supplemental ventilator care and tracheostomy … ventilator care and tracheostomy care payments...
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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:
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date ABINGTON CREST HEALTH AND REHAB CENTER 2 61 3% 5,114 $0.00 9/18/2017 ABINGTON MANOR 0 68 0% 6,816 $0.00 9/18/2017 ABRAMSON RESIDENCE 0 183 0% 17,381 $0.00 9/18/2017 ALLIED SERVICES SKILLED NURSING CENTER 27 242 11% 23,448 $19,461.84 9/18/2017 ALTOONA CENTER FOR NURSING CARE 0 79 0% 6,926 $0.00 9/18/2017 AMBLER EXTENDED CARE CENTER 0 66 0% 6,333 $0.00 9/18/2017 ANN'S CHOICE 0 7 0% 602 $0.00 9/18/2017 ARBUTUS PARK MANOR 0 80 0% 7,934 $0.00 9/18/2017 ARISTACARE AT MEADOW SPRINGS 84 118 71% 10,484 $364,633.52 9/18/2017 ARTMAN LUTHERAN HOME 0 18 0% 1,657 $0.00 9/18/2017 ASBURY HEALTH CENTER 1 47 2% 4,967 $0.00 9/18/2017 ATHENS HEALTH AND REHABILITATION CENTER 0 44 0% 4,055 $0.00 9/18/2017 ATTLEBORO NURSING AND REHAB CENTER 0 106 0% 8,887 $0.00 9/18/2017 AVALON NURSING CENTER 0 61 0% 5,541 $0.00 9/18/2017 AVALON SPRINGS NURSING CENTER 0 63 0% 6,313 $0.00 9/18/2017 BALA NURSING AND RETIREMENT CENTER 1 142 1% 13,625 $0.00 9/18/2017 BALDWIN HEALTH CENTER 0 117 0% 12,221 $0.00 9/18/2017 BALL PAVILION, THE 0 44 0% 4,158 $0.00 9/18/2017 BAPTIST HOMES OF WESTERN PENNSYLVANIA 0 70 0% 7,372 $0.00 9/18/2017 BARCLAY FRIENDS 0 22 0% 1,957 $0.00 9/18/2017 BARNES‐KASSON COUNTY HOSPITAL SNF 0 33 0% 3,221 $0.00 9/18/2017 BEACON RIDGE, A CHOICE COMMUNITY 1 65 2% 5,330 $0.00 9/18/2017 BEAVER HEALTHCARE AND REHABILITATION CTR 0 42 0% 3,731 $0.00 9/18/2017 BEAVER VALLEY HEALTH AND REHAB CENTER 0 83 0% 7,273 $0.00 9/18/2017 BELAIR HEALTH AND REHABILITATION CENTER 0 56 0% 5,300 $0.00 9/18/2017 BELLE HAVEN HEALTHCARE & REHAB CENTER 1 39 3% 3,556 $0.00 9/18/2017 BELLE REVE HEALTH CARE CENTER 0 6 0% 576 $0.00 9/18/2017 BERKS HEIM NURSING & REHABILITATION 0 289 0% 27,493 $0.00 9/18/2017 BERKSHIRE CENTER 0 77 0% 7,395 $0.00 9/18/2017 BERWICK RETIREMENT VILLAGE NRSNG HOME I 0 33 0% 2,984 $0.00 9/18/2017 BERWICK RETIREMENT VILLAGE NRSNG HOME II 0 65 0% 5,815 $0.00 9/18/2017 BETHANY VILLAGE RETIREMENT CENTER 0 18 0% 1,871 $0.00 9/18/2017 BETHLEN HM OF THE HUNGARIAN RFRMD FED 0 44 0% 4,194 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date BIRCHWOOD NURSING AND REHAB CENTER 1 82 1% 7,719 $0.00 9/18/2017 BLOOMSBURG HEALTH CARE CENTER 0 86 0% 7,969 $0.00 9/18/2017 BONHAM NURSING CENTER 0 56 0% 5,386 $0.00 9/18/2017 BRADFORD COUNTY MANOR 0 126 0% 11,418 $0.00 9/18/2017 BRADFORD ECUMENICAL HOME, INC 0 63 0% 5,876 $0.00 9/18/2017 BRADFORD MANOR 0 60 0% 6,036 $0.00 9/18/2017 BRANDYWINE HALL 1 141 1% 12,981 $0.00 9/18/2017 BRETHREN VILLAGE 0 41 0% 3,787 $0.00 9/18/2017 BRIARLEAF NURSING AND CONVAL CENTER 0 139 0% 12,929 $0.00 9/18/2017 BRIDGEVILLE REHAB AND CARE CENTER 0 65 0% 6,520 $0.00 9/18/2017 BRIGHTON REHABILITATION & WELLNESS CTR 5 354 1% 31,598 $0.00 9/18/2017 BRINTON MANOR 0 60 0% 5,586 $0.00 9/18/2017 BROAD ACRES HEALTH AND REHAB CENTER 1 72 1% 6,533 $0.00 9/18/2017 BROAD MOUNTAIN HEALTH AND REHAB CENTER 1 76 1% 7,589 $0.00 9/18/2017 BROOKLINE MANOR AND REHABILITATIVE SRVCS 0 48 0% 4,173 $0.00 9/18/2017 BROOKMONT HEALTHCARE CENTER LLC 0 72 0% 6,842 $0.00 9/18/2017 BROOKSIDE HEALTHCARE AND REHAB CENTER 1 79 1% 7,322 $0.00 9/18/2017 BROOKVIEW HEALTH CARE CENTER 0 48 0% 4,596 $0.00 9/18/2017 BROOMALL MANOR 1 63 2% 5,831 $0.00 9/18/2017 BROOMALL PRESBYTERIAN VILLAGE 0 71 0% 6,911 $0.00 9/18/2017 BROOMALL REHAB AND NURSING CENTER 0 183 0% 17,500 $0.00 9/18/2017 BRYN MAWR EXTENDED CARE CENTER 2 103 2% 9,986 $0.00 9/18/2017 BUCKINGHAM VALLEY REHAB AND NURSING CTR 0 74 0% 6,710 $0.00 9/18/2017 BUCKTAIL MEDICAL CENTER 0 32 0% 2,867 $0.00 9/18/2017 BUFFALO VALLEY LUTHERAN VILLAGE 0 64 0% 6,052 $0.00 9/18/2017 CALVARY FELLOWSHIP HOMES, INC 0 20 0% 1,879 $0.00 9/18/2017 CAMBRIA CARE CENTER 13 207 6% 17,076 $0.00 9/18/2017 CANTERBURY PLACE 0 48 0% 4,686 $0.00 9/18/2017 CARBONDALE NURSING AND REHAB CENTER 0 76 0% 7,382 $0.00 9/18/2017 CARE PAVILION NURSING AND REHAB CENTER 1 340 0% 27,325 $0.00 9/18/2017 CARING HEART REHAB AND NURSING CENTER 1 143 1% 14,068 $0.00 9/18/2017 CARING HEIGHTS COMMUNITY CARE & REHAB 0 67 0% 6,445 $0.00 9/18/2017 CARING PLACE, THE 0 70 0% 6,317 $0.00 9/18/2017 CARLETON HEALTHCARE & REHABILITATION CTR 0 15 0% 1,352 $0.00 9/18/2017 CATHEDRAL VILLAGE 0 20 0% 2,479 $0.00 9/18/2017 CEDAR HAVEN HEALTHCARE CENTER 1 245 0% 23,500 $0.00 9/18/2017 CEDARBROOK NURSING HOMES 0 529 0% 48,883 $0.00 9/18/2017 CENTENNIAL HEALTHCARE & REHAB CENTER 1 124 1% 11,288 $0.00 9/18/2017 CENTRE CREST 1 159 1% 15,129 $0.00 9/18/2017 CHAMBERS POINTE HEALTH CARE CENTER 0 17 0% 1,703 $0.00 9/18/2017 CHANDLER HALL HEALTH SERVICES INC 0 20 0% 2,057 $0.00 9/18/2017 CHAPEL MANOR 0 184 0% 16,956 $0.00 9/18/2017 CHAPEL POINTE AT CARLISLE 0 27 0% 2,304 