abcef g d zip year of initial nursing facility name ......abcef g nursing facility name medicaid...

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A B C E F G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial Construction BRADEN RIVER CARE CENTER 005021 2010 MANATEE AVENUE, E. BRADENTON FL 34208 342 1964 BRADENTON HEALTH CARE 252069 6305 CORTEZ ROAD WEST BRADENTON FL 34210 342 1999 CASA MORA REHAB. & EXTENDED CARE 263885 1902 59TH STREET W BRADENTON FL 34209 342 1978 GREENBRIAR REHABILITATION AND NURSING CENTER 227625 210 21ST AVENUE WEST BRADENTON FL 34205 342 1982 HERITAGE PARK CARE AND REHABILITATION CENTER 324345 2302 59TH STREET WEST BRADENTON FL 34209 342 1985 LIFE CARE CENTER OF SARASOTA 223786 8104 NORTH TUTTLE AVENUE SARASOTA FL 34243 342 2000 NURSING CENTER AT FREEDOM VILLAGE, THE 317195 6410 21ST AVENUE W. BRADENTON FL 34209 342 1989 RIVERFRONT NURSING & REHABILITATION CENTER 259942 105 15TH STREET, EAST BRADENTON FL 34208 342 1972 RIVIERA PALMS REHABILITATION CENTER 263451 926 HABEN BLVD. PALMETTO FL 34221 342 1988 SURREY PLACE HEALTHCARE AND REHABILITATION 256277 5525 21ST AVENUE W. BRADENTON FL 34209 342 1989 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422 1700 21ST AVENUE WEST BRADENTON FL 34205 342 1970 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815 1533 4TH AVENUE WEST BRADENTON FL 34205 342 1967 WOODS OF MANATEE SPRINGS, THE 316610 5627 9TH STREET EAST BRADENTON FL 34203 342 1985 BAY VILLAGE OF SARASOTA 999923 8400 VAMO ROAD SARASOTA FL 34231 342 BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896 741 S. BENEVA ROAD SARASOTA FL 34232 342 1982 CONSULATE HEALTH CARE OF SARASOTA 320137 4783 FRUITVILLE ROAD SARASOTA FL 34232 342 1998 GLENRIDGE ON PALMER RANCH INC. 999892 7333 SCOTLAND WAY SARASOTA FL 34238 342 HARBORCHASE OF VENICE 213322 950 PINEBROOK ROAD VENICE FL 34292 342 1997 HARMONY HEALTHCARE AND REHABILITATION CENTER 317136 2600 COURTLAND STREET SARASOTA FL 34237 342 2006 HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925 5401 SAWYER RD SARASOTA FL 34233 342 HERITAGE HEALTH CARE CENTER 252271 1026 ALBEE FARM RD VENICE FL 34292 342 1983 INN AT SARASOTA BAY CLUB 228621 1303 N TAMIAMI TRAIL SARASOTA FL 34236 342 2001 J H FLOYD SUNSHINE MANOR 202681 1755 18TH STREET SARASOTA FL 34234 342 1970 KENSINGTON MANOR 325490 3250 12TH STREET SARASOTA FL 34237 342 1969 MAGNOLIA HEALTH AND REHABILITATION CENTER 252182 1507 S TUTTLE AVE SARASOTA FL 34239 342 1994 MANORCARE HEALTH SERVICES 325473 1450 EAST VENICE AVENUE VENICE FL 34292 342 1997 MANORCARE HEALTH SERVICES SARASOTA 325465 5511 SWIFT ROAD SARASOTA FL 34231 342 1983 PALMER RANCH HEALTHCARE AND REHABILITATION 319244 5111 PALMER RANCH PARKWAY SARASOTA FL 34238 342 1999 PINEBROOK CARE AND REHABILITATION CENTER 252662 1240 PINEBROOK ROAD VENICE FL 34292 342 1985 PINES OF SARASOTA 202703 1501 N ORANGE AVE SARASOTA FL 34236 342 1970 PLYMOUTH HARBOR INCORPORATED 999922 700 JOHN RINGLING BLVD. SARASOTA FL 34236 342 QUALITY HEALTH OF NORTH PORT 225053 6940 OUTREACH WAY NORTH PORT FL 34287 342 1985 SARASOTA HEALTH AND REHABILITATION CENTER 263982 1524 EAST AVENUE SOUTH SARASOTA FL 34239 342 1971 SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355 5640 RAND BLVD. SARASOTA FL 34238 342 1987 SPRINGS AT LAKE POINTE WOODS 268780 3280 LAKE POINTE BLVD SARASOTA FL 34231 342 1986 SPRINGWOOD CARE AND REHABILITATION CENTER 253014 4602 NORTHGATE COURT SARASOTA FL 34234 342 1982 SUNNYSIDE NURSING HOME 202711 5201 BAHIA VISTA STREET SARASOTA FL 34232 342 1970 SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501 832 SUNSET LAKE BOULEVARD VENICE FL 34292 342 1992 TARPON POINT NURSING AND REHABILITATION CENTER 323781 5157 PARK CLUB DRIVE SARASOTA FL 34235 342 1990 VILLAGE ON THE ISLE 210463 910 TAMIAMI TRAIL SOUTH VENICE FL 34285 342 1984 CALUSA HARBOUR HEALTH CENTER 221473 2525 E FIRST ST FORT MYERS FL 33901 339 1984 CITRUS GARDENS OF FORT MYERS 318787 7173 CYPRESS DRIVE S.W. FORT MYERS FL 33907 339 (239) 936-0203 (239) 936-9544 1983 CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111 991 PONDELLA ROAD FORT MYERS FL 33903 339 1985 CORAL TRACE HEALTH CARE 252107 216 SANTA BARBARA BLVD CAPE CORAL FL 33991 339 1987 EVANS HEALTH CARE 252212 3735 EVANS AVE FORT MYERS FL 33901 339 1998 GULF COAST VILLAGE CARE CENTER 201120 1333 SANTA BARBARA BLVD. CAPE CORAL FL 33991 339 1989 HEALTHPARK CARE CENTER, INC. 210587 16131 ROSERUSH COURT FORT MYERS FL 33908 339 1992 HEARTLAND HEALTH CARE CENTER FORT MYERS 325325 1600 MATTHEW DRIVE FORT MYERS FL 33907 339 1990 HERITAGE PARK REHABILITATION AND HEALTHCARE 252344 2826 CLEVELAND AVE FORT MYERS FL 33901 339 1981 D Page 1 of 250

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Page 1: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B C E F G

Nursing Facility NameMedicaid Provider Number

Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Construction

BRADEN RIVER CARE CENTER 005021 2010 MANATEE AVENUE, E. BRADENTON FL 34208 342 1964BRADENTON HEALTH CARE 252069 6305 CORTEZ ROAD WEST BRADENTON FL 34210 342 1999CASA MORA REHAB. & EXTENDED CARE 263885 1902 59TH STREET W BRADENTON FL 34209 342 1978GREENBRIAR REHABILITATION AND NURSING CENTER 227625 210 21ST AVENUE WEST BRADENTON FL 34205 342 1982HERITAGE PARK CARE AND REHABILITATION CENTER 324345 2302 59TH STREET WEST BRADENTON FL 34209 342 1985LIFE CARE CENTER OF SARASOTA 223786 8104 NORTH TUTTLE AVENUE SARASOTA FL 34243 342 2000NURSING CENTER AT FREEDOM VILLAGE, THE 317195 6410 21ST AVENUE W. BRADENTON FL 34209 342 1989RIVERFRONT NURSING & REHABILITATION CENTER 259942 105 15TH STREET, EAST BRADENTON FL 34208 342 1972RIVIERA PALMS REHABILITATION CENTER 263451 926 HABEN BLVD. PALMETTO FL 34221 342 1988SURREY PLACE HEALTHCARE AND REHABILITATION 256277 5525 21ST AVENUE W. BRADENTON FL 34209 342 1989WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422 1700 21ST AVENUE WEST BRADENTON FL 34205 342 1970WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815 1533 4TH AVENUE WEST BRADENTON FL 34205 342 1967WOODS OF MANATEE SPRINGS, THE 316610 5627 9TH STREET EAST BRADENTON FL 34203 342 1985BAY VILLAGE OF SARASOTA 999923 8400 VAMO ROAD SARASOTA FL 34231 342BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896 741 S. BENEVA ROAD SARASOTA FL 34232 342 1982CONSULATE HEALTH CARE OF SARASOTA 320137 4783 FRUITVILLE ROAD SARASOTA FL 34232 342 1998GLENRIDGE ON PALMER RANCH INC. 999892 7333 SCOTLAND WAY SARASOTA FL 34238 342HARBORCHASE OF VENICE 213322 950 PINEBROOK ROAD VENICE FL 34292 342 1997HARMONY HEALTHCARE AND REHABILITATION CENTER 317136 2600 COURTLAND STREET SARASOTA FL 34237 342 2006HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925 5401 SAWYER RD SARASOTA FL 34233 342HERITAGE HEALTH CARE CENTER 252271 1026 ALBEE FARM RD VENICE FL 34292 342 1983INN AT SARASOTA BAY CLUB 228621 1303 N TAMIAMI TRAIL SARASOTA FL 34236 342 2001J H FLOYD SUNSHINE MANOR 202681 1755 18TH STREET SARASOTA FL 34234 342 1970KENSINGTON MANOR 325490 3250 12TH STREET SARASOTA FL 34237 342 1969MAGNOLIA HEALTH AND REHABILITATION CENTER 252182 1507 S TUTTLE AVE SARASOTA FL 34239 342 1994MANORCARE HEALTH SERVICES 325473 1450 EAST VENICE AVENUE VENICE FL 34292 342 1997MANORCARE HEALTH SERVICES SARASOTA 325465 5511 SWIFT ROAD SARASOTA FL 34231 342 1983PALMER RANCH HEALTHCARE AND REHABILITATION 319244 5111 PALMER RANCH PARKWAY SARASOTA FL 34238 342 1999PINEBROOK CARE AND REHABILITATION CENTER 252662 1240 PINEBROOK ROAD VENICE FL 34292 342 1985PINES OF SARASOTA 202703 1501 N ORANGE AVE SARASOTA FL 34236 342 1970PLYMOUTH HARBOR INCORPORATED 999922 700 JOHN RINGLING BLVD. SARASOTA FL 34236 342QUALITY HEALTH OF NORTH PORT 225053 6940 OUTREACH WAY NORTH PORT FL 34287 342 1985SARASOTA HEALTH AND REHABILITATION CENTER 263982 1524 EAST AVENUE SOUTH SARASOTA FL 34239 342 1971SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355 5640 RAND BLVD. SARASOTA FL 34238 342 1987SPRINGS AT LAKE POINTE WOODS 268780 3280 LAKE POINTE BLVD SARASOTA FL 34231 342 1986SPRINGWOOD CARE AND REHABILITATION CENTER 253014 4602 NORTHGATE COURT SARASOTA FL 34234 342 1982SUNNYSIDE NURSING HOME 202711 5201 BAHIA VISTA STREET SARASOTA FL 34232 342 1970SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501 832 SUNSET LAKE BOULEVARD VENICE FL 34292 342 1992TARPON POINT NURSING AND REHABILITATION CENTER 323781 5157 PARK CLUB DRIVE SARASOTA FL 34235 342 1990VILLAGE ON THE ISLE 210463 910 TAMIAMI TRAIL SOUTH VENICE FL 34285 342 1984CALUSA HARBOUR HEALTH CENTER 221473 2525 E FIRST ST FORT MYERS FL 33901 339 1984CITRUS GARDENS OF FORT MYERS 318787 7173 CYPRESS DRIVE S.W. FORT MYERS FL 33907 339 (239) 936-0203 (239) 936-9544 1983CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111 991 PONDELLA ROAD FORT MYERS FL 33903 339 1985CORAL TRACE HEALTH CARE 252107 216 SANTA BARBARA BLVD CAPE CORAL FL 33991 339 1987EVANS HEALTH CARE 252212 3735 EVANS AVE FORT MYERS FL 33901 339 1998GULF COAST VILLAGE CARE CENTER 201120 1333 SANTA BARBARA BLVD. CAPE CORAL FL 33991 339 1989HEALTHPARK CARE CENTER, INC. 210587 16131 ROSERUSH COURT FORT MYERS FL 33908 339 1992HEARTLAND HEALTH CARE CENTER FORT MYERS 325325 1600 MATTHEW DRIVE FORT MYERS FL 33907 339 1990HERITAGE PARK REHABILITATION AND HEALTHCARE 252344 2826 CLEVELAND AVE FORT MYERS FL 33901 339 1981

D

Page 1 of 250

Page 2: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B C E F G

Nursing Facility NameMedicaid Provider Number

Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Construction

D

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978 1550 LEE BLVD. LEHIGH ACRES FL 33936 339 1986LIFE CARE CENTER OF ESTERO 265381 3850 WILLIAMS ROAD ESTERO FL 33928 339 2003LODGE AT CYPRESS COVE, THE 999878 10500 CYPRESS COVE DR FORT MYERS FL 33908 339MANORCARE HEALTH SERVICES 325384 13881 EAGLE RIDGE DRIVE FORT MYERS FL 33912 339 1999REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869 2629 DEL PRADO BLVD CAPE CORAL FL 33904 339 1979SHADY REST CARE PAVILION 213900 2310 N. AIRPORT ROAD FORT MYERS FL 33907 339 1970SHELL POINT NURSING PAVILION 229202 15071 SHELL POINT BLVD. FORT MYERS FL 33908 339 1971SIGNATURE HEALTHCARE AT COLLEGE PARK 324370 13755 GOLF CLUB PKWY FORT MYERS FL 33919 339 1981WINKLER COURT 264008 3250 WINKLER AVENUE EXTENSION FORT MYERS FL 33916 339 1995AVANTE AT ORMOND BEACH, INC. 252034 170 N. KINGS ROAD ORMOND BEACH FL 32174 321 1968BISHOPS GLEN RETIREMENT CENTER 209511 900 LPGA BLVD. HOLLY HILL FL 32117 321 1986BRIDGEVIEW CENTER 260371 350 S. RIDGEWOOD AVENUE ORMOND BEACH FL 32174 321 1982CATALINA HEALTH CARE CENTER 283134 820 N. CLYDE MORRIS BLVD. DAYTONA BEACH FL 32117 321 1987CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789 130 W ARMSTRONG AVENUE DELAND FL 32720 327 1971COQUINA CENTER 260649 170 N. CENTER STREET ORMOND BEACH FL 32174 321 1987DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743 1055 3RD STREET DAYTONA BEACH FL 32117 321 1977DEBARY MANOR 005372 60 N HWY 17/92 DEBARY FL 32713 327 (386) 668-4426 (386) 668-4474 1983DELTONA HEALTH CARE 252158 1851 ELKCAM BLVD. DELTONA FL 32725 327 1983EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889 1920 MASON AVENUE DAYTONA BEACH FL 32117 321 1993GOOD SAMARITAN SOCIETY-DAYTONA 204391 325 S. SEGRAVE STREET DAYTONA BEACH FL 32114 321 1975GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792 450 NORTH MCDONALD AVENUE DELAND FL 32724 327 1997HEALTH CENTER OF DAYTONA BEACH, THE 229091 550 NATIONAL HEALTHCARE DRIVE DAYTONA BEACH FL 32114 321 1996HORIZON HEALTHCARE CENTER AT DAYTONA 223905 1350 S. NOVA ROAD DAYTONA BEACH FL 32114 321 1983INDIGO MANOR 258750 595 WILLIAMSON BLVD. DAYTONA BEACH FL 32114 321 1987JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000 901 VETERAN'S MEMORIAL PARKWAY ORANGE CITY FL 32763 327 2003MANOR ON THE GREEN 213527 324 WILDER BLVD DAYTONA BEACH FL 32114 321 (386) 252-2600 (386) 252-2660 1981OAKTREE HEALTHCARE 252476 650 REED CANAL ROAD SOUTH DAYTONA FL 32119 321 1981OAKWOOD GARDEN OF DELAND 005547 451 S AMELIA AVE DELAND FL 32724 327 (386) 734-8614 (386) 738-2616 1978OCEAN VIEW NURSING & REHABILITATION CENTER 226351 2810 SOUTH ATLANTIC AVENUE NEW SMYRNA BEACH FL 32169 321 1980ORANGE CITY NURSING AND REHAB CENTER 263567 2810 ENTERPRISE RD DEBARY FL 32713 327 1991PORT ORANGE NURSING AND REHAB CENTER 263508 5600 VICTORIA GARDENS BLVD. PORT ORANGE FL 32127 321 1992RIDGECREST NURSING AND REHABILITATION CENTER 282464 1200 NORTH STONE STREET DELAND FL 32720 327 1982SANDALWOOD NURSING CENTER 312045 1001 S. BEACH STREET DAYTONA BEACH FL 32114 321 1968SIGNATURE HEALTHCARE OF ORMOND 324442 103 NORTH CLYDE MORRIS BLVD. ORMOND BEACH FL 32174 321 1984TERRACE OF DAYTONA BEACH, LLC 282553 1704 HUNTINGTON VILLAGE CIRCLE DAYTONA BEACH FL 32114 321 1998UNIVERSITY CENTER EAST 212873 991 EAST NEW YORK AVENUE DELAND FL 32724 327 1972UNIVERSITY CENTER WEST 212831 545 WEST EUCLID AVENUE DELAND FL 32720 327 1972WOODLAND TERRACE EXTENDED CARE CENTER 212636 120 CHIPOLA AVENUE DELAND FL 32730 327 1996ALEXANDER NININGER STATE VETERANS NURSING HOME 229849 8401 W CYPRESS DR. PEMBROKE PINES FL 33025 330 2001BROWARD INSTITUTE FOR LONG TERM CARE 263851 401 EAST SAMPLE ROAD POMPANO BEACH FL 33064 330 1978BROWARD NURSING & REHABILITATION CENTER 226335 1330 S ANDREWS AVE FORT LAUDERDALE FL 33316 333 1970CHILDRENS COMPREHENSIVE CARE CENTER INC 312789 200 SE 19TH AVENUE POMPANO BEACH FL 33060 330 1992COURT AT PALM AIRE, THE 318795 2701 N. COURSE DRIVE POMPANO BEACH FL 33069 330 1988COVENANT VILLAGE CARE CENTER 210188 9211 W BROWARD BLVD PLANTATION FL 33324 333 1988CROSS POINTE CARE CENTER 001281 440 PHIPPEN WAITERS ROAD DANIA BEACH FL 33004 330 1984FORUM AT DEER CREEK 253481 3001 DEER CREEK COUNTRY CLUB DEERFIELD BEACH FL 33442 334 1990FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303 2000 EAST COMMERCIAL BLVD. FORT LAUDERDALE FL 33308 333 1984GOLFCREST HEALTHCARE CENTER 262064 600 NORTH 17TH AVENUE HOLLYWOOD FL 33020 330 1980HARBOR BEACH NURSING AND REHABILITATION CENTER 252255 1615 S. MIAMI ROAD FORT LAUDERDALE FL 33316 333 1984HEALTH CENTER OF COCONUT CREEK, THE 226581 4125 WEST SAMPLE RD COCONUT CREEK FL 33073 330 1997HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333 2599 NW 55TH AVE LAUDERHILL FL 33313 333 1989HEARTLAND OF TAMARAC 325350 5901 N.W. 79TH AVENUE TAMARAC FL 33321 333 1988

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Page 3: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B C E F G

Nursing Facility NameMedicaid Provider Number

Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Construction

D

HILLCREST NURSING AND REHABILITATION CENTER 252531 4200 WASHINGTON STREET HOLLYWOOD FL 33021 330 1986HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424 1200 NORTH 35TH AVENUE HOLLYWOOD FL 33021 330 1970JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769 830 LAKESIDE CIRCLE POMPANO BEACH FL 33060 330 1972LIFE CARE CENTER AT INVERRARY 259080 4300 ROCK ISLAND ROAD LAUDERHILL FL 33319 333 2002MANOR OAKS NURSING & REHABILITATION CENTER 256935 2121 E COMMERCIAL BLVD FORT LAUDERDALE FL 33308 333 1966MANOR PINES CONVALESCENT CENTER 254177 1701 NE 26TH ST FORT LAUDERDALE FL 33305 333 1966MANORCARE HEALTH SERVICES 325457 6931 W. SUNRISE BLVD. PLANTATION FL 33313 333 1985MARGATE HEALTH CARE CENTER 214931 5951 COLONIAL DRIVE MARGATE FL 33063 330 (954) 979-6401 (954) 970-7016 1985MEMORIAL MANOR 201006 777 SOUTH DOUGLAS ROAD PEMBROKE PINES FL 33025 330 1989PALMS REHABILITATION AND NURSING CENTER 308005 3370 NW 47TH TERRACE LAUDERDALE LAKES FL 33319 333 1982PARK SUMMIT OF CORAL SPRINGS 254134 8500 ROYAL PALM BLVD. CORAL SPRINGS FL 33065 330 1986PLANTATION NURSING & REHABILITATION CENTER 226017 4250 N.W. 5TH STREET PLANTATION FL 33317 333 1974POMPANO REHABILITATION & NURSING CENTER 263923 51 W SAMPLE ROAD POMPANO BEACH FL 33064 330 1987REGENTS PARK OF SUNRISE 269697 9711 W OAKLAND PARK BLVD SUNRISE FL 33351 333 1989SAINT JOHNS NURSING CENTER 205800 3075 NW 35TH AVENUE LAUDERDALE LAKES FL 33311 333 1980SEAVIEW NURSING AND REHABILITATION CENTER 252433 2401 N.E. 2ND STREET POMPANO BEACH FL 33062 330 1983SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631 4251 SPRINGTREE DRIVE SUNRISE FL 33351 333 1989SUNRISE HEALTH & REHABILITATION CENTER 207497 4800 NOB HILL ROAD SUNRISE FL 33351 333 1983TAMARAC REHABILITATION AND HEALTH CENTER 213098 7901 N.W. 88TH AVENUE TAMARAC FL 33321 333 1983WEST BROWARD CARE CENTER 002419 7751 W BROWARD BLVD PLANTATION FL 33324 333 1971WILTON MANORS HEALTH & REHABILITATION CENTER 227579 2675 NORTH ANDREWS AVENUE FORT LAUDERDALE FL 33311 333 1982DESTIN HEALTHCARE AND REHABILITATION CENTER 252166 195 MATTIE M. KELLY BLVD. DESTIN FL 32541 325 1994EMERALD COAST CENTER 212903 114 THIRD STREET SE FORT WALTON BEACH FL 32548 325 1973MANOR AT BLUE WATER BAY, THE 226041 1500 NORTH WHITE POINT ROAD NICEVILLE FL 32578 325 1993PARTHENON HEALTHCARE OF CRESTVIEW 251101 1849 FIRST AVENUE EAST CRESTVIEW FL 32539 325 1970PARTHENON HEALTHCARE OF FORT WALTON 229237 1 LBJ SR DRIVE FORT WALTON BEACH FL 32548 325 1960SHOAL CREEK REHABILITATION CENTER 252379 500 SOUTH HOSPITAL DRIVE CRESTVIEW FL 32539 325 2000SILVERCREST MANOR 213926 910 BROOKMEADE DRIVE CRESTVIEW FL 32539 325 (850) 682-1903 (850) 682-8689 1988WESTWOOD HEALTH CARE CENTER 316075 1001 MAR-WALT DRIVE FORT WALTON BEACH FL 32548 325 1985CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361 785 S. 2ND STREET DEFUNIAK SPRINGS FL 32433 324 1979DELTA HEALTH CARE CENTER 211621 138 SANDESTIN LANE MIRAMAR BEACH FL 32550 325 (850) 267-2887 (850) 267-3718 1988GAINESVILLE HEALTH CARE CENTER 229288 1311 SW 16TH ST GAINESVILLE FL 32608 326 1983NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361 6700 NW 10TH PLACE GAINESVILLE FL 32605 326 1984OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868 2660 SW 53RD LANE GAINESVILLE FL 32608 326PALM GARDEN OF GAINESVILLE 257265 227 SW 62ND BLVD GAINESVILLE FL 32607 326 (352) 331-0601 (352) 332-9778 1987PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765 3250 S.W. 41ST PLACE GAINESVILLE FL 32608 326 1981PARKLANDS REHABILITATION AND NURSING CENTER 317578 1000 SW 16TH AVE GAINESVILLE FL 32601 326 1980SIGNATURE HEALTHCARE OF GAINESVILLE 324388 4000 SW 20TH AVE GAINESVILLE FL 32607 326 1980WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572 7207 SW 24TH AVENUE GAINESVILLE FL 32607 326 2002AYERS HEALTH AND REHABILITATION CENTER 227871 606 N.E. 7TH STREET TRENTON FL 32693 326 1981TRI COUNTY NURSING HOME 204625 7280 SW STATE RD 26 TRENTON FL 32693 326 1992MACCLENNY NURSING AND REHAB CENTER 263516 755 S. FIFTH STREET MACCLENNY FL 32063 320 1990W FRANK WELLS NURSING HOME 211052 210 NORTH SECOND STREET MACCLENNY FL 32063 320 1970CONSULATE HEALTH CARE OF ORANGE PARK 319538 1215 KINGSLEY AVENUE ORANGE PARK FL 32073 320 1989DOCTORS LAKE OF ORANGE PARK 223883 833 KINGSLEY AVENUE ORANGE PARK FL 32073 320 1987GOVERNORS CREEK HEALTH AND REHABILITATION 252387 803 OAK STREET GREEN COVE SPRINGS FL 32043 320 1983HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261 570 WELLS ROAD ORANGE PARK FL 32073 320 1990LIFE CARE CENTER AT WELLS CROSSING 213161 355 CROSSING BOULEVARD ORANGE PARK FL 32073 320 1997LIFE CARE CENTER OF ORANGE PARK 284289 2145 KINGSLEY AVE ORANGE PARK FL 32073 320 1996PAVILION FOR HEALTH CARE, THE 999987 ONE PAVILION PLACE PENNEY FARMS FL 32079 320SIGNATURE HEALTHCARE OF ORANGE PARK 324434 2029 PROFESSIONAL CENTER DRIVE ORANGE PARK FL 32073 320 1980TERRACE AT FLEMING ISLAND, THE 284785 1125 FLEMING PLANTATION BLVD. ORANGE PARK FL 32003 320 2005

Page 3 of 250

Page 4: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B C E F G

Nursing Facility NameMedicaid Provider Number

Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Construction

D

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735 5888 BLANDING BOULEVARD JACKSONVILLE FL 32244 322 1970ATRIUM HEALTHCARE CENTER 319376 9960 ATRIUM WAY JACKSONVILLE FL 32225 322 1996AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913 1504 SEABREEZE AVENUE JACKSONVILLE BEACH FL 32250 322 1974BEAUCLERC MANOR 252051 9355 SAN JOSE BLVD. JACKSONVILLE FL 32257 322 1985CATHEDRAL GERONTOLOGY CENTER, INC. 226068 333 E. ASHLEY STREET JACKSONVILLE FL 32202 322 1970CEDAR HILLS HEALTHCARE CENTER 262714 2061 HYDE PARK ROAD JACKSONVILLE FL 32210 322 1972CONSULATE HEALTH CARE OF JACKSONVILLE 319503 4101 SOUTHPOINT DRIVE EAST JACKSONVILLE FL 32216 322 1996CYPRESS VILLAGE 307998 4600 MIDDLETON PARK CIRCLE E. JACKSONVILLE FL 32224 322 1991EDGEWOOD NURSING CENTER 254878 1771 EDGEWOOD AVENUE W. JACKSONVILLE FL 32208 322 1988FANNIE E TAYLOR HOME FOR THE AGED INC 204536 3937 SPRING PARK ROAD JACKSONVILLE FL 32207 322 1972FIRST COAST HEALTH & REHABILITATION CENTER 227838 7723 JASPER AVENUE JACKSONVILLE FL 32211 322 1983FLEET LANDING 999984 ONE FLEET LANDING BLVD. ATLANTIC BEACH FL 32233 322HARTS HARBOR HEALTH CARE CENTER 252417 11565 HARTS ROAD JACKSONVILLE FL 32218 322 1977HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236 8495 NORMANDY BLVD. JACKSONVILLE FL 32221 322 1990HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287 3648 UNIVERSITY BLVD. S. JACKSONVILLE FL 32216 322 1981JACKSONVILLE NURSING AND REHAB CENTER 263494 4134 DUNN AVENUE JACKSONVILLE FL 32218 322 1990LAKESIDE NURSING AND REHABILITATION CENTER 256757 11411 ARMSDALE ROAD JACKSONVILLE FL 32218 322 1997LANIER MANOR 268003 12740 LANIER ROAD JACKSONVILLE FL 32226 322 1984LIFE CARE CENTER OF JACKSONVILLE 283193 4813 LENOIR AVENUE JACKSONVILLE FL 32216 322 2004PALM GARDEN OF JACKSONVILLE 257273 5725 SPRING PARK ROAD JACKSONVILLE FL 32216 322 (904) 733-6954 (904) 733-4877 1990PARK RIDGE NURSING CENTER 228401 730 COLLEGE STREET JACKSONVILLE FL 32204 322 1979REGENTS PARK OF JACKSONVILLE 269727 8700 A C SKINNER PARKWAY JACKSONVILLE FL 32256 322 1986RIVER GARDEN HEBREW HOME FOR THE AGED 200859 11401 OLD SAINT AUGUSTINE ROAD JACKSONVILLE FL 32258 322 1970RIVERWOOD CENTER 260673 2802 PARENTAL HOME ROAD JACKSONVILLE FL 32216 322 1982RIVERWOOD NURSING CENTER 324612 40 ACME STREET JACKSONVILLE FL 32211 322 1970SOUTHLAKE NURSING & REHABILITATION CENTER 312371 10680 OLD ST. AUGUSTINE ROAD JACKSONVILLE FL 32257 322 1982SOUTHPOINT TERRACE 266281 4325 SOUTHPOINT BOULEVARD JACKSONVILLE FL 32216 322 2004ST CATHERINE LABOURE MANOR, INC. 205150 1750 STOCKTON STREET JACKSONVILLE FL 32204 322 1979SUMMER BROOK HEALTH CARE CENTER 265721 5377 MONCRIEF ROAD JACKSONVILLE FL 32209 322 1970TAYLOR CARE CENTER 207446 6535 CHESTER AVENUE JACKSONVILLE FL 32217 322 1983WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171 1650 FOURAKER ROAD JACKSONVILLE FL 32221 322 1990LIFE CARE CENTER OF HILLIARD 214060 3756 W THIRD ST HILLIARD FL 32046 320 1990QUALITY HEALTH OF FERNANDINA BEACH 225274 1625 LIME STREET FERNANDINA BEACH FL 32034 320 1984LIFE CARE ST. JOHNS, INC. 999869 230 TOWERVIEW DRIVE SAINT AUGUSTINE FL 32092 320MOULTRIE CREEK NURSING AND REHAB CENTER 263559 200 MARINER HEALTH WAY SAINT AUGUSTINE FL 32086 320 1986PONCE DE LEON CARE CENTER 207799 1999 OLD MOULTRIE ROAD SAINT AUGUSTINE FL 32086 320 1984SAMANTHA R WILSON SENIOR CITIZENS HOME 202606 161A MARINE STREET SAINT AUGUSTINE FL 32084 320 1970SAN MARCO TERRACE REHABILITATION AND CARE 316601 189 SAN MARCO AVENUE SAINT AUGUSTINE FL 32084 320 1983ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735 51 SUNRISE BLVD SAINT AUGUSTINE FL 32086 320 1976VICARS LANDING NURSING HOME 999981 1003 YORK ROAD PONTE VEDRA BEACH FL 32082 320WESTMINSTER WOODS ON JULINGTON CREEK 212083 25 STATE ROAD 13 JACKSONVILLE FL 32259 322 1970AUBURNDALE OAKS HEALTHCARE CENTER 207527 919 OLD WINTER HAVEN ROAD AUBURNDALE FL 33823 338 1983BARTOW CENTER 212997 2055 E. GEORGIA STREET BARTOW FL 33830 338 1972BRANDYWYNE HEALTH CARE CENTER 251399 1801 N. LAKE MARIAM DRIVE WINTER HAVEN FL 33884 338 1983CONSULATE HEALTH CARE OF LAKE PARKER 319678 2020 W. LAKE PARKER DRIVE LAKELAND FL 33805 338 1990CONSULATE HEALTH CARE OF LAKELAND 319953 5245 N. SOCRUM LOOP ROAD LAKELAND FL 33809 338 1984CONSULATE HEALTH CARE OF WINTER HAVEN 319724 2701 LAKE ALFRED ROAD WINTER HAVEN FL 33881 338 1998CROSSROADS, THE 269409 206 W. ORANGE STREET DAVENPORT FL 33837 338 1970DOVE HEALTHCARE AT LAKE WALES 319341 730 NORTH SCENIC HIGHWAY LAKE WALES FL 33853 338 1983FLORIDA PRESBYTERIAN HOMES INC 212971 909 LAKESIDE AVENUE LAKELAND FL 33803 338 1997GROVES CENTER 212881 512 S 11TH STREET LAKE WALES FL 33853 338 1973HAINES CITY HEALTH CARE CENTER 224341 409 S. 10TH STREET HAINES CITY FL 33844 338 1983

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HIGHLANDS LAKE CENTER 260576 4240 LAKELAND HIGHLANDS ROAD LAKELAND FL 33813 338 1988LAKELAND HILLS CENTER 212865 610 E. BELLA VISTA DRIVE LAKELAND FL 33805 338 1972LIFE CARE CENTER OF WINTER HAVEN 219380 1510 CYPRESS GARDENS BOULEVARD WINTER HAVEN FL 33884 338 1999MANOR AT CARPENTERS, THE 203599 1001 CARPENTERS WAY LAKELAND FL 33809 338 1989OAKBRIDGE HEALTHCARE CENTER 259926 3110 OAKBRIDGE BLVD EAST LAKELAND FL 33803 338 1991PALM GARDEN OF WINTER HAVEN 257320 1120 CYPRESS GARDENS BLVD. WINTER HAVEN FL 33884 338 (941) 293-3100 (863) 291-0578 1987PALM TERRACE OF LAKELAND 282626 1919 LAKELAND HILLS BLVD. LAKELAND FL 33805 338 (863) 688-5612 (863) 688-1398 1975ROHR HOME, THE 202533 2120 MARSHALL EDWARDS DR. BARTOW FL 33830 338 1970SPRING LAKE REHABILITATION CENTER 264571 1540 6TH STREET, N.W. WINTER HAVEN FL 33881 338 1991VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560 1350 SLEEPY HILL ROAD LAKELAND FL 33810 338 1982WEDGEWOOD HEALTHCARE CENTER 252328 1010 CARPENTER'S WAY LAKELAND FL 33809 338 1999WINTER HAVEN HEALTH & REHABILITATION CENTER 228702 202 AVENUE O NE WINTER HAVEN FL 33881 338 1982ARCH PLAZA NURSING & REHABILITATION CENTER 254291 12505 N.E. 16TH AVENUE NORTH MIAMI FL 33161 331 1978AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823 1800 N E 168TH STREET NORTH MIAMI BEACH FL 33162 331 1978BERKSHIRE MANOR 005388 1255 NE 135TH STREET NORTH MIAMI FL 33161 331 (305) 891-6850 (305) 895-8145 1983CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507 13900 N.E. 3RD COURT NORTH MIAMI FL 33161 331 1985CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864 19333 WEST COUNTRY CLUB DRIVE AVENTURA FL 33180 331CORAL GABLES NURSING AND REHABILITATION CENTER 323772 7060 S.W. 8TH STREET MIAMI FL 33144 331 1988CORAL REEF NURSING & REHABILITATION CENTER 282529 9869 SW 152ND STREET MIAMI FL 33157 331 1995EAST RIDGE RETIREMENT VILLAGE INC 228788 19301 S W 87TH AVENUE MIAMI FL 33157 331 1962FAIR HAVENS CENTER 227226 201 CURTISS PKWY. Medley FL 33166 331 1970FLORIDA CLUB CARE CENTER 207993 220 SIERRA DRIVE MIAMI FL 33179 331 1984FLORIDEAN NURSING HOME INC 200425 47 N W 32 PLACE MIAMI FL 33125 331 1970FOUNTAINHEAD CARE CENTER 005523 390 NE 135TH ST NORTH MIAMI FL 33161 331 (305) 895-4804 (305) 892-7411 1983FRANCO NURSING & REHABILITATION CENTER 319554 800 NW 95TH STREET MIAMI FL 33150 331 1996GRAMERCY PARK NURSING CENTER 214027 17475 S. DIXIE HWY. MIAMI FL 33157 331 1985HAMPTON COURT NURSING AND REHABILITATION CENTER 324027 16100 NW 2ND AVENUE NORTH MIAMI BEACH FL 33169 331 1991HARMONY HEALTH CENTER 269107 9820 N. KENDALL DRIVE MIAMI FL 33176 331 1970HEARTLAND HEALTH CARE CENTER KENDALL 325244 9400 SW 137TH AVENUE KENDALL FL 33186 331 1989HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252 5725 N.W. 186 STREET HIALEAH FL 33015 330 1990HEBREW HOME OF SOUTH BEACH 308242 320 COLLINS AVENUE MIAMI BEACH FL 33139 331 1970HIALEAH CONVALESCENT HOME 265730 190 W. 28TH STREET HIALEAH FL 33010 330 1984HIALEAH SHORES NURSING AND REHAB CENTER 250988 8785 NW 32ND AVENUE MIAMI FL 33147 331 1985HOMESTEAD MANOR 212121 1330 N.W. 1ST AVENUE HOMESTEAD FL 33030 330 1983JACKSON MEMORIAL LONG TERM CARE CENTER 204161 2500 N.W. 22ND AVE. MIAMI FL 33142 331 1973JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670 19590 OLD CULTER ROAD CUTLER BAY FL 33190 331 1971JACKSON PLAZA NURSING & REHABILITATION CENTER 253723 1861 NW 8TH AVENUE MIAMI FL 33136 331 2000MIAMI GARDENS CARE CENTRE 210617 190 NE 191ST STREET MIAMI FL 33179 331 1992MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506 5200 N.E. 2ND AVENUE MIAMI FL 33137 331 1970MIAMI SHORES NURSING AND REHAB CENTER 214035 9380 NW 7TH AVENUE MIAMI FL 33150 331 1979NORTH BEACH REHABILITATION CENTER 228001 2201 N E 170TH STREET NORTH MIAMI BEACH FL 33160 331 1982NURSING CENTER AT MERCY, THE 267902 3671 S MIAMI AVENUE MIAMI FL 33133 331 1994OCEANSIDE EXTENDED CARE CENTER 212733 550 9TH STREET MIAMI BEACH FL 33139 331 1976PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327 11215 S.W. 84TH STREET MIAMI FL 33173 331 1991PALM GARDEN OF AVENTURA 257494 21251 E DIXIE HIGHWAY NORTH MIAMI BEACH FL 33180 331 (305) 935-4827 (305) 935-0686 1988PALMETTO REHABILITATION AND HEALTH CENTER 324167 6750 WEST 22ND COURT HIALEAH FL 33016 330 1987PALMETTO SUB ACUTE CARE CENTER, INC 212806 7600 SW 8TH STREET MIAMI FL 33144 331 1997PINECREST CONVALESCENT CENTER 225754 13650 N.E. 3RD COURT NORTH MIAMI FL 33161 331 1967PINES NURSING HOME 200620 301 N.E. 141 STREET MIAMI FL 33161 331 1978PONCE PLAZA NURSING & REHABILITATION CENTER 308251 335 SW 12 AVENUE MIAMI FL 33130 331 2000REGENTS PARK AT AVENTURA 223239 18905 NE 25TH AVENUE AVENTURA FL 33180 331 1988RIVERSIDE CARE CENTER 207276 899 N.W. 4TH STREET MIAMI FL 33128 331 1975

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SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400 8333 W OKEECHOBEE ROAD HIALEAH GARDENS FL 33016 330 1987SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418 1990 S. CANAL DRIVE HOMESTEAD FL 33035 330 1987SINAI PLAZA NURSING & REHAB CENTER 260771 201 N.E. 112TH STREET MIAMI FL 33161 331 1990SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308 42 COLLINS AVENUE MIAMI BEACH FL 33139 331 1983ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473 11855 QUAIL ROOST DRIVE MIAMI FL 33177 331 1987SUSANNA WESLEY HEALTH CENTER 268062 5300 W 16TH AVENUE HIALEAH FL 33012 330 1985TREASURE ISLE CARE CENTER 226602 1735 N. TREASURE DRIVE NORTH BAY VILLAGE FL 33141 331 1983UNITY HEALTH AND REHABILITATION CENTER 227544 1404 N.W. 22ND STREET MIAMI FL 33142 331 1984VICTORIA NURSING & REHABILITATION CENTER, INC. 225177 955 N.W. 3RD STREET MIAMI FL 33128 331 2000VILLA MARIA NURSING CENTER 203165 1050 NE 125TH STREET NORTH MIAMI FL 33161 331 1970VILLA MARIA WEST SKILLED NURSING FACILITY 8850 NW 122 ST HIALEAH GARDENS FL 33018 330WATERCREST CARE CENTER 310409 16650 W DIXIE HWY NORTH MIAMI BEACH FL 33160 331 1984WEST GABLES HEALTH CARE CENTER 282359 2525 SW 75TH AVENUE MIAMI FL 33155 331 1988ARISTOCRAT, THE 225291 10949 PARNU STREET NAPLES FL 34109 341 1993BENTLEY CARE CENTER 999932 875 RETREAT DRIVE NAPLES FL 34110 341CHATEAU AT MOORINGS PARK, THE 999931 130 MOORINGS PARK DRIVE NAPLES FL 34105 341HARBORCHASE OF NAPLES 268585 7801 AIRPORT PULLING ROAD N NAPLES FL 34109 341 1997HERITAGE HEALTHCARE & REHABILITATION CENTER 252280 777 9TH ST N NAPLES FL 34102 341 1981IMPERIAL HEALTH CARE CENTER 226378 900 IMPERIAL GOLF COURSE BLVD. NAPLES FL 34110 341 1991LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846 2900 12TH STREET N. NAPLES FL 34103 341 1982MANORCARE AT LELY PALMS 325422 6135 RATTLESNAKE HAMMOCK ROAD NAPLES FL 34113 341 1984MANORCARE NURSING AND REHABILITATION CENTER 325449 3601 LAKEWOOD BLVD. NAPLES FL 34112 341 1983PREMIER PLACE AT THE GLENVIEW 999930 100 GLENVIEW PLACE NAPLES FL 34108 341HAWTHORNE HEALTH AND REHAB OF OCALA 253456 4100 SW 33RD AVE OCALA FL 34474 344 1988LIFE CARE CENTER OF OCALA 266108 2800 SW 41ST STREET OCALA FL 34474 344 1998MARION HOUSE HEALTH CARE CENTER 214043 3930 E SILVER SPRING BLVD. OCALA FL 34470 344 1991NEW HORIZON REHABILITATION CENTER 227773 635 S.E. 17TH STREET OCALA FL 34471 344 1982OAKHURST CARE AND REHABILITATION CENTER 251721 1501 SE 24TH ROAD OCALA FL 34471 344 1984OCALA HEALTH AND REHABILITATION CENTER 217395 1201 SE 24TH ROAD' OCALA FL 34471 344 1977PALM GARDEN OF OCALA 257290 2700 SW 34 STREET OCALA FL 34474 344 (352) 854-6262 (352) 861-2009 1987TIMBERRIDGE NURSING & REHABILITATION CENTER 203335 9848 S.W. 110TH STREET OCALA FL 34481 344 1991AVANTE AT LEESBURG, INC. 203122 2000 EDGEWOOD AVENUE LEESBURG FL 34748 347 1965AVANTE AT MT. DORA, INC. 252042 3050 BROWN AVENUE MOUNT DORA FL 32757 327 1963BAYVIEW CENTER 260444 301 S BAY ST EUSTIS FL 32726 327 1983EDGEWATER AT WATERMAN VILLAGE 210684 300 BROOKFIELD AVENUE MOUNT DORA FL 32757 327 1993LADY LAKE SPECIALTY CARE CENTER 227561 630 GRIFFIN AVENUE LADY LAKE FL 32159 321 1999LAKE EUSTIS CARE CENTER 213870 411 W WOODWARD AVE EUSTIS FL 32726 327 (352) 357-3565 (352) 357-2874 1983LAKE HARRIS HEALTH CENTER 228966 701 LAKE PORT BLVD. LEESBURG FL 34748 347 1990LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225 110 LODGE TERRACE DRIVE ALTOONA FL 32702 327 1981LEESBURG HEALTH AND REHAB, LLC 252956 715 E DIXIE AVE LEESBURG FL 34748 347 1980NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439 700 N PALMETTO ST LEESBURG FL 34748 347 1988RULEME CENTER 260452 2810 RULEME STREET EUSTIS FL 32726 327 1981WESTMINSTER CARE OF CLERMONT 221465 151 E MINNEHAHA AVE CLERMONT FL 34711 347 1968ADVENTIST CARE CENTERS-COURTLAND, INC 320439 730 COURTLAND STREET ORLANDO FL 32804 328 2000AVANTE AT ORLANDO, INC. 223808 2000 N. SEMORAN BLVD ORLANDO FL 32807 328 1970COLONIAL LAKES HEALTH CARE 252557 15204 W. COLONIAL DRIVE WINTER GARDEN FL 34787 347 1984COMMONS AT ORLANDO LUTHERAN TOWERS 205796 210 LAKE AVENUE ORLANDO FL 32801 328 1980CONWAY LAKES HEALTH & REHABILITATION CENTER 264512 5201 CURRY FORD ROAD ORLANDO FL 32812 328 1991COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175 1900 MERCY DRIVE ORLANDO FL 32808 328 1983EAST ORLANDO HEALTH & REHAB CENTER, INC 320421 250 SOUTH CHICKASAW TRAIL ORLANDO FL 32825 328 1993GUARDIAN CARE NURSING & REHABILITATION CENTER 201651 2500 W CHURCH STREET ORLANDO FL 32805 328 1970HEALTH CENTER OF WINDERMERE, THE 228877 4875 CASON COVE DRIVE ORLANDO FL 32811 328 1997

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HEALTH CENTRAL PARK 204811 411 NORTH DILLARD STREET WINTER GARDEN FL 34787 347 1977HUNTERS CREEK NURSING AND REHAB CENTER 263605 14155 TOWN LOOP BLVD. ORLANDO FL 32837 328 1998LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761 1091 KELTON AVENUE OCOEE FL 34761 347 1997LIFE CARE CENTER OF ORLANDO 213403 3211 ROUSE ROAD ORLANDO FL 32817 328 1997MANOR CARE NURSING & REHABILITATION CENTER 325279 2075 LOCH LOMOND DRIVE WINTER PARK FL 32792 327 1977MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588 550 W MORSE BLVD. WINTER PARK FL 32789 327 1970MAYFLOWER HEALTHCARE CENTER 999941 1620 MAYFLOWER COURT WINTER PARK FL 32792 327METRO WEST NURSING AND REHAB CENTER 263541 5900 WESTGATE DRIVE ORLANDO FL 32835 328 1994OCOEE HEALTH CARE CENTER 324159 1556 MAGUIRE ROAD OCOEE FL 34761 347 1990PALM GARDEN OF ORLANDO 257303 654 N. ECONLOCKHATCHEE TRAIL ORLANDO FL 32825 328 (407) 273-6158 (407) 382-6654 1987PARKS HEALTHCARE AND REHABILITATION CENTER 259934 9311 S. ORANGE BLOSSOM TRAIL ORLANDO FL 32837 328 1984QUALITY HEALTH OF ORANGE COUNTY 225410 12751 WEST COLONIAL DRIVE WINTER GARDEN FL 34787 347 1985REGENTS PARK OF WINTER PARK 269719 558 N. SEMORAN BLVD. WINTER PARK FL 32792 327 1988REHABILITATION CENTER OF WINTER PARK, THE 005380 1700 MONROE AVENUE MAITLAND FL 32751 327 (407) 647-2092 (407) 647-2079 1983RIO PINAR HEALTH CARE 252450 7950 LAKE UNDERHILL ROAD ORLANDO FL 32822 328 1987ROSEWOOD HEALTH AND REHABILITATION CENTER 252468 3920 ROSEWOOD WAY ORLANDO FL 32808 328 1984SAVANNAH COVE 312550 1301 W. MAITLAND BLVD. MAITLAND FL 32751 327 1995SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412 305 EAST OAK STREET APOPKA FL 32703 327 1993TERRA VISTA REHAB AND HEALTH CENTER 261611 1730 LUCERNE TERRACE ORLANDO FL 32806 328 1972WESTMINSTER CARE OF DELANEY PARK 221589 215 ANNIE STREET ORLANDO FL 32806 328 1992WESTMINSTER CARE OF ORLANDO 223654 830 W. 29TH STREET ORLANDO FL 32805 328 1971WESTMINSTER TOWERS 208540 70 WEST LUCERNE CIRCLE ORLANDO FL 32801 328 1984WINTER PARK CARE & REHABILITATION CENTER 324515 2970 SCARLETT ROAD WINTER PARK FL 32792 327 1979WINTER PARK TOWERS 209848 1111 SOUTH LAKEMONT AVENUE WINTER PARK FL 32792 327 1971AVANTE AT ST CLOUD, INC. 259870 1301 KANSAS AVENUE SAINT CLOUD FL 34769 347 1968CONSULATE HEALTH CARE OF KISSIMMEE 319511 2511 JOHN YOUNG PARKWAY NORTH KISSIMMEE FL 34741 347 1999GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303 1500 SOUTHGATE DRIVE KISSIMMEE FL 34746 347 1979KEYSTONE REHABILITATION AND HEALTH CENTER 317560 1120 W DONEGAN AVE KISSIMMEE FL 34741 347 2006OAKS OF KISSIMMEE 005549 320 N MITCHELL ST KISSIMMEE FL 34741 347 (407) 847-7200 (407) 847-2294 1985OSCEOLA HEALTH CARE CENTER 217859 4201 W. NEW NOLTE ROAD SAINT CLOUD FL 34772 347 1991PALMS AT PARK PLACE, THE 253421 221 PARK PLACE BLVD. KISSIMMEE FL 34741 347 1993PLANTATION BAY REHABILITATION CENTER 252441 4641 OLD CANOE CREEK ROAD SAINT CLOUD FL 34769 347 1995SOUTHERN OAKS HEALTH CARE CENTER 253146 3855 OLD CANOE CREEK ROAD SAINT CLOUD FL 34769 347 1986CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546 1099 WEST TOWN PARKWAY ALTAMONTE SPRINGS FL 32714 327 1994FLNC, INC 320463 3355 E. SEMORAN BLVD. APOPKA FL 32703 327 1971HEALTHCARE & REHAB OF SANFORD 263931 950 MELLONVILLE AVENUE SANFORD FL 32771 327 1972ISLAND LAKE CENTER 260657 155 LANDOVER PLACE LONGWOOD FL 32750 327 1989LAKE MARY HEALTH AND REHABILITATION CENTER 252310 710 NORTH SUN DRIVE LAKE MARY FL 32746 327 2000LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137 989 ORIENTA AVENUE ALTAMONTE SPRINGS FL 32701 327 1976LONGWOOD HEALTH CARE CENTER 005379 1520 S GRANT ST LONGWOOD FL 32750 327 (407) 339-9200 (407) 339-5032 1983LUTHERAN HAVEN NURSING HOME 313718 1525 HAVEN DRIVE OVIEDO FL 32765 327 2005TUSKAWILLA NURSING AND REHAB CENTER 263591 1024 WILLA SPRINGS DRIVE WINTER SPRINGS FL 32708 327 1994VILLAGE ON THE GREEN 999936 500 VILLAGE PLACE LONGWOOD FL 32779 327ANCHOR CARE AND REHABILITATION CENTER 324451 1515 PORT MALABAR BLVD. N.E. PALM BAY FL 32905 329 1984ATLANTIC SHORES NURSING AND REHAB CENTER 263389 4251 STACK BLVD MELBOURNE FL 32901 329 1995AVANTE AT MELBOURNE, INC. 252018 1420 SOUTH OAK STREET MELBOURNE FL 32901 329 1968CARNEGIE GARDENS NURSING CENTER 005519 1415 S HICKORY ST MELBOURNE FL 32901 329 (321) 723-1321 (321) 768-0403 1983CONSULATE HEALTH CARE OF MELBOURNE 319520 3033 SARNO RD MELBOURNE FL 32934 329 1994COURTENAY SPRINGS VILLAGE 209325 1100 S. COURTENAY PARKWAY MERRITT ISLAND FL 32952 329 1984HEALTH CENTER OF MERRITT ISLAND, THE 226700 500 CROCKETT BLVD. MERRITT ISLAND FL 32953 329 1990HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281 1775 HUNTINGTON LANE ROCKLEDGE FL 32955 329 1972INDIAN RIVER CENTER 260665 7201 GREENBORO DRIVE WEST MELBOURNE FL 32904 329 1989

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ISLAND HEALTH AND REHABILITATION CENTER 252352 125 ALMA BLVD MERRITT ISLAND FL 32953 329 1983LIFE CARE CENTER OF MELBOURNE 228338 606 E. SHERIDAN ROAD MELBOURNE FL 32901 329 1990LIFE CARE CENTER OF PALM BAY 268186 175 VILLA NUEVA AVENUE PALM BAY FL 32907 329 2003MELBOURNE TERRACE REHABILITATION CENTER 264547 251 FLORIDA AVENUE MELBOURNE FL 32901 329 1989PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395 5405 BABCOCK STREET NE PALM BAY FL 32905 329 1998ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587 587 BARTON BLVD. ROCKLEDGE FL 32955 329 1982ROYAL OAKS NURSING AND REHAB CENTER 263583 2225 KNOX MCRAE DRIVE TITUSVILLE FL 32780 327 1993TITUSVILLE REHABILITATION & NURSING CENTER 263974 1705 JESS PARRISH COURT TITUSVILLE FL 32796 327 1971VISTA MANOR 252522 1550 JESS PARRISH COURT TITUSVILLE FL 32796 327 1985WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727 2125 WEST NEW HAVEN AVENUE WEST MELBOURNE FL 32904 329 1979WUESTHOFF PROGRESSIVE CARE CENTER 253472 8050 SPYGLASS HILL ROAD VIERA FL 32940 329 1995FLAGLER PINES 005374 300 S LEMON ST BUNNELL FL 32110 321 (386) 437-4168 (386) 437-7740 1985GRAND OAKS HEALTH AND REHABILITATION CENTER 252409 3001 PALM COAST PARKWAY SE PALM COAST FL 32137 321 1997BAY CENTER 212989 1336 ST. ANDREWS BLVD. PANAMA CITY FL 32405 324 1972CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491 4419 TRAM ROAD SPRINGFIELD FL 32404 324 2003COMMUNITY HEALTH AND REHABILITATION CENTER 318779 3611 TRANSMITTER ROAD PANAMA CITY FL 32404 324 1997EMERALD SHORES HEALTH AND REHABILITATION 252191 626 NORTH TYNDALL PARKWAY CALLAWAY FL 32404 324 2000GLEN COVE NURSING PAVILION 005384 1027 E HWY 98 PANAMA CITY FL 32401 324 (850) 872-1438 (850) 763-9711 1992LISENBY ON LAKE CAROLINE 203980 1400 W. 11TH STREET PANAMA CITY FL 32401 324 1985PANAMA CITY NURSING CENTER 005385 924 W. 13TH STREET PANAMA CITY FL 32401 324 (850) 763-8463 (850) 785-5419 1984SEA BREEZE HEALTH CARE 252247 1937 JENKS AVENUE PANAMA CITY FL 32405 324 1979ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799 2100 JENKS AVENUE PANAMA CITY FL 32405 324 1986BAPTIST MANOR 208809 10095 HILLVIEW ROAD PENSACOLA FL 32514 325 1985BAYSIDE MANOR 213853 4343 LANGLEY AVENUE PENSACOLA FL 32504 325 (850) 477-4550 (850) 484-3583 1979CENTURY CARE CENTER 220604 6020 INDUSTRIAL BLVD CENTURY FL 32535 325 1994CONSULATE HEALTH CARE OF PENSACOLA 319686 235 WEST AIRPORT BLVD PENSACOLA FL 32505 325 1997HAVEN OF OUR LADY OF PEACE 258831 1900 SUMMIT BOULEVARD PENSACOLA FL 32503 325 2001HEALTH CENTER OF PENSACOLA, THE 229571 8475 UNIVERSITY PARKWAY PENSACOLA FL 32514 325 1987LIFE CARE CENTER OF PENSACOLA 315664 3291 EAST OLIVE ROAD PENSACOLA FL 32514 325 2006PENSACOLA HEALTH CARE FACILITY 224243 1717 W. AVERY STREET PENSACOLA FL 32501 325 1975ROSEWOOD MANOR 211842 3107 NORTH H STREET PENSACOLA FL 32501 325 1970SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566 600 WEST GREGORY STREET PENSACOLA FL 32501 325 1978SPECIALTY CENTER OF PENSACOLA 213918 6984 PINE FOREST ROAD PENSACOLA FL 32526 325 (850) 944-9997 (850) 944-8041 1991UNIVERSITY HILLS HEALTH AND REHABILITATION 252123 10040 HILLVIEW ROAD PENSACOLA FL 32514 325 1982WILLOWBROOKE COURT AT AZALEA TRACE 210374 10100 HILLVIEW ROAD PENSACOLA FL 32514 325 1981BAY BREEZE NURSING AND RETIREMENT CENTER 213816 3387 GULF BREEZE PARKWAY GULF BREEZE FL 32561 325 (850) 932-9257 (850) 932-5989 1984SANDY RIDGE CARE CENTER 220621 5360 GLOVER LANE MILTON FL 32570 325 1985SANTA ROSA HEALTH & REHABILITATION CENTER 220612 5386 BROAD STREET MILTON FL 32570 325 1971UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331 5530 NORTHROP ROAD MILTON FL 32570 325 2003EDGEWATER MANOR 201545 9555 S.E. FEDERAL HWY. HOBE SOUND FL 33455 334 1970MARTIN NURSING AND RESTORATIVE CARE CENTER 226033 6011 SE TOWER DRIVE STUART FL 34997 349 1997PALM CITY NURSING & REHAB CENTER 263621 2505 SW MARTIN HIGHWAY PALM CITY FL 34990 349 1993PARKWAY HEALTH & REHABILITATION CENTER 228885 800 SE CENTRAL PKWY STUART FL 34994 349 1989SALERNO BAY MANOR 214141 4801 S.E. COVE ROAD STUART FL 34997 349 (772) 286-9440 (772) 283-3061 1985STUART NURSING & RESTORATIVE CARE CENTER 225991 1500 PALM BEACH ROAD STUART FL 34994 349 1973WATERS EDGE EXTENDED CARE 213152 1500 SW CAPRI STREET PALM CITY FL 34990 349 1993ABBIEJEAN RUSSELL CARE CENTER LLC 268755 700 S 29TH STREET FORT PIERCE FL 34947 349 1976BRIGHTON GARDENS OF PORT ST LUCIE 210781 1699 SE LYNGATE DRIVE PORT SAINT LUCIE FL 34952 349 1993EMERALD HEALTH CARE CENTER 261637 1655 SE WALTON ROAD PORT SAINT LUCIE FL 34952 349 1987FORT PIERCE HEALTH CARE 252239 611 S 13TH STREET FORT PIERCE FL 34950 349 1984LAUREL POINTE HEALTH AND REHABILITATION 211516 703 29th Street FORT PIERCE FL 34947 349 1980LIFE CARE CENTER OF PORT SAINT LUCIE 217824 3720 SE JENNINGS ROAD PORT SAINT LUCIE FL 34952 349 1999

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PALM GARDEN OF PORT SAINT LUCIE 257249 1751 SE HILLMOOR DRIVE PORT SAINT LUCIE FL 34952 349 (772) 335-8844 (772) 335-9954 1988PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009 7300 OLEANDER AVENUE PORT SAINT LUCIE FL 34942 349 1982TIFFANY HALL NURSING AND REHAB CENTER 263532 1800 S E HILLMOOR DRIVE PORT SAINT LUCIE FL 34952 349 1993CHARLOTTE HARBOR HEALTHCARE 226327 4000 KINGS HWY PORT CHARLOTTE FL 33980 339 1994CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129 18480 COCHRAN BLVD. PORT CHARLOTTE FL 33948 339 1998DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492 21281 GRAYTON TERRACE PORT CHARLOTTE FL 33954 339 2004ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204 1111 DRURY LANE ENGLEWOOD FL 34224 342 1983HARBOUR HEALTH CENTER 319333 23013 WESTCHESTER BLVD. PORT CHARLOTTE FL 33980 339 1986LIFE CARE CENTER OF PUNTA GORDA 311685 450 SHREVE STREET PUNTA GORDA FL 33950 339 2005PORT CHARLOTTE REHABILITATION CENTER 319325 25325 RAMPART BLVD. PORT CHARLOTTE FL 33983 339 1985SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477 4033 BEAVER LANE PORT CHARLOTTE FL 33952 339 1980VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400 2370 HARBOR BLVD. PORT CHARLOTTE FL 33952 339 1987ATLANTIC HEALTHCARE CENTER 310581 3663 15TH AVENUE VERO BEACH FL 32960 329 1981CONSULATE HEALTH CARE OF VERO BEACH 320145 1310 37TH STREET VERO BEACH FL 32960 329 1984FLORIDA BAPTIST RETIREMENT CENTER 001416 1006 33RD ST VERO BEACH FL 32960 329 1955PALM GARDEN OF VERO BEACH 257311 1755 37TH STREET VERO BEACH FL 32960 329 (772) 567-2443 (772) 778-9979 1987ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919 2180 10TH AVENUE VERO BEACH FL 32960 329WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416 2200 INDIAN CREEK BLVD WEST VERO BEACH FL 32966 329 1955RIVERCHASE CARE CENTER 005386 1017 STRONG ROAD QUINCY FL 32351 323 (850) 875-3711 (850) 875-1980 1985BRYNWOOD CENTER 005381 1656 SOUTH JEFFERSON STREET MONTICELLO FL 32344 323 (850) 997-1800 (850) 997-7269 1987JEFFERSON HEALTH AND REHABILITATION CENTER 214001 1780 N. JEFFERSON ST MONTICELLO FL 32344 323 1980CAPITAL HEALTHCARE CENTER 252093 3333 CAPITAL MEDICAL BLVD. TALLAHASSEE FL 32308 323 1984CENTRE POINTE HEALTH AND REHAB CENTER 264563 2255 CENTERVILLE ROAD TALLAHASSEE FL 32308 323 1987CONSULATE HEALTH CARE OF TALLAHASSEE 319716 1650 PHILLIPS RD TALLAHASSEE FL 32308 323 1992HERITAGE HEALTHCARE CENTER 252298 3101 GINGER DRIVE TALLAHASSEE FL 32308 323 1983MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941 1329 ABRAHAM STREET TALLAHASSEE FL 32304 323 1970WESTMINSTER OAKS 200409 4449 MEANDERING WAY TALLAHASSEE FL 32308 323 1983EDEN SPRINGS NURSING AND REHAB CENTER 253707 4679 CRAWFORDVILLE HWY CRAWFORDVILLE FL 32326 323 1974BROOKSVILLE HEALTHCARE CENTER 228958 1114 CHATMAN BLVD. BROOKSVILLE FL 34601 346 1976EVERGREEN WOODS 263893 7045 EVERGREEN WOODS TRAIL SPRING HILL FL 34608 346 1984HEARTLAND OF BROOKSVILLE 325295 575 LAMAR AVENUE BROOKSVILLE FL 34601 346 1988HERON POINTE HEALTH AND REHABILITATION 252174 1445 HOWELL AVE BROOKSVILLE FL 34601 346 1984SPRING HILL HEALTH AND REHABILITATION CENTER 252492 12170 CORTEZ BLVD BROOKSVILLE FL 34613 346 1997BAYSHORE POINTE NURSING AND REHAB CENTER 263575 3117 W GANDY BOULEVARD TAMPA FL 33611 336 1970BRANDON HEALTH AND REHABILITATION CENTER 252077 1465 OAKFIELD DRIVE BRANDON FL 33511 335 1997BRIGHTON GARDENS OF TAMPA 284793 16702 NORTH DALE MABRY HIGHWAY TAMPA FL 33618 336 1999CANTERBURY TOWERS INC 999949 3501 BAYSHORE BLVD TAMPA FL 33629 336CARROLLWOOD CARE CENTER 263877 15002 HUTCHINSON ROAD TAMPA FL 33625 336 1987CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900 702 S. KINGS AVENUE BRANDON FL 33511 335 1991COMMUNITY CONVALESCENT CENTER 281913 2202 WEST OAK AVENUE PLANT CITY FL 33567 335 1976CONSULATE HEALTH CARE OF BRANDON 319660 701 VICTORIA STREET BRANDON FL 33510 335 1985EXCEL REHABILITATION AND HEALTH CENTER 324116 2811 CAMPUS HILL DRIVE TAMPA FL 33612 336 1995FAIRWAY OAKS CENTER 260690 13806 N. 46TH STREET TAMPA FL 33613 336 1983FLETCHER HEALTH AND REHABILITATION CENTER 252221 518 WEST FLETCHER AVE. TAMPA FL 33612 336 1998HABANA HEALTH CARE CENTER 252506 2916 HABANA WAY TAMPA FL 33614 336 1970HAWTHORNE HEALTH AND REHAB OF BRANDON 261670 851 WEST LUMSDEN ROAD BRANDON FL 33511 335 1995HEALTH CARE CENTER OF TAMPA 213039 1818 E FLETCHER AVE TAMPA FL 33612 336 (813) 971-2383 (813) 971-7708 1975HEALTH CENTER OF PLANT CITY, THE 226343 701 N. WILDER ROAD PLANT CITY FL 33566 335 1985HOME ASSOCIATION, INC., THE 201154 1203 EAST 22ND AVENUE TAMPA FL 33605 336 1970JOHN KNOX VILLAGE MED CENTER 210285 4100 E. FLETCHER AVENUE TAMPA FL 33613 336 1978LAKESHORE VILLAS HEALTH CARE CENTER 218057 16002 LAKESHORE VILLAS DRIVE TAMPA FL 33613 336 1986MANORCARE HEALTH SERVICES CARROLLWOOD 325678 3030 BEARSS AVENUE TAMPA FL 33618 336 1990

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NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462 12250 N 22ND STREET TAMPA FL 33612 336 1989PALM GARDEN OF SUN CITY 257516 3850 UPPER CREEK ROAD SUN CITY CENTER FL 33573 335 (813) 633-2875 (813) 633-8402 1991PALM GARDEN OF TAMPA 257524 3612 E. 138TH AVENUE TAMPA FL 33613 336 (813) 972-8775 (813) 978-0680 1987PLAZA WEST 211885 912 AMERICAN EAGLE BLVD SUN CITY CENTER FL 33573 335 1994REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940 4411 N. HABANA AVENUE TAMPA FL 33614 336 1970SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910 4610 S. MANHATTAN AVENUE TAMPA FL 33611 336 1978SUN TERRACE HEALTH CARE CENTER 209856 105 TRINITY LAKES DRIVE SUN CITY CENTER FL 33573 335 1983WHISPERING OAKS 266612 1514 E. CHELSEA STREET TAMPA FL 33610 336 1982WOODBRIDGE REHABILITATION & HEALTH CENTER 324141 8720 JACKSON SPRINGS ROAD TAMPA FL 33615 336 1982YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164 1709 TALIAFERRO AVE. TAMPA FL 33602 336 1970BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914 6919 PARKWAY BLVD LAND O LAKES FL 34639 346 1999BAYONET POINT HEALTH & REHABILITATION CENTER 226076 7210 BEACON WOODS DRIVE HUDSON FL 34667 346 1986BEAR CREEK NURSING CENTER 228567 8041 STATE ROAD 52 EAST HUDSON FL 34667 346 1981CONSULATE HEALTH CARE OF BAYONET POINT 319651 8132 HUDSON AVENUE HUDSON FL 34667 346 1993CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970 8417 OLD COUNTY ROAD 54 NEW PORT RICHEY FL 34653 346 1984HEARTLAND OF ZEPHYRHILLS 325708 38220 HENRY DRIVE ZEPHYRHILLS FL 33540 335 1988HEATHER HILL HEALTHCARE CENTER 228591 6630 KENTUCKY AVENUE NEW PORT RICHEY FL 34653 346 1979HERITAGE PARK 214132 37135 COLEMAN AVE DADE CITY FL 33525 335 (352) 567-8615 (352) 567-1737 1983LIFE CARE CENTER OF NEW PORT RICHEY 259357 7400 TROUBLE CREEK ROAD NEW PORT RICHEY FL 34653 346 2003MADISON POINTE REHABILITATION AND HEALTH CENTER 324124 6020 INDIANA AVENUE NEW PORT RICHEY FL 34653 346 1981ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689 4927 VOORHEES ROAD NEW PORT RICHEY FL 34653 346 1983ROYAL OAK NURSING CENTER 228575 37300 ROYAL OAK LANE DADE CITY FL 33525 335 1981SOUTHERN PINES HEALTHCARE CENTER 262706 6140 SOUTH CONGRESS STREET NEW PORT RICHEY FL 34653 346 1980TRINITY REGIONAL REHAB CENTER 003521 2144 WELBILT BLVD TRINITY FL 34655 346 2007WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991 13719 DALLAS DRIVE HUDSON FL 34667 346 1987ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391 38250 AVENUE A ZEPHYRHILLS FL 33542 335 1988ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404 7350 DAIRY RD ZEPHYRHILLS FL 33540 335 1998ABBEY REHABILITATION AND NURSING CENTER 263958 7101 DR MARTIN LUTHER KING JR ST N SAINT PETERSBURG FL 33702 337 1977ADVANCED REHABILITATION AND HEALTH CENTER 324094 401 FAIRWOOD AVENUE CLEARWATER FL 33759 337 1984ALHAMBRA HEALTH AND REHABILITATION CENTER 261254 7501 38TH AVENUE N SAINT PETERSBURG FL 33710 337 1971ALLEGRO AT COLLEGE HARBOR, THE 309800 4600 54TH AVENUE SOUTH SAINT PETERSBURG FL 33711 337 1986ALPINE HEALTH & REHABILITATION CENTER 227251 3456 21ST AVENUE S SAINT PETERSBURG FL 33711 337 1983APOLLO HEALTH & REHABILITATION CENTER 227251 1000 24TH STREET N SAINT PETERSBURG FL 33713 337 1982BAY POINTE NURSING PAVILION 263834 4201 31ST STREET S SAINT PETERSBURG FL 33712 337 1984BAY TREE CARE AND REHABILITATION CENTER 253448 2600 HIGHLANDS BLVD., N. PALM HARBOR FL 34684 346 1982BAYSIDE REHABILITATION & HEALTH CENTER 324108 811 JACKSON STREET N SAINT PETERSBURG FL 33705 337 1984BAYWOOD NURSING CENTER 316652 2000 17TH AVENUE SOUTH SAINT PETERSBURG FL 33712 337 1981BELLEAIR HEALTH CARE CENTER 264521 1150 PONCE DE LEON BLVD. CLEARWATER FL 33756 337 1981BOCA CIEGA CENTER 213004 1414 59TH STREET S. GULFPORT FL 33707 337 1973BON SECOURS MARIA MANOR NURSING CARE CENTER 200107 10300 4TH STREET N SAINT PETERSBURG FL 33716 337 1975CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524 10501 ROOSEVELT BLVD NORTH SAINT PETERSBURG FL 33716 337 1988CLEARWATER CENTER 212911 1270 TURNER STREET CLEARWATER FL 33756 337 1972COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956 2055 PALMETTO STREET CLEARWATER FL 33765 337 1983CONCORDIA MANOR 251666 321 13TH AVENUE NORTH SAINT PETERSBURG FL 33701 337 1985CONSULATE HEALTH CARE OF SAFETY HARBOR 319694 1410 DR M L KING JR STREET NORTH SAFETY HARBOR FL 34695 346 1985CONSULATE HEALTH CARE OF ST PETERSBURG 319708 9393 PARK BLVD SEMINOLE FL 33777 337 1995COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115 3825 COUNTRYSIDE BLVD. PALM HARBOR FL 34684 346 1987CROSS TERRACE REHABILITATION CENTER 001300 1351 SAN CHRISTOPHER DRIVE DUNEDIN FL 34698 346 1979CRYSTAL OAKS OF PINELLAS 264351 6767 86TH AVENUE NORTH PINELLAS PARK FL 33782 337 1998EAGLE LAKE REHAB & CARE CENTER 311065 1100 66TH STREET NORTH SAINT PETERSBURG FL 33710 337 1986EAST BAY REHABILITATION CENTER 264539 4470 E BAY DR CLEARWATER FL 33764 337 1990EDINBOROUGH HEALTHCARE CENTER 252484 1061 VIRGINIA STREET DUNEDIN FL 34698 346 1981

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EGRET COVE CENTER 212890 550 62ND STREET S SAINT PETERSBURG FL 33707 337 1971FREEDOM SQUARE NURSING CENTER 324248 10801 JOHNSON BLVD SEMINOLE FL 33772 337 1988GLEN OAKS HEALTH CARE CENTER 255840 1100 PINE STREET CLEARWATER FL 33756 337 (727) 442-7106 (727) 442-7100 1989GOLFVIEW HEALTHCARE CENTER 262722 3636 10TH AVENUE N SAINT PETERSBURG FL 33713 337 1980GRACEWOOD REHABILITATION AND NURSING CARE 316644 8600 US HWY 19 NORTH PINELLAS PARK FL 33782 337 1984HARBOURWOOD HEALTH AND REHAB CENTER 316636 2855 GULF TO BAY BLVD CLEARWATER FL 33759 337 1996HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528 1820 SHORE DR S SOUTH PASADENA FL 33707 337 1991HIGHLAND PINES REHABILITATION CENTER 263907 1111 S. HIGHLAND AVENUE CLEARWATER FL 33756 337 1971JACARANDA MANOR 281743 4250 66TH STREET NORTH SAINT PETERSBURG FL 33709 337 1970LARGO REHABILITATION CENTER 252336 9035 BRYAN DAIRY ROAD LARGO FL 33777 337 1999LAURELLWOOD NURSING CENTER 316628 3127 57TH AVENUE NORTH SAINT PETERSBURG FL 33714 337 1980LEXINGTON HEALTH AND REHABILITATION CENTER 227650 6300 46TH AVE N SAINT PETERSBURG FL 33709 337 1982MANOR CARE HEALTH SERVICES DUNEDIN 325686 870 PATRICIA AVENUE DUNEDIN FL 34698 346 1983MANOR CARE HEALTH SERVICES PALM HARBOR 325694 2851 TAMPA ROAD PALM HARBOR FL 34684 346 1990MASONIC HOME OF FLORIDA 999960 3201 1ST STREET N E SAINT PETERSBURG FL 33704 337MEASE CONTINUING CARE 204072 910 NEW YORK AVE DUNEDIN FL 34698 346 1991MENORAH MANOR 208442 255 59TH ST N SAINT PETERSBURG FL 33710 337 1985MORTON PLANT REHABILITATION CENTER 206431 400 CORBETT STREET BELLEAIR FL 33756 337 1983NORTH REHABILITATION CENTER 227641 1301 16TH STREET NORTH SAINT PETERSBURG FL 33705 337 1982OAK BLUFFS NURSING CENTER 203823 420 BAY AVENUE CLEARWATER FL 33756 337 1989OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342 3500 OAK MANOR LANE LARGO FL 33774 337 1990PALM GARDEN OF CLEARWATER 257460 3480 MCMULLEN BOOTH ROAD CLEARWATER FL 33761 337 (727) 786-6697 (727) 786-7017 1987PALM GARDEN OF LARGO 257478 10500 STARKEY ROAD LARGO FL 33777 337 (727) 397-8166 (727) 319-3704 1987PALM GARDEN OF PINELLAS 257508 200 16TH AVENUE, S.E. LARGO FL 33771 337 (727) 585-9377 (727) 588-9038 1991PALM TERRACE OF ST. PETERSBURG 282537 521 69TH AVENUE N SAINT PETERSBURG FL 33702 337 (727) 526-7000 (727) 527-7270 1995PASADENA MANOR INC 281891 1430 PASADENA AVENUE S SOUTH PASADENA FL 33707 337 1970PENINSULA CARE AND REHABILITATION CENTER 324507 900 BECKETT WAY TARPON SPRINGS FL 34689 346 1984PINELLAS PARK CARE AND REHABILITATION CENTER 324469 8701 49TH STREET NORTH PINELLAS PARK FL 33782 337 1982PINELLAS POINT NURSING AND REHAB CENTER 263486 5601 31ST STREET SO SAINT PETERSBURG FL 33712 337 1972REHABILITATION CENTER OF ST PETE 228362 435 42ND AVENUE S. SAINT PETERSBURG FL 33705 337 1984SABAL PALMS HEALTH CARE CENTER 210951 499 ALTERNATE KEENE ROAD N.E. LARGO FL 33771 337 1990SAINT MARK VILLAGE 310841 2655 NEBRASKA AVENUE PALM HARBOR FL 34684 346 1980SEMINOLE NURSING PAVILION 324230 10800 TEMPLE TERRACE SEMINOLE FL 33772 337 1982SHORE ACRES REHABILITATION AND HEALTH CENTER 324132 4500 INDIANAPOLIS STREET NE SAINT PETERSBURG FL 33703 337 1971SOUTH HERITAGE HEALTH & REHAB CENTER 226360 718 LAKEVIEW AVENUE SOUTH SAINT PETERSBURG FL 33705 337 1982SPRINGS AT BOCA CIEGA BAY 267724 1255 PASADENA AVENUE S SAINT PETERSBURG FL 33707 337 1974STRATFORD COURT OF PALM HARBOR 210943 45 KATHERINE BLVD. PALM HARBOR FL 34684 346 1992SUNSET POINT CARE AND REHABILITATION CENTER 253430 1980 SUNSET POINT ROAD CLEARWATER FL 33765 337 1980SYLVAN HEALTH CENTER 229164 2770 REGENCY OAKS BLVD CLEARWATER FL 33759 337 1991TARPON BAYOU CENTER 212849 515 CHESAPEAKE DRIVE TARPON SPRINGS FL 34689 346 1972TIERRA PINES CENTER 260568 7380 ULMERTON ROAD LARGO FL 33771 337 1979WEST BAY CARE AND REHABILITATION CENTER 253464 3865 TAMPA ROAD OLDSMAR FL 34677 346 1982WESTCHESTER GARDENS REHAB & CARE CENTER 202011 3301 MCMULLEN BOOTH ROAD CLEARWATER FL 33761 337 1989WESTMINSTER PALMS 999957 830 NORTH SHORE DRIVE NE SAINT PETERSBURG FL 33701 337WESTMINSTER SUNCOAST 212709 6909 DR MLK STREET SOUTH SAINT PETERSBURG FL 33705 337 1968WRIGHTS NURSING AND REHABILITATION CENTER 254762 11300 110TH AVENUE NORTH SEMINOLE FL 33778 337 1962AMERICAN-FINNISH NURSING HOME 205460 1800 SOUTH DRIVE LAKE WORTH FL 33461 334 1979AVANTE AT BOCA RATON, INC. 210676 1130 N.W. 15TH STREET BOCA RATON FL 33486 334 1985AVANTE AT LAKE WORTH, INC. 203238 2501 NORTH A STREET LAKE WORTH FL 33460 334 1969AZALEA COURT 252549 5065 WALLIS ROAD WEST PALM BEACH FL 33415 334 1984BARRINGTON TERRACE OF BOYNTON BEACH 999915 1425 S CONGRESS AVENUE BOYNTON BEACH FL 33426 334BOCA RATON REHABILITATION CENTER 263842 755 MEADOWS ROAD BOCA RATON FL 33486 334 1978

