Get documents about "2004 Cost Report
Document Sample
Instructions: (By doing this preliminary review before you submit your cost report y
report returned to you for corrections.)
Step One: Scan Column A for formulas which evaluated as "------FALSE------" or as "
these have failed their math edit conditions.
Step Two: Refer to the "Math Edit Formulas using Account Descriptions" column to
schedule and accounts that are being questioned. Most errors are fairly simple to d
Step Three: Many formula statements include "IF(AND(xxx,yyy)". This simply means
the formula yyy must be true for the math edit to pass.
If the Math Edit
Cost
Failed then Math Edit
Report
"---FALSE---" or Number
Schedule
"#DIV/0!"
TRUE 1 B
---FALSE--- 2 A
TRUE 3 A
TRUE 4 A, G
TRUE 5 G
---FALSE--- 6 G
TRUE 7 G
TRUE 8 G
TRUE 9 B
TRUE 10 B
TRUE 11 B
TRUE 12 B
TRUE 13 B
TRUE 14 B
TRUE 15 B
TRUE 16 B
TRUE 17 B
TRUE 18 B
TRUE 19 B
TRUE 20 B
TRUE 21 B
TRUE 22 B
TRUE 23 B
TRUE 24 B
TRUE 25 B
TRUE 26 B
TRUE 27 B
TRUE 28 B
TRUE 29 B
TRUE 30 B
TRUE 31 B
TRUE 32 B
TRUE 33 B
TRUE 34 B
TRUE 35 B
TRUE 36 B
TRUE 37 B
TRUE 38 B
TRUE 39 B
TRUE 40 B
TRUE 41 B
TRUE 42 B
TRUE 43 B
TRUE 44 B
TRUE 45 B
TRUE 46 B
TRUE 47 B
TRUE 48 B
TRUE 49 B
---FALSE--- 50 C
TRUE 51 C,G
TRUE 52 C,G
TRUE 53 C,G
TRUE 54 C,G
TRUE 55 C,G
TRUE 56 C,G
TRUE 57 C,G
TRUE 58 C,G
TRUE 59 C,G
TRUE 60 C
TRUE 61 C,G
TRUE 62 C,G
TRUE 63 C
TRUE 64 C,G
TRUE 65 D
TRUE 66 D
TRUE 67 D
TRUE 68 D
TRUE 69 D
TRUE 70 D
TRUE 71 B,D
TRUE 72 E
TRUE 73 E
TRUE 74 E
TRUE 75 G
TRUE 76 G
TRUE 77 G
TRUE 78 G
TRUE 79 G
TRUE 80 G
TRUE 81 G
TRUE 82 G
TRUE 83 G
---FALSE--- 84 G
TRUE 85 G
TRUE 86 G
TRUE 87 G
TRUE 88 G
TRUE 89 G
TRUE 90 G
TRUE 91 G
TRUE 92 G
TRUE 93 G
TRUE 94 G
TRUE 95 G
TRUE 96 G
TRUE 97 G
TRUE 98 G
TRUE 99 G
TRUE 100 G
TRUE 101 G
TRUE 102 G
TRUE 103 G
TRUE 104 G
TRUE 105 G
TRUE 106 G
TRUE 107 G
TRUE 108 G
TRUE 109 G
TRUE 110 G
TRUE 111 G
TRUE 112 G
TRUE 113 G
TRUE 114 G
TRUE 115 G
TRUE 116 G
TRUE 117 G
TRUE 118 G
TRUE 119 G
TRUE 120 G
TRUE 121 G
TRUE 122 G
TRUE 123 G
TRUE 124 G
TRUE 125 G
TRUE 126 G
TRUE 127 G
TRUE 128 G
TRUE 129 G
TRUE 130 G
TRUE 131 G
TRUE 132 G
TRUE 133 G
TRUE 134 G
TRUE 135 G
TRUE 136 G
TRUE 137 G
TRUE 138 G
TRUE 139 O
TRUE 140 G
TRUE 141 G
TRUE 142 G
TRUE 143 G
TRUE 144 G
TRUE 145 G
TRUE 146 G
TRUE 147 G
TRUE 148 G
TRUE 149 G
TRUE 150 G
TRUE 151 G
TRUE 152 G
TRUE 153 G
TRUE 154 G
TRUE 155 G
TRUE 156 G
TRUE 157 G
TRUE 158 G
TRUE 159 G
TRUE 160 G
TRUE 161 G
TRUE 162 G
TRUE 163 G
TRUE 164 G
TRUE 165 G
TRUE 166 G
TRUE 167 G, N
TRUE 168 G
TRUE 169 G
TRUE 170 G
TRUE 171 G
TRUE 172 G
TRUE 173 G
TRUE 174 G
TRUE 175 G7
TRUE 176 G7
TRUE 177 G7
TRUE 178 G7
TRUE 179 G7
TRUE 180 G7
TRUE 181 G7
TRUE 182 G7
TRUE 183 G7
TRUE 184 G7
TRUE 185 G7
TRUE 186 G7
TRUE 187 G7
TRUE 188 G7
TRUE 189 G7
TRUE 190 G7
TRUE 191 G7
TRUE 192 G7
TRUE 193 G7
TRUE 194 G7
TRUE 195 G7
TRUE 196 G7
TRUE 197 G7
TRUE 198 G7
TRUE 199 G7
TRUE 200 G7
TRUE 201 G7
TRUE 202 G7
TRUE 203 G7
TRUE 204 G7
TRUE 205 G7
TRUE 206 G7
TRUE 207 G7
TRUE 208 G7
TRUE 209 G7, N
TRUE 210 G7, N
TRUE 211 G7, N
TRUE 212 G7, N
---FALSE--- 213 G7
---FALSE--- 214 G7
---FALSE--- 215 G7
---FALSE--- 216 G7
TRUE 217 G7
TRUE 218 G7
TRUE 219 G7
TRUE 220 G7
TRUE 221 G7
TRUE 222 G7
TRUE 223 G7
TRUE 224 G7
TRUE 225 G7
TRUE 226 G7
TRUE 227 G7
TRUE 228 G7
TRUE 229 G7
TRUE 230 G,G7
TRUE 231 H1
TRUE 232 H1
TRUE 233 H1
TRUE 234 H1
TRUE 235 H3
TRUE 236 H3
TRUE 237 H3
TRUE 238 H3
TRUE 239 B4
TRUE 240 B4
TRUE 241 B4
TRUE 242 B4
TRUE 243 B4
TRUE 244 B4
TRUE 245 B4
TRUE 246 B4
TRUE 247 B4
TRUE 248 B4
TRUE 249 B4
TRUE 250 B4,B
TRUE 251 B4,B
TRUE 252 B4,B
TRUE 253 B4,B
TRUE 254 B4,B
TRUE 255 B4,B
TRUE 256 B4,B
TRUE 257 B4,B
TRUE 258 B4,B
TRUE 259 B4,B
TRUE 260 B4,B
TRUE 261 B4,B
TRUE 262 B4,B
TRUE 263 B4,B
TRUE 264 B4,B
TRUE 265 B4,B
TRUE 266 B4,B
TRUE 267 B4,B
TRUE 268 B4,B
TRUE 269 N,M
TRUE 270 N,M
TRUE 271 M
TRUE 272 M
TRUE 273 M
TRUE 274 M
TRUE 275 M
TRUE 276 M
TRUE 277 M
TRUE 278 M
TRUE 279 M
TRUE 280 M
TRUE 281 M
TRUE 282 M
TRUE 283 M
TRUE 284 M
TRUE 285 M
TRUE 286 M
TRUE 287 M
TRUE 288 M
TRUE 289 M
TRUE 290 M
TRUE 291 M
TRUE 292 M
TRUE 293 M
TRUE 294 M
TRUE 295 M
TRUE 296 M
TRUE 297 M
TRUE 298 M
TRUE 299 M
TRUE 300 M
TRUE 301 M
TRUE 302 M
TRUE 303 M
TRUE 304 M
TRUE 305 M
TRUE 306 M
TRUE 307 M
TRUE 308 M
TRUE 309 M
TRUE 310 M
TRUE 311 M
TRUE 312 M
TRUE 313 M
TRUE 314 M
TRUE 315 M
TRUE 316 M
TRUE 317 N
TRUE 318 N
TRUE 319 N
TRUE 320 N
TRUE 321 N
TRUE 322 N
TRUE 323 N
TRUE 324 N
TRUE 325 N
TRUE 326 N
TRUE 327 N
TRUE 328 N
TRUE 329 N
TRUE 330 N
TRUE 331 N
TRUE 332 N
TRUE 333 N
TRUE 334 N
TRUE 335 N
TRUE 336 N
#DIV/0! 337 A, N
TRUE 338 A, N
---FALSE--- 339 A, N
TRUE 340 O
---FALSE--- 341 O
TRUE 342 O
---FALSE--- 343 O
TRUE 344 O
---FALSE--- 345 O
---FALSE--- 346 O
TRUE 347 O
TRUE 348 O
TRUE 349 O
TRUE 350 O
TRUE 351 O
TRUE 352 O
TRUE 353 O
TRUE 354 O
TRUE 355 O
TRUE 356 O
TRUE 357 O
TRUE 358 O
TRUE 359 O
TRUE 360 O
TRUE 361 O
TRUE 362 O
TRUE 363 O
TRUE 364 O
TRUE 365 O
TRUE 366 O
TRUE 367 O
TRUE 368 O
TRUE 369 O
TRUE 370 O
TRUE 371 O
TRUE 372 O
TRUE 373 O
TRUE 374 O
TRUE 375 O
TRUE 376 O
TRUE 377 O
TRUE 378 O
TRUE 379 O
TRUE 380 O
TRUE 381 O
TRUE 382 O
TRUE 383 O
TRUE 384 O
TRUE 385 O
TRUE 386 O
TRUE 387 O
TRUE 388 O
#REF! 389 O
#REF! 390 O
#REF! 391 O
#REF! 392 O
#REF! 393 O
TRUE 394 O
---FALSE--- 395 O
TRUE 396 O
TRUE 397 O
TRUE 398 O
TRUE 399 O
---FALSE--- 400 O
TRUE 401 O
TRUE 402 O
---FALSE--- 403 O
TRUE 404 O
TRUE 405 O
---FALSE--- 406 O
TRUE 407 O
TRUE 408 O
---FALSE--- 409 O
TRUE 410 O
---FALSE--- 411 O
TRUE 412 O
TRUE 413 O
TRUE 414 O
TRUE 415 O
TRUE 416 O
TRUE 417 O
TRUE 418 O
TRUE 419 O
TRUE 420 O
TRUE 421 O
TRUE 422 O
TRUE 423 O
TRUE 424 O
TRUE 425 O
TRUE 426 O
TRUE 427 O
TRUE 428 O
TRUE 429 O
TRUE 430 O
TRUE 431 O
TRUE 432 O
TRUE 433 O
TRUE 434 O
TRUE 435 O
TRUE 436 O
TRUE 437 O
TRUE 438 O
TRUE 439 O
#REF! 440 O
TRUE 441 O
TRUE 442 O
TRUE 443 I3
TRUE 444 I4
TRUE 445 I4
TRUE 446 I4
TRUE 447 I5
TRUE 448 I5
TRUE 449 I5
TRUE 450 N
TRUE 451 N
TRUE 452 N
TRUE 453 N
TRUE 454 N
TRUE 455 N
TRUE 456 N
TRUE 457 N
TRUE 458 N
TRUE 459 N
TRUE 460 N
TRUE 461 N
TRUE 462 C,G
TRUE 463 C,G
TRUE 464 C,G
TRUE 465 C,G
TRUE 466 C,G
TRUE 467 C,G
TRUE 468 G
TRUE 469 G
TRUE 470 G
TRUE 471 G
TRUE 472 G
TRUE 473 G
TRUE 474 G
TRUE 475 G,G8
TRUE 476 G
TRUE 477 G
TRUE 478 G
TRUE 479 G
TRUE 480 G
TRUE 481 G8
TRUE 482 G
#DIV/0! 483 G8,
TRUE 484 G8,N
TRUE 485 G8
TRUE 486 O
TRUE 487 O
TRUE 488 O
TRUE 489 O
TRUE 490 O
TRUE 491 O
TRUE 492 O
TRUE 493 O
TRUE 494 O
TRUE 495 O
TRUE 496 O
TRUE 497 N,O
#DIV/0! 498 O
TRUE 499 O
TRUE 500 O
TRUE 501 O
TRUE 502 G7
TRUE 503 G7
TRUE 504 G7
TRUE 505 G7
TRUE 506 G
TRUE 507 G
TRUE 508 G
TRUE 509 G
TRUE 510 G
TRUE 511 G
TRUE 512 N
TRUE 513 N
TRUE 514 N
TRUE 515 N
TRUE 516 N
TRUE 517 N
TRUE 518 N
TRUE 519 N
TRUE 520 N
TRUE 521 N
TRUE 522 N
FALSE 523 G
TRUE 524 G
TRUE 525 G
TRUE 526 G
TRUE 527 G
FALSE 528 G
TRUE 529 G
TRUE 530 G
TRUE 531 G
TRUE 532 O
TRUE 533 O
TRUE 534 O
---FALSE--- 535 L
---FALSE--- 536 L
TRUE 537 G2HOP1
TRUE 538 A
liminary review before you submit your cost report you may prevent having the
ctions.)
