 BROAD MOUNTAIN HEALTH AND REHAB CENTER 1 80 1% 7,749 $0.00 12/7/2015 BROOKLINE MANOR AND REHABILITATIVE SRVCS 0 39 0% 3,887 $0.00 12/7/2015 BROOKMONT HEALTHCARE CENTER LLC 0 69 0% 6,138 $0.00 12/7/2015 BROOKSIDE HEALTHCARE AND REHAB CENTER 2 77 3% 7,674 $0.00 12/7/2015 BROOMALL MANOR 0 72 0% 6,835 $0.00 12/7/2015 BROOMALL PRESBYTERIAN VILLAGE 0 59 0% 6,161 $0.00 12/7/2015 BROOMALL REHAB AND NURSING CENTER 0 175 0% 17,226 $0.00 12/7/2015 BRYN MAWR EXTENDED CARE CENTER 3 100 3% 9,654 $0.00 12/7/2015 BUCKINGHAM VALLEY REHAB AND NURSING CTR 0 68 0% 6,263 $0.00 12/7/2015 BUCKTAIL MEDICAL CENTER 0 32 0% 2,987 $0.00 12/7/2015 BUFFALO VALLEY LUTHERAN VILLAGE 0 63 0% 6,032 $0.00 12/7/2015 BUTLER VALLEY MANOR HLTH AND REHAB CTR 1 25 4% 2,125 $0.00 12/7/2015 CALVARY FELLOWSHIP HOMES, INC 0 22 0% 2,172 $0.00 12/7/2015 CAMBRIA CARE CENTER 11 192 6% 16,440 $0.00 12/7/2015 CANTERBURY PLACE 0 42 0% 4,077 $0.00 12/7/2015 CARBONDALE NURSING AND REHAB CENTER 0 77 0% 7,175 $0.00 12/7/2015 CARE PAVILION NURSING AND REHAB CENTER 2 325 1% 27,010 $0.00 12/7/2015 CARING HEART REHAB AND NURSING CENTER 1 156 1% 15,385 $0.00 12/7/2015 CARING HEIGHTS COMMUNITY CARE & REHAB 0 82 0% 7,689 $0.00 12/7/2015 CARING PLACE, THE 0 66 0% 5,926 $0.00 12/7/2015 CARLETON HEALTHCARE & REHABILITATION CTR 0 15 0% 1,335 $0.00 12/7/2015 CATHEDRAL VILLAGE 0 15 0% 1,260 $0.00 12/7/2015 CEDAR HAVEN HEALTHCARE CENTER 1 265 0% 24,410 $0.00 12/7/2015 CEDARBROOK NURSING HOMES 1 480 0% 47,016 $0.00 12/7/2015 CENTENNIAL HEALTHCARE & REHAB CENTER 2 139 1% 12,504 $0.00 12/7/2015 CENTRE CREST 3 153 2% 14,438 $0.00 12/7/2015 CHANDLER HALL HEALTH SERVICES INC 0 9 0% 1,119 $0.00 12/7/2015 CHAPEL MANOR 2 186 1% 17,123 $0.00 12/7/2015 CHAPEL POINTE AT CARLISLE 0 22 0% 1,873 $0.00 12/7/2015 CHARLES COLE MEMORIAL HOSPITAL ECF 0 26 0% 2,272 $0.00 12/7/2015 CHARLES M. MORRIS NURSING AND REHAB CTR 0 50 0% 5,172 $0.00 12/7/2015 CHELTENHAM NURSING AND REHAB CENTER 3 196 2% 18,477 $0.00 12/7/2015 CHERRY TREE NURSING CENTER 2 68 3% 6,077 $0.00 12/7/2015 CHESTER VALLEY REHAB AND NURSING CENTER 1 116 1% 10,886 $0.00 12/7/2015 CHESTNUT HILL LODGE HEALTH AND REHAB CTR 2 132 2% 11,951 $0.00 12/7/2015 CHICORA MEDICAL CENTER 0 65 0% 5,952 $0.00 12/7/2015 CHRIST THE KING MANOR 0 96 0% 8,591 $0.00 12/7/2015 CHRIST'S HOME RETIREMENT COMMUNITY 0 7 0% 686 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date CHURCH OF GOD HOME, INC 0 45 0% 4,559 $0.00 12/7/2015 CHURCH OF THE BRETHREN HOME 0 75 0% 6,843 $0.00 12/7/2015 CLAREMONT NRC OF CUMBERLAND COUNTY 1 187 1% 18,606 $0.00 12/7/2015 CLARVIEW NURSING AND REHAB CENTER 1 69 1% 6,312 $0.00 12/7/2015 CLEPPER MANOR 0 31 0% 3,041 $0.00 12/7/2015 CLIVEDEN NSG & REHAB CTR 2 137 1% 12,135 $0.00 12/7/2015 COLONIAL MANOR NURSING HOME 6 167 4% 15,451 $0.00 12/7/2015 COLONIAL PARK CARE CENTER 0 130 0% 11,918 $0.00 12/7/2015 COMMUNITIES AT INDIAN HAVEN 0 39 0% 4,111 $0.00 12/7/2015 CONCORDIA AT THE CEDARS 0 20 0% 2,096 $0.00 12/7/2015 CONCORDIA LUTHERAN HEALTH AND HUMAN CARE 0 60 0% 5,495 $0.00 12/7/2015 CONESTOGA VIEW 7 370 2% 34,355 $0.00 12/7/2015 CONNER‐WILLIAMS NURSING HOME 0 27 0% 2,339 $0.00 12/7/2015 CONSULATE HEALTH CARE OF CHESWICK 1 76 1% 7,895 $0.00 12/7/2015 CONSULATE HEALTH CARE OF NORTH STRABANE 0 31 0% 3,044 $0.00 12/7/2015 CORNWALL MANOR 0 27 0% 2,657 $0.00 12/7/2015 CORRY MANOR 0 68 0% 6,658 $0.00 12/7/2015 COUNTRY MEADOWS NURSING CENTER‐BETHLEHEM 0 2 0% 180 $0.00 12/7/2015 COUNTRY MEADOWS OF SOUTH HILLS 0 48 0% 4,634 $0.00 12/7/2015 COUNTRYSIDE CHRISTIAN COMMUNITY 0 12 0% 1,362 $0.00 12/7/2015 COUNTRYSIDE CONVAL HOME LTD PARTNERSHIP 0 23 0% 2,226 $0.00 12/7/2015 COURTYARD GARDENS NURSING AND REHAB CTR 0 49 0% 4,459 $0.00 12/7/2015 COVENTRY MANOR HEALTH AND REHAB CTR 1 22 5% 2,220 $0.00 12/7/2015 CRANBERRY PLACE 1 71 1% 6,461 $0.00 12/7/2015 CRAWFORD COUNTY CARE CENTER 1 106 1% 9,997 $0.00 12/7/2015 CREEKSIDE HEALTH AND REHABILITATION CTR 0 52 0% 5,044 $0.00 12/7/2015 CRESTVIEW CENTER 0 103 0% 8,553 $0.00 12/7/2015 CROSS KEYS VILLAGE‐BRETHREN HM COMM, THE 0 131 0% 12,129 $0.00 12/7/2015 CUMBERLAND CROSSINGS RETIREMENT COMM 0 23 0% 2,041 $0.00 12/7/2015 DARWAY ELDER CARE REHABILITATION CENTER 0 50 0% 4,642 $0.00 12/7/2015 DEER MEADOWS REHABILITATION CENTER 9 103 9% 10,925 $0.00 12/7/2015 DENVER HEALTH AND REHABILITATION CENTER 2 50 4% 4,638 $0.00 12/7/2015 DOCK TERRACE 0 17 0% 1,905 $0.00 12/7/2015 DONAHOE MANOR 2 44 5% 4,039 $0.00 12/7/2015 DR ARTHUR CLIFTON MCKINLEY HEALTH CENTER 0 53 0% 4,723 $0.00 12/7/2015 DRESHER HILL HEALTH AND REHAB CENTER 0 83 0% 7,973 $0.00 12/7/2015 