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date CHARLES COLE MEMORIAL HOSPITAL ECF 0 24 0% 2,135 $0.00 9/18/2017 CHARLES M. MORRIS NURSING AND REHAB CTR 0 67 0% 6,249 $0.00 9/18/2017 CHELTENHAM NURSING AND REHAB CENTER 3 196 2% 18,219 $0.00 9/18/2017 CHERRY TREE NURSING CENTER 0 64 0% 5,446 $0.00 9/18/2017 CHESTER VALLEY REHAB AND NURSING CENTER 1 119 1% 11,124 $0.00 9/18/2017 CHESTNUT HILL LODGE HEALTH AND REHAB CTR 0 123 0% 11,643 $0.00 9/18/2017 CHICORA MEDICAL CENTER 0 70 0% 6,700 $0.00 9/18/2017 CHRIST THE KING MANOR 1 88 1% 7,855 $0.00 9/18/2017 CHRIST'S HOME RETIREMENT COMMUNITY 0 6 0% 483 $0.00 9/18/2017 CHURCH OF GOD HOME, INC 0 47 0% 4,243 $0.00 9/18/2017 CHURCH OF THE BRETHREN HOME 0 71 0% 6,393 $0.00 9/18/2017 CLAREMONT NRC OF CUMBERLAND COUNTY 1 184 1% 16,589 $0.00 9/18/2017 CLARION HEALTHCARE AND REHAB CENTER 0 33 0% 3,166 $0.00 9/18/2017 CLARVIEW NURSING AND REHAB CENTER 0 66 0% 5,685 $0.00 9/18/2017 CLEPPER MANOR 0 32 0% 3,168 $0.00 9/18/2017 CLIVEDEN NSG & REHAB CTR 1 128 1% 11,827 $0.00 9/18/2017 COLONIAL MANOR NURSING HOME 2 166 1% 15,481 $0.00 9/18/2017 COLONIAL PARK CARE CENTER 0 132 0% 12,077 $0.00 9/18/2017 COMMUNITIES AT INDIAN HAVEN 0 63 0% 5,729 $0.00 9/18/2017 CONCORDIA AT THE CEDARS 0 26 0% 3,121 $0.00 9/18/2017 CONCORDIA LUTHERAN HEALTH AND HUMAN CARE 0 67 0% 6,316 $0.00 9/18/2017 CONESTOGA VIEW 14 377 4% 34,331 $0.00 9/18/2017 CONNER‐WILLIAMS NURSING HOME 0 30 0% 2,863 $0.00 9/18/2017 CONSULATE HEALTH CARE OF CHESWICK 2 71 3% 6,789 $0.00 9/18/2017 CONSULATE HEALTH CARE OF NORTH STRABANE 0 43 0% 3,896 $0.00 9/18/2017 CONTINUING CARE AT MARIS GROVE 0 1 0% 90 $0.00 9/18/2017 CORNWALL MANOR 0 25 0% 2,433 $0.00 9/18/2017 CORRY MANOR 0 70 0% 6,301 $0.00 9/18/2017 COUNTRY MEADOWS NURSING CENTER‐BETHLEHEM 0 2 0% 180 $0.00 9/18/2017 COUNTRYSIDE CHRISTIAN COMMUNITY 0 16 0% 1,506 $0.00 9/18/2017 COUNTRYSIDE CONVAL HOME LTD PARTNERSHIP 0 22 0% 1,915 $0.00 9/18/2017 COURTYARD GARDENS NURSING AND REHAB CTR 0 47 0% 4,371 $0.00 9/18/2017 CRANBERRY PLACE 1 72 1% 6,490 $0.00 9/18/2017 CRAWFORD COUNTY CARE CENTER 2 95 2% 8,261 $0.00 9/18/2017 CREEKSIDE HEALTH AND REHABILITATION CTR 1 65 2% 6,025 $0.00 9/18/2017 CRESTVIEW CENTER 0 119 0% 10,148 $0.00 9/18/2017 CROSS KEYS VILLAGE‐BRETHREN HM COMM, THE 1 128 1% 11,611 $0.00 9/18/2017 CUMBERLAND CROSSINGS RETIREMENT COMM 0 25 0% 2,351 $0.00 9/18/2017 DARWAY HEALTHCARE & REHABILITATION CTR 1 44 2% 3,894 $0.00 9/18/2017 DEER MEADOWS REHABILITATION CENTER 10 134 7% 12,508 $0.00 9/18/2017 DOCK TERRACE 0 24 0% 2,359 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date DONAHOE MANOR 1 44 2% 3,932 $0.00 9/18/2017 DOYLESTOWN CARE AND REHABILITATION CTR 1 63 2% 5,760 $0.00 9/18/2017 DR ARTHUR CLIFTON MCKINLEY HEALTH CENTER 0 43 0% 4,005 $0.00 9/18/2017 DRESHER HILL HEALTH AND REHAB CENTER 2 87 2% 8,237 $0.00 9/18/2017 DUBOIS NURSING HOME 0 79 0% 7,456 $0.00 9/18/2017 DUNMORE HEALTH CARE CENTER 0 56 0% 5,497 $0.00 9/18/2017 EDGEHILL NURSING AND REHAB CENTER 0 49 0% 4,815 $0.00 9/18/2017 EDINBORO MANOR 2 80 3% 7,406 $0.00 9/18/2017 EDISON MANOR NURSING AND REHAB CENTER 4 72 6% 6,547 $0.00 9/18/2017 ELDERCREST NURSING CENTER 0 22 0% 2,289 $0.00 9/18/2017 ELIZABETHTOWN NURSING & REHAB CENTER 0 25 0% 2,625 $0.00 9/18/2017 ELK HAVEN NURSING HOME 0 57 0% 5,758 $0.00 9/18/2017 ELKINS CREST HEALTH AND REHAB CENTER 0 105 0% 9,905 $0.00 9/18/2017 ELLEN MEMORIAL HEALTH CARE CENTER 0 68 0% 6,090 $0.00 9/18/2017 ELM TERRACE GARDENS 0 17 0% 1,650 $0.00 9/18/2017 ELMWOOD GARDENS OF PRESBY SENIOR CARE 0 22 0% 2,358 $0.00 9/18/2017 EMMANUEL CENTER FOR NURSING AND REHAB 0 44 0% 4,175 $0.00 9/18/2017 EPHRATA MANOR 0 63 0% 6,089 $0.00 9/18/2017 EPWORTH HEALTHCARE AND REHAB CENTER 0 57 0% 5,410 $0.00 9/18/2017 EXETER GREENS CARE & REHABILITATION CTR 2 72 3% 6,959 $0.00 9/18/2017 FAIR ACRES GERIATRIC CENTER 2 633 0% 59,213 $0.00 9/18/2017 FAIR WINDS MANOR 0 44 0% 4,098 $0.00 9/18/2017 FAIRMOUNT HOMES 0 41 0% 3,790 $0.00 9/18/2017 FAIRVIEW CARE CENTER OF BETHLEHEM PIKE 1 128 1% 11,823 $0.00 9/18/2017 FAIRVIEW CARE CENTER OF PAPERMILL ROAD 0 92 0% 8,579 $0.00 9/18/2017 FAIRVIEW MANOR 0 84 0% 7,270 $0.00 9/18/2017 FALLING SPRING NURSING AND REHAB CENTER 0 121 0% 10,633 $0.00 9/18/2017 FELLOWSHIP MANOR 0 34 0% 3,426 $0.00 9/18/2017 FORBES CENTER FOR REHAB & HEALTHCARE LLC 20 79 25% 7,532 $32,462.92 9/18/2017 FOREST CITY NURSING AND REHAB CENTER 0 65 0% 5,877 $0.00 9/18/2017 FOREST PARK HEALTH CENTER 0 69 0% 6,959 $0.00 9/18/2017 FORESTVIEW 0 25 0% 2,145 $0.00 9/18/2017 FOX SUBACUTE AT CLARA BURKE 39 39 100% 3,720 $256,680.00 9/18/2017 FOX SUBACUTE AT MECHANICSBURG 29 30 97% 2,563 $166,389.96 9/18/2017 FOX SUBACUTE CENTER 31 31 100% 3,182 $219,558.00 9/18/2017 FREDERICK LIVING ‐ CEDARWOOD 0 9 0% 949 $0.00 9/18/2017 FREY VILLAGE 0 59 0% 5,987 $0.00 9/18/2017 FRIENDSHIP VILLAGE OF SOUTH HILLS 0 5 0% 402 $0.00 9/18/2017 FULTON