Supplemental Ventilator Care and Tracheostomy Care

Payments

Supplemental Ventilator Care and Tracheostomy Care payments will be made to qualifying MA

nonpublic and county nursing facilities each calendar quarter beginning July 1, 2014 and effective

January 1, 2018, to nursing facilities that are not located in a geographic zone where Community

HealthChoices operates subject to the following:

A nonpublic and county nursing facility will qualify for the payment if both of the following criteria are met based on each Picture Date:

(A) The facility has a minimum of ten MA-recipient residents who receive medically necessary ventilator care or tracheostomy care; and

(B) The facility has a minimum of 10% of their MA-recipient resident population receiving medically necessary ventilator care or tracheostomy care.

Note: On January 22, 2018, the Centers for Medicare & Medicaid Services approved State Plan Amendment 17-0021 effective January 1, 2018 limiting supplemental ventilator care and tracheostomy care payments to nursing facilities that are not located in a geographic zone where Community HealthChoices operates. Public notice Payment for Nursing Facility Services Provided by Nonpublic and County Nursing Facilities; Notice of Change for Supplemental Payments was published in the Pennsylvania Bulletin on September 30, 2017 at 47 Pa.B. 6140.

The determination of medically necessary ventilator care is based on whether there is a positive response to MDS 3.0 Section O0100F1 or O0100F2 on the MDS assessment identified on the Picture Date CMI Report. The determination of medically necessary tracheostomy care is based on whether there is a positive response to MDS 3.0 Section O0100E1 or O0100E2 on the MDS assessment identified on the Picture Date CMI Report.

The supplemental ventilator care and tracheostomy care per diem shall equal ((number of MA-recipient residents who receive necessary ventilator care or tracheostomy care/total MA-recipient residents) x $69) x (the number of MA recipient residents who receive necessary ventilator care or tracheostomy care/total MA-recipient residents). The quarterly payment shall equal the supplemental ventilator care and tracheostomy care per diem multiplied by the number of paid MA facility and therapeutic leave days.

Picture Date Authorization

Schedule

Paid Facility and Therapeutic Leave Day

Quarter February 1 September January 1 – March 31 May 1 December April 1 – June 30 August 1 March July 1 – September 30 November 1 June October 1 – December 31

Supplemental Ventilator Care and Tracheostomy Care Payments for

September:

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

ABINGTON CREST HEALTHCARE & REHAB CENTER 3 37 8% 3,074 $0.00 9/24/2018

ABINGTON MANOR 0 76 0% 7,477 $0.00 9/24/2018

ABRAMSON RESIDENCE 0 179 0% 16,220 $0.00 9/24/2018

ALLIED SERVICES SKILLED NURSING CENTER 18 213 8% 21,640 $0.00 9/24/2018

ALTOONA CENTER FOR NURSING CARE 1 75 1% 522 $0.00 9/24/2018

AMBLER EXTENDED CARE CENTER 0 76 0% 6,912 $0.00 9/24/2018

ANN'S CHOICE 0 8 0% 722 $0.00 9/24/2018

ARBUTUS PARK MANOR 0 75 0% 325 $0.00 9/24/2018

ARISTACARE AT MEADOW SPRINGS 73 110 66% 10,088 $303,245.28 9/24/2018

ARTMAN LUTHERAN HOME 0 17 0% 1,548 $0.00 9/24/2018

ASBURY HEALTH CENTER 0 48 0% 586 $0.00 9/24/2018

ATHENS HEALTH AND REHABILITATION CENTER 0 39 0% 3,591 $0.00 9/24/2018

ATTLEBORO NURSING AND REHAB CENTER 0 96 0% 8,504 $0.00 9/24/2018

AVALON PLACE 0 57 0% 426 $0.00 9/24/2018

AVALON SPRINGS PLACE 0 62 0% 5,579 $0.00 9/24/2018

BALA NURSING AND RETIREMENT CENTER 3 138 2% 13,022 $0.00 9/24/2018

BALDWIN HEALTH CENTER 0 138 0% 1,180 $0.00 9/24/2018

BALL PAVILION, THE 0 41 0% 3,769 $0.00 9/24/2018

BAPTIST HOMES OF WESTERN PENNSYLVANIA 0 82 0% 352 $0.00 9/24/2018

BARNES-KASSON COUNTY HOSPITAL SNF 0 32 0% 2,948 $0.00 9/24/2018

BEACON RIDGE, A CHOICE COMMUNITY 1 65 2% 479 $0.00 9/24/2018

BEAVER HEALTHCARE AND REHABILITATION CTR 0 39 0% 390 $0.00 9/24/2018

BEAVER VALLEY HEALTHCARE & REHAB CENTER 0 62 0% 150 $0.00 9/24/2018

BELAIR HEALTHCARE AND REHABILITATION CTR 0 62 0% 93 $0.00 9/24/2018

BELLE HAVEN HEALTHCARE & REHAB CENTER 1 41 2% 3,939 $0.00 9/24/2018

BELLE REVE HEALTH CARE CENTER 0 10 0% 480 $0.00 9/24/2018

BERKS HEIM NURSING & REHABILITATION 0 307 0% 28,284 $0.00 9/24/2018

BERKSHIRE CENTER 0 75 0% 7,159 $0.00 9/24/2018

BERWICK RETIREMENT VILLAGE NRSNG HOME I 0 32 0% 2,879 $0.00 9/24/2018

BERWICK RETIREMENT VILLAGE NRSNG HOME II 0 50 0% 5,155 $0.00 9/24/2018

BETHANY VILLAGE RETIREMENT CENTER 0 19 0% 1,823 $0.00 9/24/2018

BETHLEN HM OF THE HUNGARIAN RFRMD FED 0 53 0% 553 $0.00 9/24/2018

BIRCHWOOD NURSING AND REHAB CENTER 1 85 1% 7,714 $0.00 9/24/2018

BLOOMSBURG CARE AND REHABILITATION CTR 0 87 0% 7,938 $0.00 9/24/2018

BONHAM NURSING CENTER 0 60 0% 5,550 $0.00 9/24/2018

BRADFORD COUNTY MANOR 2 121 2% 11,187 $0.00 9/24/2018

BRADFORD ECUMENICAL HOME, INC 0 61 0% 5,602 $0.00 9/24/2018

BRADFORD MANOR 0 62 0% 5,583 $0.00 9/24/2018

BRANDYWINE HALL 2 129 2% 11,799 $0.00 9/24/2018

BRETHREN VILLAGE 0 38 0% 3,428 $0.00 9/24/2018

BRIARLEAF NURSING AND CONVAL CENTER 0 143 0% 12,763 $0.00 9/24/2018

BRIDGEVILLE REHAB AND CARE CENTER 0 86 0% 1,182 $0.00 9/24/2018

BRIGHTON REHABILITATION & WELLNESS CTR 10 330 3% 2,420 $0.00 9/24/2018

BRINTON MANOR NURSING & REHAB CENTER 0 68 0% 6,020 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