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Construction

D

BOULEVARD MANOR NURSING AND REHAB CENTER 263613 2839 S. SEACREST DRIVE BOYNTON BEACH FL 33435 334 1975BOYNTON BEACH REHABILITATION CENTER 263460 9600 LAWRENCE ROAD BOYNTON BEACH FL 33436 334 1977BOYNTON HEALTH CARE CENTER 218952 7900 VENTURE CENTER WAY BOYNTON BEACH FL 33437 334 (561) 736-6000 (561) 736-7676 1983CHATSWORTH AT PGA NATIONAL 999879 347 HIATT DRIVE PALM BEACH GARDENS FL 33418 334CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837 2792 DONNELLY DRIVE LANTANA FL 33462 334 1997CONSULATE HEALTH CARE OF WEST PALM BEACH 320153 1626 DAVIS ROAD WEST PALM BEACH FL 33406 334 1985CORAL BAY HEALTHCARE AND REHABILITATION 259918 2939 SOUTH HAVERHILL ROAD WEST PALM BEACH FL 33415 334 1993CROSSINGS, THE 269395 4445 PINE FOREST DRIVE LAKE WORTH FL 33463 334 1988DARCY HALL OF LIFE CARE 317349 2170 PALM BEACH LAKES BLVD. WEST PALM BEACH FL 33409 334 1970EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032 1200 45TH STREET WEST PALM BEACH FL 33407 334 1970FOUNTAINS NURSING HOME 212393 3800 N FEDERAL HWY BOCA RATON FL 33431 334 1970GARDENS COURT 228320 3803 PGA BOULEVARD PALM BEACH GARDENS FL 33410 334 1996GLADES HEALTH CARE CENTER 203203 230 S. BARFIELD HWY. PAHOKEE FL 33476 334 1984HAMLIN PLACE 259586 2180 HYPOLUXO ROAD LANTANA FL 33462 334 1984HARBOURS EDGE 216399 401 E LINTON BLVD DELRAY BEACH FL 33483 334 1987HEALTH CENTER AT ABBEY DELRAY 205745 2105 SW 11TH COURT DELRAY BEACH FL 33445 334 1978HEALTH CENTER AT ABBEY DELRAY SOUTH 206865 1717 HOMEWOOD BLVD DELRAY BEACH FL 33445 334 1982HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913 7225 BOCA DEL MAR BOCA RATON FL 33433 334HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309 3600 OLD BOYNTON ROAD BOYNTON BEACH FL 33436 334 1991HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341 11375 PROSPERITY FARMS ROAD PALM BEACH GARDENS FL 33410 334 1991JOSEPH L MORSE GERIATRIC CENTER INC 207381 4847 FRED GLADSTONE DRIVE WEST PALM BEACH FL 33417 334 1983JUPITER CARE CENTER 224928 17781 THELMA AVENUE JUPITER FL 33458 334 1984JUPITER MEDICAL CENTER PAVILION INC 208485 1230 SOUTH OLD DIXIE HWY JUPITER FL 33458 334 1974LAKE VIEW CARE CENTER AT DELRAY 229610 5430 LINTON BLVD. DELRAY BEACH FL 33484 334 1984LAKE WORTH MANOR 266124 1201 12TH AVENUE SOUTH LAKE WORTH FL 33460 334 1986LAKESIDE HEALTH CENTER 207683 2501 N. AUSTRALIAN AVENUE WEST PALM BEACH FL 33407 334 1984LIBERTY INN, LLC 227676 5858 HERITAGE PARK WAY DELRAY BEACH FL 33484 334 1998LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923 315 S FLAGLER DR WEST PALM BEACH FL 33401 334 1980MANORCARE HEALTH SERVICES 325368 375 N.W. 51ST STREET BOCA RATON FL 33431 334 1984MANORCARE HEALTH SERVICES 325520 16200 JOG ROAD DELRAY BEACH FL 33446 334 1999MANORCARE HEALTH SERVICES BOYNTON BEACH 325376 3001 S. CONGRESS AVENUE BOYNTON BEACH FL 33426 334 1985MANORCARE HEALTH SERVICES WEST PALM BEACH 325481 2300 VILLAGE BLVD WEST PALM BEACH FL 33409 334 1996MEDICANA NURSING AND REHAB CENTER 263524 1710 LAKE WORTH ROAD LAKE WORTH FL 33460 334 1978MENORAH HOUSE 229628 9945 CENTRAL PARK BLVD. BOCA RATON FL 33428 334 1989NORTH LAKE REHABILITATION AND HEALTH CENTER 325163 750 BAYBERRY DRIVE LAKE PARK FL 33403 334 1970NURSING CENTER AT LA POSADA, THE 999867 3600 MASTERPIECE WAY PALM BEACH GARDENS FL 33410 334PALM GARDEN OF WEST PALM BEACH 257257 300 EXECUTIVE CENTER DRIVE WEST PALM BEACH FL 33401 334 (561) 471-5566 (561) 471-3980 1988REGENTS PARK NURSING & REHABILITATION CENTER 204170 6363 VERDE TRAIL BOCA RATON FL 33433 334 1984REHABILITATION CENTER OF THE PALM BEACHES,THE 263915 301 NORTHPOINTE PARKWAY WEST PALM BEACH FL 33407 334 1970ROYAL MANOR 214108 600 BUSINESS PARKWAY ROYAL PALM BEACH FL 33411 334 (561) 798-3700 (561) 795-3583 1985SAVANNAH COVE 312312 2090 N CONGRESS AVE WEST PALM BEACH FL 33401 334 1995SIGNATURE HEALTHCARE OF PALM BEACH 001136 4405 LAKEWOOD ROAD LAKE WORTH FL 33461 334 1984STRATFORD COURT OF BOCA RATON 211010 6343 VIA DE SONRISA DEL SUR BOCA RATON FL 33433 334 1994TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031 1711 6TH AVENUE S. LAKE WORTH FL 33460 334 1977WATERFORD HEALTH CARE CENTER 206610 601 UNIVERSE BLVD JUNO BEACH FL 33408 334 1982WHITEHALL BOCA RATON 999916 7300 DEL PRADO SOUTH BOCA RATON FL 33433 334WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912 23305 BLUE WATER CIRCLE BOCA RATON FL 33433 334WILLOWBROOKE COURT AT ST ANDREWS 206521 6152 N VERDE TRAIL BOCA RATON FL 33433 334 1970WOOD LAKE NURSING AND REHABILITATION CENTER 261599 6414 13TH ROAD SOUTH WEST PALM BEACH FL 33415 334 1988BRADFORD TERRACE NURSING CENTER 251739 808 SOUTH COLLEY ROAD STARKE FL 32091 320 1981WINDSOR MANOR 213888 602 E LAURA STREET STARKE FL 32091 320 (904) 964-3383 (904) 964-6621 1990BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067 16690 CHIPOLA ROAD BLOUNTSTOWN FL 32424 324 1996

Page 12 of 250

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A B C E F G

Nursing Facility NameMedicaid Provider Number

Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Construction

D

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097 17884 N.E. CROZIER ST. BLOUNTSTOWN FL 32424 324 1974ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478 611 TURNER CAMP ROAD INVERNESS FL 34453 344 1987AVANTE AT INVERNESS, INC. 203220 304 S CITRUS AVENUE INVERNESS FL 34452 344 1968CITRUS HEALTH AND REHABILITATION CENTER 257419 701 MEDICAL COURT EAST INVERNESS FL 34452 344 1994CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263 136 NE 12TH AVE CRYSTAL RIVER FL 34429 344 1976CYPRESS COVE CARE CENTER 228940 700 SE 8TH AVE CRYSTAL RIVER FL 34429 344 1983DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269 2730 W MARC KNIGHTON COURT LECANTO FL 34461 344 1989HEALTH CENTER AT BRENTWOOD 252263 2333 N BRENTWOOD CIRCLE LECANTO FL 34461 344 1984LIFE CARE CENTER OF CITRUS COUNTY 211532 3325 W JERWAYNE LANE LECANTO FL 34461 344 1994WOODLAND TERRACE OF CITRUS COUNTY 228711 124 WEST NORVELL BRYANT HIGHWAY HERNANDO FL 34442 344 2001AVALON HEALTHCARE CENTER 261629 1270 SW MAIN BLVD. LAKE CITY FL 32025 320 1981BAYA POINTE NURSING AND REHABILITATION CENTER 308111 587 SE ERMINE AVE LAKE CITY FL 32025 320 1994HEALTH CENTER OF LAKE CITY, THE 226173 560 MCFARLANE AVENUE S.W. LAKE CITY FL 32025 320 1992DESOTO HEALTH & REHAB, LLC 316229 475 NURSIONG HOME WAY ARCADIA FL 34266 342 1980CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151 583 NE 351 HIGHWAY CROSS CITY FL 32628 326 1999BRIDGE AT BAY ST JOE, THE 324485 220 NINTH STREET PORT SAINT JOE FL 32456 324 1983SUWANNEE VALLEY NURSING CENTER 206300 427 NW 15TH AVE JASPER FL 32052 320 1969FINR III, LLC 999945 1962 VANDOLAH ROAD WAUCHULA FL 33873 338HARDEE MANOR HEALTHCARE CENTER 211435 401 ORANGE PLACE WAUCHULA FL 33873 338 1980OAKBROOK OF LABELLE 213497 250 BROWARD AVENUE LABELLE FL 33935 339 (863) 675-1440 (863) 675-7415 1986PALM TERRACE OF CLEWISTON 282618 301 S GLORIA STREET CLEWISTON FL 33440 334 (863) 983-5123 (863) 983-6698 1980KENILWORTH CARE & REHABILITATION CENTER 324493 3011 KENILWORTH BLVD. SEBRING FL 33870 338 1979LAKE PLACID HEALTH CARE CENTER 214124 125 TOMOKA BLVD. SOUTH LAKE PLACID FL 33852 338 (863) 465-7200 (863) 465-2054 1984OAKS AT AVON 263966 1010 US 27 NORTH AVON PARK FL 33825 338 1992PALMS OF SEBRING, THE 252671 725 S. PINE STREET SEBRING FL 33870 338 1970ROYAL CARE OF AVON PARK 324213 1213 W STRATFORD ROAD AVON PARK FL 33825 338 1976BONIFAY NURSING AND REHAB CENTER 263443 306 WEST BROCK AVENUE BONIFAY FL 32425 324 1984MARIANNA HEALTH AND REHABILITATION CENTER 203475 4295 FIFTH AVENUE MARIANNA FL 32446 324 1971NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383 4294 3RD AVENUE MARIANNA FL 32446 324 (850) 526-3191 (850) 526-4481 1991SIGNATURE HEALTHCARE AT THE COURTYARD 324426 2600 FOREST GLEN TRAIL MARIANNA FL 32446 324 1997SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396 1083 SANDERS AVENUE GRACEVILLE FL 32440 324 1979LAFAYETTE HEALTH CARE CENTER 264482 512 W. MAIN STREET MAYO FL 32066 320 1997WILLISTON REHABILITATION AND NURSING CENTER 317586 300 NW 1ST AVE WILLISTON FL 32696 326 1981LAKE PARK OF MADISON 211923 259 SW CAPTAIN BROWN RD MADISON FL 32340 323 1995MADISON NURSING CENTER 213462 2481 WEST US 90 MADISON FL 32340 323 1985PINE LAKE NURSING HOME 214019 13455 W US HWY 90 GREENVILLE FL 32331 323 1983PLANTATION KEY CONVALESCENT CENTER 208906 48 HIGH POINT ROAD TAVERNIER FL 33070 330 1984OKEECHOBEE HEALTH CARE FACILITY 202541 1646 HIGHWAY 441 N. OKEECHOBEE FL 34972 349 1984CRESTWOOD NURSING CENTER 312274 501 S PALM AVE PALATKA FL 32177 321 1977LAKEWOOD NURSING CENTER 312142 100 N. LAKE STREET CRESCENT CITY FL 32112 321 1969PALATKA HEALTH CARE CENTER 226025 110 KAY LARKIN DRIVE PALATKA FL 32177 321 1989ARBOR VILLAGE NURSING CENTER 283142 490 S OLD WIRE RD WILDWOOD FL 34785 347 1982OSPREY POINT NURSING CENTER 215597 1104 NORTH MAIN STREET BUSHNELL FL 33513 335 1999GOOD SAMARITAN CENTER 268763 10676 MARVIN JONES BLVD LIVE OAK FL 32060 320 1970SURREY PLACE CARE CENTER 001135 110 SE LEE AVE LIVE OAK FL 32060 320 1988SUWANNEE HEALTH CARE CENTER 005387 1620 E HELVENSTON STREET LIVE OAK FL 32064 320 (386) 362-7860 (386) 362-4417 1982MARSHALL HEALTH AND REHABILITATION CENTER 252425 207 MARSHALL DRIVE PERRY FL 32347 323 1979WASHINGTON REHABILITATION AND NURSING CENTER 324353 879 USERY ROAD CHIPLEY FL 32428 324 1982

Page 13 of 250

Page 14: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

1 2 3 4 5 6 7 8 9 10H I J K L M N O N O O

Total Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

208 105 - 240 -

60 - 120 - 120 - 120 - 110 - 120 -

60 - 59 -

120 - 120 -

- 120 -

81 - -

45 - 120 -

- 120 -

60 - 101 -

87 - 120 - 129 - 178 -

60 - 120 - 204 -

- 120 - 169 - 120 - 119 - 120 -

60 - 120 - 120 -

60 - 60 -

120 - 120 - 120 - 120 -

85 - 112 - 120 - 120 -

Page 14 of 250

Page 15: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

110 - 155 -

- 120 - 120 - 180 - 219 - 107 - 120 - 133 -

60 - 139 - 120 - 130 - 120 - 180 - 120 36,923 36,923 120 - 120 - 120 -

60 - 73 - 84 -

173 - 150 - 192 46,198 46,198

65 - 122 32,000 32,000 239 - 120 - 120 - 160 -

99 - 60 - 60 - 60 - 60 -

120 - 120 - 194 - 198 -

36 - 60 - 60 - 88 - 60 -

155 - 67 - 59 -

120 - 109 - 151 -

Page 15 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

240 - 152 - 177 - 120 - 116 - 206 - 120 - 170 61,566 61,566 120 - 120 -

35 - 152 - 127 - 120 - 181 -

83 - 110 - 325 - 120 - 120 - 118 - 119 - 120 - 120 - 180 - 120 - 120 -

60 20,836 20,836 60 -

180 - 97 36,311 36,311

180 - 120 -

- 120 46,266 46,266 154 - 120 - 120 - 120 - 120 -

81 - 120 -

68 - 120 - 120 - 120 - 120 - 120 - 180 -

- 105 - 108 -

Page 16 of 250

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A B

Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

120 - 84 -

165 - 120 - 120 - 180 - 116 - 120 -

60 - 24 -

100 - -

180 - 120 - 117 - 163 - 122 - 120 - 120 - 120 45,521 45,521 104 - 120 - 180 - 240 - 119 - 180 - 120 - 240 - 120 - 120 - 120 - 120 - 120 -

- 120 - 120 - 120 -

68 - 120 -

- 60 -

120 - 120 - 120 - 120 - 120 - 120 -

60 - 100 -

48 - 120 - 120 -

Page 17 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

179 - 120 - 177 -

72 - 120 - 120 53,203 53,203 185 85,000 85,000

60 - 120 - 300 - 120 - 144 -

98 - 75 -

245 45,000 45,000 240 -

- 87 -

120 - 60 -

269 - 180 -

60 - 146 33,038 33,038 120 - 180 - 120 - 203 - 120 - 120 - 104 - 276 - 120 -

64 - 180 - 163 - 120 - 120 - 462 -

99 - 99 -

120 - 196 - 180 - 120 44,144 44,144

90 - 95 -

100 - 46 -

147 - 180 - 120 -

Page 18 of 250

Page 19: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

214 - 120 - 150 - 230 - 240 - 120 - 176 - 294 - 253 - 212 -

- 150 - 120 -

60 - - -

40 - 97 -

113 - 120 - 117 - 120 -

- 120 - 120 - 120 - 159 - 180 - 180 - 180 78,749 78,749 180 - 116 - 116 - 120 - 120 - 145 -

90 26,500 26,500 120 -

20 - 120 - 120 - 138 - 182 - 120 - 118 - 180 - 126 - 120 - 120 - 120 - 120 - 120 -

Page 19 of 250

Page 20: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

228 - 116 - 120 - 120 - 138 -

40 - -

120 - 120 - 120 53,203 53,203 120 - 120 - 120 - 180 56,750 56,750 180 - 120 -

39 - 120 - 115 -

60 - 420 - 120 - 103 - 120 - 131 - 120 - 170 - 120 -

59 14,037 14,037 120 - 120 - 120 - 120 - 116 - 202 - 114 - 120 - 120 - 240 - 120 31,582 31,582

42 - 98 -

- 120 - 120 - 110 - 138 37,931 37,931 167 -

96 - 180 - 100 - 179 -

Page 20 of 250

Page 21: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

120 - 120 - 141 - 120 - 120 - 107 - 120 - 157 - 120 - 180 - 114 - 120 34,143 34,143 120 - 160 - 120 - 120 -

77 - 115 46,000 46,000

22 - 120 30,000 30,000 120 - 120 - 170 - 120 34,549 34,549

88 - 120 - 120 - 180 - 120 - 118 - 155 - 210 - 120 38,280 38,280 120 - 106 - 120 54,100 54,100

60 - 110 - 120 - 120 - 120 - 116 - 177 - 120 41,715 41,715 120 -

36 - 79 - 30 -

120 - 171 - 107 - 123 -

Page 21 of 250

Page 22: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

120 44,144 44,144 180 - 120 - 180 - 120 - 120 - 120 - 120 - 180 - 120 - 164 - 104 - 110 - 159 -

24 - 180 71,816 71,816

- 24 -

120 36,294 36,294 97 30,323 30,323 60 -

156 - 120 - 120 - 180 - 120 - 120 - 120 - 150 - 120 - 120 - 120 - 120 - 117 - 120 -

45 - -

120 - 120 - 120 - 120 - 120 - 120 - 120 - 150 - 120 - 266 68,019 68,019 180 -

96 - 163 - 179 - 120 -

Page 22 of 250

Page 23: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

120 - 120 46,831 46,831 120 44,432 44,432 113 - 174 - 179 - 109 - 240 - 120 -

80 - 120 - 180 - 120 - 120 - 120 - 120 - 120 - 120 38,340 38,340 113 - 119 - 120 - 120 - 120 - 120 - 103 - 120 - 103 - 152 - 120 -

60 - 52 - 57 -

120 - 120 - 120 -

92 - 59 -

120 - 120 - 274 - 120 - 120 - 150 -

39 - 120 - 120 - 120 - 104 -

60 - 59 -

120 - 93 -

Page 23 of 250

Page 24: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

120 - 116 -

76 26,371 26,371 56 -

120 - 120 -

58 - 120 - 299 - 158 -

60 - 134 - 120 - 180 -

- 100 - 180 - 120 -

49 - 60 -

180 - 120 45,610 45,610 140 67,059 67,059 120 48,907 48,907

96 38,000 38,000 122 - 120 - 120 -

60 - 159 - 244 -

60 - 120 - 109 -

74 - 109 -

60 - 120 -

60 - 120 - 120 - 120 - 120 -

- 120 -

60 - 60 -

144 - 138 - 120 -

- 120 -

Page 24 of 250

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A B

Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

167 - 169 -

81 38,442 38,442 -

60 - 120 - 120 -

60 - 220 - 198 -

51 - 120 - 120 - 120 -

54 - 114 -

90 - -

120 - 120 - 280 - 120 - 120 - 120 - 120 - 107 -

68 - 132 - 180 - 120 - 180 - 120 - 117 - 120 -

85 - -

176 81,326 81,326 180 -

99 - 120 60,382 60,382

30 - 120 -

60 - 99 - 60 -

- -

119 - 120 - 120 - 120 37,572 37,572

92 -

Page 25 of 250

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A B

Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

H I J K L M N O N O O Total

Licensed Nursing Facility Beds

Non-Nursing Facility beds

Sq. Ft Nursing Facility

Sq. Ft. Non-

Nursing Facility

Total Sq. Ft.

Renovations expected in

2009?

# New Beds 2009

Construction Cost for New

Beds 2009

# Replacement

Beds 2009

Construction Cost for

Replacement Beds 2009

Construction Costs

Renovation 2009

150 - 116 - 104 - 111 - 150 - 120 - 120 - 120 - 120 - 120 -

95 - 90 -

120 - 41 - 60 -

120 - 60 -

- 79 - 93 28,872 28,872

155 47,355 47,355 104 - 180 61,349 61,349 104 - 120 -

90 - 180 - 180 - 136 30,000 30,000 120 - 180 -

60 - 180 - 120 -

60 - 58 -

120 - 173 -

65 - 92 -

180 - 210 -

60 - 161 -

60 - 180 58,000 58,000 120 - 180 -

Page 26 of 250

Page 27: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

11 12 13 14 15 16 17 18 19 20P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-91 60 1,241,443

Jul-91 30 677,957

Jan-84 42 1,182,981 Jan-02 86 11,426,773

Jan-87 6 -

Jan-96 21 811,681 Jan-97 12 446,277 Jan-95 (60) (1,292,623)

Jan-95 37 1,230,435 Jul-97 21 732,984

Jan-90 60 1,801,380 Jan-95 7 61,702 Jan-02 (1) -

Jan-91 60 1,821,120

Jul-05 (40) -

Jul-95 42 -

Jan-01 15 - Jul-99 25 978,550 Jul-99 22 240,920

Jan-91 18 - Jan-94 12 69,312 Jan-95 (4) - Jan-96Jul-01 (26) -

Page 27 of 250

Page 28: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-04 39 1,623,609

Jul-84 (3) - Jul-86 3 - Jan-06 (4) - Jan-92 36 717,139 Jan-97 70 2,779,127 Jul-91 60 1,810,440

Jan-94 27 854,043

Jan-04 13 93,812 Jan-95 29 986,338 Jul-94 53 1,722,425

Jul-93 60 1,896,540

Jul-04 (20) 103,609

Jul-95 (1) - Jul-98 1 -

Jul-90 74 2,193,804

Jul-00 1 -

Jan-99 (84) 14,453 Jan-06 (14) -

Jan-96 24 545,012 Jan-97 50 1,745,200

Page 28 of 250

Page 29: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-82 (10) - Jul-83 10 - Jan-86 (10) - Jan-87Jul-94 38 319,550 Jul-96 5 - Jul-97 14 -

Jan-98 50 1,838,707 Jan-97 35 1,202,635

Jan-82 28 4,568,424

Jul-84 20 - Jul-86 (20) - Jul-07 21 258,069

Jan-95 25 831,375 Jan-92 85 2,595,050

Jan-98 31 1,132,306 Jul-93 (1) (14,728) Jan-02 1 - Jul-99 60 2,272,920

Jan-91 60 1,088,011

Jan-00 20 8,094,232

Jul-08 60 2,698,860 Jan-95 37 57,882

Jan-05 (25) (485,156)

Jul-90 27 805,167

Jul-01 21 1,205,100 Jul-95 60 2,005,626

Jan-01 9 81,660

Page 29 of 250

Page 30: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-82 (3) - Jul-83 3 - Jul-91 60 17,620

Jan-95 45 1,496,475 Jan-89 12 -

Jul-97 60 2,165,065

Jan-92 31 935,394 Jan-02 (3) - Jul-94 63 1,783,654

Jan-07 62 3,950,580 Jul-90 61 1,838,802 Jul-91 4 298,293

Jan-96 14 1,458,984

Jan-90 13 - Jul-92 (12) - Jul-93 12 - Jul-00 (12) 53,821

Jul-96 60 2,129,717

Jul-93 8 2,681,369

Jul-95 60 1,524,887

Jul-92 60 1,831,800

Sep-99 69 3,934,369

Jul-71 (57) - Jan-96 57 2,180,040 Jul-04 3 -

Jul-97 40 3,787,267 Jul-93 (1) (13,844) Jan-00 1 -

Page 30 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-93 59 1,828,174

Jul-08 12 640,280

Jan-96 25 1,925,460 Jan-97 35 1,274,090 Jan-91 65 -

Jul-98 (38) 2,397,185 Jan-04 18 731,415 Jul-89 25 753,259

Jul-02 2 -

Jul-84 5 - Jul-86 (1) - Jul-88 1 - Jul-89

Jul-84 (4) - Oct-85 4 -

Jul-05 10 - Jul-82 (2) - Jul-83 2 - Jul-94 30 948,270

Jan-86 122 3,477,000 Jan-95 8 -

Jul-71 35 - Jan-96 (35) - Jan-05 10 168,353

Jul-07 27 1,214,487

Jul-98 40 1,481,640

Page 31 of 250

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A B

Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-90 20 593,240 Jan-00 34 659,089

Jul-01 60 2,516,201

Jul-98 (4) - Jul-04 52 2,299,481 Jul-82 60 - Oct-85 (60) -

Jul-94 (62) - Jul-95 62 23,166 Jul-94 (60) (2,035,489)

Jan-88 (16) (466,490) Jan-00 30 908,525 Jul-00 23 - Jan-89 21 - Jul-98 20 740,820

Jan-92 60 -

Jul-96 51 2,101,995 Jul-00 19 727,529 Jul-99 60 2,272,920

Jul-91 60 41,756 Jan-99 60 2,222,460 Jul-94 64 1,947,428 Jul-95 30 1,037,388 Jul-99 30 1,157,354

Jan-05 25 1,172,619

Jul-00 60 2,246,700

Jan-91 39 1,170,897 Jul-95 3 - Jul-98 40 1,590,980 Jul-03 33 109,266

Jan-99 60 2,232,748 Jul-98 66 3,030,701

Jul-98 40 1,481,640 Jun-86 44 1,706,852

Page 32 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-88 110 113,307

Jan-04 1 - Jan-04 60 2,582,062

Jan-96 60 3,181,622

Jan-04 (1) -

Jan-98 17 126,450

Jul-04 3 32,991 Jul-89 60 1,789,260 Jul-93 20 42,979 Jan-04 18 269,062

Jul-94 1 - Jul-00 20 8,564,230

Jan-01 8 -

Jul-00 60 2,297,460

Jul-99 47 - Jan-84 (36) 5,240,380 Jul-86 36 11,474 Jul-99 60 2,222,460

Jul-92 59 -

Page 33 of 250

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Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-93 60 1,545,975

Jul-97 32 1,169,041

Jan-88 60 1,693,672

Jan-86 (20) - Jul-88 20 209,900 Jul-92 60 1,818,758

Jan-99 8 220,870 Jul-07 10 -

Jul-97 60 3,257,106

Jan-88 6 - Jul-94 16 219,646

Jul-07 (10) -

Jan-94 (4) - Jul-95 14 106,281 Jul-98 (12) 28,552 Jul-00 71 1,799,677

Jul-98 (62) - Jan-01 7 928,424 Jul-02 7 354,634 Jul-08 (20) (839,560) Jul-82 1 - Oct-85 (1) - Jul-86 1 -

Jan-93 29 154,212

Page 34 of 250

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Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

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2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jan-04 5 48,125

Jan-02 39 2,383,394

Jul-93 5 641,992 Jul-94 77 2,478,091 Jan-02 7 78,867

Jul-89 36 1,067,832 Jan-88 32 941,536

Jan-89 6 28,259 Jan-98 60 2,200,850 Jan-99 60 3,927,866 Jan-98 60 2,560,824

Jul-08 (30) - Jul-88 60 28,956

Jan-00 42 3,271,774 Jul-01 4 -

Jan-00 6 22,779 Jan-01 (6) 47,814

Jul-01 30 -

Jan-97 51 3,818,688 Jul-00 9 -

Oct-85 60 1,695,540 Jan-95 53 2,765,841 Jul-96 59 2,059,631

Page 35 of 250

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-93 180 5,614,860 Jul-09 (120) (5,090,388)

Jul-93 17 420,990 Jul-01 71 2,829,279

Jul-05 (11) -

Jan-96 60 4,376,201

Jul-95 43 - Jul-71 (60) 742,396 Jul-88 60 - Jan-90 60 1,801,380 Jul-01 3 23,154 Jul-88 6 71,895

Jan-05 10 33,989

Jul-90 (1) 0 Jul-91 1 - Jul-92 30 1,175,206 Jul-94Jul-95 (1) - Jul-97 1 -

Jul-93 (1) (16,175) Jul-96 1 16,646 Jul-91 30 905,220

Page 36 of 250

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-96 32 1,357,887

Jan-00 60 2,357,854 Jul-84 2 - Oct-85 (2) - Jul-95 2 - Jan-07

Jan-94 42 1,960,143 Jan-96 20 676,400

Jan-08 (4) -

Jan-95 60 1,948,650 Jul-96 13 495,287 Jan-98 29 979,325 Jan-03

Jul-91 (1) - Jan-00 (18) (248,561) Jan-04 (35) 33,781 Jul-08 12 195,087

Jul-01 (41) (420,701)

Jan-07 24 2,415,716 Jan-07 (24) -

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Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

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2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-92 44 1,335,488 Jul-93 13 402,818 Jan-07 1 - Jan-03 10 14,770

Jul-95 14 - Jul-00 (12) -

Jan-09 14 - Jul-94 30 999,238

Jan-91 160 4,771,360

Jul-96 10 343,610 Jul-01 11 427,306 Jan-02 28 1,027,260 Jul-01 12 -

Jan-92 30 900,690 Jan-93 30 929,580

Jul-90 60 1,778,760

Jul-96 39 1,749,373 Jul-00 60 2,291,460 Jan-99 3 - Jul-99 14 -

Jan-84 (60) - Oct-85 60 - Jan-04 (1) 550,290

Jul-84 71 1,697,232

Jul-00 11 -

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Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

P Q R P Q R P Q R P

M/Y of Construction

Addition 1

Number of Beds

Addition 1

Cost of Construction

Addition 1

M/Y of Construction

Addition 2

Number of Beds Addition

2

Cost of Construction

Addition 2

M/Y of Construction

Addition 3

Number of Beds

Addition 3

Cost of Construction

Addition 3

M/Y of Construction

Addition 4

Jul-95 30 - Jul-92 56 1,699,712

Jan-96 60 1,708,528 Jan-99 60 2,246,700 Jan-98 9 347,757

Jan-85 (1) - Oct-85 1 - Jan-09 30 1,408,884 Jul-95 60 2,066,436 Jul-88 21 617,883 Jan-92 17 515,984 Jul-94 20 74,411 Jan-06

Jan-89 19 559,037 Jan-93 33 - Jan-99 48 1,873,413 Jan-09 (13) -

Jan-98 60 2,208,526 Jul-96 16 566,976

Jan-86 (2) - Jan-87 22 - Jul-88 30 719,644 Jan-91

Jul-98 60 924,261 Jul-95 58 1,928,790 Jan-02 2 - Jul-82 (69) - Jul-86 69 -

Jul-09 60 2,698,860

Jan-00 20 433,954 Jan-09 20 765,820 Jan-02 1 -

Jul-88 30 540,930 Jul-89 30 909,477 Jan-90 5 123,509 Jul-97

Jul-90 60 1,079,702 Jul-98 60 2,588,704 Apr-83 (60) 995,681 Jul-88 60 1,765,380 Jul-98 30 1,138,447

Jan-92 54 -

Jul-93 28 - Jul-88 60 1,651,916

Page 39 of 250

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A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

21 22 23 24 25 26 27 28 29 30Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

4 -

Page 40 of 250

Page 41: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 41 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

10 -

Page 42 of 250

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A B

Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 43 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

(5) - Jul-91 5 -

Page 44 of 250

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A B

Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 45 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 46 of 250

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A B

Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 47 of 250

Page 48: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 48 of 250

Page 49: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

(1) - Jan-97 (3) 19,410

Page 49 of 250

Page 50: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

(6) 26,941

22 56,043

Page 50 of 250

Page 51: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

Page 51 of 250

Page 52: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

Q R P Q R S T U S T

Number of Beds

Addition 4

Cost of Construction

Addition 4

M/Y of Construction

Addition 5

Number of Beds

Addition 5

Cost of Construction

Addition 5

M/Y of Replacement 1

Number of Beds

Replacement 1

Cost of Beds Replacement 1

M/Y of Replacement 2

Number of Beds

Replacement 2

(77) 1,827,657

16 -

12 432,564 Jan-03 6 -

Page 52 of 250

Page 53: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

31 32 33 34 35 36 37 38 39 40U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

Page 53 of 250

Page 54: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

A B

Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

Page 54 of 250

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A B

Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

Page 59 of 250

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A B

Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

U S T U S T U S T U

Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

Number of Beds

Replacement 4

Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

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BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

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M/Y of Replacement 3

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Cost of Beds Replacement 3

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Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

Cost of Beds Replacement 5

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PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

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Cost of Beds Replacement 2

M/Y of Replacement 3

Number of Beds

Replacement 3

Cost of Beds Replacement 3

M/Y of Replacement 4

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Cost of Beds Replacement 4

M/Y of Replacement 5

Number of Beds

Replacement 5

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BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

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LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

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HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

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ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

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HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

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SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

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HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

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ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

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PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

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NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

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EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

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BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

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PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

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BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

52 53 54 55 56 57 58 59 60 61 62 63 64X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

3 1986 298,727 3 1994 104,449 3 20033 2000 455,481 3 1982 1,775,277 3 1994 204,313 3 1994 35,235 3 1995 504,256 3 19963 2002 76,680 3 2001 65,951 3 2007 68,737 3 20081 1991 60 3 1995 71,521 3 1996 2,820,617 1 1991 30 3 1992 39,109 1 1984 42 3 1971 151,516 3 19841 2002 86 3 1989 243,535 3 1990 279,779 3 1991

3 1983 80,494 3 2000 120,840 3 2006 48,780

3 2005 79,494 3 2008 38,406

1 1987 6 3 1984 2,673,470 3 2003 37,725 3 2007 70,678 3 20081 1996 21 1 1997 12 3 19711 1995 (60) 3 1989 178,617 3 19923 1997 114,616

1 1995 37 1 1997 21 3 1984

3 2006 61,491 3 1976 112,586 3 1982 485,258 3 1983

3 1977 738,570 3 1978 107,515 3 19913 2007 64,900 1 1990 60 1 1995 7 1 20023 1996 141,517 3 2002 85,621 3 20063 1978 66,200 3 1991 85,534 3 19923 2001 61,570 3 2008 160,071 1 1991 60 3 1995 121,925 3 19963 1985 33,333 3 1990 33,946 3 19971 2005 (40) 3 1989 66,741 3 2008

1 1995 42 3 2002 72,156 3 1998 490,091 3 2000 61,833 1 2001 15 1 1999 25 3 1996 60,722 3 19981 1999 22 3 2000 327,100 3 20031 1991 18 1 1994 12 1 19951 2001 (26) 3 1982 167,315 3 1982

Modification 1 Modification 2 Modificatio

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Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

3 2006 57,163 3 2007 55,614

3 2006 102,949 3 2008 126,852 1 2004 39 3 2008 111,102 3 1999 66,883 3 2002 71,108 3 2005

3 2009 94,435 3 1987 46,903 3 1999 42,166 3 20001 1984 (3) 1 1986 3 1 20061 1992 36 3 2001 752,264 3 20031 1997 70 3 1991 49,010 3 19981 1991 60 3 1988 142,794 3 1999

1 1994 27 3 1984 130,637 3 19963 1984 73,220 3 1996 201,035 3 19973 1996 63,848 3 1976 660,855 3 1979 1,091,963 3 19953 1998 92,109 3 2001 35,673 3 20071 2004 13 1 1995 29 3 1994 61,005 3 19961 1994 53

3 1982 693,636 3 1988 38,535 3 2000 91,132

1 1993 60 3 1981 346,909 3 1982

1 2004 (20) 3 1999 513,270 1 1995 (1) 1 1998 1 3 2002

1 1990 74 3 1989 428,969 3 1991 178,946 1 2000 1 3 2006 63,028 3 20073 1998 4,503 3 1995 49,646 3 1998 36,223 3 2004

3 1996 37,124 3 1999 30,355 3 20071 1999 (84) 1 2006 (14) 3 1995

3 1990 32,037 3 2000 39,649

1 1996 24 3 1995 47,437 3 20061 1997 50

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Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

3 1999 212,819 3 2000 129,860 1 1982 (10) 1 1983 10 1 19861 1994 38 1 1996 5 1 19973 2005 102,550

1 1998 50 3 2002 152,107 1 1997 35 3 1992 53,761 3 1995

3 1993 54,109 3 2002 25,800 1 1982 28 3 2003 858,476 3 2004

3 1994 67,925 3 1998 75,583 1 1984 20 1 1986 (20) 1 20073 1987 85,208 1 1995 25 3 1994 231,106 1 1992 85

3 1985 680,042 3 1989 436,631 3 20003 1994 74,508 3 1995 409,783 3 19971 1998 31 3 1999 87,759 1 1993 (1) 1 2002 1 3 19971 1999 60 1 1991 60 3 1983 79,181 3 19843 1987 188,419 1 2000 20

3 2000 87,811 1 2008 60 3 1983 135,286 1 1995 37 3 2000 93,695

3 1997 1,118,490 1 2005 (25) 3 1984 2,048,436 3 1995

1 1990 27 3 2004 124,446 3 2004

3 1984 307,530 3 1989 359,075 3 1994 43,799 1 2001 21 1 1995 60 3 1971 289,778 3 1977 283,173 3 20013 1991 107,667 3 1993 91,096 3 1994

3 1992 67,124 3 1999 66,411 3 20003 1999 81,354 3 2006 101,416 1 2001 9 3 2006 60,738

3 2003 112,483

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Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1982 (3) 1 1983 3 1 19913 2000 66,763 1 1995 45 3 1997 101,693 1 1989 12 3 1976 577,878 3 1990 135,961 3 20003 1980 449,797 3 1995 144,589 3 2000 74,660 3 1996 44,954 3 1999 83,354 3 2001

3 1991 16,503 3 1992 242,160 3 19973 1994 468,955 3 1995 87,582

3 2000 106,098 3 1997 176,965 3 1998 1,001,229 3 20061 1992 31 1 2002 (3) 3 20071 1994 63 1 2007 62 3 2003 34,118 1 1990 61 1 1991 4 3 19893 2008 226,856 1 1996 14 3 2001 69,550 3 2006 77,526 3 20071 1990 13 3 1994 70,814 1 1992 (12) 1 1993 12 1 20003 1983 159,024 3 1990 1,210,766 3 2000 114,395 1 1996 60 3 1994 76,593

1 1993 8 3 1980 431,991 3 19813 1994 130,877 3 1995 96,978 3 20043 1994 138,758 3 2004 420,419 3 20073 1997 82,913 3 2008 81,799 1 1995 60 3 2002 109,885

1 1992 60 3 1994 63,514 3 2007 312,367 3 20081 1999 69 3 2001 147,231 3 20043 1993 39,846

1 1971 (56) 1 1996 57 1 20043 1997 83,973 3 2008 65,410

3 1991 60,683 3 1993 70,787 3 19943 1989 260,223

3 1977 557,147 3 1991 62,377 3 2006 1,851,137 1 1998 40 3 2006 25,845 1 1993 (1) 1 2000 1

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Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1993 59

3 2007 96,109 1 2008 12 3 1994 30,428 3 19983 2000 68,548 3 2001 979,642 1 1996 25 1 1997 35 3 19951 1991 65 3 1983 1,262,590 3 1971 325,000 3 2007 1,533,729

3 1998 238,432

3 1995 95,166 3 1998 493,436 1 1998 (38) 1 2004 18 1 1989 25

3 2003 800,000 3 2009 188,053

3 2008 112,666

1 2002 2 3 1974 274,391 3 20053 1991 148,648 1 2004 8 1 1984 5 3 1990

3 2004 88,086

3 1998 189,829 3 1999 64,013 1 1984 (4) 1 1985 4 3 20003 2003 349,944 3 2007 296,170 3 2008

1 2005 10 3 1984 40,730 3 19891 1982 (2) 1 1983 2 1 19943 1990 293,049 3 1997 117,825 3 1999

1 1986 122 1 1995 8 3 19773 1989 60,205 3 1996 1,004,443 3 2009 71,078

3 1983 125,113 3 2006 208,057 3 1995 102,500 3 2004 117,848 3 20083 1995 70,035 3 1988 182,498 3 1993 106,663 3 19951 1971 35 1 1996 (35) 1 2005

1 2007 27 3 2000 593,370 3 2000 216,042 3 20013 1983 190,962 1 1998 40

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Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1990 20 1 2000 34

3 1995 139,345 3 1996 90,198 3 19973 1988 127,222 3 2003 130,785 1 2001 60 3 1997 103,575 3 20063 2000 90,337 3 1996 165,050 1 1998 (4) 3 1999 588,897 1 2004 52 1 1982 60 1 1985 (60) 3 1982

1 1994 (62) 1 1995 62 1 1994 (60) 3 1989 637,429 3 19903 1996 209,222

3 2005 40,336 3 2007 51,012 3 20081 1988 (16) 3 1982 203,282 3 19831 2000 30 1 2000 23 3 19941 1989 21 3 2006 275,741 3 20071 1998 20 3 1984 62,736 3 19963 1993 1,622,927

1 1992 60 3 2002 80,251

1 1996 51 1 2000 19 3 19951 1999 60 3 1996 107,360 3 20003 2002 98,619 3 2003 289,496 1 1991 60 1 1999 60 3 19951 1994 64 1 1995 30 1 19993 1971 946,558 3 1998 346,586 3 1971 802,927

3 1996 61,066 3 1998 111,434 3 20001 2005 25

1 2000 60 3 2003 162,787

3 1984 898,697 1 1991 39 3 2007 60,451 1 1995 3 3 1986 285,000 3 20001 1998 40 3 1981 384,445 3 19851 2003 33 3 2008 67,724 3 2000 233,273 1 1999 60 3 1995 101,531 1 1998 66 3 1990 32,397 3 1992

3 1998 84,902 3 1995 44,841 3 1996 54,882 1 19981 1986 44 3 1971 503,390 3 1981

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A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1988 110 3 1983 77,661 3 19893 2000 83,050 1 2004 1 1 2004 60 3 1998 55,832 3 1999

3 1971 40,008 3 1976 559,581 3 1984

3 1995 630,853 1 1996 60 3 1995 39,031 3 20023 1997 315,572 3 2002 869,785

3 1985 489,837 3 1994 77,441 3 1999 50,593 3 1995 62,125 3 1996 379,508 3 2003 102,160 3 2000 33,755 3 2002 63,392 3 20093 1976 1,104,329 3 1994 405,912 3 20023 1995 300,000 3 1997 105,627 3 2003 88,680 3 2005 64,776 1 2004 (1) 3 1983 2,034,244 3 1980 100,766 3 2000 129,486

3 1980 175,319 3 1983 115,134 3 1984

3 1995 114,606

1 1998 17 3 1988 1,154,705 1 2004 3 1 1989 60 1 1993 20 1 2004

1 1994 1 3 2002 70,820 1 2000 20 3 1977 188,921 3 1980 222,183 3 1983

1 2001 8

3 2003 81,332 1 2000 60 3 1999 87,046 3 1980 86,206 3 2000 153,440

1 1999 47 3 1997 69,868 1 1984 (36) 1 1986 36 3 19991 1999 60 3 2001 92,217 3 2003 73,232 3 20061 1992 59

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Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1993 60 3 2004 312,573 3 20053 2007 208,159 3 2009 110,492 3 1995 96,868

1 1997 32

3 1982 582,498

1 1988 60

3 2000 84,685 3 1973 335,424

3 2001 74,937

3 1991 581,121

3 1980 703,499 3 1995 789,054 3 1996 81,671 1 1986 (20) 1 1988 20 1 1992

1 1999 8 1 2007 10

3 2006 78,453 1 1997 60 3 2007 1,602,098 3 1984 189,374 3 1995 227,395 3 2002 292,371

1 1988 6 3 1983 163,686 3 19841 1994 16

3 1989 35,036 1 2007 (10) 3 1979 682,402 3 2002

3 1980 1,337,699 3 1988 130,933 3 1989

1 1994 (4) 1 1995 14 1 1998 (12) 1 2000

1 1998 (62) 3 1976 482,514 1 2001 7 1 2002 7 1 20081 1982 1 1 1985 (1) 1 19863 2000 24,610 3 2006 55,381 3 20081 1993 29 3 1997 493,185 3 1985 87,566 3 2008 100,966

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Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 2004 5

3 1984 241,791 3 2003 163,829 3 2009 85,165

3 1996 496,250 3 1984 1,161,462 3 2003 95,690 3 1990 76,703 3 1995 74,091 3 19983 2005 100,936 1 2002 39 3 1989 385,796 3 2003

1 1993 5 1 1994 77 1 2002

3 1997 40,295 3 1999 2,520,596 1 1989 36 3 1997 307,399 3 20001 1988 32 3 2007 122,592 3 1993 69,656 3 1995 82,098 3 19961 1989 6 1 1998 60 1 1999 60 3 1990 50,499 3 19991 1998 60 3 2006 241,151 3 20093 1992 143,491 3 1993 136,584 1 2008 (30) 3 1982 838,129 3 19871 1988 60 3 1995 107,419

1 2000 42 1 2001 4

3 1991 178,956

1 2000 6 1 2001 (6) 3 19903 1997 1,304,224 3 1998 127,338 3 19993 1998 85,247 3 1999 118,184 3 1990 78,588 3 1991 104,643 3 2001

3 1980 117,890 3 1982 208,247 3 19981 2001 30 3 1999 52,978 3 20003 1991 165,452 3 1997 207,576 3 20031 1997 51 1 2000 9 3 19953 1980 86,542 3 1996 58,006 3 19971 1985 60 1 1995 53 3 19801 1996 59 3 1994 442,609

Page 87 of 250

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1993 180 1 2008 (120) 3 19913 1995 214,887 3 1997 1,288,987 1 1993 17 3 1994 71,161 1 2001 71 3 1994 294,284 3 1979 103,207 1 2005 (11) 3 1987 1,751,700 3 19973 2000 268,895 3 2001 165,744 3 1992 65,364 3 1975 217,012 3 1995 649,299 3 1996

1 1996 60 3 1993 93,221

3 1996 165,029 3 1997 98,051 3 19983 1989 242,398

3 1980 71,968 3 2007 121,822 3 2005 81,540 3 2006 58,470 3 1995 163,636 3 1995 1,403,258 3 2006 65,882 3 20083 1987 66,539 3 2008 74,940 3 1995 94,024 3 2000 68,655

1 1995 43 3 2003 78,673 1 1990

1 2001 3 1 1988 6 3 1989 110,358

3 2004 34,666 3 2008 146,683 1 2005 10 3 2003 24,601 3 1996 48,394 3 1997 471,604 3 1983 737,288 3 1996 49,394 3 1997

3 1996 149,392 3 1997 111,019 3 20011 1990 (1) 1 1991 1 1 19921 1995 (1) 1997 1 2 1993 129,753 3 1995 122,106

3 1990 1,883,360 3 1996 270,703 3 2005

1 1993 (1) 1 1996 1 3 19851 1991 30 3 1992 235,771 3 19973 1995 30,848 3 1997 76,210 3 1996 60,482 3 1998 145,707 3 1999

3 2003 78,673 3 1994 29,974 3 2002 32,235 3 20063 2000 78,196 3 1982 125,676

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

3 2004 43,731 3 1980 242,347 3 1974 783,011 3 1992 273,368 3 1993

3 1990 86,756 1 1996 32 3 2005 70,250 3 2007

1 2000 60 3 1995 138,062 3 19971 1984 2 1 1985 (2) 1 19953 1994 74,937 3 1995 31,048 3 20083 1994 50,039 3 2007 420,000 3 1994 69,734 3 1997 1,149,206 1 1994 42 1 1996 20 3 1996 1,148,530 3 1997 81,799 3 2001 67,570 1 2008 (4) 3 1990 85,884 3 2004 129,217 3 2004 203,876 3 2000 546,132 3 1994 115,447 3 1995 97,656 1 1995 60 1 1996 13 1 1998

1 1991 (1) 1 2000 (18) 1 2004 (35) 1 20083 2003 51,544 3 2007 41,711 3 1996 145,977 3 2006 78,977 3 20083 2003 102,725 3 1973 100,000 3 1974 150,000 3 19933 1981 1,510,920 3 1985 70,812 3 1996 150,366 3 1997 128,326 3 19993 1995 94,134 3 1998 860,846

1 2001 (41)

3 1988 31,635 3 1989 64,576 3 20061 2007 24 3 1997 107,346 3 19981 2007 (24) 3 1971 827,434 3 1980

3 1991 341,124

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Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1992 44 1 1993 13 3 19981 2007 1 3 1999 9,996,496 1 2003 10

3 1990 322,469 3 1996 682,650 3 2000 79,213 3 1989 43,593 3 1999 55,125 3 2007 193,198 3 2009 300,443 1 1995 14 1 2000 (12) 3 19793 2005 38,911 3 2007 45,691 3 2009 232,916

3 1992 79,006 3 1999 61,026 3 2003 29,774 1 2008 14 3 1979 227,823 3 19801 1994 30 3 1983 77,460

3 2005 69,134 3 2006 67,334 1 1991 160 3 1984 181,243 3 1985

3 1983 78,037 3 2001 763,812 3 20053 1985 888,255 3 1991 183,303 1 1996 10 3 1999 60,207 3 20081 2001 11 1 2005 28 1 2001 12 3 1981 614,546 3 19951 1992 30 1 1993 30 3 19853 2005 79,152 1 1990 60 3 2006 102,202 3 1983 1,185,302 3 2009 339,254 3 2002 595,058 3 1992 108,633 3 1995 353,228

1 1996 39 3 1994 101,045 3 19961 1999 17 1 2000 60 3 19873 1987 1,135,159 3 2001 9,987,746 3 1987 99,969 3 1997 1,546,717

3 1999 76,050 3 2005 75,222 3 2000 55,051 3 2006 37,214 3 20073 2000 1,605,551 3 2002 683,852 3 1983 32,251 3 1987 56,938 3 1988

1 1984 (60) 1 1985 60 1 20043 1992 676,616 3 2000 69,196 1 1984 71 3 1985 289,561 3 2001

1 2000 11

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A B

Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

X V W X

Additional Sq Ft

Renovation 4

M/Y of Renovation 5

Cost of Renovation 5

Additional Sq Ft

Renovation 5

# Changes

1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 1 Modification 2 Modificatio

1 1995 30 3 1974 174,781 3 19751 1992 56 3 1971 879,981 3 1980 71,662 3 19713 2008 193,293

1 1996 60 3 1992 30,620 1 1999 60 3 1996 33,594 3 20001 1998 9 3 2008 94,972

1 1985 (1) 1 1985 1 1 2008 30 3 2005 46,204 3 20061 1995 60 1 1988 21 1 1992 17 1 1994

3 1972 264,900 3 1994 35,611 3 1996

1 1989 19 1 1993 33 1 1999 48 1 2002 (13) 3 19813 2005 79,126 1 1998 60 1 1996 16 3 1994 45,384 3 19951 1986 (2) 1 1987 22 1 19883 2000 69,974 3 2001 123,772 1 1998 60 1 1995 58 1 20021 1982 (69) 1 1986 69 3 1981

1 2008 60 3 1983 197,608

3 1982 646,163 3 1992 100,819 1 2000 20 1 2001 20 1 20023 1996 44,300 3 2008 43,038 3 2006 62,969 3 2008 53,180 3 1990 78,950 1 1988 30 1 1989 30 1 19903 1988 44,595

1 1990 60 1998 60 1 1983 (60) 1 1988 60 1 19983 2006 43,072 1 1992 54 3 1975 1,443,858 3 19913 1999 45,615 3 2004 71,024

1 1993 28 3 1984 357,737 1 1988 60 3 2000 140,463

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Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

65 66 67 68 69 70 71 72 73 74 75 76 77 78 79

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

225,243 3 2005 182,031

36,952 3 1999 32,377 3 2008 57,084

242,196 3 2008 85,788

38,680 3 2003 48,716 3 2004 29,744

253,842 3 1994 293,403 3 1996 2,487,567 3 1997 134,520 3 2000 62,572 3 2003

44,674 175,778 3 1977 267,323 3 1983 461,096 3 1993 42,106 3 1999 53,003 3 2002150,329 3 1993 207,593 3 1999 45,391

177,174

130,657 3 1993 1,246,969 3 1996 552,808 3 1997 635,937 3 2000 505,618 3 2008

316,498

(1) 72,559

993,311 3 2000 32,970

736,572 3 1997 101,638 43,436 3 2005 31,607 32,400

50,291 3 2008 84,093 62,817

(4) 1 1996 4 3 2006 72,323 88,617

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

Page 92 of 250

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A B

Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

68,973

110,911 3 2001 220,446 3 2002 66,006 (4) 3 1990 283,682

108,979 1,135,972 1,064,422 3 2009 94,053

933,436 105,240

284,043 3 2000 988,950 3 2000 129,405 3 2005 99,189 3 2008 94,910 126,343

283,296 3 1998 67,343 3 2007 75,978 3 2009 68,824

91,956 3 1984 1,726,308

184,065 3 2006 32,125 3 2008 110,559

43,398

69,519

35,854 1,656,174

116,191

Page 93 of 250

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Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

(10) 1 1987 10 3 1973 83,019 3 1974 559,614 3 1991 1,434,932 14 3 1976 482,744 3 1980 1,935,602 3 1989 83,405 3 1991 608,806 3 2000

63,682

103,860 3 2005 152,955

21 3 1985 734,710 3 1991 203,960 3 1997 119,698 3 2000 95,258 3 2006

364,569 490,994

73,531 3 2004 71,423

1,082,371

97,533 3 2009 202,327

79,352

217,235 162,786 3 1995 90,572 3 1996 72,208 3 1997 101,149 3 1998 66,917 3 1999

72,460

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Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

60 3 1971 789,752 3 1992 1,953,547 3 1996 64,172 3 1998 99,850 3 2000

87,927 3 2001 69,153

136,821 3 2008 62,193 3 2009 69,004

23,975 3 1998 19,366 3 1999 38,080 3 2000 35,143 3 2001 34,680 3 2002

60,533 223,375 3 2009 266,135

83,440

67,757 3 2008 84,197

(12) 3 1983 195,626 3 2005 120,520

143,151 3 1984 119,716 3 1988 153,120 3 1996 356,978 3 1997 185,057 3 2003270,371

61,068

152,349 125,302 3 2005 71,655

3 3 2000 32,216

125,664 3 1996 81,882

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Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

34,206 3 1999 203,590 3 2000 40,724 3 2002 125,430 3 2003 109,224 3 2004

59,924 3 2006 248,184

272,273 3 2009 185,664

1,368,795 3 1992 164,061 3 1999 30,038 3 2003 307,211

93,976 223,330

37,495 3 1993 27,448 30 3 1997 287,481 3 2001 279,152

121,707 3 2000 93,433 3 2002 233,402

3,181,051 3 1980 396,847 3 1988 309,929 3 1989 4,605,047 3 1992 274,397

150,239 3 2009 183,481

90,301 10 3 1999 52,474

366,156

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Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

112,509 3 1997 169,610 3 1999 117,010 3 1999 75,593 3 2000 101,538

224,623

1,148,021 3 1983 285,914 3 1989 1,074,680 3 1990 698,348 3 1991 383,310 3 1999

577,174 3 1992 95,274 3 1995 64,503

30,384 188,037 3 1984 152,808

63,639 3 1997 38,502 3 2001 419,492 106,132

51,196

51,263 3 1997 328,500 103,059 3 2007 382,109

188,100 30

94,787 3 2004 65,223

770,704 2,207,488 3 2002 96,943

130,052 3 1994 45,522 3 1995 90,902 3 1996 72,892 3 1997 42,947 3 1999

40 3 2003 139,616 38,604 3 1989 85,097 3 1993 161,521 3 1994 84,367 3 1996 449,287 3 2000

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A B

Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

820,527 3 1990 237,896 3 1994 936,966 3 1995 155,151 3 1999 350,718 3 2006

36,672 3 2001 42,278

20,242 3 1991 90,060 3 1995 56,220 3 2003 1,458,420 3 2004 2,500,000 3 2005

63,538

64,103 489,335 3 2009 440,321

133,100 3 1985 95,773 3 1988 448,689 3 1991 91,838 3 1997 96,455 3 1998

18 3 1992 607,040 3 1997 142,466 3 2003 153,846

2,721,334 3 1985 421,319 3 1995 477,769 3 1999 167,785 3 2000 190,122 3 2006

49,878

90,457 3 2007 51,425

Page 98 of 250

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Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

99,909 3 2006 90,290 3 2008 169,577

60 3 1998 227,796 3 1999 98,459 3 2001 94,083 3 2002 92,055 3 2003

3,208,184

261,625

87,337 3 1998 201,972

71

(20) 3 2002 25,290 1 3 1990 155,027 3 2007 58,176

19,842 3 2009 20,051

Page 99 of 250

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A B

Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

70,974 3 2002 59,423

89,320

7 3 1995 269,345

78,347

248,048

880,680 3 2000 75,339 3 2001 251,557 3 2003 362,281 70,038

160,093 3 2007 108,948

75,270 71,995

126,275

643,635 81,591 3 2007 81,837 3 2008 71,821

203,101 3 2004 353,994 66,798 67,155 3 2007 125,039 91,223 3 1998 198,888 3 2004 88,149

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

39,977

172,840

47,023 3 1999 53,373

136,564

63,804

60 3 1989 742,396 3 1994 201,699 3 2006 129,184 3 2007 167,054

471,604

70,070 3 2005 64,938 3 2007 69,533 3 2008 63,514 30 1 1994 (1) 1 1997 (3) 3 1993 456,141

145,789 3 2007 164,669

76,159 649,594

84,403

52,507

Page 101 of 250

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

206,098

116,049

90,824 3 2003 317,463 3 2004 501,661 3 2005 187,878 2 1 2007 (6) 3 1993 69,623 3 2004 212,720

99,637

29 1 2003 22 3 1997 175,567 3 2001 290,638

12

112,048

71,305

76,253 3 2006 158,841

86,118 3 2008 85,876 72,503 3 2000 80,333 3 2008 173,626

343,245 3 1997 92,235 3 1998 120,185

Page 102 of 250

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Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

119,983 3 1999 117,803 3 2009 366,637

99,297 3 1980 2,118,864 3 1982 158,919 3 1983 189,087 3 1989 567,817 3 1990

218,993 3 1987 75,438 3 2002 2,901,558 3 2003 10,381,895

152,000 3 1998 151,793 3 2006 350,000 3 2008 253,450

88,278

88,020

65,258 3 1997 133,055 3 1999 6,175,040 3 2004 92,907 3 2007 180,333 174,136

66,762 3 2006 563,904 288,982 3 2009 744,467

56,753

41,052 3 1996 36,711

(1) 3 1995 73,100 3 2001 3,551,310 3 2003 289,764

228,794

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Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

ModificatioModification 6 Modification 7Modification 5on 3 Modification 4

678,476 3 1984 632,617 3 1991 785,777

827,434 3 1980 343,245 3 1997 92,235 3 1998 120,185

71,407

34,687

20 1 2006 (77)

718,393 3 1998 69,430 3 1999 38,307

136,451 3 1982 1,325,521 3 2000 110,579

63,795 30 1 1991 16 3 1986 466,108 3 1990 159,815 3 2004 244,408 3 2008

2 3 1989 117,627 3 1991 111,753 102,361 3 1984 2,391,336

1

5 1 1997 12 1 2003 6 3 1985 49,012

30

1,639,008

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A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

80 81 82 83 84 85 86 87 88 89 90 91 92 93 94

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

68,236

75,994 3 2009 77,126

2,101,363

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

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Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

Page 106 of 250

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Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

814,322

101,630

63,246 3 2001 71,624

Page 107 of 250

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Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

77,159 3 2001 208,509 3 2002 205,215 3 2003 134,021 3 2007 113,960

13,659 3 2003 38,864 3 2005 13,461 3 2008 64,846 3 2009 88,375

767,049 3 2008 186,971

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Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

102,602

Page 109 of 250

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A B

Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

399,818 3 2001 360,358 3 2002 109,957

119,532 3 2000 73,942 3 2001 87,158 3 2003 68,011 3 2004 149,000 3 2005

285,142 3 2007 124,312

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Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

184,182

21,277

102,206 3 2003 120,265

174,131 3 2007 201,050

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Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

145,573 3 2004 139,069 3 2006 265,944

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A B

Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

Page 115 of 250

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Nursing Facility NameMedicaid Provider Number

BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

151,206

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Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 12 Modificationon 8 Modification 9 Modification 10 Modification 11

112,570

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A B

Nursing Facility NameMedicaid Provider Number

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENTER 227625HERITAGE PARK CARE AND REHABILITATION CENTER 324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER 259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATION 256277WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 209422WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CENTER 317136HEARTLAND HEALTH CARE & REHABILITATION CENTER 999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATION 319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER 253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENTER 308501TARPON POINT NURSING AND REHABILITATION CENTER 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYERS 320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCARE 252344

95 96 97 98 99 100 101 102 103 104 11504/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

208 208 4.59 0.41 5.01 105 10.50 1.27 11.77 240 240 6.23 0.68 6.92

60 60 10.32 0.98 11.30 120 120 11.31 1.00 12.31 120 120 10.77 1.31 12.09

60 120 7.23 0.89 8.12 110 110 11.62 1.23 12.85

90 120 8.58 1.16 9.75 60 60 8.45 1.17 9.62 17 59 6.29 0.77 7.06 34 120 8.72 1.22 9.95

120 120 20.47 1.72 22.19 - - -

120 120 7.31 1.13 8.44 81 81 9.76 1.15 10.91

- - - 45 45 10.75 1.21 11.96

120 120 10.58 1.31 11.89 - - -

114 120 10.67 1.29 11.95 60 60 9.52 1.23 10.75 68 101 12.37 1.02 13.39

147 87 7.71 0.61 8.32 120 120 10.32 1.24 11.57 129 129 8.40 1.04 9.44 120 178 11.86 0.97 12.83

60 60 10.29 1.19 11.48 120 120 10.85 1.13 11.98 204 204 14.17 1.36 15.53

- - - 120 120 14.31 1.13 15.44 169 169 8.83 0.96 9.79 120 120 11.43 1.30 12.73

53 119 7.05 0.97 8.02 120 120 8.22 0.99 9.21

60 60 10.56 1.08 11.64 120 120 10.59 1.17 11.76

60 120 13.45 1.36 14.80 60 60 11.51 0.95 12.45

100 60 7.66 0.87 8.54 120 120 9.50 1.16 10.66

78 120 6.17 0.78 6.95 120 120 11.38 1.37 12.76 105 120 9.01 1.09 10.09

60 85 10.07 1.25 11.32 90 112 7.04 1.18 8.22 90 120 7.55 1.04 8.58

146 120 9.89 0.99 10.88

Modification 16n 13 Modification 14 Modification 15

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Nursing Facility NameMedicaid Provider Number

LEHIGH ACRES HEALTH AND REHABILITATION CENTER 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORAL 263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CENTER 217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER 226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENTER 282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING HOME 229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENTER 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CENTER 252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

110 110 14.03 1.27 15.30 155 155 9.70 1.30 11.00

- - - 120 120 9.19 1.08 10.27 120 120 5.66 0.61 6.27 180 180 8.55 1.21 9.76 180 219 3.09 0.45 3.54 107 107 5.92 0.64 6.56 120 120 10.62 1.17 11.79 133 133 7.98 0.67 8.65

60 60 11.23 1.32 12.55 143 139 8.52 1.13 9.65

84 120 5.41 1.22 6.63 60 130 8.33 1.22 9.54 60 120 10.17 1.35 11.52

180 180 7.43 0.87 8.29 93 120 9.94 0.90 10.84

120 120 11.01 1.10 12.10 120 120 5.77 1.17 6.94 120 120 11.92 1.33 13.25

60 60 10.25 1.17 11.43 60 73 6.69 0.84 7.53 55 84 7.68 0.99 8.66

120 173 11.90 1.11 13.01 150 150 8.95 1.22 10.17 192 192 7.95 0.77 8.72

65 65 6.30 0.76 7.06 122 122 7.17 0.65 7.82 179 239 9.43 1.00 10.43 120 120 8.69 1.18 9.87 120 120 8.45 1.14 9.59 180 160 9.83 1.17 11.00

99 99 4.55 0.54 5.08 60 60 4.57 0.95 5.51 60 60 8.55 1.23 9.78 60 60 5.41 0.42 5.83 60 60 6.53 0.61 7.14

120 120 9.75 1.20 10.95 120 120 6.70 1.25 7.94 120 194 9.42 1.03 10.45 198 198 12.95 1.03 13.98

35 36 11.91 1.27 13.18 60 60 6.81 0.98 7.79 60 60 9.29 0.87 10.17 88 88 2.98 0.67 3.64 60 60 13.62 1.24 14.86

253 155 9.55 1.06 10.62 67 67 8.98 0.83 9.81 59 59 10.87 1.09 11.96

120 120 8.45 1.17 9.62 85 109 8.55 1.00 9.54

101 151 8.78 1.20 9.98

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A B

Nursing Facility NameMedicaid Provider Number

HILLCREST NURSING AND REHABILITATION CENTER 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER 256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CENTER 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENTER 227579DESTIN HEALTHCARE AND REHABILITATION CENTER 252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CENTER 324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CENTER 227765PARKLANDS REHABILITATION AND NURSING CENTER 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY 255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883GOVERNORS CREEK HEALTH AND REHABILITATION 252387HEARTLAND HEALTH CARE CENTER ORANGE PARK 325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

240 240 10.42 1.04 11.46 152 152 12.76 1.05 13.82 120 177 6.96 0.72 7.68 120 120 9.62 1.28 10.90 116 116 1.02 0.24 1.26 206 206 2.14 0.26 2.40 120 120 9.52 0.98 10.50 120 170 13.45 1.27 14.72

85 120 11.15 1.14 12.29 120 120 3.88 0.44 4.32

35 35 8.38 1.07 9.45 124 152 9.87 0.94 10.82 127 127 10.03 1.09 11.11 120 120 11.13 1.16 12.28 160 181 9.27 1.24 10.51

83 83 6.14 0.61 6.76 85 110 11.07 1.00 12.07

240 325 17.18 1.27 18.45 120 120 9.56 0.95 10.50 120 120 12.03 0.88 12.91 118 118 10.13 0.94 11.07

88 119 10.40 1.25 11.66 120 120 6.43 0.50 6.94

60 120 11.34 1.28 12.63 120 180 7.99 0.69 8.68 120 120 12.10 1.20 13.30 100 120 10.28 1.03 11.31

60 60 13.86 1.09 14.95 60 60 4.92 0.58 5.50

120 180 8.66 0.81 9.47 60 97 13.37 1.28 14.66

180 180 17.90 1.35 19.25 120 120 10.34 1.03 11.38

- - - 120 120 11.03 1.17 12.21 179 154 4.96 0.63 5.59 120 120 6.38 0.66 7.04

93 120 7.75 0.63 8.37 120 120 10.09 1.24 11.33 120 120 10.28 0.96 11.23

60 81 13.43 1.19 14.62 60 120 9.03 1.22 10.25 68 68 8.65 0.82 9.48

120 120 10.36 1.22 11.59 120 120 9.27 1.26 10.53 120 120 7.81 0.78 8.59 120 120 9.24 0.94 10.18 111 120 8.32 1.20 9.52 180 180 8.90 1.26 10.16

- - - 105 105 5.84 0.63 6.47 108 108 10.32 1.30 11.62

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Nursing Facility NameMedicaid Provider Number

ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE 325236HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER 256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE 316601ST AUGUSTINE HEALTH AND REHABILITATION CENTER 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

60 120 11.37 1.32 12.68 84 84 8.72 1.22 9.95

120 165 9.22 0.78 10.00 108 120 9.56 0.96 10.51 120 120 11.05 1.30 12.36 180 180 8.91 0.82 9.74 116 116 9.37 1.11 10.47

60 120 10.13 1.31 11.44 60 60 11.83 1.17 13.00 24 24 12.18 1.15 13.33

100 100 12.59 1.21 13.80 - - -

180 180 6.09 0.75 6.83 120 120 9.89 1.18 11.07

89 117 11.66 1.09 12.75 100 163 8.44 1.14 9.58

60 122 9.77 1.35 11.12 55 120 10.57 1.09 11.66

120 120 8.73 1.32 10.06 106 120 13.79 1.19 14.98 104 104 6.61 0.66 7.27 107 120 9.35 1.06 10.42 192 180 14.16 1.33 15.49 240 240 8.57 1.14 9.70 119 119 6.72 0.85 7.57 120 180 17.07 1.35 18.42 120 120 10.21 1.25 11.46 232 240 8.21 1.36 9.58 120 120 5.66 0.76 6.42 120 120 9.36 1.36 10.71 120 120 8.96 1.26 10.23

60 120 7.43 0.97 8.40 120 120 11.08 0.93 12.01

- - - 60 120 9.00 1.22 10.22

120 120 15.41 1.13 16.54 51 120 9.98 1.26 11.24 68 68 4.38 0.48 4.86

120 120 7.48 0.87 8.36 - - -

57 60 2.48 0.32 2.80 120 120 17.84 1.37 19.21 120 120 6.28 0.58 6.87 120 120 7.36 0.84 8.20 120 120 13.56 1.21 14.77 120 120 6.66 0.84 7.50 120 120 9.16 1.11 10.27

60 60 6.52 0.77 7.29 100 100 11.18 1.22 12.40

8 48 8.81 1.26 10.07 120 120 5.51 0.51 6.02 120 120 11.57 1.00 12.57

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Nursing Facility NameMedicaid Provider Number

HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CENTER 265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTER 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CENTER 284823BERKSHIRE MANOR 005388CLARIDGE HOUSE NURSING & REHABILITATION CENTER 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864CORAL GABLES NURSING AND REHABILITATION CENTER 323772CORAL REEF NURSING & REHABILITATION CENTER 282529EAST RIDGE RETIREMENT VILLAGE INC 228788FAIR HAVENS CENTER 227226FLORIDA CLUB CARE CENTER 207993FLORIDEAN NURSING HOME INC 200425FOUNTAINHEAD CARE CENTER 005523FRANCO NURSING & REHABILITATION CENTER 319554GRAMERCY PARK NURSING CENTER 214027HAMPTON COURT NURSING AND REHABILITATION CENTER 324027HARMONY HEALTH CENTER 269107HEARTLAND HEALTH CARE CENTER KENDALL 325244HEARTLAND HEALTH CARE CENTER MIAMI LAKES 325252HEBREW HOME OF SOUTH BEACH 308242HIALEAH CONVALESCENT HOME 265730HIALEAH SHORES NURSING AND REHAB CENTER 250988HOMESTEAD MANOR 212121JACKSON MEMORIAL LONG TERM CARE CENTER 204161JACKSON MEMORIAL PERDUE MEDICAL CENTER 203670JACKSON PLAZA NURSING & REHABILITATION CENTER 253723MIAMI GARDENS CARE CENTRE 210617MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 200506MIAMI SHORES NURSING AND REHAB CENTER 214035NORTH BEACH REHABILITATION CENTER 228001NURSING CENTER AT MERCY, THE 267902OCEANSIDE EXTENDED CARE CENTER 212733PALACE AT KENDALL NURSING AND REHABILITATION CENTER 203327PALM GARDEN OF AVENTURA 257494PALMETTO REHABILITATION AND HEALTH CENTER 324167PALMETTO SUB ACUTE CARE CENTER, INC 212806PINECREST CONVALESCENT CENTER 225754PINES NURSING HOME 200620PONCE PLAZA NURSING & REHABILITATION CENTER 308251REGENTS PARK AT AVENTURA 223239RIVERSIDE CARE CENTER 207276

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

120 179 9.19 1.22 10.40 120 120 4.88 0.63 5.51 177 177 9.17 1.27 10.43

60 72 12.12 1.26 13.38 120 120 8.54 1.32 9.87

60 120 12.32 1.37 13.68 120 185 8.05 0.93 8.98

60 60 13.15 1.25 14.40 120 120 10.00 1.20 11.19 300 300 9.18 0.93 10.11 120 120 10.26 1.24 11.50 144 144 8.27 0.80 9.06 118 98 13.21 1.09 14.30

50 75 8.55 0.68 9.23 245 245 11.98 0.88 12.85 240 240 12.39 0.90 13.29

- - - 87 87 12.30 1.22 13.52

120 120 9.15 1.24 10.39 60 60 5.14 0.90 6.03

267 269 7.60 0.93 8.53 180 180 14.98 1.16 16.15

55 60 10.43 1.13 11.55 146 146 14.11 1.03 15.14 120 120 9.27 1.13 10.40 180 180 13.36 1.08 14.44 120 120 12.70 1.17 13.87 203 203 8.56 1.16 9.72 120 120 8.89 1.17 10.05 120 120 12.25 0.99 13.24 104 104 7.29 0.70 7.99 276 276 14.59 1.09 15.67 120 120 7.72 0.56 8.27

54 64 9.20 1.03 10.23 150 180 12.15 1.16 13.31 163 163 14.06 1.34 15.40 120 120 12.81 1.18 13.99 120 120 12.29 0.99 13.28 332 462 12.37 1.66 14.03

99 99 7.90 0.61 8.51 99 99 11.25 1.05 12.30

120 120 9.42 1.16 10.57 196 196 7.83 0.87 8.70 180 180 11.56 1.05 12.61 120 120 10.48 1.11 11.59

90 90 12.73 1.33 14.05 85 95 11.06 0.95 12.01

100 100 6.86 0.54 7.40 46 46 5.83 0.55 6.38

120 147 13.20 1.23 14.43 180 180 13.41 1.38 14.79

80 120 6.57 0.68 7.25

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Nursing Facility NameMedicaid Provider Number

SIGNATURE HEALTHCARE CENTER OF WATERFORD 324400SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 324418SINAI PLAZA NURSING & REHAB CENTER 260771SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 311308ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 209473SUSANNA WESLEY HEALTH CENTER 268062TREASURE ISLE CARE CENTER 226602UNITY HEALTH AND REHABILITATION CENTER 227544VICTORIA NURSING & REHABILITATION CENTER, INC. 225177VILLA MARIA NURSING CENTER 203165VILLA MARIA WEST SKILLED NURSING FACILITYWATERCREST CARE CENTER 310409WEST GABLES HEALTH CARE CENTER 282359ARISTOCRAT, THE 225291BENTLEY CARE CENTER 999932CHATEAU AT MOORINGS PARK, THE 999931HARBORCHASE OF NAPLES 268585HERITAGE HEALTHCARE & REHABILITATION CENTER 252280IMPERIAL HEALTH CARE CENTER 226378LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 256846MANORCARE AT LELY PALMS 325422MANORCARE NURSING AND REHABILITATION CENTER 325449PREMIER PLACE AT THE GLENVIEW 999930HAWTHORNE HEALTH AND REHAB OF OCALA 253456LIFE CARE CENTER OF OCALA 266108MARION HOUSE HEALTH CARE CENTER 214043NEW HORIZON REHABILITATION CENTER 227773OAKHURST CARE AND REHABILITATION CENTER 251721OCALA HEALTH AND REHABILITATION CENTER 217395PALM GARDEN OF OCALA 257290TIMBERRIDGE NURSING & REHABILITATION CENTER 203335AVANTE AT LEESBURG, INC. 203122AVANTE AT MT. DORA, INC. 252042BAYVIEW CENTER 260444EDGEWATER AT WATERMAN VILLAGE 210684LADY LAKE SPECIALTY CARE CENTER 227561LAKE EUSTIS CARE CENTER 213870LAKE HARRIS HEALTH CENTER 228966LAKEVIEW TERRACE SKILLED NURSING FACILITY 259225LEESBURG HEALTH AND REHAB, LLC 252956NORTH CAMPUS REHABILITATION AND NURSING CENTER 210439RULEME CENTER 260452WESTMINSTER CARE OF CLERMONT 221465ADVENTIST CARE CENTERS-COURTLAND, INC 320439AVANTE AT ORLANDO, INC. 223808COLONIAL LAKES HEALTH CARE 252557COMMONS AT ORLANDO LUTHERAN TOWERS 205796CONWAY LAKES HEALTH & REHABILITATION CENTER 264512COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 324175EAST ORLANDO HEALTH & REHAB CENTER, INC 320421GUARDIAN CARE NURSING & REHABILITATION CENTER 201651HEALTH CENTER OF WINDERMERE, THE 228877

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

160 214 13.44 0.98 14.43 120 120 14.66 1.05 15.71 150 150 14.34 1.16 15.50 230 230 7.13 0.84 7.97 180 240 10.97 1.37 12.34 120 120 13.13 1.28 14.41 176 176 9.69 0.93 10.62 298 294 9.65 0.90 10.55 201 253 12.81 1.20 14.01 212 212 12.12 1.28 13.40

- - - 150 150 11.98 1.21 13.19 180 120 12.57 1.34 13.91

60 60 11.51 1.14 12.65 - - - - - -

40 40 10.72 1.25 11.97 113 97 11.08 1.34 12.42

60 113 9.10 0.98 10.08 99 120 9.34 0.98 10.32 97 117 9.44 1.29 10.72

120 120 8.91 1.22 10.13 - - -

60 120 12.23 1.22 13.45 120 120 10.55 1.16 11.72 120 120 12.18 1.00 13.19

89 159 11.72 1.09 12.81 120 180 11.34 1.15 12.48 180 180 10.12 1.18 11.30

60 180 12.92 1.36 14.28 56 180 9.04 1.04 10.07

116 116 10.21 0.86 11.07 116 116 7.30 0.62 7.92 120 120 8.30 1.10 9.41 120 120 7.83 1.27 9.10 120 145 13.29 1.24 14.53