DUBOIS NURSING HOME 0 85 0% 8,074 $0.00 12/7/2015 DUNMORE HEALTH CARE CENTER 0 57 0% 5,240 $0.00 12/7/2015 EASTON HEALTH AND REHABILITATION CENTER 1 136 1% 12,269 $0.00 12/7/2015 EDGEHILL NURSING AND REHAB CENTER 0 50 0% 4,508 $0.00 12/7/2015 EDINBORO MANOR 1 72 1% 6,720 $0.00 12/7/2015 EDISON MANOR NURSING AND REHAB CENTER 1 77 1% 6,893 $0.00 12/7/2015 ELDERCREST NURSING CENTER 0 17 0% 1,994 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date ELIZABETHTOWN NURSING & REHAB CENTER 1 22 5% 2,057 $0.00 12/7/2015 ELK HAVEN NURSING HOME 0 56 0% 5,077 $0.00 12/7/2015 ELKINS CREST HEALTH AND REHAB CENTER 1 107 1% 9,831 $0.00 12/7/2015 ELLEN MEMORIAL HEALTH CARE CENTER 0 66 0% 6,297 $0.00 12/7/2015 ELM TERRACE GARDENS 0 20 0% 1,781 $0.00 12/7/2015 ELMWOOD GARDENS 0 29 0% 2,517 $0.00 12/7/2015 EMMANUEL CENTER FOR NURSING AND REHAB 0 46 0% 4,212 $0.00 12/7/2015 EPHRATA MANOR 0 55 0% 5,449 $0.00 12/7/2015 EPWORTH MANOR 0 75 0% 6,636 $0.00 12/7/2015 EVERGREEN HEALTH AND REHAB CENTER 0 79 0% 7,409 $0.00 12/7/2015 FAIR ACRES GERIATRIC CENTER 2 705 0% 66,510 $0.00 12/7/2015 FAIR WINDS MANOR 0 45 0% 4,366 $0.00 12/7/2015 FAIRMOUNT HOMES 0 48 0% 4,502 $0.00 12/7/2015 FAIRVIEW CARE CENTER OF BETHLEHEM PIKE 2 132 2% 12,378 $0.00 12/7/2015 FAIRVIEW CARE CENTER OF PAPERMILL ROAD 1 86 1% 8,428 $0.00 12/7/2015 FAIRVIEW MANOR 0 77 0% 6,962 $0.00 12/7/2015 FALLING SPRING NURSING AND REHAB CENTER 0 113 0% 10,810 $0.00 12/7/2015 FELLOWSHIP MANOR 0 32 0% 3,402 $0.00 12/7/2015 FORBES CENTER FOR REHAB & HEALTHCARE LLC 18 88 20% 8,385 $23,142.60 12/7/2015 FOREST CITY NURSING AND REHAB CENTER 0 68 0% 5,878 $0.00 12/7/2015 FOREST PARK HEALTH CENTER 0 67 0% 6,913 $0.00 12/7/2015 FORESTVIEW 0 21 0% 2,210 $0.00 12/7/2015 FOX SUBACUTE AT CLARA BURKE 41 41 100% 3,816 $263,304.00 11/30/2015 FOX SUBACUTE AT MECHANICSBURG 23 23 100% 2,219 $153,111.00 11/30/2015 FOX SUBACUTE CENTER 32 32 100% 2,819 $194,511.00 11/30/2015 FREDERICK LIVING ‐ CEDARWOOD 0 11 0% 1,156 $0.00 12/7/2015 FREY VILLAGE 0 71 0% 7,422 $0.00 12/7/2015 FRIENDSHIP VILLAGE OF SOUTH HILLS 0 7 0% 645 $0.00 12/7/2015 FULTON COUNTY MEDICAL CENTER LTCU 0 48 0% 4,240 $0.00 12/7/2015 GARDEN SPOT VILLAGE 0 13 0% 1,224 $0.00 12/7/2015 GARDEN SPRING CENTER 20 126 16% 11,755 $20,806.35 12/7/2015 GARVEY MANOR 0 84 0% 7,847 $0.00 12/7/2015 GERMANTOWN HOME 0 127 0% 8,948 $0.00 12/7/2015 GETTYSBURG CENTER 0 56 0% 5,377 $0.00 12/7/2015 GLENDALE UPTOWN HOME 3 163 2% 16,243 $0.00 12/7/2015 GOLDEN HILL NURSING AND REHAB 0 133 0% 12,212 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐BLUE RIDGE MOUNTAIN 0 57 0% 5,470 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐CAMP HILL 0 67 0% 6,321 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐CLARION 0 38 0% 3,454 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐DOYLESTOWN 1 88 1% 8,361 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐EAST MOUNTAIN 0 80 0% 7,403 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐GETTYSBURG 0 70 0% 6,778 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐HAIDA 0 64 0% 5,709 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐HILLVIEW 0 85 0% 8,100 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐KINZUA 0 73 0% 6,641 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date GOLDEN LIVINGCENTER‐LANCASTER 1 96 1% 8,976 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐LANSDALE 0 84 0% 8,114 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐MANSION 0 48 0% 4,658 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐MEYERSDALE 0 65 0% 6,198 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐MONROEVILLE 0 57 0% 6,270 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐MT LEBANON 0 70 0% 6,842 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐MURRYSVILLE 0 68 0% 6,913 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐OIL CITY 0 61 0% 5,543 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐PHOENIXVILLE 0 87 0% 8,308 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐READING 3 73 4% 7,523 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐RICHLAND 0 51 0% 4,856 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐ROSEMONT 0 51 0% 4,886 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐SCRANTON 1 83 1% 7,519 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐SHIPPENVILLE 1 57 2% 5,294 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐SOUTH HILLS 0 53 0% 4,650 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐STENTON 1 65 2% 6,283 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐STROUD 0 88 0% 8,035 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐SUMMIT 0 70 0% 6,897 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐TITUSVILLE 0 48 0% 4,415 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐TUNKHANNOCK 1 82 1% 7,543 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐UNIONTOWN 0 70 0% 6,171 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐WALNUT CREEK 0 45 0% 4,117 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐WAYNESBURG 0 64 0% 6,081 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐WEST SHORE 1 147 1% 13,974 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐WESTERN RESERVE 1 85 1% 7,921 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐WILLIAM PENN 0 81 0% 7,716 $0.00 12/7/2015 GOLDEN LIVINGCENTER‐YORK TERRACE 0 45 0% 4,510 $0.00 12/7/2015 GOOD SHEPHERD HOME RAKER CENTER 10 96 10% 8,780 $6,058.20 12/7/2015 GOOD SHEPHERD HOME‐BETHLEHEM 0 58 0% 5,199 $0.00 12/7/2015 GRACEDALE ‐ NORTHAMPTON COUNTY HOME 5 485 1% 48,257 $0.00 12/7/2015 GRANDVIEW HEALTH HOMES, INC 0 111 0% 9,890 $0.00 12/7/2015 GREEN HOME, INC, THE 0 73 0% 6,774 $0.00 12/7/2015 GREEN RIDGE CARE CENTER 0 42 0% 3,815 $0.00 12/7/2015 GREEN VALLEY SKILLED NSG & REHAB CENTER 0 19 0% 1,832 $0.00 12/7/2015 GREENERY SPECIALTY CARE CENTER 23 87 26% 7,575 $35,299.50 12/7/2015 GREENLEAF NURSING HOME AND CONVAL CENTER 1 88 1% 8,194 $0.00 12/7/2015 GREENSBURG CARE CENTER 0 76 0% 6,856 $0.00 12/7/2015 GROVE MANOR 0 26 0% 2,520 $0.00 12/7/2015 GUARDIAN HEALTHCARE & REHAB CENTER 0 74 0% 7,236 $0.00 12/7/2015 GUTHRIE TOWANDA MEMORIAL HOSPITAL SNU 0 43 0% 3,661 $0.00 12/7/2015 GUY AND MARY FELT MANOR, INC 0 19 0% 1,774 $0.00 12/7/2015 GWYNEDD SQUARE CTR FOR NSG & CONVAL CARE 0 120 0% 11,146 $0.00 12/7/2015 HAMILTON ARMS CENTER 0 63 0% 5,960 $0.00 12/7/2015 HAMPTON HOUSE 0 70 0% 6,781 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date HANOVER HALL 10 83 12% 8,011 $7,930.89 12/7/2015 HARMAR VILLAGE CARE CENTER 0 70 0% 7,013 $0.00 12/7/2015 HARMON HOUSE CARE CENTER 1 75 1% 6,318 $0.00 12/7/2015 HARRISON SENIOR LIVING OF CHRISTIANA 0 74 0% 7,418 $0.00 12/7/2015 HARSTON HALL 1 92 1% 8,110 $0.00 12/7/2015 HAVEN CONVALESCENT HOME, INC 0 71 0% 6,240 $0.00 12/7/2015 HAVEN SKILLED REHABILITATION AND NURSING 0 41 0% 3,913 $0.00 12/7/2015 HAVENCREST NURSING CENTER 0 16 0% 1,624 $0.00 12/7/2015 HEARTHSIDE REHAB AND NURSING CENTER, THE 0 104 0% 9,331 $0.00 12/7/2015 HEMPFIELD MANOR 0 58 0% 5,509 $0.00 12/7/2015 HENRY CLAY VILLA, LP 0 56 0% 4,937 $0.00 12/7/2015 HICKORY HOUSE NURSING HOME 0 37 0% 3,956 $0.00 12/7/2015 HIGHLAND MANOR REHAB & NURSING CENTER 1 78 1% 7,220 $0.00 12/7/2015 HIGHLAND PARK CARE CENTER 0 92 0% 8,676 $0.00 12/7/2015 HIGHLAND VIEW HEALTHCARE & REHAB CENTER 0 30 0% 2,708 $0.00 12/7/2015 HIGHLANDS CARE CENTER, THE 0 96 0% 8,792 $0.00 12/7/2015 HILLCREST CENTER 0 146 0% 14,023 $0.00 12/7/2015 HILLSDALE REHABILITATION AND NURSING CTR 0 45 0% 4,159 $0.00 12/7/2015 HOLY FAMILY HOME 0 36 0% 3,287 $0.00 12/7/2015 HOLY FAMILY MANOR 0 115 0% 11,211 $0.00 12/7/2015 HOLY FAMILY RESIDENCE 0 44 0% 4,242 $0.00 12/7/2015 HOMELAND CENTER 0 50 0% 4,760 $0.00 12/7/2015 HOMESTEAD VILLAGE, INC 0 19 0% 1,577 $0.00 12/7/2015 HOMETOWN NURSING AND REHAB CENTER 1 92 1% 8,565 $0.00 12/7/2015 HOMEWOOD AT MARTINSBURG PA INC 0 59 0% 5,566 $0.00 12/7/2015 HOMEWOOD AT PLUM CREEK 0 40 0% 3,869 $0.00 12/7/2015 HOPKINS CENTER 0 84 0% 7,277 $0.00 12/7/2015 HOSPITALITY CARE CENTER OF HERMITAGE INC 0 24 0% 2,066 $0.00 12/7/2015 HUNTINGDON HILLS REHAB & NURSING CENTER 0 57 0% 4,649 $0.00 12/7/2015 IMMACULATE MARY CTR FOR REHAB & HLTHCARE 0 189 0% 18,484 $0.00 12/7/2015 INGLIS HOUSE 8 255 3% 23,978 $0.00 12/7/2015 IVY HILL REHABILITATION AND NURSING CTR 0 99 0% 9,100 $0.00 12/7/2015 JAMESON CARE CENTER 0 24 0% 2,316 $0.00 12/7/2015 JEFFERSON HILLS HEALTHCARE & REHAB CTR 0 36 0% 4,054 $0.00 12/7/2015 JEFFERSON MANOR HEALTH CENTER 1 93 1% 8,312 $0.00 12/7/2015 JEWISH HOME OF EASTERN PENNSYLVANIA 0 113 0% 9,584 $0.00 12/7/2015 JEWISH HOME OF GREATER HARRISBURG 0 70 0% 7,176 $0.00 12/7/2015 JOHN J KANE REGIONAL CENTER‐GLEN HAZEL 0 145 0% 14,136 $0.00 12/7/2015 JOHN J KANE REGIONAL CENTER‐MCKEESPORT 0 219 0% 20,164 $0.00 12/7/2015 JOHN J KANE REGIONAL CENTER‐ROSS TWNSHP 0 172 0% 16,429 $0.00 12/7/2015 JOHN J KANE REGIONAL CENTER‐SCOTT TWNSHP 0 176 0% 16,118 $0.00 12/7/2015 JULIA POUND CARE CENTER 0 59 0% 5,479 $0.00 12/7/2015 JULIA RIBAUDO EXTENDED CARE CENTER 0 65 0% 6,216 $0.00 12/7/2015 KADE HEALTH AND REHABILITATION CENTER 0 56 0% 4,959 $0.00 12/7/2015 KEARSLEY REHAB AND