BROAD ACRES HEALTH AND REHAB CENTER 0 61 0% 5,629 $0.00 9/24/2018

BROAD MOUNTAIN HEALTH & REHAB CENTER 0 78 0% 7,108 $0.00 9/24/2018

BROOKLINE MANOR AND REHABILITATIVE SRVCS 0 35 0% 3,838 $0.00 9/24/2018

BROOKMONT HEALTHCARE CENTER LLC 0 69 0% 7,085 $0.00 9/24/2018

BROOKSIDE HEALTHCARE AND REHAB CENTER 2 90 2% 8,215 $0.00 9/24/2018

BROOKVIEW HEALTH CARE CENTER 0 50 0% 4,865 $0.00 9/24/2018

BROOMALL MANOR 1 66 2% 5,957 $0.00 9/24/2018

BROOMALL PRESBYTERIAN VILLAGE 0 74 0% 6,673 $0.00 9/24/2018

BROOMALL REHAB AND NURSING CENTER 0 166 0% 16,077 $0.00 9/24/2018

BRYN MAWR EXTENDED CARE CENTER 3 111 3% 9,844 $0.00 9/24/2018

BUCKINGHAM VALLEY NURSING & REHAB CENTER 0 75 0% 7,377 $0.00 9/24/2018

BUCKTAIL MEDICAL CENTER 0 28 0% 2,595 $0.00 9/24/2018

BUFFALO VALLEY LUTHERAN VILLAGE 0 62 0% 5,964 $0.00 9/24/2018

CALVARY FELLOWSHIP HOMES, INC 0 19 0% 1,877 $0.00 9/24/2018

CAMBRIA CARE CENTER 10 204 5% 738 $0.00 9/24/2018

CANTERBURY PLACE 0 50 0% 410 $0.00 9/24/2018

CARBONDALE NURSING AND REHAB CENTER 0 71 0% 6,959 $0.00 9/24/2018

CARE PAVILION NURSING AND REHAB CENTER 3 323 1% 28,058 $0.00 9/24/2018

CARING HEART REHAB AND NURSING CENTER 2 157 1% 13,876 $0.00 9/24/2018

CARING HEIGHTS COMMUNITY CARE & REHAB 0 75 0% 415 $0.00 9/24/2018

CARING PLACE, THE 0 61 0% 5,643 $0.00 9/24/2018

CARLETON HEALTHCARE & REHABILITATION CTR 0 13 0% 1,261 $0.00 9/24/2018

CATHEDRAL VILLAGE 0 29 0% 2,573 $0.00 9/24/2018

CEDAR HAVEN HEALTHCARE CENTER 1 247 0% 22,206 $0.00 9/24/2018

CEDARBROOK SENIORCARE AND REHABILITATION 0 512 0% 48,747 $0.00 9/24/2018

CENTENNIAL HEALTHCARE & REHAB CENTER 0 125 0% 11,723 $0.00 9/24/2018

CENTRE CREST 0 159 0% 14,979 $0.00 9/24/2018

CHAMBERS POINTE HEALTH CARE CENTER 0 19 0% 1,730 $0.00 9/24/2018

CHANDLER HALL HEALTH SERVICES INC 0 21 0% 1,833 $0.00 9/24/2018

CHAPEL MANOR 0 166 0% 15,167 $0.00 9/24/2018

CHAPEL POINTE AT CARLISLE 0 24 0% 2,121 $0.00 9/24/2018

CHARLES M. MORRIS NURSING AND REHAB CTR 0 58 0% 137 $0.00 9/24/2018

CHELTENHAM NURSING AND REHAB CENTER 1 187 1% 15,197 $0.00 9/24/2018

CHERRY TREE NURSING CENTER 0 66 0% 356 $0.00 9/24/2018

CHESTNUT HILL LODGE HEALTH AND REHAB CTR 1 119 1% 10,860 $0.00 9/24/2018

CHESTNUT NURSING AND REHAB CENTER LLC 0 76 0% 7,024 $0.00 9/24/2018

CHESWICK REHAB & WELLNESS CTR LLC 2 76 3% 639 $0.00 9/24/2018

CHRIST THE KING MANOR 0 79 0% 7,095 $0.00 9/24/2018

CHRIST'S HOME RETIREMENT COMMUNITY 0 3 0% 270 $0.00 9/24/2018

CHURCH OF GOD HOME, INC 0 40 0% 3,717 $0.00 9/24/2018

CLAREMONT NRC OF CUMBERLAND COUNTY 1 168 1% 16,893 $0.00 9/24/2018

CLARION HEALTHCARE AND REHAB CENTER 0 34 0% 2,966 $0.00 9/24/2018

CLARVIEW NURSING AND REHAB CENTER 2 54 4% 4,852 $0.00 9/24/2018

CLEPPER MANOR 0 38 0% 3,668 $0.00 9/24/2018

CLIVEDEN NSG & REHAB CTR 2 131 2% 11,813 $0.00 9/24/2018

COLONIAL MANOR NURSING HOME 3 163 2% 15,597 $0.00 9/24/2018

COLONIAL PARK CARE CENTER 0 133 0% 12,372 $0.00 9/24/2018

COMMUNITIES AT INDIAN HAVEN 0 48 0% 192 $0.00 9/24/2018

CONCORDIA AT THE CEDARS 0 29 0% 255 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

CONCORDIA AT VILLA ST. JOSEPH 0 54 0% 304 $0.00 9/24/2018 CONCORDIA LUTHERAN HEALTH AND HUMAN CARE 0 71 0% 380 $0.00 9/24/2018

CONESTOGA VIEW 9 364 2% 33,712 $0.00 9/24/2018

CONNER-WILLIAMS NURSING HOME 0 20 0% 2,588 $0.00 9/24/2018

CONTINUING CARE AT MARIS GROVE 0 1 0% 81 $0.00 9/24/2018

CORNWALL MANOR 0 22 0% 2,254 $0.00 9/24/2018

CORRY MANOR 1 72 1% 6,810 $0.00 9/24/2018 COUNTRY MEADOWS NURSING CENTER-BETHLEHEM 0 1 0% 161 $0.00 9/24/2018

COUNTRYSIDE CHRISTIAN COMMUNITY 0 17 0% 1,559 $0.00 9/24/2018

COURTYARD GARDENS NURSING AND REHAB CTR 0 53 0% 4,734 $0.00 9/24/2018

CRANBERRY PLACE 1 66 2% 479 $0.00 9/24/2018

CRAWFORD COUNTY CARE CENTER 1 95 1% 8,969 $0.00 9/24/2018

CREEKSIDE HEALTH AND REHABILITATION CTR 1 60 2% 5,398 $0.00 9/24/2018

CRESTVIEW CENTER 0 129 0% 11,220 $0.00 9/24/2018

CROSS KEYS VILLAGE-BRETHREN HM COMM, THE 1 97 1% 9,524 $0.00 9/24/2018

CUMBERLAND CROSSINGS RETIREMENT COMM 0 29 0% 2,807 $0.00 9/24/2018

DARWAY HEALTHCARE & REHABILITATION CTR 0 58 0% 4,969 $0.00 9/24/2018

DEER MEADOWS REHABILITATION CENTER 9 132 7% 12,293 $0.00 9/24/2018

DOCK TERRACE 0 21 0% 2,228 $0.00 9/24/2018

DONAHOE MANOR 1 43 2% 352 $0.00 9/24/2018

DR ARTHUR CLIFTON MCKINLEY HEALTH CENTER 1 44 2% 3,858 $0.00 9/24/2018

DRESHER HILL HEALTH & REHAB CENTER 0 88 0% 7,924 $0.00 9/24/2018

DUBOIS NURSING HOME 0 82 0% 7,922 $0.00 9/24/2018

DUNMORE HEALTH CARE CENTER 0 62 0% 5,662 $0.00 9/24/2018

EDGEHILL NURSING AND REHAB CENTER 0 48 0% 4,624 $0.00 9/24/2018

EDINBORO MANOR 2 77 3% 6,981 $0.00 9/24/2018

EDISON MANOR NURSING AND REHAB CENTER 1 69 1% 819 $0.00 9/24/2018

ELDERCREST HEALTHCARE & REHAB CENTER 0 27 0% 110 $0.00 9/24/2018

ELIZABETH MANOR HEALTHCARE & REHAB CTR 0 44 0% 4,588 $0.00 9/24/2018

ELIZABETHTOWN HEALTHCARE & REHAB CENTER 0 25 0% 2,624 $0.00 9/24/2018

ELK HAVEN NURSING HOME 0 60 0% 5,658 $0.00 9/24/2018

ELKINS CREST HEALTH & REHAB CENTER 1 97 1% 9,049 $0.00 9/24/2018

ELLEN MEMORIAL HEALTH CARE CENTER 0 58 0% 5,364 $0.00 9/24/2018

ELM TERRACE GARDENS 0 25 0% 2,401 $0.00 9/24/2018

ELMWOOD GARDENS OF PRESBY SENIOR CARE 0 23 0% 2,215 $0.00 9/24/2018

EMMANUEL CENTER FOR NURSING AND REHAB 0 58 0% 4,992 $0.00 9/24/2018

EPHRATA MANOR 0 60 0% 5,794 $0.00 9/24/2018

EPWORTH HEALTHCARE AND REHAB CENTER 0 65 0% 796 $0.00 9/24/2018

FAIR ACRES GERIATRIC CENTER 1 583 0% 54,122 $0.00 9/24/2018

FAIRLANE GARDENS NSG & REHAB AT READING 2 73 3% 6,835 $0.00 9/24/2018

FAIRMOUNT HOMES 0 43 0% 3,965 $0.00 9/24/2018

FAIRVIEW MANOR 0 79 0% 7,264 $0.00 9/24/2018

FAIRVIEW NURSING AND REHABILITATION CTR 0 120 0% 11,641 $0.00 9/24/2018

FALLING SPRING NURSING AND REHAB CENTER 0 120 0% 11,008 $0.00 9/24/2018

FELLOWSHIP MANOR 0 31 0% 3,372 $0.00 9/24/2018

FORBES CENTER FOR REHAB & HEALTHCARE LLC 13 65 20% 480 $0.00 9/24/2018

FOREST CITY NURSING AND REHAB CENTER 0 66 0% 6,026 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