90 90 8.93 0.93 9.86 60 120 10.75 1.18 11.93 20 20 6.18 0.72 6.90

120 120 6.73 0.81 7.55 81 120 10.78 1.26 12.03

135 138 7.40 0.80 8.20 142 182 7.62 1.00 8.61

87 120 7.62 0.94 8.56 118 118 8.55 0.72 9.27 120 180 10.91 1.32 12.23

67,711 3 2006 99,496 3 2007 423,030 3 2008 768,849 60 126 14.40 1.14 15.54 120 120 9.79 1.17 10.96 120 120 6.45 0.76 7.21

80 120 7.24 1.10 8.34 76 120 13.70 1.13 14.83

120 120 8.67 1.22 9.88

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Nursing Facility NameMedicaid Provider Number

HEALTH CENTRAL PARK 204811HUNTERS CREEK NURSING AND REHAB CENTER 263605LAKE BENNETT HEALTH AND REHABILITATION CENTER 318761LIFE CARE CENTER OF ORLANDO 213403MANOR CARE NURSING & REHABILITATION CENTER 325279MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 201588MAYFLOWER HEALTHCARE CENTER 999941METRO WEST NURSING AND REHAB CENTER 263541OCOEE HEALTH CARE CENTER 324159PALM GARDEN OF ORLANDO 257303PARKS HEALTHCARE AND REHABILITATION CENTER 259934QUALITY HEALTH OF ORANGE COUNTY 225410REGENTS PARK OF WINTER PARK 269719REHABILITATION CENTER OF WINTER PARK, THE 005380RIO PINAR HEALTH CARE 252450ROSEWOOD HEALTH AND REHABILITATION CENTER 252468SAVANNAH COVE 312550SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 320412TERRA VISTA REHAB AND HEALTH CENTER 261611WESTMINSTER CARE OF DELANEY PARK 221589WESTMINSTER CARE OF ORLANDO 223654WESTMINSTER TOWERS 208540WINTER PARK CARE & REHABILITATION CENTER 324515WINTER PARK TOWERS 209848AVANTE AT ST CLOUD, INC. 259870CONSULATE HEALTH CARE OF KISSIMMEE 319511GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 205303KEYSTONE REHABILITATION AND HEALTH CENTER 317560OAKS OF KISSIMMEE 005549OSCEOLA HEALTH CARE CENTER 217859PALMS AT PARK PLACE, THE 253421PLANTATION BAY REHABILITATION CENTER 252441SOUTHERN OAKS HEALTH CARE CENTER 253146CONSULATE HEALTH CARE OF WEST ALTAMONTE 319546FLNC, INC 320463HEALTHCARE & REHAB OF SANFORD 263931ISLAND LAKE CENTER 260657LAKE MARY HEALTH AND REHABILITATION CENTER 252310LIFE CARE CENTER OF ALTAMONTE SPRINGS 210137LONGWOOD HEALTH CARE CENTER 005379LUTHERAN HAVEN NURSING HOME 313718TUSKAWILLA NURSING AND REHAB CENTER 263591VILLAGE ON THE GREEN 999936ANCHOR CARE AND REHABILITATION CENTER 324451ATLANTIC SHORES NURSING AND REHAB CENTER 263389AVANTE AT MELBOURNE, INC. 252018CARNEGIE GARDENS NURSING CENTER 005519CONSULATE HEALTH CARE OF MELBOURNE 319520COURTENAY SPRINGS VILLAGE 209325HEALTH CENTER OF MERRITT ISLAND, THE 226700HUNTINGTON PLACE CARE AND REHABILITATION CENTER 211281INDIAN RIVER CENTER 260665

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

118 228 12.99 1.09 14.08 116 116 9.09 1.23 10.32 119 120 9.56 1.23 10.78

60 120 8.40 1.29 9.69 138 138 6.16 0.62 6.78

40 40 13.66 1.28 14.94 - - -

120 120 8.72 1.18 9.90 120 120 15.32 1.38 16.70

60 120 12.02 1.19 13.20 120 120 8.62 1.33 9.95 120 120 13.61 1.12 14.73 120 120 9.77 1.13 10.90 180 180 12.28 0.74 13.02 180 180 10.64 1.06 11.70 120 120 11.21 1.12 12.33

39 39 7.93 1.16 9.09 120 120 7.29 1.05 8.34 115 115 11.15 0.98 12.13

60 60 9.06 1.23 10.29 420 420 10.58 0.95 11.53 120 120 12.01 0.99 13.01 103 103 5.01 0.47 5.48 121 120 6.70 0.68 7.38 131 131 7.56 0.64 8.20 120 120 9.33 1.13 10.46 170 170 10.44 1.02 11.46 120 120 9.03 1.31 10.35

59 59 7.02 0.65 7.67 120 120 13.06 1.06 14.12 120 120 12.82 1.04 13.86 103 120 9.25 1.11 10.36 120 120 9.60 1.25 10.85 113 116 12.20 1.09 13.30 104 202 10.18 0.98 11.16 114 114 3.96 0.43 4.39 119 120 9.22 1.22 10.44 100 120 10.31 1.03 11.34 240 240 10.59 1.02 11.60 120 120 7.96 0.76 8.72

42 42 7.23 1.29 8.52 90 98 7.87 1.07 8.94

- - - 120 120 5.73 0.62 6.35

60 120 9.19 1.24 10.43 110 110 8.57 0.72 9.30 138 138 10.19 1.07 11.26 120 167 12.29 1.10 13.39

96 96 17.08 1.33 18.41 120 180 9.86 1.19 11.05 100 100 6.41 0.64 7.05 120 179 9.13 1.21 10.34

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A B

Nursing Facility NameMedicaid Provider Number

ISLAND HEALTH AND REHABILITATION CENTER 252352LIFE CARE CENTER OF MELBOURNE 228338LIFE CARE CENTER OF PALM BAY 268186MELBOURNE TERRACE REHABILITATION CENTER 264547PALMS REHABILITATION AND HEALTHCARE CENTER, THE 252395ROCKLEDGE HEALTH AND REHABILITATION CENTER 227587ROYAL OAKS NURSING AND REHAB CENTER 263583TITUSVILLE REHABILITATION & NURSING CENTER 263974VISTA MANOR 252522WEST MELBOURNE HEALTH & REHABILITATION CENTER 217727WUESTHOFF PROGRESSIVE CARE CENTER 253472FLAGLER PINES 005374GRAND OAKS HEALTH AND REHABILITATION CENTER 252409BAY CENTER 212989CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 264491COMMUNITY HEALTH AND REHABILITATION CENTER 318779EMERALD SHORES HEALTH AND REHABILITATION 252191GLEN COVE NURSING PAVILION 005384LISENBY ON LAKE CAROLINE 203980PANAMA CITY NURSING CENTER 005385SEA BREEZE HEALTH CARE 252247ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 323799BAPTIST MANOR 208809BAYSIDE MANOR 213853CENTURY CARE CENTER 220604CONSULATE HEALTH CARE OF PENSACOLA 319686HAVEN OF OUR LADY OF PEACE 258831HEALTH CENTER OF PENSACOLA, THE 229571LIFE CARE CENTER OF PENSACOLA 315664PENSACOLA HEALTH CARE FACILITY 224243ROSEWOOD MANOR 211842SOUTHERN OAKS REHABILITATION AND NURSING CENTER 324566SPECIALTY CENTER OF PENSACOLA 213918UNIVERSITY HILLS HEALTH AND REHABILITATION 252123WILLOWBROOKE COURT AT AZALEA TRACE 210374BAY BREEZE NURSING AND RETIREMENT CENTER 213816SANDY RIDGE CARE CENTER 220621SANTA ROSA HEALTH & REHABILITATION CENTER 220612UNIHEALTH POST-ACUTE CARE - SANTA ROSA 259331EDGEWATER MANOR 201545MARTIN NURSING AND RESTORATIVE CARE CENTER 226033PALM CITY NURSING & REHAB CENTER 263621PARKWAY HEALTH & REHABILITATION CENTER 228885SALERNO BAY MANOR 214141STUART NURSING & RESTORATIVE CARE CENTER 225991WATERS EDGE EXTENDED CARE 213152ABBIEJEAN RUSSELL CARE CENTER LLC 268755BRIGHTON GARDENS OF PORT ST LUCIE 210781EMERALD HEALTH CARE CENTER 261637FORT PIERCE HEALTH CARE 252239LAUREL POINTE HEALTH AND REHABILITATION 211516LIFE CARE CENTER OF PORT SAINT LUCIE 217824

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

120 120 7.15 0.86 8.01 60 120 11.52 1.24 12.76

141 141 10.01 1.30 11.32 120 120 12.88 1.24 14.12 120 120 10.25 1.24 11.48

75 107 9.20 0.86 10.06 120 120 8.54 1.16 9.69 157 157 5.07 0.55 5.62 120 120 10.77 1.08 11.85 120 180 7.52 0.75 8.27 114 114 7.64 1.16 8.80 120 120 10.23 0.75 10.98 120 120 10.33 1.03 11.37 160 160 8.01 0.74 8.75 120 120 4.17 1.27 5.44 120 120 10.16 1.26 11.42

77 77 10.32 1.24 11.56 115 115 12.26 0.94 13.20

22 22 12.96 1.34 14.30 120 120 5.96 0.45 6.40 120 120 7.05 0.72 7.77 120 120 15.72 1.37 17.09 110 170 13.73 1.37 15.09 120 120 7.49 0.59 8.07

70 88 9.57 9.57 120 120 12.64 1.13 13.77 120 120 5.23 1.27 6.50 120 180 14.08 1.37 15.45 120 120 8.93 1.33 10.26 118 118 4.99 0.50 5.49 155 155 5.42 0.50 5.93 210 210 4.56 0.61 5.17 120 120 12.95 1.01 13.96 114 120 10.62 1.06 11.68

90 106 4.84 0.76 5.60 120 120 12.19 0.96 13.15

60 60 13.02 1.09 14.11 120 110 9.05 0.73 9.78 120 120 10.31 1.11 11.42 120 120 11.02 1.05 12.07 120 120 10.03 1.21 11.24 120 116 8.55 1.16 9.71 104 177 7.93 0.91 8.85 120 120 10.22 1.20 11.41 182 120 9.62 1.06 10.68

42 36 10.26 1.19 11.45 78 79 3.87 1.07 4.94 30 30 12.18 1.27 13.45 91 120 11.46 1.12 12.59

171 171 9.22 0.88 10.10 107 107 6.24 0.73 6.97 123 123 9.68 1.08 10.76

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Nursing Facility NameMedicaid Provider Number

PALM GARDEN OF PORT SAINT LUCIE 257249PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 226009TIFFANY HALL NURSING AND REHAB CENTER 263532CHARLOTTE HARBOR HEALTHCARE 226327CONSULATE HEALTH CARE OF PORT CHARLOTTE 320129DOUGLAS JACOBSON STATE VETERANS NURSING HOME 269492ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 252204HARBOUR HEALTH CENTER 319333LIFE CARE CENTER OF PUNTA GORDA 311685PORT CHARLOTTE REHABILITATION CENTER 319325SIGNATURE HEALTHCARE OF PORT CHARLOTTE 324477VILLAGE PLACE HEALTH AND REHABILITATION CENTER 002400ATLANTIC HEALTHCARE CENTER 310581CONSULATE HEALTH CARE OF VERO BEACH 320145FLORIDA BAPTIST RETIREMENT CENTER 001416PALM GARDEN OF VERO BEACH 257311ROYAL PALM HEALTHCARE & REHABILITATION CENTER 999919WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 001416RIVERCHASE CARE CENTER 005386BRYNWOOD CENTER 005381JEFFERSON HEALTH AND REHABILITATION CENTER 214001CAPITAL HEALTHCARE CENTER 252093CENTRE POINTE HEALTH AND REHAB CENTER 264563CONSULATE HEALTH CARE OF TALLAHASSEE 319716HERITAGE HEALTHCARE CENTER 252298MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 202941WESTMINSTER OAKS 200409EDEN SPRINGS NURSING AND REHAB CENTER 253707BROOKSVILLE HEALTHCARE CENTER 228958EVERGREEN WOODS 263893HEARTLAND OF BROOKSVILLE 325295HERON POINTE HEALTH AND REHABILITATION 252174SPRING HILL HEALTH AND REHABILITATION CENTER 252492BAYSHORE POINTE NURSING AND REHAB CENTER 263575BRANDON HEALTH AND REHABILITATION CENTER 252077BRIGHTON GARDENS OF TAMPA 284793CANTERBURY TOWERS INC 999949CARROLLWOOD CARE CENTER 263877CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 259900COMMUNITY CONVALESCENT CENTER 281913CONSULATE HEALTH CARE OF BRANDON 319660EXCEL REHABILITATION AND HEALTH CENTER 324116FAIRWAY OAKS CENTER 260690FLETCHER HEALTH AND REHABILITATION CENTER 252221HABANA HEALTH CARE CENTER 252506HAWTHORNE HEALTH AND REHAB OF BRANDON 261670HEALTH CARE CENTER OF TAMPA 213039HEALTH CENTER OF PLANT CITY, THE 226343HOME ASSOCIATION, INC., THE 201154JOHN KNOX VILLAGE MED CENTER 210285LAKESHORE VILLAS HEALTH CARE CENTER 218057MANORCARE HEALTH SERVICES CARROLLWOOD 325678

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

120 120 9.36 1.12 10.48 180 180 11.90 1.31 13.22 120 120 8.69 1.18 9.87 180 180 10.23 0.99 11.21 115 120 9.11 1.10 10.22 120 120 4.24 1.29 5.53 120 120 10.24 1.23 11.48 120 120 13.28 1.15 14.43 180 180 16.36 1.24 17.59 120 120 13.95 1.32 15.27 164 164 5.99 0.65 6.64 104 104 11.30 1.05 12.36 110 110 6.43 0.76 7.18 120 159 9.00 1.13 10.13

24 24 4.97 0.78 5.76 91 180 11.78 1.33 13.11

- - - 24 24 4.97 0.78 5.76

120 120 12.99 1.02 14.01 97 97 10.23 0.80 11.04 60 60 12.56 1.31 13.87

120 156 8.83 0.88 9.72 88 120 8.28 1.29 9.57

120 120 12.49 1.11 13.60 114 180 10.72 1.07 11.79

60 120 13.39 1.36 14.75 60 120 10.32 1.05 11.36

120 120 8.90 0.78 9.69 180 150 10.54 0.98 11.52

60 120 10.95 1.19 12.14 120 120 9.59 1.32 10.92 120 120 6.82 0.68 7.50 120 120 10.19 1.02 11.20

75 117 9.97 1.14 11.11 116 120 9.83 1.18 11.01

45 45 3.99 1.18 5.17 - - -

120 120 10.73 1.16 11.89 120 120 7.51 1.16 8.67 120 120 6.57 0.74 7.31 120 120 13.67 1.23 14.90 120 120 14.32 1.27 15.59 120 120 8.31 1.10 9.42 120 120 10.43 1.04 11.47 150 150 7.14 0.71 7.85

90 120 11.87 1.25 13.12 266 266 7.88 0.64 8.52 120 180 8.73 1.29 10.02

96 96 7.40 0.72 8.12 50 163 8.09 1.02 9.11

120 179 9.37 1.06 10.43 120 120 9.99 1.05 11.05

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Nursing Facility NameMedicaid Provider Number

NURSING CENTER AT UNIVERSITY VILLAGE, THE 259462PALM GARDEN OF SUN CITY 257516PALM GARDEN OF TAMPA 257524PLAZA WEST 211885REHABILITATION AND HEALTHCARE CENTER OF TAMPA 263940SOUTH TAMPA HEALTH AND REHABILITATION CENTER 224910SUN TERRACE HEALTH CARE CENTER 209856WHISPERING OAKS 266612WOODBRIDGE REHABILITATION & HEALTH CENTER 324141YBOR CITY HEALTHCARE & REHABILITATION CENTER 212164BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 214914BAYONET POINT HEALTH & REHABILITATION CENTER 226076BEAR CREEK NURSING CENTER 228567CONSULATE HEALTH CARE OF BAYONET POINT 319651CONSULATE HEALTH CARE OF NEW PORT RICHEY 319970HEARTLAND OF ZEPHYRHILLS 325708HEATHER HILL HEALTHCARE CENTER 228591HERITAGE PARK 214132LIFE CARE CENTER OF NEW PORT RICHEY 259357MADISON POINTE REHABILITATION AND HEALTH CENTER 324124ORCHARD RIDGE CARE AND REHABILITATION CENTER 252689ROYAL OAK NURSING CENTER 228575SOUTHERN PINES HEALTHCARE CENTER 262706TRINITY REGIONAL REHAB CENTER 003521WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 263991ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 320391ZEPHYRHILLS HEALTH & REHAB CENTER, INC 320404ABBEY REHABILITATION AND NURSING CENTER 263958ADVANCED REHABILITATION AND HEALTH CENTER 324094ALHAMBRA HEALTH AND REHABILITATION CENTER 261254ALLEGRO AT COLLEGE HARBOR, THE 309800ALPINE HEALTH & REHABILITATION CENTER 227251APOLLO HEALTH & REHABILITATION CENTER 227251BAY POINTE NURSING PAVILION 263834BAY TREE CARE AND REHABILITATION CENTER 253448BAYSIDE REHABILITATION & HEALTH CENTER 324108BAYWOOD NURSING CENTER 316652BELLEAIR HEALTH CARE CENTER 264521BOCA CIEGA CENTER 213004BON SECOURS MARIA MANOR NURSING CARE CENTER 200107CARRINGTON PLACE NURSING & REHABILITATION CENTER 315524CLEARWATER CENTER 212911COMPREHENSIVE HEALTHCARE OF CLEARWATER 200956CONCORDIA MANOR 251666CONSULATE HEALTH CARE OF SAFETY HARBOR 319694CONSULATE HEALTH CARE OF ST PETERSBURG 319708COUNTRYSIDE REHAB AND HEALTHCARE CENTER 252115CROSS TERRACE REHABILITATION CENTER 001300CRYSTAL OAKS OF PINELLAS 264351EAGLE LAKE REHAB & CARE CENTER 311065EAST BAY REHABILITATION CENTER 264539EDINBOROUGH HEALTHCARE CENTER 252484

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

60 120 8.74 1.23 9.97 120 120 13.74 1.36 15.11 103 120 13.39 1.28 14.66

42 113 9.76 1.09 10.84 174 174 3.87 0.42 4.29 179 179 7.58 0.67 8.25 120 109 10.19 0.98 11.18 240 240 6.28 0.77 7.04 120 120 9.47 0.89 10.36

80 80 9.57 0.92 10.49 120 120 8.16 1.27 9.44 120 180 12.00 1.36 13.36 120 120 7.07 0.66 7.73 120 120 9.46 1.12 10.58 120 120 6.44 0.81 7.25 120 120 9.33 1.28 10.61 120 120 7.46 0.70 8.16 120 120 7.33 0.84 8.17 113 113 10.15 1.27 11.42 119 119 9.54 0.88 10.42 120 120 10.63 1.11 11.74 120 120 10.34 0.96 11.30 120 120 7.91 0.73 8.64 120 120 8.23 1.06 9.30

60 103 10.78 1.17 11.95 60 120 7.56 0.96 8.52

100 103 8.54 1.21 9.75 146 152 4.07 0.44 4.51 120 120 11.59 1.07 12.66

60 60 3.14 0.44 3.59 42 52 6.54 0.83 7.37 57 57 10.44 1.00 11.45

120 120 8.40 0.78 9.18 120 120 10.50 1.14 11.64 120 120 8.67 0.91 9.58

66 92 14.67 1.36 16.03 59 59 2.16 0.25 2.41

120 120 9.54 0.96 10.50 120 120 5.75 0.49 6.24 274 274 13.17 1.04 14.21 120 120 9.06 1.29 10.35 120 120 5.67 0.48 6.15 120 150 16.59 1.37 17.96

39 39 4.32 0.41 4.74 120 120 10.22 1.21 11.43 120 120 9.61 1.14 10.75 120 120 10.57 1.27 11.84 104 104 4.17 0.54 4.71

60 60 11.84 1.09 12.93 59 59 11.90 1.27 13.17

120 120 10.55 1.21 11.75 93 93 8.82 0.84 9.67

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Nursing Facility NameMedicaid Provider Number

EGRET COVE CENTER 212890FREEDOM SQUARE NURSING CENTER 324248GLEN OAKS HEALTH CARE CENTER 255840GOLFVIEW HEALTHCARE CENTER 262722GRACEWOOD REHABILITATION AND NURSING CARE 316644HARBOURWOOD HEALTH AND REHAB CENTER 316636HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 320528HIGHLAND PINES REHABILITATION CENTER 263907JACARANDA MANOR 281743LARGO REHABILITATION CENTER 252336LAURELLWOOD NURSING CENTER 316628LEXINGTON HEALTH AND REHABILITATION CENTER 227650MANOR CARE HEALTH SERVICES DUNEDIN 325686MANOR CARE HEALTH SERVICES PALM HARBOR 325694MASONIC HOME OF FLORIDA 999960MEASE CONTINUING CARE 204072MENORAH MANOR 208442MORTON PLANT REHABILITATION CENTER 206431NORTH REHABILITATION CENTER 227641OAK BLUFFS NURSING CENTER 203823OAK MANOR HEALTHCARE & REHABILITATION CENTER 258342PALM GARDEN OF CLEARWATER 257460PALM GARDEN OF LARGO 257478PALM GARDEN OF PINELLAS 257508PALM TERRACE OF ST. PETERSBURG 282537PASADENA MANOR INC 281891PENINSULA CARE AND REHABILITATION CENTER 324507PINELLAS PARK CARE AND REHABILITATION CENTER 324469PINELLAS POINT NURSING AND REHAB CENTER 263486REHABILITATION CENTER OF ST PETE 228362SABAL PALMS HEALTH CARE CENTER 210951SAINT MARK VILLAGE 310841SEMINOLE NURSING PAVILION 324230SHORE ACRES REHABILITATION AND HEALTH CENTER 324132SOUTH HERITAGE HEALTH & REHAB CENTER 226360SPRINGS AT BOCA CIEGA BAY 267724STRATFORD COURT OF PALM HARBOR 210943SUNSET POINT CARE AND REHABILITATION CENTER 253430SYLVAN HEALTH CENTER 229164TARPON BAYOU CENTER 212849TIERRA PINES CENTER 260568WEST BAY CARE AND REHABILITATION CENTER 253464WESTCHESTER GARDENS REHAB & CARE CENTER 202011WESTMINSTER PALMS 999957WESTMINSTER SUNCOAST 212709WRIGHTS NURSING AND REHABILITATION CENTER 254762AMERICAN-FINNISH NURSING HOME 205460AVANTE AT BOCA RATON, INC. 210676AVANTE AT LAKE WORTH, INC. 203238AZALEA COURT 252549BARRINGTON TERRACE OF BOYNTON BEACH 999915BOCA RATON REHABILITATION CENTER 263842

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

120 120 4.77 0.41 5.18 116 116 6.27 0.88 7.15

76 76 12.59 1.08 13.67 56 56 9.31 0.86 10.17

120 120 9.75 1.23 10.98 120 120 9.37 1.23 10.60

58 58 8.48 0.80 9.28 120 120 3.97 0.44 4.40 299 299 5.40 0.55 5.96 158 158 10.26 1.03 11.28

60 60 5.63 0.65 6.27 102 134 8.80 0.82 9.62 120 120 5.77 0.83 6.60 180 180 9.03 0.95 9.98

- - - 100 100 7.73 0.90 8.64 120 180 8.88 1.38 10.26 124 120 5.82 0.50 6.33

49 49 7.74 0.72 8.46 60 60 7.91 0.77 8.68

180 180 9.79 1.23 11.02 120 120 14.27 1.18 15.46

78 140 14.33 1.19 15.51 120 120 13.79 1.19 14.98

96 96 9.01 1.06 10.07 126 122 3.49 0.39 3.88 120 120 16.88 1.08 17.97 120 120 15.13 1.01 16.14

60 60 9.06 1.23 10.29 159 159 4.85 0.53 5.39 120 244 12.28 1.24 13.52

60 60 3.73 0.59 4.32 120 120 8.16 1.15 9.31 109 109 4.78 0.50 5.28

75 74 6.48 0.62 7.10 150 109 4.67 0.64 5.31

60 60 10.55 1.10 11.65 120 120 8.11 0.85 8.96

60 60 10.65 1.13 11.78 120 120 9.25 0.86 10.11 120 120 5.71 0.76 6.47 120 120 10.20 1.07 11.27 120 120 14.69 1.38 16.07

- - - 161 120 2.48 0.33 2.81

60 60 10.08 1.19 11.27 60 60 10.05 0.83 10.88

120 144 14.31 1.21 15.52 162 138 8.87 0.75 9.61 120 120 10.33 1.03 11.36

- - - 120 120 5.19 0.56 5.75

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BOULEVARD MANOR NURSING AND REHAB CENTER 263613BOYNTON BEACH REHABILITATION CENTER 263460BOYNTON HEALTH CARE CENTER 218952CHATSWORTH AT PGA NATIONAL 999879CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 213837CONSULATE HEALTH CARE OF WEST PALM BEACH 320153CORAL BAY HEALTHCARE AND REHABILITATION 259918CROSSINGS, THE 269395DARCY HALL OF LIFE CARE 317349EDWARD J HEALEY REHABILITATION AND NURSING CENTER 212032FOUNTAINS NURSING HOME 212393GARDENS COURT 228320GLADES HEALTH CARE CENTER 203203HAMLIN PLACE 259586HARBOURS EDGE 216399HEALTH CENTER AT ABBEY DELRAY 205745HEALTH CENTER AT ABBEY DELRAY SOUTH 206865HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 999913HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 325309HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 325341JOSEPH L MORSE GERIATRIC CENTER INC 207381JUPITER CARE CENTER 224928JUPITER MEDICAL CENTER PAVILION INC 208485LAKE VIEW CARE CENTER AT DELRAY 229610LAKE WORTH MANOR 266124LAKESIDE HEALTH CENTER 207683LIBERTY INN, LLC 227676LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 205923MANORCARE HEALTH SERVICES 325368MANORCARE HEALTH SERVICES 325520MANORCARE HEALTH SERVICES BOYNTON BEACH 325376MANORCARE HEALTH SERVICES WEST PALM BEACH 325481MEDICANA NURSING AND REHAB CENTER 263524MENORAH HOUSE 229628NORTH LAKE REHABILITATION AND HEALTH CENTER 325163NURSING CENTER AT LA POSADA, THE 999867PALM GARDEN OF WEST PALM BEACH 257257REGENTS PARK NURSING & REHABILITATION CENTER 204170REHABILITATION CENTER OF THE PALM BEACHES,THE 263915ROYAL MANOR 214108SAVANNAH COVE 312312SIGNATURE HEALTHCARE OF PALM BEACH 001136STRATFORD COURT OF BOCA RATON 211010TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 325031WATERFORD HEALTH CARE CENTER 206610WHITEHALL BOCA RATON 999916WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 999912WILLOWBROOKE COURT AT ST ANDREWS 206521WOOD LAKE NURSING AND REHABILITATION CENTER 261599BRADFORD TERRACE NURSING CENTER 251739WINDSOR MANOR 213888BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 264067

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

110 167 6.52 0.88 7.41 168 169 9.65 1.31 10.95

71 81 9.98 0.92 10.90 - - -

60 60 7.66 1.06 8.72 120 120 7.29 0.92 8.21 120 120 8.55 1.32 9.88

60 60 7.36 0.87 8.23 220 220 3.69 0.52 4.22 196 198 14.35 1.36 15.71

51 51 5.72 0.63 6.35 120 120 9.94 1.03 10.97 120 120 6.35 0.78 7.12 120 120 14.76 1.14 15.90

54 54 3.41 0.52 3.92 100 114 11.43 1.07 12.50

60 90 10.97 0.91 11.88 - - -

120 120 8.17 1.00 9.16 120 120 8.06 0.91 8.97 120 280 13.13 1.21 14.33 120 120 11.74 1.27 13.00 120 120 9.25 1.30 10.55 120 120 14.91 1.18 16.09 120 120 10.27 1.12 11.39

97 107 13.50 1.38 14.88 29 68 9.76 1.14 10.90

120 132 11.66 1.21 12.88 120 180 9.20 1.02 10.22 120 120 7.92 1.10 9.02 120 180 9.14 1.03 10.17 120 120 8.25 1.19 9.45 117 117 3.59 0.49 4.07 120 120 12.83 1.25 14.09

85 85 4.26 0.42 4.67 - - -

137 176 11.77 1.16 12.93 103 180 11.21 1.17 12.37

99 99 11.11 1.20 12.31 120 120 11.32 1.33 12.64

30 30 7.74 1.10 8.85 120 120 11.60 1.08 12.68

60 60 11.96 1.24 13.20 99 99 12.63 1.17 13.80 60 60 8.75 0.88 9.63

- - - - - -

120 119 12.48 1.13 13.61 120 120 13.84 1.35 15.19

49 120 15.13 1.24 16.37 120 120 13.43 1.05 14.48

81 92 9.94 0.92 10.87

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A B

Nursing Facility NameMedicaid Provider Number

PARTHENON HEALTHCARE OF BLOUNTSTOWN 251097ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 263478AVANTE AT INVERNESS, INC. 203220CITRUS HEALTH AND REHABILITATION CENTER 257419CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 217263CYPRESS COVE CARE CENTER 228940DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 256269HEALTH CENTER AT BRENTWOOD 252263LIFE CARE CENTER OF CITRUS COUNTY 211532WOODLAND TERRACE OF CITRUS COUNTY 228711AVALON HEALTHCARE CENTER 261629BAYA POINTE NURSING AND REHABILITATION CENTER 308111HEALTH CENTER OF LAKE CITY, THE 226173DESOTO HEALTH & REHAB, LLC 316229CROSS CITY REHABILITATION & HEALTH CARE CENTER 312151BRIDGE AT BAY ST JOE, THE 324485SUWANNEE VALLEY NURSING CENTER 206300FINR III, LLC 999945HARDEE MANOR HEALTHCARE CENTER 211435OAKBROOK OF LABELLE 213497PALM TERRACE OF CLEWISTON 282618KENILWORTH CARE & REHABILITATION CENTER 324493LAKE PLACID HEALTH CARE CENTER 214124OAKS AT AVON 263966PALMS OF SEBRING, THE 252671ROYAL CARE OF AVON PARK 324213BONIFAY NURSING AND REHAB CENTER 263443MARIANNA HEALTH AND REHABILITATION CENTER 203475NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 005383SIGNATURE HEALTHCARE AT THE COURTYARD 324426SIGNATURE HEALTHCARE OF NORTH FLORIDA 324396LAFAYETTE HEALTH CARE CENTER 264482WILLISTON REHABILITATION AND NURSING CENTER 317586LAKE PARK OF MADISON 211923MADISON NURSING CENTER 213462PINE LAKE NURSING HOME 214019PLANTATION KEY CONVALESCENT CENTER 208906OKEECHOBEE HEALTH CARE FACILITY 202541CRESTWOOD NURSING CENTER 312274LAKEWOOD NURSING CENTER 312142PALATKA HEALTH CARE CENTER 226025ARBOR VILLAGE NURSING CENTER 283142OSPREY POINT NURSING CENTER 215597GOOD SAMARITAN CENTER 268763SURREY PLACE CARE CENTER 001135SUWANNEE HEALTH CARE CENTER 005387MARSHALL HEALTH AND REHABILITATION CENTER 252425WASHINGTON REHABILITATION AND NURSING CENTER 324353

04/01/09 FRVS

# Beds or Renovatio

n Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt 1, 2, or 3 Year

# Beds or

Renovation Amt

# Beds Initial

Construction

80% Capital 20% ROE Total

Modification 16n 13 Modification 14 Modification 15

120 150 9.49 0.91 10.40 60 116 9.20 1.25 10.44

104 104 9.32 0.78 10.10 111 111 10.63 1.13 11.75 150 150 8.32 0.97 9.30 120 120 11.46 1.07 12.53

60 120 8.26 1.14 9.40 60 120 10.48 1.26 11.75

111 120 9.38 1.25 10.63 120 120 9.87 1.21 11.08

95 95 9.76 0.73 10.49 60 90 12.42 1.30 13.72 60 120 12.66 1.01 13.67 60 41 10.56 1.35 11.90 60 60 10.49 1.25 11.74

120 120 2.49 0.61 3.10 60 60 9.31 0.89 10.19

- - - 60 79 8.70 0.73 9.43 60 93 12.43 1.12 13.55

120 155 9.80 0.84 10.65 104 104 5.51 0.52 6.03 120 180 10.08 1.15 11.24

88 104 10.18 1.18 11.36 54 120 8.41 0.92 9.34 90 90 6.25 0.66 6.92 60 180 7.69 1.04 8.73

180 180 12.45 1.18 13.64 136 136 11.93 0.92 12.85 120 120 12.42 1.04 13.45 120 180 8.39 0.78 9.17

60 60 11.56 1.04 12.60 180 180 5.82 0.60 6.42

79 120 10.35 1.13 11.48 60 60 17.00 1.16 18.15 58 58 7.62 0.79 8.41

120 120 9.98 1.25 11.23 90 173 12.72 1.17 13.89 65 65 5.85 0.50 6.35 92 92 8.01 0.69 8.70 60 180 11.61 1.22 12.83

180 210 9.72 1.02 10.74 60 60 11.99 1.26 13.25

107 161 9.14 1.18 10.31 60 60 15.23 1.12 16.35

180 180 14.49 1.04 15.53 92 120 6.91 0.83 7.74

120 180 11.42 0.80 12.22 - - - - - - - -

Page 130 of 250

Page 131: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Example Calculation

Initial Construction 196343

Current Licensed Beds 78

Example of Bed Addition Calculation: Example of Replacement Calculation: Example of Renovation Calculation:

25 Number of Beds Replaced 21 Source1968 Year of Replacement 1994 Survey data b 63,433

Survey data c Year of Renovation 199478 Survey data d 78

Calculation of Weighted Average Age: 28 c-a e Difference in Years 20

Beds AgeWeighted Average FRV Variables tab f Rate of depreciation 2%

43 5 215 Calculation of Weighted Average Age:25 0 0 FRV Variables tab g 141.10$

68 215 Beds AgeWeighted Average Survey data h 27,504

3.16 21 0 0 Means historical cost index tab i 104.40 57 28 1596 Means historical cost index tab j 168.00

New Base Year 1965 78 1596 Location factor tab k 0.82 20.46 Survey data l 78

(g x h x (i/j x k))/l m 25,353 New Base Year 1974 a e x f x m n Accumulated Depreciation 10,141

2nd Bed Addition minimum d or b/n New Bed Equivalent 6.25

10 Calculation of Weighted Average Age:1973

Beds AgeWeighted Average

6.25 0 - Calculation of Weighted Average Age: 71.75 20 1,434.90

Beds AgeWeighted Average 78.00 20 1,434.90

68 8 555 18.40 10 0 - 78 555 New Base Year 1976

7.12

New Base Year 1966

Year of Addition

Bed TotalDifference in years

Bed Replacement Cost

Square FootageCost index -Year of Renovation2008 Cost Index

Number of Beds Added

Calculation

Location FactorLicensed Beds

Initial Beds

Number of Beds AddedYear of Addition Renovation

Bed Total

Bed Replacement Cost:Cost per Square Foot

Page 132: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

FRV MODEL CHARACTERISTICS/VARIABLES

Current Year For Aging Purposes 2009Cost per Square Foot 141.10$ 2008 RS Means 152.20 if closed shopConstruction Cost Index 1.0000 Location Factor - varies based on ZIP CodeMinimum Square Feet per Bed 375 Maximum Square Feet per Bed 700 Land Percentage 15.0%Equipment Allowance per Bed $7,500Equipment Cost Index 1.0000 Capital Cost

32.50 Depreciation Rate if FRVS Age is >= 32.5 Years 2.00%24.99 Depreciation Rate if FRVS Age is >= 25.0 and < 32.5 Years 1.75%17.49 Depreciation Rate if FRVS Age is >= 17.5 and < 25.0 Years 1.50%9.99 Depreciation Rate if FRVS Age is >= 10.0 and < 17.5 Years 1.25%- Depreciation Rate if FRVS Age is < 10.0 Years 1.00%

Maximum Age 32.50 Return Rate (varies with a floor of 9.25%) 9.25%Minimum Occupancy 85.00%

Depreciation Rate Used in Determining Initial Age 2.0%

Page 133: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

City FY02 FY03 FY04 FY05 FY06 FY07 * FY08 FY09 FY10

320 0.840321 0.900322 0.840323 0.800324 0.790325 0.850326 0.860327 0.900328 0.900329 0.930330 0.900331 0.900333 0.880334 0.860335 0.910336 0.910337 0.840338 0.900339 0.870341 0.870342 0.880344 0.860346 0.910347 0.900349 0.860

* actually FY08

Zip FactorBy Fiscal Year

Page 134: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

July of Each Year

Actual Historical

Cost Index

Trend Line

% Change

2009 169.7 1.02%2008 168.0 168.3 1.02%2007 Jan 166.3 166.3 2.65%2006 1 162.0 162.0 6.86%2005 2 151.6 151.6 5.50%2004 3 143.7 143.7 8.86%2003 4 132.0 132.0 2.56%2002 5 128.7 128.7 2.88%2001 6 125.1 125.1 3.47%2000 7 120.9 120.9 2.81%1999 8 117.6 117.6 2.17%1998 9 115.1 115.1 2.04%1997 10 112.8 112.8 2.36%1996 11 110.2 110.2 2.42%1995 12 107.6 107.6 3.07%1994 13 104.4 104.4 2.65%1993 14 101.7 101.7 2.31%1992 15 99.4 99.4 2.69%1991 16 96.8 96.8 2.65%1990 17 94.3 94.3 2.39%1989 18 92.1 92.1 2.45%1988 19 89.9 89.9 2.51%1987 20 87.7 87.7 4.16%1986 21 84.2 84.2 1.94%1985 22 82.6 82.6 0.73%1984 23 82.0 82.0 2.24%1983 24 80.2 80.2 5.39%1982 25 76.1 76.1 8.71%1981 26 70.0 70.0 11.29%1980 27 62.9 62.9 8.82%1979 28 57.8 57.8 8.04%1978 29 53.5 53.5 8.08%1977 30 49.5 49.5 5.54%1976 31 46.9 46.9 4.69%1975 32 44.8 44.8 8.21%1974 33 41.4 41.4 9.81%1973 34 37.7 37.7 8.33%1972 35 34.8 34.8 8.41%1971 36 32.1 32.1 11.85%1970 37 28.7 28.7 6.69%1969 38 26.9 26.9 8.03%1968 39 24.9 24.9 5.96%1967 40 23.5 23.5 3.52%1966 41 22.7 22.7 4.61%1965 42 21.7 21.7 2.36%1964 43 21.2 21.2 2.42%1963 44 20.7 20.7 2.48%1962 45 20.2 20.2 2.02%1961 46 19.8 19.8 0.51%1960 47 19.7 19.7 2.07%1959 48 19.3 19.3 2.66%1958 49 18.8 18.8 2.17%1957 50 18.4 18.4 4.55%1956 51 17.6 17.6 6.02%1955 52 16.6 16.6 0.00%1954 53 16.6 16.6 0.00%1953 54 16.6 16.6 0.00%1952 55 16.6 16.6 0.00%1951 56 16.6 16.6 18.57%1950 57 14.0 14.0 0.00%1949 58 14.0 14.0 0.00%1948 59 14.0 14.0 0.00%1947 60 14.0 14.0 0.00%1946 61 14.0 14.0 53.85%1945 62 9.1 9.1 0.00%1944 63 9.1 9.1 0.00%1943 64 9.1 9.1 0.00%1942 65 9.1 9.1 0.00%1941 66 9.1 9.1 30.00%1940 67 7.0 7.0

Page 135: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

375

Facility Provider #Zip Code

Factor Location

Factor Total Sq. Footage

Higher of Actual or Minimum

Total Licensed

Beds

Square Footage Per

Bed

Rounded Square Ft Per Bed

Year Initial Construction

Beds Initial Construction 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

BRADEN RIVER CARE CENTER 005021 342 0.88 - 78,000 208 0.00 0 1964 208 3 1986 84.20 298,727 BRADENTON HEALTH CARE 252069 342 0.88 - 39,375 105 0.00 0 1999 105 3 2000 120.90 455,481 CASA MORA REHAB. & EXTENDED CARE 263885 342 0.88 - 90,000 240 0.00 0 1978 240 3 1982 76.10 1,775,277 GREENBRIAR REHABILITATION AND NURSING CENT227625 342 0.88 - 22,500 60 0.00 0 1982 60 3 1994 104.40 35,235 HERITAGE PARK CARE AND REHABILITATION CENT324345 342 0.88 - 45,000 120 0.00 0 1985 120 3 2002 128.70 76,680 LIFE CARE CENTER OF SARASOTA 223786 342 0.88 - 45,000 120 0.00 0 2000 120 3 2001 125.10 65,951 NURSING CENTER AT FREEDOM VILLAGE, THE 317195 342 0.88 - 45,000 120 0.00 0 1989 60 1 1991 96.80 60 RIVERFRONT NURSING & REHABILITATION CENTER259942 342 0.88 - 41,250 110 0.00 0 1972 110 3 1996 110.20 2,820,617 RIVIERA PALMS REHABILITATION CENTER 263451 342 0.88 - 45,000 120 0.00 0 1988 90 1 1991 96.80 30 SURREY PLACE HEALTHCARE AND REHABILITATIO 256277 342 0.88 - 22,500 60 0.00 0 1989 60 3 1992 99.40 39,109 WESTMINSTER COMMUNITIES OF BRADENTON, WE209422 342 0.88 - 22,125 59 0.00 0 1970 17 1 1984 82.00 42 WESTMINSTER COMMUNITIES OF BRADENTON, WE203815 342 0.88 - 45,000 120 0.00 0 1967 34 1 2002 128.70 86 WOODS OF MANATEE SPRINGS, THE 316610 342 0.88 - 45,000 120 0.00 0 1985 120 3 1989 92.10 243,535 BAY VILLAGE OF SARASOTA 999923 342 0.88 - - - 0 - 0 0 - BENEVA LAKES HEALTHCARE AND REHABILITATION259896 342 0.88 - 45,000 120 0.00 0 1982 120 3 1983 80.20 80,494 CONSULATE HEALTH CARE OF SARASOTA 320137 342 0.88 - 30,375 81 0.00 0 1998 81 3 2000 120.90 120,840 GLENRIDGE ON PALMER RANCH INC. 999892 342 0.88 - - - 0 - 0 0 - HARBORCHASE OF VENICE 213322 342 0.88 - 16,875 45 0.00 0 1997 45 3 2005 151.60 79,494 HARMONY HEALTHCARE AND REHABILITATION CEN317136 342 0.88 - 45,000 120 0.00 0 2006 120 0 0 - HEARTLAND HEALTH CARE & REHABILITATION CEN999925 342 0.88 - - - 0 - 0 0 - HERITAGE HEALTH CARE CENTER 252271 342 0.88 - 45,000 120 0.00 0 1983 114 1 1987 87.70 6 INN AT SARASOTA BAY CLUB 228621 342 0.88 - 22,500 60 0.00 0 2001 60 3 2003 132.00 37,725 J H FLOYD SUNSHINE MANOR 202681 342 0.88 - 37,875 101 0.00 0 1970 68 1 1996 110.20 21 KENSINGTON MANOR 325490 342 0.88 - 32,625 87 0.00 0 1969 147 1 1995 107.60 (60) MAGNOLIA HEALTH AND REHABILITATION CENTER 252182 342 0.88 - 45,000 120 0.00 0 1994 120 3 1997 112.80 114,616 MANORCARE HEALTH SERVICES 325473 342 0.88 - 48,375 129 0.00 0 1997 129 0 0 - MANORCARE HEALTH SERVICES SARASOTA 325465 342 0.88 - 66,750 178 0.00 0 1983 120 1 1995 107.60 37 PALMER RANCH HEALTHCARE AND REHABILITATIO319244 342 0.88 - 22,500 60 0.00 0 1999 60 0 0 - PINEBROOK CARE AND REHABILITATION CENTER 252662 342 0.88 - 45,000 120 0.00 0 1985 120 3 2006 162.00 61,491 PINES OF SARASOTA 202703 342 0.88 - 76,500 204 0.00 0 1970 204 3 1976 46.90 112,586 PLYMOUTH HARBOR INCORPORATED 999922 342 0.88 - - - 0 - 0 0 - QUALITY HEALTH OF NORTH PORT 225053 342 0.88 - 45,000 120 0.00 0 1985 120 0 0 - SARASOTA HEALTH AND REHABILITATION CENTER 263982 342 0.88 - 63,375 169 0.00 0 1971 169 3 1977 49.50 738,570 SARASOTA MEMORIAL NURSING AND REHABILITAT260355 342 0.88 - 45,000 120 0.00 0 1987 120 3 2007 166.30 64,900 SPRINGS AT LAKE POINTE WOODS 268780 342 0.88 - 44,625 119 0.00 0 1986 53 1 1990 94.30 60 SPRINGWOOD CARE AND REHABILITATION CENTER253014 342 0.88 - 45,000 120 0.00 0 1982 120 3 1996 110.20 141,517 SUNNYSIDE NURSING HOME 202711 342 0.88 - 22,500 60 0.00 0 1970 60 3 1978 53.50 66,200 SUNSET LAKE HEALTH AND REHABILITATION CENT308501 342 0.88 - 45,000 120 0.00 0 1992 120 3 2001 125.10 61,570 TARPON POINT NURSING AND REHABILITATION CE 323781 342 0.88 - 45,000 120 0.00 0 1990 60 1 1991 96.80 60 VILLAGE ON THE ISLE 210463 342 0.88 - 22,500 60 0.00 0 1984 60 3 1985 82.60 33,333 CALUSA HARBOUR HEALTH CENTER 221473 339 0.87 - 22,500 60 0.00 0 1984 100 1 2005 151.60 (40) CITRUS GARDENS OF FORT MYERS 318787 339 0.87 - 45,000 120 0.00 0 1983 120 0 0 - CONSULATE HEALTH CARE OF NORTH FORT MYER320111 339 0.87 - 45,000 120 0.00 0 1985 78 1 1995 107.60 42 CORAL TRACE HEALTH CARE 252107 339 0.87 - 45,000 120 0.00 0 1987 120 3 1998 115.10 490,091 EVANS HEALTH CARE 252212 339 0.87 - 45,000 120 0.00 0 1998 105 1 2001 125.10 15 GULF COAST VILLAGE CARE CENTER 201120 339 0.87 - 31,875 85 0.00 0 1989 60 1 1999 117.60 25 HEALTHPARK CARE CENTER, INC. 210587 339 0.87 - 42,000 112 0.00 0 1992 90 1 1999 117.60 22 HEARTLAND HEALTH CARE CENTER FORT MYERS 325325 339 0.87 - 45,000 120 0.00 0 1990 90 1 1991 96.80 18 HERITAGE PARK REHABILITATION AND HEALTHCAR252344 339 0.87 - 45,000 120 0.00 0 1981 146 1 2001 125.10 (26) LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978 339 0.87 - 41,250 110 0.00 0 1986 110 3 2006 162.00 57,163 LIFE CARE CENTER OF ESTERO 265381 339 0.87 - 58,125 155 0.00 0 2003 155 0 0 - LODGE AT CYPRESS COVE, THE 999878 339 0.87 - - - 0 - 0 0 - MANORCARE HEALTH SERVICES 325384 339 0.87 - 45,000 120 0.00 0 1999 120 0 0 - REHAB AND HEALTHCARE CENTER OF CAPE CORA263869 339 0.87 - 45,000 120 0.00 0 1979 120 0 0 - SHADY REST CARE PAVILION 213900 339 0.87 - 67,500 180 0.00 0 1970 180 3 2006 162.00 102,949 SHELL POINT NURSING PAVILION 229202 339 0.87 - 82,125 219 0.00 0 1971 180 1 2004 143.70 39 SIGNATURE HEALTHCARE AT COLLEGE PARK 324370 339 0.87 - 40,125 107 0.00 0 1981 107 3 1999 117.60 66,883 WINKLER COURT 264008 339 0.87 - 45,000 120 0.00 0 1995 120 0 0 - AVANTE AT ORMOND BEACH, INC. 252034 321 0.90 - 49,875 133 0.00 0 1968 133 3 2009 169.71 94,435 BISHOPS GLEN RETIREMENT CENTER 209511 321 0.90 - 22,500 60 0.00 0 1986 60 3 1987 87.70 46,903 BRIDGEVIEW CENTER 260371 321 0.90 - 52,125 139 0.00 0 1982 143 1 1984 82.00 (3) CATALINA HEALTH CARE CENTER 283134 321 0.90 - 45,000 120 0.00 0 1987 84 1 1992 99.40 36 CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789 327 0.90 - 48,750 130 0.00 0 1971 60 1 1997 112.80 70 COQUINA CENTER 260649 321 0.90 - 45,000 120 0.00 0 1987 60 1 1991 96.80 60 DAYTONA BEACH HEALTH AND REHABILITATION CE217743 321 0.90 - 67,500 180 0.00 0 1977 180 0 0 - DEBARY MANOR 005372 327 0.90 36,923 45,000 120 307.69 308 1983 93 1 1994 104.40 27 DELTONA HEALTH CARE 252158 327 0.90 - 45,000 120 0.00 0 1983 120 3 1984 82.00 73,220 EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889 321 0.90 - 45,000 120 0.00 0 1993 120 3 1996 110.20 63,848 GOOD SAMARITAN SOCIETY-DAYTONA 204391 321 0.90 - 45,000 120 0.00 0 1975 120 3 1976 46.90 660,855 GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792 327 0.90 - 22,500 60 0.00 0 1997 60 3 1998 115.10 92,109 HEALTH CENTER OF DAYTONA BEACH, THE 229091 321 0.90 - 27,375 73 0.00 0 1996 60 1 2004 143.70 13 HORIZON HEALTHCARE CENTER AT DAYTONA 223905 321 0.90 - 31,500 84 0.00 0 1983 55 1 1995 107.60 29

Modification 1

Page 136: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

375

Facility Provider #Zip Code

Factor Location

Factor Total Sq. Footage

Higher of Actual or Minimum

Total Licensed

Beds

Square Footage Per

Bed

Rounded Square Ft Per Bed

Year Initial Construction

Beds Initial Construction 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 1

INDIGO MANOR 258750 321 0.90 - 64,875 173 0.00 0 1987 120 1 1994 104.40 53 JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000 327 0.90 - 56,250 150 0.00 0 2003 150 0 0 - MANOR ON THE GREEN 213527 321 0.90 46,198 72,000 192 240.61 241 1981 192 3 1982 76.10 693,636 OAKTREE HEALTHCARE 252476 321 0.90 - 24,375 65 0.00 0 1981 65 3 1988 89.90 38,535 OAKWOOD GARDEN OF DELAND 005547 327 0.90 32,000 45,750 122 262.30 262 1978 122 0 0 - OCEAN VIEW NURSING & REHABILITATION CENTER226351 321 0.90 - 89,625 239 0.00 0 1980 179 1 1993 101.70 60 ORANGE CITY NURSING AND REHAB CENTER 263567 327 0.90 - 45,000 120 0.00 0 1991 120 0 0 - PORT ORANGE NURSING AND REHAB CENTER 263508 321 0.90 - 45,000 120 0.00 0 1992 120 0 0 - RIDGECREST NURSING AND REHABILITATION CENT282464 327 0.90 - 60,000 160 0.00 0 1982 180 1 2004 143.70 (20) SANDALWOOD NURSING CENTER 312045 321 0.90 - 37,125 99 0.00 0 1968 99 3 1999 117.60 513,270 SIGNATURE HEALTHCARE OF ORMOND 324442 321 0.90 - 22,500 60 0.00 0 1984 60 1 1995 107.60 (1) TERRACE OF DAYTONA BEACH, LLC 282553 321 0.90 - 22,500 60 0.00 0 1998 60 0 0 - UNIVERSITY CENTER EAST 212873 327 0.90 - 22,500 60 0.00 0 1972 60 0 0 - UNIVERSITY CENTER WEST 212831 327 0.90 - 22,500 60 0.00 0 1972 60 0 0 - WOODLAND TERRACE EXTENDED CARE CENTER 212636 327 0.90 - 45,000 120 0.00 0 1996 120 0 0 - ALEXANDER NININGER STATE VETERANS NURSING229849 330 0.90 - 45,000 120 0.00 0 2001 120 0 0 - BROWARD INSTITUTE FOR LONG TERM CARE 263851 330 0.90 - 72,750 194 0.00 0 1978 120 1 1990 94.30 74 BROWARD NURSING & REHABILITATION CENTER 226335 333 0.88 - 74,250 198 0.00 0 1970 198 3 1991 96.80 178,946 CHILDRENS COMPREHENSIVE CARE CENTER INC 312789 330 0.90 - 13,500 36 0.00 0 1992 35 1 2000 120.90 1 COURT AT PALM AIRE, THE 318795 330 0.90 - 22,500 60 0.00 0 1988 60 3 1998 115.10 4,503 COVENANT VILLAGE CARE CENTER 210188 333 0.88 - 22,500 60 0.00 0 1988 60 3 1995 107.60 49,646 CROSS POINTE CARE CENTER 001281 330 0.90 - 33,000 88 0.00 0 1984 88 0 0 - FORUM AT DEER CREEK 253481 334 0.86 - 22,500 60 0.00 0 1990 60 3 1996 110.20 37,124 FT LAUDERDALE HEALTH & REHABILITATION CENT 321303 333 0.88 - 58,125 155 0.00 0 1984 253 1 1999 117.60 (84) GOLFCREST HEALTHCARE CENTER 262064 330 0.90 - 25,125 67 0.00 0 1980 67 0 0 - HARBOR BEACH NURSING AND REHABILITATION CE252255 333 0.88 - 22,125 59 0.00 0 1984 59 3 1990 94.30 32,037 HEALTH CENTER OF COCONUT CREEK, THE 226581 330 0.90 - 45,000 120 0.00 0 1997 120 0 0 - HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333 333 0.88 - 40,875 109 0.00 0 1989 85 1 1996 110.20 24 HEARTLAND OF TAMARAC 325350 333 0.88 - 56,625 151 0.00 0 1988 101 1 1997 112.80 50 HILLCREST NURSING AND REHABILITATION CENTE 252531 330 0.90 - 90,000 240 0.00 0 1986 240 3 1999 117.60 212,819 HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424 330 0.90 - 57,000 152 0.00 0 1970 152 1 1982 76.10 (10) JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769 330 0.90 - 66,375 177 0.00 0 1972 120 1 1994 104.40 38 LIFE CARE CENTER AT INVERRARY 259080 333 0.88 - 45,000 120 0.00 0 2002 120 3 2005 151.60 102,550 MANOR OAKS NURSING & REHABILITATION CENTER256935 333 0.88 - 43,500 116 0.00 0 1966 116 0 0 - MANOR PINES CONVALESCENT CENTER 254177 333 0.88 - 77,250 206 0.00 0 1966 206 0 0 - MANORCARE HEALTH SERVICES 325457 333 0.88 - 45,000 120 0.00 0 1985 120 0 0 - MARGATE HEALTH CARE CENTER 214931 330 0.90 61,566 63,750 170 362.15 362 1985 120 1 1998 115.10 50 MEMORIAL MANOR 201006 330 0.90 - 45,000 120 0.00 0 1989 85 1 1997 112.80 35 PALMS REHABILITATION AND NURSING CENTER 308005 333 0.88 - 45,000 120 0.00 0 1982 120 0 0 - PARK SUMMIT OF CORAL SPRINGS 254134 330 0.90 - 13,125 35 0.00 0 1986 35 3 1993 101.70 54,109 PLANTATION NURSING & REHABILITATION CENTER 226017 333 0.88 - 57,000 152 0.00 0 1974 124 1 1982 76.10 28 POMPANO REHABILITATION & NURSING CENTER 263923 330 0.90 - 47,625 127 0.00 0 1987 127 0 0 - REGENTS PARK OF SUNRISE 269697 333 0.88 - 45,000 120 0.00 0 1989 120 3 1994 104.40 67,925 SAINT JOHNS NURSING CENTER 205800 333 0.88 - 67,875 181 0.00 0 1980 160 1 1984 82.00 20 SEAVIEW NURSING AND REHABILITATION CENTER 252433 330 0.90 - 31,125 83 0.00 0 1983 83 3 1987 87.70 85,208 SPRINGTREE REHABILITATION & HEALTH CARE CE 225631 333 0.88 - 41,250 110 0.00 0 1989 85 1 1995 107.60 25 SUNRISE HEALTH & REHABILITATION CENTER 207497 333 0.88 - 121,875 325 0.00 0 1983 240 1 1992 99.40 85 TAMARAC REHABILITATION AND HEALTH CENTER 213098 333 0.88 - 45,000 120 0.00 0 1983 120 0 0 - WEST BROWARD CARE CENTER 002419 333 0.88 - 45,000 120 0.00 0 1971 120 3 1985 82.60 680,042 WILTON MANORS HEALTH & REHABILITATION CENT227579 333 0.88 - 44,250 118 0.00 0 1982 118 3 1994 104.40 74,508 DESTIN HEALTHCARE AND REHABILITATION CENTE252166 325 0.85 - 44,625 119 0.00 0 1994 88 1 1998 115.10 31 EMERALD COAST CENTER 212903 325 0.85 - 45,000 120 0.00 0 1973 120 1 1993 101.70 (1) MANOR AT BLUE WATER BAY, THE 226041 325 0.85 - 45,000 120 0.00 0 1993 60 1 1999 117.60 60 PARTHENON HEALTHCARE OF CRESTVIEW 251101 325 0.85 - 67,500 180 0.00 0 1970 120 1 1991 96.80 60 PARTHENON HEALTHCARE OF FORT WALTON 229237 325 0.85 - 45,000 120 0.00 0 1960 120 3 1987 87.70 188,419 SHOAL CREEK REHABILITATION CENTER 252379 325 0.85 - 45,000 120 0.00 0 2000 100 1 2000 120.90 20 SILVERCREST MANOR 213926 325 0.85 20,836 22,500 60 347.27 347 1988 60 0 0 - WESTWOOD HEALTH CARE CENTER 316075 325 0.85 - 22,500 60 0.00 0 1985 60 3 2000 120.90 87,811 CHAUTAUQUA REHABILITATION AND NURSING CEN324361 324 0.79 - 67,500 180 0.00 0 1979 120 1 2008 168.00 60 DELTA HEALTH CARE CENTER 211621 325 0.85 36,311 36,375 97 374.34 374 1988 60 1 1995 107.60 37 GAINESVILLE HEALTH CARE CENTER 229288 326 0.86 - 67,500 180 0.00 0 1983 180 3 2000 120.90 93,695 NORTH FLORIDA REHABILITATION AND SPECIALTY 252361 326 0.86 - 45,000 120 0.00 0 1984 120 0 0 - OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868 326 0.86 - - - 0 - 0 0 - PALM GARDEN OF GAINESVILLE 257265 326 0.86 46,266 46,266 120 385.55 386 1987 120 3 1997 112.80 1,118,490 PARK MEADOWS HEALTH AND REHABILITATION CE227765 326 0.86 - 57,750 154 0.00 0 1981 179 1 2005 151.60 (25) PARKLANDS REHABILITATION AND NURSING CENT 317578 326 0.86 - 45,000 120 0.00 0 1980 120 0 0 - SIGNATURE HEALTHCARE OF GAINESVILLE 324388 326 0.86 - 45,000 120 0.00 0 1980 93 1 1990 94.30 27 WOODLANDS CARE CENTER OF ALACHUA COUNTY255572 326 0.86 - 45,000 120 0.00 0 2002 120 0 0 - AYERS HEALTH AND REHABILITATION CENTER 227871 326 0.86 - 45,000 120 0.00 0 1981 120 3 1984 82.00 307,530 TRI COUNTY NURSING HOME 204625 326 0.86 - 30,375 81 0.00 0 1992 60 3 1994 104.40 43,799 MACCLENNY NURSING AND REHAB CENTER 263516 320 0.84 - 45,000 120 0.00 0 1990 60 1 1995 107.60 60 W FRANK WELLS NURSING HOME 211052 320 0.84 - 25,500 68 0.00 0 1970 68 3 1971 32.10 289,778 CONSULATE HEALTH CARE OF ORANGE PARK 319538 320 0.84 - 45,000 120 0.00 0 1989 120 3 1991 96.80 107,667 DOCTORS LAKE OF ORANGE PARK 223883 320 0.84 - 45,000 120 0.00 0 1987 120 0 0 -

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Facility Provider #Zip Code

Factor Location

Factor Total Sq. Footage

Higher of Actual or Minimum

Total Licensed

Beds

Square Footage Per

Bed

Rounded Square Ft Per Bed

Year Initial Construction

Beds Initial Construction 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 1

GOVERNORS CREEK HEALTH AND REHABILITATION252387 320 0.84 - 45,000 120 0.00 0 1983 120 3 1992 99.40 67,124 HEARTLAND HEALTH CARE CENTER ORANGE PARK325261 320 0.84 - 45,000 120 0.00 0 1990 120 3 1999 117.60 81,354 LIFE CARE CENTER AT WELLS CROSSING 213161 320 0.84 - 45,000 120 0.00 0 1997 111 1 2001 125.10 9 LIFE CARE CENTER OF ORANGE PARK 284289 320 0.84 - 67,500 180 0.00 0 1996 180 0 0 - PAVILION FOR HEALTH CARE, THE 999987 320 0.84 - - - 0 - 0 0 - SIGNATURE HEALTHCARE OF ORANGE PARK 324434 320 0.84 - 39,375 105 0.00 0 1980 105 3 2003 132.00 112,483 TERRACE AT FLEMING ISLAND, THE 284785 320 0.84 - 40,500 108 0.00 0 2005 108 0 0 - ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735 322 0.84 - 45,000 120 0.00 0 1970 60 1 1982 76.10 (3) ATRIUM HEALTHCARE CENTER 319376 322 0.84 - 31,500 84 0.00 0 1996 84 3 2000 120.90 66,763 AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913 322 0.84 - 61,875 165 0.00 0 1974 120 1 1995 107.60 45 BEAUCLERC MANOR 252051 322 0.84 - 45,000 120 0.00 0 1985 108 1 1989 92.10 12 CATHEDRAL GERONTOLOGY CENTER, INC. 226068 322 0.84 - 45,000 120 0.00 0 1970 120 3 1976 46.90 577,878 CEDAR HILLS HEALTHCARE CENTER 262714 322 0.84 - 67,500 180 0.00 0 1972 180 3 1980 62.90 449,797 CONSULATE HEALTH CARE OF JACKSONVILLE 319503 322 0.84 - 43,500 116 0.00 0 1996 116 3 2000 120.90 74,660 CYPRESS VILLAGE 307998 322 0.84 - 45,000 120 0.00 0 1991 60 3 1996 110.20 44,954 EDGEWOOD NURSING CENTER 254878 322 0.84 - 22,500 60 0.00 0 1988 60 0 0 - FANNIE E TAYLOR HOME FOR THE AGED INC 204536 322 0.84 - 9,000 24 0.00 0 1972 24 3 1991 96.80 16,503 FIRST COAST HEALTH & REHABILITATION CENTER 227838 322 0.84 - 37,500 100 0.00 0 1983 100 3 1994 104.40 468,955 FLEET LANDING 999984 322 0.84 - - - 0 - 0 0 - HARTS HARBOR HEALTH CARE CENTER 252417 322 0.84 - 67,500 180 0.00 0 1977 180 3 2000 120.90 106,098 HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236 322 0.84 - 45,000 120 0.00 0 1990 120 3 1997 112.80 176,965 HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287 322 0.84 - 43,875 117 0.00 0 1981 89 1 1992 99.40 31 JACKSONVILLE NURSING AND REHAB CENTER 263494 322 0.84 - 61,125 163 0.00 0 1990 100 1 1994 104.40 63 LAKESIDE NURSING AND REHABILITATION CENTER256757 322 0.84 - 45,750 122 0.00 0 1997 60 1 2007 166.30 62 LANIER MANOR 268003 322 0.84 - 45,000 120 0.00 0 1984 55 1 1990 94.30 61 LIFE CARE CENTER OF JACKSONVILLE 283193 322 0.84 - 45,000 120 0.00 0 2004 120 3 2008 168.00 226,856 PALM GARDEN OF JACKSONVILLE 257273 322 0.84 45,521 45,521 120 379.34 379 1990 106 1 1996 110.20 14 PARK RIDGE NURSING CENTER 228401 322 0.84 - 39,000 104 0.00 0 1979 104 3 2001 125.10 69,550 REGENTS PARK OF JACKSONVILLE 269727 322 0.84 - 45,000 120 0.00 0 1986 107 1 1990 94.30 13 RIVER GARDEN HEBREW HOME FOR THE AGED 200859 322 0.84 - 67,500 180 0.00 0 1970 192 1 1992 99.40 (12) RIVERWOOD CENTER 260673 322 0.84 - 90,000 240 0.00 0 1982 240 3 1983 80.20 159,024 RIVERWOOD NURSING CENTER 324612 322 0.84 - 44,625 119 0.00 0 1970 119 3 2000 120.90 114,395 SOUTHLAKE NURSING & REHABILITATION CENTER 312371 322 0.84 - 67,500 180 0.00 0 1982 120 1 1996 110.20 60 SOUTHPOINT TERRACE 266281 322 0.84 - 45,000 120 0.00 0 2004 120 0 0 - ST CATHERINE LABOURE MANOR, INC. 205150 322 0.84 - 90,000 240 0.00 0 1979 232 1 1993 101.70 8 SUMMER BROOK HEALTH CARE CENTER 265721 322 0.84 - 45,000 120 0.00 0 1970 120 3 1994 104.40 130,877 TAYLOR CARE CENTER 207446 322 0.84 - 45,000 120 0.00 0 1983 120 3 1994 104.40 138,758 WEST JACKSONVILLE HEALTH AND REHABILITATIO218171 322 0.84 - 45,000 120 0.00 0 1990 120 3 1997 112.80 82,913 LIFE CARE CENTER OF HILLIARD 214060 320 0.84 - 45,000 120 0.00 0 1990 60 1 1995 107.60 60 QUALITY HEALTH OF FERNANDINA BEACH 225274 320 0.84 - 45,000 120 0.00 0 1984 120 0 0 - LIFE CARE ST. JOHNS, INC. 999869 320 0.84 - - - 0 - 0 0 - MOULTRIE CREEK NURSING AND REHAB CENTER 263559 320 0.84 - 45,000 120 0.00 0 1986 60 1 1992 99.40 60 PONCE DE LEON CARE CENTER 207799 320 0.84 - 45,000 120 0.00 0 1984 120 3 1994 104.40 63,514 SAMANTHA R WILSON SENIOR CITIZENS HOME 202606 320 0.84 - 45,000 120 0.00 0 1970 51 1 1999 117.60 69 SAN MARCO TERRACE REHABILITATION AND CARE316601 320 0.84 - 25,500 68 0.00 0 1983 68 3 1993 101.70 39,846 ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735 320 0.84 - 45,000 120 0.00 0 1976 120 0 0 - VICARS LANDING NURSING HOME 999981 320 0.84 - - - 0 - 0 0 - WESTMINSTER WOODS ON JULINGTON CREEK 212083 322 0.84 - 22,500 60 0.00 0 1970 57 1 1971 32.10 (56) AUBURNDALE OAKS HEALTHCARE CENTER 207527 338 0.90 - 45,000 120 0.00 0 1983 120 3 1997 112.80 83,973 BARTOW CENTER 212997 338 0.90 - 45,000 120 0.00 0 1972 120 0 0 - BRANDYWYNE HEALTH CARE CENTER 251399 338 0.90 - 45,000 120 0.00 0 1983 120 0 0 - CONSULATE HEALTH CARE OF LAKE PARKER 319678 338 0.90 - 45,000 120 0.00 0 1990 120 3 1991 96.80 60,683 CONSULATE HEALTH CARE OF LAKELAND 319953 338 0.90 - 45,000 120 0.00 0 1984 120 3 1989 92.10 260,223 CONSULATE HEALTH CARE OF WINTER HAVEN 319724 338 0.90 - 45,000 120 0.00 0 1998 120 0 0 - CROSSROADS, THE 269409 338 0.90 - 22,500 60 0.00 0 1970 60 3 1977 49.50 557,147 DOVE HEALTHCARE AT LAKE WALES 319341 338 0.90 - 37,500 100 0.00 0 1983 100 3 1991 96.80 62,377 FLORIDA PRESBYTERIAN HOMES INC 212971 338 0.90 - 18,000 48 0.00 0 1997 8 1 1998 115.10 40 GROVES CENTER 212881 338 0.90 - 45,000 120 0.00 0 1973 120 1 1993 101.70 (1) HAINES CITY HEALTH CARE CENTER 224341 338 0.90 - 45,000 120 0.00 0 1983 120 0 0 - HIGHLANDS LAKE CENTER 260576 338 0.90 - 67,125 179 0.00 0 1988 120 1 1993 101.70 59 LAKELAND HILLS CENTER 212865 338 0.90 - 45,000 120 0.00 0 1972 120 0 0 - LIFE CARE CENTER OF WINTER HAVEN 219380 338 0.90 - 66,375 177 0.00 0 1999 177 3 2007 166.30 96,109 MANOR AT CARPENTERS, THE 203599 338 0.90 - 27,000 72 0.00 0 1989 60 1 2008 168.00 12 OAKBRIDGE HEALTHCARE CENTER 259926 338 0.90 - 45,000 120 0.00 0 1991 120 3 2000 120.90 68,548 PALM GARDEN OF WINTER HAVEN 257320 338 0.90 53,203 53,203 120 443.36 443 1987 60 1 1996 110.20 25 PALM TERRACE OF LAKELAND 282626 338 0.90 85,000 85,000 185 459.46 459 1975 120 1 1991 96.80 65 ROHR HOME, THE 202533 338 0.90 - 22,500 60 0.00 0 1970 60 3 1971 32.10 325,000 SPRING LAKE REHABILITATION CENTER 264571 338 0.90 - 45,000 120 0.00 0 1991 120 0 0 - VALENCIA HILLS HEALTH AND REHABILITATION CEN265560 338 0.90 - 112,500 300 0.00 0 1982 300 3 1998 115.10 238,432 WEDGEWOOD HEALTHCARE CENTER 252328 338 0.90 - 45,000 120 0.00 0 1999 120 0 0 - WINTER HAVEN HEALTH & REHABILITATION CENTE 228702 338 0.90 - 54,000 144 0.00 0 1982 144 3 1995 107.60 95,166 ARCH PLAZA NURSING & REHABILITATION CENTER 254291 331 0.90 - 36,750 98 0.00 0 1978 118 1 1998 115.10 (38) AVENTURA PLAZA REHABILITATION & NURSING CE 284823 331 0.90 - 28,125 75 0.00 0 1978 50 1 1989 92.10 25 BERKSHIRE MANOR 005388 331 0.90 45,000 91,875 245 183.67 184 1983 245 0 0 -

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Facility Provider #Zip Code

Factor Location

Factor Total Sq. Footage

Higher of Actual or Minimum

Total Licensed

Beds

Square Footage Per

Bed

Rounded Square Ft Per Bed

Year Initial Construction

Beds Initial Construction 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 1

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507 331 0.90 - 90,000 240 0.00 0 1985 240 3 2003 132.00 800,000 CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864 331 0.90 - - - 0 - 0 0 -

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Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt

3 1994 104.40 104,449 3 2003 132.00 225,243 3 2005 151.60 182,031 0 0 - 0 0 - 0 0 - 3 1994 104.40 204,313 0 0 - 0 0 - 3 1995 107.60 504,256 3 1996 110.20 36,952 3 1999 117.60 32,377 0 0 - 0 0 - 0 0 - 3 2007 166.30 68,737 3 2008 168.00 242,196 3 2008 168.00 85,788 3 1995 107.60 71,521 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1971 32.10 151,516 3 1984 82.00 38,680 3 2003 132.00 48,716 0 0 - 0 0 - 0 0 - 3 1990 94.30 279,779 3 1991 96.80 253,842 3 1994 104.40 293,403 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2006 162.00 48,780 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2008 168.00 38,406 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1984 82.00 2,673,470 0 0 - 0 0 - 3 2007 166.30 70,678 3 2008 168.00 44,674 0 0 - 1 1997 112.80 12 3 1971 32.10 175,778 3 1977 49.50 267,323 3 1989 92.10 178,617 3 1992 99.40 150,329 3 1993 101.70 207,593 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 1 1997 112.80 21 3 1984 82.00 177,174 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1982 76.10 485,258 3 1983 80.20 130,657 3 1993 101.70 1,246,969 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1978 53.50 107,515 3 1991 96.80 316,498 0 0 - 0 0 - 0 0 - 0 0 - 1 1995 107.60 7 1 2002 128.70 (1) 0 0 - 3 2002 128.70 85,621 3 2006 162.00 72,559 0 0 - 3 1991 96.80 85,534 3 1992 99.40 993,311 3 2000 120.90 32,970 3 2008 168.00 160,071 0 0 - 0 0 - 3 1995 107.60 121,925 3 1996 110.20 736,572 3 1997 112.80 101,638 3 1990 94.30 33,946 3 1997 112.80 43,436 3 2005 151.60 31,607 3 1989 92.10 66,741 3 2008 168.00 32,400 0 0 - 0 0 - 0 0 - 0 0 - 3 2002 128.70 72,156 0 0 - 0 0 - 3 2000 120.90 61,833 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1996 110.20 60,722 3 1998 115.10 50,291 3 2008 168.00 84,093 3 2000 120.90 327,100 3 2003 132.00 62,817 0 0 - 1 1994 104.40 12 1 1995 107.60 (4) 1 1996 110.20 4 3 1982 76.10 167,315 3 1982 76.10 88,617 0 0 - 3 2007 166.30 55,614 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2008 168.00 126,852 0 0 - 0 0 - 3 2008 168.00 111,102 0 0 - 0 0 - 3 2002 128.70 71,108 3 2005 151.60 68,973 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1999 117.60 42,166 3 2000 120.90 110,911 3 2001 125.10 220,446 1 1986 84.20 3 1 2006 162.00 (4) 3 1990 94.30 283,682 3 2001 125.10 752,264 3 2003 132.00 108,979 0 0 - 3 1991 96.80 49,010 3 1998 115.10 1,135,972 0 0 - 3 1988 89.90 142,794 3 1999 117.60 1,064,422 3 2009 169.71 94,053 0 0 - 0 0 - 0 0 - 3 1984 82.00 130,637 3 1996 110.20 933,436 0 0 - 3 1996 110.20 201,035 3 1997 112.80 105,240 0 0 - 0 0 - 0 0 - 0 0 - 3 1979 57.80 1,091,963 3 1995 107.60 284,043 3 2000 120.90 988,950 3 2001 125.10 35,673 3 2007 166.30 126,343 0 0 - 0 0 - 0 0 - 0 0 - 3 1994 104.40 61,005 3 1996 110.20 283,296 3 1998 115.10 67,343

Modification 2 Modification 3 Modification 4

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INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt

Modification 2 Modification 3 Modification 4

0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2000 120.90 91,132 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1981 70.00 346,909 3 1982 76.10 91,956 3 1984 82.00 1,726,308 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 1 1998 115.10 1 3 2002 128.70 184,065 3 2006 162.00 32,125 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1989 92.10 428,969 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2006 162.00 63,028 3 2007 166.30 43,398 0 0 - 0 0 - 0 0 - 0 0 - 3 1998 115.10 36,223 3 2004 143.70 69,519 0 0 - 0 0 - 0 0 - 0 0 - 3 1999 117.60 30,355 3 2007 166.30 35,854 0 0 - 1 2006 162.00 (14) 3 1995 107.60 1,656,174 0 0 - 0 0 - 0 0 - 0 0 - 3 2000 120.90 39,649 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1995 107.60 47,437 3 2006 162.00 116,191 0 0 - 0 0 - 0 0 - 0 0 - 3 2000 120.90 129,860 0 0 - 0 0 - 1 1983 80.20 10 1 1986 84.20 (10) 1 1987 87.70 10 1 1996 110.20 5 1 1997 112.80 14 3 1976 46.90 482,744 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2002 128.70 152,107 0 0 - 0 0 - 3 1992 99.40 53,761 3 1995 107.60 63,682 0 0 - 0 0 - 0 0 - 0 0 - 3 2002 128.70 25,800 0 0 - 0 0 - 3 2003 132.00 858,476 3 2004 143.70 103,860 3 2005 151.60 152,955 0 0 - 0 0 - 0 0 - 3 1998 115.10 75,583 0 0 - 0 0 - 1 1986 84.20 (20) 1 2007 166.30 21 3 1985 82.60 734,710 0 0 - 0 0 - 0 0 - 3 1994 104.40 231,106 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1989 92.10 436,631 3 2000 120.90 364,569 0 0 - 3 1995 107.60 409,783 3 1997 112.80 490,994 0 0 - 3 1999 117.60 87,759 0 0 - 0 0 - 1 2002 128.70 1 3 1997 112.80 73,531 3 2004 143.70 71,423 0 0 - 0 0 - 0 0 - 3 1983 80.20 79,181 3 1984 82.00 1,082,371 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1983 80.20 135,286 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1984 82.00 2,048,436 3 1995 107.60 97,533 3 2009 169.71 202,327 0 0 - 0 0 - 0 0 - 3 2004 143.70 124,446 3 2004 143.70 79,352 0 0 - 0 0 - 0 0 - 0 0 - 3 1989 92.10 359,075 0 0 - 0 0 - 1 2001 125.10 21 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1977 49.50 283,173 3 2001 125.10 217,235 0 0 - 3 1993 101.70 91,096 3 1994 104.40 162,786 3 1995 107.60 90,572 0 0 - 0 0 - 0 0 -

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GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt

Modification 2 Modification 3 Modification 4

3 1999 117.60 66,411 3 2000 120.90 72,460 0 0 - 3 2006 162.00 101,416 0 0 - 0 0 - 3 2006 162.00 60,738 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 1 1983 80.20 3 1 1991 96.80 60 3 1971 32.10 789,752 0 0 - 0 0 - 0 0 - 3 1997 112.80 101,693 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1990 94.30 135,961 3 2000 120.90 87,927 3 2001 125.10 69,153 3 1995 107.60 144,589 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1999 117.60 83,354 3 2001 125.10 136,821 3 2008 168.00 62,193 0 0 - 0 0 - 0 0 - 3 1992 99.40 242,160 3 1997 112.80 23,975 3 1998 115.10 19,366 3 1995 107.60 87,582 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1998 115.10 1,001,229 3 2006 162.00 60,533 0 0 - 1 2002 128.70 (3) 3 2007 166.30 223,375 3 2009 169.71 266,135 0 0 - 0 0 - 0 0 - 3 2003 132.00 34,118 0 0 - 0 0 - 1 1991 96.80 4 3 1989 92.10 83,440 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2006 162.00 77,526 3 2007 166.30 67,757 3 2008 168.00 84,197 3 1994 104.40 70,814 0 0 - 0 0 - 1 1993 101.70 12 1 2000 120.90 (12) 3 1983 80.20 195,626 3 1990 94.30 1,210,766 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1994 104.40 76,593 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1980 62.90 431,991 3 1981 70.00 143,151 3 1984 82.00 119,716 3 1995 107.60 96,978 3 2004 143.70 270,371 0 0 - 3 2004 143.70 420,419 3 2007 166.30 61,068 0 0 - 3 2008 168.00 81,799 0 0 - 0 0 - 3 2002 128.70 109,885 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2007 166.30 312,367 3 2008 168.00 152,349 0 0 - 3 2001 125.10 147,231 3 2004 143.70 125,302 3 2005 151.60 71,655 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 1 1996 110.20 57 1 2004 143.70 3 3 2000 120.90 32,216 3 2008 168.00 65,410 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1993 101.70 70,787 3 1994 104.40 125,664 3 1996 110.20 81,882 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2006 162.00 1,851,137 0 0 - 0 0 - 3 2006 162.00 25,845 0 0 - 0 0 - 1 2000 120.90 1 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1994 104.40 30,428 3 1998 115.10 34,206 3 1999 117.60 203,590 3 2001 125.10 979,642 0 0 - 0 0 - 1 1997 112.80 35 3 1995 107.60 59,924 3 2006 162.00 248,184 3 1983 80.20 1,262,590 0 0 - 0 0 - 3 2007 166.30 1,533,729 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1998 115.10 493,436 0 0 - 0 0 - 1 2004 143.70 18 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 -

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CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt

Modification 2 Modification 3 Modification 4

3 2009 169.71 188,053 0 0 - 0 0 - 0 0 - 0 0 - 0 0 -

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Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2008 168.00 57,084 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2004 143.70 29,744 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1996 110.20 2,487,567 3 1997 112.80 134,520 3 2000 120.90 62,572 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1983 80.20 461,096 3 1993 101.70 42,106 3 1999 117.60 53,003 3 1999 117.60 45,391 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1996 110.20 552,808 3 1997 112.80 635,937 3 2000 120.90 505,618 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2006 162.00 72,323 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2002 128.70 66,006 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2000 120.90 129,405 3 2005 151.60 99,189 3 2008 168.00 94,910 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2007 166.30 75,978 3 2009 169.71 68,824 0 0 -

Modification 5 Modification 6 Modification 7

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Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 5 Modification 6 Modification 7

0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2008 168.00 110,559 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1973 37.70 83,019 3 1974 41.40 559,614 3 1991 96.80 1,434,932 3 1980 62.90 1,935,602 3 1989 92.10 83,405 3 1991 96.80 608,806 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1991 96.80 203,960 3 1997 112.80 119,698 3 2000 120.90 95,258 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1996 110.20 72,208 3 1997 112.80 101,149 3 1998 115.10 66,917 0 0 - 0 0 - 0 0 -

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Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 5 Modification 6 Modification 7

0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1992 99.40 1,953,547 3 1996 110.20 64,172 3 1998 115.10 99,850 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2009 169.71 69,004 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1999 117.60 38,080 3 2000 120.90 35,143 3 2001 125.10 34,680 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2005 151.60 120,520 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 1988 89.90 153,120 3 1996 110.20 356,978 3 1997 112.80 185,057 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 3 2000 120.90 40,724 3 2002 128.70 125,430 3 2003 132.00 109,224 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 -

Page 146: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index # Beds or

Renovation Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt

Modification 5 Modification 6 Modification 7

0 0 - 0 0 - 0 0 - 0 0 - 0 0 - 0 0 -

Page 147: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3

0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 2003 132.00 68,236 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 2002 128.70 75,994 3 2009 169.71 77,126 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 2008 168.00 2,101,363 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - -

Modification 10 Modification 11Modification 9Modification 8

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Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3

Modification 10 Modification 11Modification 9Modification 8

0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 2000 120.90 814,322 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 2006 162.00 101,630 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - - 3 1999 117.60 63,246 3 2001 125.10 71,624 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - -

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Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3

Modification 10 Modification 11Modification 9Modification 8

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CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3

Modification 10 Modification 11Modification 9Modification 8

0 0 - 0 0 - 0 0 - 0 0 - - 0 0 - 0 0 - 0 0 - 0 0 - -

Page 151: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year

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Modification 15Modification 13 Modification 14Modification 12 Modif

Page 152: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

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INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 15Modification 13 Modification 14Modification 12 Modif

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GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 15Modification 13 Modification 14Modification 12 Modif

0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - -

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2009 169.71 88,375 - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - -

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CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year Cost Index

# Beds or Renovation

Amt 1, 2, or 3 Year

Modification 15Modification 13 Modification 14Modification 12 Modif

0 - - 0 - - 0 - - 0 - - - 0 - - 0 - - 0 - - 0 - - -

Page 155: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

Cost Index

# Beds or Renovation

Amt Rate of

DepreciationNew bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

- 2.0% 208 22 23,102 10,165 29.39 1967- 2.0% 105 1 33,171 663 105.00 2000- 2.0% 240 4 20,880 1,670 240.00 1982- 2.0% 60 12 28,644 6,875 5.13 1983- 2.0% 120 17 35,312 12,006 6.39 1986- 2.0% 120 1 34,324 686 96.07 2001- 2.0% 120 2 1990- 2.0% 110 24 30,236 14,513 110.00 1996- 2.0% 120 3 1989- 2.0% 60 3 27,272 1,636 23.90 1990- 2.0% 59 14 1980- 2.0% 120 35 1992- 2.0% 120 4 25,270 2,022 120.00 1989- 2.0% 0- 2.0% 120 1 22,005 440 120.00 1983- 2.0% 81 2 33,171 1,327 81.00 2000- 2.0% 0- 2.0% 45 8 41,595 6,655 11.94 1999- 2.0% 120- 2.0% 0- 2.0% 120 4 1983- 2.0% 60 2 36,217 1,449 26.04 2002- 2.0% 89 26 1976- 2.0% 87 26 1951- 2.0% 120 3 30,949 1,857 61.72 1996- 2.0% 129- 2.0% 157 12 1986- 2.0% 60- 2.0% 120 21 44,448 18,668 3.29 1986- 2.0% 204 6 12,868 1,544 72.91 1972- 2.0% 0- 2.0% 120- 2.0% 169 6 13,581 1,630 169.00 1977- 2.0% 120 20 45,628 18,251 3.56 1988- 2.0% 113 4 1988- 2.0% 120 14 30,236 8,466 16.72 1984- 2.0% 60 8 14,679 2,349 28.19 1974- 2.0% 120 9 34,324 6,178 9.97 1993- 2.0% 120 1 1991- 2.0% 60 1 22,663 453 60.00 1985- 2.0% 60 21 1970- 2.0% 120- 2.0% 120 10 1989- 2.0% 120 11 31,221 6,869 71.35 1994- 2.0% 120 3 1998- 2.0% 85 10 1992- 2.0% 112 7 1993- 2.0% 108 1 1990- 2.0% 120 20 1977- 2.0% 110 20 43,943 17,577 3.25 1987- 2.0% 155- 2.0% 0- 2.0% 120- 2.0% 120- 2.0% 180 36 43,943 31,639 3.25 1971- 2.0% 219 33 1977- 2.0% 107 18 31,899 11,484 5.82 1982- 2.0% 120- 2.0% 133 41 47,621 39,049 2.42 1969- 2.0% 60 1 24,609 492 60.00 1987- 2.0% 140 2 1982- 2.0% 120 5 1989- 2.0% 130 26 1985- 2.0% 120 4 1989- 2.0% 180- 2.0% 120 11 1985- 2.0% 120 1 23,010 460 120.00 1984- 2.0% 120 3 30,923 1,855 34.41 1994- 2.0% 120 1 13,160 263 120.00 1976- 2.0% 60 1 32,298 646 60.00 1998- 2.0% 73 8 1997- 2.0% 84 12 1987

Calculation 1fication 16

Page 156: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

Cost Index

# Beds or Renovation

Amt Rate of

DepreciationNew bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 1fication 16

- 2.0% 173 7 1989- 2.0% 150- 2.0% 192 1 21,354 427 192.00 1982- 2.0% 65 7 25,227 3,532 10.91 1982- 2.0% 122- 2.0% 239 13 1983- 2.0% 120- 2.0% 120- 2.0% 160 22 1979- 2.0% 99 31 32,999 20,460 25.09 1976- 2.0% 59 11 1984- 2.0% 60- 2.0% 60- 2.0% 60- 2.0% 120- 2.0% 120- 2.0% 194 12 1983- 2.0% 198 21 26,559 11,155 16.04 1972- 2.0% 36 8 1992- 2.0% 60 10 32,298 6,460 0.70 1988- 2.0% 60 7 29,522 4,133 12.01 1989- 2.0% 88- 2.0% 60 6 29,549 3,546 10.47 1991- 2.0% 169 15 1977- 2.0% 67- 2.0% 59 6 25,873 3,105 10.32 1985- 2.0% 120- 2.0% 109 7 1991- 2.0% 151 9 1991- 2.0% 240 13 32,999 8,580 24.80 1987- 2.0% 142 12 1969- 2.0% 158 22 1977- 2.0% 120 3 41,595 2,496 41.09 2003- 2.0% 116- 2.0% 206- 2.0% 120- 2.0% 170 13 1989- 2.0% 120 8 1991- 2.0% 120- 2.0% 35 7 28,538 3,995 13.54 1989- 2.0% 152 8 1975- 2.0% 127- 2.0% 120 5 28,644 2,864 23.71 1990- 2.0% 180 4 1980- 2.0% 83 4 24,609 1,969 43.28 1985- 2.0% 110 6 1990- 2.0% 325 9 1985- 2.0% 120- 2.0% 120 14 22,663 6,346 107.17 1984- 2.0% 118 12 28,644 6,875 10.84 1983- 2.0% 119 4 1995- 2.0% 119 20 1973- 2.0% 120 6 1996- 2.0% 180 21 1977- 2.0% 120 27 23,242 12,551 15.01 1963- 2.0% 120 0 2000- 2.0% 60- 2.0% 60 15 32,041 9,612 9.14 1987- 2.0% 180 29 1989- 2.0% 97 7 1991- 2.0% 180 17 32,418 11,022 8.50 1984- 2.0% 120- 2.0% 0- 2.0% 120 10 31,097 6,219 120.00 1997- 2.0% 154 24 1977- 2.0% 120- 2.0% 120 10 1982- 2.0% 120- 2.0% 120 3 21,987 1,319 120.00 1984- 2.0% 60 2 27,993 1,120 39.12 1993- 2.0% 120 5 1993- 2.0% 68 1 8,407 168 68.00 1971- 2.0% 120 2 25,352 1,014 106.17 1991- 2.0% 120

Page 157: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

Cost Index

# Beds or Renovation

Amt Rate of

DepreciationNew bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 1fication 16

- 2.0% 120 9 26,033 4,686 14.32 1984- 2.0% 120 9 30,799 5,544 14.67 1991- 2.0% 120 4 1997- 2.0% 180- 2.0% 0- 2.0% 105 23 34,571 15,903 7.07 1982- 2.0% 108- 2.0% 57 12 1969- 2.0% 84 4 31,664 2,533 26.36 1997- 2.0% 165 21 1980- 2.0% 120 4 1985- 2.0% 120 6 12,283 1,474 120.00 1976- 2.0% 180 8 16,473 2,636 170.65 1980- 2.0% 116 4 31,664 2,533 29.47 1997- 2.0% 60 5 28,861 2,886 15.58 1992- 2.0% 60- 2.0% 24 19 25,352 9,634 1.71 1973- 2.0% 100 11 27,342 6,015 77.96 1992- 2.0% 0- 2.0% 180 23 31,664 14,565 7.28 1978- 2.0% 120 7 29,542 4,136 42.79 1992- 2.0% 120 11 1984- 2.0% 163 4 1992- 2.0% 122 10 2002- 2.0% 116 6 1987- 2.0% 120 4 43,998 3,520 64.45 2006- 2.0% 120 6 1991- 2.0% 104 22 32,764 14,416 4.82 1980- 2.0% 120 4 1986- 2.0% 180 22 1969- 2.0% 240 1 21,004 420 240.00 1983- 2.0% 119 30 31,664 18,998 6.02 1972- 2.0% 180 14 1987- 2.0% 120- 2.0% 240 14 1979- 2.0% 120 24 27,342 13,124 9.97 1972- 2.0% 120 11 27,342 6,015 23.07 1985- 2.0% 120 7 29,542 4,136 20.05 1991- 2.0% 120 5 1993- 2.0% 120- 2.0% 0- 2.0% 120 6 1989- 2.0% 120 10 27,342 5,468 11.61 1985- 2.0% 120 29 1987- 2.0% 68 10 26,635 5,327 7.48 1984- 2.0% 120- 2.0% 0- 2.0% 1 1 1914- 2.0% 120 14 31,652 8,863 9.47 1984- 2.0% 120- 2.0% 120- 2.0% 120 1 27,163 543 111.70 1991- 2.0% 120 5 25,844 2,584 100.69 1988- 2.0% 120- 2.0% 60 7 13,890 1,945 60.00 1977- 2.0% 100 8 27,163 4,346 14.35 1984- 2.0% 48 1 1998- 2.0% 119 20 1973- 2.0% 120- 2.0% 179 5 1990- 2.0% 120- 2.0% 177 8 46,665 7,466 12.87 2000- 2.0% 72 19 1992- 2.0% 120 9 33,925 6,107 11.23 1992- 2.0% 85 9 1990- 2.0% 185 16 1981- 2.0% 60 1 9,007 180 60.00 1971- 2.0% 120- 2.0% 300 16 32,298 10,335 23.07 1983- 2.0% 120- 2.0% 144 13 30,193 7,850 12.12 1983- 2.0% 80 20 1969- 2.0% 75 11 1982- 2.0% 245

Page 158: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

Cost Index

# Beds or Renovation

Amt Rate of

DepreciationNew bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 1fication 16

- 2.0% 240 18 37,040 13,334 60.00 1989- 2.0% 0

Page 159: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

208 27 28,644 15,468 6.75 1968 208 35 36,217 25,352 8.88 1969105 105240 12 28,644 6,875 29.72 1983 24060 12 29,522 7,085 60.00 1995 60 1 30,236 605 60.00 1996

120 120120 6 45,628 5,475 12.55 2002 120 6 46,093 5,531 43.79 2004120 5 29,522 2,952 24.23 1991 120110 110120 12060 6059 -9 8,807 (1,585) (95.57) 1971 59 13 22,498 5,850 6.61 1972

120 120120 1 25,873 517 120.00 1990 120 1 26,559 531 120.00 1991

0 0120 12081 6 44,448 5,334 9.15 2001 810 0

45 9 46,093 8,297 4.63 2000 45120 120

0 0120 1 22,498 450 120.00 1984 12060 5 45,628 4,563 15.49 2003 60 5 46,093 4,609 9.69 2004

101 21 1978 101 -7 8,807 (1,233) (142.56) 197187 38 25,270 19,205 9.30 1955 87 37 27,272 20,182 7.45 1958

120 120129 129178 11 1987 178 -3 22,498 (1,350) (131.25) 198460 60

120 120204 10 20,880 4,176 116.20 1978 204 5 22,005 2,200 59.38 1979

0 0120 120169 1 14,679 294 169.00 1978 169 13 26,559 6,905 45.83 1982120 120120 7 1988 119 14 2002120 18 35,312 12,712 6.74 1985 120 21 44,448 18,668 3.89 198660 17 26,559 9,030 9.47 1977 60 15 27,272 8,182 60.00 1992

120 15 46,093 13,828 11.58 1994 120120 4 29,522 2,362 51.62 1993 120 3 30,236 1,814 120.00 199660 5 25,873 2,587 13.12 1986 60 11 30,949 6,809 6.38 198760 19 24,982 9,493 7.03 1972 60 36 45,569 32,810 0.99 1973

120 120120 13 34,910 9,077 7.95 1990 120120 6 32,795 3,935 15.71 1995 120120 12085 4 29,892 2,391 25.39 1993 85 5 31,221 3,122 16.11 1994

112 7 32,795 4,591 71.24 1997 112 6 35,805 4,297 14.62 1998120 4 1990 116 5 1995120 5 20,642 2,064 81.05 1980 120 2 20,642 826 107.32 1982110 20 45,109 18,044 3.08 1988 110155 155

0 0120 120120 120180 37 45,569 33,721 3.76 1972 180219 31 45,569 28,253 3.93 1978 219107 20 34,910 13,964 5.09 1983 107 22 41,122 18,094 3.81 1984120 120133 13360 12 32,999 7,920 5.32 1988 60 12 33,925 8,142 13.62 1991

143 4 1986 139 20 2006120 12 35,104 8,425 89.29 1998 120 5 37,040 3,704 29.42 1999130 6 27,163 3,260 15.04 1986 130 12 32,298 7,751 130.00 1998120 -1 25,227 (505) (283.02) 1988 120 11 32,999 7,260 120.00 1999180 180120 -1 23,010 (460) (283.87) 1984 120 12 30,923 7,421 120.00 1996120 12 30,923 7,421 27.09 1987 120 10 31,652 6,330 16.62 1988120 120120 3 16,219 973 120.00 1979 120 16 30,193 9,662 29.40 198360 3 35,104 2,106 16.94 1999 60 8 46,665 7,466 16.92 200173 7384 7 29,295 4,101 14.87 1988 84 8 30,923 4,948 57.26 1993

Calculation 3Calculation 2

Page 160: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 3Calculation 2

173 173150 150192 19265 18 33,925 12,213 7.46 1984 65

122 122239 -2 19,642 (786) (441.53) 1981 239 1 21,354 427 215.31 1982120 120120 120160 16099 9960 14 1998 60 4 36,114 2,889 60.00 200260 6060 6060 60

120 120120 120194 6 25,844 3,101 138.32 1987 194198 19836 14 45,458 12,728 4.95 1994 36 13 46,665 12,133 3.58 199560 6060 9 31,580 5,684 6.37 1990 60 14 39,427 11,040 6.30 199188 8860 8 31,533 5,045 6.02 1992 60 15 44,591 13,377 2.68 1993

155 29 2006 155 -11 29,522 (6,495) (255.00) 199567 6759 15 33,171 9,951 3.98 1986 59

120 120109 4 29,522 2,362 20.09 1992 109 14 44,448 12,445 9.34 1993151 151240 13 33,925 8,821 14.72 1988 240152 14 1983 142 3 1986163 19 1978 177 19 1980120 120116 116206 206120 120170 13 36,114 9,390 16.20 1990 170120 1 27,892 558 96.37 1992 120 3 30,193 1,812 35.15 1993120 12035 13 36,114 9,390 2.75 1990 35

152 28 36,217 20,282 42.33 1983 152 21 39,427 16,559 6.27 1984127 127120 8 31,580 5,053 14.96 1991 120160 6 1979 181 28 198283 83

110 4 28,644 2,292 100.85 1994 110325 325120 120120 5 25,270 2,527 120.00 1989 120 11 33,171 7,298 49.96 1994118 12 29,522 7,085 57.84 1989 118 8 30,949 4,952 99.15 1996119 4 31,166 2,493 35.20 1996 119120 29 2002 120 -5 29,894 (2,989) (24.60) 1997120 120180 6 21,254 2,551 31.04 1978 180 6 21,731 2,608 180.00 1984120 120120 12060 6060 60

180 -6 19,754 (2,370) (57.07) 1983 18097 97

180 180120 120

0 0120 120154 7 21,987 3,078 154.00 1984 154 11 28,851 6,347 15.37 1985120 120120 22 38,531 16,954 7.34 1983 120 21 38,531 16,183 4.90 1984120 120120 5 24,695 2,470 120.00 1989 12081 8 1995 81

120 12068 6 12,964 1,556 68.00 1977 68 24 32,764 15,727 13.81 1982

120 2 26,635 1,065 85.50 1992 120 2 27,342 1,094 120.00 1994120 120

Page 161: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 3Calculation 2

120 15 30,799 9,240 7.19 1985 120 15 31,664 9,499 7.63 1986120 15 42,428 12,728 7.97 1992 120120 9 42,428 7,637 7.95 1998 120180 180

0 0105 105108 10860 14 1983 120 8 198784 84

165 17 29,542 10,044 10.12 1981 165120 120120 14 24,697 6,915 19.66 1978 120 22 31,664 13,932 6.31 1979180 15 28,180 8,454 17.10 1981 180116 11660 7 30,799 4,312 19.33 1994 60 7 32,764 4,587 29.83 199760 6024 19 26,033 9,892 24.00 1992 24 5 29,542 2,954 8.12 1994

100 3 28,180 1,691 51.80 1994 1000 0

180 180120 6 30,145 3,617 120.00 1998 120 8 42,428 6,788 8.92 1999117 18 1984 117 23 43,554 20,035 11.15 1986163 163122 1 34,571 691 49.35 2002 122120 4 1987 120 2 24,121 965 86.48 1988120 120120 120104 26 42,428 22,062 3.51 1981 104 26 43,554 22,648 2.99 1982120 8 27,342 4,375 16.19 1987 120192 24 1993 180 7 2000240 7 24,697 3,458 240.00 1990 240119 119180 7 27,342 3,828 20.01 1988 180120 120240 1 16,473 329 240.00 1980 240 1 18,333 367 240.00 1981120 23 28,180 12,963 7.48 1973 120 31 37,635 23,334 11.59 1976120 19 37,635 14,301 29.40 1990 120 17 43,554 14,808 4.12 1991120 17 43,998 14,959 5.47 1992 120120 9 33,706 6,067 18.11 1994 120120 120

0 0120 120120 22 43,554 19,164 16.30 1988 120 20 43,998 17,599 8.66 1989120 14 32,764 9,174 16.05 1989 120 15 37,635 11,290 11.10 199068 68

120 1200 0

58 82 1996 61 8 1996120 24 47,141 22,628 2.89 1985 120120 120120 120120 2 28,538 1,142 62.01 1992 120 2 29,295 1,172 107.24 1994120 120120 12060 60

100 22 45,458 20,002 92.55 2004 10048 8 45,458 7,273 3.55 1999 48

120 27 2000 120120 120179 179120 120177 17772 2 29,295 1,172 25.97 1993 72 5 32,298 3,230 10.59 1994

120 9 35,104 6,319 120.00 2001 120120 7 1992 120 3 35,697 2,142 27.98 1993185 2 27,573 1,103 185.00 1983 18560 36 46,665 33,599 45.65 1998 60

120 120300 300120 120144 15 32,298 9,689 50.93 1988 14498 35 2004 9875 75

245 245

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Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 3Calculation 2

240 20 47,621 19,049 9.87 1990 2400 0

Page 163: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

208 36 41,595 29,948 6.08 1970 208105 105240 24060 3 32,266 1,936 16.72 1997 60 11 46,093 10,140 5.63

120 120120 4 46,093 3,687 23.26 2005 120120 120110 110120 12060 6059 31 36,217 22,455 2.17 1973 59 31 39,427 24,445 1.22

120 120120 3 28,644 1,719 120.00 1994 120 2 30,236 1,209 120.00

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 6 13,581 1,630 101.00 1977 101 6 22,005 2,641 101.00 87 35 27,904 19,532 10.63 1962 87 37 32,266 23,877 1.90

120 120129 129178 17860 60

120 120204 14 27,904 7,813 159.60 1990 204 6 30,236 3,628 152.36

0 0120 120169 169120 120119 119120 12060 8 33,171 5,307 6.21 1993 60

120 120120 1 30,949 619 120.00 1997 12060 18 41,595 14,974 2.11 1988 6060 60

120 120120 120120 120120 12085 14 45,569 12,759 6.59 1995 85

112 112120 1 1995 120 11 43,943 9,667 7.48 120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 10 35,104 7,021 31.40 1996 60 6 36,114 4,334 15.23

139 -16 26,461 (8,468) (33.50) 1990 139120 120130 130120 10 47,621 9,524 9.88 2000 120180 180120 120120 120120 120120 17 33,925 11,535 85.74 1995 120 5 33,925 3,393 38.14 60 6073 7384 5 32,298 3,230 20.85 1994 84 13 46,665 12,133 6.26

Calculation 4 Calculation 5

Page 164: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 4 Calculation 5

173 173150 150192 19265 65

122 122239 2 23,010 920 239.00 1984 239120 120120 120160 16099 9960 4 45,458 3,637 8.83 2003 60 5 47,141 4,714 23.45 60 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 1 1986 152 -13 10,579 (2,751) (30.18) 177 -4 13,160 (1,053) (458.52) 1976 177 4 17,650 1,412 177.00 120 120116 116206 206120 120170 170120 120120 12035 35

152 21 41,595 17,470 8.76 1985 152127 127120 120181 3 22,663 1,360 181.00 1985 181 6 26,559 3,187 64.00 83 83

110 110325 325120 120120 120118 118119 119120 7 38,083 5,332 13.40 1998 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 24 45,505 21,842 9.26 1986 154120 120120 120120 120120 12081 81

120 12068 68

120 1 28,180 564 120.00 1995 120 1 28,861 577 120.00 120 120

Page 165: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 4 Calculation 5

120 120120 120120 120180 180

0 0105 105108 108120 -16 8,407 (2,690) (293.56) 1971 120 21 26,033 10,934 120.00 84 84

165 165120 120120 22 32,764 14,416 4.80 1980 120180 180116 11660 11 43,998 9,680 6.43 1998 60 11 44,447 9,778 7.06 60 6024 4 30,145 2,412 8.03 1995 24 4 30,799 2,464 15.45

100 1000 0

180 180120 120117 23 44,447 20,445 13.02 1989 117163 163122 122120 120120 120120 120104 26 43,998 22,879 3.68 1983 104120 120180 -17 21,004 (7,141) (27.39) 1983 180 22 39,704 17,470 6.90 240 240119 119180 180120 120240 3 21,476 1,289 92.91 1982 240 6 23,545 2,825 54.19 120 120120 120120 120120 120120 120

0 0120 120120 120120 15 39,704 11,911 6.02 1991 12068 68

120 1200 0

61 4 31,664 2,533 12.72 1997 61120 120120 120120 120120 2 30,923 1,237 66.20 1995 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 5 32,999 3,300 61.70 1998 72 2 33,925 1,357 30.01

120 120120 13 53,745 13,974 17.76 1995 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 166: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

Cost Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 4 Calculation 5

240 2400 0

Page 167: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New Base Year (if

Renovation)

1998

1974

1996

19831963

1994

1996

1998

1997

1995

Page 168: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New Base Year (if

Renovation)

2005

19731980

1987

1996

Page 169: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New Base Year (if

Renovation)

1992

1999

1998

1984

1983

1999

Page 170: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New Base Year (if

Renovation)

Page 171: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

208 208105 105240 24060 60

120 120120 120120 120110 110120 12060 6059 59

120 120120 1 30,949 619 120.00 1997 120 3 33,171 1,990 31.44 1998

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 10 27,904 5,581 7.54 1984 101 15 32,266 9,680 5.48 198587 87

120 120129 129178 17860 60

120 120204 3 30,949 1,857 204.00 1997 204 3 33,171 1,990 204.00 2000

0 0120 120169 169120 120119 119120 12060 60

120 120120 12060 6060 60

120 120120 120120 120120 12085 85

112 112120 120120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 60

139 139120 120130 130120 120180 180120 120120 120120 120120 8 42,540 6,806 14.57 1998 120 10 47,141 9,428 10.07 199960 6073 7384 14 47,621 13,334 5.16 1996 84

Calculation 6 Calculation 7

Page 172: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 6 Calculation 7

173 173150 150192 19265 65

122 122239 239120 120120 120160 16099 9960 6060 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 1 11,617 232 152.00 1974 152 17 27,163 9,235 152.00 1991177 9 25,844 4,652 17.93 1981 177 10 27,163 5,433 112.07 1987120 120116 116206 206120 120170 170120 120120 12035 35

152 152127 127120 120181 10 30,949 6,190 19.34 1988 181 12 33,171 7,961 11.97 198983 83

110 110325 325120 120120 120118 118119 119120 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 154120 120120 120120 120120 12081 81

120 12068 68

120 1 29,542 591 120.00 1997 120 1 30,145 603 110.99 1998120 120

Page 173: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 6 Calculation 7

120 120120 120120 120180 180

0 0105 105108 108120 4 28,861 2,309 27.79 1993 120 5 30,145 3,014 33.12 199484 84

165 165120 120120 120180 180116 11660 6060 6024 2 31,664 1,267 24.00 2000 24 1 32,764 655 24.00 2001

100 1000 0

180 180120 120117 117163 163122 122120 120120 120120 120104 104120 120180 180240 240119 119180 180120 120240 13 28,861 7,504 47.57 1986 240 11 29,542 6,499 28.47 1987120 120120 120120 120120 120120 120

0 0120 120120 120120 12068 68

120 1200 0

61 61120 120120 120120 120120 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 3 36,114 2,167 57.89 2001 72 2 37,040 1,482 72.00 2003

120 120120 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 174: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 6 Calculation 7

240 2400 0

Page 175: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

208 208105 105240 24060 60

120 120120 120120 120110 110120 12060 6059 59

120 120120 5 36,217 3,622 18.84 1999 120

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 17 35,312 12,006 6.33 1986 101 23 46,563 21,419 3.60 198787 87

120 120129 129178 17860 60

120 120204 8 46,093 7,375 204.00 2008 204

0 0120 120169 169120 120119 119120 12060 60

120 120120 12060 6060 60

120 120120 120120 120120 12085 85

112 112120 120120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 60

139 139120 120130 130120 120180 180120 120120 120120 120120 12060 6073 7384 84

Calculation 8 Calculation 9

Page 176: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 8 Calculation 9

173 173150 150192 19265 65

122 122239 239120 120120 120160 16099 9960 6060 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 152177 13 33,925 8,821 92.32 1994 177120 120116 116206 206120 120170 170120 120120 12035 35

152 152127 127120 120181 17 44,448 15,112 6.72 1990 18183 83

110 110325 325120 120120 120118 118119 119120 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 154120 120120 120120 120120 12081 81

120 12068 68

120 1 30,799 616 102.67 1999 120 2 32,764 1,311 54.65 2000120 120

Page 177: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 8 Calculation 9

120 120120 120120 120180 180

0 0105 105108 108120 6 31,664 3,800 20.31 1995 120 6 32,764 3,932 53.03 199884 84

165 165120 120120 120180 180116 11660 6060 6024 1 33,706 674 20.26 2002 24 1 34,571 691 24.00 2003

100 1000 0

180 180120 120117 117163 163122 122120 120120 120120 120104 104120 120180 180240 240119 119180 180120 120240 16 34,571 11,063 69.34 1992 240 16 43,998 14,079 13.28 1993120 120120 120120 120120 120120 120

0 - 0120 120120 120120 12068 68

120 1200 0

61 61120 120120 120120 120120 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 1 40,323 806 72.00 2004 72

120 120120 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 178: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)

Calculation 8 Calculation 9

240 2400 0

Page 179: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

208 208105 105240 24060 60

120 120120 120120 120110 110120 12060 6059 59

120 120120 120

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 10187 87

120 120129 129178 17860 60

120 120204 204

0 0120 120169 169120 120119 119120 12060 60

120 120120 12060 6060 60

120 120120 120120 120120 12085 85

112 112120 120120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 60

139 139120 120130 130120 120180 180120 120120 120120 120120 12060 6073 7384 84

Calculation 10 Calculation 11

Page 180: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 10 Calculation 11

173 173150 150192 19265 65

122 122239 239120 120120 120160 16099 9960 6060 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 152177 177120 120116 116206 206120 120170 170120 120120 12035 35

152 152127 127120 120181 18183 83

110 110325 325120 120120 120118 118119 119120 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 154120 120120 120120 120120 12081 81

120 12068 68

120 120120 120

Page 181: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 10 Calculation 11

120 120120 120120 120180 180

0 0105 105108 108120 4 33,706 2,697 76.10 2001 120 2 34,571 1,383 96.92 84 84

165 165120 120120 120180 180116 11660 6060 6024 2 39,704 1,588 8.48 2004 24 4 43,998 3,520 18.42

100 1000 0

180 180120 120117 117163 163122 122120 120120 120120 120104 104120 120180 180240 240119 119180 180120 120240 240120 120120 120120 120120 120120 120

0 0120 120120 120120 12068 68

120 1200 0

61 61120 120120 120120 120120 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 72

120 120120 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 182: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 10 Calculation 11

240 2400 0

Page 183: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New Base Year (if

Renovation)

Page 184: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New Base Year (if

Renovation)

Page 185: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New Base Year (if

Renovation)

2003

2007

Page 186: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New Base Year (if

Renovation)

Page 187: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

208 208105 105240 24060 60

120 120120 120120 120110 110120 12060 6059 59

120 120120 120

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 10187 87

120 120129 129178 17860 60

120 120204 204

0 0120 120169 169120 120119 119120 12060 60

120 120120 12060 6060 60

120 120120 120120 120120 12085 85

112 112120 120120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 60

139 139120 120130 130120 120180 180120 120120 120120 120120 12060 6073 7384 84

Calculation 12 Calculation 13

Page 188: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 12 Calculation 13

173 173150 150192 19265 65

122 122239 239120 120120 120160 16099 9960 6060 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 152177 177120 120116 116206 206120 120170 170120 120120 12035 35

152 152127 127120 120181 18183 83

110 110325 325120 120120 120118 118119 119120 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 154120 120120 120120 120120 12081 81

120 12068 68

120 120120 120

Page 189: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 12 Calculation 13

120 120120 120120 120180 180

0 0105 105108 108120 4 43,554 3,484 32.71 2004 12084 84

165 165120 120120 120180 180116 11660 6060 6024 2 44,447 1,778 24.00 2009 24

100 1000 0

180 180120 120117 117163 163122 122120 120120 120120 120104 104120 120180 180240 240119 119180 180120 120240 240120 120120 120120 120120 120120 120

0 0120 120120 120120 12068 68

120 1200 0

61 61120 120120 120120 120120 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 72

120 120120 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 190: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in

yearsReplacement

CostAccumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 12 Calculation 13

240 2400 0

Page 191: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New Base Year (if

Renovation)

Page 192: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New Base Year (if

Renovation)

Page 193: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New Base Year (if

Renovation)

Page 194: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New Base Year (if

Renovation)

Page 195: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

208 208105 105240 24060 60

120 120120 120120 120110 110120 12060 6059 59

120 120120 120

0 0120 12081 810 0

45 45120 120

0 0120 12060 60

101 10187 87

120 120129 129178 17860 60

120 120204 204

0 0120 120169 169120 120119 119120 12060 60

120 120120 12060 6060 60

120 120120 120120 120120 12085 85

112 112120 120120 120110 110155 155

0 0120 120120 120180 180219 219107 107120 120133 13360 60

139 139120 120130 130120 120180 180120 120120 120120 120120 12060 6073 7384 84

Calculation 14 Calculation 15

Page 196: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 14 Calculation 15

173 173150 150192 19265 65

122 122239 239120 120120 120160 16099 9960 6060 6060 6060 60

120 120120 120194 194198 19836 3660 6060 6088 8860 60

155 15567 6759 59

120 120109 109151 151240 240152 152177 177120 120116 116206 206120 120170 170120 120120 12035 35

152 152127 127120 120181 18183 83

110 110325 325120 120120 120118 118119 119120 120120 120180 180120 120120 12060 6060 60

180 18097 97

180 180120 120

0 0120 120154 154120 120120 120120 120120 12081 81

120 12068 68

120 120120 120

Page 197: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 14 Calculation 15

120 120120 120120 120180 180

0 0105 105108 108120 12084 84

165 165120 120120 120180 180116 11660 6060 6024 24

100 1000 0

180 180120 120117 117163 163122 122120 120120 120120 120104 104120 120180 180240 240119 119180 180120 120240 240120 120120 120120 120120 120120 120

0 0120 120120 120120 12068 68

120 1200 0

61 61120 120120 120120 120120 120120 120120 12060 60

100 10048 48

120 120120 120179 179120 120177 17772 72

120 120120 120185 18560 60

120 120300 300120 120144 14498 9875 75

245 245

Page 198: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

New bed total

Difference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

New Base Year (if

Renovation)New bed

totalDifference in years

Replacement Cost

Accumulated Depreciation

New Bed Equivalent

New Base Year (if

Addition)

New Base Year (if

Replacement)

Calculation 14 Calculation 15

240 2400 0

Page 199: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

BRADEN RIVER CARE CENTER 005021BRADENTON HEALTH CARE 252069CASA MORA REHAB. & EXTENDED CARE 263885GREENBRIAR REHABILITATION AND NURSING CENT227625HERITAGE PARK CARE AND REHABILITATION CENT324345LIFE CARE CENTER OF SARASOTA 223786NURSING CENTER AT FREEDOM VILLAGE, THE 317195RIVERFRONT NURSING & REHABILITATION CENTER259942RIVIERA PALMS REHABILITATION CENTER 263451SURREY PLACE HEALTHCARE AND REHABILITATIO 256277WESTMINSTER COMMUNITIES OF BRADENTON, WE209422WESTMINSTER COMMUNITIES OF BRADENTON, WE203815WOODS OF MANATEE SPRINGS, THE 316610BAY VILLAGE OF SARASOTA 999923BENEVA LAKES HEALTHCARE AND REHABILITATION259896CONSULATE HEALTH CARE OF SARASOTA 320137GLENRIDGE ON PALMER RANCH INC. 999892HARBORCHASE OF VENICE 213322HARMONY HEALTHCARE AND REHABILITATION CEN317136HEARTLAND HEALTH CARE & REHABILITATION CEN999925HERITAGE HEALTH CARE CENTER 252271INN AT SARASOTA BAY CLUB 228621J H FLOYD SUNSHINE MANOR 202681KENSINGTON MANOR 325490MAGNOLIA HEALTH AND REHABILITATION CENTER 252182MANORCARE HEALTH SERVICES 325473MANORCARE HEALTH SERVICES SARASOTA 325465PALMER RANCH HEALTHCARE AND REHABILITATIO319244PINEBROOK CARE AND REHABILITATION CENTER 252662PINES OF SARASOTA 202703PLYMOUTH HARBOR INCORPORATED 999922QUALITY HEALTH OF NORTH PORT 225053SARASOTA HEALTH AND REHABILITATION CENTER 263982SARASOTA MEMORIAL NURSING AND REHABILITAT260355SPRINGS AT LAKE POINTE WOODS 268780SPRINGWOOD CARE AND REHABILITATION CENTER253014SUNNYSIDE NURSING HOME 202711SUNSET LAKE HEALTH AND REHABILITATION CENT308501TARPON POINT NURSING AND REHABILITATION CE 323781VILLAGE ON THE ISLE 210463CALUSA HARBOUR HEALTH CENTER 221473CITRUS GARDENS OF FORT MYERS 318787CONSULATE HEALTH CARE OF NORTH FORT MYER320111CORAL TRACE HEALTH CARE 252107EVANS HEALTH CARE 252212GULF COAST VILLAGE CARE CENTER 201120HEALTHPARK CARE CENTER, INC. 210587HEARTLAND HEALTH CARE CENTER FORT MYERS 325325HERITAGE PARK REHABILITATION AND HEALTHCAR252344LEHIGH ACRES HEALTH AND REHABILITATION CEN 320978LIFE CARE CENTER OF ESTERO 265381LODGE AT CYPRESS COVE, THE 999878MANORCARE HEALTH SERVICES 325384REHAB AND HEALTHCARE CENTER OF CAPE CORA263869SHADY REST CARE PAVILION 213900SHELL POINT NURSING PAVILION 229202SIGNATURE HEALTHCARE AT COLLEGE PARK 324370WINKLER COURT 264008AVANTE AT ORMOND BEACH, INC. 252034BISHOPS GLEN RETIREMENT CENTER 209511BRIDGEVIEW CENTER 260371CATALINA HEALTH CARE CENTER 283134CENTER FOR HEALTH CARE OF THE ALLIANCE COM202789COQUINA CENTER 260649DAYTONA BEACH HEALTH AND REHABILITATION CE217743DEBARY MANOR 005372DELTONA HEALTH CARE 252158EMORY L BENNETT MEMORIAL VETERANS NURSIN 210889GOOD SAMARITAN SOCIETY-DAYTONA 204391GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 212792HEALTH CENTER OF DAYTONA BEACH, THE 229091HORIZON HEALTHCARE CENTER AT DAYTONA 223905

2009 32.5

New Base Year (if

Renovation)Average

AgeAge Used

in CalcAge Year of

construction# Additions/ Renovations

Difference in Years

39 32.5 45 0 69 9 10 026 26 31 0 511 11 27 0 1623 23 24 0 14 4 9 0 518 18 20 0 213 13 37 0 2420 20 21 0 119 19 20 0 129 29 39 0 1017 17 42 0 2510 10 24 0 14

2009 32.5 2009 0 026 26 27 0 18 8 11 0 3

2009 32.5 2009 0 09 9 12 0 33 3 3 0

2009 32.5 2009 0 025 25 26 0 15 5 8 0 322 22 39 0 1740 32.5 40 0 013 13 15 0 212 12 12 0 022 22 26 0 410 10 10 0 023 23 24 0 11 1 39 0 38

2009 32.5 2009 0 024 24 24 0 027 27 38 0 1121 21 22 0 17 7 23 023 23 27 0 416 16 39 0 2315 15 17 0 212 12 19 0 721 21 25 0 425 25 25 0 026 26 26 0 019 19 24 0 514 14 22 011 11 11 0 014 14 20 0 611 11 17 013 13 19 0 627 27 28 0 121 21 23 0 26 6 6 0

2009 32.5 2009 0 010 10 10 0 030 30 30 0 037 32.5 39 031 31 38 0 725 25 28 0 314 14 14 0 040 32.5 41 0 111 11 23 0 123 3 27 0 2410 10 22 0 1211 11 38 09 9 22 032 32 32 0 013 13 26 0 1321 21 26 0 515 15 16 0 110 10 34 08 8 12 0 412 12 13 0 113 13 26 0 13

Page 200: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

INDIGO MANOR 258750JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE C269000MANOR ON THE GREEN 213527OAKTREE HEALTHCARE 252476OAKWOOD GARDEN OF DELAND 005547OCEAN VIEW NURSING & REHABILITATION CENTER226351ORANGE CITY NURSING AND REHAB CENTER 263567PORT ORANGE NURSING AND REHAB CENTER 263508RIDGECREST NURSING AND REHABILITATION CENT282464SANDALWOOD NURSING CENTER 312045SIGNATURE HEALTHCARE OF ORMOND 324442TERRACE OF DAYTONA BEACH, LLC 282553UNIVERSITY CENTER EAST 212873UNIVERSITY CENTER WEST 212831WOODLAND TERRACE EXTENDED CARE CENTER 212636ALEXANDER NININGER STATE VETERANS NURSING229849BROWARD INSTITUTE FOR LONG TERM CARE 263851BROWARD NURSING & REHABILITATION CENTER 226335CHILDRENS COMPREHENSIVE CARE CENTER INC 312789COURT AT PALM AIRE, THE 318795COVENANT VILLAGE CARE CENTER 210188CROSS POINTE CARE CENTER 001281FORUM AT DEER CREEK 253481FT LAUDERDALE HEALTH & REHABILITATION CENT 321303GOLFCREST HEALTHCARE CENTER 262064HARBOR BEACH NURSING AND REHABILITATION CE252255HEALTH CENTER OF COCONUT CREEK, THE 226581HEARTLAND HEALTH CARE CENTER LAUDERHILL 325333HEARTLAND OF TAMARAC 325350HILLCREST NURSING AND REHABILITATION CENTE 252531HOLLYWOOD HILLS REHABILITATION CENTER, LLC 313424JOHN KNOX VILLAGE HEALTH CENTER-POMPANO B203769LIFE CARE CENTER AT INVERRARY 259080MANOR OAKS NURSING & REHABILITATION CENTER256935MANOR PINES CONVALESCENT CENTER 254177MANORCARE HEALTH SERVICES 325457MARGATE HEALTH CARE CENTER 214931MEMORIAL MANOR 201006PALMS REHABILITATION AND NURSING CENTER 308005PARK SUMMIT OF CORAL SPRINGS 254134PLANTATION NURSING & REHABILITATION CENTER 226017POMPANO REHABILITATION & NURSING CENTER 263923REGENTS PARK OF SUNRISE 269697SAINT JOHNS NURSING CENTER 205800SEAVIEW NURSING AND REHABILITATION CENTER 252433SPRINGTREE REHABILITATION & HEALTH CARE CE 225631SUNRISE HEALTH & REHABILITATION CENTER 207497TAMARAC REHABILITATION AND HEALTH CENTER 213098WEST BROWARD CARE CENTER 002419WILTON MANORS HEALTH & REHABILITATION CENT227579DESTIN HEALTHCARE AND REHABILITATION CENTE252166EMERALD COAST CENTER 212903MANOR AT BLUE WATER BAY, THE 226041PARTHENON HEALTHCARE OF CRESTVIEW 251101PARTHENON HEALTHCARE OF FORT WALTON 229237SHOAL CREEK REHABILITATION CENTER 252379SILVERCREST MANOR 213926WESTWOOD HEALTH CARE CENTER 316075CHAUTAUQUA REHABILITATION AND NURSING CEN324361DELTA HEALTH CARE CENTER 211621GAINESVILLE HEALTH CARE CENTER 229288NORTH FLORIDA REHABILITATION AND SPECIALTY 252361OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, I 999868PALM GARDEN OF GAINESVILLE 257265PARK MEADOWS HEALTH AND REHABILITATION CE227765PARKLANDS REHABILITATION AND NURSING CENT 317578SIGNATURE HEALTHCARE OF GAINESVILLE 324388WOODLANDS CARE CENTER OF ALACHUA COUNTY255572AYERS HEALTH AND REHABILITATION CENTER 227871TRI COUNTY NURSING HOME 204625MACCLENNY NURSING AND REHAB CENTER 263516W FRANK WELLS NURSING HOME 211052CONSULATE HEALTH CARE OF ORANGE PARK 319538DOCTORS LAKE OF ORANGE PARK 223883

2009 32.5

New Base Year (if

Renovation)Average

AgeAge Used

in CalcAge Year of

construction# Additions/ Renovations

Difference in Years

20 20 22 06 6 6 0 027 27 28 0 125 25 28 0 331 31 31 025 25 29 0 418 18 18 017 17 17 0 027 27 27 0 033 32.5 41 0 84 4 25 0 2111 11 11 0 037 32.5 37 0 037 32.5 37 0 013 13 13 0 08 8 8 0 022 22 31 0 937 32.5 39 014 14 17 0 321 21 21 018 18 21 0 325 25 25 0 016 16 19 0 33 3 25 0 2229 29 29 0 023 23 25 0 212 12 12 0 016 16 20 0 418 18 21 021 21 23 018 18 39 0 2115 15 37 0 226 6 7 0 143 32.5 43 0 043 32.5 43 0 024 24 24 0 019 19 24 0 516 16 20 0 427 27 27 0 019 19 23 0 424 24 35 0 1122 22 22 0 018 18 20 0 219 19 29 0 1024 24 26 0 215 15 20 0 524 24 26 0 226 26 26 0 015 15 38 0 2313 13 27 0 1413 13 15 0 27 7 36 0 2913 13 16 0 325 25 39 0 1446 32.5 49 0 39 9 9 0 021 21 21 022 22 24 0 220 20 30 0 1018 18 21 0 325 25 26 0 125 25 25 0 0

2009 32.5 2009 0 012 12 22 0 1023 23 28 0 529 29 29 0 025 25 29 0 47 7 7 0 020 20 28 0 814 14 17 016 16 19 027 27 39 0 129 9 20 0 1122 22 22 0

Page 201: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

GOVERNORS CREEK HEALTH AND REHABILITATION252387HEARTLAND HEALTH CARE CENTER ORANGE PARK325261LIFE CARE CENTER AT WELLS CROSSING 213161LIFE CARE CENTER OF ORANGE PARK 284289PAVILION FOR HEALTH CARE, THE 999987SIGNATURE HEALTHCARE OF ORANGE PARK 324434TERRACE AT FLEMING ISLAND, THE 284785ALL SAINTS CATHOLIC NURSING HOME AND REHAB200735ATRIUM HEALTHCARE CENTER 319376AVANTE VILLA AT JACKSONVILLE BEACH INC. 200913BEAUCLERC MANOR 252051CATHEDRAL GERONTOLOGY CENTER, INC. 226068CEDAR HILLS HEALTHCARE CENTER 262714CONSULATE HEALTH CARE OF JACKSONVILLE 319503CYPRESS VILLAGE 307998EDGEWOOD NURSING CENTER 254878FANNIE E TAYLOR HOME FOR THE AGED INC 204536FIRST COAST HEALTH & REHABILITATION CENTER 227838FLEET LANDING 999984HARTS HARBOR HEALTH CARE CENTER 252417HEARTLAND HEALTH CARE CENTER JACKSONVILLE325236HEARTLAND HEALTH CARE CENTER OF SOUTH JAC325287JACKSONVILLE NURSING AND REHAB CENTER 263494LAKESIDE NURSING AND REHABILITATION CENTER256757LANIER MANOR 268003LIFE CARE CENTER OF JACKSONVILLE 283193PALM GARDEN OF JACKSONVILLE 257273PARK RIDGE NURSING CENTER 228401REGENTS PARK OF JACKSONVILLE 269727RIVER GARDEN HEBREW HOME FOR THE AGED 200859RIVERWOOD CENTER 260673RIVERWOOD NURSING CENTER 324612SOUTHLAKE NURSING & REHABILITATION CENTER 312371SOUTHPOINT TERRACE 266281ST CATHERINE LABOURE MANOR, INC. 205150SUMMER BROOK HEALTH CARE CENTER 265721TAYLOR CARE CENTER 207446WEST JACKSONVILLE HEALTH AND REHABILITATIO218171LIFE CARE CENTER OF HILLIARD 214060QUALITY HEALTH OF FERNANDINA BEACH 225274LIFE CARE ST. JOHNS, INC. 999869MOULTRIE CREEK NURSING AND REHAB CENTER 263559PONCE DE LEON CARE CENTER 207799SAMANTHA R WILSON SENIOR CITIZENS HOME 202606SAN MARCO TERRACE REHABILITATION AND CARE316601ST AUGUSTINE HEALTH AND REHABILITATION CEN 217735VICARS LANDING NURSING HOME 999981WESTMINSTER WOODS ON JULINGTON CREEK 212083AUBURNDALE OAKS HEALTHCARE CENTER 207527BARTOW CENTER 212997BRANDYWYNE HEALTH CARE CENTER 251399CONSULATE HEALTH CARE OF LAKE PARKER 319678CONSULATE HEALTH CARE OF LAKELAND 319953CONSULATE HEALTH CARE OF WINTER HAVEN 319724CROSSROADS, THE 269409DOVE HEALTHCARE AT LAKE WALES 319341FLORIDA PRESBYTERIAN HOMES INC 212971GROVES CENTER 212881HAINES CITY HEALTH CARE CENTER 224341HIGHLANDS LAKE CENTER 260576LAKELAND HILLS CENTER 212865LIFE CARE CENTER OF WINTER HAVEN 219380MANOR AT CARPENTERS, THE 203599OAKBRIDGE HEALTHCARE CENTER 259926PALM GARDEN OF WINTER HAVEN 257320PALM TERRACE OF LAKELAND 282626ROHR HOME, THE 202533SPRING LAKE REHABILITATION CENTER 264571VALENCIA HILLS HEALTH AND REHABILITATION CEN265560WEDGEWOOD HEALTHCARE CENTER 252328WINTER HAVEN HEALTH & REHABILITATION CENTE 228702ARCH PLAZA NURSING & REHABILITATION CENTER 254291AVENTURA PLAZA REHABILITATION & NURSING CE 284823BERKSHIRE MANOR 005388

2009 32.5

New Base Year (if

Renovation)Average

AgeAge Used

in CalcAge Year of

construction# Additions/ Renovations

Difference in Years

23 23 26 0 317 17 19 0 211 11 12 0 113 13 13 0 0

2009 32.5 2009 0 027 27 29 04 4 4 0 05 5 39 0 3412 12 13 0 128 28 35 0 724 24 24 0 029 29 39 0 1028 28 37 012 12 13 0 110 10 18 0 821 21 21 0 00 0 37 0 3715 15 26 0 11

2009 32.5 2009 0 031 31 32 0 110 10 19 0 920 20 28 0 817 17 19 0 27 7 12 0 521 21 25 0 43 3 5 018 18 19 0 126 26 30 0 422 22 23 0 19 9 39 0 3019 19 27 0 837 32.5 39 0 221 21 27 0 65 5 5 0 016 16 30 0 1433 32.5 39 0 618 18 26 0 817 17 19 0 215 15 19 0 425 25 25 0 0

2009 32.5 2009 0 020 20 23 0 320 20 25 0 518 18 39 0 2125 25 26 0 133 32.5 33 0 0

2009 32.5 2009 0 012 12 39 0 2724 24 26 0 237 32.5 37 0 026 26 26 0 014 14 19 021 21 25 0 411 11 11 0 032 32 39 0 75 5 26 010 10 12 0 29 9 36 026 26 26 0 019 19 21 0 237 32.5 37 0 09 9 10 0 15 5 20 0 158 8 18 0 1014 14 22 0 826 26 34 0 811 11 39 0 2818 18 18 0 026 26 27 0 110 10 10 0 021 21 27 0 65 5 31 0 2627 27 31 0 426 26 26 0 0

Page 202: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Facility Provider #

CLARIDGE HOUSE NURSING & REHABILITATION CE 208507CLASSIC RESIDENCE BY HYATT IN AVENTURA 999864

2009 32.5

New Base Year (if

Renovation)Average

AgeAge Used

in CalcAge Year of

construction# Additions/ Renovations

Difference in Years

19 19 24 0 52009 32.5 2009 0 0

Page 203: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Annualized

Fac # Facility NameCost Report Begin Date

Cost Report End Date

Days in the Cost Report Year

Total Patient Days

Medicaid Patient Days

Cost per Sq Ft

Cost Index

Zip Code Factor

Location Factor

Cost per Sq Ft

Current Licensed

Beds Actual Sq

Ft Actual Sq. Ft. per bed-

005021 BRADEN RIVER CARE CENTER 40,150 141.10 1.0000 342 0.8800 124.17 208 - 252069 BRADENTON HEALTH CARE 18,327 141.10 1.0000 342 0.8800 124.17 105 - 263885 CASA MORA REHAB. & EXTENDED CARE 51,521 141.10 1.0000 342 0.8800 124.17 240 - 227625 GREENBRIAR REHABILITATION AND NURSING CENTER 8,592 141.10 1.0000 342 0.8800 124.17 60 - 324345 HERITAGE PARK CARE AND REHABILITATION CENTER 23,131 141.10 1.0000 342 0.8800 124.17 120 - 223786 LIFE CARE CENTER OF SARASOTA 12,000 141.10 1.0000 342 0.8800 124.17 120 - 317195 NURSING CENTER AT FREEDOM VILLAGE, THE 12,045 141.10 1.0000 342 0.8800 124.17 120 - 259942 RIVERFRONT NURSING & REHABILITATION CENTER 28,518 141.10 1.0000 342 0.8800 124.17 110 - 263451 RIVIERA PALMS REHABILITATION CENTER 17,898 141.10 1.0000 342 0.8800 124.17 120 - 256277 SURREY PLACE HEALTHCARE AND REHABILITATION 7,110 141.10 1.0000 342 0.8800 124.17 60 - 209422 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER MANOR 6,991 141.10 1.0000 342 0.8800 124.17 59 - 203815 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINSTER TOWERS 13,883 141.10 1.0000 342 0.8800 124.17 120 - 316610 WOODS OF MANATEE SPRINGS, THE 16,146 141.10 1.0000 342 0.8800 124.17 120 - 999923 BAY VILLAGE OF SARASOTA 141.10 1.0000 342 0.8800 124.17 - - 259896 BENEVA LAKES HEALTHCARE AND REHABILITATION CENTER 27,010 141.10 1.0000 342 0.8800 124.17 120 - 320137 CONSULATE HEALTH CARE OF SARASOTA 18,071 141.10 1.0000 342 0.8800 124.17 81 - 999892 GLENRIDGE ON PALMER RANCH INC. 141.10 1.0000 342 0.8800 124.17 - - 213322 HARBORCHASE OF VENICE 3,770 141.10 1.0000 342 0.8800 124.17 45 - 317136 HARMONY HEALTHCARE AND REHABILITATION CENTER 7,426 141.10 1.0000 342 0.8800 124.17 120 - 999925 HEARTLAND HEALTH CARE & REHABILITATION CENTER 141.10 1.0000 342 0.8800 124.17 - - 252271 HERITAGE HEALTH CARE CENTER 25,109 141.10 1.0000 342 0.8800 124.17 120 - 228621 INN AT SARASOTA BAY CLUB 3,838 141.10 1.0000 342 0.8800 124.17 60 - 202681 J H FLOYD SUNSHINE MANOR 25,321 141.10 1.0000 342 0.8800 124.17 101 - 325490 KENSINGTON MANOR 15,528 141.10 1.0000 342 0.8800 124.17 87 - 252182 MAGNOLIA HEALTH AND REHABILITATION CENTER 27,998 141.10 1.0000 342 0.8800 124.17 120 - 325473 MANORCARE HEALTH SERVICES 15,895 141.10 1.0000 342 0.8800 124.17 129 - 325465 MANORCARE HEALTH SERVICES SARASOTA 30,331 141.10 1.0000 342 0.8800 124.17 178 - 319244 PALMER RANCH HEALTHCARE AND REHABILITATION 9,770 141.10 1.0000 342 0.8800 124.17 60 - 252662 PINEBROOK CARE AND REHABILITATION CENTER 23,567 141.10 1.0000 342 0.8800 124.17 120 - 202703 PINES OF SARASOTA 47,660 141.10 1.0000 342 0.8800 124.17 204 - 999922 PLYMOUTH HARBOR INCORPORATED 141.10 1.0000 342 0.8800 124.17 - - 225053 QUALITY HEALTH OF NORTH PORT 20,233 141.10 1.0000 342 0.8800 124.17 120 - 263982 SARASOTA HEALTH AND REHABILITATION CENTER 28,637 141.10 1.0000 342 0.8800 124.17 169 - 260355 SARASOTA MEMORIAL NURSING AND REHABILITATION CENTER 16,434 141.10 1.0000 342 0.8800 124.17 120 - 268780 SPRINGS AT LAKE POINTE WOODS 18,619 141.10 1.0000 342 0.8800 124.17 119 - 253014 SPRINGWOOD CARE AND REHABILITATION CENTER 23,863 141.10 1.0000 342 0.8800 124.17 120 - 202711 SUNNYSIDE NURSING HOME 6,933 141.10 1.0000 342 0.8800 124.17 60 - 308501 SUNSET LAKE HEALTH AND REHABILITATION CENTER 12,883 141.10 1.0000 342 0.8800 124.17 120 - 323781 TARPON POINT NURSING AND REHABILITATION CENTER 24,023 141.10 1.0000 342 0.8800 124.17 120 - 210463 VILLAGE ON THE ISLE 7,057 141.10 1.0000 342 0.8800 124.17 60 - 221473 CALUSA HARBOUR HEALTH CENTER 5,572 141.10 1.0000 339 0.8700 122.76 60 - 318787 CITRUS GARDENS OF FORT MYERS 30,680 141.10 1.0000 339 0.8700 122.76 120 - 320111 CONSULATE HEALTH CARE OF NORTH FORT MYERS 28,592 141.10 1.0000 339 0.8700 122.76 120 - 252107 CORAL TRACE HEALTH CARE 21,247 141.10 1.0000 339 0.8700 122.76 120 - 252212 EVANS HEALTH CARE 26,775 141.10 1.0000 339 0.8700 122.76 120 - 201120 GULF COAST VILLAGE CARE CENTER 8,225 141.10 1.0000 339 0.8700 122.76 85 - 210587 HEALTHPARK CARE CENTER, INC. 19,763 141.10 1.0000 339 0.8700 122.76 112 - 325325 HEARTLAND HEALTH CARE CENTER FORT MYERS 13,090 141.10 1.0000 339 0.8700 122.76 120 - 252344 HERITAGE PARK REHABILITATION AND HEALTHCARE 27,598 141.10 1.0000 339 0.8700 122.76 120 - 320978 LEHIGH ACRES HEALTH AND REHABILITATION CENTER 21,507 141.10 1.0000 339 0.8700 122.76 110 - 265381 LIFE CARE CENTER OF ESTERO 22,715 141.10 1.0000 339 0.8700 122.76 155 - 999878 LODGE AT CYPRESS COVE, THE 141.10 1.0000 339 0.8700 122.76 - - 325384 MANORCARE HEALTH SERVICES 13,977 141.10 1.0000 339 0.8700 122.76 120 - 263869 REHAB AND HEALTHCARE CENTER OF CAPE CORAL 25,767 141.10 1.0000 339 0.8700 122.76 120 - 213900 SHADY REST CARE PAVILION 42,775 141.10 1.0000 339 0.8700 122.76 180 - 229202 SHELL POINT NURSING PAVILION 4,318 141.10 1.0000 339 0.8700 122.76 219 - 324370 SIGNATURE HEALTHCARE AT COLLEGE PARK 16,798 141.10 1.0000 339 0.8700 122.76 107 -

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264008 WINKLER COURT 30,108 141.10 1.0000 339 0.8700 122.76 120 - 252034 AVANTE AT ORMOND BEACH, INC. 21,818 141.10 1.0000 321 0.9000 126.99 133 - 209511 BISHOPS GLEN RETIREMENT CENTER 8,379 141.10 1.0000 321 0.9000 126.99 60 - 260371 BRIDGEVIEW CENTER 34,094 141.10 1.0000 321 0.9000 126.99 139 - 283134 CATALINA HEALTH CARE CENTER 31,883 141.10 1.0000 321 0.9000 126.99 120 - 202789 CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY 21,042 141.10 1.0000 327 0.9000 126.99 130 - 260649 COQUINA CENTER 21,678 141.10 1.0000 321 0.9000 126.99 120 - 217743 DAYTONA BEACH HEALTH AND REHABILITATION CENTER 37,656 141.10 1.0000 321 0.9000 126.99 180 - 005372 DEBARY MANOR 26,752 141.10 1.0000 327 0.9000 126.99 120 36,923 308 252158 DELTONA HEALTH CARE 26,009 141.10 1.0000 327 0.9000 126.99 120 - 210889 EMORY L BENNETT MEMORIAL VETERANS NURSING HOME 15,720 141.10 1.0000 321 0.9000 126.99 120 - 204391 GOOD SAMARITAN SOCIETY-DAYTONA 24,727 141.10 1.0000 321 0.9000 126.99 120 - 212792 GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN 12,014 141.10 1.0000 327 0.9000 126.99 60 - 229091 HEALTH CENTER OF DAYTONA BEACH, THE 5,504 141.10 1.0000 321 0.9000 126.99 73 - 223905 HORIZON HEALTHCARE CENTER AT DAYTONA 11,723 141.10 1.0000 321 0.9000 126.99 84 - 258750 INDIGO MANOR 36,075 141.10 1.0000 321 0.9000 126.99 173 - 269000 JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY 14,491 141.10 1.0000 327 0.9000 126.99 150 - 213527 MANOR ON THE GREEN 32,799 141.10 1.0000 321 0.9000 126.99 192 46,198 241 252476 OAKTREE HEALTHCARE 15,509 141.10 1.0000 321 0.9000 126.99 65 - 005547 OAKWOOD GARDEN OF DELAND 27,457 141.10 1.0000 327 0.9000 126.99 122 32,000 262 226351 OCEAN VIEW NURSING & REHABILITATION CENTER 30,111 141.10 1.0000 321 0.9000 126.99 239 - 263567 ORANGE CITY NURSING AND REHAB CENTER 21,449 141.10 1.0000 327 0.9000 126.99 120 - 263508 PORT ORANGE NURSING AND REHAB CENTER 14,278 141.10 1.0000 321 0.9000 126.99 120 - 282464 RIDGECREST NURSING AND REHABILITATION CENTER 33,028 141.10 1.0000 327 0.9000 126.99 160 - 312045 SANDALWOOD NURSING CENTER 20,823 141.10 1.0000 321 0.9000 126.99 99 - 324442 SIGNATURE HEALTHCARE OF ORMOND 8,361 141.10 1.0000 321 0.9000 126.99 60 - 282553 TERRACE OF DAYTONA BEACH, LLC 12,035 141.10 1.0000 321 0.9000 126.99 60 - 212873 UNIVERSITY CENTER EAST 14,796 141.10 1.0000 327 0.9000 126.99 60 - 212831 UNIVERSITY CENTER WEST 15,435 141.10 1.0000 327 0.9000 126.99 60 - 212636 WOODLAND TERRACE EXTENDED CARE CENTER 26,674 141.10 1.0000 327 0.9000 126.99 120 - 229849 ALEXANDER NININGER STATE VETERANS NURSING HOME 20,207 141.10 1.0000 330 0.9000 126.99 120 - 263851 BROWARD INSTITUTE FOR LONG TERM CARE 35,671 141.10 1.0000 330 0.9000 126.99 194 - 226335 BROWARD NURSING & REHABILITATION CENTER 38,622 141.10 1.0000 333 0.8800 124.17 198 - 312789 CHILDRENS COMPREHENSIVE CARE CENTER INC 9,891 141.10 1.0000 330 0.9000 126.99 36 - 318795 COURT AT PALM AIRE, THE 8,951 141.10 1.0000 330 0.9000 126.99 60 - 210188 COVENANT VILLAGE CARE CENTER 3,012 141.10 1.0000 333 0.8800 124.17 60 - 001281 CROSS POINTE CARE CENTER 22,206 141.10 1.0000 330 0.9000 126.99 88 - 253481 FORUM AT DEER CREEK 6,251 141.10 1.0000 334 0.8600 121.35 60 - 321303 FT LAUDERDALE HEALTH & REHABILITATION CENTER 23,360 141.10 1.0000 333 0.8800 124.17 155 - 262064 GOLFCREST HEALTHCARE CENTER 15,236 141.10 1.0000 330 0.9000 126.99 67 - 252255 HARBOR BEACH NURSING AND REHABILITATION CENTER 11,200 141.10 1.0000 333 0.8800 124.17 59 - 226581 HEALTH CENTER OF COCONUT CREEK, THE 16,937 141.10 1.0000 330 0.9000 126.99 120 - 325333 HEARTLAND HEALTH CARE CENTER LAUDERHILL 26,518 141.10 1.0000 333 0.8800 124.17 109 - 325350 HEARTLAND OF TAMARAC 22,965 141.10 1.0000 333 0.8800 124.17 151 - 252531 HILLCREST NURSING AND REHABILITATION CENTER 48,251 141.10 1.0000 330 0.9000 126.99 240 - 313424 HOLLYWOOD HILLS REHABILITATION CENTER, LLC 18,384 141.10 1.0000 330 0.9000 126.99 152 - 203769 JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH 5,872 141.10 1.0000 330 0.9000 126.99 177 - 259080 LIFE CARE CENTER AT INVERRARY 14,611 141.10 1.0000 333 0.8800 124.17 120 - 256935 MANOR OAKS NURSING & REHABILITATION CENTER 14,191 141.10 1.0000 333 0.8800 124.17 116 - 254177 MANOR PINES CONVALESCENT CENTER 19,074 141.10 1.0000 333 0.8800 124.17 206 - 325457 MANORCARE HEALTH SERVICES 17,904 141.10 1.0000 333 0.8800 124.17 120 - 214931 MARGATE HEALTH CARE CENTER 31,499 141.10 1.0000 330 0.9000 126.99 170 61,566 362 201006 MEMORIAL MANOR 21,926 141.10 1.0000 330 0.9000 126.99 120 - 308005 PALMS REHABILITATION AND NURSING CENTER 24,297 141.10 1.0000 333 0.8800 124.17 120 - 254134 PARK SUMMIT OF CORAL SPRINGS 4,441 141.10 1.0000 330 0.9000 126.99 35 - 226017 PLANTATION NURSING & REHABILITATION CENTER 30,611 141.10 1.0000 333 0.8800 124.17 152 - 263923 POMPANO REHABILITATION & NURSING CENTER 31,603 141.10 1.0000 330 0.9000 126.99 127 - 269697 REGENTS PARK OF SUNRISE 21,929 141.10 1.0000 333 0.8800 124.17 120 - 205800 SAINT JOHNS NURSING CENTER 40,451 141.10 1.0000 333 0.8800 124.17 181 - 252433 SEAVIEW NURSING AND REHABILITATION CENTER 22,869 141.10 1.0000 330 0.9000 126.99 83 - 225631 SPRINGTREE REHABILITATION & HEALTH CARE CENTER 15,072 141.10 1.0000 333 0.8800 124.17 110 - 207497 SUNRISE HEALTH & REHABILITATION CENTER 53,718 141.10 1.0000 333 0.8800 124.17 325 -

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213098 TAMARAC REHABILITATION AND HEALTH CENTER 16,370 141.10 1.0000 333 0.8800 124.17 120 - 002419 WEST BROWARD CARE CENTER 32,086 141.10 1.0000 333 0.8800 124.17 120 - 227579 WILTON MANORS HEALTH & REHABILITATION CENTER 26,802 141.10 1.0000 333 0.8800 124.17 118 - 252166 DESTIN HEALTHCARE AND REHABILITATION CENTER 25,233 141.10 1.0000 325 0.8500 119.94 119 - 212903 EMERALD COAST CENTER 25,071 141.10 1.0000 325 0.8500 119.94 120 - 226041 MANOR AT BLUE WATER BAY, THE 20,331 141.10 1.0000 325 0.8500 119.94 120 - 251101 PARTHENON HEALTHCARE OF CRESTVIEW 28,526 141.10 1.0000 325 0.8500 119.94 180 - 229237 PARTHENON HEALTHCARE OF FORT WALTON 20,469 141.10 1.0000 325 0.8500 119.94 120 - 252379 SHOAL CREEK REHABILITATION CENTER 29,755 141.10 1.0000 325 0.8500 119.94 120 - 213926 SILVERCREST MANOR 12,493 141.10 1.0000 325 0.8500 119.94 60 20,836 347 316075 WESTWOOD HEALTH CARE CENTER 10,362 141.10 1.0000 325 0.8500 119.94 60 - 324361 CHAUTAUQUA REHABILITATION AND NURSING CENTER 31,015 141.10 1.0000 324 0.7900 111.47 180 - 211621 DELTA HEALTH CARE CENTER 17,249 141.10 1.0000 325 0.8500 119.94 97 36,311 374 229288 GAINESVILLE HEALTH CARE CENTER 35,798 141.10 1.0000 326 0.8600 121.35 180 - 252361 NORTH FLORIDA REHABILITATION AND SPECIALTY CARE 18,746 141.10 1.0000 326 0.8600 121.35 120 - 999868 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC. 141.10 1.0000 326 0.8600 121.35 - - 257265 PALM GARDEN OF GAINESVILLE 18,382 141.10 1.0000 326 0.8600 121.35 120 46,266 386 227765 PARK MEADOWS HEALTH AND REHABILITATION CENTER 38,870 141.10 1.0000 326 0.8600 121.35 154 - 317578 PARKLANDS REHABILITATION AND NURSING CENTER 28,501 141.10 1.0000 326 0.8600 121.35 120 - 324388 SIGNATURE HEALTHCARE OF GAINESVILLE 24,876 141.10 1.0000 326 0.8600 121.35 120 - 255572 WOODLANDS CARE CENTER OF ALACHUA COUNTY 25,086 141.10 1.0000 326 0.8600 121.35 120 - 227871 AYERS HEALTH AND REHABILITATION CENTER 24,070 141.10 1.0000 326 0.8600 121.35 120 - 204625 TRI COUNTY NURSING HOME 18,953 141.10 1.0000 326 0.8600 121.35 81 - 263516 MACCLENNY NURSING AND REHAB CENTER 31,715 141.10 1.0000 320 0.8400 118.52 120 - 211052 W FRANK WELLS NURSING HOME 14,368 141.10 1.0000 320 0.8400 118.52 68 - 319538 CONSULATE HEALTH CARE OF ORANGE PARK 23,847 141.10 1.0000 320 0.8400 118.52 120 - 223883 DOCTORS LAKE OF ORANGE PARK 31,395 141.10 1.0000 320 0.8400 118.52 120 - 252387 GOVERNORS CREEK HEALTH AND REHABILITATION 34,187 141.10 1.0000 320 0.8400 118.52 120 - 325261 HEARTLAND HEALTH CARE CENTER ORANGE PARK 19,181 141.10 1.0000 320 0.8400 118.52 120 - 213161 LIFE CARE CENTER AT WELLS CROSSING 19,188 141.10 1.0000 320 0.8400 118.52 120 - 284289 LIFE CARE CENTER OF ORANGE PARK 28,542 141.10 1.0000 320 0.8400 118.52 180 - 999987 PAVILION FOR HEALTH CARE, THE 141.10 1.0000 320 0.8400 118.52 - - 324434 SIGNATURE HEALTHCARE OF ORANGE PARK 23,446 141.10 1.0000 320 0.8400 118.52 105 - 284785 TERRACE AT FLEMING ISLAND, THE 24,404 141.10 1.0000 320 0.8400 118.52 108 - 200735 ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATION CENTER, INC. 22,892 141.10 1.0000 322 0.8400 118.52 120 - 319376 ATRIUM HEALTHCARE CENTER 11,179 141.10 1.0000 322 0.8400 118.52 84 - 200913 AVANTE VILLA AT JACKSONVILLE BEACH INC. 26,153 141.10 1.0000 322 0.8400 118.52 165 - 252051 BEAUCLERC MANOR 26,674 141.10 1.0000 322 0.8400 118.52 120 - 226068 CATHEDRAL GERONTOLOGY CENTER, INC. 32,587 141.10 1.0000 322 0.8400 118.52 120 - 262714 CEDAR HILLS HEALTHCARE CENTER 45,642 141.10 1.0000 322 0.8400 118.52 180 - 319503 CONSULATE HEALTH CARE OF JACKSONVILLE 20,617 141.10 1.0000 322 0.8400 118.52 116 - 307998 CYPRESS VILLAGE 20,905 141.10 1.0000 322 0.8400 118.52 120 - 254878 EDGEWOOD NURSING CENTER 15,562 141.10 1.0000 322 0.8400 118.52 60 - 204536 FANNIE E TAYLOR HOME FOR THE AGED INC 5,141 141.10 1.0000 322 0.8400 118.52 24 - 227838 FIRST COAST HEALTH & REHABILITATION CENTER 28,349 141.10 1.0000 322 0.8400 118.52 100 - 999984 FLEET LANDING 141.10 1.0000 322 0.8400 118.52 - - 252417 HARTS HARBOR HEALTH CARE CENTER 49,728 141.10 1.0000 322 0.8400 118.52 180 - 325236 HEARTLAND HEALTH CARE CENTER JACKSONVILLE 18,806 141.10 1.0000 322 0.8400 118.52 120 - 325287 HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVILLE 16,802 141.10 1.0000 322 0.8400 118.52 117 - 263494 JACKSONVILLE NURSING AND REHAB CENTER 37,808 141.10 1.0000 322 0.8400 118.52 163 - 256757 LAKESIDE NURSING AND REHABILITATION CENTER 25,027 141.10 1.0000 322 0.8400 118.52 122 - 268003 LANIER MANOR 26,470 141.10 1.0000 322 0.8400 118.52 120 - 283193 LIFE CARE CENTER OF JACKSONVILLE 6,183 141.10 1.0000 322 0.8400 118.52 120 - 257273 PALM GARDEN OF JACKSONVILLE 28,245 141.10 1.0000 322 0.8400 118.52 120 45,521 379 228401 PARK RIDGE NURSING CENTER 21,224 141.10 1.0000 322 0.8400 118.52 104 - 269727 REGENTS PARK OF JACKSONVILLE 23,620 141.10 1.0000 322 0.8400 118.52 120 - 200859 RIVER GARDEN HEBREW HOME FOR THE AGED 34,135 141.10 1.0000 322 0.8400 118.52 180 - 260673 RIVERWOOD CENTER 70,190 141.10 1.0000 322 0.8400 118.52 240 - 324612 RIVERWOOD NURSING CENTER 36,049 141.10 1.0000 322 0.8400 118.52 119 - 312371 SOUTHLAKE NURSING & REHABILITATION CENTER 40,455 141.10 1.0000 322 0.8400 118.52 180 - 266281 SOUTHPOINT TERRACE 24,404 141.10 1.0000 322 0.8400 118.52 120 - 205150 ST CATHERINE LABOURE MANOR, INC. 49,661 141.10 1.0000 322 0.8400 118.52 240 -