NURSING CENTER 1 59 2% 5,219 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date KEPLER CENTER FOR NURSING AND REHAB 0 29 0% 2,467 $0.00 12/7/2015 KINGSTON HEALTH CARE CENTER 0 22 0% 2,563 $0.00 12/7/2015 KINKORA PYTHIAN HOME 0 24 0% 2,557 $0.00 12/7/2015 KITTANNING CARE CENTER 0 81 0% 7,618 $0.00 12/7/2015 KUTZTOWN MANOR 0 95 0% 9,496 $0.00 12/7/2015 LACKAWANNA HEALTH AND REHAB CENTER 0 159 0% 14,521 $0.00 12/7/2015 LAFAYETTE MANOR, INC 1 59 2% 5,390 $0.00 12/7/2015 LAFAYETTE‐REDEEMER (DBA ENTITY OF HRHS) 0 39 0% 4,393 $0.00 12/7/2015 LAKESIDE HEALTH AND REHABILITATION CTR 0 20 0% 1,709 $0.00 12/7/2015 LAKEVIEW SENIOR CARE AND LIVING CENTER 0 19 0% 1,891 $0.00 12/7/2015 LANCASHIRE HALL 1 166 1% 15,743 $0.00 12/7/2015 LANDIS HOMES 0 40 0% 3,535 $0.00 12/7/2015 LANGHORNE GARDENS HEALTH & REHAB CENTER 1 79 1% 7,452 $0.00 12/7/2015 LATROBE HEALTH AND REHABILITATION CENTER 0 75 0% 7,383 $0.00 12/7/2015 LAUREL CARE NURSING AND REHAB CENTER 0 49 0% 4,617 $0.00 12/7/2015 LAUREL CENTER 12 85 14% 8,390 $11,326.50 12/7/2015 LAUREL RIDGE CENTER 0 37 0% 3,364 $0.00 12/7/2015 LAUREL VIEW VILLAGE 0 20 0% 1,717 $0.00 12/7/2015 LAUREL WOOD CARE CENTER 1 63 2% 5,536 $0.00 12/7/2015 LAWSON NURSING HOME, INC. 0 11 0% 1,340 $0.00 12/7/2015 LEBANON VALLEY BRETHREN HOME 0 32 0% 3,046 $0.00 12/7/2015 LEBANON VALLEY HOME THE 0 25 0% 2,312 $0.00 12/7/2015 LEHIGH CENTER 0 39 0% 3,829 $0.00 12/7/2015 LGAR HEALTH AND REHABILITATION CENTER 0 73 0% 7,264 $0.00 12/7/2015 LIFEQUEST NURSING CENTER 0 79 0% 7,651 $0.00 12/7/2015 LINWOOD NURSING AND REHABILITATION CTR 0 56 0% 5,564 $0.00 12/7/2015 LITTLE FLOWER MANOR 0 39 0% 3,694 $0.00 12/7/2015 LITTLE FLOWER MANOR OF DIOCESE SCRANTON 0 68 0% 6,944 $0.00 12/7/2015 LITTLE SISTERS OF THE POOR 0 43 0% 3,869 $0.00 12/7/2015 LOCUST GROVE RETIREMENT VILLAGE 0 72 0% 6,729 $0.00 12/7/2015 LOYALHANNA CARE CENTER 0 69 0% 6,654 $0.00 12/7/2015 LOYALSOCK CREEK REHAB AND NURSING CTR 1 60 2% 6,547 $0.00 12/7/2015 LUTHER ACRES MANOR 0 39 0% 3,606 $0.00 12/7/2015 LUTHER CREST NURSING FACILITY 0 11 0% 1,159 $0.00 12/7/2015 LUTHER WOODS CONVALESCENT CENTER 2 52 4% 5,007 $0.00 12/7/2015 LUTHERAN COMMUNITY AT TELFORD 0 26 0% 2,584 $0.00 12/7/2015 LUTHERAN HOME AT HOLLIDAYSBURG, THE 0 44 0% 4,281 $0.00 12/7/2015 LUTHERAN HOME AT JOHNSTOWN, THE 0 33 0% 2,649 $0.00 12/7/2015 LUTHERAN HOME AT KANE, THE 0 61 0% 5,868 $0.00 12/7/2015 LUTHERAN HOME AT TOPTON 0 103 0% 9,771 $0.00 12/7/2015 MAHONING VALLEY NURSING AND REHAB CENTER 0 72 0% 7,070 $0.00 12/7/2015 MAJESTIC OAKS REHAB & NURSING CENTER 0 125 0% 11,766 $0.00 12/7/2015 MALTA HOME 0 29 0% 2,347 $0.00 12/7/2015 MANATAWNY MANOR INC 0 68 0% 6,895 $0.00 12/7/2015 MANCHESTER COMMONS 0 37 0% 3,452 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date MANORCARE HEALTH SERVICES ‐ ERIE 0 79 0% 6,715 $0.00 12/7/2015 MANORCARE HEALTH SERVICES ‐ NORTHSIDE 0 65 0% 6,101 $0.00 12/7/2015 MANORCARE HEALTH SERVICES ‐WALLINGFORD 0 129 0% 12,632 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐ALLENTOWN 0 93 0% 9,244 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐BETHEL PARK 1 83 1% 7,420 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐BETHLEHEM (2021) 1 147 1% 15,121 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐BETHLEHEM (2029) 1 123 1% 13,109 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐CAMP HILL 0 75 0% 6,862 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐CARLISLE 1 93 1% 8,666 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐CHAMBERSBURG 3 132 2% 11,501 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐DALLASTOWN 0 141 0% 13,349 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐EASTON 1 130 1% 12,467 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐ELIZABETHTOWN 0 42 0% 3,884 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐GREEN TREE 1 58 2% 6,362 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐HUNTINGDON VALLEY 0 84 0% 7,558 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐JERSEY SHORE 0 70 0% 7,227 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐KING OF PRUSSIA 2 85 2% 7,773 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐KINGSTON 0 101 0% 9,122 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐KINGSTON COURT 2 82 2% 7,719 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐LANCASTER 0 107 0% 10,341 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐LANSDALE 0 112 0% 10,708 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐LAURELDALE 0 116 0% 10,821 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐LEBANON 2 98 2% 8,990 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐MERCY FITZGERALD 2 63 3% 5,802 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐MONROEVILLE 0 46 0% 4,972 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐NORTH HILLS 0 109 0% 10,623 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐OXFORD VALLEY 0 71 0% 6,173 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐PETERS TOWNSHIP 0 68 0% 6,662 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐PITTSBURGH 2 119 2% 11,346 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐POTTSTOWN 1 101 1% 9,702 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐POTTSVILLE 0 128 0% 12,086 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐SHADYSIDE 0 86 0% 8,490 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐SINKING SPRING 0 127 0% 12,628 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐SUNBURY 1 85 1% 7,828 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐WEST READING NORTH 0 129 0% 13,105 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐WHITEHALL BOROUGH 0 48 0% 4,463 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐WILLIAMSPORT NORTH 1 97 1% 8,999 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐WILLIAMSPORT SOUTH 2 78 3% 7,335 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐YEADON 4 153 3% 14,826 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐YORK NORTH 0 97 0% 9,282 $0.00 12/7/2015 MANORCARE HEALTH SVCS‐YORK SOUTH 0 92 0% 8,668 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date MANORCARE HLTH SVCS & REHAB ‐WEST ALLEN 13 90 14% 8,180 $11,043.00 12/7/2015 MAPLE FARM 0 21 0% 1,860 $0.00 12/7/2015 MAPLE WINDS CARE CENTER 0 17 0% 1,717 $0.00 12/7/2015 MAPLEWOOD NURSING AND REHABILITATION CTR 2 148 1% 13,626 $0.00 12/7/2015 MARGARET E. MOUL HOME 2 81 2% 7,227 $0.00 12/7/2015 MARIAN MANOR CORPORATION 0 65 0% 6,369 $0.00 12/7/2015 MARWOOD REST HOME, INC 0 67 0% 6,620 $0.00 12/7/2015 MASONIC VILLAGE AT ELIZABETHTOWN 1 220 0% 21,129 $0.00 12/7/2015 MASONIC VILLAGE AT LAFAYETTE HILL 0 34 0% 3,295 $0.00 12/7/2015 MASONIC VILLAGE AT SEWICKLEY 0 46 0% 4,164 $0.00 12/7/2015 MASONIC VILLAGE AT WARMINSTER 0 18 0% 1,789 $0.00 12/7/2015 MCMURRAY HILLS MANOR 0 85 0% 7,527 $0.00 12/7/2015 MEADOW VIEW HEALTHCARE & REHAB CENTER 1 41 2% 4,040 $0.00 12/7/2015 MEADOW VIEW NURSING CENTER 0 95 0% 8,896 $0.00 12/7/2015 MEADOWCREST NURSING CENTER 0 24 0% 2,471 $0.00 12/7/2015 MEADOWS NURSING AND REHAB CENTER 0 66 0% 6,199 $0.00 12/7/2015 MENNO‐HAVEN, INC. 0 53 0% 5,095 $0.00 12/7/2015 MENNONITE HOME, THE 0 65 0% 6,282 $0.00 12/7/2015 MERCY CENTER NURSING UNIT, INC 0 35 0% 3,195 $0.00 12/7/2015 MESSIAH LIFEWAYS AT MESSIAH VILLAGE 0 38 0% 3,777 $0.00 12/7/2015 MID VALLEY HEALTH CARE CENTER 0 14 0% 1,227 $0.00 12/7/2015 MIFFLIN CENTER 1 59 2% 5,959 $0.00 12/7/2015 MILFORD SENIOR CARE AND REHAB CENTER 0 47 0% 4,207 $0.00 12/7/2015 MILLCREEK MANOR 0 30 0% 2,670 $0.00 12/7/2015 MILLVILLE HEALTH AND REHABILITATION CTR 0 77 0% 7,136 $0.00 12/7/2015 MILTON NURSING AND REHABILITATION CENTER 1 94 1% 8,709 $0.00 12/7/2015 MISERICORDIA NURSING & REHAB CENTER 0 12 0% 1,205 $0.00 12/7/2015 MON VALLEY CARE CENTER 0 22 0% 1,915 $0.00 12/7/2015 MORAVIAN HALL SQ. HLTH AND WELLNESS CTR 0 4 0% 320 $0.00 12/7/2015 MORAVIAN MANOR 0 36 0% 3,239 $0.00 12/7/2015 MORRISONS COVE HOME 0 87 0% 7,592 $0.00 12/7/2015 MOSSER NURSING HOME 0 19 0% 2,248 $0.00 12/7/2015 MOUNT CARMEL NURSING AND REHAB CENTER 0 74 0% 6,953 $0.00 12/7/2015 MOUNT HOPE NAZARENE RETIREMENT COMMUNITY 0 37 0% 3,280 $0.00 12/7/2015 MOUNT MACRINA MANOR NURSING HOME 0 82 0% 7,610 $0.00 12/7/2015 MOUNTAIN CITY NURSING AND REHAB CENTER 1 195 1% 19,001 $0.00 12/7/2015 MOUNTAIN LAUREL NRC 0 154 0% 13,865 $0.00 12/7/2015 MOUNTAIN TOP SENIOR CARE AND REHAB CTR 0 67 0% 6,498 $0.00 12/7/2015 MOUNTAIN VIEW CARE CENTER 0 99 0% 8,874 $0.00 12/7/2015 MOUNTAIN VIEW, A NURSING AND REHAB CTR 0 150 0% 13,995 $0.00 12/7/2015 MOUNTAINVIEW SPECIALTY CARE CENTER 9 73 12% 6,763 $0.00 12/7/2015 MULBERRY SQUARE HEALTHCARE & REHAB CTR 0 39 0% 4,264 $0.00 12/7/2015 NAAMANS CREEK COUNTRY MANOR 1 45 2% 4,407 $0.00 12/7/2015 NESHAMINY MANOR HOME 1 238 0% 23,015 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date NEW EASTWOOD HEALTHCARE AND REHAB CENTER 1 44 2% 4,310 $0.00 12/7/2015 NORMANDIE RIDGE 0 24 0% 2,363 $0.00 12/7/2015 NORTH HILLS HEALTH AND REHAB CENTER 0 24 0% 2,378 $0.00 12/7/2015 NOTTINGHAM VILLAGE 0 59 0% 5,603 $0.00 12/7/2015 NUGENT CONVALESCENT HOME 0 65 0% 6,068 $0.00 12/7/2015 OAK HILL NURSING AND REHAB CENTER 1 23 