FOREST PARK HEALTH CENTER 0 75 0% 7,512 $0.00 9/24/2018

FORESTVIEW 0 17 0% 1,801 $0.00 9/24/2018

FOX SUBACUTE AT CLARA BURKE 43 43 100% 3,724 $256,956.00 9/24/2018

FOX SUBACUTE AT MECHANICSBURG 35 35 100% 2,902 $200,238.00 9/24/2018

FOX SUBACUTE AT SOUTH PHILADELPHIA 7 7 100% 839 $0.00 9/24/2018

FOX SUBACUTE CENTER 31 32 97% 3,290 $213,586.80 9/24/2018

FREDERICK LIVING - CEDARWOOD 0 14 0% 1,365 $0.00 9/24/2018

FREY VILLAGE 0 70 0% 6,912 $0.00 9/24/2018

FRIENDSHIP VILLAGE OF SOUTH HILLS 0 3 0% 0 $0.00 9/24/2018

FULTON COUNTY MEDICAL CENTER LTCU 0 53 0% 4,638 $0.00 9/24/2018

GARDEN SPOT VILLAGE 0 11 0% 1,170 $0.00 9/24/2018

GARDEN SPRING NURSING & REHAB CENTER 27 111 24% 10,735 $42,617.95 9/24/2018

GARVEY MANOR 0 73 0% 603 $0.00 9/24/2018

GERMANTOWN HOME 1 158 1% 10,930 $0.00 9/24/2018

GETTYSBURG CENTER 0 70 0% 6,294 $0.00 9/24/2018

GLENDALE UPTOWN HOME 5 169 3% 16,336 $0.00 9/24/2018

GOOD SHEPHERD HOME RAKER CENTER 12 91 13% 8,286 $9,694.62 9/24/2018

GOOD SHEPHERD HOME-BETHLEHEM 0 53 0% 5,033 $0.00 9/24/2018

GRACEDALE - NORTHAMPTON COUNTY HOME 2 504 0% 49,098 $0.00 9/24/2018

GRANDVIEW NURSING AND REHABILITATION 0 105 0% 9,948 $0.00 9/24/2018

GREEN HOME, INC, THE 0 78 0% 7,281 $0.00 9/24/2018

GREEN MEADOWS NURSING & REHAB CENTER 1 111 1% 10,524 $0.00 9/24/2018

GREEN RIDGE CARE CENTER 0 50 0% 5,030 $0.00 9/24/2018

GREEN VALLEY SKILLED NSG & REHAB CENTER 0 24 0% 2,601 $0.00 9/24/2018

GREENERY CENTER FOR REHAB & NURSING 6 81 7% 339 $0.00 9/24/2018 GREENLEAF NURSING HOME AND CONVAL CENTER 1 100 1% 9,382 $0.00 9/24/2018

GREENSBURG CARE CENTER 0 79 0% 296 $0.00 9/24/2018

GROVE MANOR 0 21 0% 1,961 $0.00 9/24/2018

GUARDIAN HEALTHCARE & REHAB CENTER 0 79 0% 7,430 $0.00 9/24/2018

GUTHRIE TOWANDA MEMORIAL HOSPITAL SNU 0 35 0% 3,470 $0.00 9/24/2018

GUY AND MARY FELT MANOR, INC 0 17 0% 1,718 $0.00 9/24/2018

GWYNEDD HEALTHCARE & REHABILITATION CTR 0 134 0% 12,659 $0.00 9/24/2018

HAIDA HEALTHCARE AND REHAB CENTER 0 63 0% 235 $0.00 9/24/2018

HAMILTON ARMS CENTER 0 65 0% 5,813 $0.00 9/24/2018

HAMPTON HOUSE 1 68 1% 6,519 $0.00 9/24/2018

HANOVER HALL 1 96 1% 9,410 $0.00 9/24/2018

HARBORVIEW REHAB & C C AT DOYLESTOWN 2 70 3% 5,696 $0.00 9/24/2018

HARBORVIEW REHAB & CARE CTR AT LANSDALE 0 77 0% 6,712 $0.00 9/24/2018

HARMAR VILLAGE CARE CENTER 0 77 0% 889 $0.00 9/24/2018

HARMON HOUSE CARE CENTER 1 72 1% 328 $0.00 9/24/2018

HARRISON SENIOR LIVING OF CHRISTIANA 0 79 0% 7,840 $0.00 9/24/2018

HARSTON HALL 1 82 1% 7,563 $0.00 9/24/2018

HAVEN CONVALESCENT HOME, INC 0 70 0% 367 $0.00 9/24/2018

HAVEN SKILLED REHABILITATION AND NURSING 0 44 0% 4,125 $0.00 9/24/2018

HAVENCREST HEALTHCARE & REHAB CENTER 0 21 0% 46 $0.00 9/24/2018

HEARTHSIDE REHAB CENTER 1 84 1% 8,170 $0.00 9/24/2018

HEMPFIELD MANOR 0 76 0% 174 $0.00 9/24/2018

HICKORY HOUSE NURSING HOME 0 67 0% 6,133 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