ormulas which evaluated as "------FALSE------" or as "#DIV/0" (division by zero) -
t conditions.
dit Formulas using Account Descriptions" column to identify and review the
being questioned. Most errors are fairly simple to detect.
ments include "IF(AND(xxx,yyy)". This simply means that both the formula xxx and
r the math edit to pass.
Math Edit Formulas using Account Descriptions
[SCHLB : TOTAL CURRENT ASSETS-Col 6]=[SCHLB : Cash-Col 6]+[SCHLB : Marketable Securities-Col
6]+[SCHLB : Patient Accounts Receivable-Col 6]+[SCHLB : Other Receivable-Col 6]+[SCHLB : Less: Allowances
for Doubtful Accounts-Col 6]+[SCHLB : Inventories-Col 6]+[SCHLB : Prepaid Expenses-Col 6]+[SCHLB : Due
from Other Funds-Col 6]+[SCHLB : Home Office Current Assets-Col 6]+[SCHLB : Current Intercompany
Receivable-Col 6]+[SCHLB : Other Current Assets-Col 6]
if([SCHLA : Report Period Beginning Date]>=1/1/2011,true,"---FALSE---")
if([SCHLA : Report Period Ending Date]<=12/31/2011,true,"---FALSE---")
IF(AND([SCHLA : Report Period Ending Date]<>0,[SCHLG : Original Structure-Sq Ft (Line
239)]<>0),TRUE,IF(AND([SCHLA : Report Period Ending Date]=0,[SCHLG : Original Structure-Sq Ft (Line
239)]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]<>0,[SCHLG : Original Structure-Date Built (Line
239)]<>0),TRUE,IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]=0,[SCHLG : Original Structure-Date Built
(Line 239)]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Original Structure-Date Built (Line 239)]<>0,[SCHLG : Original Structure-Age in Years (Line
239)]<>0),TRUE,IF(AND([SCHLG : Original Structure-Date Built (Line 239)]=0,[SCHLG : Original Structure-Age in
Years (Line 239)]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]<>0,[SCHLG : Buiding Type (Line
246)]<>0),TRUE,IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]=0,[SCHLG : Buiding Type (Line
246)]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]<>0,[SCHLG : Buiding Type (Line
246)]<>0),TRUE,IF(AND([SCHLG : Original Structure-Sq Ft (Line 239)]=0,[SCHLG : Buiding Type (Line
246)]=0),TRUE,"---FALSE---"))
[SCHLB : Land-Col 6]=[SCHLB : Land-Col 3]+[SCHLB : Land-Col 4]-[SCHLB : Land-Col 5]
[SCHLB : Land Improvements-Col 6]=[SCHLB : Land Improvements-Col 3]+[SCHLB : Land Improvements-Col 4]-
[SCHLB : Land Improvements-Col 5]
[SCHLB : Building-Col 6]=[SCHLB : Building-Col 3]+[SCHLB : Building-Col 4]-[SCHLB : Building-Col 5]
[SCHLB : Building Improvements-Col 6]=[SCHLB : Building Improvements-Col 3]+[SCHLB : Building
Improvements-Col 4]-[SCHLB : Building Improvements-Col 5]
[SCHLB : Fixed Equipment-Col 6]=[SCHLB : Fixed Equipment-Col 3]+[SCHLB : Fixed Equipment-Col 4]-[SCHLB
: Fixed Equipment-Col 5]
[SCHLB : Movable Equipment-Col 6]=[SCHLB : Movable Equipment-Col 3]+[SCHLB : Movable Equipment-Col 4]-
[SCHLB : Movable Equipment-Col 5]
[SCHLB : Vehicles-Col 6]=[SCHLB : Vehicles-Col 3]+[SCHLB : Vehicles-Col 4]-[SCHLB : Vehicles-Col 5]
[SCHLB : Other Equipment-Col 6]=[SCHLB : Other Equipment-Col 3]+[SCHLB : Other Equipment-Col 4]-[SCHLB
: Other Equipment-Col 5]
[SCHLB : Leasehold Improvements-Col 6]=[SCHLB : Leasehold Improvements-Col 3]+[SCHLB : Leasehold
Improvements-Col 4]-[SCHLB : Leasehold Improvements-Col 5]
[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 6]=[SCHLB : TOTAL FACILITY
PROPERTY, PLANT & EQUIPMENT-Col 3]+[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-
Col 4]-[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 5]
[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 3]=[SCHLB : Land-Col 3]+[SCHLB : Land
Improvements-Col 3]+[SCHLB : Building-Col 3]+[SCHLB : Building Improvements-Col 3]+[SCHLB : Fixed
Equipment-Col 3]+[SCHLB : Movable Equipment-Col 3]+[SCHLB : Vehicles-Col 3]+[SCHLB : Other Equipment-
Col 3]+[SCHLB : Leasehold Improvements-Col 3]
[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 4]=[SCHLB : Land-Col 4]+[SCHLB : Land
Improvements-Col 4]+[SCHLB : Building-Col 4]+[SCHLB : Building Improvements-Col 4]+[SCHLB : Fixed
Equipment-Col 4]+[SCHLB : Movable Equipment-Col 4]+[SCHLB : Vehicles-Col 4]+[SCHLB : Other Equipment-
Col 4]+[SCHLB : Leasehold Improvements-Col 4]
[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 5]=[SCHLB : Land-Col 5]+[SCHLB : Land
Improvements-Col 5]+[SCHLB : Building-Col 5]+[SCHLB : Building Improvements-Col 5]+[SCHLB : Fixed
Equipment-Col 5]+[SCHLB : Movable Equipment-Col 5]+[SCHLB : Vehicles-Col 5]+[SCHLB : Other Equipment-
Col 5]+[SCHLB : Leasehold Improvements-Col 5]
[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 6]=[SCHLB : Land-Col 6]+[SCHLB : Land
Improvements-Col 6]+[SCHLB : Building-Col 6]+[SCHLB : Building Improvements-Col 6]+[SCHLB : Fixed
Equipment-Col 6]+[SCHLB : Movable Equipment-Col 6]+[SCHLB : Vehicles-Col 6]+[SCHLB : Other Equipment-
Col 6]+[SCHLB : Leasehold Improvements-Col 6]
[SCHLB : Accum. Deprec.-Land Improvements-Col 6]=[SCHLB : Accum. Deprec.-Land Improvements-Col
3]+[SCHLB : Accum. Deprec.-Land Improvements-Col 4]-[SCHLB : Accum. Deprec.-Land Improvements-Col 5]
[SCHLB : Accum. Deprec. - Building-Col 4]=[SCHLB : Accum. Deprec. - Building-Col 2]+[SCHLB : Accum.
Deprec. - Building-Col 4]-[SCHLB : Accum. Deprec. - Building-Col 4]
[SCHLB : Accum. Deprec. - Building Improv.-Col 4]=[SCHLB : Accum. Deprec. - Building Improv.-Col 2]+[SCHLB
: Accum. Deprec. - Building Improv.-Col 4]-[SCHLB : Accum. Deprec. - Building Improv.-Col 4]
[SCHLB : Accum. Deprec. - Fixed Equipment-Col 4]=[SCHLB : Accum. Deprec. - Fixed Equipment-Col
2]+[SCHLB : Accum. Deprec. - Fixed Equipment-Col 4]-[SCHLB : Accum. Deprec. - Fixed Equipment-Col 4]
[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]=[SCHLB : Accum. Deprec. - Movable Equipment-Col
2]+[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]-[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]
[SCHLB : Accum. Deprec. - Vehicles-Col 4]=[SCHLB : Accum. Deprec. - Vehicles-Col 2]+[SCHLB : Accum.
Deprec. - Vehicles-Col 4]-[SCHLB : Accum. Deprec. - Vehicles-Col 4]
[SCHLB : Accum. Deprec. - Other Equipment-Col 4]=[SCHLB : Accum. Deprec. - Other Equipment-Col
2]+[SCHLB : Accum. Deprec. - Other Equipment-Col 4]-[SCHLB : Accum. Deprec. - Other Equipment-Col 4]
[SCHLB : Accum. Deprec. - Leasehold Improv.-Col 4]=[SCHLB : Accum. Deprec. - Leasehold Improv.-Col
2]+[SCHLB : Accum. Deprec. - Leasehold Improv.-Col 4]-[SCHLB : Accum. Deprec. - Leasehold Improv.-Col 4]
[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 6]=[SCHLB : TOTAL ACCUMULATED DEPRECIATION-
Col 3]+[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 4]-[SCHLB : TOTAL ACCUMULATED
DEPRECIATION-Col 5]
[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 6]=[SCHLB : Accum. Deprec.-Land Improvements-Col
6]+[SCHLB : Accum. Deprec. - Building-Col 4]+[SCHLB : Accum. Deprec. - Building Improv.-Col 4]+[SCHLB :
Accum. Deprec. - Fixed Equipment-Col 4]+[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]+[SCHLB :
Accum. Deprec. - Vehicles-Col 4]+[SCHLB : Accum. Deprec. - Other Equipment-Col 4]+[SCHLB : Accum.