COUNTY MEDICAL CENTER LTCU 0 53 0% 4,747 $0.00 9/18/2017 GARDEN SPOT VILLAGE 0 13 0% 1,222 $0.00 9/18/2017 GARDEN SPRING CENTER 29 129 22% 11,557 $38,600.38 9/18/2017 GARVEY MANOR 0 86 0% 7,660 $0.00 9/18/2017 GERMANTOWN HOME 0 160 0% 10,570 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date GETTYSBURG CENTER 0 63 0% 6,140 $0.00 9/18/2017 GLENDALE UPTOWN HOME 7 171 4% 16,168 $0.00 9/18/2017 GOLDEN HILL NURSING AND REHAB 0 138 0% 12,607 $0.00 9/18/2017 GOOD SHEPHERD HOME RAKER CENTER 12 93 13% 8,461 $9,899.37 9/18/2017 GOOD SHEPHERD HOME‐BETHLEHEM 0 58 0% 5,297 $0.00 9/18/2017 GRACEDALE ‐ NORTHAMPTON COUNTY HOME 1 501 0% 48,493 $0.00 9/18/2017 GRANDVIEW HEALTH HOMES, INC 0 117 0% 10,416 $0.00 9/18/2017 GREEN HOME, INC, THE 0 71 0% 6,899 $0.00 9/18/2017 GREEN RIDGE CARE CENTER 0 56 0% 5,142 $0.00 9/18/2017 GREEN VALLEY SKILLED NSG & REHAB CENTER 0 23 0% 2,143 $0.00 9/18/2017 GREENERY CENTER FOR REHAB & NURSING 5 83 6% 7,270 $0.00 9/18/2017 GREENLEAF NURSING HOME AND CONVAL CENTER 0 104 0% 9,950 $0.00 9/18/2017 GREENSBURG CARE CENTER 0 84 0% 6,244 $0.00 9/18/2017 GROVE MANOR 0 20 0% 1,843 $0.00 9/18/2017 GUARDIAN HEALTHCARE & REHAB CENTER 0 81 0% 7,515 $0.00 9/18/2017 GUTHRIE TOWANDA MEMORIAL HOSPITAL SNU 0 40 0% 3,784 $0.00 9/18/2017 GUY AND MARY FELT MANOR, INC 0 19 0% 1,820 $0.00 9/18/2017 GWYNEDD HEALTHCARE & REHABILITATION CTR 0 135 0% 12,765 $0.00 9/18/2017 HAIDA HEALTHCARE AND REHAB CENTER 1 68 1% 5,912 $0.00 9/18/2017 HAMILTON ARMS CENTER 0 61 0% 5,868 $0.00 9/18/2017 HAMPTON HOUSE 0 60 0% 6,002 $0.00 9/18/2017 HANOVER HALL 7 95 7% 9,108 $0.00 9/18/2017 HARMAR VILLAGE CARE CENTER 0 79 0% 7,570 $0.00 9/18/2017 HARMON HOUSE CARE CENTER 1 71 1% 6,263 $0.00 9/18/2017 HARRISON SENIOR LIVING OF CHRISTIANA 0 77 0% 7,570 $0.00 9/18/2017 HARSTON HALL 2 97 2% 8,461 $0.00 9/18/2017 HAVEN CONVALESCENT HOME, INC 0 76 0% 6,692 $0.00 9/18/2017 HAVEN SKILLED REHABILITATION AND NURSING 0 51 0% 4,794 $0.00 9/18/2017 HAVENCREST NURSING CENTER 0 24 0% 2,054 $0.00 9/18/2017 HEARTHSIDE REHAB CENTER 0 102 0% 9,609 $0.00 9/18/2017 HEMPFIELD MANOR 0 64 0% 5,837 $0.00 9/18/2017 HENRY CLAY VILLA, LP 0 60 0% 4,860 $0.00 9/18/2017 HICKORY HOUSE NURSING HOME 0 63 0% 5,510 $0.00 9/18/2017 HIGHLAND MANOR REHAB & NURSING CENTER 0 76 0% 7,578 $0.00 9/18/2017 HIGHLAND PARK CARE CENTER 0 97 0% 9,222 $0.00 9/18/2017 HIGHLAND VIEW HEALTHCARE & REHAB CENTER 0 31 0% 2,728 $0.00 9/18/2017 HIGHLANDS HEALTHCARE & REHAB CENTER 0 98 0% 8,798 $0.00 9/18/2017 HILLCREST CENTER 1 150 1% 13,737 $0.00 9/18/2017 HILLSDALE PARK REHAB CENTER 0 50 0% 4,558 $0.00 9/18/2017 HILLVIEW HEALTHCARE AND REHAB CENTER 1 82 1% 7,959 $0.00 9/18/2017 HOLY FAMILY HOME 0 37 0% 3,310 $0.00 9/18/2017 HOLY FAMILY MANOR 0 103 0% 9,688 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date HOLY FAMILY RESIDENCE 0 46 0% 4,335 $0.00 9/18/2017 HOMELAND CENTER 0 45 0% 4,202 $0.00 9/18/2017 HOMESTEAD VILLAGE, INC 0 10 0% 929 $0.00 9/18/2017 HOMETOWN NURSING AND REHAB CENTER 0 89 0% 8,645 $0.00 9/18/2017 HOMEWOOD AT MARTINSBURG PA INC 0 49 0% 4,823 $0.00 9/18/2017 HOMEWOOD AT PLUM CREEK 0 39 0% 3,646 $0.00 9/18/2017 HOPKINS CENTER 1 87 1% 7,630 $0.00 9/18/2017 HOSPITALITY CARE CENTER OF HERMITAGE INC 0 16 0% 1,707 $0.00 9/18/2017 HUNTINGDON PARK REHAB CENTER 0 48 0% 4,347 $0.00 9/18/2017 IMMACULATE MARY CTR FOR REHAB & HLTHCARE 0 185 0% 18,826 $0.00 9/18/2017 INGLIS HOUSE 7 217 3% 19,713 $0.00 9/18/2017 IVY HILL REHAB CENTER 0 105 0% 10,014 $0.00 9/18/2017 JAMESON CARE CENTER 0 45 0% 3,719 $0.00 9/18/2017 JEFFERSON HILLS HEALTHCARE & REHAB CTR 0 38 0% 4,075 $0.00 9/18/2017 JEFFERSON MANOR HEALTH CENTER 1 76 1% 6,931 $0.00 9/18/2017 JEWISH HOME OF EASTERN PENNSYLVANIA 0 109 0% 9,446 $0.00 9/18/2017 JEWISH HOME OF GREATER HARRISBURG 0 80 0% 7,634 $0.00 9/18/2017 JOHN J KANE REGIONAL CENTER‐GLEN HAZEL 1 159 1% 14,394 $0.00 9/18/2017 JOHN J KANE REGIONAL CENTER‐MCKEESPORT 0 226 0% 19,696 $0.00 9/18/2017 JOHN J KANE REGIONAL CENTER‐ROSS TWNSHP 0 185 0% 16,420 $0.00 9/18/2017 JOHN J KANE REGIONAL CENTER‐SCOTT TWNSHP 0 201 0% 18,601 $0.00 9/18/2017 JULIA POUND CARE CENTER 0 63 0% 6,380 $0.00 9/18/2017 JULIA RIBAUDO EXTENDED CARE CENTER 0 68 0% 6,167 $0.00 9/18/2017 KEARSLEY REHAB AND NURSING CENTER 0 45 0% 4,076 $0.00 9/18/2017 KEPLER CENTER FOR NURSING AND REHAB 0 17 0% 1,582 $0.00 9/18/2017 KINGSTON HEALTH CARE CENTER 0 31 0% 3,150 $0.00 9/18/2017 KINKORA PYTHIAN HOME CORPORATION 0 22 0% 2,118 $0.00 9/18/2017 KINZUA HEALTHCARE AND REHAB CENTER 0 68 0% 6,316 $0.00 9/18/2017 KITTANNING CARE CENTER 0 82 0% 7,557 $0.00 9/18/2017 KUTZTOWN MANOR 0 92 0% 8,988 $0.00 9/18/2017 LACKAWANNA HEALTH AND REHAB CENTER 0 157 0% 14,283 $0.00 9/18/2017 LAFAYETTE MANOR, INC 0 53 0% 4,774 $0.00 9/18/2017 LAFAYETTE‐REDEEMER (DBA ENTITY OF HRHS) 0 48 0% 5,249 $0.00 9/18/2017 LAKEVIEW HEALTHCARE & REHABILITATION CTR 0 20 0% 1,796 $0.00 9/18/2017 LANCASHIRE