HIGHLAND MANOR REHAB & NURSING CENTER 0 80 0% 7,414 $0.00 9/24/2018

HIGHLAND PARK CARE CENTER 0 94 0% 591 $0.00 9/24/2018

HIGHLAND VIEW HEALTHCARE & REHAB CENTER 0 21 0% 2,073 $0.00 9/24/2018

HIGHLANDS HEALTHCARE & REHAB CENTER 0 100 0% 9,107 $0.00 9/24/2018

HILLCREST CENTER 1 130 1% 12,894 $0.00 9/24/2018

HILLSDALE PARK REHAB CENTER 0 52 0% 629 $0.00 9/24/2018

HILLVIEW HEALTHCARE AND REHAB CENTER 0 84 0% 529 $0.00 9/24/2018

HOLY FAMILY HOME 0 37 0% 3,478 $0.00 9/24/2018

HOLY FAMILY MANOR 1 97 1% 8,714 $0.00 9/24/2018

HOLY FAMILY RESIDENCE 0 45 0% 4,385 $0.00 9/24/2018

HOMELAND CENTER 0 42 0% 4,263 $0.00 9/24/2018

HOMESTEAD VILLAGE, INC 0 13 0% 1,197 $0.00 9/24/2018

HOMETOWN NURSING AND REHAB CENTER 1 101 1% 9,196 $0.00 9/24/2018

HOMEWOOD AT MARTINSBURG PA INC 0 48 0% 93 $0.00 9/24/2018

HOMEWOOD AT PLUM CREEK 0 35 0% 3,288 $0.00 9/24/2018

HOPKINS CENTER 2 79 3% 7,400 $0.00 9/24/2018

HOSPITALITY CARE CENTER OF HERMITAGE INC 0 21 0% 1,727 $0.00 9/24/2018

HUNTINGDON PARK REHAB CENTER 0 60 0% 5,124 $0.00 9/24/2018

IMMACULATE MARY CTR FOR REHAB & HLTHCARE 2 173 1% 16,078 $0.00 9/24/2018

INGLIS HOUSE 11 219 5% 19,747 $0.00 9/24/2018

IVY HILL REHAB CENTER 0 104 0% 9,264 $0.00 9/24/2018

JAMESON CARE CENTER 0 38 0% 329 $0.00 9/24/2018

JEFFERSON HILLS HEALTHCARE & REHAB CTR 2 45 4% 655 $0.00 9/24/2018

JEFFERSON MANOR HEALTH CENTER 2 75 3% 6,590 $0.00 9/24/2018

JEWISH HOME OF EASTERN PENNSYLVANIA 0 99 0% 8,699 $0.00 9/24/2018

JEWISH HOME OF GREATER HARRISBURG 0 83 0% 7,768 $0.00 9/24/2018

JOHN J KANE REGIONAL CENTER-GLEN HAZEL 2 169 1% 804 $0.00 9/24/2018

JOHN J KANE REGIONAL CENTER-MCKEESPORT 0 192 0% 567 $0.00 9/24/2018

JOHN J KANE REGIONAL CENTER-ROSS TWNSHP 0 165 0% 919 $0.00 9/24/2018

JOHN J KANE REGIONAL CENTER-SCOTT TWNSHP 0 184 0% 1,241 $0.00 9/24/2018

JULIA POUND CARE CENTER 0 69 0% 588 $0.00 9/24/2018

JULIA RIBAUDO EXTENDED CARE CENTER 0 68 0% 6,438 $0.00 9/24/2018

KEARSLEY REHAB AND NURSING CENTER 0 35 0% 3,147 $0.00 9/24/2018

KINGSTON HEALTH CARE CENTER 0 43 0% 4,010 $0.00 9/24/2018

KINKORA PYTHIAN HOME CORPORATION 0 27 0% 2,432 $0.00 9/24/2018

KINZUA HEALTHCARE AND REHAB CENTER 0 73 0% 6,527 $0.00 9/24/2018

KITTANNING CARE CENTER 0 71 0% 118 $0.00 9/24/2018

KUTZTOWN MANOR 0 102 0% 10,113 $0.00 9/24/2018

LACKAWANNA HEALTH AND REHAB CENTER 0 141 0% 13,321 $0.00 9/24/2018

LAFAYETTE MANOR, INC 0 54 0% 237 $0.00 9/24/2018

LAFAYETTE-REDEEMER (DBA ENTITY OF HRHS) 0 55 0% 5,121 $0.00 9/24/2018

LAKEVIEW HEALTHCARE & REHABILITATION CTR 0 13 0% 1,207 $0.00 9/24/2018

LANCASHIRE HALL 1 169 1% 16,338 $0.00 9/24/2018

LANDIS HOMES 0 30 0% 2,786 $0.00 9/24/2018

LANGHORNE GARDENS HEALTH & REHAB CENTER 0 72 0% 7,390 $0.00 9/24/2018

LAUREL CENTER 18 83 22% 7,380 $24,649.20 9/24/2018

LAUREL RIDGE CENTER 1 41 2% 131 $0.00 9/24/2018

LAUREL SQUARE HEALTHCARE & REHAB CTR 0 71 0% 6,354 $0.00 9/24/2018

LAUREL VIEW VILLAGE 0 25 0% 213 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

LAUREL WOOD CARE CENTER 0 86 0% 394 $0.00 9/24/2018

LAWSON NURSING HOME, INC. 0 19 0% 59 $0.00 9/24/2018

LEBANON VALLEY BRETHREN HOME 0 27 0% 2,665 $0.00 9/24/2018

LEBANON VALLEY HOME THE 0 26 0% 2,536 $0.00 9/24/2018

LECOM AT PRESQUE ISLE, INC. 16 74 22% 7,502 $25,056.68 9/24/2018

LEHIGH CENTER 0 67 0% 6,162 $0.00 9/24/2018

LGAR HEALTH AND REHABILITATION CENTER 0 78 0% 637 $0.00 9/24/2018

LIBERTY CENTER FOR REHAB AND NURSING 1 65 2% 6,135 $0.00 9/24/2018

LIFEQUEST NURSING CENTER 0 83 0% 7,751 $0.00 9/24/2018

LINWOOD NURSING AND REHABILITATION CTR 0 54 0% 4,812 $0.00 9/24/2018

LITTLE FLOWER MANOR 0 55 0% 5,199 $0.00 9/24/2018

LITTLE FLOWER MANOR OF DIOCESE SCRANTON 0 75 0% 7,464 $0.00 9/24/2018

LITTLE SISTERS OF THE POOR 0 40 0% 121 $0.00 9/24/2018

LOCUST GROVE RETIREMENT VILLAGE 0 67 0% 5,969 $0.00 9/24/2018

LOYALHANNA CARE CENTER 0 69 0% 215 $0.00 9/24/2018

LOYALSOCK REHAB CENTER 1 85 1% 7,577 $0.00 9/24/2018

LUTHER ACRES MANOR 0 41 0% 4,084 $0.00 9/24/2018

LUTHER CREST NURSING FACILITY 0 25 0% 2,432 $0.00 9/24/2018

LUTHER WOODS NURSING & REHAB CENTER 1 75 1% 7,161 $0.00 9/24/2018

LUTHERAN COMMUNITY AT TELFORD 0 22 0% 2,019 $0.00 9/24/2018

LUTHERAN HOME AT HOLLIDAYSBURG, THE 0 37 0% 436 $0.00 9/24/2018

LUTHERAN HOME AT JOHNSTOWN, THE 1 30 3% 432 $0.00 9/24/2018

LUTHERAN HOME AT KANE, THE 0 51 0% 4,868 $0.00 9/24/2018

LUTHERAN HOME AT TOPTON 1 108 1% 10,024 $0.00 9/24/2018

MAHONING VALLEY NURSING AND REHAB CENTER 0 73 0% 6,886 $0.00 9/24/2018

MAJESTIC OAKS REHAB & NURSING CENTER 0 125 0% 11,784 $0.00 9/24/2018

MANATAWNY MANOR INC 0 75 0% 6,846 $0.00 9/24/2018

MANCHESTER COMMONS OF PRESBY SR. CARE 0 34 0% 3,231 $0.00 9/24/2018

MANORCARE HEALTH SERVICES - MONTGOMERY 0 75 0% 7,813 $0.00 9/24/2018

MANORCARE HEALTH SERVICES - NORTHSIDE 0 77 0% 337 $0.00 9/24/2018

MANORCARE HEALTH SERVICES - WALLINGFORD 1 140 1% 12,437 $0.00 9/24/2018

MANORCARE HEALTH SVCS-ALLENTOWN 2 112 2% 11,070 $0.00 9/24/2018

MANORCARE HEALTH SVCS-BETHEL PARK 1 88 1% 832 $0.00 9/24/2018

MANORCARE HEALTH SVCS-BETHLEHEM (2021) 1 168 1% 15,539 $0.00 9/24/2018

MANORCARE HEALTH SVCS-BETHLEHEM (2029) 1 180 1% 15,709 $0.00 9/24/2018

MANORCARE HEALTH SVCS-CAMP HILL 0 73 0% 6,717 $0.00 9/24/2018

MANORCARE HEALTH SVCS-CARLISLE 0 97 0% 9,405 $0.00 9/24/2018

MANORCARE HEALTH SVCS-CHAMBERSBURG 1 124 1% 11,894 $0.00 9/24/2018

MANORCARE HEALTH SVCS-DALLASTOWN 1 143 1% 13,544 $0.00 9/24/2018

MANORCARE HEALTH SVCS-EASTON 0 171 0% 16,183 $0.00 9/24/2018

MANORCARE HEALTH SVCS-GREEN TREE 2 86 2% 1,472 $0.00 9/24/2018

MANORCARE HEALTH SVCS-HUNTINGDON VALLEY 3 89 3% 8,343 $0.00 9/24/2018

MANORCARE HEALTH SVCS-JERSEY SHORE 0 86 0% 7,621 $0.00 9/24/2018

MANORCARE HEALTH SVCS-KING OF PRUSSIA 1 94 1% 8,409 $0.00 9/24/2018

MANORCARE HEALTH SVCS-KINGSTON 0 103 0% 9,703 $0.00 9/24/2018

MANORCARE HEALTH SVCS-KINGSTON COURT 1 93 1% 8,830 $0.00 9/24/2018

MANORCARE HEALTH SVCS-LANCASTER 0 105 0% 10,055 $0.00 9/24/2018

MANORCARE HEALTH SVCS-LAURELDALE 3 121 2% 11,638 $0.00 9/24/2018

MANORCARE HEALTH SVCS-LEBANON 2 105 2% 10,347 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

MANORCARE HEALTH SVCS-MONROEVILLE 1 69 1% 533 $0.00 9/24/2018

MANORCARE HEALTH SVCS-NORTH HILLS 0 121 0% 741 $0.00 9/24/2018

MANORCARE HEALTH SVCS-OXFORD VALLEY 0 82 0% 8,154 $0.00 9/24/2018

MANORCARE HEALTH SVCS-PETERS TOWNSHIP 1 80 1% 419 $0.00 9/24/2018

MANORCARE HEALTH SVCS-PITTSBURGH 2 121 2% 1,137 $0.00 9/24/2018

MANORCARE HEALTH SVCS-POTTSTOWN 0 99 0% 8,935 $0.00 9/24/2018

MANORCARE HEALTH SVCS-POTTSVILLE 0 105 0% 10,124 $0.00 9/24/2018

MANORCARE HEALTH SVCS-SHADYSIDE 1 106 1% 447 $0.00 9/24/2018

MANORCARE HEALTH SVCS-SINKING SPRING 1 142 1% 13,791 $0.00 9/24/2018

MANORCARE HEALTH SVCS-SUNBURY 0 88 0% 7,783 $0.00 9/24/2018 MANORCARE HEALTH SVCS-WEST READING NORTH 1 134 1% 12,317 $0.00 9/24/2018 MANORCARE HEALTH SVCS-WHITEHALL BOROUGH 0 71 0% 1,168 $0.00 9/24/2018 MANORCARE HEALTH SVCS-WILLIAMSPORT NORTH 1 95 1% 8,524 $0.00 9/24/2018 MANORCARE HEALTH SVCS-WILLIAMSPORT SOUTH 1 68 1% 5,950 $0.00 9/24/2018