Deprec. - Leasehold Improv.-Col 4]
[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 6]=[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col
3]+[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 4]-[SCHLB : NET BOOK VALUE-FACILITY ASSETS-
Col 5]
[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 3]=[SCHLB : Accum. Deprec.-Land Improvements-Col
3]+[SCHLB : Accum. Deprec. - Building-Col 2]+[SCHLB : Accum. Deprec. - Building Improv.-Col 2]+[SCHLB :
Accum. Deprec. - Fixed Equipment-Col 2]+[SCHLB : Accum. Deprec. - Movable Equipment-Col 2]+[SCHLB :
Accum. Deprec. - Vehicles-Col 2]+[SCHLB : Accum. Deprec. - Other Equipment-Col 2]+[SCHLB : Accum.
Deprec. - Leasehold Improv.-Col 2] DEPRECIATION-Col 4]=[SCHLB : Accum. Deprec.-Land Improvements-Col
[SCHLB : TOTAL ACCUMULATED
4]+[SCHLB : Accum. Deprec. - Building-Col 4]+[SCHLB : Accum. Deprec. - Building Improv.-Col 4]+[SCHLB :
Accum. Deprec. - Fixed Equipment-Col 4]+[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]+[SCHLB :
Accum. Deprec. - Vehicles-Col 4]+[SCHLB : Accum. Deprec. - Other Equipment-Col 4]+[SCHLB : Accum.
Deprec. - Leasehold Improv.-Col 4] DEPRECIATION-Col 5]=[SCHLB : Accum. Deprec.-Land Improvements-Col
[SCHLB : TOTAL ACCUMULATED
5]+[SCHLB : Accum. Deprec. - Building-Col 4]+[SCHLB : Accum. Deprec. - Building Improv.-Col 4]+[SCHLB :
Accum. Deprec. - Fixed Equipment-Col 4]+[SCHLB : Accum. Deprec. - Movable Equipment-Col 4]+[SCHLB :
Accum. Deprec. - Vehicles-Col 4]+[SCHLB : Accum. Deprec. - Other Equipment-Col 4]+[SCHLB : Accum.
Deprec. - Leasehold Improv.-Col 4]
[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 3]=[SCHLB : TOTAL FACILITY PROPERTY, PLANT &
EQUIPMENT-Col 3]+[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 3]
[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 4]=[SCHLB : TOTAL FACILITY PROPERTY, PLANT &
EQUIPMENT-Col 4]+[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 4]
[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 5]=[SCHLB : TOTAL FACILITY PROPERTY, PLANT &
EQUIPMENT-Col 5]+[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 5]
[SCHLB : NET BOOK VALUE-FACILITY ASSETS-Col 6]=[SCHLB : TOTAL FACILITY PROPERTY, PLANT &
EQUIPMENT-Col 6]+[SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 6]
[SCHLB : NET PROPERTY, PLANT & EQUIPMENT-Col 3]=[SCHLB : NET BOOK VALUE-FACILITY ASSETS-
Col 3]+[SCHLB : Construction in Progress-Col 3]+[SCHLB : Home Office Deprec. Assets-Col 3]+[SCHLB :
Accum. Deprec.-Home Office-Col 3]
[SCHLB : NET PROPERTY, PLANT & EQUIPMENT-Col 6]=[SCHLB : NET BOOK VALUE-FACILITY ASSETS-
Col 6]+[SCHLB : Construction in Progress-Col 6]+[SCHLB : Home Office Deprec. Assets-Col 6]+[SCHLB :
Accum. Deprec.-Home Office-Col 6]
[SCHLB : TOTAL NON-CURRENT ASSETS-Col 6]=[SCHLB : Long Term Investments-Col 6]+[SCHLB :
Intercompany Receivable-Col 6]+[SCHLB : Unamortized Start-Up Costs-Col 6]+[SCHLB : Goodwill-Col
6]+[SCHLB : Home Office Non-Current Assets-Col 6]+[SCHLB : Other Non-Current Assets-Col 6]
[SCHLB : TOTAL ASSETS-Col 6]=[SCHLB : TOTAL CURRENT ASSETS-Col 6]+[SCHLB : NET PROPERTY,
PLANT & EQUIPMENT-Col 6]+[SCHLB : TOTAL NON-CURRENT ASSETS-Col 6]
[SCHLB : TOTAL ASSETS-Col 6]=[SCHLB : TOTAL LIABILITIES AND EQUITY-Col 6]
[SCHLB : TOTAL CURRENT LIABILITIES-Col 6]=[SCHLB : Accounts Payable-Col 6]+[SCHLB : Notes Payable-
Col 6]+[SCHLB : Accrued Payroll & Related Liab.-Col 6]+[SCHLB : Current Portion of Long-Term Debt-Col
6]+[SCHLB : Due to Other Funds-Col 6]+[SCHLB : Home Office Current Liab-Col 6]+[SCHLB : Current
Intercompany Payable-Col 6]+[SCHLB : Other Current Liabilities-Col 6]
[SCHLB : TOTAL LONG-TERM LIABILITIES-Col 6]=[SCHLB : Mortgage Payable-Col 6]+[SCHLB : Notes Payable-
Col 6]+[SCHLB : Capitalized Lease Obligations-Col 6]+[SCHLB : Intercompany Payable-Col 6]+[SCHLB :
Deferred Income Tax-Col 6]+[SCHLB : Home Office Long-Term Liabilities-Col 6]+[SCHLB : Other Long-Term
Liabilities-Col 6]
[SCHLB : TOTAL EQUITY/FUND BALANCES-Col 6]=[SCHLB : Common Stock-Col 6]+[SCHLB : Preferred Stock-
Col 6]+[SCHLB : Treasury Stock-Col 6]+[SCHLB : Additional Paid-In Capital-Col 6]+[SCHLB : Proprietorship
Equity-Col 6]+[SCHLB : Partnership Equity-Col 6]+[SCHLB : Fund Balance-Col 6]+[SCHLB : Retained Earnings-
Col 6]+[SCHLB : Divisional Equity-Col 6]
[SCHLB : TOTAL LIABILITIES AND EQUITY-Col 6]=[SCHLB : TOTAL CURRENT LIABILITIES-Col 6]+[SCHLB :
TOTAL LONG-TERM LIABILITIES-Col 6]+[SCHLB : TOTAL EQUITY/FUND BALANCES-Col 6]
if([SCHLC : Average Charge to Private Patients]>0,true,"---FALSE---")
[SCHLC : Routine Care Revenue]=[SCHLG : TOTAL ROUTINE REVENUE - Column 5]
[SCHLC : Other Patient Revenue]=[SCHLG : TOTAL OTHER PATIENT REVENUE-Column 5]
[SCHLC : Other Operating Revenue]=[SCHLG : TOTAL OTHER OPERATING REVENUE-Column 5]
[SCHLC : Revenue Deductions]=[SCHLG : REVENUE DEDUCTIONS - Column 5]
[SCHLC : Net Operating Revenue]=[SCHLC : Routine Care Revenue]+[SCHLC : Other Patient
Revenue]+[SCHLC : Other Operating Revenue]+[SCHLC : Revenue Deductions]
[SCHLC : Property]=[SCHLG : TOTAL PROPERTY-Column 5]
[SCHLC : Total Routine Expenses]=[SCHLG : TOTAL ROUTINE EXPENSES-Column 5]
[SCHLC : Other Patient Expense]=[SCHLG : TOTAL OTHER PATIENT EXPENSES-Column 5]
[SCHLC : Other Operating Expenses]=[SCHLG : TOTAL OTHER OPERATING EXPENSES-Column 5]
[SCHLC : Total Operating Expenses]=[SCHLC : Total Routine Expenses]+[SCHLC : Other Patient
Expense]+[SCHLC : Other Operating Expenses]
[SCHLC : Non-Operating Revenue]=[SCHLG : TOTAL NON-OPERATING REVENUE-Column 5]
[SCHLC : Non-Operating Expenses]=[SCHLG : TOTAL NON-OPERATING EXPENSES-Column 5]
[SCHLC : Net Income (Loss)]=[SCHLC : Net Operating Revenue]-[SCHLC : Total Operating Expenses]+[SCHLC
: Non-Operating Revenue]-[SCHLC : Non-Operating Expenses]
[SCHLC : Net Income (Loss)]=[SCHLG : NET INCOME/(LOSS)-Column 5]
[SCHLD : Total Adjustments to Reconcile Net Income to Net Cash Provided by Operating Activities]=[SCHLD :
Depreciation & Amortization]+[SCHLD : (Increase)/Decrease in Inventory]+[SCHLD : Loss/(Gain) on Sale of
Property and Equipment]+[SCHLD : (Increase)/Decrease in Patient Accounts Receivable]+[SCHLD :
(Increase)/Decrease in Prepaid Expenses]+[SCHLD : Increase/(Decrease) in Trade Accounts Payable]+[SCHLD :
Increase/(Decrease) in Accrued Payroll & Related Liabilities]+[SCHLD : Increase/(Decrease) in Other Accrued
[SCHLD : Net Cash Provided (Used) by Operating Activities]=[SCHLD : Net Income (Loss)]+[SCHLD : Total
Adjustments to Reconcile Net Income to Net Cash Provided by Operating Activities]
[SCHLD : Net Cash Provided (Used) by Investing Activities]=[SCHLD : Net Purchases of Property &
Equipment]+[SCHLD : Proceeds from Disposal of Property & Equipment]+[SCHLD : Purchase of Marketable
Securities & Long-Term Securities]+[SCHLD : Proceeds from Sales of Marketable Securities and Long-Term
Securities]+[SCHLD : (Increase)/Decrease in Intercompany Receivables]+[SCHLD : (Increase)/Decrease in Other
Receivables]+[SCHLD : Other]
[SCHLD : Net Cash Flow Provided (Used) by Financing Activities]=[SCHLD : Net Borrowings - Long
Term]+[SCHLD : Net Borrowings - Short Term]+[SCHLD : Debt Reduction - Long Term]+[SCHLD : Debt
Reduction - Short Term]+[SCHLD : Increase/(Decrease) in Current Portion of Long-Term Debt]+[SCHLD :
Increase/(Decrease) in Intercompany Payables]+[SCHLD : Proceeds from Issuing Common Stock]+[SCHLD :
Dividends Paid or Owner Draws]+[SCHLD : Other]
[SCHLD : Net Increase (Decrease) in Cash]=[SCHLD : Net Cash Provided (Used) by Operating
Activities]+[SCHLD : Net Cash Provided (Used) by Investing Activities]+[SCHLD : Net Cash Flow Provided (Used)
by Financing Activities]
[SCHLD : Cash at End of Year]=[SCHLD : Net Increase (Decrease) in Cash]+[SCHLD : Cash at Beginning of
Year]
if([SCHLD : Cash at End of Year]=[SCHLB : Cash-Col 3],true, false)
[SCHLE : Total Additions]=[SCHLE : Net Income (Loss)]+[SCHLE : Additional Stock Issues]+[SCHLE : Additional
Paid-In Capital]+[SCHLE : Increases in Intercompany Debt]+[SCHLE : Other (Line 14)]+[SCHLE : Other (Line
15)]+[SCHLE : Other (Line 16)]
[SCHLE : Total Deductions]=[SCHLE : Dividends]+[SCHLE : Partnership Distributions]+[SCHLE : Owner
Draws]+[SCHLE : Decreases in Intercompany Debt]+[SCHLE : Other (Line 23)]+[SCHLE : Other (Line 24)]
[SCHLE : Ending Equity / Fund Balance]=[SCHLE : Adjusted Beginning Balance]+[SCHLE : Total Additions]-
[SCHLE : Total Deductions]
[SCHLG : TOTAL ROUTINE REVENUE - Column 5]=[SCHLG : Medicare Revenue - Column 5]+[SCHLG :
Medicaid Revenue - Column 5]+[SCHLG : Private Revenue - Column 5]+[SCHLG : Other Routine Care Revenue-
Column 5]
[SCHLG : TOTAL OTHER PATIENT REVENUE-Column 5]=[SCHLG : Physical Therapy Revenue-Column
5]+[SCHLG : Speech Therapy Revenue-Column 5]+[SCHLG : Occupational Therapy Revenue-Column
5]+[SCHLG : Other Therapy Revenue-Column 5]+[SCHLG : Physician Care Revenue-Column 5]+[SCHLG :
Pharmacy Revenue-Column 5]+[SCHLG : Nursing Supplies Revenue-Column 5]+[SCHLG : Equipment Rental
Revenue-Column 5]+[SCHLG : Patient Activities-Column 5]+[SCHLG : Laboratory Revenue-Column 5]+[SCHLG :
Exceptional Care Revenue-Column 5]+[SCHLG : Oxygen Revenue-Column 5]+[SCHLG : Other Patient Revenue-
Column 5]+[SCHLG : Respite Care Revenue-Column 5]+[SCHLG : Mental Health Revenue-Column 5]+[SCHLG :
[SCHLG : TOTAL OTHER OPERATING REVENUE-Column 5]=[SCHLG : Laundry Revenue-Column 5]+[SCHLG
: Meals Revenue-Column 5]+[SCHLG : Vending Machines Revenue-Column 5]+[SCHLG : Barber & Beauty Shop
Revenue-Column 5]+[SCHLG : Gift Shop-Column 5]+[SCHLG : Patient Telephone Revenue-Column 5]+[SCHLG
: Property Rental Revenue-Column 5]+[SCHLG : Other Operating Revenue-Column 5]
[SCHLG : TOTAL NON-OPERATING REVENUE-Column 5]=[SCHLG : Gain on Sale of Fixed Assets-Column
5]+[SCHLG : Interest Income-Column 5]+[SCHLG : Dividend Income-Column 5]+[SCHLG : Other Non-Operating
Income-Column 5]