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265721 SUMMER BROOK HEALTH CARE CENTER 37,950 141.10 1.0000 322 0.8400 118.52 120 - 207446 TAYLOR CARE CENTER 22,462 141.10 1.0000 322 0.8400 118.52 120 - 218171 WEST JACKSONVILLE HEALTH AND REHABILITATION CENTER 21,718 141.10 1.0000 322 0.8400 118.52 120 - 214060 LIFE CARE CENTER OF HILLIARD 25,145 141.10 1.0000 320 0.8400 118.52 120 - 225274 QUALITY HEALTH OF FERNANDINA BEACH 30,530 141.10 1.0000 320 0.8400 118.52 120 - 999869 LIFE CARE ST. JOHNS, INC. 141.10 1.0000 320 0.8400 118.52 - - 263559 MOULTRIE CREEK NURSING AND REHAB CENTER 23,882 141.10 1.0000 320 0.8400 118.52 120 - 207799 PONCE DE LEON CARE CENTER 24,036 141.10 1.0000 320 0.8400 118.52 120 - 202606 SAMANTHA R WILSON SENIOR CITIZENS HOME 18,830 141.10 1.0000 320 0.8400 118.52 120 - 316601 SAN MARCO TERRACE REHABILITATION AND CARE 12,691 141.10 1.0000 320 0.8400 118.52 68 - 217735 ST AUGUSTINE HEALTH AND REHABILITATION CENTER 24,234 141.10 1.0000 320 0.8400 118.52 120 - 999981 VICARS LANDING NURSING HOME 141.10 1.0000 320 0.8400 118.52 - - 212083 WESTMINSTER WOODS ON JULINGTON CREEK 5,543 141.10 1.0000 322 0.8400 118.52 60 - 207527 AUBURNDALE OAKS HEALTHCARE CENTER 27,482 141.10 1.0000 338 0.9000 126.99 120 - 212997 BARTOW CENTER 28,367 141.10 1.0000 338 0.9000 126.99 120 - 251399 BRANDYWYNE HEALTH CARE CENTER 31,608 141.10 1.0000 338 0.9000 126.99 120 - 319678 CONSULATE HEALTH CARE OF LAKE PARKER 23,305 141.10 1.0000 338 0.9000 126.99 120 - 319953 CONSULATE HEALTH CARE OF LAKELAND 26,820 141.10 1.0000 338 0.9000 126.99 120 - 319724 CONSULATE HEALTH CARE OF WINTER HAVEN 18,858 141.10 1.0000 338 0.9000 126.99 120 - 269409 CROSSROADS, THE 12,974 141.10 1.0000 338 0.9000 126.99 60 - 319341 DOVE HEALTHCARE AT LAKE WALES 17,651 141.10 1.0000 338 0.9000 126.99 100 - 212971 FLORIDA PRESBYTERIAN HOMES INC 5,840 141.10 1.0000 338 0.9000 126.99 48 - 212881 GROVES CENTER 28,048 141.10 1.0000 338 0.9000 126.99 120 - 224341 HAINES CITY HEALTH CARE CENTER 19,516 141.10 1.0000 338 0.9000 126.99 120 - 260576 HIGHLANDS LAKE CENTER 40,062 141.10 1.0000 338 0.9000 126.99 179 - 212865 LAKELAND HILLS CENTER 27,831 141.10 1.0000 338 0.9000 126.99 120 - 219380 LIFE CARE CENTER OF WINTER HAVEN 27,151 141.10 1.0000 338 0.9000 126.99 177 - 203599 MANOR AT CARPENTERS, THE 3,534 141.10 1.0000 338 0.9000 126.99 72 - 259926 OAKBRIDGE HEALTHCARE CENTER 14,805 141.10 1.0000 338 0.9000 126.99 120 - 257320 PALM GARDEN OF WINTER HAVEN 26,230 141.10 1.0000 338 0.9000 126.99 120 53,203 443 282626 PALM TERRACE OF LAKELAND 34,517 141.10 1.0000 338 0.9000 126.99 185 85,000 459 202533 ROHR HOME, THE 16,528 141.10 1.0000 338 0.9000 126.99 60 - 264571 SPRING LAKE REHABILITATION CENTER 21,692 141.10 1.0000 338 0.9000 126.99 120 - 265560 VALENCIA HILLS HEALTH AND REHABILITATION CENTER 62,892 141.10 1.0000 338 0.9000 126.99 300 - 252328 WEDGEWOOD HEALTHCARE CENTER 18,136 141.10 1.0000 338 0.9000 126.99 120 - 228702 WINTER HAVEN HEALTH & REHABILITATION CENTER 33,227 141.10 1.0000 338 0.9000 126.99 144 - 254291 ARCH PLAZA NURSING & REHABILITATION CENTER 22,217 141.10 1.0000 331 0.9000 126.99 98 - 284823 AVENTURA PLAZA REHABILITATION & NURSING CENTER 17,939 141.10 1.0000 331 0.9000 126.99 75 - 005388 BERKSHIRE MANOR 36,913 141.10 1.0000 331 0.9000 126.99 245 45,000 184 208507 CLARIDGE HOUSE NURSING & REHABILITATION CENTER 57,352 141.10 1.0000 331 0.9000 126.99 240 - 999864 CLASSIC RESIDENCE BY HYATT IN AVENTURA 141.10 1.0000 331 0.9000 126.99 - - 323772 CORAL GABLES NURSING AND REHABILITATION CENTER 19,443 141.10 1.0000 331 0.9000 126.99 87 - 282529 CORAL REEF NURSING & REHABILITATION CENTER 24,182 141.10 1.0000 331 0.9000 126.99 120 - 228788 EAST RIDGE RETIREMENT VILLAGE INC 2,514 141.10 1.0000 331 0.9000 126.99 60 - 227226 FAIR HAVENS CENTER 68,823 141.10 1.0000 331 0.9000 126.99 269 - 207993 FLORIDA CLUB CARE CENTER 43,903 141.10 1.0000 331 0.9000 126.99 180 - 200425 FLORIDEAN NURSING HOME INC 6,259 141.10 1.0000 331 0.9000 126.99 60 - 005523 FOUNTAINHEAD CARE CENTER 39,229 141.10 1.0000 331 0.9000 126.99 146 33,038 226 319554 FRANCO NURSING & REHABILITATION CENTER 28,253 141.10 1.0000 331 0.9000 126.99 120 - 214027 GRAMERCY PARK NURSING CENTER 42,793 141.10 1.0000 331 0.9000 126.99 180 - 324027 HAMPTON COURT NURSING AND REHABILITATION CENTER 27,332 141.10 1.0000 331 0.9000 126.99 120 - 269107 HARMONY HEALTH CENTER 33,878 141.10 1.0000 331 0.9000 126.99 203 - 325244 HEARTLAND HEALTH CARE CENTER KENDALL 14,330 141.10 1.0000 331 0.9000 126.99 120 - 325252 HEARTLAND HEALTH CARE CENTER MIAMI LAKES 13,848 141.10 1.0000 330 0.9000 126.99 120 - 308242 HEBREW HOME OF SOUTH BEACH 25,658 141.10 1.0000 331 0.9000 126.99 104 - 265730 HIALEAH CONVALESCENT HOME 69,340 141.10 1.0000 330 0.9000 126.99 276 - 250988 HIALEAH SHORES NURSING AND REHAB CENTER 25,556 141.10 1.0000 331 0.9000 126.99 120 - 212121 HOMESTEAD MANOR 15,523 141.10 1.0000 330 0.9000 126.99 64 - 204161 JACKSON MEMORIAL LONG TERM CARE CENTER 41,057 141.10 1.0000 331 0.9000 126.99 180 - 203670 JACKSON MEMORIAL PERDUE MEDICAL CENTER 31,956 141.10 1.0000 331 0.9000 126.99 163 - 253723 JACKSON PLAZA NURSING & REHABILITATION CENTER 32,116 141.10 1.0000 331 0.9000 126.99 120 - 210617 MIAMI GARDENS CARE CENTRE 24,803 141.10 1.0000 331 0.9000 126.99 120 -

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200506 MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC. 95,539 141.10 1.0000 331 0.9000 126.99 462 - 214035 MIAMI SHORES NURSING AND REHAB CENTER 24,363 141.10 1.0000 331 0.9000 126.99 99 - 228001 NORTH BEACH REHABILITATION CENTER 20,089 141.10 1.0000 331 0.9000 126.99 99 - 267902 NURSING CENTER AT MERCY, THE 7,512 141.10 1.0000 331 0.9000 126.99 120 - 212733 OCEANSIDE EXTENDED CARE CENTER 51,811 141.10 1.0000 331 0.9000 126.99 196 - 203327 PALACE AT KENDALL NURSING AND REHABILITATION CENTER 29,950 141.10 1.0000 331 0.9000 126.99 180 - 257494 PALM GARDEN OF AVENTURA 24,149 141.10 1.0000 331 0.9000 126.99 120 44,144 368 324167 PALMETTO REHABILITATION AND HEALTH CENTER 14,640 141.10 1.0000 330 0.9000 126.99 90 - 212806 PALMETTO SUB ACUTE CARE CENTER, INC 9,794 141.10 1.0000 331 0.9000 126.99 95 - 225754 PINECREST CONVALESCENT CENTER 25,073 141.10 1.0000 331 0.9000 126.99 100 - 200620 PINES NURSING HOME 11,660 141.10 1.0000 331 0.9000 126.99 46 - 308251 PONCE PLAZA NURSING & REHABILITATION CENTER 30,865 141.10 1.0000 331 0.9000 126.99 147 - 223239 REGENTS PARK AT AVENTURA 33,894 141.10 1.0000 331 0.9000 126.99 180 - 207276 RIVERSIDE CARE CENTER 37,787 141.10 1.0000 331 0.9000 126.99 120 - 324400 SIGNATURE HEALTHCARE CENTER OF WATERFORD 59,169 141.10 1.0000 330 0.9000 126.99 214 - 324418 SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS 30,359 141.10 1.0000 330 0.9000 126.99 120 - 260771 SINAI PLAZA NURSING & REHAB CENTER 26,510 141.10 1.0000 331 0.9000 126.99 150 - 311308 SOUTH POINTE PLAZA REHABILITATION AND NURSING CENTER 53,393 141.10 1.0000 331 0.9000 126.99 230 - 209473 ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC 48,960 141.10 1.0000 331 0.9000 126.99 240 - 268062 SUSANNA WESLEY HEALTH CENTER 27,145 141.10 1.0000 330 0.9000 126.99 120 - 226602 TREASURE ISLE CARE CENTER 49,228 141.10 1.0000 331 0.9000 126.99 176 - 227544 UNITY HEALTH AND REHABILITATION CENTER 90,349 141.10 1.0000 331 0.9000 126.99 294 - 225177 VICTORIA NURSING & REHABILITATION CENTER, INC. 50,276 141.10 1.0000 331 0.9000 126.99 253 - 203165 VILLA MARIA NURSING CENTER 43,453 141.10 1.0000 331 0.9000 126.99 212 -

0 VILLA MARIA WEST SKILLED NURSING FACILITY 141.10 1.0000 #N/A #N/A #N/A #VALUE!310409 WATERCREST CARE CENTER 41,307 141.10 1.0000 331 0.9000 126.99 150 - 282359 WEST GABLES HEALTH CARE CENTER 17,669 141.10 1.0000 331 0.9000 126.99 120 - 225291 ARISTOCRAT, THE 8,182 141.10 1.0000 341 0.8700 122.76 60 - 999932 BENTLEY CARE CENTER 141.10 1.0000 341 0.8700 122.76 - - 999931 CHATEAU AT MOORINGS PARK, THE 141.10 1.0000 341 0.8700 122.76 - - 268585 HARBORCHASE OF NAPLES 4,028 141.10 1.0000 341 0.8700 122.76 40 - 252280 HERITAGE HEALTHCARE & REHABILITATION CENTER 21,911 141.10 1.0000 341 0.8700 122.76 97 - 226378 IMPERIAL HEALTH CARE CENTER 15,992 141.10 1.0000 341 0.8700 122.76 113 - 256846 LAKESIDE PAVILLION CARE AND REHABILITATION CENTER 24,409 141.10 1.0000 341 0.8700 122.76 120 - 325422 MANORCARE AT LELY PALMS 18,219 141.10 1.0000 341 0.8700 122.76 117 - 325449 MANORCARE NURSING AND REHABILITATION CENTER 19,295 141.10 1.0000 341 0.8700 122.76 120 - 999930 PREMIER PLACE AT THE GLENVIEW 141.10 1.0000 341 0.8700 122.76 - - 253456 HAWTHORNE HEALTH AND REHAB OF OCALA 23,973 141.10 1.0000 344 0.8600 121.35 120 - 266108 LIFE CARE CENTER OF OCALA 10,782 141.10 1.0000 344 0.8600 121.35 120 - 214043 MARION HOUSE HEALTH CARE CENTER 25,445 141.10 1.0000 344 0.8600 121.35 120 - 227773 NEW HORIZON REHABILITATION CENTER 31,011 141.10 1.0000 344 0.8600 121.35 159 - 251721 OAKHURST CARE AND REHABILITATION CENTER 22,667 141.10 1.0000 344 0.8600 121.35 180 - 217395 OCALA HEALTH AND REHABILITATION CENTER 43,147 141.10 1.0000 344 0.8600 121.35 180 - 257290 PALM GARDEN OF OCALA 36,572 141.10 1.0000 344 0.8600 121.35 180 78,749 437 203335 TIMBERRIDGE NURSING & REHABILITATION CENTER 22,088 141.10 1.0000 344 0.8600 121.35 180 - 203122 AVANTE AT LEESBURG, INC. 12,947 141.10 1.0000 347 0.9000 126.99 116 - 252042 AVANTE AT MT. DORA, INC. 16,668 141.10 1.0000 327 0.9000 126.99 116 - 260444 BAYVIEW CENTER 26,000 141.10 1.0000 327 0.9000 126.99 120 - 210684 EDGEWATER AT WATERMAN VILLAGE 15,038 141.10 1.0000 327 0.9000 126.99 120 - 227561 LADY LAKE SPECIALTY CARE CENTER 18,100 141.10 1.0000 321 0.9000 126.99 145 - 213870 LAKE EUSTIS CARE CENTER 18,467 141.10 1.0000 327 0.9000 126.99 90 26,500 294 228966 LAKE HARRIS HEALTH CENTER 18,009 141.10 1.0000 347 0.9000 126.99 120 - 259225 LAKEVIEW TERRACE SKILLED NURSING FACILITY 688 141.10 1.0000 327 0.9000 126.99 20 - 252956 LEESBURG HEALTH AND REHAB, LLC 15,592 141.10 1.0000 347 0.9000 126.99 120 - 210439 NORTH CAMPUS REHABILITATION AND NURSING CENTER 15,413 141.10 1.0000 347 0.9000 126.99 120 - 260452 RULEME CENTER 25,721 141.10 1.0000 327 0.9000 126.99 138 - 221465 WESTMINSTER CARE OF CLERMONT 38,692 141.10 1.0000 347 0.9000 126.99 182 - 320439 ADVENTIST CARE CENTERS-COURTLAND, INC 21,191 141.10 1.0000 328 0.9000 126.99 120 - 223808 AVANTE AT ORLANDO, INC. 27,169 141.10 1.0000 328 0.9000 126.99 118 - 252557 COLONIAL LAKES HEALTH CARE 42,576 141.10 1.0000 347 0.9000 126.99 180 - 205796 COMMONS AT ORLANDO LUTHERAN TOWERS 17,781 141.10 1.0000 328 0.9000 126.99 126 - 264512 CONWAY LAKES HEALTH & REHABILITATION CENTER 22,023 141.10 1.0000 328 0.9000 126.99 120 -

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324175 COURTYARDS OF ORLANDO REHABILITATION AND HEALTH CENTER 34,288 141.10 1.0000 328 0.9000 126.99 120 - 320421 EAST ORLANDO HEALTH & REHAB CENTER, INC 20,841 141.10 1.0000 328 0.9000 126.99 120 - 201651 GUARDIAN CARE NURSING & REHABILITATION CENTER 29,942 141.10 1.0000 328 0.9000 126.99 120 - 228877 HEALTH CENTER OF WINDERMERE, THE 17,169 141.10 1.0000 328 0.9000 126.99 120 - 204811 HEALTH CENTRAL PARK 49,307 141.10 1.0000 347 0.9000 126.99 228 - 263605 HUNTERS CREEK NURSING AND REHAB CENTER 22,165 141.10 1.0000 328 0.9000 126.99 116 - 318761 LAKE BENNETT HEALTH AND REHABILITATION CENTER 22,623 141.10 1.0000 347 0.9000 126.99 120 - 213403 LIFE CARE CENTER OF ORLANDO 6,167 141.10 1.0000 328 0.9000 126.99 120 - 325279 MANOR CARE NURSING & REHABILITATION CENTER 19,921 141.10 1.0000 327 0.9000 126.99 138 - 201588 MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC. 8,908 141.10 1.0000 327 0.9000 126.99 40 - 999941 MAYFLOWER HEALTHCARE CENTER 141.10 1.0000 327 0.9000 126.99 - - 263541 METRO WEST NURSING AND REHAB CENTER 24,385 141.10 1.0000 328 0.9000 126.99 120 - 324159 OCOEE HEALTH CARE CENTER 23,905 141.10 1.0000 347 0.9000 126.99 120 - 257303 PALM GARDEN OF ORLANDO 26,820 141.10 1.0000 328 0.9000 126.99 120 53,203 443 259934 PARKS HEALTHCARE AND REHABILITATION CENTER 28,500 141.10 1.0000 328 0.9000 126.99 120 - 225410 QUALITY HEALTH OF ORANGE COUNTY 27,315 141.10 1.0000 347 0.9000 126.99 120 - 269719 REGENTS PARK OF WINTER PARK 15,780 141.10 1.0000 327 0.9000 126.99 120 - 005380 REHABILITATION CENTER OF WINTER PARK, THE 27,505 141.10 1.0000 327 0.9000 126.99 180 56,750 315 252450 RIO PINAR HEALTH CARE 41,425 141.10 1.0000 328 0.9000 126.99 180 - 252468 ROSEWOOD HEALTH AND REHABILITATION CENTER 28,520 141.10 1.0000 328 0.9000 126.99 120 - 312550 SAVANNAH COVE 3,140 141.10 1.0000 327 0.9000 126.99 39 - 320412 SUNBELT HEALTH & REHAB CENTER-APOPKA, INC 23,166 141.10 1.0000 327 0.9000 126.99 120 - 261611 TERRA VISTA REHAB AND HEALTH CENTER 24,269 141.10 1.0000 328 0.9000 126.99 115 - 221589 WESTMINSTER CARE OF DELANEY PARK 8,779 141.10 1.0000 328 0.9000 126.99 60 - 223654 WESTMINSTER CARE OF ORLANDO 94,756 141.10 1.0000 328 0.9000 126.99 420 - 208540 WESTMINSTER TOWERS 16,336 141.10 1.0000 328 0.9000 126.99 120 - 324515 WINTER PARK CARE & REHABILITATION CENTER 21,865 141.10 1.0000 327 0.9000 126.99 103 - 209848 WINTER PARK TOWERS 12,918 141.10 1.0000 327 0.9000 126.99 120 - 259870 AVANTE AT ST CLOUD, INC. 30,175 141.10 1.0000 347 0.9000 126.99 131 - 319511 CONSULATE HEALTH CARE OF KISSIMMEE 25,241 141.10 1.0000 347 0.9000 126.99 120 - 205303 GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE 29,130 141.10 1.0000 347 0.9000 126.99 170 - 317560 KEYSTONE REHABILITATION AND HEALTH CENTER 13,327 141.10 1.0000 347 0.9000 126.99 120 - 005549 OAKS OF KISSIMMEE 17,376 141.10 1.0000 347 0.9000 126.99 59 14,037 238 217859 OSCEOLA HEALTH CARE CENTER 25,098 141.10 1.0000 347 0.9000 126.99 120 - 253421 PALMS AT PARK PLACE, THE 24,615 141.10 1.0000 347 0.9000 126.99 120 - 252441 PLANTATION BAY REHABILITATION CENTER 23,149 141.10 1.0000 347 0.9000 126.99 120 - 253146 SOUTHERN OAKS HEALTH CARE CENTER 29,415 141.10 1.0000 347 0.9000 126.99 120 - 319546 CONSULATE HEALTH CARE OF WEST ALTAMONTE 21,390 141.10 1.0000 327 0.9000 126.99 116 - 320463 FLNC, INC 50,876 141.10 1.0000 327 0.9000 126.99 202 - 263931 HEALTHCARE & REHAB OF SANFORD 26,219 141.10 1.0000 327 0.9000 126.99 114 - 260657 ISLAND LAKE CENTER 23,869 141.10 1.0000 327 0.9000 126.99 120 - 252310 LAKE MARY HEALTH AND REHABILITATION CENTER 22,924 141.10 1.0000 327 0.9000 126.99 120 - 210137 LIFE CARE CENTER OF ALTAMONTE SPRINGS 46,025 141.10 1.0000 327 0.9000 126.99 240 - 005379 LONGWOOD HEALTH CARE CENTER 27,824 141.10 1.0000 327 0.9000 126.99 120 31,582 263 313718 LUTHERAN HAVEN NURSING HOME 7,048 141.10 1.0000 327 0.9000 126.99 42 - 263591 TUSKAWILLA NURSING AND REHAB CENTER 13,031 141.10 1.0000 327 0.9000 126.99 98 - 999936 VILLAGE ON THE GREEN 141.10 1.0000 327 0.9000 126.99 - - 324451 ANCHOR CARE AND REHABILITATION CENTER 25,809 141.10 1.0000 329 0.9300 131.22 120 - 263389 ATLANTIC SHORES NURSING AND REHAB CENTER 22,082 141.10 1.0000 329 0.9300 131.22 120 - 252018 AVANTE AT MELBOURNE, INC. 24,345 141.10 1.0000 329 0.9300 131.22 110 - 005519 CARNEGIE GARDENS NURSING CENTER 31,155 141.10 1.0000 329 0.9300 131.22 138 37,931 275 319520 CONSULATE HEALTH CARE OF MELBOURNE 25,821 141.10 1.0000 329 0.9300 131.22 167 - 209325 COURTENAY SPRINGS VILLAGE 20,139 141.10 1.0000 329 0.9300 131.22 96 - 226700 HEALTH CENTER OF MERRITT ISLAND, THE 27,285 141.10 1.0000 329 0.9300 131.22 180 - 211281 HUNTINGTON PLACE CARE AND REHABILITATION CENTER 17,733 141.10 1.0000 329 0.9300 131.22 100 - 260665 INDIAN RIVER CENTER 45,880 141.10 1.0000 329 0.9300 131.22 179 - 252352 ISLAND HEALTH AND REHABILITATION CENTER 25,958 141.10 1.0000 329 0.9300 131.22 120 - 228338 LIFE CARE CENTER OF MELBOURNE 15,105 141.10 1.0000 329 0.9300 131.22 120 - 268186 LIFE CARE CENTER OF PALM BAY 19,774 141.10 1.0000 329 0.9300 131.22 141 - 264547 MELBOURNE TERRACE REHABILITATION CENTER 25,479 141.10 1.0000 329 0.9300 131.22 120 - 252395 PALMS REHABILITATION AND HEALTHCARE CENTER, THE 27,197 141.10 1.0000 329 0.9300 131.22 120 - 227587 ROCKLEDGE HEALTH AND REHABILITATION CENTER 24,304 141.10 1.0000 329 0.9300 131.22 107 -

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263583 ROYAL OAKS NURSING AND REHAB CENTER 16,872 141.10 1.0000 327 0.9000 126.99 120 - 263974 TITUSVILLE REHABILITATION & NURSING CENTER 34,090 141.10 1.0000 327 0.9000 126.99 157 - 252522 VISTA MANOR 23,091 141.10 1.0000 327 0.9000 126.99 120 - 217727 WEST MELBOURNE HEALTH & REHABILITATION CENTER 27,793 141.10 1.0000 329 0.9300 131.22 180 - 253472 WUESTHOFF PROGRESSIVE CARE CENTER 13,056 141.10 1.0000 329 0.9300 131.22 114 - 005374 FLAGLER PINES 28,009 141.10 1.0000 321 0.9000 126.99 120 34,143 285 252409 GRAND OAKS HEALTH AND REHABILITATION CENTER 20,084 141.10 1.0000 321 0.9000 126.99 120 - 212989 BAY CENTER 35,771 141.10 1.0000 324 0.7900 111.47 160 - 264491 CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOME 13,590 141.10 1.0000 324 0.7900 111.47 120 - 318779 COMMUNITY HEALTH AND REHABILITATION CENTER 20,161 141.10 1.0000 324 0.7900 111.47 120 - 252191 EMERALD SHORES HEALTH AND REHABILITATION 13,272 141.10 1.0000 324 0.7900 111.47 77 - 005384 GLEN COVE NURSING PAVILION 26,489 141.10 1.0000 324 0.7900 111.47 115 46,000 400 203980 LISENBY ON LAKE CAROLINE 3,134 141.10 1.0000 324 0.7900 111.47 22 - 005385 PANAMA CITY NURSING CENTER 27,680 141.10 1.0000 324 0.7900 111.47 120 30,000 250 252247 SEA BREEZE HEALTH CARE 25,629 141.10 1.0000 324 0.7900 111.47 120 - 323799 ST ANDREWS BAY SKILLED NURSING AND REHABILITATION CENTER 28,545 141.10 1.0000 324 0.7900 111.47 120 - 208809 BAPTIST MANOR 36,352 141.10 1.0000 325 0.8500 119.94 170 - 213853 BAYSIDE MANOR 25,476 141.10 1.0000 325 0.8500 119.94 120 34,549 288 220604 CENTURY CARE CENTER 23,200 141.10 1.0000 325 0.8500 119.94 88 - 319686 CONSULATE HEALTH CARE OF PENSACOLA 23,415 141.10 1.0000 325 0.8500 119.94 120 - 258831 HAVEN OF OUR LADY OF PEACE 12,937 141.10 1.0000 325 0.8500 119.94 120 - 229571 HEALTH CENTER OF PENSACOLA, THE 35,172 141.10 1.0000 325 0.8500 119.94 180 - 315664 LIFE CARE CENTER OF PENSACOLA 3,108 141.10 1.0000 325 0.8500 119.94 120 - 224243 PENSACOLA HEALTH CARE FACILITY 23,791 141.10 1.0000 325 0.8500 119.94 118 - 211842 ROSEWOOD MANOR 41,975 141.10 1.0000 325 0.8500 119.94 155 - 324566 SOUTHERN OAKS REHABILITATION AND NURSING CENTER 40,836 141.10 1.0000 325 0.8500 119.94 210 - 213918 SPECIALTY CENTER OF PENSACOLA 24,452 141.10 1.0000 325 0.8500 119.94 120 38,280 319 252123 UNIVERSITY HILLS HEALTH AND REHABILITATION 28,655 141.10 1.0000 325 0.8500 119.94 120 - 210374 WILLOWBROOKE COURT AT AZALEA TRACE 13,063 141.10 1.0000 325 0.8500 119.94 106 - 213816 BAY BREEZE NURSING AND RETIREMENT CENTER 141.10 1.0000 325 0.8500 119.94 120 54,100 451 220621 SANDY RIDGE CARE CENTER 15,275 141.10 1.0000 325 0.8500 119.94 60 - 220612 SANTA ROSA HEALTH & REHABILITATION CENTER 28,354 141.10 1.0000 325 0.8500 119.94 110 - 259331 UNIHEALTH POST-ACUTE CARE - SANTA ROSA 27,699 141.10 1.0000 325 0.8500 119.94 120 - 201545 EDGEWATER MANOR 26,132 141.10 1.0000 334 0.8600 121.35 120 - 226033 MARTIN NURSING AND RESTORATIVE CARE CENTER 14,826 141.10 1.0000 349 0.8600 121.35 120 - 263621 PALM CITY NURSING & REHAB CENTER 20,434 141.10 1.0000 349 0.8600 121.35 116 - 228885 PARKWAY HEALTH & REHABILITATION CENTER 32,413 141.10 1.0000 349 0.8600 121.35 177 - 214141 SALERNO BAY MANOR 26,303 141.10 1.0000 349 0.8600 121.35 120 41,715 348 225991 STUART NURSING & RESTORATIVE CARE CENTER 18,766 141.10 1.0000 349 0.8600 121.35 120 - 213152 WATERS EDGE EXTENDED CARE 1,773 141.10 1.0000 349 0.8600 121.35 36 - 268755 ABBIEJEAN RUSSELL CARE CENTER LLC 14,633 141.10 1.0000 349 0.8600 121.35 79 - 210781 BRIGHTON GARDENS OF PORT ST LUCIE 3,731 141.10 1.0000 349 0.8600 121.35 30 - 261637 EMERALD HEALTH CARE CENTER 23,213 141.10 1.0000 349 0.8600 121.35 120 - 252239 FORT PIERCE HEALTH CARE 46,532 141.10 1.0000 349 0.8600 121.35 171 - 211516 LAUREL POINTE HEALTH AND REHABILITATION 26,838 141.10 1.0000 349 0.8600 121.35 107 - 217824 LIFE CARE CENTER OF PORT SAINT LUCIE 12,560 141.10 1.0000 349 0.8600 121.35 123 - 257249 PALM GARDEN OF PORT SAINT LUCIE 26,872 141.10 1.0000 349 0.8600 121.35 120 44,144 368 226009 PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTER 32,535 141.10 1.0000 349 0.8600 121.35 180 - 263532 TIFFANY HALL NURSING AND REHAB CENTER 25,728 141.10 1.0000 349 0.8600 121.35 120 - 226327 CHARLOTTE HARBOR HEALTHCARE 25,362 141.10 1.0000 339 0.8700 122.76 180 - 320129 CONSULATE HEALTH CARE OF PORT CHARLOTTE 24,040 141.10 1.0000 339 0.8700 122.76 120 - 269492 DOUGLAS JACOBSON STATE VETERANS NURSING HOME 22,570 141.10 1.0000 339 0.8700 122.76 120 - 252204 ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER 22,931 141.10 1.0000 342 0.8800 124.17 120 - 319333 HARBOUR HEALTH CENTER 11,886 141.10 1.0000 339 0.8700 122.76 120 - 311685 LIFE CARE CENTER OF PUNTA GORDA 31,599 141.10 1.0000 339 0.8700 122.76 180 - 319325 PORT CHARLOTTE REHABILITATION CENTER 23,662 141.10 1.0000 339 0.8700 122.76 120 - 324477 SIGNATURE HEALTHCARE OF PORT CHARLOTTE 20,511 141.10 1.0000 339 0.8700 122.76 164 - 002400 VILLAGE PLACE HEALTH AND REHABILITATION CENTER 16,556 141.10 1.0000 339 0.8700 122.76 104 - 310581 ATLANTIC HEALTHCARE CENTER 21,165 141.10 1.0000 329 0.9300 131.22 110 - 320145 CONSULATE HEALTH CARE OF VERO BEACH 34,435 141.10 1.0000 329 0.9300 131.22 159 - 001416 FLORIDA BAPTIST RETIREMENT CENTER 1,971 141.10 1.0000 329 0.9300 131.22 24 - 257311 PALM GARDEN OF VERO BEACH 39,543 141.10 1.0000 329 0.9300 131.22 180 71,816 399

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999919 ROYAL PALM HEALTHCARE & REHABILITATION CENTER 141.10 1.0000 329 0.9300 131.22 - - 001416 WILLOWBROOKE COURT AT INDIAN RIVER ESTATES 1,971 141.10 1.0000 329 0.9300 131.22 24 - 005386 RIVERCHASE CARE CENTER 36,523 141.10 1.0000 323 0.8000 112.88 120 36,294 302 005381 BRYNWOOD CENTER 24,783 141.10 1.0000 323 0.8000 112.88 97 30,323 313 214001 JEFFERSON HEALTH AND REHABILITATION CENTER 13,843 141.10 1.0000 323 0.8000 112.88 60 - 252093 CAPITAL HEALTHCARE CENTER 33,482 141.10 1.0000 323 0.8000 112.88 156 - 264563 CENTRE POINTE HEALTH AND REHAB CENTER 17,057 141.10 1.0000 323 0.8000 112.88 120 - 319716 CONSULATE HEALTH CARE OF TALLAHASSEE 15,962 141.10 1.0000 323 0.8000 112.88 120 - 252298 HERITAGE HEALTHCARE CENTER 42,084 141.10 1.0000 323 0.8000 112.88 180 - 202941 MIRACLE HILL NURSING & CONVALESCENT CENTER, INC. 35,980 141.10 1.0000 323 0.8000 112.88 120 - 200409 WESTMINSTER OAKS 11,412 141.10 1.0000 323 0.8000 112.88 120 - 253707 EDEN SPRINGS NURSING AND REHAB CENTER 28,393 141.10 1.0000 323 0.8000 112.88 120 - 228958 BROOKSVILLE HEALTHCARE CENTER 29,969 141.10 1.0000 346 0.9100 128.40 150 - 263893 EVERGREEN WOODS 21,176 141.10 1.0000 346 0.9100 128.40 120 - 325295 HEARTLAND OF BROOKSVILLE 22,128 141.10 1.0000 346 0.9100 128.40 120 - 252174 HERON POINTE HEALTH AND REHABILITATION 28,906 141.10 1.0000 346 0.9100 128.40 120 - 252492 SPRING HILL HEALTH AND REHABILITATION CENTER 16,687 141.10 1.0000 346 0.9100 128.40 120 - 263575 BAYSHORE POINTE NURSING AND REHAB CENTER 21,786 141.10 1.0000 336 0.9100 128.40 117 - 252077 BRANDON HEALTH AND REHABILITATION CENTER 18,527 141.10 1.0000 335 0.9100 128.40 120 - 284793 BRIGHTON GARDENS OF TAMPA 5,102 141.10 1.0000 336 0.9100 128.40 45 - 999949 CANTERBURY TOWERS INC 141.10 1.0000 336 0.9100 128.40 - - 263877 CARROLLWOOD CARE CENTER 26,885 141.10 1.0000 336 0.9100 128.40 120 - 259900 CENTRAL PARK HEALTHCARE & REHABILITATION CENTER 24,107 141.10 1.0000 335 0.9100 128.40 120 - 281913 COMMUNITY CONVALESCENT CENTER 32,751 141.10 1.0000 335 0.9100 128.40 120 - 319660 CONSULATE HEALTH CARE OF BRANDON 30,145 141.10 1.0000 335 0.9100 128.40 120 - 324116 EXCEL REHABILITATION AND HEALTH CENTER 24,029 141.10 1.0000 336 0.9100 128.40 120 - 260690 FAIRWAY OAKS CENTER 31,922 141.10 1.0000 336 0.9100 128.40 120 - 252221 FLETCHER HEALTH AND REHABILITATION CENTER 21,921 141.10 1.0000 336 0.9100 128.40 120 - 252506 HABANA HEALTH CARE CENTER 35,794 141.10 1.0000 336 0.9100 128.40 150 - 261670 HAWTHORNE HEALTH AND REHAB OF BRANDON 17,236 141.10 1.0000 335 0.9100 128.40 120 - 213039 HEALTH CARE CENTER OF TAMPA 67,157 141.10 1.0000 336 0.9100 128.40 266 68,019 256 226343 HEALTH CENTER OF PLANT CITY, THE 39,293 141.10 1.0000 335 0.9100 128.40 180 - 201154 HOME ASSOCIATION, INC., THE 21,795 141.10 1.0000 336 0.9100 128.40 96 - 210285 JOHN KNOX VILLAGE MED CENTER 20,755 141.10 1.0000 336 0.9100 128.40 163 - 218057 LAKESHORE VILLAS HEALTH CARE CENTER 39,501 141.10 1.0000 336 0.9100 128.40 179 - 325678 MANORCARE HEALTH SERVICES CARROLLWOOD 11,649 141.10 1.0000 336 0.9100 128.40 120 - 259462 NURSING CENTER AT UNIVERSITY VILLAGE, THE 22,891 141.10 1.0000 336 0.9100 128.40 120 - 257516 PALM GARDEN OF SUN CITY 21,301 141.10 1.0000 335 0.9100 128.40 120 46,831 390 257524 PALM GARDEN OF TAMPA 26,582 141.10 1.0000 336 0.9100 128.40 120 44,432 370 211885 PLAZA WEST 9,342 141.10 1.0000 335 0.9100 128.40 113 - 263940 REHABILITATION AND HEALTHCARE CENTER OF TAMPA 42,155 141.10 1.0000 336 0.9100 128.40 174 - 224910 SOUTH TAMPA HEALTH AND REHABILITATION CENTER 46,213 141.10 1.0000 336 0.9100 128.40 179 - 209856 SUN TERRACE HEALTH CARE CENTER 16,032 141.10 1.0000 335 0.9100 128.40 109 - 266612 WHISPERING OAKS 73,003 141.10 1.0000 336 0.9100 128.40 240 - 324141 WOODBRIDGE REHABILITATION & HEALTH CENTER 27,223 141.10 1.0000 336 0.9100 128.40 120 - 212164 YBOR CITY HEALTHCARE & REHABILITATION CENTER 21,688 141.10 1.0000 336 0.9100 128.40 80 - 214914 BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME 26,806 141.10 1.0000 346 0.9100 128.40 120 - 226076 BAYONET POINT HEALTH & REHABILITATION CENTER 31,160 141.10 1.0000 346 0.9100 128.40 180 - 228567 BEAR CREEK NURSING CENTER 20,607 141.10 1.0000 346 0.9100 128.40 120 - 319651 CONSULATE HEALTH CARE OF BAYONET POINT 22,202 141.10 1.0000 346 0.9100 128.40 120 - 319970 CONSULATE HEALTH CARE OF NEW PORT RICHEY 26,626 141.10 1.0000 346 0.9100 128.40 120 - 325708 HEARTLAND OF ZEPHYRHILLS 22,418 141.10 1.0000 335 0.9100 128.40 120 - 228591 HEATHER HILL HEALTHCARE CENTER 30,758 141.10 1.0000 346 0.9100 128.40 120 - 214132 HERITAGE PARK 27,846 141.10 1.0000 335 0.9100 128.40 120 38,340 320 259357 LIFE CARE CENTER OF NEW PORT RICHEY 7,842 141.10 1.0000 346 0.9100 128.40 113 - 324124 MADISON POINTE REHABILITATION AND HEALTH CENTER 25,135 141.10 1.0000 346 0.9100 128.40 119 - 252689 ORCHARD RIDGE CARE AND REHABILITATION CENTER 17,153 141.10 1.0000 346 0.9100 128.40 120 - 228575 ROYAL OAK NURSING CENTER 26,839 141.10 1.0000 335 0.9100 128.40 120 - 262706 SOUTHERN PINES HEALTHCARE CENTER 23,040 141.10 1.0000 346 0.9100 128.40 120 - 003521 TRINITY REGIONAL REHAB CENTER 7,780 141.10 1.0000 346 0.9100 128.40 120 - 263991 WINDSOR WOODS REHABILITATION AND HEALTHCARE CENTER 20,714 141.10 1.0000 346 0.9100 128.40 103 - 320391 ZEPHYR HAVEN HEALTH & REHAB CENTER, INC 29,336 141.10 1.0000 335 0.9100 128.40 120 -

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320404 ZEPHYRHILLS HEALTH & REHAB CENTER, INC 20,759 141.10 1.0000 335 0.9100 128.40 103 - 263958 ABBEY REHABILITATION AND NURSING CENTER 31,245 141.10 1.0000 337 0.8400 118.52 152 - 324094 ADVANCED REHABILITATION AND HEALTH CENTER 31,499 141.10 1.0000 337 0.8400 118.52 120 - 261254 ALHAMBRA HEALTH AND REHABILITATION CENTER 9,707 141.10 1.0000 337 0.8400 118.52 60 - 309800 ALLEGRO AT COLLEGE HARBOR, THE 5,572 141.10 1.0000 337 0.8400 118.52 52 - 227251 ALPINE HEALTH & REHABILITATION CENTER 14,745 141.10 1.0000 337 0.8400 118.52 57 - 227251 APOLLO HEALTH & REHABILITATION CENTER 14,745 141.10 1.0000 337 0.8400 118.52 57 - 263834 BAY POINTE NURSING PAVILION 32,094 141.10 1.0000 337 0.8400 118.52 120 - 253448 BAY TREE CARE AND REHABILITATION CENTER 28,945 141.10 1.0000 346 0.9100 128.40 120 - 324108 BAYSIDE REHABILITATION & HEALTH CENTER 22,704 141.10 1.0000 337 0.8400 118.52 92 - 316652 BAYWOOD NURSING CENTER 17,110 141.10 1.0000 337 0.8400 118.52 59 - 264521 BELLEAIR HEALTH CARE CENTER 25,740 141.10 1.0000 337 0.8400 118.52 120 - 213004 BOCA CIEGA CENTER 27,816 141.10 1.0000 337 0.8400 118.52 120 - 200107 BON SECOURS MARIA MANOR NURSING CARE CENTER 58,679 141.10 1.0000 337 0.8400 118.52 274 - 315524 CARRINGTON PLACE NURSING & REHABILITATION CENTER 25,248 141.10 1.0000 337 0.8400 118.52 120 - 212911 CLEARWATER CENTER 31,908 141.10 1.0000 337 0.8400 118.52 120 - 200956 COMPREHENSIVE HEALTHCARE OF CLEARWATER 33,088 141.10 1.0000 337 0.8400 118.52 150 - 251666 CONCORDIA MANOR 8,985 141.10 1.0000 337 0.8400 118.52 39 - 319694 CONSULATE HEALTH CARE OF SAFETY HARBOR 29,456 141.10 1.0000 346 0.9100 128.40 120 - 319708 CONSULATE HEALTH CARE OF ST PETERSBURG 22,087 141.10 1.0000 337 0.8400 118.52 120 - 252115 COUNTRYSIDE REHAB AND HEALTHCARE CENTER 28,582 141.10 1.0000 346 0.9100 128.40 120 - 001300 CROSS TERRACE REHABILITATION CENTER 23,057 141.10 1.0000 346 0.9100 128.40 104 - 264351 CRYSTAL OAKS OF PINELLAS 13,561 141.10 1.0000 337 0.8400 118.52 60 - 311065 EAGLE LAKE REHAB & CARE CENTER 11,708 141.10 1.0000 337 0.8400 118.52 59 - 264539 EAST BAY REHABILITATION CENTER 22,146 141.10 1.0000 337 0.8400 118.52 120 - 252484 EDINBOROUGH HEALTHCARE CENTER 22,309 141.10 1.0000 346 0.9100 128.40 93 - 212890 EGRET COVE CENTER 28,521 141.10 1.0000 337 0.8400 118.52 120 - 324248 FREEDOM SQUARE NURSING CENTER 13,299 141.10 1.0000 337 0.8400 118.52 116 - 255840 GLEN OAKS HEALTH CARE CENTER 20,210 141.10 1.0000 337 0.8400 118.52 76 26,371 347 262722 GOLFVIEW HEALTHCARE CENTER 11,053 141.10 1.0000 337 0.8400 118.52 56 - 316644 GRACEWOOD REHABILITATION AND NURSING CARE 30,117 141.10 1.0000 337 0.8400 118.52 120 - 316636 HARBOURWOOD HEALTH AND REHAB CENTER 28,510 141.10 1.0000 337 0.8400 118.52 120 - 320528 HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW, THE 7,444 141.10 1.0000 337 0.8400 118.52 58 - 263907 HIGHLAND PINES REHABILITATION CENTER 30,326 141.10 1.0000 337 0.8400 118.52 120 - 281743 JACARANDA MANOR 88,923 141.10 1.0000 337 0.8400 118.52 299 - 252336 LARGO REHABILITATION CENTER 35,763 141.10 1.0000 337 0.8400 118.52 158 - 316628 LAURELLWOOD NURSING CENTER 11,142 141.10 1.0000 337 0.8400 118.52 60 - 227650 LEXINGTON HEALTH AND REHABILITATION CENTER 23,544 141.10 1.0000 337 0.8400 118.52 134 - 325686 MANOR CARE HEALTH SERVICES DUNEDIN 16,040 141.10 1.0000 346 0.9100 128.40 120 - 325694 MANOR CARE HEALTH SERVICES PALM HARBOR 23,690 141.10 1.0000 346 0.9100 128.40 180 - 999960 MASONIC HOME OF FLORIDA 141.10 1.0000 337 0.8400 118.52 - - 204072 MEASE CONTINUING CARE 14,652 141.10 1.0000 346 0.9100 128.40 100 - 208442 MENORAH MANOR 41,222 141.10 1.0000 337 0.8400 118.52 180 - 206431 MORTON PLANT REHABILITATION CENTER 4,272 141.10 1.0000 337 0.8400 118.52 120 - 227641 NORTH REHABILITATION CENTER 9,729 141.10 1.0000 337 0.8400 118.52 49 - 203823 OAK BLUFFS NURSING CENTER 10,723 141.10 1.0000 337 0.8400 118.52 60 - 258342 OAK MANOR HEALTHCARE & REHABILITATION CENTER 37,365 141.10 1.0000 337 0.8400 118.52 180 - 257460 PALM GARDEN OF CLEARWATER 19,471 141.10 1.0000 337 0.8400 118.52 120 45,610 380 257478 PALM GARDEN OF LARGO 27,950 141.10 1.0000 337 0.8400 118.52 140 67,059 479 257508 PALM GARDEN OF PINELLAS 25,087 141.10 1.0000 337 0.8400 118.52 120 48,907 408 282537 PALM TERRACE OF ST. PETERSBURG 21,902 141.10 1.0000 337 0.8400 118.52 96 38,000 396 281891 PASADENA MANOR INC 26,783 141.10 1.0000 337 0.8400 118.52 122 - 324507 PENINSULA CARE AND REHABILITATION CENTER 27,750 141.10 1.0000 346 0.9100 128.40 120 - 324469 PINELLAS PARK CARE AND REHABILITATION CENTER 24,549 141.10 1.0000 337 0.8400 118.52 120 - 263486 PINELLAS POINT NURSING AND REHAB CENTER 12,952 141.10 1.0000 337 0.8400 118.52 60 - 228362 REHABILITATION CENTER OF ST PETE 37,900 141.10 1.0000 337 0.8400 118.52 159 - 210951 SABAL PALMS HEALTH CARE CENTER 59,829 141.10 1.0000 337 0.8400 118.52 244 - 310841 SAINT MARK VILLAGE 4,650 141.10 1.0000 346 0.9100 128.40 60 - 324230 SEMINOLE NURSING PAVILION 12,153 141.10 1.0000 337 0.8400 118.52 120 - 324132 SHORE ACRES REHABILITATION AND HEALTH CENTER 26,117 141.10 1.0000 337 0.8400 118.52 109 - 226360 SOUTH HERITAGE HEALTH & REHAB CENTER 21,811 141.10 1.0000 337 0.8400 118.52 74 - 267724 SPRINGS AT BOCA CIEGA BAY 10,550 141.10 1.0000 337 0.8400 118.52 109 -

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210943 STRATFORD COURT OF PALM HARBOR 8,030 141.10 1.0000 346 0.9100 128.40 60 - 253430 SUNSET POINT CARE AND REHABILITATION CENTER 24,747 141.10 1.0000 337 0.8400 118.52 120 - 229164 SYLVAN HEALTH CENTER 4,981 141.10 1.0000 337 0.8400 118.52 60 - 212849 TARPON BAYOU CENTER 29,469 141.10 1.0000 346 0.9100 128.40 120 - 260568 TIERRA PINES CENTER 33,165 141.10 1.0000 337 0.8400 118.52 120 - 253464 WEST BAY CARE AND REHABILITATION CENTER 26,122 141.10 1.0000 346 0.9100 128.40 120 - 202011 WESTCHESTER GARDENS REHAB & CARE CENTER 17,913 141.10 1.0000 337 0.8400 118.52 120 - 999957 WESTMINSTER PALMS 141.10 1.0000 337 0.8400 118.52 - - 212709 WESTMINSTER SUNCOAST 18,371 141.10 1.0000 337 0.8400 118.52 120 - 254762 WRIGHTS NURSING AND REHABILITATION CENTER 5,143 141.10 1.0000 337 0.8400 118.52 60 - 205460 AMERICAN-FINNISH NURSING HOME 10,154 141.10 1.0000 334 0.8600 121.35 60 - 210676 AVANTE AT BOCA RATON, INC. 22,141 141.10 1.0000 334 0.8600 121.35 144 - 203238 AVANTE AT LAKE WORTH, INC. 31,780 141.10 1.0000 334 0.8600 121.35 138 - 252549 AZALEA COURT 30,991 141.10 1.0000 334 0.8600 121.35 120 - 999915 BARRINGTON TERRACE OF BOYNTON BEACH 141.10 1.0000 334 0.8600 121.35 - - 263842 BOCA RATON REHABILITATION CENTER 26,239 141.10 1.0000 334 0.8600 121.35 120 - 263613 BOULEVARD MANOR NURSING AND REHAB CENTER 31,097 141.10 1.0000 334 0.8600 121.35 167 - 263460 BOYNTON BEACH REHABILITATION CENTER 21,746 141.10 1.0000 334 0.8600 121.35 169 - 218952 BOYNTON HEALTH CARE CENTER 10,948 141.10 1.0000 334 0.8600 121.35 81 38,442 475 999879 CHATSWORTH AT PGA NATIONAL 141.10 1.0000 334 0.8600 121.35 - - 213837 CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE 365 141.10 1.0000 334 0.8600 121.35 60 - 320153 CONSULATE HEALTH CARE OF WEST PALM BEACH 29,880 141.10 1.0000 334 0.8600 121.35 120 - 259918 CORAL BAY HEALTHCARE AND REHABILITATION 15,531 141.10 1.0000 334 0.8600 121.35 120 - 269395 CROSSINGS, THE 15,895 141.10 1.0000 334 0.8600 121.35 60 - 317349 DARCY HALL OF LIFE CARE 38,648 141.10 1.0000 334 0.8600 121.35 220 - 212032 EDWARD J HEALEY REHABILITATION AND NURSING CENTER 29,198 141.10 1.0000 334 0.8600 121.35 198 - 212393 FOUNTAINS NURSING HOME 9,226 141.10 1.0000 334 0.8600 121.35 51 - 228320 GARDENS COURT 11,510 141.10 1.0000 334 0.8600 121.35 120 - 203203 GLADES HEALTH CARE CENTER 30,799 141.10 1.0000 334 0.8600 121.35 120 - 259586 HAMLIN PLACE 21,473 141.10 1.0000 334 0.8600 121.35 120 - 216399 HARBOURS EDGE 483 141.10 1.0000 334 0.8600 121.35 54 - 205745 HEALTH CENTER AT ABBEY DELRAY 7,721 141.10 1.0000 334 0.8600 121.35 114 - 206865 HEALTH CENTER AT ABBEY DELRAY SOUTH 8,538 141.10 1.0000 334 0.8600 121.35 90 - 999913 HEARTLAND HEALTH CARE AND REHABILITATION CENTER OF BOCA RATON 141.10 1.0000 334 0.8600 121.35 - - 325309 HEARTLAND HEALTH CARE CENTER BOYNTON BEACH 24,666 141.10 1.0000 334 0.8600 121.35 120 - 325341 HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS 16,989 141.10 1.0000 334 0.8600 121.35 120 - 207381 JOSEPH L MORSE GERIATRIC CENTER INC 66,476 141.10 1.0000 334 0.8600 121.35 280 - 224928 JUPITER CARE CENTER 21,465 141.10 1.0000 334 0.8600 121.35 120 - 208485 JUPITER MEDICAL CENTER PAVILION INC 19,536 141.10 1.0000 334 0.8600 121.35 120 - 229610 LAKE VIEW CARE CENTER AT DELRAY 17,909 141.10 1.0000 334 0.8600 121.35 120 - 266124 LAKE WORTH MANOR 21,952 141.10 1.0000 334 0.8600 121.35 120 - 207683 LAKESIDE HEALTH CENTER 23,142 141.10 1.0000 334 0.8600 121.35 107 - 227676 LIBERTY INN, LLC 2,450 141.10 1.0000 334 0.8600 121.35 68 - 205923 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC CARE, INC. 21,767 141.10 1.0000 334 0.8600 121.35 132 - 325368 MANORCARE HEALTH SERVICES 36,091 141.10 1.0000 334 0.8600 121.35 180 - 325520 MANORCARE HEALTH SERVICES 13,757 141.10 1.0000 334 0.8600 121.35 120 - 325376 MANORCARE HEALTH SERVICES BOYNTON BEACH 31,224 141.10 1.0000 334 0.8600 121.35 180 - 325481 MANORCARE HEALTH SERVICES WEST PALM BEACH 16,552 141.10 1.0000 334 0.8600 121.35 120 - 263524 MEDICANA NURSING AND REHAB CENTER 16,939 141.10 1.0000 334 0.8600 121.35 117 - 229628 MENORAH HOUSE 25,783 141.10 1.0000 334 0.8600 121.35 120 - 325163 NORTH LAKE REHABILITATION AND HEALTH CENTER 23,166 141.10 1.0000 334 0.8600 121.35 85 - 999867 NURSING CENTER AT LA POSADA, THE 141.10 1.0000 334 0.8600 121.35 - - 257257 PALM GARDEN OF WEST PALM BEACH 28,987 141.10 1.0000 334 0.8600 121.35 176 81,326 462 204170 REGENTS PARK NURSING & REHABILITATION CENTER 29,752 141.10 1.0000 334 0.8600 121.35 180 - 263915 REHABILITATION CENTER OF THE PALM BEACHES,THE 22,788 141.10 1.0000 334 0.8600 121.35 99 - 214108 ROYAL MANOR 23,936 141.10 1.0000 334 0.8600 121.35 120 60,382 503 312312 SAVANNAH COVE 2,027 141.10 1.0000 334 0.8600 121.35 30 - 001136 SIGNATURE HEALTHCARE OF PALM BEACH 17,246 141.10 1.0000 334 0.8600 121.35 120 - 211010 STRATFORD COURT OF BOCA RATON 5,621 141.10 1.0000 334 0.8600 121.35 60 - 325031 TERRACES OF LAKE WORTH REHABILITATION AND HEALTH CENTER 26,766 141.10 1.0000 334 0.8600 121.35 99 - 206610 WATERFORD HEALTH CARE CENTER 2,812 141.10 1.0000 334 0.8600 121.35 60 - 999916 WHITEHALL BOCA RATON 141.10 1.0000 334 0.8600 121.35 - -

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Fac # Facility NameCost Report Begin Date

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Total Patient Days

Medicaid Patient Days

Cost per Sq Ft

Cost Index

Zip Code Factor

Location Factor

Cost per Sq Ft

Current Licensed

Beds Actual Sq

Ft Actual Sq. Ft. per bed-

999912 WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES 141.10 1.0000 334 0.8600 121.35 - - 206521 WILLOWBROOKE COURT AT ST ANDREWS 3,751 141.10 1.0000 334 0.8600 121.35 119 - 261599 WOOD LAKE NURSING AND REHABILITATION CENTER 27,092 141.10 1.0000 334 0.8600 121.35 120 - 251739 BRADFORD TERRACE NURSING CENTER 32,226 141.10 1.0000 320 0.8400 118.52 120 - 213888 WINDSOR MANOR 29,428 141.10 1.0000 320 0.8400 118.52 120 37,572 313 264067 BLOUNTSTOWN HEALTH AND REHABILITATION CENTER 24,861 141.10 1.0000 324 0.7900 111.47 92 - 251097 PARTHENON HEALTHCARE OF BLOUNTSTOWN 36,735 141.10 1.0000 324 0.7900 111.47 150 - 263478 ARBOR TRAIL REHAB AND SKILLED NURSING CENTER 22,728 141.10 1.0000 344 0.8600 121.35 116 - 203220 AVANTE AT INVERNESS, INC. 21,021 141.10 1.0000 344 0.8600 121.35 104 - 257419 CITRUS HEALTH AND REHABILITATION CENTER 19,137 141.10 1.0000 344 0.8600 121.35 111 - 217263 CRYSTAL RIVER HEALTH AND REHABILITATION CENTER 31,812 141.10 1.0000 344 0.8600 121.35 150 - 228940 CYPRESS COVE CARE CENTER 23,033 141.10 1.0000 344 0.8600 121.35 120 - 256269 DIAMOND RIDGE HEALTH AND REHABILITATION CENTER 18,611 141.10 1.0000 344 0.8600 121.35 120 - 252263 HEALTH CENTER AT BRENTWOOD 18,061 141.10 1.0000 344 0.8600 121.35 120 - 211532 LIFE CARE CENTER OF CITRUS COUNTY 12,439 141.10 1.0000 344 0.8600 121.35 120 - 228711 WOODLAND TERRACE OF CITRUS COUNTY 25,569 141.10 1.0000 344 0.8600 121.35 120 - 261629 AVALON HEALTHCARE CENTER 19,867 141.10 1.0000 320 0.8400 118.52 95 - 308111 BAYA POINTE NURSING AND REHABILITATION CENTER 13,544 141.10 1.0000 320 0.8400 118.52 90 - 226173 HEALTH CENTER OF LAKE CITY, THE 26,537 141.10 1.0000 320 0.8400 118.52 120 - 316229 DESOTO HEALTH & REHAB, LLC 5,595 141.10 1.0000 342 0.8800 124.17 41 - 312151 CROSS CITY REHABILITATION & HEALTH CARE CENTER 12,739 141.10 1.0000 326 0.8600 121.35 60 - 324485 BRIDGE AT BAY ST JOE, THE 28,829 141.10 1.0000 324 0.7900 111.47 120 - 206300 SUWANNEE VALLEY NURSING CENTER 18,852 141.10 1.0000 320 0.8400 118.52 60 - 999945 FINR III, LLC 141.10 1.0000 338 0.9000 126.99 - - 211435 HARDEE MANOR HEALTHCARE CENTER 17,825 141.10 1.0000 338 0.9000 126.99 79 - 213497 OAKBROOK OF LABELLE 25,582 141.10 1.0000 339 0.8700 122.76 93 28,872 310 282618 PALM TERRACE OF CLEWISTON 28,315 141.10 1.0000 334 0.8600 121.35 155 47,355 306 324493 KENILWORTH CARE & REHABILITATION CENTER 17,821 141.10 1.0000 338 0.9000 126.99 104 - 214124 LAKE PLACID HEALTH CARE CENTER 40,434 141.10 1.0000 338 0.9000 126.99 180 61,349 341 263966 OAKS AT AVON 22,490 141.10 1.0000 338 0.9000 126.99 104 - 252671 PALMS OF SEBRING, THE 15,971 141.10 1.0000 338 0.9000 126.99 120 - 324213 ROYAL CARE OF AVON PARK 17,355 141.10 1.0000 338 0.9000 126.99 90 - 263443 BONIFAY NURSING AND REHAB CENTER 48,350 141.10 1.0000 324 0.7900 111.47 180 - 203475 MARIANNA HEALTH AND REHABILITATION CENTER 51,871 141.10 1.0000 324 0.7900 111.47 180 - 005383 NURSING PAVILION AT CHIPOLA RETIREMENT CENTER 15,156 141.10 1.0000 324 0.7900 111.47 136 30,000 221 324426 SIGNATURE HEALTHCARE AT THE COURTYARD 30,202 141.10 1.0000 324 0.7900 111.47 120 - 324396 SIGNATURE HEALTHCARE OF NORTH FLORIDA 41,319 141.10 1.0000 324 0.7900 111.47 180 - 264482 LAFAYETTE HEALTH CARE CENTER 15,319 141.10 1.0000 320 0.8400 118.52 60 - 317586 WILLISTON REHABILITATION AND NURSING CENTER 31,391 141.10 1.0000 326 0.8600 121.35 180 - 211923 LAKE PARK OF MADISON 31,221 141.10 1.0000 323 0.8000 112.88 120 - 213462 MADISON NURSING CENTER 15,297 141.10 1.0000 323 0.8000 112.88 60 - 214019 PINE LAKE NURSING HOME 15,537 141.10 1.0000 323 0.8000 112.88 58 - 208906 PLANTATION KEY CONVALESCENT CENTER 21,974 141.10 1.0000 330 0.9000 126.99 120 - 202541 OKEECHOBEE HEALTH CARE FACILITY 46,338 141.10 1.0000 349 0.8600 121.35 173 - 312274 CRESTWOOD NURSING CENTER 16,755 141.10 1.0000 321 0.9000 126.99 65 - 312142 LAKEWOOD NURSING CENTER 26,442 141.10 1.0000 321 0.9000 126.99 92 - 226025 PALATKA HEALTH CARE CENTER 44,307 141.10 1.0000 321 0.9000 126.99 180 - 283142 ARBOR VILLAGE NURSING CENTER 45,342 141.10 1.0000 347 0.9000 126.99 210 - 215597 OSPREY POINT NURSING CENTER 9,374 141.10 1.0000 335 0.9100 128.40 60 - 268763 GOOD SAMARITAN CENTER 44,007 141.10 1.0000 320 0.8400 118.52 161 - 001135 SURREY PLACE CARE CENTER 14,273 141.10 1.0000 320 0.8400 118.52 60 - 005387 SUWANNEE HEALTH CARE CENTER 45,680 141.10 1.0000 320 0.8400 118.52 180 58,000 322 252425 MARSHALL HEALTH AND REHABILITATION CENTER 31,257 141.10 1.0000 323 0.8000 112.88 120 - 324353 WASHINGTON REHABILITATION AND NURSING CENTER 44,437 141.10 1.0000 324 0.7900 111.47 180 -

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Fac # Facility NameCost Report Begin Date

Cost Report End Date

Days in the Cost Report Year

Total Patient Days

Medicaid Patient Days

Cost per Sq Ft

Cost Index

Zip Code Factor

Location Factor

Cost per Sq Ft

Current Licensed

Beds Actual Sq

Ft Actual Sq. Ft. per bed-

Page 215: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name

005021 BRADEN RIVER CARE CENTER252069 BRADENTON HEALTH CARE263885 CASA MORA REHAB. & EXTENDED CARE227625 GREENBRIAR REHABILITATION AND NURSING CENTER324345 HERITAGE PARK CARE AND REHABILITATION CENTER223786 LIFE CARE CENTER OF SARASOTA317195 NURSING CENTER AT FREEDOM VILLAGE, THE259942 RIVERFRONT NURSING & REHABILITATION CENTER263451 RIVIERA PALMS REHABILITATION CENTER256277 SURREY PLACE HEALTHCARE AND REHABILITATION209422 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST203815 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST316610 WOODS OF MANATEE SPRINGS, THE999923 BAY VILLAGE OF SARASOTA259896 BENEVA LAKES HEALTHCARE AND REHABILITATION CENTE320137 CONSULATE HEALTH CARE OF SARASOTA999892 GLENRIDGE ON PALMER RANCH INC.213322 HARBORCHASE OF VENICE317136 HARMONY HEALTHCARE AND REHABILITATION CENTER999925 HEARTLAND HEALTH CARE & REHABILITATION CENTER252271 HERITAGE HEALTH CARE CENTER228621 INN AT SARASOTA BAY CLUB202681 J H FLOYD SUNSHINE MANOR325490 KENSINGTON MANOR252182 MAGNOLIA HEALTH AND REHABILITATION CENTER325473 MANORCARE HEALTH SERVICES325465 MANORCARE HEALTH SERVICES SARASOTA319244 PALMER RANCH HEALTHCARE AND REHABILITATION252662 PINEBROOK CARE AND REHABILITATION CENTER202703 PINES OF SARASOTA999922 PLYMOUTH HARBOR INCORPORATED225053 QUALITY HEALTH OF NORTH PORT263982 SARASOTA HEALTH AND REHABILITATION CENTER260355 SARASOTA MEMORIAL NURSING AND REHABILITATION CEN268780 SPRINGS AT LAKE POINTE WOODS253014 SPRINGWOOD CARE AND REHABILITATION CENTER202711 SUNNYSIDE NURSING HOME308501 SUNSET LAKE HEALTH AND REHABILITATION CENTER323781 TARPON POINT NURSING AND REHABILITATION CENTER210463 VILLAGE ON THE ISLE221473 CALUSA HARBOUR HEALTH CENTER318787 CITRUS GARDENS OF FORT MYERS320111 CONSULATE HEALTH CARE OF NORTH FORT MYERS252107 CORAL TRACE HEALTH CARE252212 EVANS HEALTH CARE201120 GULF COAST VILLAGE CARE CENTER210587 HEALTHPARK CARE CENTER, INC.325325 HEARTLAND HEALTH CARE CENTER FORT MYERS252344 HERITAGE PARK REHABILITATION AND HEALTHCARE320978 LEHIGH ACRES HEALTH AND REHABILITATION CENTER265381 LIFE CARE CENTER OF ESTERO999878 LODGE AT CYPRESS COVE, THE325384 MANORCARE HEALTH SERVICES263869 REHAB AND HEALTHCARE CENTER OF CAPE CORAL213900 SHADY REST CARE PAVILION229202 SHELL POINT NURSING PAVILION324370 SIGNATURE HEALTHCARE AT COLLEGE PARK

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

78,000 145,600 9,685,104 15.00% 1,452,766 $7,500 1.0000 1,560,000 11,245,104 45 32.50 39,375 73,500 4,889,115 15.00% 733,367 $7,500 1.0000 787,500 5,676,615 10 9.00 90,000 168,000 11,175,120 15.00% 1,676,268 $7,500 1.0000 1,800,000 12,975,120 31 26.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 27 11.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 24 23.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 9 4.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 20 18.00 41,250 77,000 5,121,930 15.00% 768,290 $7,500 1.0000 825,000 5,946,930 37 13.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 21 20.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 20 19.00 22,125 41,300 2,747,217 15.00% 412,083 $7,500 1.0000 442,500 3,189,717 39 29.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 42 17.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 24 10.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 27 26.00 30,375 56,700 3,771,603 15.00% 565,740 $7,500 1.0000 607,500 4,379,103 11 8.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 16,875 31,500 2,095,335 15.00% 314,300 $7,500 1.0000 337,500 2,432,835 12 9.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 3 3.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 26 25.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 8 5.00 37,875 70,700 4,702,863 15.00% 705,429 $7,500 1.0000 757,500 5,460,363 39 22.00 32,625 60,900 4,050,981 15.00% 607,647 $7,500 1.0000 652,500 4,703,481 40 32.50 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 15 13.00 48,375 90,300 6,006,627 15.00% 900,994 $7,500 1.0000 967,500 6,974,127 12 12.00 66,750 124,600 8,288,214 15.00% 1,243,232 $7,500 1.0000 1,335,000 9,623,214 26 22.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 10 10.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 24 23.00 76,500 142,800 9,498,852 15.00% 1,424,828 $7,500 1.0000 1,530,000 11,028,852 39 1.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 24 24.00 63,375 118,300 7,869,147 15.00% 1,180,372 $7,500 1.0000 1,267,500 9,136,647 38 27.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 22 21.00 44,625 83,300 5,540,997 15.00% 831,150 $7,500 1.0000 892,500 6,433,497 23 7.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 27 23.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 39 16.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 17 15.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 19 12.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 25 21.00 22,500 42,000 2,762,033 15.00% 414,305 $7,500 1.0000 450,000 3,212,033 25 25.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 26 26.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 24 19.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 22 14.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 11 11.00 31,875 59,500 3,912,879 15.00% 586,932 $7,500 1.0000 637,500 4,550,379 20 14.00 42,000 78,400 5,155,794 15.00% 773,369 $7,500 1.0000 840,000 5,995,794 17 11.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 19 13.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 28 27.00 41,250 77,000 5,063,726 15.00% 759,559 $7,500 1.0000 825,000 5,888,726 23 21.00 58,125 108,500 7,135,251 15.00% 1,070,288 $7,500 1.0000 1,162,500 8,297,751 6 6.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 10 10.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 30 30.00 67,500 126,000 8,286,098 15.00% 1,242,915 $7,500 1.0000 1,350,000 9,636,098 39 32.50 82,125 153,300 10,081,419 15.00% 1,512,213 $7,500 1.0000 1,642,500 11,723,919 38 31.00 40,125 74,900 4,925,625 15.00% 738,844 $7,500 1.0000 802,500 5,728,125 28 25.00

Page 216: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name264008 WINKLER COURT252034 AVANTE AT ORMOND BEACH, INC.209511 BISHOPS GLEN RETIREMENT CENTER260371 BRIDGEVIEW CENTER283134 CATALINA HEALTH CARE CENTER202789 CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY260649 COQUINA CENTER217743 DAYTONA BEACH HEALTH AND REHABILITATION CENTER005372 DEBARY MANOR252158 DELTONA HEALTH CARE210889 EMORY L BENNETT MEMORIAL VETERANS NURSING HOME204391 GOOD SAMARITAN SOCIETY-DAYTONA212792 GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN229091 HEALTH CENTER OF DAYTONA BEACH, THE223905 HORIZON HEALTHCARE CENTER AT DAYTONA258750 INDIGO MANOR269000 JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY213527 MANOR ON THE GREEN252476 OAKTREE HEALTHCARE005547 OAKWOOD GARDEN OF DELAND226351 OCEAN VIEW NURSING & REHABILITATION CENTER263567 ORANGE CITY NURSING AND REHAB CENTER263508 PORT ORANGE NURSING AND REHAB CENTER282464 RIDGECREST NURSING AND REHABILITATION CENTER312045 SANDALWOOD NURSING CENTER324442 SIGNATURE HEALTHCARE OF ORMOND282553 TERRACE OF DAYTONA BEACH, LLC212873 UNIVERSITY CENTER EAST212831 UNIVERSITY CENTER WEST212636 WOODLAND TERRACE EXTENDED CARE CENTER229849 ALEXANDER NININGER STATE VETERANS NURSING HOME263851 BROWARD INSTITUTE FOR LONG TERM CARE226335 BROWARD NURSING & REHABILITATION CENTER312789 CHILDRENS COMPREHENSIVE CARE CENTER INC318795 COURT AT PALM AIRE, THE210188 COVENANT VILLAGE CARE CENTER001281 CROSS POINTE CARE CENTER253481 FORUM AT DEER CREEK321303 FT LAUDERDALE HEALTH & REHABILITATION CENTER262064 GOLFCREST HEALTHCARE CENTER252255 HARBOR BEACH NURSING AND REHABILITATION CENTER226581 HEALTH CENTER OF COCONUT CREEK, THE325333 HEARTLAND HEALTH CARE CENTER LAUDERHILL325350 HEARTLAND OF TAMARAC252531 HILLCREST NURSING AND REHABILITATION CENTER313424 HOLLYWOOD HILLS REHABILITATION CENTER, LLC203769 JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH259080 LIFE CARE CENTER AT INVERRARY256935 MANOR OAKS NURSING & REHABILITATION CENTER254177 MANOR PINES CONVALESCENT CENTER325457 MANORCARE HEALTH SERVICES214931 MARGATE HEALTH CARE CENTER201006 MEMORIAL MANOR308005 PALMS REHABILITATION AND NURSING CENTER254134 PARK SUMMIT OF CORAL SPRINGS226017 PLANTATION NURSING & REHABILITATION CENTER263923 POMPANO REHABILITATION & NURSING CENTER269697 REGENTS PARK OF SUNRISE205800 SAINT JOHNS NURSING CENTER252433 SEAVIEW NURSING AND REHABILITATION CENTER225631 SPRINGTREE REHABILITATION & HEALTH CARE CENTER207497 SUNRISE HEALTH & REHABILITATION CENTER

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 14 14.00 49,875 93,100 6,333,626 15.00% 950,044 $7,500 1.0000 997,500 7,331,126 41 32.50 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 23 11.00 52,125 97,300 6,619,354 15.00% 992,903 $7,500 1.0000 1,042,500 7,661,854 27 3.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 22 10.00 48,750 91,000 6,190,763 15.00% 928,614 $7,500 1.0000 975,000 7,165,763 38 11.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 22 9.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 32 32.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 13.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 21.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 15.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 34 10.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 12 8.00 27,375 51,100 3,476,351 15.00% 521,453 $7,500 1.0000 547,500 4,023,851 13 12.00 31,500 58,800 4,000,185 15.00% 600,028 $7,500 1.0000 630,000 4,630,185 26 13.00 64,875 121,100 8,238,476 15.00% 1,235,771 $7,500 1.0000 1,297,500 9,535,976 22 20.00 56,250 105,000 7,143,188 15.00% 1,071,478 $7,500 1.0000 1,125,000 8,268,188 6 6.00 72,000 134,400 9,143,280 15.00% 1,371,492 $7,500 1.0000 1,440,000 10,583,280 28 27.00 24,375 45,500 3,095,381 15.00% 464,307 $7,500 1.0000 487,500 3,582,881 28 25.00 45,750 85,400 5,809,793 15.00% 871,469 $7,500 1.0000 915,000 6,724,793 31 31.00 89,625 167,300 11,381,479 15.00% 1,707,222 $7,500 1.0000 1,792,500 13,173,979 29 25.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 18.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 17 17.00 60,000 112,000 7,619,400 15.00% 1,142,910 $7,500 1.0000 1,200,000 8,819,400 27 27.00 37,125 69,300 4,714,504 15.00% 707,176 $7,500 1.0000 742,500 5,457,004 41 32.50 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 25 4.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 11 11.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 37 32.50 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 37 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 13 13.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 8 8.00 72,750 135,800 9,238,523 15.00% 1,385,778 $7,500 1.0000 1,455,000 10,693,523 31 22.00 74,250 138,600 9,219,474 15.00% 1,382,921 $7,500 1.0000 1,485,000 10,704,474 39 32.50 13,500 25,200 1,714,365 15.00% 257,155 $7,500 1.0000 270,000 1,984,365 17 14.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 21 21.00 22,500 42,000 2,793,780 15.00% 419,067 $7,500 1.0000 450,000 3,243,780 21 18.00 33,000 61,600 4,190,670 15.00% 628,601 $7,500 1.0000 660,000 4,850,670 25 25.00 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 19 16.00 58,125 108,500 7,217,265 15.00% 1,082,590 $7,500 1.0000 1,162,500 8,379,765 25 3.00 25,125 46,900 3,190,624 15.00% 478,594 $7,500 1.0000 502,500 3,693,124 29 29.00 22,125 41,300 2,747,217 15.00% 412,083 $7,500 1.0000 442,500 3,189,717 25 23.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 12 12.00 40,875 76,300 5,075,367 15.00% 761,305 $7,500 1.0000 817,500 5,892,867 20 16.00 56,625 105,700 7,031,013 15.00% 1,054,652 $7,500 1.0000 1,132,500 8,163,513 21 18.00 90,000 168,000 11,429,100 15.00% 1,714,365 $7,500 1.0000 1,800,000 13,229,100 23 21.00 57,000 106,400 7,238,430 15.00% 1,085,765 $7,500 1.0000 1,140,000 8,378,430 39 18.00 66,375 123,900 8,428,961 15.00% 1,264,344 $7,500 1.0000 1,327,500 9,756,461 37 15.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 7 6.00 43,500 81,200 5,401,308 15.00% 810,196 $7,500 1.0000 870,000 6,271,308 43 32.50 77,250 144,200 9,591,978 15.00% 1,438,797 $7,500 1.0000 1,545,000 11,136,978 43 32.50 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 24 24.00 63,750 119,000 8,095,613 15.00% 1,214,342 $7,500 1.0000 1,275,000 9,370,613 24 19.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 20 16.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 27 27.00 13,125 24,500 1,666,744 15.00% 250,012 $7,500 1.0000 262,500 1,929,244 23 19.00 57,000 106,400 7,077,576 15.00% 1,061,636 $7,500 1.0000 1,140,000 8,217,576 35 24.00 47,625 88,900 6,047,899 15.00% 907,185 $7,500 1.0000 952,500 7,000,399 22 22.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 20 18.00 67,875 126,700 8,427,903 15.00% 1,264,185 $7,500 1.0000 1,357,500 9,785,403 29 19.00 31,125 58,100 3,952,564 15.00% 592,885 $7,500 1.0000 622,500 4,575,064 26 24.00 41,250 77,000 5,121,930 15.00% 768,290 $7,500 1.0000 825,000 5,946,930 20 15.00

121,875 227,500 15,132,975 15.00% 2,269,946 $7,500 1.0000 2,437,500 17,570,475 26 24.00

Page 217: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name213098 TAMARAC REHABILITATION AND HEALTH CENTER002419 WEST BROWARD CARE CENTER227579 WILTON MANORS HEALTH & REHABILITATION CENTER252166 DESTIN HEALTHCARE AND REHABILITATION CENTER212903 EMERALD COAST CENTER226041 MANOR AT BLUE WATER BAY, THE251101 PARTHENON HEALTHCARE OF CRESTVIEW229237 PARTHENON HEALTHCARE OF FORT WALTON252379 SHOAL CREEK REHABILITATION CENTER213926 SILVERCREST MANOR316075 WESTWOOD HEALTH CARE CENTER324361 CHAUTAUQUA REHABILITATION AND NURSING CENTER211621 DELTA HEALTH CARE CENTER229288 GAINESVILLE HEALTH CARE CENTER252361 NORTH FLORIDA REHABILITATION AND SPECIALTY CARE999868 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC.257265 PALM GARDEN OF GAINESVILLE227765 PARK MEADOWS HEALTH AND REHABILITATION CENTER317578 PARKLANDS REHABILITATION AND NURSING CENTER324388 SIGNATURE HEALTHCARE OF GAINESVILLE255572 WOODLANDS CARE CENTER OF ALACHUA COUNTY227871 AYERS HEALTH AND REHABILITATION CENTER204625 TRI COUNTY NURSING HOME263516 MACCLENNY NURSING AND REHAB CENTER211052 W FRANK WELLS NURSING HOME319538 CONSULATE HEALTH CARE OF ORANGE PARK223883 DOCTORS LAKE OF ORANGE PARK252387 GOVERNORS CREEK HEALTH AND REHABILITATION325261 HEARTLAND HEALTH CARE CENTER ORANGE PARK213161 LIFE CARE CENTER AT WELLS CROSSING284289 LIFE CARE CENTER OF ORANGE PARK999987 PAVILION FOR HEALTH CARE, THE324434 SIGNATURE HEALTHCARE OF ORANGE PARK284785 TERRACE AT FLEMING ISLAND, THE200735 ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATIO319376 ATRIUM HEALTHCARE CENTER200913 AVANTE VILLA AT JACKSONVILLE BEACH INC.252051 BEAUCLERC MANOR226068 CATHEDRAL GERONTOLOGY CENTER, INC.262714 CEDAR HILLS HEALTHCARE CENTER319503 CONSULATE HEALTH CARE OF JACKSONVILLE307998 CYPRESS VILLAGE254878 EDGEWOOD NURSING CENTER204536 FANNIE E TAYLOR HOME FOR THE AGED INC227838 FIRST COAST HEALTH & REHABILITATION CENTER999984 FLEET LANDING252417 HARTS HARBOR HEALTH CARE CENTER325236 HEARTLAND HEALTH CARE CENTER JACKSONVILLE325287 HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVI263494 JACKSONVILLE NURSING AND REHAB CENTER256757 LAKESIDE NURSING AND REHABILITATION CENTER268003 LANIER MANOR283193 LIFE CARE CENTER OF JACKSONVILLE257273 PALM GARDEN OF JACKSONVILLE228401 PARK RIDGE NURSING CENTER269727 REGENTS PARK OF JACKSONVILLE200859 RIVER GARDEN HEBREW HOME FOR THE AGED260673 RIVERWOOD CENTER324612 RIVERWOOD NURSING CENTER312371 SOUTHLAKE NURSING & REHABILITATION CENTER266281 SOUTHPOINT TERRACE205150 ST CATHERINE LABOURE MANOR, INC.