MANORCARE HEALTH SVCS-YEADON 3 165 2% 14,771 $0.00 9/24/2018

MANORCARE HEALTH SVCS-YORK NORTH 0 104 0% 9,925 $0.00 9/24/2018

MANORCARE HEALTH SVCS-YORK SOUTH 1 93 1% 8,782 $0.00 9/24/2018

MANORCARE HLTH SVCS & REHAB -WEST ALLEN 6 115 5% 11,086 $0.00 9/24/2018

MAPLE FARM 0 16 0% 1,519 $0.00 9/24/2018

MAPLE WINDS HEALTHCARE & REHAB CTR, LLC 1 23 4% 194 $0.00 9/24/2018

MAPLEWOOD NURSING AND REHABILITATION CTR 1 145 1% 13,375 $0.00 9/24/2018

MARGARET E. MOUL HOME 2 82 2% 7,255 $0.00 9/24/2018

MARIAN MANOR CORPORATION 0 65 0% 319 $0.00 9/24/2018

MASONIC VILLAGE AT ELIZABETHTOWN 0 250 0% 24,116 $0.00 9/24/2018

MASONIC VILLAGE AT LAFAYETTE HILL 0 31 0% 3,316 $0.00 9/24/2018

MASONIC VILLAGE AT SEWICKLEY 0 31 0% 416 $0.00 9/24/2018

MASONIC VILLAGE AT WARMINSTER 0 29 0% 2,870 $0.00 9/24/2018

MAYBROOK HILLS REHAB & HEALTHCARE CENTER 3 158 2% 698 $0.00 9/24/2018

MCMURRAY HILLS MANOR 0 78 0% 355 $0.00 9/24/2018

MEADOW VIEW HEALTHCARE & REHAB CENTER 0 42 0% 3,838 $0.00 9/24/2018

MEADOW VIEW NURSING CENTER 0 99 0% 759 $0.00 9/24/2018

MEADOWCREST HEALTHCARE AND REHAB CENTER 0 30 0% 0 $0.00 9/24/2018

MEADOWS NURSING AND REHAB CENTER 1 80 1% 7,521 $0.00 9/24/2018

MEADOWVIEW REHAB & NURSING CENTER 2 183 1% 16,973 $0.00 9/24/2018

MENNONITE HOME, THE 0 49 0% 4,807 $0.00 9/24/2018

MERCY CENTER NURSING UNIT, INC 0 32 0% 2,859 $0.00 9/24/2018

MESSIAH LIFEWAYS AT MESSIAH VILLAGE 0 46 0% 4,109 $0.00 9/24/2018

MEYERSDALE HEALTHCARE AND REHAB CTR 0 53 0% 691 $0.00 9/24/2018

MID VALLEY HEALTH CARE CENTER 0 14 0% 1,389 $0.00 9/24/2018

MIFFLIN CENTER 0 81 0% 7,628 $0.00 9/24/2018

MILFORD HEALTHCARE AND REHAB CENTER 0 54 0% 5,163 $0.00 9/24/2018

MILLCREEK MANOR 1 78 1% 6,978 $0.00 9/24/2018

MILTON REHABILITATION AND NURSING CENTER 0 92 0% 8,150 $0.00 9/24/2018

MISERICORDIA NURSING & REHAB CENTER 0 13 0% 1,243 $0.00 9/24/2018

MON VALLEY CARE CENTER 1 30 3% 30 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

MONROEVILLE REHAB & WELLNESS CENTER 0 65 0% 251 $0.00 9/24/2018

MORAVIAN HALL SQ. HLTH AND WELLNESS CTR 0 2 0% 394 $0.00 9/24/2018

MORAVIAN MANOR 0 30 0% 3,062 $0.00 9/24/2018

MORRISONS COVE HOME 0 74 0% 775 $0.00 9/24/2018

MOSSER NURSING HOME 0 34 0% 3,027 $0.00 9/24/2018

MOUNT CARMEL NURSING AND REHAB CENTER 0 83 0% 7,608 $0.00 9/24/2018 MOUNT HOPE NAZARENE RETIREMENT COMMUNITY 0 37 0% 3,310 $0.00 9/24/2018

MOUNT MACRINA MANOR NURSING HOME 0 66 0% 318 $0.00 9/24/2018

MOUNTAIN CITY NURSING AND REHAB CENTER 1 225 0% 20,784 $0.00 9/24/2018

MOUNTAIN LAUREL HEALTHCARE & REHAB CTR 0 123 0% 10,982 $0.00 9/24/2018

MOUNTAIN TOP HEALTHCARE AND REHAB CTR 0 72 0% 6,649 $0.00 9/24/2018

MOUNTAIN VIEW CARE AND REHAB CENTER 1 104 1% 7,712 $0.00 9/24/2018

MOUNTAIN VIEW, A NURSING AND REHAB CTR 1 194 1% 17,065 $0.00 9/24/2018

MOUNTAINVIEW SPECIALTY CARE CENTER 15 74 20% 170 $0.00 9/24/2018

MT. LEBANON REHAB AND WELLNESS CENTER 1 74 1% 571 $0.00 9/24/2018

MULBERRY HEALTHCARE & REHAB CTR 0 49 0% 4,426 $0.00 9/24/2018

MURRYSVILLE REHAB & WELLNESS CENTER 0 78 0% 581 $0.00 9/24/2018

NAAMANS CREEK COUNTRY MANOR 0 42 0% 4,461 $0.00 9/24/2018

NESHAMINY MANOR HOME 0 263 0% 24,154 $0.00 9/24/2018 NEW EASTWOOD HEALTHCARE AND REHAB CENTER 1 37 3% 4,192 $0.00 9/24/2018

NORMANDIE RIDGE 0 23 0% 2,310 $0.00 9/24/2018

NORRITON SQUARE NURSING & REHAB CENTER 0 58 0% 5,067 $0.00 9/24/2018

NORTH HILLS HEALTH AND REHAB CENTER 0 29 0% 270 $0.00 9/24/2018

NORTH STRABANE REHAB & WELLNESS CTR LLC 0 40 0% 360 $0.00 9/24/2018

NOTTINGHAM VILLAGE 0 58 0% 5,376 $0.00 9/24/2018

NUGENT CONVALESCENT HOME 0 71 0% 6,625 $0.00 9/24/2018

NURSING & REHABILITATION AT THE MANSION 0 50 0% 4,345 $0.00 9/24/2018

OAK HILL HEALTHCARE & REHAB CENTER 0 24 0% 54 $0.00 9/24/2018

OAKMONT CENTER FOR NURSING AND REHAB 0 53 0% 483 $0.00 9/24/2018

OAKWOOD HEALTHCARE & REHABILITATION CTR 1 92 1% 8,886 $0.00 9/24/2018

OAKWOOD HEIGHTS OF PRESBY SENIOR CARE 0 55 0% 5,188 $0.00 9/24/2018

OHESSON MANOR 1 87 1% 8,440 $0.00 9/24/2018

OIL CITY HEALTHCARE AND REHAB CENTER 1 60 2% 5,396 $0.00 9/24/2018

OLD ORCHARD HEALTH CARE CENTER 2 110 2% 10,269 $0.00 9/24/2018

ORCHARD MANOR, INC 0 78 0% 6,896 $0.00 9/24/2018

ORWIGSBURG NURSING & REHAB CENTER 0 75 0% 7,335 $0.00 9/24/2018

OXFORD HEALTH CENTER 0 69 0% 6,964 $0.00 9/24/2018

PAPERMILL ROAD NURSING & REHAB CENTER 0 77 0% 7,241 $0.00 9/24/2018

PARAMOUNT NURSING & REHAB @ FAYETTEVILLE 0 44 0% 4,374 $0.00 9/24/2018

PARK AVENUE REHAB CENTER 2 97 2% 8,401 $0.00 9/24/2018

PARKHOUSE REHABILITATION AND NURSING CTR 1 283 0% 26,279 $0.00 9/24/2018

PASSAVANT RETIREMENT AND HEALTH CENTER 0 53 0% 298 $0.00 9/24/2018

PAUL'S RUN 0 38 0% 4,277 $0.00 9/24/2018

PEMBROOKE HEALTH AND REHAB CENTER 0 127 0% 11,992 $0.00 9/24/2018

PENNKNOLL VILLAGE 2 96 2% 434 $0.00 9/24/2018

PENNSBURG MANOR 0 66 0% 6,601 $0.00 9/24/2018

PENNYPACK NURSING & REHAB CENTER 0 26 0% 2,498 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