[SCHLG : TOTAL REVENUE-Column 5]=[SCHLG : TOTAL ROUTINE REVENUE - Column 5]+[SCHLG : TOTAL
OTHER PATIENT REVENUE-Column 5]+[SCHLG : TOTAL OTHER OPERATING REVENUE-Column
5]+[SCHLG : TOTAL NON-OPERATING REVENUE-Column 5]+[SCHLG : REVENUE DEDUCTIONS - Column
5]
[SCHLG : TOTAL IN-HOUSE SALARIES-Column 5]=[SCHLG : In-House DNS-Column 5]+[SCHLG : In-House
RN-Column 5]+[SCHLG : In-House LPN-Column 5]+[SCHLG : In-House CNA-Column 5]+[SCHLG : In-House
Activities-Column 5]+[SCHLG : In-House Medical Director-Column 5]+[SCHLG : In-House Pharmaceutical-
Column 5]+[SCHLG : In-House Social Worker-Column 5]+[SCHLG : In-House Medical Records-Column
5]+[SCHLG : In-House Geriatric Nurse-Column 5]+[SCHLG : In-House Inservice Director-Column 5]+[SCHLG : In-
House Patient Care Coord-Column 5]+[SCHLG : In-House Patient Choices Coord-Column 5]+[SCHLG : In-House
Staff Development-Column 5]+[SCHLG : In-House Quality Assurance-Column 5]+[SCHLG : In-House QMRP-
Column 5]+[SCHLG : In-House Infection Control-Column 5]+[SCHLG : In-House Other NS-Column 5]
[SCHLG : TOTAL PURCHASED SALARIES-Column 5]=[SCHLG : Purchased DNS-Column 5]+[SCHLG :
Purchased RN-Column 5]+[SCHLG : Purchased LPN-Column 5]+[SCHLG : Purchased CNA-Column 5]+[SCHLG
: Purchased Activities-Column 5]+[SCHLG : Purchased Medical Director-Column 5]+[SCHLG : Purchased
Pharmaceutical-Column 5]+[SCHLG : Purchased Social Worker-Column 5]+[SCHLG : Purchased Medical
Records-Column 5]+[SCHLG : Purchased Geriatric Nurse-Column 5]+[SCHLG : Purchased Inservice Director-
Column 5]+[SCHLG : Purchased Patient Care Coord-Column 5]+[SCHLG : Purchased Patient Choices Coord-
Column 5]+[SCHLG : Purchased Staff Development-Column 5]+[SCHLG : Purchased Quality Assurance-Column
5]+[SCHLG : Purchased QMRP-Column 5]+[SCHLG : Purchased Infection Control-Column 5]+[SCHLG :
[SCHLG : TOTAL ALLOCATED SALARIES-Column 5]=[SCHLG : Allocated DNS-Column 5]+[SCHLG : Allocated
RN-Column 5]+[SCHLG : Allocated LPN-Column 5]+[SCHLG : Allocated CNA-Column 5]+[SCHLG : Allocated
Activities-Column 5]+[SCHLG : Allocated Medical Director-Column 5]+[SCHLG : Allocated Pharmaceutical-
Column 5]+[SCHLG : Allocated Social Worker-Column 5]+[SCHLG : Allocated Medical Records-Column
5]+[SCHLG : Allocated Geriatric Nurse-Column 5]+[SCHLG : Allocated Inservice Director-Column 5]+[SCHLG :
Allocated Patient Care Coord-Column 5]+[SCHLG : Allocated Patient Choices Coord-Column 5]+[SCHLG :
Allocated Staff Development-Column 5]+[SCHLG : Allocated Quality Assurance-Column 5]+[SCHLG : Allocated
QMRP-Column 5]+[SCHLG : Allocated Infection Control-Column 5]+[SCHLG : Allocated Other NS-Column 5]
[SCHLG : TOTAL IN-HOUSE SALARIES Hours-Column 6]=[SCHLG : In-House DNS Hours-Column 6]+[SCHLG
: In-House RN Hours-Column 6]+[SCHLG : In-House LPN Hours-Column 6]+[SCHLG : In-House CNA Hours-
Column 6]+[SCHLG : In-House Activities Hours-Column 6]+[SCHLG : In-House Medical Director Hours-Column
6]+[SCHLG : In-House Pharmaceutical Hours-Column 6]+[SCHLG : In-House Social Worker Hours-Column
6]+[SCHLG : In-House Medical Records Hours-Column 6]+[SCHLG : In-House Geriatric Nurse Hours-Column
6]+[SCHLG : In-House Inservice Director Hours-Column 6]+[SCHLG : In-House Patient Care Coord Hours-
Column 6]+[SCHLG : In-House Patient Choices Coord Hours-Column 6]+[SCHLG : In-House Staff Development
Hours-Column 6]+[SCHLG : In-House Quality Assurance Hours-Column 6]+[SCHLG : In-House QMRP Hours-
IF(AND([SCHLG : In-House DNS Hours-Column 6]<>0,[SCHLG : In-House RN Hours-Column 6]<>0,[SCHLG : In-
House LPN Hours-Column 6]<>0,[SCHLG : In-House CNA Hours-Column 6]<>0),[SCHLG : In-House DNS-
Column 5]/[SCHLG : In-House DNS Hours-Column 6]>[SCHLG : In-House RN-Column 5]/[SCHLG : In-House RN
Hours-Column 6]>[SCHLG : In-House LPN-Column 5]/[SCHLG : In-House LPN Hours-Column 6]>[SCHLG : In-
House CNA-Column 5]/[SCHLG : In-House CNA Hours-Column 6],"---FALSE---")
IF(AND([SCHLG : In-House DNS-Column 5]<>0,[SCHLG : In-House DNS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House DNS-Column 5]=0,[SCHLG : In-House DNS Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House RN-Column 5]<>0,[SCHLG : In-House RN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House RN-Column 5]=0,[SCHLG : In-House RN Hours-Column 6]=0),TRUE,"--
-FALSE---"))
IF(AND([SCHLG : In-House LPN-Column 5]<>0,[SCHLG : In-House LPN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House LPN-Column 5]=0,[SCHLG : In-House LPN Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House CNA-Column 5]<>0,[SCHLG : In-House CNA Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House CNA-Column 5]=0,[SCHLG : In-House CNA Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased CNA-Column 5]<>0,[SCHLG : Purchased CNA Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased CNA-Column 5]=0,[SCHLG : Purchased CNA Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Activities-Column 5]<>0,[SCHLG : In-House Activities Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Activities-Column 5]=0,[SCHLG : In-House Activities Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Medical Director-Column 5]<>0,[SCHLG : In-House Medical Director Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Medical Director-Column 5]=0,[SCHLG : In-House Medical Director
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Pharmaceutical-Column 5]<>0,[SCHLG : In-House Pharmaceutical Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Pharmaceutical-Column 5]=0,[SCHLG : In-House Pharmaceutical
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Social Worker-Column 5]<>0,[SCHLG : In-House Social Worker Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Social Worker-Column 5]=0,[SCHLG : In-House Social Worker Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Medical Records-Column 5]<>0,[SCHLG : In-House Medical Records Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Medical Records-Column 5]=0,[SCHLG : In-House Medical Records
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Geriatric Nurse-Column 5]<>0,[SCHLG : In-House Geriatric Nurse Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Geriatric Nurse-Column 5]=0,[SCHLG : In-House Geriatric Nurse
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Inservice Director-Column 5]<>0,[SCHLG : In-House Inservice Director Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : In-House Inservice Director-Column 5]=0,[SCHLG : In-House Inservice
Director Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Patient Care Coord-Column 5]<>0,[SCHLG : In-House Patient Care Coord Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : In-House Patient Care Coord-Column 5]=0,[SCHLG : In-House Patient
Care Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Patient Choices Coord-Column 5]<>0,[SCHLG : In-House Patient Choices Coord
Hours-Column 6]<>0),TRUE,IF(AND([SCHLG : In-House Patient Choices Coord-Column 5]=0,[SCHLG : In-
House Patient Choices Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Staff Development-Column 5]<>0,[SCHLG : In-House Staff Development Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : In-House Staff Development-Column 5]=0,[SCHLG : In-House Staff
Development Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Quality Assurance-Column 5]<>0,[SCHLG : In-House Quality Assurance Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : In-House Quality Assurance-Column 5]=0,[SCHLG : In-House Quality
Assurance Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House QMRP-Column 5]<>0,[SCHLG : In-House QMRP Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House QMRP-Column 5]=0,[SCHLG : In-House QMRP Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Infection Control-Column 5]<>0,[SCHLG : In-House Infection Control Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Infection Control-Column 5]=0,[SCHLG : In-House Infection Control
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Other NS-Column 5]<>0,[SCHLG : In-House Other NS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Other NS-Column 5]=0,[SCHLG : In-House Other NS Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased DNS-Column 5]<>0,[SCHLG : Purchased DNS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased DNS-Column 5]=0,[SCHLG : Purchased DNS Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased RN-Column 5]<>0,[SCHLG : Purchased RN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased RN-Column 5]=0,[SCHLG : Purchased RN Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased LPN-Column 5]<>0,[SCHLG : Purchased LPN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased LPN-Column 5]=0,[SCHLG : Purchased LPN Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased CNA-Column 5]<>0,[SCHLG : Purchased CNA Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased CNA-Column 5]=0,[SCHLG : Purchased CNA Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Activities-Column 5]<>0,[SCHLG : Purchased Activities Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased Activities-Column 5]=0,[SCHLG : Purchased Activities Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Social Worker-Column 5]<>0,[SCHLG : Purchased Social Worker Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased Social Worker-Column 5]=0,[SCHLG : Purchased Social Worker
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Medical Records-Column 5]<>0,[SCHLG : Purchased Medical Records Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Medical Records-Column 5]=0,[SCHLG : Purchased Medical
Records Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Geriatric Nurse-Column 5]<>0,[SCHLG : Purchased Geriatric Nurse Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased Geriatric Nurse-Column 5]=0,[SCHLG : Purchased Geriatric Nurse