HALL 1 160 1% 15,812 $0.00 9/18/2017 LANCASTER CARE AND REHABILITATION CENTER 0 91 0% 8,469 $0.00 9/18/2017 LANDIS HOMES 0 35 0% 3,439 $0.00 9/18/2017 LANGHORNE GARDENS HEALTH & REHAB CENTER 0 84 0% 7,980 $0.00 9/18/2017 LANSDALE CARE AND REHABILITATION CENTER 0 76 0% 6,962 $0.00 9/18/2017 LAUREL CARE NURSING AND REHAB CENTER 0 54 0% 4,951 $0.00 9/18/2017 LAUREL CENTER 14 89 16% 8,150 $14,425.50 9/18/2017 LAUREL RIDGE CENTER 0 40 0% 3,559 $0.00 9/18/2017 LAUREL SQUARE HEALTHCARE & REHAB CTR 0 70 0% 6,148 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date LAUREL VIEW VILLAGE 0 21 0% 1,795 $0.00 9/18/2017 LAUREL WOOD CARE CENTER 0 92 0% 7,115 $0.00 9/18/2017 LAWSON NURSING HOME, INC. 0 23 0% 2,259 $0.00 9/18/2017 LEBANON VALLEY BRETHREN HOME 0 38 0% 3,578 $0.00 9/18/2017 LEBANON VALLEY HOME THE 0 28 0% 2,421 $0.00 9/18/2017 LECOM AT PRESQUE ISLE, INC. 23 91 25% 7,912 $34,100.72 9/18/2017 LEHIGH CENTER 0 59 0% 5,465 $0.00 9/18/2017 LGAR HEALTH AND REHABILITATION CENTER 0 82 0% 7,643 $0.00 9/18/2017 LIFEQUEST NURSING CENTER 0 94 0% 8,697 $0.00 9/18/2017 LINWOOD NURSING AND REHABILITATION CTR 0 61 0% 5,570 $0.00 9/18/2017 LITTLE FLOWER MANOR 0 56 0% 5,060 $0.00 9/18/2017 LITTLE FLOWER MANOR OF DIOCESE SCRANTON 0 76 0% 7,355 $0.00 9/18/2017 LITTLE SISTERS OF THE POOR 0 46 0% 4,185 $0.00 9/18/2017 LOCUST GROVE RETIREMENT VILLAGE 1 66 2% 5,608 $0.00 9/18/2017 LOYALHANNA CARE CENTER 1 63 2% 6,302 $0.00 9/18/2017 LOYALSOCK REHAB CENTER 0 88 0% 8,100 $0.00 9/18/2017 LUTHER ACRES MANOR 0 35 0% 3,581 $0.00 9/18/2017 LUTHER CREST NURSING FACILITY 0 17 0% 1,874 $0.00 9/18/2017 LUTHER WOODS NURSING & REHAB CENTER 1 69 1% 6,428 $0.00 9/18/2017 LUTHERAN COMMUNITY AT TELFORD 0 24 0% 2,324 $0.00 9/18/2017 LUTHERAN HOME AT HOLLIDAYSBURG, THE 0 38 0% 3,546 $0.00 9/18/2017 LUTHERAN HOME AT JOHNSTOWN, THE 0 28 0% 2,768 $0.00 9/18/2017 LUTHERAN HOME AT KANE, THE 0 50 0% 4,653 $0.00 9/18/2017 LUTHERAN HOME AT TOPTON 1 105 1% 10,771 $0.00 9/18/2017 MAHONING VALLEY NURSING AND REHAB CENTER 0 83 0% 7,699 $0.00 9/18/2017 MAJESTIC OAKS REHAB & NURSING CENTER 0 122 0% 11,708 $0.00 9/18/2017 MANATAWNY MANOR INC 0 71 0% 6,954 $0.00 9/18/2017 MANCHESTER COMMONS OF PRESBY SR. CARE 0 43 0% 3,877 $0.00 9/18/2017 MANORCARE HEALTH SERVICES ‐ ERIE 1 79 1% 7,311 $0.00 9/18/2017 MANORCARE HEALTH SERVICES ‐MONTGOMERY 1 100 1% 8,894 $0.00 9/18/2017 MANORCARE HEALTH SERVICES ‐ NORTHSIDE 0 73 0% 6,697 $0.00 9/18/2017 MANORCARE HEALTH SERVICES ‐WALLINGFORD 3 126 2% 12,294 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐ALLENTOWN 2 111 2% 10,080 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐BETHEL PARK 0 87 0% 8,287 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐BETHLEHEM (2021) 1 170 1% 15,145 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐BETHLEHEM (2029) 2 153 1% 14,734 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐CAMP HILL 0 68 0% 6,286 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐CARLISLE 0 98 0% 9,212 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐CHAMBERSBURG 0 134 0% 12,280 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐DALLASTOWN 0 137 0% 12,749 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐EASTON 0 152 0% 14,461 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐ELIZABETHTOWN 1 45 2% 4,329 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐GREEN TREE 3 82 4% 7,641 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date MANORCARE HEALTH SVCS‐HUNTINGDON VALLEY 2 82 2% 7,899 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐JERSEY SHORE 0 89 0% 8,284 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐KING OF PRUSSIA 1 89 1% 8,804 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐KINGSTON 1 107 1% 9,691 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐KINGSTON COURT 1 82 1% 8,271 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐LANCASTER 0 104 0% 10,039 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐LAURELDALE 0 113 0% 11,443 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐LEBANON 2 95 2% 9,660 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐MERCY FITZGERALD 2 78 3% 6,660 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐MONROEVILLE 0 57 0% 5,633 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐NORTH HILLS 1 115 1% 10,619 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐OXFORD VALLEY 0 70 0% 7,347 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐PETERS TOWNSHIP 1 81 1% 7,387 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐PITTSBURGH 2 135 1% 12,487 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐POTTSTOWN 0 92 0% 8,699 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐POTTSVILLE 0 110 0% 10,381 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐SHADYSIDE 1 103 1% 8,883 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐SINKING SPRING 1 