PETER BECKER COMMUNITY 0 23 0% 2,016 $0.00 9/24/2018

PHILADELPHIA NURSING HOME 9 352 3% 31,660 $0.00 9/24/2018

PHILADELPHIA PROTESTANT HOME 0 59 0% 5,459 $0.00 9/24/2018

PHOEBE ALLENTOWN HEALTH CARE 0 144 0% 12,668 $0.00 9/24/2018

PHOEBE BERKS HEALTH CARE CENTER, INC 0 21 0% 1,857 $0.00 9/24/2018

PHOEBE RICHLAND HCC 0 59 0% 5,641 $0.00 9/24/2018

PHOEBE WYNCOTE 0 28 0% 2,518 $0.00 9/24/2018

PICKERING MANOR HOME 0 16 0% 1,527 $0.00 9/24/2018

PINE RUN HEALTH CENTER 0 23 0% 2,026 $0.00 9/24/2018

PINECREST MANOR 0 82 0% 7,493 $0.00 9/24/2018

PLATINUM RIDGE CTR FOR REHAB & HEALING 0 65 0% 263 $0.00 9/24/2018

PLEASANT ACRES NURSING AND REHAB CENTER 11 303 4% 28,248 $0.00 9/24/2018

PLEASANT RIDGE MANOR WEST 4 231 2% 21,656 $0.00 9/24/2018

PLEASANT VALLEY MANOR, INC 0 122 0% 11,323 $0.00 9/24/2018

PLEASANT VIEW RETIREMENT COMMUNITY 0 51 0% 5,059 $0.00 9/24/2018

POCOPSON HOME 0 200 0% 18,437 $0.00 9/24/2018

POWERBACK REHABILITATION 1526 0 59 0% 3,592 $0.00 9/24/2018

POWERBACK REHABILITATION 3485 0 17 0% 1,562 $0.00 9/24/2018

PREMIER ARMSTRONG REHAB & NSG FACILITY 0 68 0% 571 $0.00 9/24/2018

PREMIER AT PERRY VLG FOR NURSE AND REHAB 0 68 0% 6,403 $0.00 9/24/2018

PREMIER AT SUSQUEHANNA FOR NURSE & REHAB 0 98 0% 9,861 $0.00 9/24/2018

PREMIER WASHINGTON REHAB AND NURSING CTR 0 171 0% 1,421 $0.00 9/24/2018 PRESBYTERIAN HOMES-PRESBYTERY-HUNTINGDON 0 27 0% 448 $0.00 9/24/2018

PROSPECT PARK HEALTH AND REHAB CENTER 16 101 16% 9,134 $16,167.18 9/24/2018

PROVIDENCE CARE CENTER 0 122 0% 1,127 $0.00 9/24/2018

PROVIDENCE REHAB & HCC MERCY FITZGERALD 1 79 1% 6,858 $0.00 9/24/2018

QUAKERTOWN CENTER 1 88 1% 8,905 $0.00 9/24/2018

QUALITY LIFE SERVICES - APOLLO 3 112 3% 571 $0.00 9/24/2018

QUALITY LIFE SERVICES - CHICORA 0 74 0% 521 $0.00 9/24/2018

QUALITY LIFE SERVICES - GROVE CITY 0 75 0% 6,972 $0.00 9/24/2018

QUALITY LIFE SERVICES - HENRY CLAY 0 62 0% 30 $0.00 9/24/2018

QUALITY LIFE SERVICES - MARKLEYSBURG 1 50 2% 55 $0.00 9/24/2018

QUALITY LIFE SERVICES - MERCER 0 27 0% 2,227 $0.00 9/24/2018

QUALITY LIFE SERVICES - NEW CASTLE 0 125 0% 1,354 $0.00 9/24/2018

QUALITY LIFE SERVICES - SARVER 0 42 0% 583 $0.00 9/24/2018

QUALITY LIFE SERVICES - SUGAR CREEK 0 81 0% 482 $0.00 9/24/2018

QUALITY LIFE SERVICES - WESTMONT 0 15 0% 366 $0.00 9/24/2018

QUARRYVILLE PRESBYTERIAN RETIREMENT COMM 0 44 0% 3,979 $0.00 9/24/2018

QUINCY RETIREMENT COMMUNITY 0 78 0% 7,565 $0.00 9/24/2018

REDSTONE HIGHLANDS HEALTH CARE CENTER 0 31 0% 185 $0.00 9/24/2018

REFORMED PRESBYTERIAN HOME 0 26 0% 51 $0.00 9/24/2018

REGINA COMMUNITY NURSING CENTER 0 91 0% 8,157 $0.00 9/24/2018

REHAB & NURSING CTR GREATER PITTSBURGH 0 53 0% 258 $0.00 9/24/2018

RENAISSANCE HEALTHCARE & REHAB CENTER 1 87 1% 7,134 $0.00 9/24/2018

REST HAVEN-YORK 0 90 0% 7,701 $0.00 9/24/2018

RICHBORO REHABILITATION & NURSING CENTER 0 43 0% 3,879 $0.00 9/24/2018

RICHFIELD HEALTHCARE AND REHAB CENTER 0 25 0% 2,447 $0.00 9/24/2018

RICHLAND HEALTHCARE AND REHAB CENTER 0 58 0% 656 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