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Inservice Director-Column 5]<>0,[SCHLG : Purchased Inservice Director Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Inservice Director-Column 5]=0,[SCHLG : Purchased
Inservice Director Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Patient Care Coord-Column 5]<>0,[SCHLG : Purchased Patient Care Coord Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Patient Care Coord-Column 5]=0,[SCHLG : Purchased
Patient Care Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Patient Choices Coord-Column 5]<>0,[SCHLG : Purchased Patient Choices Coord
Hours-Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Patient Choices Coord-Column 5]=0,[SCHLG :
Purchased Patient Choices Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Staff Development-Column 5]<>0,[SCHLG : Purchased Staff Development Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Staff Development-Column 5]=0,[SCHLG : Purchased Staff
Development Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Quality Assurance-Column 5]<>0,[SCHLG : Purchased Quality Assurance Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Quality Assurance-Column 5]=0,[SCHLG : Purchased
Quality Assurance Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased QMRP-Column 5]<>0,[SCHLG : Purchased QMRP Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased QMRP-Column 5]=0,[SCHLG : Purchased QMRP Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Infection Control-Column 5]<>0,[SCHLG : Purchased Infection Control Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Purchased Infection Control-Column 5]=0,[SCHLG : Purchased Infection
Control Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Purchased Other NS-Column 5]<>0,[SCHLG : Purchased Other NS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Purchased Other NS-Column 5]=0,[SCHLG : Purchased Other NS Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated DNS-Column 5]<>0,[SCHLG : Allocated DNS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated DNS-Column 5]=0,[SCHLG : Allocated DNS Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated RN-Column 5]<>0,[SCHLG : Allocated RN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated RN-Column 5]=0,[SCHLG : Allocated RN Hours-Column 6]=0),TRUE,"--
-FALSE---"))
IF(AND([SCHLG : Allocated LPN-Column 5]<>0,[SCHLG : Allocated LPN Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated LPN-Column 5]=0,[SCHLG : Allocated LPN Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated CNA-Column 5]<>0,[SCHLG : Allocated CNA Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated CNA-Column 5]=0,[SCHLG : Allocated CNA Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Activities-Column 5]<>0,[SCHLG : Allocated Activities Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Activities-Column 5]=0,[SCHLG : Allocated Activities Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Medical Director-Column 5]<>0,[SCHLG : Allocated Medical Director Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Medical Director-Column 5]=0,[SCHLG : Allocated Medical Director
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Pharmaceutical-Column 5]<>0,[SCHLG : Allocated Pharmaceutical Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Pharmaceutical-Column 5]=0,[SCHLG : Allocated Pharmaceutical
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Social Worker-Column 5]<>0,[SCHLG : Allocated Social Worker Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Social Worker-Column 5]=0,[SCHLG : Allocated Social Worker Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Medical Records-Column 5]<>0,[SCHLG : Allocated Medical Records Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Medical Records-Column 5]=0,[SCHLG : Allocated Medical Records
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Geriatric Nurse-Column 5]<>0,[SCHLG : Allocated Geriatric Nurse Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Geriatric Nurse-Column 5]=0,[SCHLG : Allocated Geriatric Nurse
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Inservice Director-Column 5]<>0,[SCHLG : Allocated Inservice Director Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Allocated Inservice Director-Column 5]=0,[SCHLG : Allocated Inservice
Director Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Patient Care Coord-Column 5]<>0,[SCHLG : Allocated Patient Care Coord Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Allocated Patient Care Coord-Column 5]=0,[SCHLG : Allocated Patient
Care Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Patient Choices Coord-Column 5]<>0,[SCHLG : Allocated Patient Choices Coord
Hours-Column 6]<>0),TRUE,IF(AND([SCHLG : Allocated Patient Choices Coord-Column 5]=0,[SCHLG :
Allocated Patient Choices Coord Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Staff Development-Column 5]<>0,[SCHLG : Allocated Staff Development Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Allocated Staff Development-Column 5]=0,[SCHLG : Allocated Staff
Development Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Quality Assurance-Column 5]<>0,[SCHLG : Allocated Quality Assurance Hours-
Column 6]<>0),TRUE,IF(AND([SCHLG : Allocated Quality Assurance-Column 5]=0,[SCHLG : Allocated Quality
Assurance Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated QMRP-Column 5]<>0,[SCHLG : Allocated QMRP Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated QMRP-Column 5]=0,[SCHLG : Allocated QMRP Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Infection Control-Column 5]<>0,[SCHLG : Allocated Infection Control Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Infection Control-Column 5]=0,[SCHLG : Allocated Infection Control
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Allocated Other NS-Column 5]<>0,[SCHLG : Allocated Other NS Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Allocated Other NS-Column 5]=0,[SCHLG : Allocated Other NS Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : TOTAL ALLOCATED SALARIES-Column 5]<>0,[SCHLG : TOTAL ALLOCATED SALARIES
Hours-Column 6]<>0),TRUE,IF(AND([SCHLG : TOTAL ALLOCATED SALARIES-Column 5]=0,[SCHLG : TOTAL
ALLOCATED SALARIES Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLO : BALANCE DUE PROVIDER]<50000,[SCHLO : BALANCE DUE DSHS]<50000),TRUE,"---
FALSE---")
[SCHLG : TOTAL FOOD-Column 5]=[SCHLG : Food-Column 5]+[SCHLG : FD Revenue Offset-Column 5]
[SCHLG : TOTAL IN-HOUSE AD SALARIES-Column 5]=[SCHLG : In-House Administrator-Column 5]+[SCHLG :
In-House Asst. Administrator-Column 5]+[SCHLG : In-House AIT-Column 5]+[SCHLG : In-House Ward Clerks-
Column 5]+[SCHLG : In-House Accounting/Bkkpg-Column 5]+[SCHLG : In-House Legal-Column 5]+[SCHLG : In-
House Other AD-Column 5]
[SCHLG : TOTAL PURCHASED AD SALARIES-Column 5]=[SCHLG : Purchased Administrator-Column
5]+[SCHLG : Purchased Asst. Administrator-Column 5]+[SCHLG : Purchased AIT-Column 5]+[SCHLG :
Purchased Ward Clerks-Column 5]+[SCHLG : Purchased Accounting/Bkkpg-Column 5]+[SCHLG : Purchased
Legal-Column 5]+[SCHLG : Purchased Other AD-Column 5]
[SCHLG : TOTAL ALLOCATED AD SALARIES-Column 5]=[SCHLG : Allocated Administrator-Column
5]+[SCHLG : Allocated Asst. Administrator-Column 5]+[SCHLG : Allocated AIT-Column 5]+[SCHLG : Allocated
Ward Clerks-Column 5]+[SCHLG : Allocated Accounting/Bkkpg-Column 5]+[SCHLG : Allocated Legal-Column
5]+[SCHLG : Allocated Other AD-Column 5]+[SCHLG : Allocated General Mgmt Fees-Column 5]+[SCHLG :
Management Fees-Column 5]+[SCHLG : Other Allocated Expenses-Column 5]
[SCHLG : TOTAL ADMINISTRATIVE-Column 5]=[SCHLG : Administator Fringe-Column 5]+[SCHLG :
Administrator Payroll Taxes-Column 5]+[SCHLG : Other AD Fringe-Column 5]+[SCHLG : Other AD Payroll Taxes-
Column 5]+[SCHLG : Administrative Supplies-Column 5]+[SCHLG : TOTAL PURCHASED AD SALARIES-
Column 5]+[SCHLG : TOTAL ALLOCATED AD SALARIES-Column 5]+[SCHLG : Travel-Column 5]+[SCHLG :
Telephone-Column 5]+[SCHLG : Dues & Subscriptions-Column 5]+[SCHLG : Education & In-Service-Column
5]+[SCHLG : Insurance-Column 5]+[SCHLG : Miscellaneous Taxes-Column 5]+[SCHLG : Start-Up/Organization
Costs-Column 5]+[SCHLG : Advertising-Column 5]+[SCHLG : Other Vehicle-Column 5]+[SCHLG : Group Retro
Expenses-Column 5]+[SCHLG : Office Equip. Lease Pay-Column 5]+[SCHLG : Licenses-Column 5]+[SCHLG :
[SCHLG : TOTAL IN-HOUSE AD SALARIESHours-Column 6]=[SCHLG : In-House AdministratorHours-Column
6]+[SCHLG : In-House Asst. AdministratorHours-Column 6]+[SCHLG : In-House AITHours-Column 6]+[SCHLG :
In-House Ward ClerksHours-Column 6]+[SCHLG : In-House Accounting/BkkpgHours-Column 6]+[SCHLG : In-
House LegalHours-Column 6]+[SCHLG : In-House Other ADHours-Column 6]
[SCHLG : TOTAL PURCHASED AD SALARIESHours-Column 6]=[SCHLG : Purchased AdministratorHours-
Column 6]+[SCHLG : Purchased Asst. AdministratorHours-Column 6]+[SCHLG : Purchased AITHours-Column
6]+[SCHLG : Purchased Ward ClerksHours-Column 6]+[SCHLG : Purchased Accounting/BkkpgHours-Column
6]+[SCHLG : Purchased LegalHours-Column 6]+[SCHLG : Purchased Other ADHours-Column 6]
[SCHLG : TOTAL ALLOCATED AD SALARIESHours-Column 6]=[SCHLG : Allocated AdministratorHours-
Column 6]+[SCHLG : Allocated Asst. AdministratorHours-Column 6]+[SCHLG : Allocated AITHours-Column
6]+[SCHLG : Allocated Ward ClerksHours-Column 6]+[SCHLG : Allocated Accounting/BkkpgHours-Column
6]+[SCHLG : Allocated LegalHours-Column 6]+[SCHLG : Allocated Other ADHours-Column 6]
IF(AND([SCHLG : In-House Administrator-Column 5]>0,[SCHLG : In-House AdministratorHours-Column
6]>0),TRUE,IF(AND([SCHLG : In-House Administrator-Column 5]=0,[SCHLG : In-House AdministratorHours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Asst. Administrator-Column 5]>0,[SCHLG : In-House Asst. AdministratorHours-
Column 6]>0),TRUE,IF(AND([SCHLG : In-House Asst. Administrator-Column 5]=0,[SCHLG : In-House Asst.