145 1% 13,713 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐SUNBURY 0 85 0% 7,473 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐WEST READING NORTH 0 137 0% 12,505 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐WHITEHALL BOROUGH 0 64 0% 6,130 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐WILLIAMSPORT NORTH 1 96 1% 8,204 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐WILLIAMSPORT SOUTH 2 80 3% 7,346 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐YEADON 5 173 3% 15,124 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐YORK NORTH 0 105 0% 10,003 $0.00 9/18/2017 MANORCARE HEALTH SVCS‐YORK SOUTH 1 97 1% 8,859 $0.00 9/18/2017 MANORCARE HLTH SVCS & REHAB ‐WEST ALLEN 7 108 6% 10,197 $0.00 9/18/2017 MAPLE FARM 0 16 0% 1,729 $0.00 9/18/2017 MAPLE WINDS HEALTHCARE & REHAB CTR, LLC 0 17 0% 1,708 $0.00 9/18/2017 MAPLEWOOD NURSING AND REHABILITATION CTR 1 153 1% 14,054 $0.00 9/18/2017 MARGARET E. MOUL HOME 2 80 3% 7,156 $0.00 9/18/2017 MARIAN MANOR CORPORATION 0 64 0% 5,985 $0.00 9/18/2017 MASONIC VILLAGE AT ELIZABETHTOWN 1 252 0% 23,995 $0.00 9/18/2017 MASONIC VILLAGE AT LAFAYETTE HILL 0 29 0% 2,738 $0.00 9/18/2017 MASONIC VILLAGE AT SEWICKLEY 0 38 0% 3,573 $0.00 9/18/2017 MASONIC VILLAGE AT WARMINSTER 0 25 0% 2,426 $0.00 9/18/2017 MAYBROOK HILLS REHAB & HEALTHCARE CENTER 3 162 2% 15,082 $0.00 9/18/2017 MCMURRAY HILLS MANOR 0 85 0% 7,582 $0.00 9/18/2017 MEADOW VIEW HEALTHCARE & REHAB CENTER 0 36 0% 3,388 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date MEADOW VIEW NURSING CENTER 0 106 0% 9,710 $0.00 9/18/2017 MEADOWCREST NURSING CENTER 0 32 0% 3,087 $0.00 9/18/2017 MEADOWS NURSING AND REHAB CENTER 0 73 0% 7,015 $0.00 9/18/2017 MEADOWVIEW REHAB & NURSING CENTER 0 173 0% 16,021 $0.00 9/18/2017 MENNONITE HOME, THE 0 54 0% 5,153 $0.00 9/18/2017 MERCY CENTER NURSING UNIT, INC 0 36 0% 3,362 $0.00 9/18/2017 MESSIAH LIFEWAYS AT MESSIAH VILLAGE 0 57 0% 5,439 $0.00 9/18/2017 MEYERSDALE HEALTHCARE AND REHAB CTR 1 60 2% 5,531 $0.00 9/18/2017 MID VALLEY HEALTH CARE CENTER 0 21 0% 1,918 $0.00 9/18/2017 MIFFLIN CENTER 0 72 0% 7,142 $0.00 9/18/2017 MILFORD HEALTHCARE AND REHAB CENTER 0 54 0% 5,004 $0.00 9/18/2017 MILLCREEK MANOR 0 88 0% 7,999 $0.00 9/18/2017 MILTON REHABILITATION AND NURSING CENTER 1 86 1% 7,760 $0.00 9/18/2017 MISERICORDIA NURSING & REHAB CENTER 0 17 0% 1,653 $0.00 9/18/2017 MON VALLEY CARE CENTER 0 26 0% 2,383 $0.00 9/18/2017 MONROEVILLE REHAB & WELLNESS CENTER 0 74 0% 6,918 $0.00 9/18/2017 MORAVIAN HALL SQ. HLTH AND WELLNESS CTR 0 2 0% 318 $0.00 9/18/2017 MORAVIAN MANOR 0 33 0% 3,005 $0.00 9/18/2017 MORRISONS COVE HOME 0 73 0% 6,783 $0.00 9/18/2017 MOSSER NURSING HOME 0 36 0% 3,409 $0.00 9/18/2017 MOUNT CARMEL NURSING AND REHAB CENTER 0 90 0% 7,800 $0.00 9/18/2017 MOUNT HOPE NAZARENE RETIREMENT COMMUNITY 0 36 0% 3,261 $0.00 9/18/2017 MOUNT MACRINA MANOR NURSING HOME 0 65 0% 6,065 $0.00 9/18/2017 MOUNTAIN CITY NURSING AND REHAB CENTER 1 223 0% 20,303 $0.00 9/18/2017 MOUNTAIN LAUREL NRC 0 163 0% 14,095 $0.00 9/18/2017 MOUNTAIN TOP HEALTHCARE AND REHAB CTR 0 75 0% 6,839 $0.00 9/18/2017 MOUNTAIN VIEW CARE CENTER 1 100 1% 7,424 $0.00 9/18/2017 MOUNTAIN VIEW, A NURSING AND REHAB CTR 0 184 0% 16,251 $0.00 9/18/2017 MOUNTAINVIEW SPECIALTY CARE CENTER 14 75 19% 6,992 $17,410.08 9/18/2017 MT. LEBANON REHAB AND WELLNESS CENTER 0 57 0% 5,450 $0.00 9/18/2017 MULBERRY HEALTHCARE & REHAB CTR 0 50 0% 4,228 $0.00 9/18/2017 MURRYSVILLE REHAB & WELLNESS CENTER 1 72 1% 6,459 $0.00 9/18/2017 NAAMANS CREEK COUNTRY MANOR 1 40 3% 4,088 $0.00 9/18/2017 NESHAMINY MANOR HOME 0 272 0% 25,456 $0.00 9/18/2017 NEW EASTWOOD HEALTHCARE AND REHAB CENTER 1 39 3% 3,794 $0.00 9/18/2017 NORMANDIE RIDGE 0 29 0% 2,713 $0.00 9/18/2017 NORRITON SQUARE NURSING & REHAB CENTER 1 57 2% 5,641 $0.00 9/18/2017 NORTH HILLS HEALTH AND REHAB CENTER 0 30 0% 3,105 $0.00 9/18/2017 NOTTINGHAM VILLAGE 0 57 0% 5,219 $0.00 9/18/2017 NUGENT CONVALESCENT HOME 0 71 0% 6,719 $0.00 9/18/2017 NURSING & REHABILITATION AT THE MANSION 0 44 0% 4,540 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date OAK HILL NURSING AND REHAB CENTER 0 26 0% 2,361 $0.00 9/18/2017 OAKMONT CENTER FOR NURSING AND REHAB 0 51 0% 4,619 $0.00 9/18/2017 OAKWOOD HEALTHCARE & REHABILITATION CTR 2 90 2% 8,229 $0.00 9/18/2017 OAKWOOD HEIGHTS OF PRESBY SENIOR CARE 0 56 0% 5,081 $0.00 9/18/2017 OHESSON MANOR 1 89 1% 8,232 $0.00 9/18/2017 OIL CITY HEALTHCARE AND REHAB CENTER 0 62 0% 5,516 $0.00 9/18/2017 OLD ORCHARD HEALTH CARE CENTER 1 103 1% 10,030 $0.00 9/18/2017 ORCHARD MANOR, INC 0 77 0% 6,976 $0.00 9/18/2017 ORWIGSBURG CENTER 0 76 0% 7,535 $0.00 9/18/2017 OXFORD HEALTH CENTER 0 62 0% 6,592 $0.00 9/18/2017 PARK AVENUE REHAB CENTER 4 109 4% 9,800 $0.00 9/18/2017 PARKHOUSE REHABILITATION AND NURSING CTR 1 294 0% 27,823 $0.00 9/18/2017 PASSAVANT RETIREMENT AND HEALTH CENTER 0 53 0% 4,981 $0.00 9/18/2017 