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 26 26.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 38 15.00 44,250 82,600 5,494,434 15.00% 824,165 $7,500 1.0000 885,000 6,379,434 27 13.00 44,625 83,300 5,352,099 15.00% 802,815 $7,500 1.0000 892,500 6,244,599 15 13.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 36 7.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 16 13.00 67,500 126,000 8,095,613 15.00% 1,214,342 $7,500 1.0000 1,350,000 9,445,613 39 25.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 49 32.50 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 9 9.00 22,500 42,000 2,698,538 15.00% 404,781 $7,500 1.0000 450,000 3,148,538 21 21.00 22,500 42,000 2,698,538 15.00% 404,781 $7,500 1.0000 450,000 3,148,538 24 22.00 67,500 126,000 7,524,158 15.00% 1,128,624 $7,500 1.0000 1,350,000 8,874,158 30 20.00 36,375 67,900 4,362,636 15.00% 654,395 $7,500 1.0000 727,500 5,090,136 21 18.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 26 25.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 25.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 46,266 84,000 5,614,194 15.00% 842,129 $7,500 1.0000 900,000 6,514,194 22 12.00 57,750 107,800 7,007,732 15.00% 1,051,160 $7,500 1.0000 1,155,000 8,162,732 28 23.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 29 29.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 29 25.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 7 7.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 28 20.00 30,375 56,700 3,685,885 15.00% 552,883 $7,500 1.0000 607,500 4,293,385 17 14.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 16.00 25,500 47,600 3,022,362 15.00% 453,354 $7,500 1.0000 510,000 3,532,362 39 27.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 20 9.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 22 22.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 26 23.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 17.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 12 11.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 13 13.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 39,375 73,500 4,666,883 15.00% 700,032 $7,500 1.0000 787,500 5,454,383 29 27.00 40,500 75,600 4,800,222 15.00% 720,033 $7,500 1.0000 810,000 5,610,222 4 4.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 39 5.00 31,500 58,800 3,733,506 15.00% 560,026 $7,500 1.0000 630,000 4,363,506 13 12.00 61,875 115,500 7,333,673 15.00% 1,100,051 $7,500 1.0000 1,237,500 8,571,173 35 28.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 24 24.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 39 29.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 37 28.00 43,500 81,200 5,155,794 15.00% 773,369 $7,500 1.0000 870,000 6,025,794 13 12.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 18 10.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 21 21.00

9,000 16,800 1,066,716 15.00% 160,007 $7,500 1.0000 180,000 1,246,716 37 - 37,500 70,000 4,444,650 15.00% 666,698 $7,500 1.0000 750,000 5,194,650 26 15.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 32 31.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 10.00 43,875 81,900 5,200,241 15.00% 780,036 $7,500 1.0000 877,500 6,077,741 28 20.00 61,125 114,100 7,244,780 15.00% 1,086,717 $7,500 1.0000 1,222,500 8,467,280 19 17.00 45,750 85,400 5,422,473 15.00% 813,371 $7,500 1.0000 915,000 6,337,473 12 7.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 21.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 5 3.00 45,521 84,000 5,395,331 15.00% 809,300 $7,500 1.0000 900,000 6,295,331 19 18.00 39,000 72,800 4,622,436 15.00% 693,365 $7,500 1.0000 780,000 5,402,436 30 26.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 23 22.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 39 9.00 90,000 168,000 10,667,160 15.00% 1,600,074 $7,500 1.0000 1,800,000 12,467,160 27 19.00 44,625 83,300 5,289,134 15.00% 793,370 $7,500 1.0000 892,500 6,181,634 39 32.50 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 27 21.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 5 5.00 90,000 168,000 10,667,160 15.00% 1,600,074 $7,500 1.0000 1,800,000 12,467,160 30 16.00

Page 218: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name265721 SUMMER BROOK HEALTH CARE CENTER207446 TAYLOR CARE CENTER218171 WEST JACKSONVILLE HEALTH AND REHABILITATION CENTE214060 LIFE CARE CENTER OF HILLIARD225274 QUALITY HEALTH OF FERNANDINA BEACH999869 LIFE CARE ST. JOHNS, INC.263559 MOULTRIE CREEK NURSING AND REHAB CENTER207799 PONCE DE LEON CARE CENTER202606 SAMANTHA R WILSON SENIOR CITIZENS HOME316601 SAN MARCO TERRACE REHABILITATION AND CARE217735 ST AUGUSTINE HEALTH AND REHABILITATION CENTER999981 VICARS LANDING NURSING HOME212083 WESTMINSTER WOODS ON JULINGTON CREEK207527 AUBURNDALE OAKS HEALTHCARE CENTER212997 BARTOW CENTER251399 BRANDYWYNE HEALTH CARE CENTER319678 CONSULATE HEALTH CARE OF LAKE PARKER319953 CONSULATE HEALTH CARE OF LAKELAND319724 CONSULATE HEALTH CARE OF WINTER HAVEN269409 CROSSROADS, THE319341 DOVE HEALTHCARE AT LAKE WALES212971 FLORIDA PRESBYTERIAN HOMES INC212881 GROVES CENTER224341 HAINES CITY HEALTH CARE CENTER260576 HIGHLANDS LAKE CENTER212865 LAKELAND HILLS CENTER219380 LIFE CARE CENTER OF WINTER HAVEN203599 MANOR AT CARPENTERS, THE259926 OAKBRIDGE HEALTHCARE CENTER257320 PALM GARDEN OF WINTER HAVEN282626 PALM TERRACE OF LAKELAND202533 ROHR HOME, THE264571 SPRING LAKE REHABILITATION CENTER265560 VALENCIA HILLS HEALTH AND REHABILITATION CENTER252328 WEDGEWOOD HEALTHCARE CENTER228702 WINTER HAVEN HEALTH & REHABILITATION CENTER254291 ARCH PLAZA NURSING & REHABILITATION CENTER284823 AVENTURA PLAZA REHABILITATION & NURSING CENTER005388 BERKSHIRE MANOR208507 CLARIDGE HOUSE NURSING & REHABILITATION CENTER999864 CLASSIC RESIDENCE BY HYATT IN AVENTURA323772 CORAL GABLES NURSING AND REHABILITATION CENTER282529 CORAL REEF NURSING & REHABILITATION CENTER228788 EAST RIDGE RETIREMENT VILLAGE INC227226 FAIR HAVENS CENTER207993 FLORIDA CLUB CARE CENTER200425 FLORIDEAN NURSING HOME INC005523 FOUNTAINHEAD CARE CENTER319554 FRANCO NURSING & REHABILITATION CENTER214027 GRAMERCY PARK NURSING CENTER324027 HAMPTON COURT NURSING AND REHABILITATION CENTER269107 HARMONY HEALTH CENTER325244 HEARTLAND HEALTH CARE CENTER KENDALL325252 HEARTLAND HEALTH CARE CENTER MIAMI LAKES308242 HEBREW HOME OF SOUTH BEACH265730 HIALEAH CONVALESCENT HOME250988 HIALEAH SHORES NURSING AND REHAB CENTER212121 HOMESTEAD MANOR204161 JACKSON MEMORIAL LONG TERM CARE CENTER203670 JACKSON MEMORIAL PERDUE MEDICAL CENTER253723 JACKSON PLAZA NURSING & REHABILITATION CENTER210617 MIAMI GARDENS CARE CENTRE

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 39 32.50 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 26 18.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 17.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 15.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 25.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 23 20.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 20.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 39 18.00 25,500 47,600 3,022,362 15.00% 453,354 $7,500 1.0000 510,000 3,532,362 26 25.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 33 32.50

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 39 12.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 37 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 26.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 19 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 25 21.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 11 11.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 39 32.00 37,500 70,000 4,762,125 15.00% 714,319 $7,500 1.0000 750,000 5,512,125 26 5.00 18,000 33,600 2,285,820 15.00% 342,873 $7,500 1.0000 360,000 2,645,820 12 10.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 36 9.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 26.00 67,125 125,300 8,524,204 15.00% 1,278,631 $7,500 1.0000 1,342,500 9,866,704 21 19.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 37 32.50 66,375 123,900 8,428,961 15.00% 1,264,344 $7,500 1.0000 1,327,500 9,756,461 10 9.00 27,000 50,400 3,428,730 15.00% 514,310 $7,500 1.0000 540,000 3,968,730 20 5.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 8.00 53,203 84,000 6,756,249 15.00% 1,013,437 $7,500 1.0000 900,000 7,656,249 22 14.00 85,000 129,500 10,794,150 15.00% 1,619,123 $7,500 1.0000 1,387,500 12,181,650 34 26.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 39 11.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 18.00

112,500 210,000 14,286,375 15.00% 2,142,956 $7,500 1.0000 2,250,000 16,536,375 27 26.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 10 10.00 54,000 100,800 6,857,460 15.00% 1,028,619 $7,500 1.0000 1,080,000 7,937,460 27 21.00 36,750 68,600 4,666,883 15.00% 700,032 $7,500 1.0000 735,000 5,401,883 31 5.00 28,125 52,500 3,571,594 15.00% 535,739 $7,500 1.0000 562,500 4,134,094 31 27.00 91,875 171,500 11,667,206 15.00% 1,750,081 $7,500 1.0000 1,837,500 13,504,706 26 26.00 90,000 168,000 11,429,100 15.00% 1,714,365 $7,500 1.0000 1,800,000 13,229,100 24 19.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 32,625 60,900 4,143,049 15.00% 621,457 $7,500 1.0000 652,500 4,795,549 21 21.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 14 13.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 47 32.50

100,875 188,300 12,810,116 15.00% 1,921,517 $7,500 1.0000 2,017,500 14,827,616 39 32.50 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 25 23.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 39 10.00 54,750 102,200 6,952,703 15.00% 1,042,905 $7,500 1.0000 1,095,000 8,047,703 26 26.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 13 12.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 24 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 18.00 76,125 142,100 9,667,114 15.00% 1,450,067 $7,500 1.0000 1,522,500 11,189,614 39 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 20 20.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 19 16.00 39,000 72,800 4,952,610 15.00% 742,892 $7,500 1.0000 780,000 5,732,610 39 23.00

103,500 193,200 13,143,465 15.00% 1,971,520 $7,500 1.0000 2,070,000 15,213,465 25 21.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 24 24.00 24,000 44,800 3,047,760 15.00% 457,164 $7,500 1.0000 480,000 3,527,760 26 23.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 36 19.00 61,125 114,100 7,762,264 15.00% 1,164,340 $7,500 1.0000 1,222,500 8,984,764 38 30.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 9 9.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 17 17.00

Page 219: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name200506 MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC.214035 MIAMI SHORES NURSING AND REHAB CENTER228001 NORTH BEACH REHABILITATION CENTER267902 NURSING CENTER AT MERCY, THE212733 OCEANSIDE EXTENDED CARE CENTER203327 PALACE AT KENDALL NURSING AND REHABILITATION CENT257494 PALM GARDEN OF AVENTURA324167 PALMETTO REHABILITATION AND HEALTH CENTER212806 PALMETTO SUB ACUTE CARE CENTER, INC225754 PINECREST CONVALESCENT CENTER200620 PINES NURSING HOME308251 PONCE PLAZA NURSING & REHABILITATION CENTER223239 REGENTS PARK AT AVENTURA207276 RIVERSIDE CARE CENTER324400 SIGNATURE HEALTHCARE CENTER OF WATERFORD324418 SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS260771 SINAI PLAZA NURSING & REHAB CENTER311308 SOUTH POINTE PLAZA REHABILITATION AND NURSING CEN209473 ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC268062 SUSANNA WESLEY HEALTH CENTER226602 TREASURE ISLE CARE CENTER227544 UNITY HEALTH AND REHABILITATION CENTER225177 VICTORIA NURSING & REHABILITATION CENTER, INC.203165 VILLA MARIA NURSING CENTER

0 VILLA MARIA WEST SKILLED NURSING FACILITY310409 WATERCREST CARE CENTER282359 WEST GABLES HEALTH CARE CENTER225291 ARISTOCRAT, THE999932 BENTLEY CARE CENTER999931 CHATEAU AT MOORINGS PARK, THE268585 HARBORCHASE OF NAPLES252280 HERITAGE HEALTHCARE & REHABILITATION CENTER226378 IMPERIAL HEALTH CARE CENTER256846 LAKESIDE PAVILLION CARE AND REHABILITATION CENTER325422 MANORCARE AT LELY PALMS325449 MANORCARE NURSING AND REHABILITATION CENTER999930 PREMIER PLACE AT THE GLENVIEW253456 HAWTHORNE HEALTH AND REHAB OF OCALA266108 LIFE CARE CENTER OF OCALA214043 MARION HOUSE HEALTH CARE CENTER227773 NEW HORIZON REHABILITATION CENTER251721 OAKHURST CARE AND REHABILITATION CENTER217395 OCALA HEALTH AND REHABILITATION CENTER257290 PALM GARDEN OF OCALA203335 TIMBERRIDGE NURSING & REHABILITATION CENTER203122 AVANTE AT LEESBURG, INC.252042 AVANTE AT MT. DORA, INC.260444 BAYVIEW CENTER210684 EDGEWATER AT WATERMAN VILLAGE227561 LADY LAKE SPECIALTY CARE CENTER213870 LAKE EUSTIS CARE CENTER228966 LAKE HARRIS HEALTH CENTER259225 LAKEVIEW TERRACE SKILLED NURSING FACILITY252956 LEESBURG HEALTH AND REHAB, LLC210439 NORTH CAMPUS REHABILITATION AND NURSING CENTER260452 RULEME CENTER221465 WESTMINSTER CARE OF CLERMONT320439 ADVENTIST CARE CENTERS-COURTLAND, INC223808 AVANTE AT ORLANDO, INC.252557 COLONIAL LAKES HEALTH CARE205796 COMMONS AT ORLANDO LUTHERAN TOWERS264512 CONWAY LAKES HEALTH & REHABILITATION CENTER

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

173,250 323,400 22,001,018 15.00% 3,300,153 $7,500 1.0000 3,465,000 25,466,018 39 19.00 37,125 69,300 4,714,504 15.00% 707,176 $7,500 1.0000 742,500 5,457,004 30 29.00 37,125 69,300 4,714,504 15.00% 707,176 $7,500 1.0000 742,500 5,457,004 27 12.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 15 15.00 73,500 137,200 9,333,765 15.00% 1,400,065 $7,500 1.0000 1,470,000 10,803,765 33 31.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 18 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 21 20.00 33,750 63,000 4,285,913 15.00% 642,887 $7,500 1.0000 675,000 4,960,913 22 17.00 35,625 66,500 4,524,019 15.00% 678,603 $7,500 1.0000 712,500 5,236,519 12 12.00 37,500 70,000 4,762,125 15.00% 714,319 $7,500 1.0000 750,000 5,512,125 42 32.50 17,250 32,200 2,190,578 15.00% 328,587 $7,500 1.0000 345,000 2,535,578 31 31.00 55,125 102,900 7,000,324 15.00% 1,050,049 $7,500 1.0000 1,102,500 8,102,824 9 8.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 21 11.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 34 23.00 80,250 149,800 10,190,948 15.00% 1,528,642 $7,500 1.0000 1,605,000 11,795,948 22 20.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 22 22.00 56,250 105,000 7,143,188 15.00% 1,071,478 $7,500 1.0000 1,125,000 8,268,188 19 10.00 86,250 161,000 10,952,888 15.00% 1,642,933 $7,500 1.0000 1,725,000 12,677,888 26 24.00 90,000 168,000 11,429,100 15.00% 1,714,365 $7,500 1.0000 1,800,000 13,229,100 22 16.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 24 23.00 66,000 123,200 8,381,340 15.00% 1,257,201 $7,500 1.0000 1,320,000 9,701,340 26 24.00

110,250 205,800 14,000,648 15.00% 2,100,097 $7,500 1.0000 2,205,000 16,205,648 25 22.00 94,875 177,100 12,048,176 15.00% 1,807,226 $7,500 1.0000 1,897,500 13,945,676 9 8.00 79,500 148,400 10,095,705 15.00% 1,514,356 $7,500 1.0000 1,590,000 11,685,705 39 12.00

#VALUE! #VALUE! #VALUE! 15.00% #VALUE! $7,500 1.0000 #VALUE! #VALUE! 32.50 56,250 105,000 7,143,188 15.00% 1,071,478 $7,500 1.0000 1,125,000 8,268,188 25 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 21 17.00 22,500 42,000 2,762,033 15.00% 414,305 $7,500 1.0000 450,000 3,212,033 16 13.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 - - - 15.00% - $7,500 1.0000 - - 2,009 32.50

15,000 28,000 1,841,355 15.00% 276,203 $7,500 1.0000 300,000 2,141,355 12 9.00 36,375 67,900 4,465,286 15.00% 669,793 $7,500 1.0000 727,500 5,192,786 28 25.00 42,375 79,100 5,201,828 15.00% 780,274 $7,500 1.0000 847,500 6,049,328 18 9.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 27 22.00 43,875 81,900 5,385,963 15.00% 807,895 $7,500 1.0000 877,500 6,263,463 25 23.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 26 16.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 21 18.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 11 11.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 18 18.00 59,625 111,300 7,235,255 15.00% 1,085,288 $7,500 1.0000 1,192,500 8,427,755 27 16.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 25 16.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 32 29.00 78,749 126,000 9,555,876 15.00% 1,433,381 $7,500 1.0000 1,350,000 10,905,876 22 15.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 18 15.00 43,500 81,200 5,524,065 15.00% 828,610 $7,500 1.0000 870,000 6,394,065 44 32.50 43,500 81,200 5,524,065 15.00% 828,610 $7,500 1.0000 870,000 6,394,065 46 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 26.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 12.00 54,375 101,500 6,905,081 15.00% 1,035,762 $7,500 1.0000 1,087,500 7,992,581 10 9.00 33,750 63,000 4,285,913 15.00% 642,887 $7,500 1.0000 675,000 4,960,913 26 26.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 19 12.00

7,500 14,000 952,425 15.00% 142,864 $7,500 1.0000 150,000 1,102,425 28 28.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 29 25.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 21 19.00 51,750 96,600 6,571,733 15.00% 985,760 $7,500 1.0000 1,035,000 7,606,733 28 16.00 68,250 127,400 8,667,068 15.00% 1,300,060 $7,500 1.0000 1,365,000 10,032,068 41 23.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 9 7.00 44,250 82,600 5,619,308 15.00% 842,896 $7,500 1.0000 885,000 6,504,308 39 32.50 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 25 19.00 47,250 88,200 6,000,278 15.00% 900,042 $7,500 1.0000 945,000 6,945,278 29 3.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 18.00

Page 220: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name324175 COURTYARDS OF ORLANDO REHABILITATION AND HEALTH 320421 EAST ORLANDO HEALTH & REHAB CENTER, INC201651 GUARDIAN CARE NURSING & REHABILITATION CENTER228877 HEALTH CENTER OF WINDERMERE, THE204811 HEALTH CENTRAL PARK263605 HUNTERS CREEK NURSING AND REHAB CENTER318761 LAKE BENNETT HEALTH AND REHABILITATION CENTER213403 LIFE CARE CENTER OF ORLANDO325279 MANOR CARE NURSING & REHABILITATION CENTER201588 MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC.999941 MAYFLOWER HEALTHCARE CENTER263541 METRO WEST NURSING AND REHAB CENTER324159 OCOEE HEALTH CARE CENTER257303 PALM GARDEN OF ORLANDO259934 PARKS HEALTHCARE AND REHABILITATION CENTER225410 QUALITY HEALTH OF ORANGE COUNTY269719 REGENTS PARK OF WINTER PARK005380 REHABILITATION CENTER OF WINTER PARK, THE252450 RIO PINAR HEALTH CARE252468 ROSEWOOD HEALTH AND REHABILITATION CENTER312550 SAVANNAH COVE320412 SUNBELT HEALTH & REHAB CENTER-APOPKA, INC261611 TERRA VISTA REHAB AND HEALTH CENTER221589 WESTMINSTER CARE OF DELANEY PARK223654 WESTMINSTER CARE OF ORLANDO208540 WESTMINSTER TOWERS324515 WINTER PARK CARE & REHABILITATION CENTER209848 WINTER PARK TOWERS259870 AVANTE AT ST CLOUD, INC.319511 CONSULATE HEALTH CARE OF KISSIMMEE205303 GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE317560 KEYSTONE REHABILITATION AND HEALTH CENTER005549 OAKS OF KISSIMMEE217859 OSCEOLA HEALTH CARE CENTER253421 PALMS AT PARK PLACE, THE252441 PLANTATION BAY REHABILITATION CENTER253146 SOUTHERN OAKS HEALTH CARE CENTER319546 CONSULATE HEALTH CARE OF WEST ALTAMONTE320463 FLNC, INC263931 HEALTHCARE & REHAB OF SANFORD260657 ISLAND LAKE CENTER252310 LAKE MARY HEALTH AND REHABILITATION CENTER210137 LIFE CARE CENTER OF ALTAMONTE SPRINGS005379 LONGWOOD HEALTH CARE CENTER313718 LUTHERAN HAVEN NURSING HOME263591 TUSKAWILLA NURSING AND REHAB CENTER999936 VILLAGE ON THE GREEN324451 ANCHOR CARE AND REHABILITATION CENTER263389 ATLANTIC SHORES NURSING AND REHAB CENTER252018 AVANTE AT MELBOURNE, INC.005519 CARNEGIE GARDENS NURSING CENTER319520 CONSULATE HEALTH CARE OF MELBOURNE209325 COURTENAY SPRINGS VILLAGE226700 HEALTH CENTER OF MERRITT ISLAND, THE211281 HUNTINGTON PLACE CARE AND REHABILITATION CENTER260665 INDIAN RIVER CENTER252352 ISLAND HEALTH AND REHABILITATION CENTER228338 LIFE CARE CENTER OF MELBOURNE268186 LIFE CARE CENTER OF PALM BAY264547 MELBOURNE TERRACE REHABILITATION CENTER252395 PALMS REHABILITATION AND HEALTHCARE CENTER, THE227587 ROCKLEDGE HEALTH AND REHABILITATION CENTER

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 25.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 11.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 39 22.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 12 12.00 85,500 159,600 10,857,645 15.00% 1,628,647 $7,500 1.0000 1,710,000 12,567,645 32 11.00 43,500 81,200 5,524,065 15.00% 828,610 $7,500 1.0000 870,000 6,394,065 11 10.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 12 12.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 12 8.00 51,750 96,600 6,571,733 15.00% 985,760 $7,500 1.0000 1,035,000 7,606,733 32 32.00 15,000 28,000 1,904,850 15.00% 285,728 $7,500 1.0000 300,000 2,204,850 39 4.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 15 15.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 19 14.00 53,203 84,000 6,756,249 15.00% 1,013,437 $7,500 1.0000 900,000 7,656,249 22 16.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 25 11.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 24 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 21 21.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 26 26.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 22 22.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 25 23.00 14,625 27,300 1,857,229 15.00% 278,584 $7,500 1.0000 292,500 2,149,729 14 12.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 15.00 43,125 80,500 5,476,444 15.00% 821,467 $7,500 1.0000 862,500 6,338,944 37 31.00 22,500 42,000 2,857,275 15.00% 428,591 $7,500 1.0000 450,000 3,307,275 17 14.00

157,500 294,000 20,000,925 15.00% 3,000,139 $7,500 1.0000 3,150,000 23,150,925 38 28.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 25 20.00 38,625 72,100 4,904,989 15.00% 735,748 $7,500 1.0000 772,500 5,677,489 30 28.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 38 26.00 49,125 91,700 6,238,384 15.00% 935,758 $7,500 1.0000 982,500 7,220,884 41 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 10 10.00 63,750 119,000 8,095,613 15.00% 1,214,342 $7,500 1.0000 1,275,000 9,370,613 30 17.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 3 3.00 22,125 41,300 2,809,654 15.00% 421,448 $7,500 1.0000 442,500 3,252,154 24 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 18 16.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 16.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 14 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 23 21.00 43,500 81,200 5,524,065 15.00% 828,610 $7,500 1.0000 870,000 6,394,065 15 15.00 75,750 141,400 9,619,493 15.00% 1,442,924 $7,500 1.0000 1,515,000 11,134,493 38 20.00 42,750 79,800 5,428,823 15.00% 814,323 $7,500 1.0000 855,000 6,283,823 37 32.50 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 20 19.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 9 9.00 90,000 168,000 11,429,100 15.00% 1,714,365 $7,500 1.0000 1,800,000 13,229,100 33 17.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 26 26.00 15,750 29,400 2,000,093 15.00% 300,014 $7,500 1.0000 315,000 2,315,093 4 4.00 36,750 68,600 4,666,883 15.00% 700,032 $7,500 1.0000 735,000 5,401,883 15 14.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 25 24.00 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 14 10.00 41,250 77,000 5,412,949 15.00% 811,942 $7,500 1.0000 825,000 6,237,949 41 32.50 51,750 96,600 6,790,790 15.00% 1,018,619 $7,500 1.0000 1,035,000 7,825,790 26 26.00 62,625 116,900 8,217,840 15.00% 1,232,676 $7,500 1.0000 1,252,500 9,470,340 15 13.00 36,000 67,200 4,724,028 15.00% 708,604 $7,500 1.0000 720,000 5,444,028 25 22.00 67,500 126,000 8,857,553 15.00% 1,328,633 $7,500 1.0000 1,350,000 10,207,553 19 16.00 37,500 70,000 4,920,863 15.00% 738,129 $7,500 1.0000 750,000 5,670,863 37 32.50 67,125 125,300 8,808,344 15.00% 1,321,252 $7,500 1.0000 1,342,500 10,150,844 20 19.00 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 26 26.00 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 19 11.00 52,875 98,700 6,938,416 15.00% 1,040,762 $7,500 1.0000 1,057,500 7,995,916 6 3.00 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 20 19.00 45,000 84,000 5,905,035 15.00% 885,755 $7,500 1.0000 900,000 6,805,035 11 11.00 40,125 74,900 5,265,323 15.00% 789,798 $7,500 1.0000 802,500 6,067,823 27 23.00

Page 221: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name263583 ROYAL OAKS NURSING AND REHAB CENTER263974 TITUSVILLE REHABILITATION & NURSING CENTER252522 VISTA MANOR217727 WEST MELBOURNE HEALTH & REHABILITATION CENTER253472 WUESTHOFF PROGRESSIVE CARE CENTER005374 FLAGLER PINES252409 GRAND OAKS HEALTH AND REHABILITATION CENTER212989 BAY CENTER264491 CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOM318779 COMMUNITY HEALTH AND REHABILITATION CENTER252191 EMERALD SHORES HEALTH AND REHABILITATION005384 GLEN COVE NURSING PAVILION203980 LISENBY ON LAKE CAROLINE005385 PANAMA CITY NURSING CENTER252247 SEA BREEZE HEALTH CARE323799 ST ANDREWS BAY SKILLED NURSING AND REHABILITATION 208809 BAPTIST MANOR213853 BAYSIDE MANOR220604 CENTURY CARE CENTER319686 CONSULATE HEALTH CARE OF PENSACOLA258831 HAVEN OF OUR LADY OF PEACE229571 HEALTH CENTER OF PENSACOLA, THE315664 LIFE CARE CENTER OF PENSACOLA224243 PENSACOLA HEALTH CARE FACILITY211842 ROSEWOOD MANOR324566 SOUTHERN OAKS REHABILITATION AND NURSING CENTER213918 SPECIALTY CENTER OF PENSACOLA252123 UNIVERSITY HILLS HEALTH AND REHABILITATION210374 WILLOWBROOKE COURT AT AZALEA TRACE213816 BAY BREEZE NURSING AND RETIREMENT CENTER220621 SANDY RIDGE CARE CENTER220612 SANTA ROSA HEALTH & REHABILITATION CENTER259331 UNIHEALTH POST-ACUTE CARE - SANTA ROSA201545 EDGEWATER MANOR226033 MARTIN NURSING AND RESTORATIVE CARE CENTER263621 PALM CITY NURSING & REHAB CENTER228885 PARKWAY HEALTH & REHABILITATION CENTER214141 SALERNO BAY MANOR225991 STUART NURSING & RESTORATIVE CARE CENTER213152 WATERS EDGE EXTENDED CARE268755 ABBIEJEAN RUSSELL CARE CENTER LLC210781 BRIGHTON GARDENS OF PORT ST LUCIE261637 EMERALD HEALTH CARE CENTER252239 FORT PIERCE HEALTH CARE211516 LAUREL POINTE HEALTH AND REHABILITATION217824 LIFE CARE CENTER OF PORT SAINT LUCIE257249 PALM GARDEN OF PORT SAINT LUCIE226009 PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTE263532 TIFFANY HALL NURSING AND REHAB CENTER226327 CHARLOTTE HARBOR HEALTHCARE320129 CONSULATE HEALTH CARE OF PORT CHARLOTTE269492 DOUGLAS JACOBSON STATE VETERANS NURSING HOME252204 ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER319333 HARBOUR HEALTH CENTER311685 LIFE CARE CENTER OF PUNTA GORDA319325 PORT CHARLOTTE REHABILITATION CENTER324477 SIGNATURE HEALTHCARE OF PORT CHARLOTTE002400 VILLAGE PLACE HEALTH AND REHABILITATION CENTER310581 ATLANTIC HEALTHCARE CENTER320145 CONSULATE HEALTH CARE OF VERO BEACH001416 FLORIDA BAPTIST RETIREMENT CENTER257311 PALM GARDEN OF VERO BEACH

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 16 16.00 58,875 109,900 7,476,536 15.00% 1,121,480 $7,500 1.0000 1,177,500 8,654,036 38 29.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 24 24.00 67,500 126,000 8,857,553 15.00% 1,328,633 $7,500 1.0000 1,350,000 10,207,553 30 27.00 42,750 79,800 5,609,783 15.00% 841,467 $7,500 1.0000 855,000 6,464,783 14 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 24 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 12 11.00 60,000 112,000 6,688,140 15.00% 1,003,221 $7,500 1.0000 1,200,000 7,888,140 37 32.50 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 6 6.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 12 11.00 28,875 53,900 3,218,667 15.00% 482,800 $7,500 1.0000 577,500 3,796,167 9 9.00 46,000 80,500 5,127,574 15.00% 769,136 $7,500 1.0000 862,500 5,990,074 17 17.00

8,250 15,400 919,619 15.00% 137,943 $7,500 1.0000 165,000 1,084,619 24 18.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 25 25.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 30 29.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 23 13.00 63,750 119,000 7,645,856 15.00% 1,146,878 $7,500 1.0000 1,275,000 8,920,856 24 11.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 30 30.00 33,000 61,600 3,957,855 15.00% 593,678 $7,500 1.0000 660,000 4,617,855 15 13.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 12 12.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 8 7.00 67,500 126,000 8,095,613 15.00% 1,214,342 $7,500 1.0000 1,350,000 9,445,613 22 19.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 3 2.00 44,250 82,600 5,307,124 15.00% 796,069 $7,500 1.0000 885,000 6,192,124 34 27.00 58,125 108,500 6,971,222 15.00% 1,045,683 $7,500 1.0000 1,162,500 8,133,722 39 32.50 78,750 147,000 9,444,881 15.00% 1,416,732 $7,500 1.0000 1,575,000 11,019,881 31 31.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 18 18.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 27 25.00 39,750 74,200 4,767,416 15.00% 715,112 $7,500 1.0000 795,000 5,562,416 28 26.00 54,100 84,000 6,488,484 15.00% 973,273 $7,500 1.0000 900,000 7,388,484 25 25.00 22,500 42,000 2,698,538 15.00% 404,781 $7,500 1.0000 450,000 3,148,538 24 23.00 41,250 77,000 4,947,319 15.00% 742,098 $7,500 1.0000 825,000 5,772,319 38 27.00 45,000 84,000 5,397,075 15.00% 809,561 $7,500 1.0000 900,000 6,297,075 6 6.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 39 23.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 12 12.00 43,500 81,200 5,278,551 15.00% 791,783 $7,500 1.0000 870,000 6,148,551 16 16.00 66,375 123,900 8,054,341 15.00% 1,208,151 $7,500 1.0000 1,327,500 9,381,841 20 16.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 24 24.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 36 32.50 13,500 25,200 1,638,171 15.00% 245,726 $7,500 1.0000 270,000 1,908,171 16 1.00 29,625 55,300 3,594,875 15.00% 539,231 $7,500 1.0000 592,500 4,187,375 33 28.00 11,250 21,000 1,365,143 15.00% 204,771 $7,500 1.0000 225,000 1,590,143 16 11.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 22 14.00 64,125 119,700 7,781,312 15.00% 1,167,197 $7,500 1.0000 1,282,500 9,063,812 25 24.00 40,125 74,900 4,869,008 15.00% 730,351 $7,500 1.0000 802,500 5,671,508 29 28.00 46,125 86,100 5,597,084 15.00% 839,563 $7,500 1.0000 922,500 6,519,584 10 10.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 21 21.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 27 27.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 16 16.00 67,500 126,000 8,286,098 15.00% 1,242,915 $7,500 1.0000 1,350,000 9,636,098 15 15.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 11 11.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 5 5.00 45,000 84,000 5,587,560 15.00% 838,134 $7,500 1.0000 900,000 6,487,560 26 25.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 23 20.00 67,500 126,000 8,286,098 15.00% 1,242,915 $7,500 1.0000 1,350,000 9,636,098 4 4.00 45,000 84,000 5,524,065 15.00% 828,610 $7,500 1.0000 900,000 6,424,065 24 17.00 61,500 114,800 7,549,556 15.00% 1,132,433 $7,500 1.0000 1,230,000 8,779,556 29 24.00 39,000 72,800 4,787,523 15.00% 718,128 $7,500 1.0000 780,000 5,567,523 22 18.00 41,250 77,000 5,412,949 15.00% 811,942 $7,500 1.0000 825,000 6,237,949 28 27.00 59,625 111,300 7,824,171 15.00% 1,173,626 $7,500 1.0000 1,192,500 9,016,671 25 19.00

9,000 16,800 1,181,007 15.00% 177,151 $7,500 1.0000 180,000 1,361,007 54 32.50 71,816 126,000 9,423,911 15.00% 1,413,587 $7,500 1.0000 1,350,000 10,773,911 22 17.00

Page 222: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name999919 ROYAL PALM HEALTHCARE & REHABILITATION CENTER001416 WILLOWBROOKE COURT AT INDIAN RIVER ESTATES005386 RIVERCHASE CARE CENTER005381 BRYNWOOD CENTER214001 JEFFERSON HEALTH AND REHABILITATION CENTER252093 CAPITAL HEALTHCARE CENTER264563 CENTRE POINTE HEALTH AND REHAB CENTER319716 CONSULATE HEALTH CARE OF TALLAHASSEE252298 HERITAGE HEALTHCARE CENTER202941 MIRACLE HILL NURSING & CONVALESCENT CENTER, INC.200409 WESTMINSTER OAKS253707 EDEN SPRINGS NURSING AND REHAB CENTER228958 BROOKSVILLE HEALTHCARE CENTER263893 EVERGREEN WOODS325295 HEARTLAND OF BROOKSVILLE252174 HERON POINTE HEALTH AND REHABILITATION252492 SPRING HILL HEALTH AND REHABILITATION CENTER263575 BAYSHORE POINTE NURSING AND REHAB CENTER252077 BRANDON HEALTH AND REHABILITATION CENTER284793 BRIGHTON GARDENS OF TAMPA999949 CANTERBURY TOWERS INC263877 CARROLLWOOD CARE CENTER259900 CENTRAL PARK HEALTHCARE & REHABILITATION CENTER281913 COMMUNITY CONVALESCENT CENTER319660 CONSULATE HEALTH CARE OF BRANDON324116 EXCEL REHABILITATION AND HEALTH CENTER260690 FAIRWAY OAKS CENTER252221 FLETCHER HEALTH AND REHABILITATION CENTER252506 HABANA HEALTH CARE CENTER261670 HAWTHORNE HEALTH AND REHAB OF BRANDON213039 HEALTH CARE CENTER OF TAMPA226343 HEALTH CENTER OF PLANT CITY, THE201154 HOME ASSOCIATION, INC., THE210285 JOHN KNOX VILLAGE MED CENTER218057 LAKESHORE VILLAS HEALTH CARE CENTER325678 MANORCARE HEALTH SERVICES CARROLLWOOD259462 NURSING CENTER AT UNIVERSITY VILLAGE, THE257516 PALM GARDEN OF SUN CITY257524 PALM GARDEN OF TAMPA211885 PLAZA WEST263940 REHABILITATION AND HEALTHCARE CENTER OF TAMPA224910 SOUTH TAMPA HEALTH AND REHABILITATION CENTER209856 SUN TERRACE HEALTH CARE CENTER266612 WHISPERING OAKS324141 WOODBRIDGE REHABILITATION & HEALTH CENTER212164 YBOR CITY HEALTHCARE & REHABILITATION CENTER214914 BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME226076 BAYONET POINT HEALTH & REHABILITATION CENTER228567 BEAR CREEK NURSING CENTER319651 CONSULATE HEALTH CARE OF BAYONET POINT319970 CONSULATE HEALTH CARE OF NEW PORT RICHEY325708 HEARTLAND OF ZEPHYRHILLS228591 HEATHER HILL HEALTHCARE CENTER214132 HERITAGE PARK259357 LIFE CARE CENTER OF NEW PORT RICHEY324124 MADISON POINTE REHABILITATION AND HEALTH CENTER252689 ORCHARD RIDGE CARE AND REHABILITATION CENTER228575 ROYAL OAK NURSING CENTER262706 SOUTHERN PINES HEALTHCARE CENTER003521 TRINITY REGIONAL REHAB CENTER263991 WINDSOR WOODS REHABILITATION AND HEALTHCARE CEN320391 ZEPHYR HAVEN HEALTH & REHAB CENTER, INC

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 9,000 16,800 1,181,007 15.00% 177,151 $7,500 1.0000 180,000 1,361,007 54 32.50

45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 24 24.00 36,375 67,900 4,106,010 15.00% 615,902 $7,500 1.0000 727,500 4,833,510 22 22.00 22,500 42,000 2,539,800 15.00% 380,970 $7,500 1.0000 450,000 2,989,800 29 10.00 58,500 109,200 6,603,480 15.00% 990,522 $7,500 1.0000 1,170,000 7,773,480 25 19.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 22 21.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 17 13.00 67,500 126,000 7,619,400 15.00% 1,142,910 $7,500 1.0000 1,350,000 8,969,400 26 21.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 39 6.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 26 15.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 35 31.00 56,250 105,000 7,222,556 15.00% 1,083,383 $7,500 1.0000 1,125,000 8,347,556 33 24.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 25 23.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 21 20.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 25 25.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 12 12.00 43,875 81,900 5,633,594 15.00% 845,039 $7,500 1.0000 877,500 6,511,094 39 28.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 12 12.00 16,875 31,500 2,166,767 15.00% 325,015 $7,500 1.0000 337,500 2,504,267 10 10.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 22 19.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 18 18.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 33 32.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 24 10.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 14 12.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 26 22.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 11 11.00 56,250 105,000 7,222,556 15.00% 1,083,383 $7,500 1.0000 1,125,000 8,347,556 39 27.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 14 8.00 99,750 186,200 12,808,000 15.00% 1,921,200 $7,500 1.0000 1,995,000 14,803,000 34 29.00 67,500 126,000 8,667,068 15.00% 1,300,060 $7,500 1.0000 1,350,000 10,017,068 24 18.00 36,000 67,200 4,622,436 15.00% 693,365 $7,500 1.0000 720,000 5,342,436 39 32.50 61,125 114,100 7,848,511 15.00% 1,177,277 $7,500 1.0000 1,222,500 9,071,011 31 23.00 67,125 125,300 8,618,917 15.00% 1,292,838 $7,500 1.0000 1,342,500 9,961,417 23 20.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 19 15.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 20 17.00 46,831 84,000 6,013,147 15.00% 901,972 $7,500 1.0000 900,000 6,913,147 18 12.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 22 20.00 42,375 79,100 5,440,992 15.00% 816,149 $7,500 1.0000 847,500 6,288,492 15 11.00 65,250 121,800 8,378,165 15.00% 1,256,725 $7,500 1.0000 1,305,000 9,683,165 39 32.50 67,125 125,300 8,618,917 15.00% 1,292,838 $7,500 1.0000 1,342,500 9,961,417 31 30.00 40,875 76,300 5,248,391 15.00% 787,259 $7,500 1.0000 817,500 6,065,891 26 20.00 90,000 168,000 11,556,090 15.00% 1,733,414 $7,500 1.0000 1,800,000 13,356,090 27 24.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 27 26.00 30,000 56,000 3,852,030 15.00% 577,805 $7,500 1.0000 600,000 4,452,030 39 19.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 10 10.00 67,500 126,000 8,667,068 15.00% 1,300,060 $7,500 1.0000 1,350,000 10,017,068 23 19.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 28 28.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 16 11.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 25 21.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 21 21.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 30 29.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 26 25.00 42,375 79,100 5,440,992 15.00% 816,149 $7,500 1.0000 847,500 6,288,492 6 4.00 44,625 83,300 5,729,895 15.00% 859,484 $7,500 1.0000 892,500 6,622,395 28 26.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 26 12.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 28 26.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 29 27.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 2 2.00 38,625 72,100 4,959,489 15.00% 743,923 $7,500 1.0000 772,500 5,731,989 22 18.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 21 21.00

Page 223: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name320404 ZEPHYRHILLS HEALTH & REHAB CENTER, INC263958 ABBEY REHABILITATION AND NURSING CENTER324094 ADVANCED REHABILITATION AND HEALTH CENTER261254 ALHAMBRA HEALTH AND REHABILITATION CENTER309800 ALLEGRO AT COLLEGE HARBOR, THE227251 ALPINE HEALTH & REHABILITATION CENTER227251 APOLLO HEALTH & REHABILITATION CENTER263834 BAY POINTE NURSING PAVILION253448 BAY TREE CARE AND REHABILITATION CENTER324108 BAYSIDE REHABILITATION & HEALTH CENTER316652 BAYWOOD NURSING CENTER264521 BELLEAIR HEALTH CARE CENTER213004 BOCA CIEGA CENTER200107 BON SECOURS MARIA MANOR NURSING CARE CENTER315524 CARRINGTON PLACE NURSING & REHABILITATION CENTER212911 CLEARWATER CENTER200956 COMPREHENSIVE HEALTHCARE OF CLEARWATER251666 CONCORDIA MANOR319694 CONSULATE HEALTH CARE OF SAFETY HARBOR319708 CONSULATE HEALTH CARE OF ST PETERSBURG252115 COUNTRYSIDE REHAB AND HEALTHCARE CENTER001300 CROSS TERRACE REHABILITATION CENTER264351 CRYSTAL OAKS OF PINELLAS311065 EAGLE LAKE REHAB & CARE CENTER264539 EAST BAY REHABILITATION CENTER252484 EDINBOROUGH HEALTHCARE CENTER212890 EGRET COVE CENTER324248 FREEDOM SQUARE NURSING CENTER255840 GLEN OAKS HEALTH CARE CENTER262722 GOLFVIEW HEALTHCARE CENTER316644 GRACEWOOD REHABILITATION AND NURSING CARE316636 HARBOURWOOD HEALTH AND REHAB CENTER320528 HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW,263907 HIGHLAND PINES REHABILITATION CENTER281743 JACARANDA MANOR252336 LARGO REHABILITATION CENTER316628 LAURELLWOOD NURSING CENTER227650 LEXINGTON HEALTH AND REHABILITATION CENTER325686 MANOR CARE HEALTH SERVICES DUNEDIN325694 MANOR CARE HEALTH SERVICES PALM HARBOR999960 MASONIC HOME OF FLORIDA204072 MEASE CONTINUING CARE208442 MENORAH MANOR206431 MORTON PLANT REHABILITATION CENTER227641 NORTH REHABILITATION CENTER203823 OAK BLUFFS NURSING CENTER258342 OAK MANOR HEALTHCARE & REHABILITATION CENTER257460 PALM GARDEN OF CLEARWATER257478 PALM GARDEN OF LARGO257508 PALM GARDEN OF PINELLAS282537 PALM TERRACE OF ST. PETERSBURG281891 PASADENA MANOR INC324507 PENINSULA CARE AND REHABILITATION CENTER324469 PINELLAS PARK CARE AND REHABILITATION CENTER263486 PINELLAS POINT NURSING AND REHAB CENTER228362 REHABILITATION CENTER OF ST PETE210951 SABAL PALMS HEALTH CARE CENTER310841 SAINT MARK VILLAGE324230 SEMINOLE NURSING PAVILION324132 SHORE ACRES REHABILITATION AND HEALTH CENTER226360 SOUTH HERITAGE HEALTH & REHAB CENTER267724 SPRINGS AT BOCA CIEGA BAY

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

38,625 72,100 4,959,489 15.00% 743,923 $7,500 1.0000 772,500 5,731,989 11 11.00 57,000 106,400 6,755,868 15.00% 1,013,380 $7,500 1.0000 1,140,000 7,895,868 32 30.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 25.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 38 32.50 19,500 36,400 2,311,218 15.00% 346,683 $7,500 1.0000 390,000 2,701,218 23 18.00 21,375 39,900 2,533,451 15.00% 380,018 $7,500 1.0000 427,500 2,960,951 26 12.00 21,375 39,900 2,533,451 15.00% 380,018 $7,500 1.0000 427,500 2,960,951 26 12.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 25.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 27 20.00 34,500 64,400 4,089,078 15.00% 613,362 $7,500 1.0000 690,000 4,779,078 25 12.00 22,125 41,300 2,622,344 15.00% 393,352 $7,500 1.0000 442,500 3,064,844 28 28.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 28 14.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 36 32.50

102,750 191,800 12,178,341 15.00% 1,826,751 $7,500 1.0000 2,055,000 14,233,341 34 16.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 21 21.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 37 13.00 56,250 105,000 6,666,975 15.00% 1,000,046 $7,500 1.0000 1,125,000 7,791,975 26 14.00 14,625 27,300 1,733,414 15.00% 260,012 $7,500 1.0000 292,500 2,025,914 24 23.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 24 23.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 14 10.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 22 22.00 39,000 72,800 5,007,639 15.00% 751,146 $7,500 1.0000 780,000 5,787,639 30 30.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 11 9.00 22,125 41,300 2,622,344 15.00% 393,352 $7,500 1.0000 442,500 3,064,844 23 20.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 18.00 34,875 65,100 4,477,985 15.00% 671,698 $7,500 1.0000 697,500 5,175,485 28 27.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 38 32.50 43,500 81,200 5,155,794 15.00% 773,369 $7,500 1.0000 870,000 6,025,794 21 21.00 28,500 53,200 3,377,934 15.00% 506,690 $7,500 1.0000 570,000 3,947,934 20 20.00 21,000 39,200 2,489,004 15.00% 373,351 $7,500 1.0000 420,000 2,909,004 29 29.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 25 25.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 13 13.00 21,750 40,600 2,577,897 15.00% 386,685 $7,500 1.0000 435,000 3,012,897 18 17.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 38 32.00

112,125 209,300 13,289,504 15.00% 1,993,426 $7,500 1.0000 2,242,500 15,532,004 39 32.00 59,250 110,600 7,022,547 15.00% 1,053,382 $7,500 1.0000 1,185,000 8,207,547 10 10.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 29 26.00 50,250 93,800 5,955,831 15.00% 893,375 $7,500 1.0000 1,005,000 6,960,831 27 22.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 26 26.00 67,500 126,000 8,667,068 15.00% 1,300,060 $7,500 1.0000 1,350,000 10,017,068 19 19.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 37,500 70,000 4,815,038 15.00% 722,256 $7,500 1.0000 750,000 5,565,038 18 18.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 24 9.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 26 2.00 18,375 34,300 2,177,879 15.00% 326,682 $7,500 1.0000 367,500 2,545,379 27 21.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 20 18.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 19 16.00 45,610 84,000 5,405,880 15.00% 810,882 $7,500 1.0000 900,000 6,305,880 22 12.00 67,059 98,000 7,948,101 15.00% 1,192,215 $7,500 1.0000 1,050,000 8,998,101 22 19.00 48,907 84,000 5,796,653 15.00% 869,498 $7,500 1.0000 900,000 6,696,653 18 12.00 38,000 67,200 4,503,912 15.00% 675,587 $7,500 1.0000 720,000 5,223,912 14 13.00 45,750 85,400 5,422,473 15.00% 813,371 $7,500 1.0000 915,000 6,337,473 39 32.50 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 25 24.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 27 25.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 37 23.00 59,625 111,300 7,066,994 15.00% 1,060,049 $7,500 1.0000 1,192,500 8,259,494 25 23.00 91,500 170,800 10,844,946 15.00% 1,626,742 $7,500 1.0000 1,830,000 12,674,946 19 12.00 22,500 42,000 2,889,023 15.00% 433,353 $7,500 1.0000 450,000 3,339,023 29 29.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 27 27.00 40,875 76,300 4,844,669 15.00% 726,700 $7,500 1.0000 817,500 5,662,169 38 32.50 27,750 51,800 3,289,041 15.00% 493,356 $7,500 1.0000 555,000 3,844,041 27 27.00 40,875 76,300 4,844,669 15.00% 726,700 $7,500 1.0000 817,500 5,662,169 35 5.00

Page 224: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name210943 STRATFORD COURT OF PALM HARBOR253430 SUNSET POINT CARE AND REHABILITATION CENTER229164 SYLVAN HEALTH CENTER212849 TARPON BAYOU CENTER260568 TIERRA PINES CENTER253464 WEST BAY CARE AND REHABILITATION CENTER202011 WESTCHESTER GARDENS REHAB & CARE CENTER999957 WESTMINSTER PALMS212709 WESTMINSTER SUNCOAST254762 WRIGHTS NURSING AND REHABILITATION CENTER205460 AMERICAN-FINNISH NURSING HOME210676 AVANTE AT BOCA RATON, INC.203238 AVANTE AT LAKE WORTH, INC.252549 AZALEA COURT999915 BARRINGTON TERRACE OF BOYNTON BEACH263842 BOCA RATON REHABILITATION CENTER263613 BOULEVARD MANOR NURSING AND REHAB CENTER263460 BOYNTON BEACH REHABILITATION CENTER218952 BOYNTON HEALTH CARE CENTER999879 CHATSWORTH AT PGA NATIONAL213837 CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE320153 CONSULATE HEALTH CARE OF WEST PALM BEACH259918 CORAL BAY HEALTHCARE AND REHABILITATION269395 CROSSINGS, THE317349 DARCY HALL OF LIFE CARE212032 EDWARD J HEALEY REHABILITATION AND NURSING CENTER212393 FOUNTAINS NURSING HOME228320 GARDENS COURT203203 GLADES HEALTH CARE CENTER259586 HAMLIN PLACE216399 HARBOURS EDGE205745 HEALTH CENTER AT ABBEY DELRAY206865 HEALTH CENTER AT ABBEY DELRAY SOUTH999913 HEARTLAND HEALTH CARE AND REHABILITATION CENTER O325309 HEARTLAND HEALTH CARE CENTER BOYNTON BEACH325341 HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS207381 JOSEPH L MORSE GERIATRIC CENTER INC224928 JUPITER CARE CENTER208485 JUPITER MEDICAL CENTER PAVILION INC229610 LAKE VIEW CARE CENTER AT DELRAY266124 LAKE WORTH MANOR207683 LAKESIDE HEALTH CENTER227676 LIBERTY INN, LLC205923 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC C325368 MANORCARE HEALTH SERVICES325520 MANORCARE HEALTH SERVICES325376 MANORCARE HEALTH SERVICES BOYNTON BEACH325481 MANORCARE HEALTH SERVICES WEST PALM BEACH263524 MEDICANA NURSING AND REHAB CENTER229628 MENORAH HOUSE325163 NORTH LAKE REHABILITATION AND HEALTH CENTER999867 NURSING CENTER AT LA POSADA, THE257257 PALM GARDEN OF WEST PALM BEACH204170 REGENTS PARK NURSING & REHABILITATION CENTER263915 REHABILITATION CENTER OF THE PALM BEACHES,THE214108 ROYAL MANOR312312 SAVANNAH COVE001136 SIGNATURE HEALTHCARE OF PALM BEACH211010 STRATFORD COURT OF BOCA RATON325031 TERRACES OF LAKE WORTH REHABILITATION AND HEALTH 206610 WATERFORD HEALTH CARE CENTER999916 WHITEHALL BOCA RATON

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

22,500 42,000 2,889,023 15.00% 433,353 $7,500 1.0000 450,000 3,339,023 17 15.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 29 25.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 18 16.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 37 32.50 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 30 27.00 45,000 84,000 5,778,045 15.00% 866,707 $7,500 1.0000 900,000 6,678,045 27 21.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 20 11.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 41 32.50 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 47 32.50 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 30 23.00 54,000 100,800 6,552,684 15.00% 982,903 $7,500 1.0000 1,080,000 7,632,684 24 16.00 51,750 96,600 6,279,656 15.00% 941,948 $7,500 1.0000 1,035,000 7,314,656 40 29.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 25.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 31 26.00 62,625 116,900 7,599,293 15.00% 1,139,894 $7,500 1.0000 1,252,500 8,851,793 34 24.00 63,375 118,300 7,690,303 15.00% 1,153,545 $7,500 1.0000 1,267,500 8,957,803 32 10.00 38,442 56,700 4,664,783 15.00% 699,717 $7,500 1.0000 607,500 5,272,283 26 24.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 12 12.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 24 19.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 16 12.00 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 21 19.00 82,500 154,000 10,011,045 15.00% 1,501,657 $7,500 1.0000 1,650,000 11,661,045 39 32.50 74,250 138,600 9,009,941 15.00% 1,351,491 $7,500 1.0000 1,485,000 10,494,941 39 19.00 19,125 35,700 2,320,742 15.00% 348,111 $7,500 1.0000 382,500 2,703,242 39 32.50 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 13 11.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 25.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 23.00 20,250 37,800 2,457,257 15.00% 368,588 $7,500 1.0000 405,000 2,862,257 22 21.00 42,750 79,800 5,187,542 15.00% 778,131 $7,500 1.0000 855,000 6,042,542 31 6.00 33,750 63,000 4,095,428 15.00% 614,314 $7,500 1.0000 675,000 4,770,428 27 23.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 18 18.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 18 16.00

105,000 196,000 12,741,330 15.00% 1,911,200 $7,500 1.0000 2,100,000 14,841,330 26 21.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 25.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 35 23.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 24.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 23 20.00 40,125 74,900 4,869,008 15.00% 730,351 $7,500 1.0000 802,500 5,671,508 25 22.00 25,500 47,600 3,094,323 15.00% 464,148 $7,500 1.0000 510,000 3,604,323 11 8.00 49,500 92,400 6,006,627 15.00% 900,994 $7,500 1.0000 990,000 6,996,627 29 7.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 25 22.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 10 9.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 24 22.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 13 12.00 43,875 81,900 5,324,056 15.00% 798,608 $7,500 1.0000 877,500 6,201,556 31 23.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 20 13.00 31,875 59,500 3,867,904 15.00% 580,186 $7,500 1.0000 637,500 4,505,404 39 30.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 81,326 123,200 9,868,585 15.00% 1,480,288 $7,500 1.0000 1,320,000 11,188,585 21 14.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 25 17.00 37,125 69,300 4,504,970 15.00% 675,746 $7,500 1.0000 742,500 5,247,470 39 8.00 60,382 84,000 7,327,114 15.00% 1,099,067 $7,500 1.0000 900,000 8,227,114 24 12.00 11,250 21,000 1,365,143 15.00% 204,771 $7,500 1.0000 225,000 1,590,143 14 14.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 23.00 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 15 12.00 37,125 69,300 4,504,970 15.00% 675,746 $7,500 1.0000 742,500 5,247,470 32 7.00 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 27 22.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50

Page 225: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name999912 WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES206521 WILLOWBROOKE COURT AT ST ANDREWS261599 WOOD LAKE NURSING AND REHABILITATION CENTER251739 BRADFORD TERRACE NURSING CENTER213888 WINDSOR MANOR264067 BLOUNTSTOWN HEALTH AND REHABILITATION CENTER251097 PARTHENON HEALTHCARE OF BLOUNTSTOWN263478 ARBOR TRAIL REHAB AND SKILLED NURSING CENTER203220 AVANTE AT INVERNESS, INC.257419 CITRUS HEALTH AND REHABILITATION CENTER217263 CRYSTAL RIVER HEALTH AND REHABILITATION CENTER228940 CYPRESS COVE CARE CENTER256269 DIAMOND RIDGE HEALTH AND REHABILITATION CENTER252263 HEALTH CENTER AT BRENTWOOD211532 LIFE CARE CENTER OF CITRUS COUNTY228711 WOODLAND TERRACE OF CITRUS COUNTY261629 AVALON HEALTHCARE CENTER308111 BAYA POINTE NURSING AND REHABILITATION CENTER226173 HEALTH CENTER OF LAKE CITY, THE316229 DESOTO HEALTH & REHAB, LLC312151 CROSS CITY REHABILITATION & HEALTH CARE CENTER324485 BRIDGE AT BAY ST JOE, THE206300 SUWANNEE VALLEY NURSING CENTER999945 FINR III, LLC211435 HARDEE MANOR HEALTHCARE CENTER213497 OAKBROOK OF LABELLE282618 PALM TERRACE OF CLEWISTON324493 KENILWORTH CARE & REHABILITATION CENTER214124 LAKE PLACID HEALTH CARE CENTER263966 OAKS AT AVON252671 PALMS OF SEBRING, THE324213 ROYAL CARE OF AVON PARK263443 BONIFAY NURSING AND REHAB CENTER203475 MARIANNA HEALTH AND REHABILITATION CENTER005383 NURSING PAVILION AT CHIPOLA RETIREMENT CENTER324426 SIGNATURE HEALTHCARE AT THE COURTYARD324396 SIGNATURE HEALTHCARE OF NORTH FLORIDA264482 LAFAYETTE HEALTH CARE CENTER317586 WILLISTON REHABILITATION AND NURSING CENTER211923 LAKE PARK OF MADISON213462 MADISON NURSING CENTER214019 PINE LAKE NURSING HOME208906 PLANTATION KEY CONVALESCENT CENTER202541 OKEECHOBEE HEALTH CARE FACILITY312274 CRESTWOOD NURSING CENTER312142 LAKEWOOD NURSING CENTER226025 PALATKA HEALTH CARE CENTER283142 ARBOR VILLAGE NURSING CENTER215597 OSPREY POINT NURSING CENTER268763 GOOD SAMARITAN CENTER001135 SURREY PLACE CARE CENTER005387 SUWANNEE HEALTH CARE CENTER252425 MARSHALL HEALTH AND REHABILITATION CENTER324353 WASHINGTON REHABILITATION AND NURSING CENTER

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 44,625 83,300 5,415,065 15.00% 812,260 $7,500 1.0000 892,500 6,307,565 39 5.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 21 16.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 28 21.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 19 19.00 34,500 64,400 3,845,681 15.00% 576,852 $7,500 1.0000 690,000 4,535,681 13 13.00 56,250 105,000 6,270,131 15.00% 940,520 $7,500 1.0000 1,125,000 7,395,131 35 18.00 43,500 81,200 5,278,551 15.00% 791,783 $7,500 1.0000 870,000 6,148,551 22 20.00 39,000 72,800 4,732,494 15.00% 709,874 $7,500 1.0000 780,000 5,512,494 41 26.00 41,625 77,700 5,051,027 15.00% 757,654 $7,500 1.0000 832,500 5,883,527 15 13.00 56,250 105,000 6,825,713 15.00% 1,023,857 $7,500 1.0000 1,125,000 7,950,713 33 32.50 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 26 26.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 20 16.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 25 16.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 15 14.00 45,000 84,000 5,460,570 15.00% 819,086 $7,500 1.0000 900,000 6,360,570 8 8.00 35,625 66,500 4,222,418 15.00% 633,363 $7,500 1.0000 712,500 4,934,918 28 24.00 33,750 63,000 4,000,185 15.00% 600,028 $7,500 1.0000 675,000 4,675,185 15 9.00 45,000 84,000 5,333,580 15.00% 800,037 $7,500 1.0000 900,000 6,233,580 17 15.00 15,375 28,700 1,909,083 15.00% 286,362 $7,500 1.0000 307,500 2,216,583 29 3.00 22,500 42,000 2,730,285 15.00% 409,543 $7,500 1.0000 450,000 3,180,285 10 10.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 26 26.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 40 12.00

- - - 15.00% - $7,500 1.0000 - - 2,009 32.50 29,625 55,300 3,762,079 15.00% 564,312 $7,500 1.0000 592,500 4,354,579 29 27.00 34,875 65,100 4,281,150 15.00% 642,173 $7,500 1.0000 697,500 4,978,650 23 21.00 58,125 108,500 7,053,236 15.00% 1,057,985 $7,500 1.0000 1,162,500 8,215,736 29 24.00 39,000 72,800 4,952,610 15.00% 742,892 $7,500 1.0000 780,000 5,732,610 30 29.00 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 25 20.00 39,000 72,800 4,952,610 15.00% 742,892 $7,500 1.0000 780,000 5,732,610 17 14.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 39 16.00 33,750 63,000 4,285,913 15.00% 642,887 $7,500 1.0000 675,000 4,960,913 33 30.00 67,500 126,000 7,524,158 15.00% 1,128,624 $7,500 1.0000 1,350,000 8,874,158 25 17.00 67,500 126,000 7,524,158 15.00% 1,128,624 $7,500 1.0000 1,350,000 8,874,158 38 23.00 51,000 95,200 5,684,919 15.00% 852,738 $7,500 1.0000 1,020,000 6,704,919 18 18.00 45,000 84,000 5,016,105 15.00% 752,416 $7,500 1.0000 900,000 5,916,105 12 12.00 67,500 126,000 7,524,158 15.00% 1,128,624 $7,500 1.0000 1,350,000 8,874,158 30 20.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 12 12.00 67,500 126,000 8,190,855 15.00% 1,228,628 $7,500 1.0000 1,350,000 9,540,855 28 26.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 14 12.00 22,500 42,000 2,539,800 15.00% 380,970 $7,500 1.0000 450,000 2,989,800 24 22.00 21,750 40,600 2,455,140 15.00% 368,271 $7,500 1.0000 435,000 2,890,140 26 24.00 45,000 84,000 5,714,550 15.00% 857,183 $7,500 1.0000 900,000 6,614,550 25 24.00 64,875 121,100 7,872,322 15.00% 1,180,848 $7,500 1.0000 1,297,500 9,169,822 25 21.00 24,375 45,500 3,095,381 15.00% 464,307 $7,500 1.0000 487,500 3,582,881 32 31.00 34,500 64,400 4,381,155 15.00% 657,173 $7,500 1.0000 690,000 5,071,155 40 32.50 67,500 126,000 8,571,825 15.00% 1,285,774 $7,500 1.0000 1,350,000 9,921,825 20 19.00 78,750 147,000 10,000,463 15.00% 1,500,069 $7,500 1.0000 1,575,000 11,575,463 27 20.00 22,500 42,000 2,889,023 15.00% 433,353 $7,500 1.0000 450,000 3,339,023 10 9.00 60,375 112,700 7,155,887 15.00% 1,073,383 $7,500 1.0000 1,207,500 8,363,387 39 18.00 22,500 42,000 2,666,790 15.00% 400,019 $7,500 1.0000 450,000 3,116,790 21 18.00 67,500 126,000 8,000,370 15.00% 1,200,056 $7,500 1.0000 1,350,000 9,350,370 27 27.00 45,000 84,000 5,079,600 15.00% 761,940 $7,500 1.0000 900,000 5,979,600 30 25.00 67,500 126,000 7,524,158 15.00% 1,128,624 $7,500 1.0000 1,350,000 8,874,158 27 24.00

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Fac # Facility Name

700

Higher of Actual or Minimum

Maximum Sq Ft

Replacement Value

Land Percentage Land Value

Equipment Allowance

Cost Index

Equipment Value

Facility Value Excluding Land

Facility Actual Age

Facility FRV Adj Age

Page 227: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name

005021 BRADEN RIVER CARE CENTER252069 BRADENTON HEALTH CARE263885 CASA MORA REHAB. & EXTENDED CARE227625 GREENBRIAR REHABILITATION AND NURSING CENTER324345 HERITAGE PARK CARE AND REHABILITATION CENTER223786 LIFE CARE CENTER OF SARASOTA317195 NURSING CENTER AT FREEDOM VILLAGE, THE259942 RIVERFRONT NURSING & REHABILITATION CENTER263451 RIVIERA PALMS REHABILITATION CENTER256277 SURREY PLACE HEALTHCARE AND REHABILITATION209422 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST203815 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST316610 WOODS OF MANATEE SPRINGS, THE999923 BAY VILLAGE OF SARASOTA259896 BENEVA LAKES HEALTHCARE AND REHABILITATION CENTE320137 CONSULATE HEALTH CARE OF SARASOTA999892 GLENRIDGE ON PALMER RANCH INC.213322 HARBORCHASE OF VENICE317136 HARMONY HEALTHCARE AND REHABILITATION CENTER999925 HEARTLAND HEALTH CARE & REHABILITATION CENTER252271 HERITAGE HEALTH CARE CENTER228621 INN AT SARASOTA BAY CLUB202681 J H FLOYD SUNSHINE MANOR325490 KENSINGTON MANOR252182 MAGNOLIA HEALTH AND REHABILITATION CENTER325473 MANORCARE HEALTH SERVICES325465 MANORCARE HEALTH SERVICES SARASOTA319244 PALMER RANCH HEALTHCARE AND REHABILITATION252662 PINEBROOK CARE AND REHABILITATION CENTER202703 PINES OF SARASOTA999922 PLYMOUTH HARBOR INCORPORATED225053 QUALITY HEALTH OF NORTH PORT263982 SARASOTA HEALTH AND REHABILITATION CENTER260355 SARASOTA MEMORIAL NURSING AND REHABILITATION CEN268780 SPRINGS AT LAKE POINTE WOODS253014 SPRINGWOOD CARE AND REHABILITATION CENTER202711 SUNNYSIDE NURSING HOME308501 SUNSET LAKE HEALTH AND REHABILITATION CENTER323781 TARPON POINT NURSING AND REHABILITATION CENTER210463 VILLAGE ON THE ISLE221473 CALUSA HARBOUR HEALTH CENTER318787 CITRUS GARDENS OF FORT MYERS320111 CONSULATE HEALTH CARE OF NORTH FORT MYERS252107 CORAL TRACE HEALTH CARE252212 EVANS HEALTH CARE201120 GULF COAST VILLAGE CARE CENTER210587 HEALTHPARK CARE CENTER, INC.325325 HEARTLAND HEALTH CARE CENTER FORT MYERS252344 HERITAGE PARK REHABILITATION AND HEALTHCARE320978 LEHIGH ACRES HEALTH AND REHABILITATION CENTER265381 LIFE CARE CENTER OF ESTERO999878 LODGE AT CYPRESS COVE, THE325384 MANORCARE HEALTH SERVICES263869 REHAB AND HEALTHCARE CENTER OF CAPE CORAL213900 SHADY REST CARE PAVILION229202 SHELL POINT NURSING PAVILION324370 SIGNATURE HEALTHCARE AT COLLEGE PARK

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

2.00% 7,309,318 3,935,786 5,388,552 9.25% 498,441 64,532 40,150 7.72 5.01 1.00% 510,895 5,165,720 5,899,087 9.25% 545,666 32,576 18,327 16.75 11.77 1.75% 5,903,680 7,071,440 8,747,708 9.25% 809,163 74,460 51,521 10.87 6.92 1.25% 446,020 2,797,760 3,216,827 9.25% 297,557 18,615 8,592 15.98 11.30 1.50% 2,238,208 4,249,352 5,087,486 9.25% 470,592 37,230 23,131 12.64 12.31 1.00% 259,502 6,228,058 7,066,192 9.25% 653,623 37,230 12,000 17.56 12.09 1.50% 1,751,641 4,735,919 5,574,053 9.25% 515,600 37,230 12,045 13.85 8.12 1.25% 966,376 4,980,554 5,748,843 9.25% 531,768 34,128 28,518 15.58 12.85 1.50% 1,946,268 4,541,292 5,379,426 9.25% 497,597 37,230 17,898 13.37 9.75 1.50% 924,477 2,319,303 2,738,370 9.25% 253,299 18,615 7,110 13.61 9.62 1.75% 1,618,781 1,570,936 1,983,018 9.25% 183,429 18,305 6,991 10.02 7.06 1.25% 1,378,607 5,108,954 5,947,088 9.25% 550,106 37,230 13,883 14.78 9.95 1.25% 810,945 5,676,615 6,514,749 9.25% 602,614 37,230 16,146 16.19 22.19 2.00% - - - 9.25% - - - - - 1.75% 2,951,840 3,535,720 4,373,854 9.25% 404,582 37,230 27,010 10.87 8.44 1.00% 350,328 4,028,775 4,594,515 9.25% 424,993 25,130 18,071 16.91 10.91 2.00% - - - 9.25% - - - - - 1.00% 218,955 2,213,880 2,528,180 9.25% 233,857 13,961 3,770 16.75 11.96 1.00% 194,627 6,292,933 7,131,067 9.25% 659,624 37,230 7,426 17.72 11.89 2.00% - - - 9.25% - - - - - 1.75% 2,838,308 3,649,253 4,487,387 9.25% 415,083 37,230 25,109 11.15 11.95 1.00% 162,189 3,081,591 3,500,658 9.25% 323,811 18,615 3,838 17.40 10.75 1.50% 1,801,920 3,658,443 4,363,873 9.25% 403,658 31,335 25,321 12.88 13.39 2.00% 3,057,263 1,646,218 2,253,866 9.25% 208,483 26,992 15,528 7.72 8.32 1.25% 1,054,229 5,433,332 6,271,466 9.25% 580,111 37,230 27,998 15.58 11.57 1.25% 1,046,119 5,928,008 6,829,002 9.25% 631,683 40,022 15,895 15.78 9.44 1.50% 3,175,661 6,447,553 7,690,785 9.25% 711,398 55,225 30,331 12.88 12.83 1.25% 405,473 2,838,308 3,257,375 9.25% 301,307 18,615 9,770 16.19 11.48 1.50% 2,238,208 4,249,352 5,087,486 9.25% 470,592 37,230 23,567 12.64 11.98 1.00% 110,289 10,918,563 12,343,391 9.25% 1,141,764 63,291 47,660 18.04 15.53 2.00% - - - 9.25% - - - - - 1.50% 2,335,522 4,152,038 4,990,172 9.25% 461,591 37,230 20,233 12.40 15.44 1.75% 4,317,066 4,819,581 5,999,953 9.25% 554,996 52,432 28,637 10.59 9.79 1.50% 2,043,581 4,443,979 5,282,113 9.25% 488,595 37,230 16,434 13.12 12.73 1.00% 450,345 5,983,152 6,814,302 9.25% 630,323 36,920 18,619 17.07 8.02 1.50% 2,238,208 4,249,352 5,087,486 9.25% 470,592 37,230 23,863 12.64 9.21 1.25% 648,756 2,595,024 3,014,091 9.25% 278,803 18,615 6,933 14.98 11.64 1.25% 1,216,418 5,271,143 6,109,277 9.25% 565,108 37,230 12,883 15.18 11.76 1.25% 973,134 5,514,426 6,352,560 9.25% 587,612 37,230 24,023 15.78 14.80 1.50% 1,021,791 2,221,989 2,641,056 9.25% 244,298 18,615 7,057 13.12 12.45 1.75% 1,405,264 1,806,768 2,221,073 9.25% 205,449 18,615 5,572 11.04 8.54 1.75% 2,922,950 3,501,115 4,329,725 9.25% 400,500 37,230 30,680 10.76 10.66 1.50% 1,830,859 4,593,206 5,421,816 9.25% 501,518 37,230 28,592 13.47 6.95 1.25% 1,124,211 5,299,854 6,128,463 9.25% 566,883 37,230 21,247 15.23 12.76 1.25% 883,309 5,540,756 6,369,366 9.25% 589,166 37,230 26,775 15.83 10.09 1.25% 796,316 3,754,063 4,340,995 9.25% 401,542 26,371 8,225 15.23 11.32 1.25% 824,422 5,171,372 5,944,741 9.25% 549,889 34,748 19,763 15.83 8.22 1.25% 1,043,911 5,380,154 6,208,764 9.25% 574,311 37,230 13,090 15.43 8.58 1.75% 3,035,371 3,388,694 4,217,304 9.25% 390,101 37,230 27,598 10.48 10.88 1.50% 1,854,949 4,033,777 4,793,336 9.25% 443,384 34,128 21,507 12.99 15.30 1.00% 497,865 7,799,886 8,870,173 9.25% 820,491 48,089 22,715 17.06 11.00 2.00% - - - 9.25% - - - - - 1.25% 803,008 5,621,057 6,449,667 9.25% 596,594 37,230 13,977 16.02 10.27 1.75% 3,372,634 3,051,431 3,880,041 9.25% 358,904 37,230 25,767 9.64 6.27 2.00% 6,263,463 3,372,634 4,615,549 9.25% 426,938 55,845 42,775 7.65 9.76 1.75% 6,360,226 5,363,693 6,875,906 9.25% 636,021 67,945 4,318 9.36 3.54 1.75% 2,506,055 3,222,070 3,960,914 9.25% 366,385 33,197 16,798 11.04 6.56

Page 228: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name264008 WINKLER COURT252034 AVANTE AT ORMOND BEACH, INC.209511 BISHOPS GLEN RETIREMENT CENTER260371 BRIDGEVIEW CENTER283134 CATALINA HEALTH CARE CENTER202789 CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY260649 COQUINA CENTER217743 DAYTONA BEACH HEALTH AND REHABILITATION CENTER005372 DEBARY MANOR252158 DELTONA HEALTH CARE210889 EMORY L BENNETT MEMORIAL VETERANS NURSING HOME204391 GOOD SAMARITAN SOCIETY-DAYTONA212792 GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN229091 HEALTH CENTER OF DAYTONA BEACH, THE223905 HORIZON HEALTHCARE CENTER AT DAYTONA258750 INDIGO MANOR269000 JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY213527 MANOR ON THE GREEN252476 OAKTREE HEALTHCARE005547 OAKWOOD GARDEN OF DELAND226351 OCEAN VIEW NURSING & REHABILITATION CENTER263567 ORANGE CITY NURSING AND REHAB CENTER263508 PORT ORANGE NURSING AND REHAB CENTER282464 RIDGECREST NURSING AND REHABILITATION CENTER312045 SANDALWOOD NURSING CENTER324442 SIGNATURE HEALTHCARE OF ORMOND282553 TERRACE OF DAYTONA BEACH, LLC212873 UNIVERSITY CENTER EAST212831 UNIVERSITY CENTER WEST212636 WOODLAND TERRACE EXTENDED CARE CENTER229849 ALEXANDER NININGER STATE VETERANS NURSING HOME263851 BROWARD INSTITUTE FOR LONG TERM CARE226335 BROWARD NURSING & REHABILITATION CENTER312789 CHILDRENS COMPREHENSIVE CARE CENTER INC318795 COURT AT PALM AIRE, THE210188 COVENANT VILLAGE CARE CENTER001281 CROSS POINTE CARE CENTER253481 FORUM AT DEER CREEK321303 FT LAUDERDALE HEALTH & REHABILITATION CENTER262064 GOLFCREST HEALTHCARE CENTER252255 HARBOR BEACH NURSING AND REHABILITATION CENTER226581 HEALTH CENTER OF COCONUT CREEK, THE325333 HEARTLAND HEALTH CARE CENTER LAUDERHILL325350 HEARTLAND OF TAMARAC252531 HILLCREST NURSING AND REHABILITATION CENTER313424 HOLLYWOOD HILLS REHABILITATION CENTER, LLC203769 JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH259080 LIFE CARE CENTER AT INVERRARY256935 MANOR OAKS NURSING & REHABILITATION CENTER254177 MANOR PINES CONVALESCENT CENTER325457 MANORCARE HEALTH SERVICES214931 MARGATE HEALTH CARE CENTER201006 MEMORIAL MANOR308005 PALMS REHABILITATION AND NURSING CENTER254134 PARK SUMMIT OF CORAL SPRINGS226017 PLANTATION NURSING & REHABILITATION CENTER263923 POMPANO REHABILITATION & NURSING CENTER269697 REGENTS PARK OF SUNRISE205800 SAINT JOHNS NURSING CENTER252433 SEAVIEW NURSING AND REHABILITATION CENTER225631 SPRINGTREE REHABILITATION & HEALTH CARE CENTER207497 SUNRISE HEALTH & REHABILITATION CENTER

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.25% 1,124,211 5,299,854 6,128,463 9.25% 566,883 37,230 30,108 15.23 11.79 2.00% 4,765,232 2,565,894 3,515,938 9.25% 325,224 41,263 21,818 7.88 8.65 1.25% 454,750 2,852,525 3,281,116 9.25% 303,503 18,615 8,379 16.30 12.55 1.00% 229,856 7,431,998 8,424,901 9.25% 779,303 43,125 34,094 18.07 9.65 1.25% 826,819 5,787,731 6,644,914 9.25% 614,655 37,230 31,883 16.51 6.63 1.25% 985,292 6,180,470 7,109,085 9.25% 657,590 40,333 21,042 16.30 9.54 1.00% 595,310 6,019,241 6,876,423 9.25% 636,069 37,230 21,678 17.08 11.52 1.75% 5,556,222 4,365,603 5,651,377 9.25% 522,752 55,845 37,656 9.36 8.29 1.25% 1,074,864 5,539,686 6,396,868 9.25% 591,710 37,230 26,752 15.89 10.84 1.50% 2,083,583 4,530,967 5,388,149 9.25% 498,404 37,230 26,009 13.39 12.10 1.25% 1,240,228 5,374,322 6,231,504 9.25% 576,414 37,230 15,720 15.48 6.94 1.25% 826,819 5,787,731 6,644,914 9.25% 614,655 37,230 24,727 16.51 13.25 1.00% 264,582 3,042,693 3,471,284 9.25% 321,094 18,615 12,014 17.25 11.43 1.25% 603,578 3,420,274 3,941,726 9.25% 364,610 22,648 5,504 16.10 7.53 1.25% 752,405 3,877,780 4,477,808 9.25% 414,197 26,061 11,723 15.89 8.66 1.50% 2,860,793 6,675,183 7,910,955 9.25% 731,763 53,673 36,075 13.63 13.01 1.00% 496,091 7,772,096 8,843,574 9.25% 818,031 46,538 14,491 17.58 10.17 1.75% 5,000,600 5,582,680 6,954,172 9.25% 643,261 59,568 32,799 10.80 8.72 1.75% 1,567,511 2,015,371 2,479,678 9.25% 229,370 20,166 15,509 11.37 7.06 1.75% 3,648,200 3,076,593 3,948,061 9.25% 365,196 37,851 27,457 9.65 7.82 1.75% 5,763,616 7,410,363 9,117,585 9.25% 843,377 74,150 30,111 11.37 10.43 1.50% 1,785,929 4,828,622 5,685,804 9.25% 525,937 37,230 21,449 14.13 9.87 1.25% 1,405,592 5,208,958 6,066,141 9.25% 561,118 37,230 14,278 15.07 9.59 1.75% 4,167,167 4,652,234 5,795,144 9.25% 536,051 49,640 33,028 10.80 11.00 2.00% 3,547,052 1,909,951 2,617,127 9.25% 242,084 30,715 20,823 7.88 5.08 1.00% 132,291 3,174,984 3,603,575 9.25% 333,331 18,615 8,361 17.91 5.51 1.25% 454,750 2,852,525 3,281,116 9.25% 303,503 18,615 12,035 16.30 9.78 2.00% 2,149,729 1,157,546 1,586,138 9.25% 146,718 18,615 14,796 7.88 5.83 2.00% 2,149,729 1,157,546 1,586,138 9.25% 146,718 18,615 15,435 7.88 7.14 1.25% 1,074,864 5,539,686 6,396,868 9.25% 591,710 37,230 26,674 15.89 10.95 1.00% 529,164 6,085,386 6,942,569 9.25% 642,188 37,230 20,207 17.25 7.94 1.50% 3,528,862 7,164,660 8,550,438 9.25% 790,916 60,189 35,671 13.14 10.45 2.00% 6,957,908 3,746,566 5,129,487 9.25% 474,478 61,430 38,622 7.72 13.98 1.25% 347,264 1,637,101 1,894,256 9.25% 175,219 11,169 9,891 15.69 13.18 1.50% 1,041,792 2,265,483 2,694,075 9.25% 249,202 18,615 8,951 13.39 7.79 1.50% 875,821 2,367,959 2,787,026 9.25% 257,800 18,615 3,012 13.85 10.17 1.75% 2,122,168 2,728,502 3,357,102 9.25% 310,532 27,302 22,206 11.37 3.64 1.25% 636,057 2,544,228 2,953,771 9.25% 273,224 18,615 6,251 14.68 14.86 1.00% 251,393 8,128,372 9,210,962 9.25% 852,014 48,089 23,360 17.72 10.62 1.75% 1,874,260 1,818,863 2,297,457 9.25% 212,515 20,787 15,236 10.22 9.81 1.50% 1,100,452 2,089,265 2,501,347 9.25% 231,375 18,305 11,200 12.64 11.96 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 16,937 16.10 9.62 1.25% 1,178,573 4,714,294 5,475,599 9.25% 506,493 33,817 26,518 14.98 9.54 1.50% 2,204,149 5,959,364 7,014,016 9.25% 648,797 46,848 22,965 13.85 9.98 1.50% 4,167,167 9,061,934 10,776,299 9.25% 996,808 74,460 48,251 13.39 11.46 1.50% 2,262,176 6,116,254 7,202,018 9.25% 666,187 47,158 18,384 14.13 13.82 1.25% 1,829,336 7,927,125 9,191,469 9.25% 850,211 54,914 5,872 15.48 7.68 1.00% 389,254 6,098,306 6,936,440 9.25% 641,621 37,230 14,611 17.23 10.90 2.00% 4,076,350 2,194,958 3,005,154 9.25% 277,977 35,989 14,191 7.72 1.26 2.00% 7,239,036 3,897,942 5,336,739 9.25% 493,648 63,912 19,074 7.72 2.40 1.50% 2,335,522 4,152,038 4,990,172 9.25% 461,591 37,230 17,904 12.40 10.50 1.50% 2,670,625 6,699,988 7,914,330 9.25% 732,076 52,743 31,499 13.88 14.72 1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 21,926 15.28 12.29 1.75% 3,065,372 3,422,188 4,260,322 9.25% 394,080 37,230 24,297 10.59 4.32 1.50% 549,834 1,379,409 1,629,421 9.25% 150,721 10,859 4,441 13.88 9.45 1.50% 2,958,327 5,259,249 6,320,885 9.25% 584,682 47,158 30,611 12.40 10.82 1.50% 2,310,132 4,690,267 5,597,452 9.25% 517,764 39,402 31,603 13.14 11.11 1.50% 1,751,641 4,735,919 5,574,053 9.25% 515,600 37,230 21,929 13.85 12.28 1.50% 2,788,840 6,996,563 8,260,749 9.25% 764,119 56,155 40,451 13.61 10.51 1.50% 1,647,023 2,928,041 3,520,925 9.25% 325,686 25,751 22,869 12.65 6.76 1.25% 1,115,049 4,831,881 5,600,170 9.25% 518,016 34,128 15,072 15.18 12.07 1.50% 6,325,371 11,245,104 13,515,050 9.25% 1,250,142 100,831 53,718 12.40 18.45

Page 229: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name213098 TAMARAC REHABILITATION AND HEALTH CENTER002419 WEST BROWARD CARE CENTER227579 WILTON MANORS HEALTH & REHABILITATION CENTER252166 DESTIN HEALTHCARE AND REHABILITATION CENTER212903 EMERALD COAST CENTER226041 MANOR AT BLUE WATER BAY, THE251101 PARTHENON HEALTHCARE OF CRESTVIEW229237 PARTHENON HEALTHCARE OF FORT WALTON252379 SHOAL CREEK REHABILITATION CENTER213926 SILVERCREST MANOR316075 WESTWOOD HEALTH CARE CENTER324361 CHAUTAUQUA REHABILITATION AND NURSING CENTER211621 DELTA HEALTH CARE CENTER229288 GAINESVILLE HEALTH CARE CENTER252361 NORTH FLORIDA REHABILITATION AND SPECIALTY CARE999868 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC.257265 PALM GARDEN OF GAINESVILLE227765 PARK MEADOWS HEALTH AND REHABILITATION CENTER317578 PARKLANDS REHABILITATION AND NURSING CENTER324388 SIGNATURE HEALTHCARE OF GAINESVILLE255572 WOODLANDS CARE CENTER OF ALACHUA COUNTY227871 AYERS HEALTH AND REHABILITATION CENTER204625 TRI COUNTY NURSING HOME263516 MACCLENNY NURSING AND REHAB CENTER211052 W FRANK WELLS NURSING HOME319538 CONSULATE HEALTH CARE OF ORANGE PARK223883 DOCTORS LAKE OF ORANGE PARK252387 GOVERNORS CREEK HEALTH AND REHABILITATION325261 HEARTLAND HEALTH CARE CENTER ORANGE PARK213161 LIFE CARE CENTER AT WELLS CROSSING284289 LIFE CARE CENTER OF ORANGE PARK999987 PAVILION FOR HEALTH CARE, THE324434 SIGNATURE HEALTHCARE OF ORANGE PARK284785 TERRACE AT FLEMING ISLAND, THE200735 ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATIO319376 ATRIUM HEALTHCARE CENTER200913 AVANTE VILLA AT JACKSONVILLE BEACH INC.252051 BEAUCLERC MANOR226068 CATHEDRAL GERONTOLOGY CENTER, INC.262714 CEDAR HILLS HEALTHCARE CENTER319503 CONSULATE HEALTH CARE OF JACKSONVILLE307998 CYPRESS VILLAGE254878 EDGEWOOD NURSING CENTER204536 FANNIE E TAYLOR HOME FOR THE AGED INC227838 FIRST COAST HEALTH & REHABILITATION CENTER999984 FLEET LANDING252417 HARTS HARBOR HEALTH CARE CENTER325236 HEARTLAND HEALTH CARE CENTER JACKSONVILLE325287 HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVI263494 JACKSONVILLE NURSING AND REHAB CENTER256757 LAKESIDE NURSING AND REHABILITATION CENTER268003 LANIER MANOR283193 LIFE CARE CENTER OF JACKSONVILLE257273 PALM GARDEN OF JACKSONVILLE228401 PARK RIDGE NURSING CENTER269727 REGENTS PARK OF JACKSONVILLE200859 RIVER GARDEN HEBREW HOME FOR THE AGED260673 RIVERWOOD CENTER324612 RIVERWOOD NURSING CENTER312371 SOUTHLAKE NURSING & REHABILITATION CENTER266281 SOUTHPOINT TERRACE205150 ST CATHERINE LABOURE MANOR, INC.