4% 2,470 $0.00 12/7/2015 OAKMONT CENTER FOR NURSING AND REHAB 0 51 0% 4,946 $0.00 12/7/2015 OAKWOOD HEALTHCARE & REHABILITATION CTR 0 86 0% 8,057 $0.00 12/7/2015 OAKWOOD HEIGHTS 0 70 0% 6,558 $0.00 12/7/2015 OHESSON MANOR 0 85 0% 7,723 $0.00 12/7/2015 OLD ORCHARD HEALTH CARE CENTER 1 96 1% 9,572 $0.00 12/7/2015 ORANGEVILLE HEALTH AND REHAB CENTER 0 79 0% 7,121 $0.00 12/7/2015 ORCHARD MANOR, INC 0 76 0% 6,590 $0.00 12/7/2015 ORWIGSBURG CENTER 0 77 0% 7,629 $0.00 12/7/2015 OVERLOOK HEALTH AND REHAB CENTER 0 66 0% 6,004 $0.00 12/7/2015 OXFORD HEALTH CENTER 0 61 0% 6,735 $0.00 12/7/2015 PALMYRA HEALTH AND REHABILITATION CTR 0 23 0% 2,293 $0.00 12/7/2015 PARK AVENUE REHAB AND NURSING CENTER 5 111 5% 10,315 $0.00 12/7/2015 PARKHOUSE NURSING AND REHABILITATION CTR 1 331 0% 30,761 $0.00 12/7/2015 PASSAVANT RETIREMENT AND HEALTH CENTER 0 53 0% 4,365 $0.00 12/7/2015 PAUL'S RUN 0 38 0% 4,002 $0.00 12/7/2015 PAVILION AT BRMC 0 57 0% 4,835 $0.00 12/7/2015 PEMBROOKE HEALTH AND REHAB CENTER 0 120 0% 11,655 $0.00 12/7/2015 PENN CENTER FOR REHABILITATION AND CARE 0 78 0% 7,026 $0.00 12/7/2015 PENN HALL AT MENNO HAVEN 0 23 0% 2,111 $0.00 12/7/2015 PENNKNOLL VILLAGE 0 88 0% 8,592 $0.00 12/7/2015 PENNSBURG MANOR 0 64 0% 6,639 $0.00 12/7/2015 PENNYPACK CENTER 0 21 0% 1,718 $0.00 12/7/2015 PETER BECKER COMMUNITY 0 16 0% 1,807 $0.00 12/7/2015 PHILADELPHIA NURSING HOME 9 343 3% 32,708 $0.00 12/7/2015 PHILADELPHIA PROTESTANT HOME 0 45 0% 4,864 $0.00 12/7/2015 PHOEBE ALLENTOWN HEALTH CARE 0 197 0% 19,960 $0.00 12/7/2015 PHOEBE BERKS HEALTH CARE CENTER, INC 0 20 0% 1,776 $0.00 12/7/2015 PHOEBE RICHLAND HCC 0 61 0% 6,215 $0.00 12/7/2015 PHOEBE WYNCOTE 0 29 0% 2,905 $0.00 12/7/2015 PICKERING MANOR HOME 0 12 0% 1,139 $0.00 12/7/2015 PINE RUN HEALTH CENTER 1 11 9% 958 $0.00 12/7/2015 PINECREST MANOR 0 93 0% 8,459 $0.00 12/7/2015 PLATINUM RIDGE CTR FOR REHAB & HEALING 0 56 0% 5,363 $0.00 12/7/2015 PLEASANT ACRES NURSING AND REHAB CENTER 8 296 3% 28,140 $0.00 12/7/2015 PLEASANT RIDGE MANOR WEST 5 282 2% 26,975 $0.00 12/7/2015 PLEASANT VALLEY MANOR, INC 0 110 0% 10,702 $0.00 12/7/2015 PLEASANT VIEW RETIREMENT COMMUNITY 0 47 0% 4,590 $0.00 12/7/2015 POCOPSON HOME 0 207 0% 19,318 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date POWERBACK REHABILITATION 1526 0 47 0% 3,175 $0.00 12/7/2015 POWERBACK REHABILITATION 1700 0 30 0% 2,739 $0.00 12/7/2015 POWERBACK REHABILITATION 3485 0 12 0% 1,093 $0.00 12/7/2015 PRAXIS ALZHEIMER'S FACILITY 0 92 0% 8,393 $0.00 12/7/2015 PRESBYTERIAN HOME OF GREATER JOHNSTOWN 0 21 0% 2,042 $0.00 12/7/2015 PRESBYTERIAN HOMES‐PRESBYTERY‐HUNTINGDON 0 28 0% 2,939 $0.00 12/7/2015 PRESQUE ISLE REHAB & NURSING CENTER 24 99 24% 8,834 $35,070.98 12/7/2015 PROSPECT PARK HEALTH AND REHAB CENTER 15 117 13% 10,672 $12,486.24 12/7/2015 PROVIDENCE CARE CENTER 0 135 0% 12,597 $0.00 12/7/2015 QUAKERTOWN CENTER 0 90 0% 8,333 $0.00 12/7/2015 QUARRYVILLE PRESBYTERIAN RETIREMENT COMM 0 28 0% 3,216 $0.00 12/7/2015 QUINCY RETIREMENT COMMUNITY 0 72 0% 6,860 $0.00 12/7/2015 REDSTONE HIGHLANDS HEALTH CARE CENTER 0 36 0% 3,372 $0.00 12/7/2015 REFORMED PRESBYTERIAN HOME 0 39 0% 2,245 $0.00 12/7/2015 REGINA COMMUNITY NURSING CENTER 0 80 0% 7,780 $0.00 12/7/2015 REHAB & NURSING CTR GREATER PITTSBURGH 0 39 0% 3,529 $0.00 12/7/2015 RENAISSANCE HEALTHCARE & REHAB CENTER 2 82 2% 7,364 $0.00 12/7/2015 REST HAVEN‐YORK 0 84 0% 7,926 $0.00 12/7/2015 RICHBORO REHAB AND NURSING CENTER 0 47 0% 4,557 $0.00 12/7/2015 RICHFIELD SENIOR LIVING AND REHAB CENTE 0 24 0% 2,217 $0.00 12/7/2015 RIDGEVIEW HEALTHCARE & REHAB CENTER 0 90 0% 8,302 $0.00 12/7/2015 RIDGEVIEW HEALTHCARE & REHAB CENTER, LLC 1 59 2% 5,570 $0.00 12/7/2015 RIVER RUN REHAB AND NURSING CENTER 1 71 1% 6,408 $0.00 12/7/2015 RIVER'S EDGE NURSING AND REHAB CENTER 0 64 0% 5,933 $0.00 12/7/2015 RIVERSIDE CARE CENTER 0 89 0% 7,382 $0.00 12/7/2015 RIVERSIDE REHABILITATION AND NURSING CTR 1 110 1% 10,552 $0.00 12/7/2015 RIVERSTREET MANOR 0 70 0% 6,582 $0.00 12/7/2015 RIVERWOODS 0 90 0% 8,128 $0.00 12/7/2015 ROCHESTER MANOR 0 64 0% 4,513 $0.00 12/7/2015 ROCKHILL MENNONITE COMMUNITY 0 26 0% 2,263 $0.00 12/7/2015 ROLLING FIELDS, INC 0 126 0% 11,619 $0.00 12/7/2015 ROLLING HILLS HEALTHCARE & REHAB CENTER 0 44 0% 4,088 $0.00 12/7/2015 ROLLING MEADOWS 0 70 0% 6,689 $0.00 12/7/2015 ROSE VIEW CENTER 1 87 1% 7,955 $0.00 12/7/2015 ROSEWOOD REHABILITATION & NURSING CENTER 0 92 0% 9,389 $0.00 12/7/2015 ROUSE WARREN COUNTY HOME 0 117 0% 10,333 $0.00 12/7/2015 RYDAL PARK OF PHILADELPHIA PRSBYTR HOMES 0 20 0% 1,790 $0.00 12/7/2015 SAINT ANNE HOME 0 54 0% 5,273 $0.00 12/7/2015 SAINT ANNE'S RETIREMENT COMMUNITY 0 41 0% 3,746 $0.00 12/7/2015 SAINT JOHN XXIII HOME 0 50 0% 4,627 $0.00 12/7/2015 SAINT JOSEPH VILLA 1 46 2% 5,087 $0.00 12/7/2015 SAINT MARY'S AT ASBURY RIDGE 0 33 0% 2,925 $0.00 12/7/2015 SAINT MARY'S EAST 0 67 0% 6,552 $0.00 12/7/2015 SAINT MARY'S VILLA NURSING HOME, INC 0 63 0% 5,970 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date SAINT PAUL HOMES 0 104 0% 9,674 $0.00 12/7/2015 SANATOGA CENTER 0 68 0% 6,524 $0.00 12/7/2015 SARAH A TODD MEMORIAL HOME 0 72 0% 6,837 $0.00 12/7/2015 SARAH REED SENIOR LIVING 0 49 0% 4,738 $0.00 12/7/2015 SAUNDERS HOUSE 2 82 2% 7,079 $0.00 12/7/2015 SAXONY HEALTH CENTER 0 37 0% 3,483 $0.00 12/7/2015 SAYRE HEALTH CARE CENTER, LLC 0 16 0% 1,506 $0.00 12/7/2015 SCENERY HILL HEALTHCARE & REHAB CENTER 0 25 0% 2,420 $0.00 12/7/2015 SCHUYLKILL CENTER 0 143 0% 13,015 $0.00 12/7/2015 SCOTTDALE HEALTHCARE & REHAB CENTER 0 8 0% 988 $0.00 12/7/2015 SCRANTON HEALTH CARE CENTER 0 18 0% 1,913 $0.00 12/7/2015 SENA‐KEAN MANOR 1 96 1% 8,489 $0.00 12/7/2015 SENECA PLACE 9 90 10% 7,782 $0.00 12/7/2015 SETON MANOR INC 0 72 0% 6,886 $0.00 12/7/2015 SHENANDOAH MANOR NURSING CENTER 3 87 3% 7,837 $0.00 12/7/2015 SHENANGO PRESBYTERIAN SENIORCARE 0 4 0% 360 $0.00 12/7/2015 SHERWOOD OAKS 0 1 0% 90 $0.00 12/7/2015 SHIPPENSBURG HEALTH CARE CENTER 0 86 0% 8,019 $0.00 12/7/2015 SHOOK HOME, THE 0 30 0% 2,834 $0.00 12/7/2015 SIEMONS' LAKEVIEW MANOR NSG AND REHAB 1 78 1% 7,076 $0.00 12/7/2015 SILVER LAKE CENTER 2 123 2% 10,653 $0.00 12/7/2015 SILVER OAKS HEALTH AND REHAB CENTER 0 47 0% 4,401 $0.00 12/7/2015 SILVER STREAM CENTER 2 103 2% 9,651 $0.00 12/7/2015 SIMPSON HOUSE, INC 0 114 0% 10,556 $0.00 12/7/2015 SLATE BELT HEALTH AND REHAB CENTER 1 65 2% 6,371 $0.00 12/7/2015 SMITH HEALTH CARE, LTD 0 13 0% 1,331 $0.00 12/7/2015 SNYDER MEMORIAL HEALTH CARE CENTER 0 80 0% 7,221 $0.00 12/7/2015 SOMERTON CENTER 15 153 10% 14,923 $10,296.87 12/7/2015 SOUDERTON MENNONITE HOMES 0 22 0% 1,991 $0.00 12/7/2015 SOUTH FAYETTE NURSING CENTER 0 53 0% 4,715 $0.00 12/7/2015 SOUTHMONT OF PRESBYTERIAN SENIORCARE 0 67 0% 6,109 $0.00 12/7/2015 SOUTHWESTERN NURSING CARE CENTER 1 43 2% 4,694 $0.00 12/7/2015 SPANG CREST MANOR 0 43 0% 4,226 $0.00 12/7/2015 SPIRITRUST LUTHERAN VLG @ SHREWSBURY 0 48 0% 4,346 $0.00 12/7/2015 SPIRITRUST LUTHERAN VLG @ GETTYSBURG 0 39 0% 3,725 $0.00 12/7/2015 SPIRITRUST LUTHERAN VLG @ SPRENKLE DRIVE 0 49 0% 4,788 $0.00 12/7/2015 SPIRITRUST LUTHERAN VLG @ UTZ TERRACE 0 24 0% 2,178 $0.00 12/7/2015 SPRING CREEK REHAB AND NURSING CENTER 18 280 6% 26,471 $0.00 12/7/2015 SPRINGS AT THE WATERMARK, THE 0 33 0% 3,312 $0.00 12/7/2015 SPRUCE MANOR NURSING AND REHAB CENTER 2 131 2% 12,860 $0.00 12/7/2015 SQUIRREL HILL CTR FOR REHAB AND HEALING 2 118 2% 11,093 $0.00 12/7/2015 ST FRANCIS CENTER FOR REHAB & HEALTHCARE 1 186 1% 17,687 $0.00 12/7/2015 ST JOHN NEUMANN CTR FOR REHAB & HLTHCARE 0 152 0% 14,203 $0.00 12/7/2015 ST JOHN SPECIALTY CARE CENTER 3 163 2% 12,767 $0.00 12/7/2015 ST JOSEPH'S MANOR (DBA ENTITY OF HRHS) 0 135 0% 13,120 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date ST LUKE'S REHABILITATION AND NURSING CTR 0 23 0% 2,306 $0.00 12/7/2015 ST MARTHA CENTER FOR REHAB & HEALTHCARE 0 48 0% 5,150 $0.00 12/7/2015 ST MARY CENTER FOR REHAB & HEALTHCARE 0 58 0% 5,250 $0.00 12/7/2015 ST MONICA CENTER FOR REHAB & HEALTHCARE 1 107 1% 9,681 $0.00 12/7/2015 ST. BARNABAS NURSING HOME 1 43 2% 4,312 $0.00 12/7/2015 ST. IGNATIUS NURSING & REHAB CENTER 1 137 1% 8,984 $0.00 12/7/2015 ST. LUKE'S VILLA 0 23 0% 2,175 $0.00 12/7/2015 STATESMAN HEALTH AND REHAB CENTER 19 67 28% 6,065 $32,811.65 12/7/2015 STERLING HEALTH CARE AND REHAB CENTER 2 127 2% 11,667 $0.00 12/7/2015 STONEBRIDGE HEALTH AND REHAB CENTER 0 28 0% 2,944 $0.00 12/7/2015 STONERIDGE POPLAR RUN 0 24 0% 2,378 $0.00 12/7/2015 STONERIDGE TOWNE CENTRE 0 66 0% 6,947 $0.00 12/7/2015 SUBURBAN WOODS HEALTH AND REHAB CENTER 1 78 1% 7,324 $0.00 12/7/2015 SUGAR CREEK REST 4 73 5% 7,973 $0.00 12/7/2015 SUGAR CREEK STATION SKILLED NSG & REHAB 0 100 0% 9,126 $0.00 12/7/2015 SUMMIT AT BLUE MOUNTAIN NURSING & REHAB 0 58 0% 5,222 $0.00 12/7/2015 SUNBURY COMMUNITY HEALTH & REHAB CENTER 0 14 0% 1,378 $0.00 12/7/2015 SUNNYVIEW NURSING AND REHABILITATION CTR 0 151 0% 13,519 $0.00 12/7/2015 SUSQUE VIEW HOME, INC 1 94 1% 8,832 $0.00 12/7/2015 SUSQUEHANNA HLTH SKILLED NSG & REHAB CTR 12 85 14% 7,689 $10,380.15 12/7/2015 SUSQUEHANNA VALLEY NURSING AND REHAB CTR 0 98 0% 9,525 $0.00 12/7/2015 SWAIM HEALTH CENTER 0 35 0% 3,397 $0.00 12/7/2015 SWEDEN VALLEY MANOR 1 79 1% 