PAUL'S RUN 0 47 0% 4,594 $0.00 9/18/2017 PAVILION AT BRMC 0 54 0% 4,937 $0.00 9/18/2017 PEMBROOKE HEALTH AND REHAB CENTER 0 123 0% 11,264 $0.00 9/18/2017 PENN CENTER FOR REHABILITATION AND CARE 0 84 0% 7,739 $0.00 9/18/2017 PENNKNOLL VILLAGE 1 99 1% 8,958 $0.00 9/18/2017 PENNSBURG MANOR 0 73 0% 7,117 $0.00 9/18/2017 PENNYPACK CENTER 0 29 0% 2,420 $0.00 9/18/2017 PETER BECKER COMMUNITY 0 15 0% 1,552 $0.00 9/18/2017 PHILADELPHIA NURSING HOME 8 348 2% 32,413 $0.00 9/18/2017 PHILADELPHIA PROTESTANT HOME 0 63 0% 5,761 $0.00 9/18/2017 PHOEBE ALLENTOWN HEALTH CARE 0 187 0% 17,984 $0.00 9/18/2017 PHOEBE BERKS HEALTH CARE CENTER, INC 0 26 0% 2,421 $0.00 9/18/2017 PHOEBE RICHLAND HCC 0 69 0% 6,410 $0.00 9/18/2017 PHOEBE WYNCOTE 0 26 0% 2,968 $0.00 9/18/2017 PHOENIXVILLE CARE AND REHABILITATION CTR 0 70 0% 6,010 $0.00 9/18/2017 PICKERING MANOR HOME 0 16 0% 1,451 $0.00 9/18/2017 PINE RUN HEALTH CENTER 1 16 6% 1,861 $0.00 9/18/2017 PINECREST MANOR 0 81 0% 7,100 $0.00 9/18/2017 PLATINUM RIDGE CTR FOR REHAB & HEALING 0 57 0% 5,846 $0.00 9/18/2017 PLEASANT ACRES NURSING AND REHAB CENTER 8 302 3% 28,319 $0.00 9/18/2017 PLEASANT RIDGE MANOR WEST 4 218 2% 21,510 $0.00 9/18/2017 PLEASANT VALLEY MANOR, INC 0 126 0% 11,886 $0.00 9/18/2017 PLEASANT VIEW RETIREMENT COMMUNITY 0 56 0% 5,126 $0.00 9/18/2017 POCOPSON HOME 0 214 0% 19,575 $0.00 9/18/2017 POWERBACK REHABILITATION 1526 0 43 0% 3,319 $0.00 9/18/2017 POWERBACK REHABILITATION 3485 0 23 0% 1,533 $0.00 9/18/2017 PREMIER ARMSTRONG REHAB & NSG FACILITY 0 65 0% 6,112 $0.00 9/18/2017 PRESBYTERIAN HOMES‐PRESBYTERY‐HUNTINGDON 0 26 0% 2,499 $0.00 9/18/2017 PROSPECT PARK HEALTH AND REHAB CENTER 14 116 12% 9,581 $9,485.19 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date PROVIDENCE CARE CENTER 0 127 0% 11,509 $0.00 9/18/2017 QUAKERTOWN CENTER 0 77 0% 8,817 $0.00 9/18/2017 QUARRYVILLE PRESBYTERIAN RETIREMENT COMM 0 47 0% 4,213 $0.00 9/18/2017 QUINCY RETIREMENT COMMUNITY 0 74 0% 7,502 $0.00 9/18/2017 REDSTONE HIGHLANDS HEALTH CARE CENTER 0 36 0% 3,432 $0.00 9/18/2017 REFORMED PRESBYTERIAN HOME 0 32 0% 1,824 $0.00 9/18/2017 REGINA COMMUNITY NURSING CENTER 0 84 0% 7,797 $0.00 9/18/2017 REHAB & NURSING CTR GREATER PITTSBURGH 0 41 0% 3,998 $0.00 9/18/2017 RENAISSANCE HEALTHCARE & REHAB CENTER 0 70 0% 6,351 $0.00 9/18/2017 REST HAVEN‐YORK 0 78 0% 6,660 $0.00 9/18/2017 RICHBORO REHABILITATION & NURSING CENTER 0 55 0% 4,938 $0.00 9/18/2017 RICHFIELD HEALTHCARE AND REHAB CENTER 0 26 0% 2,476 $0.00 9/18/2017 RICHLAND HEALTHCARE AND REHAB CENTER 0 46 0% 4,636 $0.00 9/18/2017 RIDGEVIEW HEALTHCARE & REHAB CENTER 1 83 1% 7,580 $0.00 9/18/2017 RIDGEVIEW HEALTHCARE & REHAB CENTER 0 64 0% 5,988 $0.00 9/18/2017 RIVER RUN REHAB AND NURSING CENTER 1 66 2% 5,568 $0.00 9/18/2017 RIVER'S EDGE NURSING AND REHAB CENTER 0 75 0% 6,832 $0.00 9/18/2017 RIVERSIDE CARE CENTER 0 83 0% 6,868 $0.00 9/18/2017 RIVERSIDE REHABILITATION AND NURSING CTR 0 107 0% 9,658 $0.00 9/18/2017 RIVERSTREET MANOR 2 75 3% 7,542 $0.00 9/18/2017 RIVERWOODS 0 78 0% 7,043 $0.00 9/18/2017 ROCHESTER MANOR 0 58 0% 3,844 $0.00 9/18/2017 ROLLING FIELDS, INC 0 124 0% 11,069 $0.00 9/18/2017 ROLLING HILLS HEALTHCARE & REHAB CENTER 0 40 0% 3,943 $0.00 9/18/2017 ROLLING MEADOWS 0 78 0% 7,097 $0.00 9/18/2017 ROSE VIEW CENTER 0 81 0% 7,586 $0.00 9/18/2017 ROSEMONT CARE AND REHABILITATION CENTER 0 52 0% 4,773 $0.00 9/18/2017 ROSEWOOD REHABILITATION & NURSING CENTER 0 109 0% 10,164 $0.00 9/18/2017 ROUSE WARREN COUNTY HOME 0 123 0% 11,248 $0.00 9/18/2017 RYDAL PARK OF PHILADELPHIA PRSBYTR HOMES 0 15 0% 1,447 $0.00 9/18/2017 SAINT ANNE HOME 0 51 0% 4,886 $0.00 9/18/2017 SAINT ANNE'S RETIREMENT COMMUNITY 0 38 0% 3,530 $0.00 9/18/2017 SAINT JOHN XXIII HOME 0 54 0% 4,798 $0.00 9/18/2017 SAINT JOSEPH VILLA 1 48 2% 4,596 $0.00 9/18/2017 SAINT MARY'S AT ASBURY RIDGE 0 35 0% 3,619 $0.00 9/18/2017 SAINT MARY'S EAST 0 76 0% 7,144 $0.00 9/18/2017 SAINT MARY'S VILLA NURSING HOME, INC 0 68 0% 6,088 $0.00 9/18/2017 SAINT PAUL HOMES 0 97 0% 9,318 $0.00 9/18/2017 SANATOGA CENTER 0 73 0% 7,344 $0.00 9/18/2017 SARAH A TODD MEMORIAL HOME 0 80 0% 7,204 $0.00 9/18/2017 SARAH REED SENIOR LIVING 0 49 0% 4,562 $0.00 9/18/2017 SAUNDERS HOUSE 2 80 3% 7,718 $0.00 9/18/2017 SAXONY HEALTH CENTER 0 37 0% 3,409 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date SAYRE HEALTH CARE CENTER, LLC 0 32 0% 2,920 $0.00 9/18/2017 SCENERY HILL HEALTHCARE & REHAB CENTER 0 35 0% 3,312 $0.00 9/18/2017 SCHUYLKILL CENTER 0 122 0% 11,945 $0.00 9/18/2017 SCOTTDALE HEALTHCARE & REHAB CENTER 0 15 0% 1,296 $0.00 9/18/2017 SCRANTON HEALTH CARE CENTER 0 22 0% 2,161 $0.00 9/18/2017 SENA‐KEAN MANOR 0 108 0% 9,721 $0.00 9/18/2017 SENECA PLACE 1 73 1% 6,977 $0.00 9/18/2017 SETON MANOR NURSING & REHABILITATION CTR 0 69 0% 6,347 $0.00 9/18/2017 SHENANDOAH MANOR NURSING CENTER 2 98 2% 8,866 $0.00 9/18/2017 SHENANGO PRESBYTERIAN SENIORCARE 0 3 0% 270 $0.00 