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.75% 2,951,840 3,535,720 4,373,854 9.25% 404,582 37,230 16,370 10.87 10.50 1.25% 1,216,418 5,271,143 6,109,277 9.25% 565,108 37,230 32,086 15.18 12.91 1.25% 1,036,658 5,342,776 6,166,941 9.25% 570,442 36,610 26,802 15.58 11.07 1.25% 1,014,747 5,229,852 6,032,667 9.25% 558,022 36,920 25,233 15.11 11.66 1.00% 440,795 5,856,280 6,665,841 9.25% 616,590 37,230 25,071 16.56 6.94 1.25% 1,023,275 5,273,800 6,083,362 9.25% 562,711 37,230 20,331 15.11 12.63 1.75% 4,132,455 5,313,157 6,527,499 9.25% 603,794 55,845 28,526 10.81 8.68 2.00% 4,093,099 2,203,976 3,013,538 9.25% 278,752 37,230 20,469 7.49 13.30 1.00% 566,737 5,730,338 6,539,900 9.25% 604,941 37,230 29,755 16.25 11.31 1.50% 991,789 2,156,748 2,561,529 9.25% 236,941 18,615 12,493 12.73 14.95 1.50% 1,039,017 2,109,520 2,514,301 9.25% 232,573 18,615 10,362 12.49 5.50 1.50% 2,662,247 6,211,910 7,340,534 9.25% 678,999 55,845 31,015 12.16 9.47 1.50% 1,374,337 3,715,799 4,370,194 9.25% 404,243 30,094 17,249 13.43 14.66 1.75% 4,174,124 5,366,731 6,595,359 9.25% 610,071 55,845 35,798 10.92 19.25 1.75% 2,782,749 3,577,821 4,396,906 9.25% 406,714 37,230 18,746 10.92 11.38 2.00% - - - 9.25% - - - - - 1.25% 977,129 5,537,065 6,379,194 9.25% 590,075 37,230 18,382 15.85 12.21 1.50% 2,816,142 5,346,589 6,397,749 9.25% 591,792 47,779 38,870 12.39 5.59 1.75% 3,227,989 3,132,581 3,951,666 9.25% 365,529 37,230 28,501 9.82 7.04 1.75% 2,782,749 3,577,821 4,396,906 9.25% 406,714 37,230 24,876 10.92 8.37 1.00% 445,240 5,915,330 6,734,416 9.25% 622,933 37,230 25,086 16.73 11.33 1.50% 1,908,171 4,452,399 5,271,485 9.25% 487,612 37,230 24,070 13.10 11.23 1.25% 751,342 3,542,042 4,094,925 9.25% 378,781 25,130 18,953 15.07 14.62 1.25% 1,246,716 4,986,864 5,786,901 9.25% 535,288 37,230 31,715 14.38 10.25 1.75% 1,669,041 1,863,321 2,316,675 9.25% 214,292 21,097 14,368 10.16 9.48 1.00% 561,022 5,672,558 6,472,595 9.25% 598,715 37,230 23,847 16.08 11.59 1.50% 2,057,081 4,176,499 4,976,536 9.25% 460,330 37,230 31,395 12.36 10.53 1.50% 2,150,585 4,082,995 4,883,032 9.25% 451,680 37,230 34,187 12.13 8.59 1.25% 1,324,636 4,908,944 5,708,981 9.25% 528,081 37,230 19,181 14.18 10.18 1.25% 857,117 5,376,463 6,176,500 9.25% 571,326 37,230 19,188 15.35 9.52 1.25% 1,519,435 7,830,935 9,030,990 9.25% 835,367 55,845 28,542 14.96 10.16 2.00% - - - 9.25% - - - - - 1.75% 2,577,196 2,877,187 3,577,219 9.25% 330,893 32,576 23,446 10.16 6.47 1.00% 224,409 5,385,813 6,105,846 9.25% 564,791 33,507 24,404 16.86 11.62 1.00% 311,679 5,921,901 6,721,938 9.25% 621,779 37,230 22,892 16.70 12.68 1.25% 654,526 3,708,980 4,269,006 9.25% 394,883 26,061 11,179 15.15 9.95 1.75% 4,199,875 4,371,298 5,471,349 9.25% 506,100 51,191 26,153 9.89 10.00 1.50% 2,244,089 3,989,491 4,789,528 9.25% 443,031 37,230 26,674 11.90 10.51 1.75% 3,163,542 3,070,038 3,870,075 9.25% 357,982 37,230 32,587 9.62 12.36 1.75% 4,581,681 4,768,689 5,968,744 9.25% 552,109 55,845 45,642 9.89 9.74 1.25% 903,869 5,121,925 5,895,294 9.25% 545,315 35,989 20,617 15.15 10.47 1.25% 779,198 5,454,383 6,254,420 9.25% 578,534 37,230 20,905 15.54 11.44 1.50% 981,789 2,135,001 2,535,020 9.25% 234,489 18,615 15,562 12.60 13.00 1.00% - 1,246,716 1,406,723 9.25% 130,122 7,446 5,141 17.48 13.33 1.25% 973,997 4,220,653 4,887,351 9.25% 452,080 31,025 28,349 14.57 13.80 2.00% - - - 9.25% - - - - - 1.75% 5,072,576 4,277,794 5,477,850 9.25% 506,701 55,845 49,728 9.07 6.83 1.25% 779,198 5,454,383 6,254,420 9.25% 578,534 37,230 18,806 15.54 11.07 1.50% 1,823,322 4,254,418 5,034,454 9.25% 465,687 36,299 16,802 12.83 12.75 1.25% 1,799,297 6,667,983 7,754,700 9.25% 717,310 50,571 37,808 14.18 9.58 1.00% 443,623 5,893,850 6,707,221 9.25% 620,418 37,851 25,027 16.39 11.12 1.50% 1,963,578 4,270,002 5,070,039 9.25% 468,979 37,230 26,470 12.60 11.66 1.00% 187,007 6,046,573 6,846,610 9.25% 633,311 37,230 6,183 17.01 10.06 1.50% 1,699,739 4,595,592 5,404,891 9.25% 499,952 37,230 28,245 13.43 14.98 1.75% 2,458,108 2,944,328 3,637,693 9.25% 336,487 32,266 21,224 10.43 7.27 1.50% 2,057,081 4,176,499 4,976,536 9.25% 460,330 37,230 23,620 12.36 10.42 1.00% 841,533 8,508,837 9,708,892 9.25% 898,073 55,845 34,135 16.08 15.49 1.50% 3,553,141 8,914,019 10,514,093 9.25% 972,554 74,460 70,190 13.06 9.70 2.00% 4,018,062 2,163,572 2,956,942 9.25% 273,517 36,920 36,049 7.41 7.57 1.50% 2,945,367 6,405,003 7,605,059 9.25% 703,468 55,845 40,455 12.60 18.42 1.00% 311,679 5,921,901 6,721,938 9.25% 621,779 37,230 24,404 16.70 11.46 1.25% 2,493,432 9,973,728 11,573,802 9.25% 1,070,577 74,460 49,661 14.38 9.58

Page 230: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name265721 SUMMER BROOK HEALTH CARE CENTER207446 TAYLOR CARE CENTER218171 WEST JACKSONVILLE HEALTH AND REHABILITATION CENTE214060 LIFE CARE CENTER OF HILLIARD225274 QUALITY HEALTH OF FERNANDINA BEACH999869 LIFE CARE ST. JOHNS, INC.263559 MOULTRIE CREEK NURSING AND REHAB CENTER207799 PONCE DE LEON CARE CENTER202606 SAMANTHA R WILSON SENIOR CITIZENS HOME316601 SAN MARCO TERRACE REHABILITATION AND CARE217735 ST AUGUSTINE HEALTH AND REHABILITATION CENTER999981 VICARS LANDING NURSING HOME212083 WESTMINSTER WOODS ON JULINGTON CREEK207527 AUBURNDALE OAKS HEALTHCARE CENTER212997 BARTOW CENTER251399 BRANDYWYNE HEALTH CARE CENTER319678 CONSULATE HEALTH CARE OF LAKE PARKER319953 CONSULATE HEALTH CARE OF LAKELAND319724 CONSULATE HEALTH CARE OF WINTER HAVEN269409 CROSSROADS, THE319341 DOVE HEALTHCARE AT LAKE WALES212971 FLORIDA PRESBYTERIAN HOMES INC212881 GROVES CENTER224341 HAINES CITY HEALTH CARE CENTER260576 HIGHLANDS LAKE CENTER212865 LAKELAND HILLS CENTER219380 LIFE CARE CENTER OF WINTER HAVEN203599 MANOR AT CARPENTERS, THE259926 OAKBRIDGE HEALTHCARE CENTER257320 PALM GARDEN OF WINTER HAVEN282626 PALM TERRACE OF LAKELAND202533 ROHR HOME, THE264571 SPRING LAKE REHABILITATION CENTER265560 VALENCIA HILLS HEALTH AND REHABILITATION CENTER252328 WEDGEWOOD HEALTHCARE CENTER228702 WINTER HAVEN HEALTH & REHABILITATION CENTER254291 ARCH PLAZA NURSING & REHABILITATION CENTER284823 AVENTURA PLAZA REHABILITATION & NURSING CENTER005388 BERKSHIRE MANOR208507 CLARIDGE HOUSE NURSING & REHABILITATION CENTER999864 CLASSIC RESIDENCE BY HYATT IN AVENTURA323772 CORAL GABLES NURSING AND REHABILITATION CENTER282529 CORAL REEF NURSING & REHABILITATION CENTER228788 EAST RIDGE RETIREMENT VILLAGE INC227226 FAIR HAVENS CENTER207993 FLORIDA CLUB CARE CENTER200425 FLORIDEAN NURSING HOME INC005523 FOUNTAINHEAD CARE CENTER319554 FRANCO NURSING & REHABILITATION CENTER214027 GRAMERCY PARK NURSING CENTER324027 HAMPTON COURT NURSING AND REHABILITATION CENTER269107 HARMONY HEALTH CENTER325244 HEARTLAND HEALTH CARE CENTER KENDALL325252 HEARTLAND HEALTH CARE CENTER MIAMI LAKES308242 HEBREW HOME OF SOUTH BEACH265730 HIALEAH CONVALESCENT HOME250988 HIALEAH SHORES NURSING AND REHAB CENTER212121 HOMESTEAD MANOR204161 JACKSON MEMORIAL LONG TERM CARE CENTER203670 JACKSON MEMORIAL PERDUE MEDICAL CENTER253723 JACKSON PLAZA NURSING & REHABILITATION CENTER210617 MIAMI GARDENS CARE CENTRE

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

2.00% 4,051,827 2,181,753 2,981,790 9.25% 275,816 37,230 37,950 7.41 6.42 1.50% 1,683,067 4,550,513 5,350,550 9.25% 494,926 37,230 22,462 13.29 10.71 1.25% 1,324,636 4,908,944 5,708,981 9.25% 528,081 37,230 21,718 14.18 10.23 1.25% 1,168,796 5,064,784 5,864,821 9.25% 542,496 37,230 25,145 14.57 8.40 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 30,530 10.70 12.01 2.00% - - - 9.25% - - - - - 1.50% 1,870,074 4,363,506 5,163,543 9.25% 477,628 37,230 23,882 12.83 10.22 1.50% 1,870,074 4,363,506 5,163,543 9.25% 477,628 37,230 24,036 12.83 16.54 1.50% 1,683,067 4,550,513 5,350,550 9.25% 494,926 37,230 18,830 13.29 11.24 1.75% 1,545,408 1,986,954 2,440,308 9.25% 225,728 21,097 12,691 10.70 4.86 2.00% 4,051,827 2,181,753 2,981,790 9.25% 275,816 37,230 24,234 7.41 8.36 2.00% - - - 9.25% - - - - - 1.25% 467,519 2,649,272 3,049,290 9.25% 282,059 18,615 5,543 15.15 2.80 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 27,482 12.65 19.21 2.00% 4,299,458 2,315,093 3,172,275 9.25% 293,435 37,230 28,367 7.88 6.87 1.75% 3,009,620 3,604,930 4,462,112 9.25% 412,745 37,230 31,608 11.09 8.20 1.25% 1,157,546 5,457,004 6,314,186 9.25% 584,062 37,230 23,305 15.69 14.77 1.50% 2,083,583 4,530,967 5,388,149 9.25% 498,404 37,230 26,820 13.39 7.50 1.25% 909,501 5,705,049 6,562,232 9.25% 607,006 37,230 18,858 16.30 10.27 1.75% 1,852,074 1,455,201 1,883,792 9.25% 174,251 18,615 12,974 9.36 7.29 1.00% 275,606 5,236,519 5,950,838 9.25% 550,452 31,025 17,651 17.74 12.40 1.25% 330,728 2,315,093 2,657,966 9.25% 245,862 14,892 5,840 16.51 10.07 1.00% 595,310 6,019,241 6,876,423 9.25% 636,069 37,230 28,048 17.08 6.02 1.75% 3,009,620 3,604,930 4,462,112 9.25% 412,745 37,230 19,516 11.09 12.57 1.50% 2,812,011 7,054,693 8,333,324 9.25% 770,832 55,535 40,062 13.88 10.40 2.00% 4,299,458 2,315,093 3,172,275 9.25% 293,435 37,230 27,831 7.88 5.51 1.00% 878,082 8,878,380 10,142,724 9.25% 938,202 54,914 27,151 17.08 10.43 1.00% 198,437 3,770,294 4,284,603 9.25% 396,326 22,338 3,534 17.74 13.38 1.00% 529,164 6,085,386 6,942,569 9.25% 642,188 37,230 14,805 17.25 9.87 1.25% 1,339,844 6,316,405 7,329,843 9.25% 678,010 37,230 26,230 18.21 13.68 1.75% 5,542,651 6,638,999 8,258,122 9.25% 763,876 57,396 34,517 13.31 8.98 1.25% 454,750 2,852,525 3,281,116 9.25% 303,503 18,615 16,528 16.30 14.40 1.50% 1,785,929 4,828,622 5,685,804 9.25% 525,937 37,230 21,692 14.13 11.19 1.75% 7,524,051 9,012,324 11,155,281 9.25% 1,031,863 93,075 62,892 11.09 10.11 1.25% 826,819 5,787,731 6,644,914 9.25% 614,655 37,230 18,136 16.51 11.50 1.50% 2,500,300 5,437,160 6,465,779 9.25% 598,085 44,676 33,227 13.39 9.06 1.00% 270,094 5,131,788 5,831,821 9.25% 539,443 30,405 22,217 17.74 14.30 1.75% 1,953,359 2,180,734 2,716,474 9.25% 251,274 23,269 17,939 10.80 9.23 1.75% 6,144,641 7,360,065 9,110,146 9.25% 842,688 76,011 36,913 11.09 12.85 1.50% 3,770,294 9,458,807 11,173,172 9.25% 1,033,518 74,460 57,352 13.88 13.29 2.00% - - - 9.25% - - - - - 1.50% 1,510,598 3,284,951 3,906,408 9.25% 361,343 26,992 19,443 13.39 13.52 1.25% 1,074,864 5,539,686 6,396,868 9.25% 591,710 37,230 24,182 15.89 10.39 2.00% 2,149,729 1,157,546 1,586,138 9.25% 146,718 18,615 2,514 7.88 6.03 2.00% 9,637,951 5,189,666 7,111,183 9.25% 657,784 83,457 68,823 7.88 8.53 1.50% 3,423,030 6,498,795 7,784,569 9.25% 720,073 55,845 43,903 12.89 16.15 1.25% 413,409 2,893,866 3,322,457 9.25% 307,327 18,615 6,259 16.51 11.55 1.75% 3,661,705 4,385,998 5,428,903 9.25% 502,174 45,297 39,229 11.09 15.14 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 28,253 16.10 10.40 1.50% 3,571,857 6,349,968 7,635,742 9.25% 706,306 55,845 42,793 12.65 14.44 1.50% 1,785,929 4,828,622 5,685,804 9.25% 525,937 37,230 27,332 14.13 13.87 2.00% 7,273,249 3,916,365 5,366,432 9.25% 496,395 62,981 33,878 7.88 9.72 1.50% 1,984,365 4,630,185 5,487,368 9.25% 507,581 37,230 14,330 13.63 10.05 1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 13,848 15.28 13.24 1.50% 1,977,750 3,754,860 4,497,751 9.25% 416,042 32,266 25,658 12.89 7.99 1.50% 4,792,241 10,421,224 12,392,743 9.25% 1,146,329 85,629 69,340 13.39 15.67 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 25,556 12.65 8.27 1.50% 1,217,077 2,310,683 2,767,847 9.25% 256,026 19,856 15,523 12.89 10.23 1.50% 2,827,720 7,094,105 8,379,879 9.25% 775,139 55,845 41,057 13.88 13.31 1.75% 4,717,001 4,267,763 5,432,102 9.25% 502,469 50,571 31,956 9.94 15.40 1.00% 595,310 6,019,241 6,876,423 9.25% 636,069 37,230 32,116 17.08 13.99 1.25% 1,405,592 5,208,958 6,066,141 9.25% 561,118 37,230 24,803 15.07 13.28

Page 231: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name200506 MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC.214035 MIAMI SHORES NURSING AND REHAB CENTER228001 NORTH BEACH REHABILITATION CENTER267902 NURSING CENTER AT MERCY, THE212733 OCEANSIDE EXTENDED CARE CENTER203327 PALACE AT KENDALL NURSING AND REHABILITATION CENT257494 PALM GARDEN OF AVENTURA324167 PALMETTO REHABILITATION AND HEALTH CENTER212806 PALMETTO SUB ACUTE CARE CENTER, INC225754 PINECREST CONVALESCENT CENTER200620 PINES NURSING HOME308251 PONCE PLAZA NURSING & REHABILITATION CENTER223239 REGENTS PARK AT AVENTURA207276 RIVERSIDE CARE CENTER324400 SIGNATURE HEALTHCARE CENTER OF WATERFORD324418 SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS260771 SINAI PLAZA NURSING & REHAB CENTER311308 SOUTH POINTE PLAZA REHABILITATION AND NURSING CEN209473 ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC268062 SUSANNA WESLEY HEALTH CENTER226602 TREASURE ISLE CARE CENTER227544 UNITY HEALTH AND REHABILITATION CENTER225177 VICTORIA NURSING & REHABILITATION CENTER, INC.203165 VILLA MARIA NURSING CENTER

0 VILLA MARIA WEST SKILLED NURSING FACILITY310409 WATERCREST CARE CENTER282359 WEST GABLES HEALTH CARE CENTER225291 ARISTOCRAT, THE999932 BENTLEY CARE CENTER999931 CHATEAU AT MOORINGS PARK, THE268585 HARBORCHASE OF NAPLES252280 HERITAGE HEALTHCARE & REHABILITATION CENTER226378 IMPERIAL HEALTH CARE CENTER256846 LAKESIDE PAVILLION CARE AND REHABILITATION CENTER325422 MANORCARE AT LELY PALMS325449 MANORCARE NURSING AND REHABILITATION CENTER999930 PREMIER PLACE AT THE GLENVIEW253456 HAWTHORNE HEALTH AND REHAB OF OCALA266108 LIFE CARE CENTER OF OCALA214043 MARION HOUSE HEALTH CARE CENTER227773 NEW HORIZON REHABILITATION CENTER251721 OAKHURST CARE AND REHABILITATION CENTER217395 OCALA HEALTH AND REHABILITATION CENTER257290 PALM GARDEN OF OCALA203335 TIMBERRIDGE NURSING & REHABILITATION CENTER203122 AVANTE AT LEESBURG, INC.252042 AVANTE AT MT. DORA, INC.260444 BAYVIEW CENTER210684 EDGEWATER AT WATERMAN VILLAGE227561 LADY LAKE SPECIALTY CARE CENTER213870 LAKE EUSTIS CARE CENTER228966 LAKE HARRIS HEALTH CENTER259225 LAKEVIEW TERRACE SKILLED NURSING FACILITY252956 LEESBURG HEALTH AND REHAB, LLC210439 NORTH CAMPUS REHABILITATION AND NURSING CENTER260452 RULEME CENTER221465 WESTMINSTER CARE OF CLERMONT320439 ADVENTIST CARE CENTERS-COURTLAND, INC223808 AVANTE AT ORLANDO, INC.252557 COLONIAL LAKES HEALTH CARE205796 COMMONS AT ORLANDO LUTHERAN TOWERS264512 CONWAY LAKES HEALTH & REHABILITATION CENTER

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.50% 7,257,815 18,208,203 21,508,355 9.25% 1,989,523 143,336 95,539 13.88 14.03 1.75% 2,769,429 2,687,574 3,394,750 9.25% 314,014 30,715 24,363 10.22 8.51 1.25% 818,551 4,638,453 5,345,629 9.25% 494,471 30,715 20,089 16.10 12.30 1.25% 1,240,228 5,374,322 6,231,504 9.25% 576,414 37,230 7,512 15.48 10.57 1.75% 5,861,043 4,942,722 6,342,787 9.25% 586,708 60,809 51,811 9.65 8.70 1.25% 1,736,319 8,185,506 9,471,279 9.25% 876,093 55,845 29,950 15.69 12.61 1.50% 1,984,365 4,630,185 5,487,368 9.25% 507,581 37,230 24,149 13.63 11.59 1.25% 1,054,194 3,906,719 4,549,605 9.25% 420,839 27,923 14,640 15.07 14.05 1.25% 785,478 4,451,041 5,129,644 9.25% 474,492 29,474 9,794 16.10 12.01 2.00% 3,582,881 1,929,244 2,643,563 9.25% 244,530 31,025 25,073 7.88 7.40 1.75% 1,375,551 1,160,027 1,488,613 9.25% 137,697 14,272 11,660 9.65 6.38 1.00% 648,226 7,454,598 8,504,646 9.25% 786,680 45,607 30,865 17.25 14.43 1.25% 1,364,251 8,557,574 9,843,348 9.25% 910,510 55,845 33,894 16.30 14.79 1.50% 2,282,020 4,332,530 5,189,713 9.25% 480,048 37,230 37,787 12.89 7.25 1.50% 3,538,784 8,257,163 9,785,805 9.25% 905,187 66,394 59,169 13.63 14.43 1.50% 2,182,802 4,431,749 5,288,931 9.25% 489,226 37,230 30,359 13.14 15.71 1.25% 1,033,523 7,234,664 8,306,142 9.25% 768,318 46,538 26,510 16.51 15.50 1.50% 4,564,040 8,113,848 9,756,781 9.25% 902,502 71,358 53,393 12.65 7.97 1.25% 2,645,820 10,583,280 12,297,645 9.25% 1,137,532 74,460 48,960 15.28 12.34 1.50% 2,282,020 4,332,530 5,189,713 9.25% 480,048 37,230 27,145 12.89 14.41 1.50% 3,492,482 6,208,858 7,466,059 9.25% 690,610 54,604 49,228 12.65 10.62 1.50% 5,347,864 10,857,784 12,957,881 9.25% 1,198,604 91,214 90,349 13.14 10.55 1.00% 1,115,654 12,830,022 14,637,249 9.25% 1,353,945 78,493 50,276 17.25 14.01 1.25% 1,752,856 9,932,849 11,447,205 9.25% 1,058,866 65,773 43,453 16.10 13.40 2.00% #VALUE! #VALUE! #VALUE! 9.25% #VALUE! - - 1.25% 1,446,933 6,821,255 7,892,733 9.25% 730,078 46,538 41,307 15.69 13.19 1.25% 1,405,592 5,208,958 6,066,141 9.25% 561,118 37,230 17,669 15.07 13.91 1.25% 521,955 2,690,077 3,104,382 9.25% 287,155 18,615 8,182 15.43 12.65 2.00% - - - 9.25% - - - - - 2.00% - - - 9.25% - - - - - 1.00% 192,722 1,948,633 2,224,836 9.25% 205,797 12,410 4,028 16.58 11.97 1.75% 2,271,844 2,920,942 3,590,735 9.25% 332,143 30,094 21,911 11.04 12.42 1.00% 544,440 5,504,888 6,285,163 9.25% 581,378 35,058 15,992 16.58 10.08 1.50% 2,119,941 4,304,124 5,132,733 9.25% 474,778 37,230 24,409 12.75 10.32 1.50% 2,160,895 4,102,569 4,910,463 9.25% 454,218 36,299 18,219 12.51 10.72 1.25% 1,284,813 5,139,252 5,967,862 9.25% 552,027 37,230 19,295 14.83 10.13 2.00% - - - 9.25% - - - - - 1.50% 1,717,354 4,643,216 5,462,302 9.25% 505,263 37,230 23,973 13.57 13.45 1.25% 874,578 5,485,992 6,305,077 9.25% 583,220 37,230 10,782 15.67 11.72 1.50% 1,717,354 4,643,216 5,462,302 9.25% 505,263 37,230 25,445 13.57 13.19 1.25% 1,685,551 6,742,204 7,827,492 9.25% 724,043 49,330 31,011 14.68 12.81 1.25% 1,908,171 7,632,684 8,861,312 9.25% 819,671 55,845 22,667 14.68 12.48 1.75% 4,841,984 4,698,871 5,927,499 9.25% 548,294 55,845 43,147 9.82 11.30 1.25% 2,044,852 8,861,024 10,294,406 9.25% 952,233 55,845 36,572 17.05 14.28 1.25% 1,788,910 7,751,945 8,980,573 9.25% 830,703 55,845 22,088 14.88 10.07 2.00% 4,156,142 2,237,923 3,066,533 9.25% 283,654 35,989 12,947 7.88 11.07 2.00% 4,156,142 2,237,923 3,066,533 9.25% 283,654 35,989 16,668 7.88 7.92 1.75% 3,009,620 3,604,930 4,462,112 9.25% 412,745 37,230 26,000 11.09 9.41 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 15,038 16.10 9.10 1.00% 719,332 7,273,249 8,309,011 9.25% 768,584 44,986 18,100 17.08 14.53 1.75% 2,257,215 2,703,697 3,346,584 9.25% 309,559 27,923 18,467 11.09 9.86 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 18,009 16.10 11.93 1.75% 540,188 562,237 705,101 9.25% 65,222 6,205 688 10.51 6.90 1.75% 2,893,866 3,720,684 4,577,867 9.25% 423,453 37,230 15,592 11.37 7.55 1.50% 1,885,147 4,729,403 5,586,586 9.25% 516,759 37,230 15,413 13.88 12.03 1.25% 1,521,347 6,085,386 7,071,146 9.25% 654,081 42,815 25,721 15.28 8.20 1.50% 3,461,063 6,571,004 7,871,064 9.25% 728,073 56,466 38,692 12.89 8.61 1.00% 463,019 6,151,532 7,008,714 9.25% 648,306 37,230 21,191 17.41 8.56 2.00% 4,227,800 2,276,508 3,119,404 9.25% 288,545 36,610 27,169 7.88 9.27 1.50% 2,827,720 7,094,105 8,379,879 9.25% 775,139 55,845 42,576 13.88 12.23 1.00% 208,358 6,736,919 7,636,961 9.25% 706,419 39,092 17,781 18.07 15.54 1.50% 1,785,929 4,828,622 5,685,804 9.25% 525,937 37,230 22,023 14.13 10.96

Page 232: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name324175 COURTYARDS OF ORLANDO REHABILITATION AND HEALTH 320421 EAST ORLANDO HEALTH & REHAB CENTER, INC201651 GUARDIAN CARE NURSING & REHABILITATION CENTER228877 HEALTH CENTER OF WINDERMERE, THE204811 HEALTH CENTRAL PARK263605 HUNTERS CREEK NURSING AND REHAB CENTER318761 LAKE BENNETT HEALTH AND REHABILITATION CENTER213403 LIFE CARE CENTER OF ORLANDO325279 MANOR CARE NURSING & REHABILITATION CENTER201588 MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC.999941 MAYFLOWER HEALTHCARE CENTER263541 METRO WEST NURSING AND REHAB CENTER324159 OCOEE HEALTH CARE CENTER257303 PALM GARDEN OF ORLANDO259934 PARKS HEALTHCARE AND REHABILITATION CENTER225410 QUALITY HEALTH OF ORANGE COUNTY269719 REGENTS PARK OF WINTER PARK005380 REHABILITATION CENTER OF WINTER PARK, THE252450 RIO PINAR HEALTH CARE252468 ROSEWOOD HEALTH AND REHABILITATION CENTER312550 SAVANNAH COVE320412 SUNBELT HEALTH & REHAB CENTER-APOPKA, INC261611 TERRA VISTA REHAB AND HEALTH CENTER221589 WESTMINSTER CARE OF DELANEY PARK223654 WESTMINSTER CARE OF ORLANDO208540 WESTMINSTER TOWERS324515 WINTER PARK CARE & REHABILITATION CENTER209848 WINTER PARK TOWERS259870 AVANTE AT ST CLOUD, INC.319511 CONSULATE HEALTH CARE OF KISSIMMEE205303 GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE317560 KEYSTONE REHABILITATION AND HEALTH CENTER005549 OAKS OF KISSIMMEE217859 OSCEOLA HEALTH CARE CENTER253421 PALMS AT PARK PLACE, THE252441 PLANTATION BAY REHABILITATION CENTER253146 SOUTHERN OAKS HEALTH CARE CENTER319546 CONSULATE HEALTH CARE OF WEST ALTAMONTE320463 FLNC, INC263931 HEALTHCARE & REHAB OF SANFORD260657 ISLAND LAKE CENTER252310 LAKE MARY HEALTH AND REHABILITATION CENTER210137 LIFE CARE CENTER OF ALTAMONTE SPRINGS005379 LONGWOOD HEALTH CARE CENTER313718 LUTHERAN HAVEN NURSING HOME263591 TUSKAWILLA NURSING AND REHAB CENTER999936 VILLAGE ON THE GREEN324451 ANCHOR CARE AND REHABILITATION CENTER263389 ATLANTIC SHORES NURSING AND REHAB CENTER252018 AVANTE AT MELBOURNE, INC.005519 CARNEGIE GARDENS NURSING CENTER319520 CONSULATE HEALTH CARE OF MELBOURNE209325 COURTENAY SPRINGS VILLAGE226700 HEALTH CENTER OF MERRITT ISLAND, THE211281 HUNTINGTON PLACE CARE AND REHABILITATION CENTER260665 INDIAN RIVER CENTER252352 ISLAND HEALTH AND REHABILITATION CENTER228338 LIFE CARE CENTER OF MELBOURNE268186 LIFE CARE CENTER OF PALM BAY264547 MELBOURNE TERRACE REHABILITATION CENTER252395 PALMS REHABILITATION AND HEALTHCARE CENTER, THE227587 ROCKLEDGE HEALTH AND REHABILITATION CENTER

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.75% 2,893,866 3,720,684 4,577,867 9.25% 423,453 37,230 34,288 11.37 7.21 1.25% 909,501 5,705,049 6,562,232 9.25% 607,006 37,230 20,841 16.30 8.34 1.50% 2,182,802 4,431,749 5,288,931 9.25% 489,226 37,230 29,942 13.14 14.83 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 17,169 16.10 9.88 1.25% 1,728,051 10,839,594 12,468,241 9.25% 1,153,312 70,737 49,307 16.30 14.08 1.25% 799,258 5,594,807 6,423,417 9.25% 594,166 35,989 22,165 16.51 10.32 1.25% 992,183 5,622,368 6,479,550 9.25% 599,358 37,230 22,623 16.10 10.78 1.00% 529,164 6,085,386 6,942,569 9.25% 642,188 37,230 6,167 17.25 9.69 1.75% 4,259,770 3,346,962 4,332,722 9.25% 400,777 42,815 19,921 9.36 6.78 1.00% 88,194 2,116,656 2,402,384 9.25% 222,220 12,410 8,908 17.91 14.94 2.00% - - - 9.25% - - - - - 1.25% 1,240,228 5,374,322 6,231,504 9.25% 576,414 37,230 24,385 15.48 9.90 1.25% 1,157,546 5,457,004 6,314,186 9.25% 584,062 37,230 23,905 15.69 16.70 1.25% 1,531,250 6,124,999 7,138,437 9.25% 660,305 37,230 26,820 17.74 13.20 1.25% 909,501 5,705,049 6,562,232 9.25% 607,006 37,230 28,500 16.30 9.95 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 27,315 12.65 14.73 1.50% 2,083,583 4,530,967 5,388,149 9.25% 498,404 37,230 15,780 13.39 10.90 1.75% 4,514,430 5,407,395 6,693,168 9.25% 619,118 55,845 27,505 11.09 13.02 1.50% 3,274,202 6,647,623 7,933,397 9.25% 733,839 55,845 41,425 13.14 11.70 1.50% 2,282,020 4,332,530 5,189,713 9.25% 480,048 37,230 28,520 12.89 12.33 1.25% 322,459 1,827,269 2,105,854 9.25% 194,791 12,100 3,140 16.10 9.09 1.25% 1,240,228 5,374,322 6,231,504 9.25% 576,414 37,230 23,166 15.48 8.34 1.75% 3,438,877 2,900,067 3,721,533 9.25% 344,242 35,679 24,269 9.65 12.13 1.25% 578,773 2,728,502 3,157,093 9.25% 292,031 18,615 8,779 15.69 10.29 1.75% 11,343,953 11,806,972 14,807,111 9.25% 1,369,658 130,305 94,756 10.51 11.53 1.50% 1,984,365 4,630,185 5,487,368 9.25% 507,581 37,230 16,336 13.63 13.01 1.75% 2,781,969 2,895,519 3,631,268 9.25% 335,892 31,956 21,865 10.51 5.48 1.75% 3,009,620 3,604,930 4,462,112 9.25% 412,745 37,230 12,918 11.09 7.38 2.00% 4,693,574 2,527,309 3,463,067 9.25% 320,334 40,643 30,175 7.88 8.20 1.25% 826,819 5,787,731 6,644,914 9.25% 614,655 37,230 25,241 16.51 10.46 1.25% 1,991,255 7,379,357 8,593,699 9.25% 794,917 52,743 29,130 15.07 11.46 1.00% 198,437 6,416,114 7,273,296 9.25% 672,780 37,230 13,327 18.07 10.35 1.50% 1,170,775 2,081,378 2,502,826 9.25% 231,511 18,305 17,376 12.65 7.67 1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 25,098 15.28 14.12 1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 24,615 15.28 13.86 1.25% 1,157,546 5,457,004 6,314,186 9.25% 584,062 37,230 23,149 15.69 10.36 1.50% 2,083,583 4,530,967 5,388,149 9.25% 498,404 37,230 29,415 13.39 10.85 1.25% 1,198,887 5,195,178 6,023,788 9.25% 557,200 35,989 21,390 15.48 13.30 1.50% 3,340,348 7,794,145 9,237,069 9.25% 854,429 62,671 50,876 13.63 11.16 2.00% 4,084,485 2,199,338 3,013,661 9.25% 278,764 35,369 26,219 7.88 4.39 1.50% 1,885,147 4,729,403 5,586,586 9.25% 516,759 37,230 23,869 13.88 10.44 1.00% 595,310 6,019,241 6,876,423 9.25% 636,069 37,230 22,924 17.08 11.34 1.25% 2,811,184 10,417,916 12,132,281 9.25% 1,122,236 74,460 46,025 15.07 11.60 1.75% 3,009,620 3,604,930 4,462,112 9.25% 412,745 37,230 27,824 11.09 8.72 1.00% 92,604 2,222,489 2,522,503 9.25% 233,331 13,031 7,048 17.91 8.52 1.25% 945,329 4,456,553 5,156,585 9.25% 476,984 30,405 13,031 15.69 8.94 2.00% - - - 9.25% - - - - - 1.50% 2,449,813 4,355,222 5,240,978 9.25% 484,790 37,230 25,809 13.02 6.35 1.25% 850,629 5,954,406 6,840,161 9.25% 632,715 37,230 22,082 16.99 10.43 2.00% 4,054,667 2,183,282 2,995,224 9.25% 277,058 34,128 24,345 8.12 9.30 1.75% 3,560,735 4,265,056 5,283,674 9.25% 488,740 42,815 31,155 11.42 11.26 1.25% 1,538,930 7,931,410 9,164,086 9.25% 847,678 51,812 25,821 16.36 13.39 1.50% 1,796,529 3,647,499 4,356,103 9.25% 402,940 29,784 20,139 13.53 18.41 1.25% 2,041,511 8,166,042 9,494,675 9.25% 878,257 55,845 27,285 15.73 11.05 2.00% 3,686,061 1,984,802 2,722,931 9.25% 251,871 31,025 17,733 8.12 7.05 1.50% 2,892,991 7,257,853 8,579,105 9.25% 793,567 55,535 45,880 14.29 10.34 1.75% 3,096,291 3,708,744 4,594,499 9.25% 424,991 37,230 25,958 11.42 8.01 1.25% 935,692 5,869,343 6,755,098 9.25% 624,847 37,230 15,105 16.78 12.76 1.00% 239,877 7,756,039 8,796,801 9.25% 813,704 43,745 19,774 18.60 11.32 1.50% 1,939,435 4,865,600 5,751,355 9.25% 532,000 37,230 25,479 14.29 14.12 1.25% 935,692 5,869,343 6,755,098 9.25% 624,847 37,230 27,197 16.78 11.48 1.50% 2,093,399 3,974,424 4,764,222 9.25% 440,691 33,197 24,304 13.28 10.06

Page 233: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name263583 ROYAL OAKS NURSING AND REHAB CENTER263974 TITUSVILLE REHABILITATION & NURSING CENTER252522 VISTA MANOR217727 WEST MELBOURNE HEALTH & REHABILITATION CENTER253472 WUESTHOFF PROGRESSIVE CARE CENTER005374 FLAGLER PINES252409 GRAND OAKS HEALTH AND REHABILITATION CENTER212989 BAY CENTER264491 CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOM318779 COMMUNITY HEALTH AND REHABILITATION CENTER252191 EMERALD SHORES HEALTH AND REHABILITATION005384 GLEN COVE NURSING PAVILION203980 LISENBY ON LAKE CAROLINE005385 PANAMA CITY NURSING CENTER252247 SEA BREEZE HEALTH CARE323799 ST ANDREWS BAY SKILLED NURSING AND REHABILITATION 208809 BAPTIST MANOR213853 BAYSIDE MANOR220604 CENTURY CARE CENTER319686 CONSULATE HEALTH CARE OF PENSACOLA258831 HAVEN OF OUR LADY OF PEACE229571 HEALTH CENTER OF PENSACOLA, THE315664 LIFE CARE CENTER OF PENSACOLA224243 PENSACOLA HEALTH CARE FACILITY211842 ROSEWOOD MANOR324566 SOUTHERN OAKS REHABILITATION AND NURSING CENTER213918 SPECIALTY CENTER OF PENSACOLA252123 UNIVERSITY HILLS HEALTH AND REHABILITATION210374 WILLOWBROOKE COURT AT AZALEA TRACE213816 BAY BREEZE NURSING AND RETIREMENT CENTER220621 SANDY RIDGE CARE CENTER220612 SANTA ROSA HEALTH & REHABILITATION CENTER259331 UNIHEALTH POST-ACUTE CARE - SANTA ROSA201545 EDGEWATER MANOR226033 MARTIN NURSING AND RESTORATIVE CARE CENTER263621 PALM CITY NURSING & REHAB CENTER228885 PARKWAY HEALTH & REHABILITATION CENTER214141 SALERNO BAY MANOR225991 STUART NURSING & RESTORATIVE CARE CENTER213152 WATERS EDGE EXTENDED CARE268755 ABBIEJEAN RUSSELL CARE CENTER LLC210781 BRIGHTON GARDENS OF PORT ST LUCIE261637 EMERALD HEALTH CARE CENTER252239 FORT PIERCE HEALTH CARE211516 LAUREL POINTE HEALTH AND REHABILITATION217824 LIFE CARE CENTER OF PORT SAINT LUCIE257249 PALM GARDEN OF PORT SAINT LUCIE226009 PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTE263532 TIFFANY HALL NURSING AND REHAB CENTER226327 CHARLOTTE HARBOR HEALTHCARE320129 CONSULATE HEALTH CARE OF PORT CHARLOTTE269492 DOUGLAS JACOBSON STATE VETERANS NURSING HOME252204 ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER319333 HARBOUR HEALTH CENTER311685 LIFE CARE CENTER OF PUNTA GORDA319325 PORT CHARLOTTE REHABILITATION CENTER324477 SIGNATURE HEALTHCARE OF PORT CHARLOTTE002400 VILLAGE PLACE HEALTH AND REHABILITATION CENTER310581 ATLANTIC HEALTHCARE CENTER320145 CONSULATE HEALTH CARE OF VERO BEACH001416 FLORIDA BAPTIST RETIREMENT CENTER257311 PALM GARDEN OF VERO BEACH

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 16,872 15.28 9.69 1.75% 4,391,923 4,262,113 5,383,593 9.25% 497,982 48,709 34,090 10.22 5.62 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 23,091 12.65 11.85 1.75% 4,823,069 5,384,484 6,713,117 9.25% 620,963 55,845 27,793 11.12 8.27 1.25% 1,131,337 5,333,446 6,174,914 9.25% 571,180 35,369 13,056 16.15 8.80 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 28,009 12.65 10.98 1.25% 909,501 5,705,049 6,562,232 9.25% 607,006 37,230 20,084 16.30 11.37 2.00% 5,127,291 2,760,849 3,764,070 9.25% 348,176 49,640 35,771 7.01 8.75 1.00% 354,966 5,561,139 6,313,554 9.25% 584,004 37,230 13,590 15.69 5.44 1.25% 813,464 5,102,641 5,855,056 9.25% 541,593 37,230 20,161 14.55 11.42 1.00% 341,655 3,454,512 3,937,312 9.25% 364,201 23,889 13,272 15.25 11.56 1.25% 1,272,891 4,717,183 5,486,319 9.25% 507,485 35,679 26,489 14.22 13.20 1.50% 292,847 791,772 929,715 9.25% 85,999 6,826 3,134 12.60 14.30 1.75% 2,588,296 3,327,809 4,080,225 9.25% 377,421 37,230 27,680 10.14 6.40 1.75% 3,002,423 2,913,682 3,666,097 9.25% 339,114 37,230 25,629 9.11 7.77 1.25% 961,367 4,954,738 5,707,154 9.25% 527,912 37,230 28,545 14.18 17.09 1.25% 1,226,618 7,694,239 8,841,117 9.25% 817,803 52,743 36,352 15.51 15.09 1.75% 3,305,964 2,991,111 3,800,672 9.25% 351,562 37,230 25,476 9.44 8.07 1.25% 750,401 3,867,454 4,461,132 9.25% 412,655 27,302 23,200 15.11 9.57 1.25% 944,561 5,352,514 6,162,075 9.25% 569,992 37,230 23,415 15.31 13.77 1.00% 440,795 5,856,280 6,665,841 9.25% 616,590 37,230 12,937 16.56 6.50 1.50% 2,692,000 6,753,613 7,967,955 9.25% 737,036 55,845 35,172 13.20 15.45 1.00% 125,942 6,171,134 6,980,695 9.25% 645,714 37,230 3,108 17.34 10.26 1.75% 2,925,778 3,266,345 4,062,414 9.25% 375,773 36,610 23,791 10.26 5.49 2.00% 5,286,919 2,846,803 3,892,486 9.25% 360,055 48,089 41,975 7.49 5.93 1.75% 5,978,286 5,041,596 6,458,328 9.25% 597,395 65,153 40,836 9.17 5.17 1.50% 1,700,210 4,596,865 5,406,426 9.25% 500,094 37,230 24,452 13.43 13.96 1.75% 2,754,970 3,542,105 4,351,666 9.25% 402,529 37,230 28,655 10.81 11.68 1.75% 2,530,899 3,031,517 3,746,629 9.25% 346,563 32,887 13,063 10.54 5.60 1.75% 3,232,462 4,156,022 5,129,294 9.25% 474,460 37,230 - 12.74 13.15 1.50% 1,086,245 2,062,292 2,467,073 9.25% 228,204 18,615 15,275 12.26 14.11 1.75% 2,727,421 3,044,898 3,786,996 9.25% 350,297 34,128 28,354 10.26 9.78 1.00% 377,825 5,919,251 6,728,812 9.25% 622,415 37,230 27,699 16.72 11.42 1.50% 2,194,397 4,166,173 4,985,259 9.25% 461,136 37,230 26,132 12.39 12.07 1.25% 954,086 5,406,485 6,225,570 9.25% 575,865 37,230 14,826 15.47 11.24 1.25% 1,229,710 4,918,841 5,710,623 9.25% 528,233 35,989 20,434 14.68 9.71 1.25% 1,876,368 7,505,473 8,713,624 9.25% 806,010 54,914 32,413 14.68 8.85 1.50% 2,289,805 4,070,765 4,889,850 9.25% 452,311 37,230 26,303 12.15 11.41 2.00% 4,134,371 2,226,200 3,045,285 9.25% 281,689 37,230 18,766 7.57 10.68 1.00% 19,082 1,889,089 2,134,815 9.25% 197,470 11,169 1,773 17.68 11.45 1.75% 2,051,814 2,135,561 2,674,793 9.25% 247,418 24,510 14,633 10.09 4.94 1.25% 218,645 1,371,498 1,576,269 9.25% 145,805 9,308 3,731 15.67 13.45 1.25% 1,113,100 5,247,470 6,066,556 9.25% 561,156 37,230 23,213 15.07 12.59 1.50% 3,262,972 5,800,840 6,968,037 9.25% 644,543 53,053 46,532 12.15 10.10 1.75% 2,779,039 2,892,469 3,622,820 9.25% 335,111 33,197 26,838 10.09 6.97 1.25% 814,948 5,704,636 6,544,199 9.25% 605,338 38,161 12,560 15.86 10.76 1.50% 2,003,580 4,356,990 5,176,076 9.25% 478,787 37,230 26,872 12.86 10.48 1.75% 4,508,054 5,032,801 6,261,429 9.25% 579,182 55,845 32,535 10.37 13.22 1.25% 1,272,114 5,088,456 5,907,542 9.25% 546,448 37,230 25,728 14.68 9.87 1.25% 1,806,768 7,829,329 9,072,244 9.25% 839,183 55,845 25,362 15.03 11.21 1.25% 883,309 5,540,756 6,369,366 9.25% 589,166 37,230 24,040 15.83 10.22 1.00% 321,203 6,102,862 6,931,472 9.25% 641,161 37,230 22,570 17.22 5.53 1.75% 2,838,308 3,649,253 4,487,387 9.25% 415,083 37,230 22,931 11.15 11.48 1.50% 1,927,220 4,496,846 5,325,455 9.25% 492,605 37,230 11,886 13.23 14.43 1.00% 385,444 9,250,654 10,493,568 9.25% 970,655 55,845 31,599 17.38 17.59 1.25% 1,365,114 5,058,951 5,887,561 9.25% 544,599 37,230 23,662 14.63 15.27 1.50% 3,160,640 5,618,916 6,751,349 9.25% 624,500 50,881 20,511 12.27 6.64 1.50% 1,503,231 4,064,292 4,782,420 9.25% 442,374 32,266 16,556 13.71 12.36 1.75% 2,947,431 3,290,518 4,102,460 9.25% 379,478 34,128 21,165 11.12 7.18 1.50% 2,569,751 6,446,920 7,620,546 9.25% 704,900 49,330 34,435 14.29 10.13 2.00% 884,655 476,352 653,504 9.25% 60,449 7,446 1,971 8.12 5.76 1.25% 2,289,456 8,484,455 9,898,042 9.25% 915,569 55,845 39,543 16.39 13.11

Page 234: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name999919 ROYAL PALM HEALTHCARE & REHABILITATION CENTER001416 WILLOWBROOKE COURT AT INDIAN RIVER ESTATES005386 RIVERCHASE CARE CENTER005381 BRYNWOOD CENTER214001 JEFFERSON HEALTH AND REHABILITATION CENTER252093 CAPITAL HEALTHCARE CENTER264563 CENTRE POINTE HEALTH AND REHAB CENTER319716 CONSULATE HEALTH CARE OF TALLAHASSEE252298 HERITAGE HEALTHCARE CENTER202941 MIRACLE HILL NURSING & CONVALESCENT CENTER, INC.200409 WESTMINSTER OAKS253707 EDEN SPRINGS NURSING AND REHAB CENTER228958 BROOKSVILLE HEALTHCARE CENTER263893 EVERGREEN WOODS325295 HEARTLAND OF BROOKSVILLE252174 HERON POINTE HEALTH AND REHABILITATION252492 SPRING HILL HEALTH AND REHABILITATION CENTER263575 BAYSHORE POINTE NURSING AND REHAB CENTER252077 BRANDON HEALTH AND REHABILITATION CENTER284793 BRIGHTON GARDENS OF TAMPA999949 CANTERBURY TOWERS INC263877 CARROLLWOOD CARE CENTER259900 CENTRAL PARK HEALTHCARE & REHABILITATION CENTER281913 COMMUNITY CONVALESCENT CENTER319660 CONSULATE HEALTH CARE OF BRANDON324116 EXCEL REHABILITATION AND HEALTH CENTER260690 FAIRWAY OAKS CENTER252221 FLETCHER HEALTH AND REHABILITATION CENTER252506 HABANA HEALTH CARE CENTER261670 HAWTHORNE HEALTH AND REHAB OF BRANDON213039 HEALTH CARE CENTER OF TAMPA226343 HEALTH CENTER OF PLANT CITY, THE201154 HOME ASSOCIATION, INC., THE210285 JOHN KNOX VILLAGE MED CENTER218057 LAKESHORE VILLAS HEALTH CARE CENTER325678 MANORCARE HEALTH SERVICES CARROLLWOOD259462 NURSING CENTER AT UNIVERSITY VILLAGE, THE257516 PALM GARDEN OF SUN CITY257524 PALM GARDEN OF TAMPA211885 PLAZA WEST263940 REHABILITATION AND HEALTHCARE CENTER OF TAMPA224910 SOUTH TAMPA HEALTH AND REHABILITATION CENTER209856 SUN TERRACE HEALTH CARE CENTER266612 WHISPERING OAKS324141 WOODBRIDGE REHABILITATION & HEALTH CENTER212164 YBOR CITY HEALTHCARE & REHABILITATION CENTER214914 BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME226076 BAYONET POINT HEALTH & REHABILITATION CENTER228567 BEAR CREEK NURSING CENTER319651 CONSULATE HEALTH CARE OF BAYONET POINT319970 CONSULATE HEALTH CARE OF NEW PORT RICHEY325708 HEARTLAND OF ZEPHYRHILLS228591 HEATHER HILL HEALTHCARE CENTER214132 HERITAGE PARK259357 LIFE CARE CENTER OF NEW PORT RICHEY324124 MADISON POINTE REHABILITATION AND HEALTH CENTER252689 ORCHARD RIDGE CARE AND REHABILITATION CENTER228575 ROYAL OAK NURSING CENTER262706 SOUTHERN PINES HEALTHCARE CENTER003521 TRINITY REGIONAL REHAB CENTER263991 WINDSOR WOODS REHABILITATION AND HEALTHCARE CEN320391 ZEPHYR HAVEN HEALTH & REHAB CENTER, INC

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

2.00% - - - 9.25% - - - - - 2.00% 884,655 476,352 653,504 9.25% 60,449 7,446 1,971 8.12 5.76 1.50% 2,152,656 3,826,944 4,588,884 9.25% 424,472 37,230 36,523 11.40 14.01 1.50% 1,595,058 3,238,452 3,854,353 9.25% 356,528 30,094 24,783 11.85 11.04 1.25% 373,725 2,616,075 2,997,045 9.25% 277,227 18,615 13,843 14.89 13.87 1.50% 2,215,442 5,558,038 6,548,560 9.25% 605,742 48,399 33,482 12.52 9.72 1.50% 1,883,574 4,096,026 4,857,966 9.25% 449,362 37,230 17,057 12.07 9.57 1.25% 971,685 5,007,915 5,769,855 9.25% 533,712 37,230 15,962 14.34 13.60 1.50% 2,825,361 6,144,039 7,286,949 9.25% 674,043 55,845 42,084 12.07 11.79 1.00% 358,776 5,620,824 6,382,764 9.25% 590,406 37,230 35,980 15.86 14.75 1.25% 1,121,175 4,858,425 5,620,365 9.25% 519,884 37,230 11,412 13.96 11.36 1.75% 3,243,933 2,735,667 3,497,607 9.25% 323,529 37,230 28,393 8.69 9.69 1.50% 3,005,120 5,342,436 6,425,819 9.25% 594,388 46,538 29,969 12.77 11.52 1.50% 2,303,926 4,374,119 5,240,826 9.25% 484,776 37,230 21,176 13.02 12.14 1.50% 2,003,414 4,674,632 5,541,338 9.25% 512,574 37,230 22,128 13.77 10.92 1.75% 2,921,645 3,756,400 4,623,107 9.25% 427,637 37,230 28,906 11.49 7.50 1.25% 1,001,707 5,676,338 6,543,045 9.25% 605,232 37,230 16,687 16.26 11.20 1.75% 3,190,436 3,320,658 4,165,697 9.25% 385,327 36,299 21,786 10.62 11.11 1.25% 1,001,707 5,676,338 6,543,045 9.25% 605,232 37,230 18,527 16.26 11.01 1.25% 313,033 2,191,234 2,516,249 9.25% 232,753 13,961 5,102 16.67 5.17 2.00% - - - 9.25% - - - - - 1.50% 1,903,243 4,774,802 5,641,509 9.25% 521,840 37,230 26,885 14.02 11.89 1.50% 1,803,072 4,874,973 5,741,680 9.25% 531,105 37,230 24,107 14.27 8.67 1.75% 3,739,705 2,938,340 3,805,047 9.25% 351,967 37,230 32,751 9.45 7.31 1.25% 834,756 5,843,289 6,709,996 9.25% 620,675 37,230 30,145 16.67 14.90 1.25% 1,001,707 5,676,338 6,543,045 9.25% 605,232 37,230 24,029 16.26 15.59 1.50% 2,203,755 4,474,290 5,340,997 9.25% 494,042 37,230 31,922 13.27 9.42 1.25% 918,231 5,759,814 6,626,521 9.25% 612,953 37,230 21,921 16.46 11.47 1.75% 3,944,220 4,403,336 5,486,719 9.25% 507,522 46,538 35,794 10.91 7.85 1.00% 534,244 6,143,801 7,010,508 9.25% 648,472 37,230 17,236 17.42 13.12 1.75% 7,512,522 7,290,477 9,211,677 9.25% 852,080 82,527 67,157 10.32 8.52 1.50% 2,704,608 7,312,459 8,612,519 9.25% 796,658 55,845 39,293 14.27 10.02 2.00% 3,472,583 1,869,853 2,563,218 9.25% 237,098 29,784 21,795 7.96 8.12 1.50% 3,129,499 5,941,512 7,118,789 9.25% 658,488 50,571 20,755 13.02 9.11 1.50% 2,988,425 6,972,992 8,265,830 9.25% 764,589 55,535 39,501 13.77 10.43 1.25% 1,252,133 5,425,912 6,292,618 9.25% 582,067 37,230 11,649 15.63 11.05 1.25% 1,419,085 5,258,960 6,125,667 9.25% 566,624 37,230 22,891 15.22 9.97 1.25% 1,036,972 5,876,175 6,778,147 9.25% 626,979 37,230 21,301 16.84 15.11 1.50% 2,003,414 4,674,632 5,541,338 9.25% 512,574 37,230 26,582 13.77 14.66 1.25% 864,668 5,423,825 6,239,974 9.25% 577,198 35,058 9,342 16.46 10.84 2.00% 6,294,057 3,389,108 4,645,833 9.25% 429,740 53,984 42,155 7.96 4.29 1.75% 5,229,744 4,731,673 6,024,511 9.25% 557,267 55,535 46,213 10.03 8.25 1.50% 1,819,767 4,246,124 5,033,382 9.25% 465,588 33,817 16,032 13.77 11.18 1.50% 4,808,192 8,547,898 10,281,311 9.25% 951,021 74,460 73,003 12.77 7.04 1.75% 3,038,510 3,639,535 4,506,241 9.25% 416,827 37,230 27,223 11.20 10.36 1.50% 1,268,829 3,183,201 3,761,006 9.25% 347,893 24,820 21,688 14.02 10.49 1.25% 834,756 5,843,289 6,709,996 9.25% 620,675 37,230 26,806 16.67 9.44 1.50% 2,854,864 7,162,203 8,462,263 9.25% 782,759 55,845 31,160 14.02 13.36 1.75% 3,272,242 3,405,803 4,272,510 9.25% 395,207 37,230 20,607 10.62 7.73 1.25% 918,231 5,759,814 6,626,521 9.25% 612,953 37,230 22,202 16.46 10.58 1.50% 2,103,584 4,574,461 5,441,168 9.25% 503,308 37,230 26,626 13.52 7.25 1.50% 2,103,584 4,574,461 5,441,168 9.25% 503,308 37,230 22,418 13.52 10.61 1.75% 3,389,108 3,288,937 4,155,644 9.25% 384,397 37,230 30,758 10.32 8.16 1.75% 2,921,645 3,756,400 4,623,107 9.25% 427,637 37,230 27,846 11.49 8.17 1.00% 251,540 6,036,953 6,853,102 9.25% 633,912 35,058 7,842 18.08 11.42 1.75% 3,013,190 3,609,205 4,468,689 9.25% 413,354 36,920 25,135 11.20 10.42 1.25% 1,001,707 5,676,338 6,543,045 9.25% 605,232 37,230 17,153 16.26 11.74 1.75% 3,038,510 3,639,535 4,506,241 9.25% 416,827 37,230 26,839 11.20 11.30 1.75% 3,155,376 3,522,669 4,389,375 9.25% 406,017 37,230 23,040 10.91 8.64 1.00% 133,561 6,544,484 7,411,191 9.25% 685,535 37,230 7,780 18.41 9.30 1.50% 1,547,637 4,184,352 4,928,275 9.25% 455,865 31,956 20,714 14.27 11.95 1.50% 2,103,584 4,574,461 5,441,168 9.25% 503,308 37,230 29,336 13.52 8.52

Page 235: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name320404 ZEPHYRHILLS HEALTH & REHAB CENTER, INC263958 ABBEY REHABILITATION AND NURSING CENTER324094 ADVANCED REHABILITATION AND HEALTH CENTER261254 ALHAMBRA HEALTH AND REHABILITATION CENTER309800 ALLEGRO AT COLLEGE HARBOR, THE227251 ALPINE HEALTH & REHABILITATION CENTER227251 APOLLO HEALTH & REHABILITATION CENTER263834 BAY POINTE NURSING PAVILION253448 BAY TREE CARE AND REHABILITATION CENTER324108 BAYSIDE REHABILITATION & HEALTH CENTER316652 BAYWOOD NURSING CENTER264521 BELLEAIR HEALTH CARE CENTER213004 BOCA CIEGA CENTER200107 BON SECOURS MARIA MANOR NURSING CARE CENTER315524 CARRINGTON PLACE NURSING & REHABILITATION CENTER212911 CLEARWATER CENTER200956 COMPREHENSIVE HEALTHCARE OF CLEARWATER251666 CONCORDIA MANOR319694 CONSULATE HEALTH CARE OF SAFETY HARBOR319708 CONSULATE HEALTH CARE OF ST PETERSBURG252115 COUNTRYSIDE REHAB AND HEALTHCARE CENTER001300 CROSS TERRACE REHABILITATION CENTER264351 CRYSTAL OAKS OF PINELLAS311065 EAGLE LAKE REHAB & CARE CENTER264539 EAST BAY REHABILITATION CENTER252484 EDINBOROUGH HEALTHCARE CENTER212890 EGRET COVE CENTER324248 FREEDOM SQUARE NURSING CENTER255840 GLEN OAKS HEALTH CARE CENTER262722 GOLFVIEW HEALTHCARE CENTER316644 GRACEWOOD REHABILITATION AND NURSING CARE316636 HARBOURWOOD HEALTH AND REHAB CENTER320528 HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW,263907 HIGHLAND PINES REHABILITATION CENTER281743 JACARANDA MANOR252336 LARGO REHABILITATION CENTER316628 LAURELLWOOD NURSING CENTER227650 LEXINGTON HEALTH AND REHABILITATION CENTER325686 MANOR CARE HEALTH SERVICES DUNEDIN325694 MANOR CARE HEALTH SERVICES PALM HARBOR999960 MASONIC HOME OF FLORIDA204072 MEASE CONTINUING CARE208442 MENORAH MANOR206431 MORTON PLANT REHABILITATION CENTER227641 NORTH REHABILITATION CENTER203823 OAK BLUFFS NURSING CENTER258342 OAK MANOR HEALTHCARE & REHABILITATION CENTER257460 PALM GARDEN OF CLEARWATER257478 PALM GARDEN OF LARGO257508 PALM GARDEN OF PINELLAS282537 PALM TERRACE OF ST. PETERSBURG281891 PASADENA MANOR INC324507 PENINSULA CARE AND REHABILITATION CENTER324469 PINELLAS PARK CARE AND REHABILITATION CENTER263486 PINELLAS POINT NURSING AND REHAB CENTER228362 REHABILITATION CENTER OF ST PETE210951 SABAL PALMS HEALTH CARE CENTER310841 SAINT MARK VILLAGE324230 SEMINOLE NURSING PAVILION324132 SHORE ACRES REHABILITATION AND HEALTH CENTER226360 SOUTH HERITAGE HEALTH & REHAB CENTER267724 SPRINGS AT BOCA CIEGA BAY

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.25% 788,148 4,943,840 5,687,763 9.25% 526,118 31,956 20,759 16.46 9.75 1.75% 4,145,331 3,750,537 4,763,918 9.25% 440,662 47,158 31,245 9.34 4.51 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 31,499 10.70 12.66 2.00% 2,025,914 1,090,877 1,490,895 9.25% 137,908 18,615 9,707 7.41 3.59 1.50% 729,329 1,971,889 2,318,572 9.25% 214,468 16,133 5,572 13.29 7.37 1.25% 444,143 2,516,808 2,896,826 9.25% 267,956 17,684 14,745 15.15 11.45 1.25% 444,143 2,516,808 2,896,826 9.25% 267,956 17,684 14,745 15.15 11.45 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 32,094 10.70 11.64 1.50% 2,003,414 4,674,632 5,541,338 9.25% 512,574 37,230 28,945 13.77 9.58 1.25% 716,862 4,062,216 4,675,578 9.25% 432,491 28,543 22,704 15.15 16.03 1.75% 1,501,773 1,563,070 1,956,422 9.25% 180,969 18,305 17,110 9.89 2.41 1.25% 1,090,877 5,142,704 5,942,741 9.25% 549,703 37,230 25,740 14.77 10.50 2.00% 4,051,827 2,181,753 2,981,790 9.25% 275,816 37,230 27,816 7.41 6.24 1.25% 2,846,668 11,386,673 13,213,424 9.25% 1,222,242 85,009 58,679 14.38 14.21 1.50% 1,963,578 4,270,002 5,070,039 9.25% 468,979 37,230 25,248 12.60 10.35 1.25% 1,012,957 5,220,623 6,020,660 9.25% 556,911 37,230 31,908 14.96 6.15 1.25% 1,363,596 6,428,379 7,428,426 9.25% 687,129 46,538 33,088 14.77 17.96 1.50% 698,940 1,326,973 1,586,985 9.25% 146,796 12,100 8,985 12.13 4.74 1.50% 2,303,926 4,374,119 5,240,826 9.25% 484,776 37,230 29,456 13.02 11.43 1.25% 779,198 5,454,383 6,254,420 9.25% 578,534 37,230 22,087 15.54 10.75 1.50% 2,203,755 4,474,290 5,340,997 9.25% 494,042 37,230 28,582 13.27 11.84 1.75% 3,038,510 2,749,129 3,500,274 9.25% 323,775 32,266 23,057 10.03 4.71 1.00% 280,511 2,836,279 3,236,297 9.25% 299,358 18,615 13,561 16.08 12.93 1.50% 919,453 2,145,390 2,538,742 9.25% 234,834 18,305 11,708 12.83 13.17 1.50% 1,683,067 4,550,513 5,350,550 9.25% 494,926 37,230 22,146 13.29 11.75 1.75% 2,445,417 2,730,068 3,401,766 9.25% 314,663 28,853 22,309 10.91 9.67 2.00% 4,051,827 2,181,753 2,981,790 9.25% 275,816 37,230 28,521 7.41 5.18 1.50% 1,898,125 4,127,669 4,901,038 9.25% 453,346 35,989 13,299 12.60 7.15 1.50% 1,184,380 2,763,554 3,270,244 9.25% 302,498 23,579 20,210 12.83 13.67 1.75% 1,476,320 1,432,684 1,806,035 9.25% 167,058 17,374 11,053 9.62 10.17 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 30,117 10.70 10.98 1.25% 1,012,957 5,220,623 6,020,660 9.25% 556,911 37,230 28,510 14.96 10.60 1.25% 640,241 2,372,656 2,759,341 9.25% 255,239 17,995 7,444 14.18 9.28 1.75% 3,490,805 2,742,775 3,542,812 9.25% 327,710 37,230 30,326 8.80 4.40 1.75% 8,697,922 6,834,082 8,827,507 9.25% 816,544 92,765 88,923 8.80 5.96 1.25% 1,025,943 7,181,604 8,234,986 9.25% 761,736 49,020 35,763 15.54 11.28 1.75% 1,418,139 1,698,651 2,098,669 9.25% 194,127 18,615 11,142 10.43 6.27 1.50% 2,297,074 4,663,757 5,557,131 9.25% 514,035 41,574 23,544 12.36 9.62 1.75% 3,038,510 3,639,535 4,506,241 9.25% 416,827 37,230 16,040 11.20 6.60 1.50% 2,854,864 7,162,203 8,462,263 9.25% 782,759 55,845 23,690 14.02 9.98 2.00% - - - 9.25% - - - - - 1.50% 1,502,560 4,062,477 4,784,733 9.25% 442,588 31,025 14,652 14.27 8.64 1.00% 841,533 8,508,837 9,708,892 9.25% 898,073 55,845 41,222 16.08 10.26 1.00% 124,672 6,108,908 6,908,945 9.25% 639,077 37,230 4,272 17.17 6.33 1.50% 801,794 1,743,584 2,070,266 9.25% 191,500 15,202 9,729 12.60 8.46 1.50% 841,533 2,275,257 2,675,275 9.25% 247,463 18,615 10,723 13.29 8.68 1.25% 1,870,074 7,480,296 8,680,352 9.25% 802,933 55,845 37,365 14.38 11.02 1.25% 945,882 5,359,998 6,170,880 9.25% 570,806 37,230 19,471 15.33 15.46 1.50% 2,564,459 6,433,642 7,625,857 9.25% 705,392 43,435 27,950 16.24 15.51 1.25% 1,004,498 5,692,155 6,561,653 9.25% 606,953 37,230 25,087 16.30 14.98 1.25% 848,886 4,375,026 5,050,613 9.25% 467,182 29,784 21,902 15.69 10.07 2.00% 4,119,357 2,218,116 3,031,487 9.25% 280,413 37,851 26,783 7.41 3.88 1.50% 2,404,096 4,273,949 5,140,656 9.25% 475,511 37,230 27,750 12.77 17.97 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 24,549 10.70 16.14 1.50% 1,075,293 2,041,497 2,441,516 9.25% 225,840 18,615 12,952 12.13 10.29 1.50% 2,849,525 5,409,968 6,470,017 9.25% 598,477 49,330 37,900 12.13 5.39 1.25% 1,901,242 10,773,704 12,400,446 9.25% 1,147,041 75,701 59,829 15.15 13.52 1.75% 1,694,554 1,644,469 2,077,822 9.25% 192,199 18,615 4,650 10.32 4.32 1.75% 2,945,367 3,288,213 4,088,250 9.25% 378,163 37,230 12,153 10.16 9.31 2.00% 3,680,410 1,981,759 2,708,459 9.25% 250,532 33,817 26,117 7.41 5.28 1.75% 1,816,309 2,027,732 2,521,088 9.25% 233,201 22,959 21,811 10.16 7.10 1.00% 283,108 5,379,060 6,105,760 9.25% 564,783 33,817 10,550 16.70 5.31

Page 236: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name210943 STRATFORD COURT OF PALM HARBOR253430 SUNSET POINT CARE AND REHABILITATION CENTER229164 SYLVAN HEALTH CENTER212849 TARPON BAYOU CENTER260568 TIERRA PINES CENTER253464 WEST BAY CARE AND REHABILITATION CENTER202011 WESTCHESTER GARDENS REHAB & CARE CENTER999957 WESTMINSTER PALMS212709 WESTMINSTER SUNCOAST254762 WRIGHTS NURSING AND REHABILITATION CENTER205460 AMERICAN-FINNISH NURSING HOME210676 AVANTE AT BOCA RATON, INC.203238 AVANTE AT LAKE WORTH, INC.252549 AZALEA COURT999915 BARRINGTON TERRACE OF BOYNTON BEACH263842 BOCA RATON REHABILITATION CENTER263613 BOULEVARD MANOR NURSING AND REHAB CENTER263460 BOYNTON BEACH REHABILITATION CENTER218952 BOYNTON HEALTH CARE CENTER999879 CHATSWORTH AT PGA NATIONAL213837 CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE320153 CONSULATE HEALTH CARE OF WEST PALM BEACH259918 CORAL BAY HEALTHCARE AND REHABILITATION269395 CROSSINGS, THE317349 DARCY HALL OF LIFE CARE212032 EDWARD J HEALEY REHABILITATION AND NURSING CENTER212393 FOUNTAINS NURSING HOME228320 GARDENS COURT203203 GLADES HEALTH CARE CENTER259586 HAMLIN PLACE216399 HARBOURS EDGE205745 HEALTH CENTER AT ABBEY DELRAY206865 HEALTH CENTER AT ABBEY DELRAY SOUTH999913 HEARTLAND HEALTH CARE AND REHABILITATION CENTER O325309 HEARTLAND HEALTH CARE CENTER BOYNTON BEACH325341 HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS207381 JOSEPH L MORSE GERIATRIC CENTER INC224928 JUPITER CARE CENTER208485 JUPITER MEDICAL CENTER PAVILION INC229610 LAKE VIEW CARE CENTER AT DELRAY266124 LAKE WORTH MANOR207683 LAKESIDE HEALTH CENTER227676 LIBERTY INN, LLC205923 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC C325368 MANORCARE HEALTH SERVICES325520 MANORCARE HEALTH SERVICES325376 MANORCARE HEALTH SERVICES BOYNTON BEACH325481 MANORCARE HEALTH SERVICES WEST PALM BEACH263524 MEDICANA NURSING AND REHAB CENTER229628 MENORAH HOUSE325163 NORTH LAKE REHABILITATION AND HEALTH CENTER999867 NURSING CENTER AT LA POSADA, THE257257 PALM GARDEN OF WEST PALM BEACH204170 REGENTS PARK NURSING & REHABILITATION CENTER263915 REHABILITATION CENTER OF THE PALM BEACHES,THE214108 ROYAL MANOR312312 SAVANNAH COVE001136 SIGNATURE HEALTHCARE OF PALM BEACH211010 STRATFORD COURT OF BOCA RATON325031 TERRACES OF LAKE WORTH REHABILITATION AND HEALTH 206610 WATERFORD HEALTH CARE CENTER999916 WHITEHALL BOCA RATON