7,371 $0.00 12/7/2015 TEL HAI RETIREMENT COMMUNITY 0 58 0% 5,677 $0.00 12/7/2015 THE BELVEDERE CENTER, GENESIS HEALTHCARE 1 128 1% 11,693 $0.00 12/7/2015 THE MANOR AT PENN VILLAGE 0 107 0% 10,040 $0.00 12/7/2015 THE MANOR AT PERRY VILLAGE 1 83 1% 7,691 $0.00 12/7/2015 THE MANOR AT ST LUKE VILLAGE 0 64 0% 6,251 $0.00 12/7/2015 THE MANOR AT SUSQUEHANNA VILLAGE 0 121 0% 11,267 $0.00 12/7/2015 THE PATRIOT, A CHOICE COMMUNITY 0 55 0% 5,058 $0.00 12/7/2015 THE PAVILION AT ST LUKE VILLAGE 0 72 0% 6,497 $0.00 12/7/2015 THE RIDGE AT WHITEMARSH HEALTH AND REHAB 4 168 2% 14,957 $0.00 12/7/2015 THORNWALD HOME 0 46 0% 4,168 $0.00 12/7/2015 TIMBER RIDGE HEALTH CENTER 3 120 3% 11,232 $0.00 12/7/2015 TOWNE MANOR EAST 0 86 0% 7,612 $0.00 12/7/2015 TOWNE MANOR WEST 1 93 1% 8,521 $0.00 12/7/2015 TOWNVIEW HEALTH AND REHAB CENTER 0 69 0% 5,366 $0.00 12/7/2015 TRANSITIONS HEALTHCARE AUTUMN GROVE 0 73 0% 6,787 $0.00 12/7/2015 TRANSITIONS HEALTHCARE GETTYSBURG 0 97 0% 8,681 $0.00 12/7/2015 TRANSITIONS HEALTHCARE NORTH HUNTINGDON 0 52 0% 5,243 $0.00 12/7/2015 TRANSITIONS HEALTHCARE WASHINGTON PA 4 60 7% 5,778 $0.00 12/7/2015 TREMONT HEALTH AND REHABILITATION CENTER 1 108 1% 10,588 $0.00 12/7/2015 TRINITY LIVING CENTER 0 69 0% 6,715 $0.00 12/7/2015 TUCKER HOUSE NSG & REHAB CTR 3 138 2% 11,450 $0.00 12/7/2015 TWIN OAKS HEALTH AND REHAB CENTER 0 19 0% 2,009 $0.00 12/7/2015
# MA Paid Facility Vents‐ and Trach # MA Therapeutic
02/01/2015 02/01/2015 % MA Days for Total Vent‐Picture Picture Vents‐ Quarter Ending Trach
Name Date Date Trach 03/31/2015 Payment RA Date TWIN PINES HEALTH CARE CENTER 0 71 0% 6,615 $0.00 12/7/2015 UNITED ZION RETIREMENT COMMUNITY 0 21 0% 2,361 $0.00 12/7/2015 UPMC HERITAGE PLACE 1 83 1% 6,590 $0.00 12/7/2015 VALENCIA WOODS AT ST BARNABAS 0 8 0% 782 $0.00 12/7/2015 VALLEY MANOR HEALTH AND REHAB CENTER 3 128 2% 12,588 $0.00 12/7/2015 VALLEY VIEW HAVEN, INC 0 64 0% 5,816 $0.00 12/7/2015 VALLEY VIEW HEALTH & REHABILITATION CTR 2 167 1% 14,974 $0.00 12/7/2015 VALLEY VIEW NURSING CENTER 0 86 0% 7,688 $0.00 12/7/2015 VILLA SAINT JOSEPH OF BADEN INC. 1 68 1% 6,443 $0.00 12/7/2015 VILLAGE AT LUTHER SQUARE 0 100 0% 7,759 $0.00 12/7/2015 VILLAGE AT PENNWOOD 2 86 2% 8,237 $0.00 12/7/2015 VINCENTIAN DE MARILLAC 0 33 0% 3,069 $0.00 12/7/2015 VINCENTIAN HOME 0 71 0% 6,810 $0.00 12/7/2015 WARREN MANOR 0 56 0% 5,200 $0.00 12/7/2015 WASHINGTON COUNTY HEALTH CENTER 0 201 0% 19,130 $0.00 12/7/2015 WATSONTOWN NURSING AND REHAB CENTER 1 80 1% 7,165 $0.00 12/7/2015 WAYNE CENTER 2 54 4% 5,861 $0.00 12/7/2015 WAYNE WOODLANDS MANOR 0 63 0% 5,643 $0.00 12/7/2015 WEATHERWOOD NURSING HOME AND REHAB CTR 0 124 0% 12,687 $0.00 12/7/2015 WESBURY UNITED METHODIST COMMUNITY 1 109 1% 10,142 $0.00 12/7/2015 WESLEY ENHANCED LIVING AT STAPELY 0 70 0% 6,661 $0.00 12/7/2015 WESLEY ENHANCED LIVING MAIN LINE REHAB 0 8 0% 885 $0.00 12/7/2015 WESLEY ENHANCED LIVING PENNYPACK PARK 0 67 0% 6,355 $0.00 12/7/2015 WESLEY ENHANCED LIVING‐DOYLESTOWN 0 23 0% 2,113 $0.00 12/7/2015 WESLEY VILLAGE 0 105 0% 9,741 $0.00 12/7/2015 WEST HAVEN MANOR 1 90 1% 8,980 $0.00 12/7/2015 WEST HILLS HEALTH AND REHAB CENTER 0 67 0% 6,344 $0.00 12/7/2015 WESTGATE REHABILITATION AND NURSING CTR 1 58 2% 6,076 $0.00 12/7/2015 WESTMINSTER VILLAGE 0 65 0% 6,170 $0.00 12/7/2015 WESTMINSTER WOODS AT HUNTINGDON 1 28 4% 2,406 $0.00 12/7/2015 WESTMORELAND MANOR 1 314 0% 29,717 $0.00 12/7/2015 WESTON REHABILITATION AND NURSING CENTER 0 18 0% 1,615 $0.00 12/7/2015 WEXFORD HEALTHCARE CENTER 0 83 0% 8,003 $0.00 12/7/2015 WHITE CLIFF HEALTH AND REHAB CENTER 0 113 0% 10,480 $0.00 12/7/2015 WHITESTONE CARE CENTER 0 53 0% 4,832 $0.00 12/7/2015 WILLIAM PENN CARE CENTER 2 69 3% 6,868 $0.00 12/7/2015 WILLIAMSPORT HOME, THE 0 67 0% 5,910 $0.00 12/7/2015 WILLOW TERRACE 0 111 0% 10,829 $0.00 12/7/2015 WILLOWBROOKE COURT AT BRITTANY POINTE 0 7 0% 599 $0.00 12/7/2015 WILLOWCREST 0 9 0% 374 $0.00 12/7/2015 WILLOWS OF PRESBYTERIAN SENIORCARE, THE 0 71 0% 6,695 $0.00 12/7/2015 WINDY HILL VILLAGE OF PRESBYTERIAN HOMES 0 87 0% 7,936 $0.00 12/7/2015 WOODHAVEN CARE CENTER 0 75 0% 7,398 $0.00 12/7/2015 WOODLAND REHABILITATION AND NURSING CTR 0 80 0% 7,443 $0.00 12/7/2015 WYOMISSING HEALTH AND REHABILITATION CTR 0 51 0% 5,618 $0.00 12/7/2015
# MA Vents‐
Paid Facility and
Name
Trach 02/01/2015 Picture Date
# MA 02/01/2015 Picture Date
% MA Vents‐Trach
Therapeutic Days for
Quarter Ending 03/31/2015
Total Vent‐Trach
Payment RA Date YORK NURSING AND REHABILITATION CENTER 2 181 1% 17,356 $0.00 12/7/2015 ZERBE SISTERS NURSING CENTER, INC. 0 55 0% 5,251 $0.00 12/7/2015