AdministratorHours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House AIT-Column 5]>0,[SCHLG : In-House AITHours-Column
6]>0),TRUE,IF(AND([SCHLG : In-House AIT-Column 5]=0,[SCHLG : In-House AITHours-Column 6]=0),TRUE,"---
FALSE---"))
IF(AND([SCHLG : In-House Ward Clerks-Column 5]>0,[SCHLG : In-House Ward ClerksHours-Column
6]>0),TRUE,IF(AND([SCHLG : In-House Ward Clerks-Column 5]=0,[SCHLG : In-House Ward ClerksHours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Accounting/Bkkpg-Column 5]>0,[SCHLG : In-House Accounting/BkkpgHours-
Column 6]>0),TRUE,IF(AND([SCHLG : In-House Accounting/Bkkpg-Column 5]=0,[SCHLG : In-House
Accounting/BkkpgHours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Legal-Column 5]>0,[SCHLG : In-House LegalHours-Column
6]>0),TRUE,IF(AND([SCHLG : In-House Legal-Column 5]=0,[SCHLG : In-House LegalHours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Other AD-Column 5]>0,[SCHLG : In-House Other ADHours-Column
6]>0),TRUE,IF(AND([SCHLG : In-House Other AD-Column 5]=0,[SCHLG : In-House Other ADHours-Column
6]=0),TRUE,"---FALSE---"))
[SCHLG : TOTAL MAINTENANCE-Column 4]=[SCHLG : Maintenance Salaries-Column 4]+[SCHLG :
Maintenance Fringe-Column 4]+[SCHLG : Maintenance Payroll Taxes-Column 4]+[SCHLG : Maintenance
Purchased Services-Column 4]+[SCHLG : Maintenance Allocated Services-Column 4]+[SCHLG : Maintenance
Allocated Expenses-Column 4]+[SCHLG : Maintenance Supplies-Column 4]
[SCHLG : TOTAL LAUNDRY-Column 4]=[SCHLG : Laundry Salaries-Column 4]+[SCHLG : Laundry Fringe-
Column 4]+[SCHLG : Laundry Payroll Taxes-Column 4]+[SCHLG : Laundry Purchased Services-Column
4]+[SCHLG : Laundry Allocated Services-Column 4]+[SCHLG : Laundry Allocated Expenses-Column 4]+[SCHLG
: Laundry Supplies-Column 4]
[SCHLG : TOTAL HOUSEKEEPING-Column 4]=[SCHLG : Housekeeping Salaries-Column 4]+[SCHLG :
Housekeeping Fringe-Column 4]+[SCHLG : Housekeeping Payroll Taxes-Column 4]+[SCHLG : Housekeeping
Purchased Services-Column 4]+[SCHLG : Housekeeping Allocated Services-Column 4]+[SCHLG : Housekeeping
Allocated Expenses-Column 4]+[SCHLG : Housekeeping Supplies-Column 4]
[SCHLG : TOTAL DIETARY-Column 4]=[SCHLG : Dietary Salaries-Column 4]+[SCHLG : Dietary Fringe-Column
4]+[SCHLG : Dietary Payroll Taxes-Column 4]+[SCHLG : Dietary Purchased Services-Column 4]+[SCHLG :
Dietary Allocated Services-Column 4]+[SCHLG : Dietary Allocated Expenses-Column 4]+[SCHLG : Dietary
Supplies-Column 4]
[SCHLG : TOTAL OTHER PROPERTY-Column 4]=[SCHLG : Utilities-Column 4]+[SCHLG : Property Insurance-
Column 4]+[SCHLG : Real Estate Taxes-Column 4]+[SCHLG : Personal Property Taxes-Column 4]+[SCHLG :
Allocated Expenses-Column 4]+[SCHLG : Minor Equipment-Column 4]+[SCHLG : Other OP Expenses-Column
4]+[SCHLG : Incidental Rentals-Column 4]
[SCHLG : TOTAL DEPRECIATION-Column 5]=[SCHLG : Land Improvements-Column 5]+[SCHLG : Buildings-
Column 5]+[SCHLG : Building Improvements-Column 5]+[SCHLG : Fixed Equipment-Column 5]+[SCHLG :
Movable Equipment-Column 5]+[SCHLG : Vehicles-Column 5]+[SCHLG : Other Equipment-Column 5]+[SCHLG :
Leasehold Improvement-Column 5]
[SCHLG : TOTAL PROPERTY-Column 5]=[SCHLG : TOTAL DEPRECIATION-Column 5]+[SCHLG :
ALLOCATED EXPENSES-Column 5]+[SCHLG : PR REVENUE OFFSET-Column 5]
[SCHLG : TOTAL PHYSICAL THERAPY-Column 5]=[SCHLG : Physical Therapy Salaries-Column 5]+[SCHLG :
Physical Therapy Fringe-Column 5]+[SCHLG : Physical Therapy Payroll Taxes-Column 5]+[SCHLG : Physical
Therapy Purchased-Column 5]+[SCHLG : Physical Therapy Allocated Expenses-Column 5]+[SCHLG : Physical
Therapy Supplies-Column 5]
[SCHLG : TOTAL SPEECH THERAPY-Column 5]=[SCHLG : Speech Therapy Salaries-Column 5]+[SCHLG :
Speech Therapy Fringe-Column 5]+[SCHLG : Speech Therapy Payroll Taxes-Column 5]+[SCHLG : Speech
Therapy Purchased-Column 5]+[SCHLG : Speech Therapy Allocated Expenses-Column 5]+[SCHLG : Speech
Therapy Supplies-Column 5]
[SCHLG : TOTAL OCCUPATIONAL THERAPY-Column 5]=[SCHLG : Occupational Therapy Salaries-Column
5]+[SCHLG : Occupational Therapy Fringe-Column 5]+[SCHLG : Occupational Therapy Payroll Taxes-Column
5]+[SCHLG : Occupational Therapy Purchased-Column 5]+[SCHLG : Occupational Therapy Allocated Expenses-
Column 5]+[SCHLG : Occupational Therapy Supplies-Column 5]
[SCHLG : TOTAL OTHER THERAPY-Column 5]=[SCHLG : Other Therapy Salaries-Column 5]+[SCHLG : Other
Therapy Fringe-Column 5]+[SCHLG : Other Therapy Payroll Taxes-Column 5]+[SCHLG : Other Therapy
Purchased-Column 5]+[SCHLG : Other Therapy Allocated Expenses-Column 5]+[SCHLG : Other Therapy
Supplies-Column 5]
[SCHLG : TOTAL EXCEPTIONAL CARE-Column 5]=[SCHLG : Exceptional Care Salaries-Column 5]+[SCHLG :
Exceptional Care Fringe-Column 5]+[SCHLG : Exceptional Care Payroll Taxes-Column 5]+[SCHLG : Exceptional
Care Purchased-Column 5]+[SCHLG : Exceptional Care Allocated Expenses-Column 5]+[SCHLG : Exceptional
Care Supplies-Column 5]
IF([SCHLG : TOTAL EXCEPTIONAL CARE-Column 5]=0,[SCHLN : MEDICAID EXCEPTIONAL CARE
DAYS]=0,[SCHLN : MEDICAID EXCEPTIONAL CARE DAYS]>0)
[SCHLG : TOTAL OTHER PATIENT EXPENSES-Column 5]=[SCHLG : TOTAL PHYSICAL THERAPY-Column
5]+[SCHLG : TOTAL SPEECH THERAPY-Column 5]+[SCHLG : TOTAL OCCUPATIONAL THERAPY-Column
5]+[SCHLG : TOTAL OTHER THERAPY-Column 5]+[SCHLG : TOTAL EXCEPTIONAL CARE-Column
5]+[SCHLG : In-House Mental Health-Column 5]+[SCHLG : Fringe Mental Health-Column 5]+[SCHLG : Payroll
Mental Health-Column 5]+[SCHLG : Purchased Mental Health-Column 5]+[SCHLG : Allocated Mental Health-
[SCHLG : TOTAL OTHER OPERATING EXPENSES-Column 5]=[SCHLG : Unallowable Depreciation-Column
5]+[SCHLG : Unallowable Bad Debts-Column 5]+[SCHLG : Unallowable Advertising-Column 5]+[SCHLG :
Unallowable Travel-Column 5]+[SCHLG : Unallowable Interest-Column 5]+[SCHLG : Unallowable Allocated
Property-Column 5]+[SCHLG : Unallowable Lease Payments-Column 5]+[SCHLG : Total Other Unallowable-
Column 5]+[SCHLG : Unallowable (Line 306)-Column 5]+[SCHLG : Unallowable CNA Training (Operations)
[SCHLG : TOTAL NON-OPERATING EXPENSES-Column 5]=[SCHLG : Loss on Sale of Fixed Assets-Column
5]+[SCHLG : Income Taxes-Column 5]+[SCHLG : Other-Column 5]+[SCHLG : Other (Line 316)-Column
5]+[SCHLG : Other (Line 317)-Column 5]
[SCHLG : TOTAL EXPENSES-Column 5]=[SCHLG : TOTAL ROUTINE EXPENSES-Column 5]+[SCHLG :
TOTAL OTHER PATIENT EXPENSES-Column 5]+[SCHLG : TOTAL OTHER OPERATING EXPENSES-Column
5]+[SCHLG : TOTAL NON-OPERATING EXPENSES-Column 5]
[SCHLG : NET INCOME/(LOSS)-Column 5]=[SCHLG : TOTAL REVENUE-Column 5]-[SCHLG : TOTAL
EXPENSES-Column 5]
[SCHLG : Total Purchase Price-Column 2]=[SCHLG : Land Purchase Price-Column 2]+[SCHLG : Building
Purchase Price-Column 2]+[SCHLG : Equipment Purchase Price-Column 2]+[SCHLG : Other Purchase Price-
Column 2]
[SCHLG : Total Sale Price-Column 2]=[SCHLG : Land Sale Price-Column 2]+[SCHLG : Building Sale Price-
Column 2]+[SCHLG : Equipment Sale Price-Column 2]+[SCHLG : Other Sale Price-Column 2]
[SCHLG7 : Physical-Total Therapy Charges]=[SCHLG7 : Physical-Medicaid Only]+[SCHLG7 : Physical-