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

1.25% 626,067 2,712,956 3,146,309 9.25% 291,034 18,615 8,030 15.63 11.65 1.75% 2,727,191 3,506,389 4,306,426 9.25% 398,344 37,230 24,747 10.70 8.96 1.25% 623,358 2,493,432 2,893,451 9.25% 267,644 18,615 4,981 14.38 11.78 2.00% 4,340,729 2,337,316 3,204,023 9.25% 296,372 37,230 29,469 7.96 10.11 1.75% 2,945,367 3,288,213 4,088,250 9.25% 378,163 37,230 33,165 10.16 6.47 1.50% 2,103,584 4,574,461 5,441,168 9.25% 503,308 37,230 26,122 13.52 11.27 1.25% 857,117 5,376,463 6,176,500 9.25% 571,326 37,230 17,913 15.35 16.07 2.00% - - - 9.25% - - - - - 2.00% 4,051,827 2,181,753 2,981,790 9.25% 275,816 37,230 18,371 7.41 2.81 2.00% 2,025,914 1,090,877 1,490,895 9.25% 137,908 18,615 5,143 7.41 11.27 1.50% 1,097,198 2,083,087 2,492,629 9.25% 230,568 18,615 10,154 12.39 10.88 1.25% 1,526,537 6,106,147 7,089,050 9.25% 655,737 44,676 22,141 14.68 15.52 1.75% 3,712,188 3,602,468 4,544,416 9.25% 420,358 42,815 31,780 9.82 9.61 1.75% 2,782,749 3,577,821 4,396,906 9.25% 406,714 37,230 30,991 10.92 11.36 2.00% - - - 9.25% - - - - - 1.75% 2,894,059 3,466,511 4,285,596 9.25% 396,418 37,230 26,239 10.65 5.75 1.50% 3,186,646 5,665,148 6,805,042 9.25% 629,466 51,812 31,097 12.15 7.41 1.25% 1,119,725 7,838,077 8,991,623 9.25% 831,725 52,432 21,746 15.86 10.95 1.50% 1,898,022 3,374,261 4,073,979 9.25% 376,843 25,130 10,948 15.00 10.90 2.00% - - - 9.25% - - - - - 1.25% 477,043 2,703,242 3,112,785 9.25% 287,933 18,615 365 15.47 8.72 1.50% 1,812,762 4,547,808 5,366,893 9.25% 496,438 37,230 29,880 13.33 8.21 1.25% 954,086 5,406,485 6,225,570 9.25% 575,865 37,230 15,531 15.47 9.88 1.50% 906,381 2,273,904 2,683,447 9.25% 248,219 18,615 15,895 13.33 8.23 2.00% 7,579,679 4,081,366 5,583,023 9.25% 516,430 68,255 38,648 7.57 4.22 1.50% 2,991,058 7,503,882 8,855,374 9.25% 819,122 61,430 29,198 13.33 15.71 2.00% 1,757,107 946,135 1,294,246 9.25% 119,718 15,823 9,226 7.57 6.35 1.25% 874,578 5,485,992 6,305,077 9.25% 583,220 37,230 11,510 15.67 10.97 1.75% 2,782,749 3,577,821 4,396,906 9.25% 406,714 37,230 30,799 10.92 7.12 1.50% 2,194,397 4,166,173 4,985,259 9.25% 461,136 37,230 21,473 12.39 15.90 1.50% 901,611 1,960,646 2,329,234 9.25% 215,454 16,754 483 12.86 3.92 1.00% 362,552 5,679,989 6,458,120 9.25% 597,376 35,369 7,721 16.89 12.50 1.50% 1,645,797 3,124,630 3,738,944 9.25% 345,852 27,923 8,538 12.39 11.88 2.00% - - - 9.25% - - - - - 1.50% 1,717,354 4,643,216 5,462,302 9.25% 505,263 37,230 24,666 13.57 9.16 1.25% 1,272,114 5,088,456 5,907,542 9.25% 546,448 37,230 16,989 14.68 8.97 1.50% 4,675,019 10,166,311 12,077,511 9.25% 1,117,170 86,870 66,476 12.86 14.33 1.75% 2,782,749 3,577,821 4,396,906 9.25% 406,714 37,230 21,465 10.92 13.00 1.50% 2,194,397 4,166,173 4,985,259 9.25% 461,136 37,230 19,536 12.39 10.55 1.50% 2,289,805 4,070,765 4,889,850 9.25% 452,311 37,230 17,909 12.15 16.09 1.50% 1,908,171 4,452,399 5,271,485 9.25% 487,612 37,230 21,952 13.10 11.39 1.50% 1,871,598 3,799,911 4,530,262 9.25% 419,049 33,197 23,142 12.62 14.88 1.00% 288,346 3,315,977 3,780,126 9.25% 349,662 21,097 2,450 16.57 10.90 1.00% 489,764 6,506,863 7,407,857 9.25% 685,227 40,953 21,767 16.73 12.88 1.50% 3,148,482 6,392,373 7,621,001 9.25% 704,943 55,845 36,091 12.62 10.22 1.00% 572,451 5,788,119 6,607,204 9.25% 611,166 37,230 13,757 16.42 9.02 1.50% 3,148,482 6,392,373 7,621,001 9.25% 704,943 55,845 31,224 12.62 10.17 1.25% 954,086 5,406,485 6,225,570 9.25% 575,865 37,230 16,552 15.47 9.45 1.50% 2,139,537 4,062,019 4,860,627 9.25% 449,608 36,299 16,939 12.39 4.07 1.25% 1,033,593 5,326,977 6,146,063 9.25% 568,511 37,230 25,783 15.27 14.09 1.75% 2,365,337 2,140,067 2,720,252 9.25% 251,623 26,371 23,166 9.54 4.67 2.00% - - - 9.25% - - - - - 1.25% 1,958,002 9,230,582 10,710,870 9.25% 990,755 54,604 28,987 18.14 12.93 1.25% 2,027,432 7,513,423 8,742,052 9.25% 808,640 55,845 29,752 14.48 12.37 1.00% 419,798 4,827,673 5,503,418 9.25% 509,066 30,715 22,788 16.57 12.31 1.25% 1,234,067 6,993,047 8,092,114 9.25% 748,521 37,230 23,936 20.11 12.64 1.25% 278,275 1,311,868 1,516,639 9.25% 140,289 9,308 2,027 15.07 8.85 1.50% 2,194,397 4,166,173 4,985,259 9.25% 461,136 37,230 17,246 12.39 12.68 1.25% 477,043 2,703,242 3,112,785 9.25% 287,933 18,615 5,621 15.47 13.20 1.00% 367,323 4,880,147 5,555,893 9.25% 513,920 30,715 26,766 16.73 13.80 1.50% 1,049,494 2,130,791 2,540,334 9.25% 234,981 18,615 2,812 12.62 9.63 2.00% - - - 9.25% - - - - -

Page 237: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name999912 WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES206521 WILLOWBROOKE COURT AT ST ANDREWS261599 WOOD LAKE NURSING AND REHABILITATION CENTER251739 BRADFORD TERRACE NURSING CENTER213888 WINDSOR MANOR264067 BLOUNTSTOWN HEALTH AND REHABILITATION CENTER251097 PARTHENON HEALTHCARE OF BLOUNTSTOWN263478 ARBOR TRAIL REHAB AND SKILLED NURSING CENTER203220 AVANTE AT INVERNESS, INC.257419 CITRUS HEALTH AND REHABILITATION CENTER217263 CRYSTAL RIVER HEALTH AND REHABILITATION CENTER228940 CYPRESS COVE CARE CENTER256269 DIAMOND RIDGE HEALTH AND REHABILITATION CENTER252263 HEALTH CENTER AT BRENTWOOD211532 LIFE CARE CENTER OF CITRUS COUNTY228711 WOODLAND TERRACE OF CITRUS COUNTY261629 AVALON HEALTHCARE CENTER308111 BAYA POINTE NURSING AND REHABILITATION CENTER226173 HEALTH CENTER OF LAKE CITY, THE316229 DESOTO HEALTH & REHAB, LLC312151 CROSS CITY REHABILITATION & HEALTH CARE CENTER324485 BRIDGE AT BAY ST JOE, THE206300 SUWANNEE VALLEY NURSING CENTER999945 FINR III, LLC211435 HARDEE MANOR HEALTHCARE CENTER213497 OAKBROOK OF LABELLE282618 PALM TERRACE OF CLEWISTON324493 KENILWORTH CARE & REHABILITATION CENTER214124 LAKE PLACID HEALTH CARE CENTER263966 OAKS AT AVON252671 PALMS OF SEBRING, THE324213 ROYAL CARE OF AVON PARK263443 BONIFAY NURSING AND REHAB CENTER203475 MARIANNA HEALTH AND REHABILITATION CENTER005383 NURSING PAVILION AT CHIPOLA RETIREMENT CENTER324426 SIGNATURE HEALTHCARE AT THE COURTYARD324396 SIGNATURE HEALTHCARE OF NORTH FLORIDA264482 LAFAYETTE HEALTH CARE CENTER317586 WILLISTON REHABILITATION AND NURSING CENTER211923 LAKE PARK OF MADISON213462 MADISON NURSING CENTER214019 PINE LAKE NURSING HOME208906 PLANTATION KEY CONVALESCENT CENTER202541 OKEECHOBEE HEALTH CARE FACILITY312274 CRESTWOOD NURSING CENTER312142 LAKEWOOD NURSING CENTER226025 PALATKA HEALTH CARE CENTER283142 ARBOR VILLAGE NURSING CENTER215597 OSPREY POINT NURSING CENTER268763 GOOD SAMARITAN CENTER001135 SURREY PLACE CARE CENTER005387 SUWANNEE HEALTH CARE CENTER252425 MARSHALL HEALTH AND REHABILITATION CENTER324353 WASHINGTON REHABILITATION AND NURSING CENTER

Depreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

2.00% - - - 9.25% - - - - - 1.00% 315,378 5,992,187 6,804,447 9.25% 629,411 36,920 3,751 17.05 13.61 1.25% 1,272,114 5,088,456 5,907,542 9.25% 546,448 37,230 27,092 14.68 15.19 1.50% 1,963,578 4,270,002 5,070,039 9.25% 468,979 37,230 32,226 12.60 16.37 1.50% 1,776,570 4,457,010 5,257,047 9.25% 486,277 37,230 29,428 13.06 14.48 1.25% 737,048 3,798,632 4,375,484 9.25% 404,732 28,543 24,861 14.18 10.87 1.50% 1,996,685 5,398,446 6,338,966 9.25% 586,354 46,538 36,735 12.60 10.40 1.50% 1,844,565 4,303,986 5,095,768 9.25% 471,359 35,989 22,728 13.10 10.44 1.75% 2,508,185 3,004,309 3,714,183 9.25% 343,562 32,266 21,021 10.65 10.10 1.25% 956,073 4,927,454 5,685,108 9.25% 525,873 34,438 19,137 15.27 11.75 2.00% 5,167,963 2,782,749 3,806,606 9.25% 352,111 46,538 31,812 7.57 9.30 1.75% 2,894,059 3,466,511 4,285,596 9.25% 396,418 37,230 23,033 10.65 12.53 1.25% 1,272,114 5,088,456 5,907,542 9.25% 546,448 37,230 18,611 14.68 9.40 1.25% 1,272,114 5,088,456 5,907,542 9.25% 546,448 37,230 18,061 14.68 11.75 1.25% 1,113,100 5,247,470 6,066,556 9.25% 561,156 37,230 12,439 15.07 10.63 1.00% 508,846 5,851,724 6,670,810 9.25% 617,050 37,230 25,569 16.57 11.08 1.50% 1,776,570 3,158,347 3,791,710 9.25% 350,733 29,474 19,867 11.90 10.49 1.00% 420,767 4,254,418 4,854,446 9.25% 449,036 27,923 13,544 16.08 13.72 1.25% 1,168,796 5,064,784 5,864,821 9.25% 542,496 37,230 26,537 14.57 13.67 1.00% 66,497 2,150,086 2,436,448 9.25% 225,371 12,720 5,595 17.72 11.90 1.25% 397,536 2,782,749 3,192,292 9.25% 295,287 18,615 12,739 15.86 11.74 1.75% 2,691,828 3,224,277 3,976,693 9.25% 367,844 37,230 28,829 9.88 3.10 1.25% 467,519 2,649,272 3,049,290 9.25% 282,059 18,615 18,852 15.15 10.19 2.00% - - - 9.25% - - - - - 1.75% 2,057,538 2,297,040 2,861,352 9.25% 264,675 24,510 17,825 10.80 9.43 1.50% 1,568,275 3,410,376 4,052,548 9.25% 374,861 28,853 25,582 12.99 13.55 1.50% 2,957,665 5,258,071 6,316,057 9.25% 584,235 48,089 28,315 12.15 10.65 1.75% 2,909,300 2,823,310 3,566,202 9.25% 329,874 32,266 17,821 10.22 6.03 1.50% 2,976,548 6,945,278 8,231,051 9.25% 761,372 55,845 40,434 13.63 11.24 1.25% 1,003,207 4,729,403 5,472,295 9.25% 506,187 32,266 22,490 15.69 11.36 1.25% 1,322,910 5,291,640 6,148,823 9.25% 568,766 37,230 15,971 15.28 9.34 1.75% 2,604,479 2,356,433 2,999,320 9.25% 277,437 27,923 17,355 9.94 6.92 1.25% 1,885,758 6,988,399 8,117,023 9.25% 750,825 55,845 48,350 13.44 8.73 1.50% 3,061,584 5,812,573 6,941,197 9.25% 642,061 55,845 51,871 11.50 13.64 1.50% 1,810,328 4,894,591 5,747,329 9.25% 531,628 42,194 15,156 12.60 12.85 1.25% 887,416 5,028,689 5,781,105 9.25% 534,752 37,230 30,202 14.36 13.45 1.50% 2,662,247 6,211,910 7,340,534 9.25% 678,999 55,845 41,319 12.16 9.17 1.25% 467,519 2,649,272 3,049,290 9.25% 282,059 18,615 15,319 15.15 12.60 1.75% 4,341,089 5,199,766 6,428,394 9.25% 594,626 55,845 31,391 10.65 6.42 1.25% 896,940 5,082,660 5,844,600 9.25% 540,626 37,230 31,221 14.52 11.48 1.50% 986,634 2,003,166 2,384,136 9.25% 220,533 18,615 15,297 11.85 18.15 1.50% 1,040,450 1,849,690 2,217,961 9.25% 205,161 17,995 15,537 11.40 8.41 1.50% 2,381,238 4,233,312 5,090,495 9.25% 470,871 37,230 21,974 12.65 11.23 1.50% 2,888,494 6,281,328 7,462,176 9.25% 690,251 53,673 46,338 12.86 13.89 1.75% 1,943,713 1,639,168 2,103,475 9.25% 194,571 20,166 16,755 9.65 6.35 2.00% 3,296,251 1,774,904 2,432,078 9.25% 224,967 28,543 26,442 7.88 8.70 1.50% 2,827,720 7,094,105 8,379,879 9.25% 775,139 55,845 44,307 13.88 12.83 1.50% 3,472,639 8,102,824 9,602,893 9.25% 888,268 65,153 45,342 13.63 10.74 1.00% 300,512 3,038,510 3,471,864 9.25% 321,147 18,615 9,374 17.25 13.25 1.50% 2,258,114 6,105,272 7,178,655 9.25% 664,026 49,950 44,007 13.29 10.31 1.50% 841,533 2,275,257 2,675,275 9.25% 247,463 18,615 14,273 13.29 16.35 1.75% 4,418,050 4,932,320 6,132,376 9.25% 567,245 55,845 45,680 10.16 15.53 1.75% 2,616,075 3,363,525 4,125,465 9.25% 381,606 37,230 31,257 10.25 7.74 1.50% 3,194,697 5,679,461 6,808,084 9.25% 629,748 55,845 44,437 11.28 12.22

Page 238: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility NameDepreciation Rate per Year

Depreciation using the FRV Adj

Age

Depreciated Replacement

Value

Depreciated Replacement Value & Land

Rental Rate Rental Amount

Bed Days Available at

85% of Occupancy

MA Patient Days

Proposed FRV Amount

PPDExisting FRV Amount PPD

Page 239: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name

005021 BRADEN RIVER CARE CENTER252069 BRADENTON HEALTH CARE263885 CASA MORA REHAB. & EXTENDED CARE227625 GREENBRIAR REHABILITATION AND NURSING CENTER324345 HERITAGE PARK CARE AND REHABILITATION CENTER223786 LIFE CARE CENTER OF SARASOTA317195 NURSING CENTER AT FREEDOM VILLAGE, THE259942 RIVERFRONT NURSING & REHABILITATION CENTER263451 RIVIERA PALMS REHABILITATION CENTER256277 SURREY PLACE HEALTHCARE AND REHABILITATION209422 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST203815 WESTMINSTER COMMUNITIES OF BRADENTON, WESTMINST316610 WOODS OF MANATEE SPRINGS, THE999923 BAY VILLAGE OF SARASOTA259896 BENEVA LAKES HEALTHCARE AND REHABILITATION CENTE320137 CONSULATE HEALTH CARE OF SARASOTA999892 GLENRIDGE ON PALMER RANCH INC.213322 HARBORCHASE OF VENICE317136 HARMONY HEALTHCARE AND REHABILITATION CENTER999925 HEARTLAND HEALTH CARE & REHABILITATION CENTER252271 HERITAGE HEALTH CARE CENTER228621 INN AT SARASOTA BAY CLUB202681 J H FLOYD SUNSHINE MANOR325490 KENSINGTON MANOR252182 MAGNOLIA HEALTH AND REHABILITATION CENTER325473 MANORCARE HEALTH SERVICES325465 MANORCARE HEALTH SERVICES SARASOTA319244 PALMER RANCH HEALTHCARE AND REHABILITATION252662 PINEBROOK CARE AND REHABILITATION CENTER202703 PINES OF SARASOTA999922 PLYMOUTH HARBOR INCORPORATED225053 QUALITY HEALTH OF NORTH PORT263982 SARASOTA HEALTH AND REHABILITATION CENTER260355 SARASOTA MEMORIAL NURSING AND REHABILITATION CEN268780 SPRINGS AT LAKE POINTE WOODS253014 SPRINGWOOD CARE AND REHABILITATION CENTER202711 SUNNYSIDE NURSING HOME308501 SUNSET LAKE HEALTH AND REHABILITATION CENTER323781 TARPON POINT NURSING AND REHABILITATION CENTER210463 VILLAGE ON THE ISLE221473 CALUSA HARBOUR HEALTH CENTER318787 CITRUS GARDENS OF FORT MYERS320111 CONSULATE HEALTH CARE OF NORTH FORT MYERS252107 CORAL TRACE HEALTH CARE252212 EVANS HEALTH CARE201120 GULF COAST VILLAGE CARE CENTER210587 HEALTHPARK CARE CENTER, INC.325325 HEARTLAND HEALTH CARE CENTER FORT MYERS252344 HERITAGE PARK REHABILITATION AND HEALTHCARE320978 LEHIGH ACRES HEALTH AND REHABILITATION CENTER265381 LIFE CARE CENTER OF ESTERO999878 LODGE AT CYPRESS COVE, THE325384 MANORCARE HEALTH SERVICES263869 REHAB AND HEALTHCARE CENTER OF CAPE CORAL213900 SHADY REST CARE PAVILION229202 SHELL POINT NURSING PAVILION324370 SIGNATURE HEALTHCARE AT COLLEGE PARK

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys

2.72 109,077 40,150 - 4.98 91,346 18,327 - 3.95 203,440 51,521 - 4.68 40,233 8,592 - 0.33 7,738 23,131 - 5.47 65,629 12,000 - 5.73 69,022 12,045 - 2.73 77,769 28,518 - 3.62 64,799 17,898 - 3.98 28,331 7,110 - 2.96 20,699 6,991 - 4.83 67,064 13,883 -

(6.00) (96,903) 16,146 - - - - -

2.43 65,564 27,010 - 6.00 108,419 18,071 - - - - -

4.79 18,055 3,770 - 5.83 43,274 7,426 - - - - -

(0.81) (20,219) 25,109 - 6.65 25,523 3,838 -

(0.50) (12,766) 25,321 - (0.60) (9,257) 15,528 - 4.01 112,409 27,998 - 6.34 100,804 15,895 - 0.05 1,578 30,331 - 4.71 46,020 9,770 - 0.66 15,598 23,567 - 2.51 119,451 47,660 - - - - -

(3.05) (61,633) 20,233 - 0.79 22,672 28,637 - 0.40 6,496 16,434 - 9.05 168,524 18,619 - 3.43 81,949 23,863 - 3.34 23,138 6,933 - 3.42 44,001 12,883 - 0.98 23,585 24,023 - 0.67 4,736 7,057 - 2.50 13,936 5,572 - 0.09 2,845 30,680 - 6.52 186,540 28,592 - 2.47 52,478 21,247 - 5.73 153,433 26,775 - 3.91 32,155 8,225 - 7.61 150,385 19,763 - 6.84 89,586 13,090 -

(0.40) (11,066) 27,598 - (2.31) (49,606) 21,507 - 6.07 137,812 22,715 - - - - -

5.75 80,433 13,977 - 3.37 86,783 25,767 -

(2.12) (90,552) 42,775 - 5.82 25,149 4,318 - 4.48 75,179 16,798 -

Page 240: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name264008 WINKLER COURT252034 AVANTE AT ORMOND BEACH, INC.209511 BISHOPS GLEN RETIREMENT CENTER260371 BRIDGEVIEW CENTER283134 CATALINA HEALTH CARE CENTER202789 CENTER FOR HEALTH CARE OF THE ALLIANCE COMMUNITY260649 COQUINA CENTER217743 DAYTONA BEACH HEALTH AND REHABILITATION CENTER005372 DEBARY MANOR252158 DELTONA HEALTH CARE210889 EMORY L BENNETT MEMORIAL VETERANS NURSING HOME204391 GOOD SAMARITAN SOCIETY-DAYTONA212792 GOOD SAMARITAN SOCIETY-FLORIDA LUTHERAN229091 HEALTH CENTER OF DAYTONA BEACH, THE223905 HORIZON HEALTHCARE CENTER AT DAYTONA258750 INDIGO MANOR269000 JOHN KNOX VILLAGE MEDICAL CENTER-ORANGE CITY213527 MANOR ON THE GREEN252476 OAKTREE HEALTHCARE005547 OAKWOOD GARDEN OF DELAND226351 OCEAN VIEW NURSING & REHABILITATION CENTER263567 ORANGE CITY NURSING AND REHAB CENTER263508 PORT ORANGE NURSING AND REHAB CENTER282464 RIDGECREST NURSING AND REHABILITATION CENTER312045 SANDALWOOD NURSING CENTER324442 SIGNATURE HEALTHCARE OF ORMOND282553 TERRACE OF DAYTONA BEACH, LLC212873 UNIVERSITY CENTER EAST212831 UNIVERSITY CENTER WEST212636 WOODLAND TERRACE EXTENDED CARE CENTER229849 ALEXANDER NININGER STATE VETERANS NURSING HOME263851 BROWARD INSTITUTE FOR LONG TERM CARE226335 BROWARD NURSING & REHABILITATION CENTER312789 CHILDRENS COMPREHENSIVE CARE CENTER INC318795 COURT AT PALM AIRE, THE210188 COVENANT VILLAGE CARE CENTER001281 CROSS POINTE CARE CENTER253481 FORUM AT DEER CREEK321303 FT LAUDERDALE HEALTH & REHABILITATION CENTER262064 GOLFCREST HEALTHCARE CENTER252255 HARBOR BEACH NURSING AND REHABILITATION CENTER226581 HEALTH CENTER OF COCONUT CREEK, THE325333 HEARTLAND HEALTH CARE CENTER LAUDERHILL325350 HEARTLAND OF TAMARAC252531 HILLCREST NURSING AND REHABILITATION CENTER313424 HOLLYWOOD HILLS REHABILITATION CENTER, LLC203769 JOHN KNOX VILLAGE HEALTH CENTER-POMPANO BEACH259080 LIFE CARE CENTER AT INVERRARY256935 MANOR OAKS NURSING & REHABILITATION CENTER254177 MANOR PINES CONVALESCENT CENTER325457 MANORCARE HEALTH SERVICES214931 MARGATE HEALTH CARE CENTER201006 MEMORIAL MANOR308005 PALMS REHABILITATION AND NURSING CENTER254134 PARK SUMMIT OF CORAL SPRINGS226017 PLANTATION NURSING & REHABILITATION CENTER263923 POMPANO REHABILITATION & NURSING CENTER269697 REGENTS PARK OF SUNRISE205800 SAINT JOHNS NURSING CENTER252433 SEAVIEW NURSING AND REHABILITATION CENTER225631 SPRINGTREE REHABILITATION & HEALTH CARE CENTER207497 SUNRISE HEALTH & REHABILITATION CENTER

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys3.44 103,557 30,108 -

(0.77) (16,704) 21,818 - 3.75 31,438 8,379 - 8.42 287,177 34,094 - 9.88 315,114 31,883 - 6.76 142,274 21,042 - 5.56 120,613 21,678 - 1.07 40,219 37,656 - 5.05 135,207 26,752 36,923 1.28 33,353 26,009 - 8.54 134,320 15,720 - 3.26 80,574 24,727 - 5.82 69,933 12,014 - 8.57 47,167 5,504 - 7.23 84,750 11,723 - 0.62 22,470 36,075 - 7.41 107,327 14,491 - 2.08 68,086 32,799 46,198 4.32 66,942 15,509 - 1.83 50,251 27,457 32,000 0.95 28,544 30,111 - 4.26 91,390 21,449 - 5.48 78,287 14,278 -

(0.20) (6,580) 33,028 - 2.80 58,292 20,823 -

12.39 103,609 8,361 - 6.52 78,522 12,035 - 2.05 30,298 14,796 - 0.74 11,488 15,435 - 4.94 131,836 26,674 - 9.30 188,018 20,207 - 2.69 95,946 35,671 -

(6.26) (241,587) 38,622 - 2.51 24,829 9,891 - 5.59 50,060 8,951 - 3.68 11,096 3,012 - 7.73 171,654 22,206 -

(0.18) (1,139) 6,251 - 7.10 165,847 23,360 - 0.42 6,374 15,236 - 0.68 7,646 11,200 - 6.48 109,796 16,937 - 5.43 144,084 26,518 - 3.87 88,944 22,965 - 1.92 92,871 48,251 - 0.31 5,695 18,384 - 7.80 45,821 5,872 - 6.34 92,595 14,611 - 6.47 91,785 14,191 - 5.32 101,507 19,074 - 1.90 33,997 17,904 -

(0.84) (26,510) 31,499 61,566 2.99 65,539 21,926 - 6.26 152,150 24,297 - 4.43 19,672 4,441 - 1.58 48,468 30,611 - 2.03 64,076 31,603 - 1.57 34,335 21,929 - 3.10 125,348 40,451 - 5.89 134,740 22,869 - 3.11 46,825 15,072 -

(6.05) (324,942) 53,718 -

Page 241: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name213098 TAMARAC REHABILITATION AND HEALTH CENTER002419 WEST BROWARD CARE CENTER227579 WILTON MANORS HEALTH & REHABILITATION CENTER252166 DESTIN HEALTHCARE AND REHABILITATION CENTER212903 EMERALD COAST CENTER226041 MANOR AT BLUE WATER BAY, THE251101 PARTHENON HEALTHCARE OF CRESTVIEW229237 PARTHENON HEALTHCARE OF FORT WALTON252379 SHOAL CREEK REHABILITATION CENTER213926 SILVERCREST MANOR316075 WESTWOOD HEALTH CARE CENTER324361 CHAUTAUQUA REHABILITATION AND NURSING CENTER211621 DELTA HEALTH CARE CENTER229288 GAINESVILLE HEALTH CARE CENTER252361 NORTH FLORIDA REHABILITATION AND SPECIALTY CARE999868 OAK HAMMOCK AT THE UNIVERSITY OF FLORIDA, INC.257265 PALM GARDEN OF GAINESVILLE227765 PARK MEADOWS HEALTH AND REHABILITATION CENTER317578 PARKLANDS REHABILITATION AND NURSING CENTER324388 SIGNATURE HEALTHCARE OF GAINESVILLE255572 WOODLANDS CARE CENTER OF ALACHUA COUNTY227871 AYERS HEALTH AND REHABILITATION CENTER204625 TRI COUNTY NURSING HOME263516 MACCLENNY NURSING AND REHAB CENTER211052 W FRANK WELLS NURSING HOME319538 CONSULATE HEALTH CARE OF ORANGE PARK223883 DOCTORS LAKE OF ORANGE PARK252387 GOVERNORS CREEK HEALTH AND REHABILITATION325261 HEARTLAND HEALTH CARE CENTER ORANGE PARK213161 LIFE CARE CENTER AT WELLS CROSSING284289 LIFE CARE CENTER OF ORANGE PARK999987 PAVILION FOR HEALTH CARE, THE324434 SIGNATURE HEALTHCARE OF ORANGE PARK284785 TERRACE AT FLEMING ISLAND, THE200735 ALL SAINTS CATHOLIC NURSING HOME AND REHABILITATIO319376 ATRIUM HEALTHCARE CENTER200913 AVANTE VILLA AT JACKSONVILLE BEACH INC.252051 BEAUCLERC MANOR226068 CATHEDRAL GERONTOLOGY CENTER, INC.262714 CEDAR HILLS HEALTHCARE CENTER319503 CONSULATE HEALTH CARE OF JACKSONVILLE307998 CYPRESS VILLAGE254878 EDGEWOOD NURSING CENTER204536 FANNIE E TAYLOR HOME FOR THE AGED INC227838 FIRST COAST HEALTH & REHABILITATION CENTER999984 FLEET LANDING252417 HARTS HARBOR HEALTH CARE CENTER325236 HEARTLAND HEALTH CARE CENTER JACKSONVILLE325287 HEARTLAND HEALTH CARE CENTER OF SOUTH JACKSONVI263494 JACKSONVILLE NURSING AND REHAB CENTER256757 LAKESIDE NURSING AND REHABILITATION CENTER268003 LANIER MANOR283193 LIFE CARE CENTER OF JACKSONVILLE257273 PALM GARDEN OF JACKSONVILLE228401 PARK RIDGE NURSING CENTER269727 REGENTS PARK OF JACKSONVILLE200859 RIVER GARDEN HEBREW HOME FOR THE AGED260673 RIVERWOOD CENTER324612 RIVERWOOD NURSING CENTER312371 SOUTHLAKE NURSING & REHABILITATION CENTER266281 SOUTHPOINT TERRACE205150 ST CATHERINE LABOURE MANOR, INC.

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys0.36 5,935 16,370 - 2.26 72,666 32,086 - 4.51 120,869 26,802 - 3.46 87,282 25,233 - 9.62 241,277 25,071 - 2.49 50,576 20,331 - 2.13 60,896 28,526 -

(5.81) (119,019) 20,469 - 4.94 146,991 29,755 -

(2.22) (27,714) 12,493 20,836 7.00 72,497 10,362 - 2.69 83,432 31,015 -

(1.22) (21,098) 17,249 36,311 (8.32) (297,912) 35,798 - (0.45) (8,487) 18,746 -

- - - - 3.64 66,913 18,382 46,266 6.80 264,271 38,870 - 2.78 79,154 28,501 - 2.55 63,495 24,876 - 5.40 135,428 25,086 - 1.86 44,830 24,070 - 0.45 8,610 18,953 - 4.12 130,786 31,715 - 0.68 9,784 14,368 - 4.49 107,147 23,847 - 1.83 57,543 31,395 - 3.54 121,113 34,187 - 4.00 76,798 19,181 - 5.82 111,716 19,188 - 4.79 136,832 28,542 - - - - -

3.69 86,494 23,446 - 5.24 127,755 24,404 - 4.02 91,967 22,892 - 5.21 58,193 11,179 -

(0.11) (2,844) 26,153 - 1.39 37,003 26,674 -

(2.74) (89,311) 32,587 - 0.15 6,903 45,642 - 4.68 96,489 20,617 - 4.10 85,701 20,905 -

(0.40) (6,293) 15,562 - 4.15 21,327 5,141 - 0.77 21,939 28,349 - - - - -

2.24 111,368 49,728 - 4.47 84,030 18,806 - 0.08 1,385 16,802 - 4.60 174,033 37,808 - 5.27 131,977 25,027 - 0.94 24,757 26,470 - 6.96 43,006 6,183 -

(1.55) (43,812) 28,245 45,521 3.16 67,030 21,224 - 1.95 46,011 23,620 - 0.59 20,270 34,135 - 3.36 235,665 70,190 -

(0.16) (5,688) 36,049 - (5.82) (235,610) 40,455 - 5.24 127,787 24,404 - 4.80 238,506 49,661 -

Page 242: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name265721 SUMMER BROOK HEALTH CARE CENTER207446 TAYLOR CARE CENTER218171 WEST JACKSONVILLE HEALTH AND REHABILITATION CENTE214060 LIFE CARE CENTER OF HILLIARD225274 QUALITY HEALTH OF FERNANDINA BEACH999869 LIFE CARE ST. JOHNS, INC.263559 MOULTRIE CREEK NURSING AND REHAB CENTER207799 PONCE DE LEON CARE CENTER202606 SAMANTHA R WILSON SENIOR CITIZENS HOME316601 SAN MARCO TERRACE REHABILITATION AND CARE217735 ST AUGUSTINE HEALTH AND REHABILITATION CENTER999981 VICARS LANDING NURSING HOME212083 WESTMINSTER WOODS ON JULINGTON CREEK207527 AUBURNDALE OAKS HEALTHCARE CENTER212997 BARTOW CENTER251399 BRANDYWYNE HEALTH CARE CENTER319678 CONSULATE HEALTH CARE OF LAKE PARKER319953 CONSULATE HEALTH CARE OF LAKELAND319724 CONSULATE HEALTH CARE OF WINTER HAVEN269409 CROSSROADS, THE319341 DOVE HEALTHCARE AT LAKE WALES212971 FLORIDA PRESBYTERIAN HOMES INC212881 GROVES CENTER224341 HAINES CITY HEALTH CARE CENTER260576 HIGHLANDS LAKE CENTER212865 LAKELAND HILLS CENTER219380 LIFE CARE CENTER OF WINTER HAVEN203599 MANOR AT CARPENTERS, THE259926 OAKBRIDGE HEALTHCARE CENTER257320 PALM GARDEN OF WINTER HAVEN282626 PALM TERRACE OF LAKELAND202533 ROHR HOME, THE264571 SPRING LAKE REHABILITATION CENTER265560 VALENCIA HILLS HEALTH AND REHABILITATION CENTER252328 WEDGEWOOD HEALTHCARE CENTER228702 WINTER HAVEN HEALTH & REHABILITATION CENTER254291 ARCH PLAZA NURSING & REHABILITATION CENTER284823 AVENTURA PLAZA REHABILITATION & NURSING CENTER005388 BERKSHIRE MANOR208507 CLARIDGE HOUSE NURSING & REHABILITATION CENTER999864 CLASSIC RESIDENCE BY HYATT IN AVENTURA323772 CORAL GABLES NURSING AND REHABILITATION CENTER282529 CORAL REEF NURSING & REHABILITATION CENTER228788 EAST RIDGE RETIREMENT VILLAGE INC227226 FAIR HAVENS CENTER207993 FLORIDA CLUB CARE CENTER200425 FLORIDEAN NURSING HOME INC005523 FOUNTAINHEAD CARE CENTER319554 FRANCO NURSING & REHABILITATION CENTER214027 GRAMERCY PARK NURSING CENTER324027 HAMPTON COURT NURSING AND REHABILITATION CENTER269107 HARMONY HEALTH CENTER325244 HEARTLAND HEALTH CARE CENTER KENDALL325252 HEARTLAND HEALTH CARE CENTER MIAMI LAKES308242 HEBREW HOME OF SOUTH BEACH265730 HIALEAH CONVALESCENT HOME250988 HIALEAH SHORES NURSING AND REHAB CENTER212121 HOMESTEAD MANOR204161 JACKSON MEMORIAL LONG TERM CARE CENTER203670 JACKSON MEMORIAL PERDUE MEDICAL CENTER253723 JACKSON PLAZA NURSING & REHABILITATION CENTER210617 MIAMI GARDENS CARE CENTRE

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys0.99 37,503 37,950 - 2.58 57,955 22,462 - 3.96 85,927 21,718 - 6.17 155,144 25,145 -

(1.31) (40,103) 30,530 - - - - -

2.61 62,330 23,882 - (3.71) (89,188) 24,036 - 2.05 38,695 18,830 - 5.84 74,100 12,691 -

(0.95) (22,949) 24,234 - - - - -

12.35 68,470 5,543 - (6.56) (180,342) 27,482 - 1.01 28,753 28,367 - 2.88 91,122 31,608 - 0.92 21,400 23,305 - 5.88 157,808 26,820 - 6.04 113,814 18,858 - 2.07 26,851 12,974 - 5.34 94,289 17,651 - 6.44 37,608 5,840 -

11.07 310,381 28,048 - (1.48) (28,900) 19,516 - 3.48 139,259 40,062 - 2.37 66,009 27,831 - 6.65 180,648 27,151 - 4.36 15,423 3,534 - 7.38 109,317 14,805 - 4.53 118,790 26,230 53,203 4.33 149,411 34,517 85,000 1.90 31,404 16,528 - 2.94 63,683 21,692 - 0.98 61,720 62,892 - 5.01 90,920 18,136 - 4.33 143,715 33,227 - 3.45 76,545 22,217 - 1.57 28,113 17,939 -

(1.77) (65,223) 36,913 45,000 0.59 33,860 57,352 - - - - -

(0.13) (2,493) 19,443 - 5.50 132,996 24,182 - 1.85 4,644 2,514 -

(0.65) (44,722) 68,823 - (3.25) (142,789) 43,903 - 4.96 31,017 6,259 -

(4.05) (158,891) 39,229 33,038 5.70 161,096 28,253 -

(1.80) (76,873) 42,793 - 0.26 6,975 27,332 -

(1.84) (62,193) 33,878 - 3.58 51,317 14,330 - 2.04 28,208 13,848 - 4.91 125,956 25,658 -

(2.29) (158,528) 69,340 - 4.37 111,790 25,556 - 2.66 41,310 15,523 - 0.57 23,402 41,057 -

(5.46) (174,589) 31,956 - 3.10 99,520 32,116 - 1.79 44,424 24,803 -

Page 243: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name200506 MIAMI JEWISH HOME & HOSPITAL FOR THE AGED, INC.214035 MIAMI SHORES NURSING AND REHAB CENTER228001 NORTH BEACH REHABILITATION CENTER267902 NURSING CENTER AT MERCY, THE212733 OCEANSIDE EXTENDED CARE CENTER203327 PALACE AT KENDALL NURSING AND REHABILITATION CENT257494 PALM GARDEN OF AVENTURA324167 PALMETTO REHABILITATION AND HEALTH CENTER212806 PALMETTO SUB ACUTE CARE CENTER, INC225754 PINECREST CONVALESCENT CENTER200620 PINES NURSING HOME308251 PONCE PLAZA NURSING & REHABILITATION CENTER223239 REGENTS PARK AT AVENTURA207276 RIVERSIDE CARE CENTER324400 SIGNATURE HEALTHCARE CENTER OF WATERFORD324418 SIGNATURE HEALTHCARE OF BROOKWOOD GARDENS260771 SINAI PLAZA NURSING & REHAB CENTER311308 SOUTH POINTE PLAZA REHABILITATION AND NURSING CEN209473 ST ANNES NURSING CENTER, ST ANNES RESIDENCE INC268062 SUSANNA WESLEY HEALTH CENTER226602 TREASURE ISLE CARE CENTER227544 UNITY HEALTH AND REHABILITATION CENTER225177 VICTORIA NURSING & REHABILITATION CENTER, INC.203165 VILLA MARIA NURSING CENTER

0 VILLA MARIA WEST SKILLED NURSING FACILITY310409 WATERCREST CARE CENTER282359 WEST GABLES HEALTH CARE CENTER225291 ARISTOCRAT, THE999932 BENTLEY CARE CENTER999931 CHATEAU AT MOORINGS PARK, THE268585 HARBORCHASE OF NAPLES252280 HERITAGE HEALTHCARE & REHABILITATION CENTER226378 IMPERIAL HEALTH CARE CENTER256846 LAKESIDE PAVILLION CARE AND REHABILITATION CENTER325422 MANORCARE AT LELY PALMS325449 MANORCARE NURSING AND REHABILITATION CENTER999930 PREMIER PLACE AT THE GLENVIEW253456 HAWTHORNE HEALTH AND REHAB OF OCALA266108 LIFE CARE CENTER OF OCALA214043 MARION HOUSE HEALTH CARE CENTER227773 NEW HORIZON REHABILITATION CENTER251721 OAKHURST CARE AND REHABILITATION CENTER217395 OCALA HEALTH AND REHABILITATION CENTER257290 PALM GARDEN OF OCALA203335 TIMBERRIDGE NURSING & REHABILITATION CENTER203122 AVANTE AT LEESBURG, INC.252042 AVANTE AT MT. DORA, INC.260444 BAYVIEW CENTER210684 EDGEWATER AT WATERMAN VILLAGE227561 LADY LAKE SPECIALTY CARE CENTER213870 LAKE EUSTIS CARE CENTER228966 LAKE HARRIS HEALTH CENTER259225 LAKEVIEW TERRACE SKILLED NURSING FACILITY252956 LEESBURG HEALTH AND REHAB, LLC210439 NORTH CAMPUS REHABILITATION AND NURSING CENTER260452 RULEME CENTER221465 WESTMINSTER CARE OF CLERMONT320439 ADVENTIST CARE CENTERS-COURTLAND, INC223808 AVANTE AT ORLANDO, INC.252557 COLONIAL LAKES HEALTH CARE205796 COMMONS AT ORLANDO LUTHERAN TOWERS264512 CONWAY LAKES HEALTH & REHABILITATION CENTER

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys(0.15) (14,676) 95,539 - 1.71 41,677 24,363 - 3.80 76,390 20,089 - 4.91 36,883 7,512 - 0.95 49,115 51,811 - 3.08 92,149 29,950 - 2.05 49,418 24,149 44,144 1.02 14,894 14,640 - 4.08 40,004 9,794 - 0.48 12,047 25,073 - 3.27 38,127 11,660 - 2.82 87,116 30,865 - 1.52 51,378 33,894 - 5.65 213,373 37,787 -

(0.79) (46,923) 59,169 - (2.57) (77,885) 30,359 - 1.01 26,750 26,510 - 4.68 249,848 53,393 - 2.94 143,976 48,960 -

(1.51) (41,040) 27,145 - 2.03 99,939 49,228 - 2.59 233,728 90,349 - 3.24 162,879 50,276 - 2.70 117,210 43,453 - - - - #N/A

2.50 103,145 41,307 - 1.16 20,570 17,669 - 2.78 22,722 8,182 - - - - - - - - -

4.61 18,582 4,028 - (1.38) (30,269) 21,911 - 6.50 103,999 15,992 - 2.43 59,406 24,409 - 1.79 32,635 18,219 - 4.70 90,597 19,295 - - - - -

0.12 2,857 23,973 - 3.95 42,564 10,782 - 0.38 9,788 25,445 - 1.87 57,904 31,011 - 2.19 49,711 22,667 -

(1.49) (64,111) 43,147 - 2.77 101,357 36,572 78,749 4.80 106,043 22,088 -

(3.19) (41,243) 12,947 - (0.04) (617) 16,668 - 1.68 43,674 26,000 - 7.00 105,286 15,038 - 2.56 46,274 18,100 - 1.23 22,682 18,467 26,500 4.17 75,040 18,009 - 3.61 2,482 688 - 3.83 59,695 15,592 - 1.85 28,471 15,413 - 7.08 182,156 25,721 - 4.28 165,584 38,692 - 8.86 187,677 21,191 -

(1.39) (37,780) 27,169 - 1.65 70,377 42,576 - 2.53 44,920 17,781 - 3.17 69,740 22,023 -

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Fac # Facility Name324175 COURTYARDS OF ORLANDO REHABILITATION AND HEALTH 320421 EAST ORLANDO HEALTH & REHAB CENTER, INC201651 GUARDIAN CARE NURSING & REHABILITATION CENTER228877 HEALTH CENTER OF WINDERMERE, THE204811 HEALTH CENTRAL PARK263605 HUNTERS CREEK NURSING AND REHAB CENTER318761 LAKE BENNETT HEALTH AND REHABILITATION CENTER213403 LIFE CARE CENTER OF ORLANDO325279 MANOR CARE NURSING & REHABILITATION CENTER201588 MARY LEE DEPUGH NURSING HOME ASSOCIATION, INC.999941 MAYFLOWER HEALTHCARE CENTER263541 METRO WEST NURSING AND REHAB CENTER324159 OCOEE HEALTH CARE CENTER257303 PALM GARDEN OF ORLANDO259934 PARKS HEALTHCARE AND REHABILITATION CENTER225410 QUALITY HEALTH OF ORANGE COUNTY269719 REGENTS PARK OF WINTER PARK005380 REHABILITATION CENTER OF WINTER PARK, THE252450 RIO PINAR HEALTH CARE252468 ROSEWOOD HEALTH AND REHABILITATION CENTER312550 SAVANNAH COVE320412 SUNBELT HEALTH & REHAB CENTER-APOPKA, INC261611 TERRA VISTA REHAB AND HEALTH CENTER221589 WESTMINSTER CARE OF DELANEY PARK223654 WESTMINSTER CARE OF ORLANDO208540 WESTMINSTER TOWERS324515 WINTER PARK CARE & REHABILITATION CENTER209848 WINTER PARK TOWERS259870 AVANTE AT ST CLOUD, INC.319511 CONSULATE HEALTH CARE OF KISSIMMEE205303 GOOD SAMARITAN SOCIETY-KISSIMMEE VILLAGE317560 KEYSTONE REHABILITATION AND HEALTH CENTER005549 OAKS OF KISSIMMEE217859 OSCEOLA HEALTH CARE CENTER253421 PALMS AT PARK PLACE, THE252441 PLANTATION BAY REHABILITATION CENTER253146 SOUTHERN OAKS HEALTH CARE CENTER319546 CONSULATE HEALTH CARE OF WEST ALTAMONTE320463 FLNC, INC263931 HEALTHCARE & REHAB OF SANFORD260657 ISLAND LAKE CENTER252310 LAKE MARY HEALTH AND REHABILITATION CENTER210137 LIFE CARE CENTER OF ALTAMONTE SPRINGS005379 LONGWOOD HEALTH CARE CENTER313718 LUTHERAN HAVEN NURSING HOME263591 TUSKAWILLA NURSING AND REHAB CENTER999936 VILLAGE ON THE GREEN324451 ANCHOR CARE AND REHABILITATION CENTER263389 ATLANTIC SHORES NURSING AND REHAB CENTER252018 AVANTE AT MELBOURNE, INC.005519 CARNEGIE GARDENS NURSING CENTER319520 CONSULATE HEALTH CARE OF MELBOURNE209325 COURTENAY SPRINGS VILLAGE226700 HEALTH CENTER OF MERRITT ISLAND, THE211281 HUNTINGTON PLACE CARE AND REHABILITATION CENTER260665 INDIAN RIVER CENTER252352 ISLAND HEALTH AND REHABILITATION CENTER228338 LIFE CARE CENTER OF MELBOURNE268186 LIFE CARE CENTER OF PALM BAY264547 MELBOURNE TERRACE REHABILITATION CENTER252395 PALMS REHABILITATION AND HEALTHCARE CENTER, THE227587 ROCKLEDGE HEALTH AND REHABILITATION CENTER

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys4.17 142,935 34,288 - 7.96 165,962 20,841 -

(1.69) (50,553) 29,942 - 6.21 106,686 17,169 - 2.22 109,478 49,307 - 6.19 137,218 22,165 - 5.31 120,230 22,623 - 7.56 46,605 6,167 - 2.58 51,406 19,921 - 2.97 26,432 8,908 - - - - -

5.59 136,230 24,385 - (1.01) (24,169) 23,905 - 4.53 121,552 26,820 53,203 6.35 181,024 28,500 -

(2.08) (56,897) 27,315 - 2.49 39,277 15,780 -

(1.93) (53,154) 27,505 56,750 1.44 59,658 41,425 - 0.56 16,021 28,520 - 7.01 22,007 3,140 - 7.14 165,501 23,166 -

(2.48) (60,275) 24,269 - 5.40 47,390 8,779 -

(1.02) (96,522) 94,756 - 0.63 10,244 16,336 - 5.03 109,902 21,865 - 3.70 47,854 12,918 -

(0.32) (9,566) 30,175 - 6.05 152,704 25,241 - 3.62 105,330 29,130 - 7.72 102,933 13,327 - 4.98 86,453 17,376 14,037 1.16 29,026 25,098 - 1.42 35,002 24,615 - 5.33 123,293 23,149 - 2.53 74,510 29,415 - 2.19 46,778 21,390 - 2.47 125,794 50,876 - 3.50 91,669 26,219 - 3.44 82,090 23,869 - 5.75 131,723 22,924 - 3.47 159,723 46,025 - 2.37 65,828 27,824 31,582 9.38 66,142 7,048 - 6.75 87,978 13,031 - - - - -

6.67 172,252 25,809 - 6.56 144,868 22,082 -

(1.18) (28,687) 24,345 - 0.15 4,769 31,155 37,931 2.97 76,588 25,821 -

(4.88) (98,314) 20,139 - 4.68 127,718 27,285 - 1.07 19,024 17,733 - 3.95 181,376 45,880 - 3.40 88,275 25,958 - 4.03 60,842 15,105 - 7.29 144,065 19,774 - 0.17 4,404 25,479 - 5.30 144,106 27,197 - 3.22 78,225 24,304 -

Page 245: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name263583 ROYAL OAKS NURSING AND REHAB CENTER263974 TITUSVILLE REHABILITATION & NURSING CENTER252522 VISTA MANOR217727 WEST MELBOURNE HEALTH & REHABILITATION CENTER253472 WUESTHOFF PROGRESSIVE CARE CENTER005374 FLAGLER PINES252409 GRAND OAKS HEALTH AND REHABILITATION CENTER212989 BAY CENTER264491 CLIFFORD CHESTER SIMS STATE VETERANS NURSING HOM318779 COMMUNITY HEALTH AND REHABILITATION CENTER252191 EMERALD SHORES HEALTH AND REHABILITATION005384 GLEN COVE NURSING PAVILION203980 LISENBY ON LAKE CAROLINE005385 PANAMA CITY NURSING CENTER252247 SEA BREEZE HEALTH CARE323799 ST ANDREWS BAY SKILLED NURSING AND REHABILITATION 208809 BAPTIST MANOR213853 BAYSIDE MANOR220604 CENTURY CARE CENTER319686 CONSULATE HEALTH CARE OF PENSACOLA258831 HAVEN OF OUR LADY OF PEACE229571 HEALTH CENTER OF PENSACOLA, THE315664 LIFE CARE CENTER OF PENSACOLA224243 PENSACOLA HEALTH CARE FACILITY211842 ROSEWOOD MANOR324566 SOUTHERN OAKS REHABILITATION AND NURSING CENTER213918 SPECIALTY CENTER OF PENSACOLA252123 UNIVERSITY HILLS HEALTH AND REHABILITATION210374 WILLOWBROOKE COURT AT AZALEA TRACE213816 BAY BREEZE NURSING AND RETIREMENT CENTER220621 SANDY RIDGE CARE CENTER220612 SANTA ROSA HEALTH & REHABILITATION CENTER259331 UNIHEALTH POST-ACUTE CARE - SANTA ROSA201545 EDGEWATER MANOR226033 MARTIN NURSING AND RESTORATIVE CARE CENTER263621 PALM CITY NURSING & REHAB CENTER228885 PARKWAY HEALTH & REHABILITATION CENTER214141 SALERNO BAY MANOR225991 STUART NURSING & RESTORATIVE CARE CENTER213152 WATERS EDGE EXTENDED CARE268755 ABBIEJEAN RUSSELL CARE CENTER LLC210781 BRIGHTON GARDENS OF PORT ST LUCIE261637 EMERALD HEALTH CARE CENTER252239 FORT PIERCE HEALTH CARE211516 LAUREL POINTE HEALTH AND REHABILITATION217824 LIFE CARE CENTER OF PORT SAINT LUCIE257249 PALM GARDEN OF PORT SAINT LUCIE226009 PORT SAINT LUCIE NURSING & RESTORATIVE CARE CENTE263532 TIFFANY HALL NURSING AND REHAB CENTER226327 CHARLOTTE HARBOR HEALTHCARE320129 CONSULATE HEALTH CARE OF PORT CHARLOTTE269492 DOUGLAS JACOBSON STATE VETERANS NURSING HOME252204 ENGLEWOOD HEALTHCARE AND REHABILITATION CENTER319333 HARBOUR HEALTH CENTER311685 LIFE CARE CENTER OF PUNTA GORDA319325 PORT CHARLOTTE REHABILITATION CENTER324477 SIGNATURE HEALTHCARE OF PORT CHARLOTTE002400 VILLAGE PLACE HEALTH AND REHABILITATION CENTER310581 ATLANTIC HEALTHCARE CENTER320145 CONSULATE HEALTH CARE OF VERO BEACH001416 FLORIDA BAPTIST RETIREMENT CENTER257311 PALM GARDEN OF VERO BEACH

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys5.58 94,188 16,872 - 4.61 157,004 34,090 - 0.80 18,496 23,091 - 2.85 79,174 27,793 - 7.35 95,907 13,056 - 1.67 46,789 28,009 34,143 4.94 99,169 20,084 -

(1.74) (62,072) 35,771 - 10.25 139,281 13,590 -

3.12 62,989 20,161 - 3.68 48,884 13,272 - 1.03 27,184 26,489 46,000

(1.70) (5,316) 3,134 - 3.73 103,347 27,680 30,000 1.34 34,325 25,629 -

(2.91) (83,156) 28,545 - 0.41 14,980 36,352 - 1.37 34,858 25,476 34,549 5.55 128,743 23,200 - 1.54 36,022 23,415 -

10.07 130,226 12,937 - (2.25) (79,138) 35,172 - 7.08 22,019 3,108 - 4.77 113,551 23,791 - 1.56 65,510 41,975 - 4.00 163,401 40,836 -

(0.53) (12,914) 24,452 38,280 (0.87) (25,011) 28,655 - 4.94 64,533 13,063 -

(0.41) - - 54,100 (1.85) (28,302) 15,275 - 0.48 13,632 28,354 - 5.30 146,722 27,699 - 0.31 8,162 26,132 - 4.23 62,654 14,826 - 4.97 101,610 20,434 - 5.83 189,053 32,413 - 0.74 19,391 26,303 41,715

(3.12) (58,464) 18,766 - 6.23 11,044 1,773 - 5.15 75,412 14,633 - 2.22 8,275 3,731 - 2.49 57,742 23,213 - 2.05 95,233 46,532 - 3.12 83,796 26,838 - 5.10 64,103 12,560 - 2.38 64,086 26,872 44,144

(2.85) (92,574) 32,535 - 4.81 123,767 25,728 - 3.81 96,718 25,362 - 5.61 134,837 24,040 -

11.69 263,855 22,570 - (0.33) (7,492) 22,931 - (1.19) (14,191) 11,886 - (0.21) (6,663) 31,599 - (0.65) (15,305) 23,662 - 5.63 115,502 20,511 - 1.35 22,402 16,556 - 3.94 83,318 21,165 - 4.16 143,093 34,435 - 2.36 4,650 1,971 - 3.28 129,757 39,543 71,816

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Fac # Facility Name999919 ROYAL PALM HEALTHCARE & REHABILITATION CENTER001416 WILLOWBROOKE COURT AT INDIAN RIVER ESTATES005386 RIVERCHASE CARE CENTER005381 BRYNWOOD CENTER214001 JEFFERSON HEALTH AND REHABILITATION CENTER252093 CAPITAL HEALTHCARE CENTER264563 CENTRE POINTE HEALTH AND REHAB CENTER319716 CONSULATE HEALTH CARE OF TALLAHASSEE252298 HERITAGE HEALTHCARE CENTER202941 MIRACLE HILL NURSING & CONVALESCENT CENTER, INC.200409 WESTMINSTER OAKS253707 EDEN SPRINGS NURSING AND REHAB CENTER228958 BROOKSVILLE HEALTHCARE CENTER263893 EVERGREEN WOODS325295 HEARTLAND OF BROOKSVILLE252174 HERON POINTE HEALTH AND REHABILITATION252492 SPRING HILL HEALTH AND REHABILITATION CENTER263575 BAYSHORE POINTE NURSING AND REHAB CENTER252077 BRANDON HEALTH AND REHABILITATION CENTER284793 BRIGHTON GARDENS OF TAMPA999949 CANTERBURY TOWERS INC263877 CARROLLWOOD CARE CENTER259900 CENTRAL PARK HEALTHCARE & REHABILITATION CENTER281913 COMMUNITY CONVALESCENT CENTER319660 CONSULATE HEALTH CARE OF BRANDON324116 EXCEL REHABILITATION AND HEALTH CENTER260690 FAIRWAY OAKS CENTER252221 FLETCHER HEALTH AND REHABILITATION CENTER252506 HABANA HEALTH CARE CENTER261670 HAWTHORNE HEALTH AND REHAB OF BRANDON213039 HEALTH CARE CENTER OF TAMPA226343 HEALTH CENTER OF PLANT CITY, THE201154 HOME ASSOCIATION, INC., THE210285 JOHN KNOX VILLAGE MED CENTER218057 LAKESHORE VILLAS HEALTH CARE CENTER325678 MANORCARE HEALTH SERVICES CARROLLWOOD259462 NURSING CENTER AT UNIVERSITY VILLAGE, THE257516 PALM GARDEN OF SUN CITY257524 PALM GARDEN OF TAMPA211885 PLAZA WEST263940 REHABILITATION AND HEALTHCARE CENTER OF TAMPA224910 SOUTH TAMPA HEALTH AND REHABILITATION CENTER209856 SUN TERRACE HEALTH CARE CENTER266612 WHISPERING OAKS324141 WOODBRIDGE REHABILITATION & HEALTH CENTER212164 YBOR CITY HEALTHCARE & REHABILITATION CENTER214914 BALDOMERO LOPEZ MEMORIAL VETERANS NURSING HOME226076 BAYONET POINT HEALTH & REHABILITATION CENTER228567 BEAR CREEK NURSING CENTER319651 CONSULATE HEALTH CARE OF BAYONET POINT319970 CONSULATE HEALTH CARE OF NEW PORT RICHEY325708 HEARTLAND OF ZEPHYRHILLS228591 HEATHER HILL HEALTHCARE CENTER214132 HERITAGE PARK259357 LIFE CARE CENTER OF NEW PORT RICHEY324124 MADISON POINTE REHABILITATION AND HEALTH CENTER252689 ORCHARD RIDGE CARE AND REHABILITATION CENTER228575 ROYAL OAK NURSING CENTER262706 SOUTHERN PINES HEALTHCARE CENTER003521 TRINITY REGIONAL REHAB CENTER263991 WINDSOR WOODS REHABILITATION AND HEALTHCARE CEN320391 ZEPHYR HAVEN HEALTH & REHAB CENTER, INC

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys- - - -

2.36 4,650 1,971 - (2.61) (95,243) 36,523 36,294 0.81 20,090 24,783 30,323 1.02 14,179 13,843 - 2.80 93,679 33,482 - 2.50 42,632 17,057 - 0.73 11,718 15,962 - 0.28 11,930 42,084 - 1.11 39,943 35,980 - 2.60 29,671 11,412 -

(1.00) (28,331) 28,393 - 1.25 37,487 29,969 - 0.88 18,585 21,176 - 2.85 63,060 22,128 - 3.99 115,291 28,906 - 5.05 84,315 16,687 -

(0.49) (10,743) 21,786 - 5.25 97,184 18,527 -

11.50 58,685 5,102 - - - - -

2.13 57,263 26,885 - 5.59 134,862 24,107 - 2.14 70,072 32,751 - 1.77 53,446 30,145 - 0.67 15,995 24,029 - 3.85 122,960 31,922 - 4.99 109,448 21,921 - 3.05 109,252 35,794 - 4.30 74,084 17,236 - 1.81 121,240 67,157 68,019 4.24 166,729 39,293 -

(0.16) (3,438) 21,795 - 3.91 81,117 20,755 - 3.34 131,877 39,501 - 4.59 53,457 11,649 - 5.25 120,108 22,891 - 1.73 36,931 21,301 46,831

(0.90) (23,845) 26,582 44,432 5.62 52,508 9,342 - 3.67 154,594 42,155 - 1.78 82,461 46,213 - 2.59 41,567 16,032 - 5.73 418,113 73,003 - 0.83 22,650 27,223 - 3.53 76,473 21,688 - 7.23 193,932 26,806 - 0.66 20,564 31,160 - 2.88 59,445 20,607 - 5.89 130,720 22,202 - 6.27 167,000 26,626 - 2.91 65,180 22,418 - 2.16 66,589 30,758 - 3.32 92,437 27,846 38,340 6.66 52,246 7,842 - 0.78 19,545 25,135 - 4.52 77,457 17,153 -

(0.10) (2,748) 26,839 - 2.26 52,173 23,040 - 9.12 70,916 7,780 - 2.32 47,980 20,714 - 5.00 146,565 29,336 -

Page 247: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name320404 ZEPHYRHILLS HEALTH & REHAB CENTER, INC263958 ABBEY REHABILITATION AND NURSING CENTER324094 ADVANCED REHABILITATION AND HEALTH CENTER261254 ALHAMBRA HEALTH AND REHABILITATION CENTER309800 ALLEGRO AT COLLEGE HARBOR, THE227251 ALPINE HEALTH & REHABILITATION CENTER227251 APOLLO HEALTH & REHABILITATION CENTER263834 BAY POINTE NURSING PAVILION253448 BAY TREE CARE AND REHABILITATION CENTER324108 BAYSIDE REHABILITATION & HEALTH CENTER316652 BAYWOOD NURSING CENTER264521 BELLEAIR HEALTH CARE CENTER213004 BOCA CIEGA CENTER200107 BON SECOURS MARIA MANOR NURSING CARE CENTER315524 CARRINGTON PLACE NURSING & REHABILITATION CENTER212911 CLEARWATER CENTER200956 COMPREHENSIVE HEALTHCARE OF CLEARWATER251666 CONCORDIA MANOR319694 CONSULATE HEALTH CARE OF SAFETY HARBOR319708 CONSULATE HEALTH CARE OF ST PETERSBURG252115 COUNTRYSIDE REHAB AND HEALTHCARE CENTER001300 CROSS TERRACE REHABILITATION CENTER264351 CRYSTAL OAKS OF PINELLAS311065 EAGLE LAKE REHAB & CARE CENTER264539 EAST BAY REHABILITATION CENTER252484 EDINBOROUGH HEALTHCARE CENTER212890 EGRET COVE CENTER324248 FREEDOM SQUARE NURSING CENTER255840 GLEN OAKS HEALTH CARE CENTER262722 GOLFVIEW HEALTHCARE CENTER316644 GRACEWOOD REHABILITATION AND NURSING CARE316636 HARBOURWOOD HEALTH AND REHAB CENTER320528 HEALTH AND REHABILITATION CENTRE AT DOLPHINS VIEW,263907 HIGHLAND PINES REHABILITATION CENTER281743 JACARANDA MANOR252336 LARGO REHABILITATION CENTER316628 LAURELLWOOD NURSING CENTER227650 LEXINGTON HEALTH AND REHABILITATION CENTER325686 MANOR CARE HEALTH SERVICES DUNEDIN325694 MANOR CARE HEALTH SERVICES PALM HARBOR999960 MASONIC HOME OF FLORIDA204072 MEASE CONTINUING CARE208442 MENORAH MANOR206431 MORTON PLANT REHABILITATION CENTER227641 NORTH REHABILITATION CENTER203823 OAK BLUFFS NURSING CENTER258342 OAK MANOR HEALTHCARE & REHABILITATION CENTER257460 PALM GARDEN OF CLEARWATER257478 PALM GARDEN OF LARGO257508 PALM GARDEN OF PINELLAS282537 PALM TERRACE OF ST. PETERSBURG281891 PASADENA MANOR INC324507 PENINSULA CARE AND REHABILITATION CENTER324469 PINELLAS PARK CARE AND REHABILITATION CENTER263486 PINELLAS POINT NURSING AND REHAB CENTER228362 REHABILITATION CENTER OF ST PETE210951 SABAL PALMS HEALTH CARE CENTER310841 SAINT MARK VILLAGE324230 SEMINOLE NURSING PAVILION324132 SHORE ACRES REHABILITATION AND HEALTH CENTER226360 SOUTH HERITAGE HEALTH & REHAB CENTER267724 SPRINGS AT BOCA CIEGA BAY

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys6.71 139,358 20,759 - 4.83 150,982 31,245 -

(1.96) (61,702) 31,499 - 3.82 37,095 9,707 - 5.93 33,015 5,572 - 3.71 54,638 14,745 - 3.71 54,638 14,745 -

(0.94) (30,118) 32,094 - 4.19 121,145 28,945 -

(0.87) (19,837) 22,704 - 7.48 127,982 17,110 - 4.27 109,850 25,740 - 1.17 32,551 27,816 - 0.17 9,757 58,679 - 2.24 56,621 25,248 - 8.81 280,990 31,908 -

(3.19) (105,625) 33,088 - 7.39 66,420 8,985 - 1.59 46,848 29,456 - 4.79 105,829 22,087 - 1.43 40,804 28,582 - 5.33 122,838 23,057 - 3.15 42,719 13,561 -

(0.34) (3,975) 11,708 - 1.54 34,088 22,146 - 1.24 27,624 22,309 - 2.23 63,583 28,521 - 5.45 72,420 13,299 -

(0.84) (16,938) 20,210 26,371 (0.56) (6,161) 11,053 - (0.28) (8,549) 30,117 - 4.36 124,337 28,510 - 4.90 36,504 7,444 - 4.40 133,356 30,326 - 2.85 253,165 88,923 - 4.26 152,238 35,763 - 4.16 46,316 11,142 - 2.74 64,519 23,544 - 4.60 73,712 16,040 - 4.03 95,517 23,690 - - - - -

5.63 82,476 14,652 - 5.82 239,839 41,222 -

10.84 46,302 4,272 - 4.13 40,206 9,729 - 4.61 49,477 10,723 - 3.36 125,579 37,365 -

(0.12) (2,399) 19,471 45,610 0.73 20,277 27,950 67,059 1.32 33,187 25,087 48,907 5.62 122,990 21,902 38,000 3.52 94,384 26,783 -

(5.19) (144,107) 27,750 - (5.44) (133,651) 24,549 - 1.84 23,836 12,952 - 6.75 255,714 37,900 - 1.63 97,674 59,829 - 6.00 27,922 4,650 - 0.85 10,330 12,153 - 2.12 55,491 26,117 - 3.05 66,624 21,811 -

11.39 120,156 10,550 -

Page 248: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name210943 STRATFORD COURT OF PALM HARBOR253430 SUNSET POINT CARE AND REHABILITATION CENTER229164 SYLVAN HEALTH CENTER212849 TARPON BAYOU CENTER260568 TIERRA PINES CENTER253464 WEST BAY CARE AND REHABILITATION CENTER202011 WESTCHESTER GARDENS REHAB & CARE CENTER999957 WESTMINSTER PALMS212709 WESTMINSTER SUNCOAST254762 WRIGHTS NURSING AND REHABILITATION CENTER205460 AMERICAN-FINNISH NURSING HOME210676 AVANTE AT BOCA RATON, INC.203238 AVANTE AT LAKE WORTH, INC.252549 AZALEA COURT999915 BARRINGTON TERRACE OF BOYNTON BEACH263842 BOCA RATON REHABILITATION CENTER263613 BOULEVARD MANOR NURSING AND REHAB CENTER263460 BOYNTON BEACH REHABILITATION CENTER218952 BOYNTON HEALTH CARE CENTER999879 CHATSWORTH AT PGA NATIONAL213837 CLASSIC RESIDENCE BY HYATT AT LAKESIDE VILLAGE320153 CONSULATE HEALTH CARE OF WEST PALM BEACH259918 CORAL BAY HEALTHCARE AND REHABILITATION269395 CROSSINGS, THE317349 DARCY HALL OF LIFE CARE212032 EDWARD J HEALEY REHABILITATION AND NURSING CENTER212393 FOUNTAINS NURSING HOME228320 GARDENS COURT203203 GLADES HEALTH CARE CENTER259586 HAMLIN PLACE216399 HARBOURS EDGE205745 HEALTH CENTER AT ABBEY DELRAY206865 HEALTH CENTER AT ABBEY DELRAY SOUTH999913 HEARTLAND HEALTH CARE AND REHABILITATION CENTER O325309 HEARTLAND HEALTH CARE CENTER BOYNTON BEACH325341 HEARTLAND HEALTH CARE CENTER PROSPERITY OAKS207381 JOSEPH L MORSE GERIATRIC CENTER INC224928 JUPITER CARE CENTER208485 JUPITER MEDICAL CENTER PAVILION INC229610 LAKE VIEW CARE CENTER AT DELRAY266124 LAKE WORTH MANOR207683 LAKESIDE HEALTH CENTER227676 LIBERTY INN, LLC205923 LOURDES-NOREEN MCKEEN RESIDENCE FOR GERIATRIC C325368 MANORCARE HEALTH SERVICES325520 MANORCARE HEALTH SERVICES325376 MANORCARE HEALTH SERVICES BOYNTON BEACH325481 MANORCARE HEALTH SERVICES WEST PALM BEACH263524 MEDICANA NURSING AND REHAB CENTER229628 MENORAH HOUSE325163 NORTH LAKE REHABILITATION AND HEALTH CENTER999867 NURSING CENTER AT LA POSADA, THE257257 PALM GARDEN OF WEST PALM BEACH204170 REGENTS PARK NURSING & REHABILITATION CENTER263915 REHABILITATION CENTER OF THE PALM BEACHES,THE214108 ROYAL MANOR312312 SAVANNAH COVE001136 SIGNATURE HEALTHCARE OF PALM BEACH211010 STRATFORD COURT OF BOCA RATON325031 TERRACES OF LAKE WORTH REHABILITATION AND HEALTH 206610 WATERFORD HEALTH CARE CENTER999916 WHITEHALL BOCA RATON

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys3.98 31,995 8,030 - 1.73 42,930 24,747 - 2.59 12,923 4,981 -

(2.15) (63,321) 29,469 - 3.68 122,206 33,165 - 2.25 58,704 26,122 -

(0.72) (12,909) 17,913 - - - - -

4.60 84,456 18,371 - (3.86) (19,849) 5,143 - 1.51 15,299 10,154 -

(0.84) (18,704) 22,141 - 0.20 6,503 31,780 -

(0.43) (13,417) 30,991 - - - - -

4.90 128,592 26,239 - 4.74 147,462 31,097 - 4.91 106,744 21,746 - 4.10 44,870 10,948 38,442 - - - -

6.75 2,464 365 - 5.13 153,169 29,880 - 5.59 86,846 15,531 - 5.10 81,143 15,895 - 3.35 129,493 38,648 -

(2.38) (69,373) 29,198 - 1.22 11,264 9,226 - 4.70 54,057 11,510 - 3.80 117,063 30,799 -

(3.51) (75,440) 21,473 - 8.94 4,317 483 - 4.39 33,906 7,721 - 0.51 4,343 8,538 - - - - -

4.41 108,713 24,666 - 5.71 97,038 16,989 -

(1.47) (97,956) 66,476 - (2.08) (44,642) 21,465 - 1.84 35,914 19,536 -

(3.94) (70,538) 17,909 - 1.71 37,518 21,952 -

(2.26) (52,188) 23,142 - 5.67 13,890 2,450 - 3.86 83,952 21,767 - 2.40 86,719 36,091 - 7.40 101,811 13,757 - 2.45 76,605 31,224 - 6.02 99,687 16,552 - 8.31 140,830 16,939 - 1.18 30,474 25,783 - 4.87 112,744 23,166 - - - - -

5.22 151,248 28,987 81,326 2.11 62,678 29,752 - 4.26 97,113 22,788 - 7.46 178,613 23,936 60,382 6.23 12,620 2,027 -

(0.29) (5,078) 17,246 - 2.27 12,734 5,621 - 2.93 78,425 26,766 - 2.99 8,418 2,812 - - - - -

Page 249: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name999912 WILLOWBROOKE COURT AT EDGEWATER POINTE ESTATES206521 WILLOWBROOKE COURT AT ST ANDREWS261599 WOOD LAKE NURSING AND REHABILITATION CENTER251739 BRADFORD TERRACE NURSING CENTER213888 WINDSOR MANOR264067 BLOUNTSTOWN HEALTH AND REHABILITATION CENTER251097 PARTHENON HEALTHCARE OF BLOUNTSTOWN263478 ARBOR TRAIL REHAB AND SKILLED NURSING CENTER203220 AVANTE AT INVERNESS, INC.257419 CITRUS HEALTH AND REHABILITATION CENTER217263 CRYSTAL RIVER HEALTH AND REHABILITATION CENTER228940 CYPRESS COVE CARE CENTER256269 DIAMOND RIDGE HEALTH AND REHABILITATION CENTER252263 HEALTH CENTER AT BRENTWOOD211532 LIFE CARE CENTER OF CITRUS COUNTY228711 WOODLAND TERRACE OF CITRUS COUNTY261629 AVALON HEALTHCARE CENTER308111 BAYA POINTE NURSING AND REHABILITATION CENTER226173 HEALTH CENTER OF LAKE CITY, THE316229 DESOTO HEALTH & REHAB, LLC312151 CROSS CITY REHABILITATION & HEALTH CARE CENTER324485 BRIDGE AT BAY ST JOE, THE206300 SUWANNEE VALLEY NURSING CENTER999945 FINR III, LLC211435 HARDEE MANOR HEALTHCARE CENTER213497 OAKBROOK OF LABELLE282618 PALM TERRACE OF CLEWISTON324493 KENILWORTH CARE & REHABILITATION CENTER214124 LAKE PLACID HEALTH CARE CENTER263966 OAKS AT AVON252671 PALMS OF SEBRING, THE324213 ROYAL CARE OF AVON PARK263443 BONIFAY NURSING AND REHAB CENTER203475 MARIANNA HEALTH AND REHABILITATION CENTER005383 NURSING PAVILION AT CHIPOLA RETIREMENT CENTER324426 SIGNATURE HEALTHCARE AT THE COURTYARD324396 SIGNATURE HEALTHCARE OF NORTH FLORIDA264482 LAFAYETTE HEALTH CARE CENTER317586 WILLISTON REHABILITATION AND NURSING CENTER211923 LAKE PARK OF MADISON213462 MADISON NURSING CENTER214019 PINE LAKE NURSING HOME208906 PLANTATION KEY CONVALESCENT CENTER202541 OKEECHOBEE HEALTH CARE FACILITY312274 CRESTWOOD NURSING CENTER312142 LAKEWOOD NURSING CENTER226025 PALATKA HEALTH CARE CENTER283142 ARBOR VILLAGE NURSING CENTER215597 OSPREY POINT NURSING CENTER268763 GOOD SAMARITAN CENTER001135 SURREY PLACE CARE CENTER005387 SUWANNEE HEALTH CARE CENTER252425 MARSHALL HEALTH AND REHABILITATION CENTER324353 WASHINGTON REHABILITATION AND NURSING CENTER

Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys- - - -

3.44 12,885 3,751 - (0.51) (13,830) 27,092 - (3.77) (121,557) 32,226 - (1.42) (41,846) 29,428 37,572 3.31 82,361 24,861 - 2.20 80,961 36,735 - 2.66 60,345 22,728 - 0.55 11,528 21,021 - 3.52 67,323 19,137 -

(1.73) (55,000) 31,812 - (1.88) (43,274) 23,033 - 5.28 98,242 18,611 - 2.93 52,910 18,061 - 4.45 55,307 12,439 - 5.49 140,397 25,569 - 1.41 28,057 19,867 - 2.36 31,972 13,544 - 0.90 23,978 26,537 - 5.81 32,531 5,595 - 4.12 52,544 12,739 - 6.78 195,343 28,829 - 4.96 93,475 18,852 - - - - -

1.37 24,347 17,825 - (0.56) (14,265) 25,582 28,872 1.50 42,490 28,315 47,355 4.19 74,682 17,821 - 2.40 96,923 40,434 61,349 4.32 97,268 22,490 - 5.94 94,898 15,971 - 3.02 52,370 17,355 - 4.71 227,728 48,350 -

(2.14) (111,082) 51,871 - (0.25) (3,806) 15,156 30,000 0.91 27,450 30,202 - 2.99 123,541 41,319 - 2.56 39,150 15,319 - 4.23 132,771 31,391 - 3.04 94,966 31,221 -

(6.31) (96,488) 15,297 - 2.99 46,402 15,537 - 1.42 31,120 21,974 -

(1.03) (47,726) 46,338 - 3.30 55,246 16,755 -

(0.82) (21,553) 26,442 - 1.05 46,717 44,307 - 2.89 130,987 45,342 - 4.01 37,549 9,374 - 2.98 131,173 44,007 -

(3.05) (43,598) 14,273 - (5.38) (245,558) 45,680 58,000 2.51 78,432 31,257 -

(0.94) (41,855) 44,437 -

36,017,072 Estimated Cost (676,826)

(6,540,577) 113 Lose Funding (21,443,541) 264 42,557,649 527 Gain Funding 20,766,714 376

Impact Before Bed Additions and Renovations

Page 250: ABCEF G D Zip Year of Initial Nursing Facility Name ......ABCEF G Nursing Facility Name Medicaid Provider Number Address City State Zip Zip Factor Telephone # Fax # Year of Initial

Fac # Facility Name Difference

Estimated Annual

Medicaid Impact

MA days of completed

surveys418,113 Max 241,139

(324,942) Min (632,982) Lose Gain Lose Gain

47 337 More than 50,000$ 16 167 More than 100,000$ 72 59

9 55 More than 150,000$ 37 10 5 18 More than 200,000$ 24 2 2 9 More than 250,000$ 19 - 1 3 More than 300,000$ 9 -