9/18/2017 SHIPPENSBURG HEALTH CARE CENTER 0 70 0% 6,644 $0.00 9/18/2017 SHIPPENVILLE HEALTHCARE AND REHAB CENTER 1 55 2% 4,942 $0.00 9/18/2017 SHOOK HOME, THE 0 36 0% 3,385 $0.00 9/18/2017 SIEMONS' LAKEVIEW MANOR NSG AND REHAB 0 82 0% 7,346 $0.00 9/18/2017 SIGNATURE HEALTHCARE OF BLOOMSBURG REHAB 0 44 0% 3,967 $0.00 9/18/2017 SILVER LAKE CENTER 3 127 2% 11,252 $0.00 9/18/2017 SILVER STREAM CENTER 1 98 1% 8,739 $0.00 9/18/2017 SIMPSON HOUSE, INC 0 102 0% 9,387 $0.00 9/18/2017 SLATE BELT HEALTH AND REHAB CENTER 0 79 0% 7,245 $0.00 9/18/2017 SMITH HEALTH CARE, LTD 0 15 0% 1,432 $0.00 9/18/2017 SNYDER MEMORIAL HEALTH CARE CENTER 0 83 0% 7,230 $0.00 9/18/2017 SOMERTON CENTER 17 151 11% 15,029 $12,474.07 9/18/2017 SOUDERTON MENNONITE HOMES 0 25 0% 2,414 $0.00 9/18/2017 SOUTH FAYETTE NURSING CENTER 0 50 0% 4,488 $0.00 9/18/2017 SOUTH HILLS REHAB & WELLNESS CENTER 0 67 0% 5,679 $0.00 9/18/2017 SOUTHMONT OF PRESBYTERIAN SENIORCARE 0 79 0% 6,916 $0.00 9/18/2017 SOUTHWESTERN NURSING CARE CENTER 0 69 0% 6,594 $0.00 9/18/2017 SPANG CREST MANOR 0 44 0% 4,053 $0.00 9/18/2017 SPIRITRUST LUTHERAN VLG @ SHREWSBURY 0 55 0% 5,140 $0.00 9/18/2017 SPIRITRUST LUTHERAN VLG @ GETTYSBURG 0 49 0% 4,555 $0.00 9/18/2017 SPIRITRUST LUTHERAN VLG @ SPRENKLE DRIVE 0 41 0% 4,200 $0.00 9/18/2017 SPIRITRUST LUTHERAN VLG @ UTZ TERRACE 0 22 0% 2,013 $0.00 9/18/2017 SPRING CREEK REHAB AND NURSING CENTER 16 282 6% 25,365 $0.00 9/18/2017 SPRINGS AT THE WATERMARK, THE 0 25 0% 2,752 $0.00 9/18/2017 SPRUCE MANOR NURSING AND REHAB CENTER 2 146 1% 13,511 $0.00 9/18/2017 SQUIRREL HILL CTR FOR REHAB AND HEALING 1 95 1% 9,758 $0.00 9/18/2017 ST FRANCIS CENTER FOR REHAB & HEALTHCARE 2 204 1% 18,255 $0.00 9/18/2017 ST JOHN NEUMANN CTR FOR REHAB & HLTHCARE 1 152 1% 14,312 $0.00 9/18/2017 ST JOHN SPECIALTY CARE CENTER 6 125 5% 9,981 $0.00 9/18/2017 ST JOSEPH'S MANOR (DBA ENTITY OF HRHS) 1 132 1% 13,382 $0.00 9/18/2017 ST LUKE'S REHABILITATION AND NURSING CTR 0 25 0% 2,363 $0.00 9/18/2017 ST MARTHA CENTER FOR REHAB & HEALTHCARE 0 64 0% 5,881 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date ST MARY CENTER FOR REHAB & HEALTHCARE 0 74 0% 6,488 $0.00 9/18/2017 ST MONICA CENTER FOR REHAB & HEALTHCARE 0 109 0% 10,076 $0.00 9/18/2017 ST. BARNABAS NURSING HOME 0 47 0% 4,551 $0.00 9/18/2017 ST. IGNATIUS NURSING & REHAB CENTER 2 127 2% 9,435 $0.00 9/18/2017 ST. LUKE'S VILLA 0 28 0% 2,583 $0.00 9/18/2017 STATESMAN HEALTH AND REHAB CENTER 14 63 22% 5,537 $18,493.58 9/18/2017 STENTON CARE AND REHABILITATION CENTER 0 66 0% 5,969 $0.00 9/18/2017 STERLING HEALTH CARE AND REHAB CENTER 3 130 2% 11,534 $0.00 9/18/2017 STONEBRIDGE HEALTH AND REHAB CENTER 0 34 0% 3,164 $0.00 9/18/2017 STONERIDGE POPLAR RUN 0 29 0% 2,730 $0.00 9/18/2017 STONERIDGE TOWNE CENTRE 0 71 0% 6,816 $0.00 9/18/2017 SUBURBAN WOODS HEALTH AND REHAB CENTER 0 79 0% 7,137 $0.00 9/18/2017 SUGAR CREEK REST 1 82 1% 7,557 $0.00 9/18/2017 SUGAR CREEK STATION SKILLED NSG & REHAB 0 82 0% 7,485 $0.00 9/18/2017 SUMMIT AT BLUE MOUNTAIN NURSING & REHAB 0 46 0% 4,671 $0.00 9/18/2017 SUNBURY COMMUNITY HEALTH & REHAB CENTER 0 13 0% 1,240 $0.00 9/18/2017 SUNNYVIEW NURSING AND REHABILITATION CTR 0 165 0% 14,812 $0.00 9/18/2017 SUSQUE VIEW HOME, INC 0 95 0% 8,526 $0.00 9/18/2017 SUSQUEHANNA HLTH SKILLED NSG & REHAB CTR 10 87 11% 8,085 $6,710.55 9/18/2017 SUSQUEHANNA VALLEY NURSING AND REHAB CTR 0 91 0% 10,101 $0.00 9/18/2017 SWAIM HEALTH CENTER 0 44 0% 4,130 $0.00 9/18/2017 SWEDEN VALLEY MANOR 0 82 0% 7,166 $0.00 9/18/2017 TEL HAI RETIREMENT COMMUNITY 0 51 0% 4,937 $0.00 9/18/2017 THE BELVEDERE CENTER, GENESIS HEALTHCARE 0 121 0% 11,345 $0.00 9/18/2017 THE COMMUNITY AT ROCKHILL 0 24 0% 2,071 $0.00 9/18/2017 THE GARDENS AT BUTLER 0 22 0% 2,015 $0.00 9/18/2017 THE GARDENS AT CAMPBELLTOWN 0 26 0% 2,692 $0.00 9/18/2017 THE GARDENS AT EAST MOUNTAIN 0 76 0% 6,811 $0.00 9/18/2017 THE GARDENS AT EASTON 0 147 0% 13,879 $0.00 9/18/2017 THE GARDENS AT LAKESIDE 1 19 5% 1,878 $0.00 9/18/2017 THE GARDENS AT LITITZ 0 18 0% 1,782 $0.00 9/18/2017 THE GARDENS AT MILLVILLE 0 70 0% 6,882 $0.00 9/18/2017 THE GARDENS AT ORANGEVILLE 1 78 1% 7,300 $0.00 9/18/2017 THE GARDENS AT PALMYRA 0 19 0% 2,244 $0.00 9/18/2017 THE GARDENS AT POTTSTOWN 0 28 0% 2,599 $0.00 9/18/2017 THE GARDENS AT STEVENS 2 57 4% 4,768 $0.00 9/18/2017 THE GARDENS AT TUNKHANNOCK 0 81 0% 7,521 $0.00 9/18/2017 THE GARDENS AT WYOMING VALLEY 0 80 0% 7,133 $0.00 9/18/2017 THE GARDENS FOR MEMORY CARE AT EASTON 0 86 0% 7,714 $0.00 9/18/2017 THE GROVE AT GREENVILLE 0 113 0% 10,568 $0.00 9/18/2017 THE GROVE AT HARMONY 1 78 1% 7,244 $0.00 9/18/2017 THE GROVE AT IRWIN 0 79 0% 6,806 $0.00 9/18/2017 THE GROVE AT LATROBE 0 91 0% 7,748 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date THE GROVE AT NEW CASTLE 0 45 0% 3,519 $0.00 9/18/2017 THE GROVE AT NEW WILMINGTON 1 74 1% 6,770 $0.00 9/18/2017 THE GROVE AT WASHINGTON 0 52 0% 4,748 $0.00 9/18/2017 THE MANOR AT PENN VILLAGE 0 110 0% 9,772 $0.00 9/18/2017 THE MANOR AT PERRY VILLAGE 0 71 0% 6,662 $0.00 9/18/2017 THE MANOR AT ST LUKE VILLAGE 0 72 0% 6,493 $0.00 9/18/2017 THE MANOR AT SUSQUEHANNA VILLAGE 0 117 0% 10,216 $0.00 9/18/2017 THE MEADOWS @ GETTYSBURG FOR NSG & REHAB 0 69 0% 6,466 $0.00 9/18/2017 THE MEADOWS @ STROUD FOR NSG & REHAB LLC 0 81 0% 7,783 $0.00 9/18/2017 THE MEADOWS @ WEST SHORE FOR NSG & REHAB 0 141 0% 13,226 $0.00 9/18/2017 THE MEADOWS AT BLUE RIDGE 0 71 0% 5,906 $0.00 9/18/2017 THE MEADOWS AT CAMP HILL FOR NSG & REHAB 0 60 0% 5,838 $0.00 9/18/2017 THE MEADOWS AT SCRANTON FOR NSG & REHAB 1 78 1% 6,977 $0.00 9/18/2017 THE MEADOWS AT YORK TERRACE 0 54 0% 5,001 $0.00 9/18/2017 THE PATRIOT, A CHOICE COMMUNITY 0 59 0% 5,241 $0.00 9/18/2017 THE PAVILION AT ST LUKE VILLAGE 0 81 0% 7,399 $0.00 9/18/2017 THORNWALD HOME 0 40 0% 3,659 $0.00 9/18/2017 TIMBER RIDGE HEALTH CENTER 1 132 1% 11,986 $0.00 9/18/2017 TITUSVILLE HEALTHCARE & REHAB CENTER 0 56 0% 4,671 $0.00 9/18/2017 TOWNE MANOR EAST 0 89 0% 8,111 $0.00 9/18/2017 TOWNE MANOR WEST 1 82 1% 7,694 $0.00 9/18/2017 TOWNVIEW HEALTH AND REHAB CENTER 0 66 0% 5,235 $0.00 9/18/2017 TRANSITIONS HEALTHCARE AUTUMN GROVE C C 0 86 0% 7,518 $0.00 9/18/2017 TRANSITIONS HEALTHCARE GETTYSBURG 0 89 0% 8,463 $0.00 9/18/2017 TRANSITIONS HEALTHCARE NORTH HUNTINGDON 0 70 0% 6,309 $0.00 9/18/2017 TRANSITIONS HEALTHCARE WASHINGTON PA 11 72 15% 6,463 $10,017.65 9/18/2017 TREMONT HEALTH AND REHABILITATION CENTER 1 126 1% 12,050 $0.00 9/18/2017 TRINITY LIVING CENTER 0 77 0% 6,629 $0.00 9/18/2017 TUCKER HOUSE NSG & REHAB CTR 2 137 1% 11,907 $0.00 9/18/2017 TWIN PINES HEALTH CARE CENTER 0 90 0% 8,127 $0.00 9/18/2017 UNIONTOWN HEALTHCARE & REHAB CENTER 0 70 0% 5,862 $0.00 9/18/2017 UNITED ZION RETIREMENT COMMUNITY 0 28 0% 2,614 $0.00 9/18/2017 UPMC HERITAGE PLACE 1 68 1% 5,624 $0.00 9/18/2017 VALENCIA WOODS AT ST BARNABAS 0 8 0% 1,225 $0.00 9/18/2017 VALLEY MANOR HEALTH AND REHAB CENTER 4 139 3% 12,520 $0.00 9/18/2017 VALLEY VIEW HAVEN, INC 0 87 0% 8,215 $0.00 9/18/2017 VALLEY VIEW NURSING CENTER 0 83 0% 7,328 $0.00 9/18/2017 VILLA SAINT JOSEPH OF BADEN INC. 0 56 0% 5,462 $0.00 9/18/2017 VILLAGE AT LUTHER SQUARE 0 83 0% 7,279 $0.00 9/18/2017 VILLAGE AT PENNWOOD 1 74 1% 6,324 $0.00 9/18/2017 VINCENTIAN DE MARILLAC 0 27 0% 2,795 $0.00 9/18/2017
Paid Facility # MA and Vents‐ Therapeutic Trach # MA Days for
2/1/2017 2/1/2017 % MA Quarter Total Vent‐Picture Picture Vents‐ Ending Trach
Name Date Date Trach 3/31/2017 Payment RA Date VINCENTIAN HOME 0 75 0% 7,075 $0.00 9/18/2017 WALNUT CREEK HEALTHCARE & REHAB CENTER 1 58 2% 5,333 $0.00 9/18/2017 WARREN MANOR 1 55 2% 4,811 $0.00 9/18/2017 WASHINGTON COUNTY HEALTH CENTER 0 209 0% 18,910 $0.00 9/18/2017 WATSONTOWN REHABILITATION AND NRSG CTR 0 73 0% 6,742 $0.00 9/18/2017 WAYNE CENTER 1 70 1% 6,187 $0.00 9/18/2017 WAYNE WOODLANDS MANOR 0 64 0% 6,039 $0.00 9/18/2017 WAYNESBURG HEALTHCARE & REHAB CENTER 1 68 1% 6,180 $0.00 9/18/2017 WEATHERWOOD HEALTHCARE AND REHAB CTR 0 144 0% 13,806 $0.00 9/18/2017 WESBURY UNITED METHODIST COMMUNITY 0 124 0% 11,738 $0.00 9/18/2017 WESLEY ENHANCED LIVING AT STAPELEY 0 76 0% 7,445 $0.00 9/18/2017 WESLEY ENHANCED LIVING MAIN LINE REHAB 0 22 0% 1,998 $0.00 9/18/2017 WESLEY ENHANCED LIVING PENNYPACK PARK 1 64 2% 6,244 $0.00 9/18/2017 WESLEY ENHANCED LIVING‐DOYLESTOWN 0 29 0% 2,667 $0.00 9/18/2017 WESLEY VILLAGE 0 104 0% 10,026 $0.00 9/18/2017 WEST HAVEN MANOR 1 104 1% 9,707 $0.00 9/18/2017 WEST HILLS HEALTH AND REHAB CENTER 0 77 0% 7,276 $0.00 9/18/2017 WESTERN RESERVE HEALTHCARE & REHAB CTR 2 75 3% 6,777 $0.00 9/18/2017 WESTGATE REHABILITATION AND NURSING CTR 0 60 0% 5,863 $0.00 9/18/2017 WESTMINSTER VILLAGE 0 77 0% 7,154 $0.00 9/18/2017 WESTMINSTER WOODS AT HUNTINGDON 0 28 0% 2,747 $0.00 9/18/2017 WESTMONT WOODS 0 25 0% 2,443 $0.00 9/18/2017 WESTMORELAND MANOR 0 309 0% 29,031 $0.00 9/18/2017 WESTON REHABILITATION AND NURSING CENTER 0 22 0% 2,320 $0.00 9/18/2017 WEXFORD HEALTHCARE CENTER 1 99 1% 9,618 $0.00 9/18/2017 WHITESTONE CARE CENTER 0 39 0% 3,495 $0.00 9/18/2017 WILLIAM PENN CARE CENTER 3 78 4% 7,010 $0.00 9/18/2017 WILLIAM PENN HEALTHCARE & REHAB CENTER 0 64 0% 6,688 $0.00 9/18/2017 WILLIAMSPORT HOME, THE 0 64 0% 5,710 $0.00 9/18/2017 WILLOW TERRACE 0 122 0% 11,470 $0.00 9/18/2017 WILLOWBROOKE COURT AT BRITTANY POINTE 0 5 0% 270 $0.00 9/18/2017 WILLOWCREST 1 2 50% 203 $0.00 9/18/2017 WILLOWS OF PRESBYTERIAN SENIORCARE, THE 0 86 0% 7,931 $0.00 9/18/2017 WINDY HILL VILLAGE OF PRESBYTERIAN HOMES 0 80 0% 8,098 $0.00 9/18/2017 WOODHAVEN CARE CENTER 0 82 0% 8,076 $0.00 9/18/2017 WOODLAND PARK REHAB CENTER 0 85 0% 7,436 $0.00 9/18/2017 WYOMISSING HEALTH AND REHABILITATION CTR 0 64 0% 6,478 $0.00 9/18/2017 YORK NURSING AND REHABILITATION CENTER 1 184 1% 17,068 $0.00 9/18/2017 ZERBE SISTERS NURSING CENTER, INC. 0 56 0% 5,069 $0.00 9/18/2017