Medicare/Medicaid Co-Insurer]+[SCHLG7 : Physical-Medicare/Other Co-Insurer]+[SCHLG7 : Physical-Medicare
Part A]+[SCHLG7 : Physical-All Other Payers]
[SCHLG7 : Speech-Total Therapy Charges]=[SCHLG7 : Speech-Medicaid Only]+[SCHLG7 : Speech-
Medicare/Medicaid Co-Insurer]+[SCHLG7 : Speech-Medicare/Other Co-Insurer]+[SCHLG7 : Speech-Medicare
Part A]+[SCHLG7 : Speech-All Other Payers]
[SCHLG7 : Occupational-Total Therapy Charges]=[SCHLG7 : Occupational-Medicaid Only]+[SCHLG7 :
Occupational-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Occupational-Medicare/Other Co-Insurer]+[SCHLG7 :
Occupational-Medicare Part A]+[SCHLG7 : Occupational-All Other Payers]
[SCHLG7 : Other (Line 4)-Total Therapy Charges]=[SCHLG7 : Other (Line 4)-Medicaid Only]+[SCHLG7 : Other
(Line 4)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 4)-Medicare/Other Co-Insurer]+[SCHLG7 : Other
(Line 4)-Medicare Part A]+[SCHLG7 : Other (Line 4)-All Other Payers]
[SCHLG7 : Other (Line 5)-Total Therapy Charges]=[SCHLG7 : Other (Line 5)-Medicaid Only]+[SCHLG7 : Other
(Line 5)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 5)-Medicare/Other Co-Insurer]+[SCHLG7 : Other
(Line 5)-Medicare Part A]+[SCHLG7 : Other (Line 5)-All Other Payers]
[SCHLG7 : Other (Line 6)-Total Therapy Charges]=[SCHLG7 : Other (Line 6)-Medicaid Only]+[SCHLG7 : Other
(Line 6)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 6)-Medicare/Other Co-Insurer]+[SCHLG7 : Other
(Line 6)-Medicare Part A]+[SCHLG7 : Other (Line 6)-All Other Payers]
[SCHLG7 : Other (Line 7)-Total Therapy Charges]=[SCHLG7 : Other (Line 7)-Medicaid Only]+[SCHLG7 : Other
(Line 7)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 7)-Medicare/Other Co-Insurer]+[SCHLG7 : Other
(Line 7)-Medicare Part A]+[SCHLG7 : Other (Line 7)-All Other Payers]
[SCHLG7 : TOTAL THERAPY CHARGES]=[SCHLG7 : TOTAL MEDICAID ONLY]+[SCHLG7 : TOTAL
MEDICARE/MEDICAID CO-INSURER]+[SCHLG7 : TOTAL MEDICARE/OTHER CO-INSURER]+[SCHLG7 :
TOTAL MEDICARE PART A]+[SCHLG7 : TOTAL ALL OTHER PAYERS]
[SCHLG7 : TOTAL MEDICAID ONLY]=[SCHLG7 : Physical-Medicaid Only]+[SCHLG7 : Speech-Medicaid
Only]+[SCHLG7 : Occupational-Medicaid Only]+[SCHLG7 : Other (Line 4)-Medicaid Only]+[SCHLG7 : Other (Line
5)-Medicaid Only]+[SCHLG7 : Other (Line 6)-Medicaid Only]+[SCHLG7 : Other (Line 7)-Medicaid Only]
[SCHLG7 : TOTAL MEDICARE/MEDICAID CO-INSURER]=[SCHLG7 : Physical-Medicare/Medicaid Co-
Insurer]+[SCHLG7 : Speech-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Occupational-Medicare/Medicaid Co-
Insurer]+[SCHLG7 : Other (Line 4)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 5)-Medicare/Medicaid
Co-Insurer]+[SCHLG7 : Other (Line 6)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 7)-
[SCHLG7 : TOTAL Co-Insurer]
Medicare/Medicaid MEDICARE/OTHER CO-INSURER]=[SCHLG7 : Physical-Medicare/Other Co-
Insurer]+[SCHLG7 : Speech-Medicare/Other Co-Insurer]+[SCHLG7 : Occupational-Medicare/Other Co-
Insurer]+[SCHLG7 : Other (Line 4)-Medicare/Other Co-Insurer]+[SCHLG7 : Other (Line 5)-Medicare/Other Co-
Insurer]+[SCHLG7 : Other (Line 6)-Medicare/Other Co-Insurer]+[SCHLG7 : Other (Line 7)-Medicare/Other Co-
Insurer] : TOTAL MEDICARE PART A]=[SCHLG7 : Physical-Medicare Part A]+[SCHLG7 : Speech-Medicare
[SCHLG7
Part A]+[SCHLG7 : Occupational-Medicare Part A]+[SCHLG7 : Other (Line 4)-Medicare Part A]+[SCHLG7 : Other
(Line 5)-Medicare Part A]+[SCHLG7 : Other (Line 6)-Medicare Part A]+[SCHLG7 : Other (Line 7)-Medicare Part
A]
[SCHLG7 : TOTAL ALL OTHER PAYERS]=[SCHLG7 : Physical-All Other Payers]+[SCHLG7 : Speech-All Other
Payers]+[SCHLG7 : Occupational-All Other Payers]+[SCHLG7 : Other (Line 4)-All Other Payers]+[SCHLG7 :
Other (Line 5)-All Other Payers]+[SCHLG7 : Other (Line 6)-All Other Payers]+[SCHLG7 : Other (Line 7)-All Other
Payers]
[SCHLG7 : TOTAL THERAPY CHARGES]=[SCHLG7 : Physical-Total Therapy Charges]+[SCHLG7 : Speech-
Total Therapy Charges]+[SCHLG7 : Occupational-Total Therapy Charges]+[SCHLG7 : Other (Line 4)-Total
Therapy Charges]+[SCHLG7 : Other (Line 5)-Total Therapy Charges]+[SCHLG7 : Other (Line 6)-Total Therapy
Charges]+[SCHLG7 : Other (Line 7)-Total Therapy Charges]
ABS(([SCHLG7 : Physical-Medicare/Medicaid Co-Insurer]*0.20)-[SCHLG7 : Physical-Medicare Part B])<1
ABS(([SCHLG7 : Speech-Medicare/Medicaid Co-Insurer]*0.20)-[SCHLG7 : Speech-Medicare Part B])<1
ABS(([SCHLG7 : Occupational-Medicare/Medicaid Co-Insurer]*0.20)-[SCHLG7 : Occupational-Medicare Part
B])<1
ABS((([SCHLG7 : Other (Line 4)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 5)-Medicare/Medicaid
Co-Insurer]+[SCHLG7 : Other (Line 6)-Medicare/Medicaid Co-Insurer]+[SCHLG7 : Other (Line 7)-
Medicare/Medicaid Co-Insurer])*0.20)-[SCHLG7 : Other-Medicare Part B])<3
[SCHLG7 : Physical-Medicaid Only]=[SCHLG7 : Physical-Medicaid Only]
[SCHLG7 : Speech-Medicaid Only]=[SCHLG7 : Speech-Medicaid Only]
[SCHLG7 : Occupational-Medicaid Only]=[SCHLG7 : Occupational-Medicaid Only]
[SCHLG7 : Other-Medicaid Only]=[SCHLG7 : Other (Line 4)-Medicaid Only]+[SCHLG7 : Other (Line 5)-Medicaid
Only]+[SCHLG7 : Other (Line 6)-Medicaid Only]+[SCHLG7 : Other (Line 7)-Medicaid Only]
[SCHLG7 : Physical-Total Medicaid/Medicare Part B]=[SCHLG7 : Physical-Medicare Part B]+[SCHLG7 : Physical-
Medicaid Only]
[SCHLG7 : Speech-Total Medicaid/Medicare Part B]=[SCHLG7 : Speech-Medicare Part B]+[SCHLG7 : Speech-
Medicaid Only]
[SCHLG7 : Occupational-Total Medicaid/Medicare Part B]=[SCHLG7 : Occupational-Medicare Part B]+[SCHLG7 :
Occupational-Medicaid Only]
[SCHLG7 : Other-Total Medicaid/Medicare Part B]=[SCHLG7 : Other-Medicare Part B]+[SCHLG7 : Other-
Medicaid Only]
IF([SCHLG7 : Physical-Total Therapy Charges],ROUND([SCHLG7 : Physical-Percent Medicaid to
Total],4)=ROUND([SCHLG7 : Physical-Total Medicaid/Medicare Part B]/[SCHLG7 : Physical-Total Therapy
Charges],4),TRUE)
IF([SCHLG7 : Speech-Total Therapy Charges],ROUND([SCHLG7 : Speech-Percent Medicaid to
Total],4)=ROUND([SCHLG7 : Speech-Total Medicaid/Medicare Part B]/[SCHLG7 : Speech-Total Therapy
Charges],4),TRUE)
IF([SCHLG7 : Occupational-Total Therapy Charges],ROUND([SCHLG7 : Occupational-Percent Medicaid to
Total],4)=ROUND([SCHLG7 : Occupational-Total Medicaid/Medicare Part B]/[SCHLG7 : Occupational-Total
Therapy Charges],4),TRUE)
IF(([SCHLG7 : Other (Line 4)-Total Therapy Charges]+[SCHLG7 : Other (Line 5)-Total Therapy
Charges]+[SCHLG7 : Other (Line 6)-Total Therapy Charges]+[SCHLG7 : Other (Line 7)-Total Therapy
Charges])<>0,ROUND([SCHLG7 : Other-Percent Medicaid to Total],4)=ROUND(([SCHLG7 : Other-Total
Medicaid/Medicare Part B]/([SCHLG7 : Other (Line 4)-Total Therapy Charges]+[SCHLG7 : Other (Line 5)-Total
Therapy Charges]+[SCHLG7 : Other (Line 6)-Total Therapy Charges]+[SCHLG7 : Other (Line 7)-Total Therapy
ROUND([SCHLG7 : Physical-Medicaid Allow. Therapy],0)=ROUND([SCHLG7 : Physical-One-On-One
Expenses]*[SCHLG7 : Physical-Percent Medicaid to Total],0)
ROUND([SCHLG7 : Speech-Medicaid Allow. Therapy],0)=ROUND([SCHLG7 : Speech-One-On-One
Expenses]*[SCHLG7 : Speech-Percent Medicaid to Total],0)