RIDGEVIEW HEALTHCARE & REHAB CENTER 1 72 1% 6,954 $0.00 9/24/2018

RIDGEVIEW HEALTHCARE & REHAB CENTER 1 83 1% 7,496 $0.00 9/24/2018

RIVER RUN REHAB AND NURSING CENTER 1 61 2% 5,607 $0.00 9/24/2018

RIVER'S EDGE NURSING AND REHAB CENTER 1 71 1% 6,399 $0.00 9/24/2018

RIVERSIDE CARE CENTER 1 93 1% 521 $0.00 9/24/2018

RIVERSIDE REHABILITATION AND NURSING CTR 0 99 0% 9,063 $0.00 9/24/2018

RIVERSTREET MANOR 1 72 1% 6,681 $0.00 9/24/2018

RIVERWOODS 0 76 0% 6,997 $0.00 9/24/2018

ROCHESTER MANOR 0 65 0% 139 $0.00 9/24/2018

ROLLING FIELDS, INC 0 122 0% 11,362 $0.00 9/24/2018

ROLLING HILLS HEALTHCARE & REHAB CENTER 0 42 0% 3,937 $0.00 9/24/2018

ROLLING MEADOWS 0 77 0% 122 $0.00 9/24/2018

ROSE CITY NURSING AND REHAB AT LANCASTER 1 89 1% 8,033 $0.00 9/24/2018

ROSE VIEW NURSING & REHAB CENTER 0 79 0% 7,440 $0.00 9/24/2018

ROSEMONT CENTER 1 54 2% 4,938 $0.00 9/24/2018

ROSEWOOD REHABILITATION & NURSING CENTER 0 109 0% 10,184 $0.00 9/24/2018

ROUSE WARREN COUNTY HOME 0 104 0% 9,483 $0.00 9/24/2018

RYDAL PARK OF PHILADELPHIA PRSBYTR HOMES 0 17 0% 1,701 $0.00 9/24/2018

SAINT ANNE HOME 0 55 0% 587 $0.00 9/24/2018

SAINT ANNE'S RETIREMENT COMMUNITY 0 32 0% 3,191 $0.00 9/24/2018

SAINT JOHN XXIII HOME 0 51 0% 4,495 $0.00 9/24/2018

SAINT JOSEPH VILLA 1 41 2% 4,074 $0.00 9/24/2018

SAINT MARY'S AT ASBURY RIDGE 0 32 0% 3,157 $0.00 9/24/2018

SAINT MARY'S EAST 0 75 0% 7,303 $0.00 9/24/2018

SAINT MARY'S VILLA NURSING HOME, INC 0 67 0% 6,034 $0.00 9/24/2018

SAINT PAUL HOMES 1 110 1% 9,879 $0.00 9/24/2018

SANATOGA CENTER 0 78 0% 7,255 $0.00 9/24/2018

SARAH A TODD MEMORIAL HOME 0 74 0% 7,128 $0.00 9/24/2018

SARAH REED SENIOR LIVING 0 52 0% 5,245 $0.00 9/24/2018

SAUNDERS HOUSE 1 89 1% 8,648 $0.00 9/24/2018

SAXONY HEALTH CENTER 0 33 0% 509 $0.00 9/24/2018

SAYRE HEALTH CARE CENTER, LLC 0 38 0% 3,557 $0.00 9/24/2018

SCENERY HILL HEALTHCARE & REHAB CENTER 0 33 0% 66 $0.00 9/24/2018

SCHUYLKILL CENTER 0 131 0% 12,098 $0.00 9/24/2018

SCOTTDALE HEALTHCARE & REHAB CENTER 0 10 0% 271 $0.00 9/24/2018

SCRANTON HEALTH CARE CENTER 0 20 0% 2,358 $0.00 9/24/2018

SENA-KEAN MANOR 0 116 0% 10,189 $0.00 9/24/2018

SENECA PLACE 1 72 1% 572 $0.00 9/24/2018

SETON MANOR NURSING & REHABILITATION CTR 0 78 0% 7,238 $0.00 9/24/2018

SHENANDOAH MANOR NURSING CENTER 1 86 1% 8,214 $0.00 9/24/2018

SHENANGO PRESBYTERIAN SENIORCARE 0 5 0% 32 $0.00 9/24/2018

SHERWOOD OAKS 0 1 0% 0 $0.00 9/24/2018

SHIPPENSBURG HEALTH CARE CENTER 0 69 0% 6,725 $0.00 9/24/2018

SHIPPENVILLE HEALTHCARE AND REHAB CENTER 1 59 2% 4,996 $0.00 9/24/2018

SHOOK HOME, THE 0 31 0% 2,857 $0.00 9/24/2018

SIEMONS' LAKEVIEW MANOR NSG AND REHAB 1 76 1% 361 $0.00 9/24/2018

SILVER LAKE CENTER 2 125 2% 11,233 $0.00 9/24/2018

SILVER STREAM NURSING & REHAB CENTER 1 85 1% 7,592 $0.00 9/24/2018

SIMPSON HOUSE, INC 0 90 0% 9,123 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

SLATE BELT HEALTH AND REHAB CENTER 0 67 0% 6,174 $0.00 9/24/2018

SMITH HEALTH CARE, LTD 0 18 0% 1,831 $0.00 9/24/2018

SNYDER MEMORIAL HEALTH CARE CENTER 0 76 0% 7,035 $0.00 9/24/2018

SOMERTON NURSING & REHAB CENTER 19 154 12% 13,918 $13,778.82 9/24/2018

SOUDERTON MENNONITE HOMES 0 20 0% 1,973 $0.00 9/24/2018

SOUTH HILLS REHAB & WELLNESS CENTER 0 75 0% 386 $0.00 9/24/2018

SOUTHMONT OF PRESBYTERIAN SENIORCARE 0 78 0% 452 $0.00 9/24/2018

SOUTHWESTERN NURSING CARE CENTER 1 70 1% 673 $0.00 9/24/2018

SPANG CREST MANOR 0 39 0% 3,731 $0.00 9/24/2018

SPIRITRUST LUTHERAN VLG @ SHREWSBURY 0 57 0% 5,252 $0.00 9/24/2018

SPIRITRUST LUTHERAN VLG @ GETTYSBURG 0 42 0% 4,076 $0.00 9/24/2018

SPIRITRUST LUTHERAN VLG @ SPRENKLE DRIVE 0 50 0% 4,690 $0.00 9/24/2018

SPIRITRUST LUTHERAN VLG @ UTZ TERRACE 0 24 0% 2,207 $0.00 9/24/2018

SPRING CREEK REHAB AND NURSING CENTER 8 268 3% 26,699 $0.00 9/24/2018

SPRINGS AT THE WATERMARK, THE 0 30 0% 2,764 $0.00 9/24/2018

SPRUCE MANOR NURSING AND REHAB CENTER 3 132 2% 12,701 $0.00 9/24/2018

SQUIRREL HILL CTR FOR REHAB AND HEALING 0 97 0% 974 $0.00 9/24/2018

ST FRANCIS CENTER FOR REHAB & HEALTHCARE 2 156 1% 13,726 $0.00 9/24/2018

ST JOHN NEUMANN CTR FOR REHAB & HLTHCARE 0 127 0% 12,052 $0.00 9/24/2018

ST JOHN SPECIALTY CARE CENTER 8 127 6% 1,773 $0.00 9/24/2018

ST JOSEPH'S MANOR (DBA ENTITY OF HRHS) 1 141 1% 13,427 $0.00 9/24/2018

ST LUKE'S REHABILITATION AND NURSING CTR 0 27 0% 2,807 $0.00 9/24/2018

ST MARTHA CENTER FOR REHAB & HEALTHCARE 0 68 0% 6,872 $0.00 9/24/2018

ST MARY CENTER FOR REHAB & HEALTHCARE 0 70 0% 6,489 $0.00 9/24/2018

ST MONICA CENTER FOR REHAB & HEALTHCARE 0 96 0% 8,644 $0.00 9/24/2018

ST. BARNABAS NURSING HOME 0 49 0% 468 $0.00 9/24/2018

ST. IGNATIUS NURSING & REHAB CENTER 1 131 1% 9,030 $0.00 9/24/2018

ST. LUKE'S VILLA 0 17 0% 1,518 $0.00 9/24/2018

STATESMAN HEALTH & REHAB CENTER 11 60 18% 5,652 $12,660.48 9/24/2018

STERLING HEALTH CARE AND REHAB CENTER 2 117 2% 10,966 $0.00 9/24/2018

STONEBRIDGE HEALTH & REHAB CENTER, LLC 0 36 0% 3,445 $0.00 9/24/2018

STONERIDGE POPLAR RUN 0 22 0% 1,903 $0.00 9/24/2018

STONERIDGE TOWNE CENTRE 0 71 0% 6,694 $0.00 9/24/2018

SUBURBAN WOODS HEALTH AND REHAB CENTER 1 64 2% 6,203 $0.00 9/24/2018

SUGAR CREEK STATION SKILLED NSG & REHAB 0 83 0% 7,527 $0.00 9/24/2018

SUMMIT AT BLUE MOUNTAIN NURSING & REHAB 0 53 0% 5,105 $0.00 9/24/2018

SUNBURY COMMUNITY HEALTH & REHAB CENTER 0 14 0% 1,581 $0.00 9/24/2018

SUNNYVIEW NURSING AND REHABILITATION CTR 0 163 0% 754 $0.00 9/24/2018

SUNSET RIDGE HEALTHCARE & REHAB CENTER 0 45 0% 4,130 $0.00 9/24/2018

SUSQUE VIEW HOME, INC 0 88 0% 8,404 $0.00 9/24/2018

SUSQUEHANNA HLTH SKILLED NSG & REHAB CTR 10 89 11% 8,490 $7,046.70 9/24/2018

SUSQUEHANNA VALLEY NURSING AND REHAB CTR 1 115 1% 10,892 $0.00 9/24/2018

SWAIM HEALTH CENTER 0 40 0% 4,007 $0.00 9/24/2018

SWEDEN VALLEY MANOR 0 85 0% 7,536 $0.00 9/24/2018

TEL HAI RETIREMENT COMMUNITY 0 56 0% 5,129 $0.00 9/24/2018

THE BELVEDERE CENTER, GENESIS HEALTHCARE 0 118 0% 10,338 $0.00 9/24/2018

THE COMMUNITY AT ROCKHILL 0 17 0% 1,504 $0.00 9/24/2018

THE GARDENS AT BLUE RIDGE 0 65 0% 6,413 $0.00 9/24/2018

THE GARDENS AT BUTLER 1 27 4% 2,467 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

THE GARDENS AT CAMP HILL 1 70 1% 6,764 $0.00 9/24/2018

THE GARDENS AT CAMPBELLTOWN 0 30 0% 3,025 $0.00 9/24/2018

THE GARDENS AT EAST MOUNTAIN 1 75 1% 6,484 $0.00 9/24/2018

THE GARDENS AT EASTON 2 141 1% 13,603 $0.00 9/24/2018

THE GARDENS AT GETTYSBURG 0 69 0% 7,327 $0.00 9/24/2018

THE GARDENS AT LAKESIDE 1 20 5% 1,934 $0.00 9/24/2018

THE GARDENS AT LITITZ 0 21 0% 2,026 $0.00 9/24/2018

THE GARDENS AT MILLVILLE 0 85 0% 7,862 $0.00 9/24/2018

THE GARDENS AT ORANGEVILLE 2 88 2% 7,798 $0.00 9/24/2018

THE GARDENS AT PALMYRA 0 22 0% 2,028 $0.00 9/24/2018

THE GARDENS AT POTTSTOWN 0 25 0% 2,522 $0.00 9/24/2018

THE GARDENS AT SCRANTON 1 73 1% 7,265 $0.00 9/24/2018

THE GARDENS AT STEVENS 1 55 2% 4,958 $0.00 9/24/2018

THE GARDENS AT STROUD 0 83 0% 7,601 $0.00 9/24/2018

THE GARDENS AT TUNKHANNOCK 0 75 0% 7,112 $0.00 9/24/2018

THE GARDENS AT WEST SHORE 0 139 0% 13,820 $0.00 9/24/2018

THE GARDENS AT WYOMING VALLEY 0 86 0% 7,926 $0.00 9/24/2018

THE GARDENS AT YORK TERRACE 0 45 0% 4,508 $0.00 9/24/2018

THE GARDENS FOR MEMORY CARE AT EASTON 0 89 0% 8,153 $0.00 9/24/2018

THE GROVE AT GREENVILLE 1 113 1% 10,522 $0.00 9/24/2018

THE GROVE AT HARMONY 0 68 0% 1,161 $0.00 9/24/2018

THE GROVE AT IRWIN 1 70 1% 536 $0.00 9/24/2018

THE GROVE AT LATROBE 0 85 0% 633 $0.00 9/24/2018

THE GROVE AT NEW CASTLE 0 39 0% 198 $0.00 9/24/2018

THE GROVE AT NEW WILMINGTON 0 70 0% 557 $0.00 9/24/2018

THE GROVE AT WASHINGTON 2 55 4% 383 $0.00 9/24/2018

THE MANOR AT PENN VILLAGE 0 104 0% 9,173 $0.00 9/24/2018

THE MANOR AT ST LUKE VILLAGE 0 68 0% 6,293 $0.00 9/24/2018

THE PATRIOT, A CHOICE COMMUNITY 0 60 0% 139 $0.00 9/24/2018

THE PAVILION AT BRMC 1 61 2% 5,836 $0.00 9/24/2018

THE PAVILION AT ST LUKE VILLAGE 0 67 0% 6,251 $0.00 9/24/2018

THE PHOENIX CENTER FOR REHAB AND NURSING 1 72 1% 6,128 $0.00 9/24/2018

THORNWALD HOME 0 44 0% 4,128 $0.00 9/24/2018

TIMBER RIDGE HEALTH CENTER 2 117 2% 11,495 $0.00 9/24/2018

TITUSVILLE HEALTHCARE & REHAB CENTER 0 54 0% 4,852 $0.00 9/24/2018

TOWNE MANOR EAST 0 94 0% 8,762 $0.00 9/24/2018

TOWNE MANOR WEST 0 80 0% 7,469 $0.00 9/24/2018

TOWNVIEW HEALTH AND REHAB CENTER 1 73 1% 371 $0.00 9/24/2018

TRANSITIONS HEALTHCARE AUTUMN GROVE C C 0 83 0% 159 $0.00 9/24/2018

TRANSITIONS HEALTHCARE GETTYSBURG 1 93 1% 8,747 $0.00 9/24/2018

TRANSITIONS HEALTHCARE NORTH HUNTINGDON 0 76 0% 907 $0.00 9/24/2018

TRANSITIONS HEALTHCARE WASHINGTON PA 15 73 21% 404 $0.00 9/24/2018

TREMONT HEALTH & REHABILITATION CENTER 1 126 1% 11,756 $0.00 9/24/2018

TUCKER HOUSE NSG & REHAB CTR 1 131 1% 10,885 $0.00 9/24/2018

TWIN PINES HEALTH CARE CENTER 0 78 0% 7,347 $0.00 9/24/2018

TWINBROOK HEALTHCARE & REHAB CENTER 0 85 0% 7,663 $0.00 9/24/2018

UNIONTOWN HEALTHCARE & REHAB CENTER 1 82 1% 834 $0.00 9/24/2018

UNITED ZION RETIREMENT COMMUNITY 0 23 0% 2,164 $0.00 9/24/2018

UPMC COLE SKILLED NURSING & REHAB UNIT 0 20 0% 1,821 $0.00 9/24/2018

Name

# MA Vents-Trach

2/1/2018 Picture

Date

# MA 2/1/2018

Picture Date

% MA Vents-Trach

Paid Facility and

Therapeutic Days for Quarter Ending

3/31/2018

Total Vent-Trach

Payment RA Date

UPMC HERITAGE PLACE 0 62 0% 294 $0.00 9/24/2018

VALENCIA WOODS AT ST BARNABAS 0 14 0% 44 $0.00 9/24/2018

VALLEY MANOR REHAB AND HEALTHCARE CTR 1 127 1% 11,738 $0.00 9/24/2018

VALLEY VIEW HAVEN, INC 0 81 0% 7,239 $0.00 9/24/2018

VALLEY VIEW REHAB AND NURSING CENTER 0 83 0% 7,694 $0.00 9/24/2018

VILLAGE AT LUTHER SQUARE 1 84 1% 7,062 $0.00 9/24/2018

VILLAGE AT PENNWOOD 1 61 2% 191 $0.00 9/24/2018

VINCENTIAN HOME 0 102 0% 344 $0.00 9/24/2018

WALNUT CREEK HEALTHCARE & REHAB CENTER 1 68 1% 6,510 $0.00 9/24/2018

WARREN MANOR 0 65 0% 6,011 $0.00 9/24/2018

WATSONTOWN REHABILITATION AND NRSG CTR 0 67 0% 6,698 $0.00 9/24/2018

WAYNE CENTER 1 68 1% 6,693 $0.00 9/24/2018

WAYNE WOODLANDS MANOR 0 60 0% 5,469 $0.00 9/24/2018

WAYNESBURG HEALTHCARE & REHAB CENTER 0 68 0% 61 $0.00 9/24/2018

WEATHERWOOD HEALTHCARE AND REHAB CTR 1 145 1% 13,573 $0.00 9/24/2018

WESBURY UNITED METHODIST COMMUNITY 0 115 0% 10,701 $0.00 9/24/2018

WESLEY ENHANCED LIVING AT STAPELEY 0 77 0% 7,098 $0.00 9/24/2018

WESLEY ENHANCED LIVING MAIN LINE REHAB 0 25 0% 2,414 $0.00 9/24/2018

WESLEY ENHANCED LIVING PENNYPACK PARK 0 58 0% 5,541 $0.00 9/24/2018

WESLEY ENHANCED LIVING-DOYLESTOWN 0 25 0% 2,414 $0.00 9/24/2018

WESLEY VILLAGE 0 91 0% 8,554 $0.00 9/24/2018

WEST HILLS HEALTH AND REHAB CENTER 0 67 0% 811 $0.00 9/24/2018

WESTERN RESERVE HEALTHCARE & REHAB CTR 3 72 4% 6,397 $0.00 9/24/2018

WESTGATE HILLS REHAB AND NURSING CENTER 0 61 0% 5,951 $0.00 9/24/2018

WESTMINSTER VILLAGE 0 75 0% 6,985 $0.00 9/24/2018

WESTMINSTER WOODS AT HUNTINGDON 0 31 0% 2,963 $0.00 9/24/2018

WESTMORELAND MANOR 0 314 0% 3,985 $0.00 9/24/2018

WESTON REHABILITATION AND NURSING CENTER 0 19 0% 1,754 $0.00 9/24/2018

WEXFORD HEALTHCARE CENTER 0 97 0% 1,406 $0.00 9/24/2018

WHITESTONE CARE CENTER 0 36 0% 3,478 $0.00 9/24/2018

WILLIAM PENN CARE CENTER 4 74 5% 288 $0.00 9/24/2018

WILLIAM PENN HEALTHCARE & REHAB CENTER 0 80 0% 7,302 $0.00 9/24/2018

WILLIAMSPORT HOME, THE 0 72 0% 6,264 $0.00 9/24/2018

WILLOW TERRACE 0 104 0% 10,096 $0.00 9/24/2018

WILLOWBROOKE CT SCC AT BRITTANY POINTE 0 4 0% 358 $0.00 9/24/2018

WILLOWCREST 1 4 25% 117 $0.00 9/24/2018

WILLOWS OF PRESBYTERIAN SENIORCARE, THE 0 81 0% 689 $0.00 9/24/2018

WINDBER WOODS SENIOR LIVING & REHAB CTR 0 72 0% 301 $0.00 9/24/2018

WINDY HILL VILLAGE OF PRESBYTERIAN HOMES 0 83 0% 7,353 $0.00 9/24/2018

WOODHAVEN CARE CENTER 1 74 1% 312 $0.00 9/24/2018

WOODLAND PARK REHAB CENTER 0 73 0% 6,991 $0.00 9/24/2018

WYNDMOOR HILLS HEALTH CARE & REHAB CTR 0 1 0% 27 $0.00 9/24/2018

WYOMISSING HEALTH AND REHABILITATION CTR 0 68 0% 6,337 $0.00 9/24/2018

YORK NURSING AND REHABILITATION CENTER 0 170 0% 16,303 $0.00 9/24/2018

ZERBE SISTERS NURSING CENTER, INC. 0 50 0% 4,865 $0.00 9/24/2018