ROUND([SCHLG7 : Occupational-Medicaid Allow. Therapy],0)=ROUND([SCHLG7 : Occupational-One-On-One
Expenses]*[SCHLG7 : Occupational-Percent Medicaid to Total],0)
ROUND([SCHLG7 : Other-Medicaid Allow. Therapy],0)=ROUND([SCHLG7 : Other-One-On-One
Expenses]*[SCHLG7 : Other-Percent Medicaid to Total],0)
[SCHLG7 : Physical-Medicaid Patient Days]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[SCHLN :
Total Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]
[SCHLG7 : Speech-Medicaid Patient Days]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[SCHLN :
Total Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]
[SCHLG7 : Occupational-Medicaid Patient Days]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[SCHLN :
Total Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]
[SCHLG7 : Other-Medicaid Patient Days]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[SCHLN : Total
Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]
IF([SCHLG7 : Physical-Medicaid Patient Days],ROUND([SCHLG7 : Physical-Rate PPD],4)=ROUND([SCHLG7 :
Physical-Medicaid Allow. Therapy]/[SCHLG7 : Physical-Medicaid Patient Days],4),"---FALSE---")
IF([SCHLG7 : Speech-Medicaid Patient Days],ROUND([SCHLG7 : Speech-Rate PPD],4)=ROUND([SCHLG7 :
Speech-Medicaid Allow. Therapy]/[SCHLG7 : Speech-Medicaid Patient Days],4),"---FALSE---")
IF([SCHLG7 : Occupational-Medicaid Patient Days],ROUND([SCHLG7 : Occupational-Rate
PPD],4)=ROUND([SCHLG7 : Occupational-Medicaid Allow. Therapy]/[SCHLG7 : Occupational-Medicaid Patient
Days],4),"---FALSE---")
IF([SCHLG7 : Other-Medicaid Patient Days],ROUND([SCHLG7 : Other-Rate PPD],4)=ROUND([SCHLG7 : Other-
Medicaid Allow. Therapy]/[SCHLG7 : Other-Medicaid Patient Days],4),"---FALSE---")
[SCHLG7 : Physical-Total Patient Days]=[SCHLN : TOTAL PATIENT DAYS]
[SCHLG7 : Speech-Total Patient Days]=[SCHLN : TOTAL PATIENT DAYS]
[SCHLG7 : Occupational-Total Patient Days]=[SCHLN : TOTAL PATIENT DAYS]
[SCHLG7 : Other-Total Patient Days]=[SCHLN : TOTAL PATIENT DAYS]
ROUND([SCHLG7 : Physical-Allowable One-On-One Expense],0)=ROUND([SCHLG7 : Physical-Rate
PPD]*[SCHLG7 : Physical-Total Patient Days],0)
ROUND([SCHLG7 : Speech-Allowable One-On-One Expense],0)=ROUND([SCHLG7 : Speech-Rate
PPD]*[SCHLG7 : Speech-Total Patient Days],0)
ROUND([SCHLG7 : Occupational-Allowable One-On-One Expense],0)=ROUND([SCHLG7 : Occupational-Rate
PPD]*[SCHLG7 : Occupational-Total Patient Days],0)
ROUND([SCHLG7 : Other-Allowable One-On-One Expense],0)=ROUND([SCHLG7 : Other-Rate PPD]*[SCHLG7
: Other-Total Patient Days],0)
[SCHLG7 : Physical-Allowable Therapy]=[SCHLG7 : Physical-Allowable One-On-One Expense]+[SCHLG7 :
Physical-Consultant]
[SCHLG7 : Speech-Allowable Therapy]=[SCHLG7 : Speech-Allowable One-On-One Expense]+[SCHLG7 :
Speech-Consultant]
[SCHLG7 : Occupational-Allowable Therapy]=[SCHLG7 : Occupational-Allowable One-On-One
Expense]+[SCHLG7 : Occupational-Consultant]
[SCHLG7 : Other-Allowable Therapy]=[SCHLG7 : Other-Allowable One-On-One Expense]+[SCHLG7 : Other-
Consultant]
[SCHLG7 : TOTAL ALLOWABLE THERAPY]=[SCHLG7 : Physical-Allowable Therapy]+[SCHLG7 : Speech-
Allowable Therapy]+[SCHLG7 : Occupational-Allowable Therapy]+[SCHLG7 : Other-Allowable Therapy]
[SCHLG : Therapy-Column 5]=[SCHLG7 : TOTAL ALLOWABLE THERAPY]
[SCHLH1 : Total Loan Balance-Beginning of Year-Line 9]=[SCHLH1 : Loan Balance-Beginning of Year-Line
1]+[SCHLH1 : Loan Balance-Beginning of Year-Line 2]+[SCHLH1 : Loan Balance-Beginning of Year-Line
3]+[SCHLH1 : Loan Balance-Beginning of Year-Line 4]+[SCHLH1 : Loan Balance-Beginning of Year-Line
5]+[SCHLH1 : Loan Balance-Beginning of Year-Line 6]+[SCHLH1 : Loan Balance-Beginning of Year-Line
7]+[SCHLH1 : Loan Balance-BeginningYear-Line 9]=[SCHLH1 : Principal Paid During Year-Line 1]+[SCHLH1 :
[SCHLH1 : Total Principal Paid During of Year-Line 8]
Principal Paid During Year-Line 2]+[SCHLH1 : Principal Paid During Year-Line 3]+[SCHLH1 : Principal Paid
During Year-Line 4]+[SCHLH1 : Principal Paid During Year-Line 5]+[SCHLH1 : Principal Paid During Year-Line
6]+[SCHLH1 : Principal Paid During Year-Line 7]+[SCHLH1 : Principal Paid During Year-Line 8]
[SCHLH1 : Total Interest Expense Paid-Line 9]=[SCHLH1 : Interest Expense Paid-Line 1]+[SCHLH1 : Interest
Expense Paid-Line 2]+[SCHLH1 : Interest Expense Paid-Line 3]+[SCHLH1 : Interest Expense Paid-Line
4]+[SCHLH1 : Interest Expense Paid-Line 5]+[SCHLH1 : Interest Expense Paid-Line 6]+[SCHLH1 : Interest
Expense Paid-Line 7]+[SCHLH1 : Interest Expense Paid-Line 8]
[SCHLH1 : Total Year End Balance-Line 9]=[SCHLH1 : Year End Balance-Line 1]+[SCHLH1 : Year End Balance-
Line 2]+[SCHLH1 : Year End Balance-Line 3]+[SCHLH1 : Year End Balance-Line 4]+[SCHLH1 : Year End
Balance-Line 5]+[SCHLH1 : Year End Balance-Line 6]+[SCHLH1 : Year End Balance-Line 7]+[SCHLH1 : Year
End Balance-Line 8]
[SCHLH3 : Total Debt Balance at Beginning of Year-Line 9]=[SCHLH3 : Debt Balance at Beginning of Year-Line
1]+[SCHLH3 : Debt Balance at Beginning of Year-Line 2]+[SCHLH3 : Debt Balance at Beginning of Year-Line
3]+[SCHLH3 : Debt Balance at Beginning of Year-Line 4]+[SCHLH3 : Debt Balance at Beginning of Year-Line
5]+[SCHLH3 : Debt Balance at Beginning of Year-Line 6]+[SCHLH3 : Debt Balance at Beginning of Year-Line
7]+[SCHLH3 : Debt Balance at Beginning of Year-Line 8]
[SCHLH3 : Total Principal Paid During Year-Line 9]=[SCHLH3 : Principal Paid During Year-Line 1]+[SCHLH3 :
Principal Paid During Year-Line 2]+[SCHLH3 : Principal Paid During Year-Line 3]+[SCHLH3 : Principal Paid
During Year-Line 4]+[SCHLH3 : Principal Paid During Year-Line 5]+[SCHLH3 : Principal Paid During Year-Line
6]+[SCHLH3 : Principal Paid During Year-Line 7]+[SCHLH3 : Principal Paid During Year-Line 8]
[SCHLH3 : Total Interest/Lease Expense Paid-Line 9]=[SCHLH3 : Interest/Lease Expense Paid-Line 1]+[SCHLH3
: Interest/Lease Expense Paid-Line 2]+[SCHLH3 : Interest/Lease Expense Paid-Line 3]+[SCHLH3 :
Interest/Lease Expense Paid-Line 4]+[SCHLH3 : Interest/Lease Expense Paid-Line 5]+[SCHLH3 : Interest/Lease
Expense Paid-Line 6]+[SCHLH3 : Interest/Lease Expense Paid-Line 7]+[SCHLH3 : Interest/Lease Expense Paid-
Line 8]
[SCHLH3 : Total Year-End Balance-Line 9]=[SCHLH3 : Year-End Balance-Line 1]+[SCHLH3 : Year-End Balance-
Line 2]+[SCHLH3 : Year-End Balance-Line 3]+[SCHLH3 : Year-End Balance-Line 4]+[SCHLH3 : Year-End
Balance-Line 5]+[SCHLH3 : Year-End Balance-Line 6]+[SCHLH3 : Year-End Balance-Line 7]+[SCHLH3 : Year-
End Balance-Line 8]
[SCHLB4 : TOTAL-Col 1]=[SCHLB4 : Land-Prior Yr Balance]+[SCHLB4 : Land Improv-Col 1]+[SCHLB4 :
Buildings-Col 1]+[SCHLB4 : Building Improv.-Col 1]+[SCHLB4 : Fixed Equipment-Col 1]+[SCHLB4 : Movable
Equip-Col 1]+[SCHLB4 : Vehicles-Col 1]+[SCHLB4 : Other Equipment-Col 1]+[SCHLB4 : Leasehold Improv-Col
1]
[SCHLB4 : TOTAL-Col 2]=[SCHLB4 : Land-Additions]+[SCHLB4 : Land Improv-Col 2]+[SCHLB4 : Buildings-Col
2]+[SCHLB4 : Building Improv.-Col 2]+[SCHLB4 : Fixed Equipment-Col 2]+[SCHLB4 : Movable Equip-Col
2]+[SCHLB4 : Vehicles-Col 2]+[SCHLB4 : Other Equipment-Col 2]+[SCHLB4 : Leasehold Improv-Col 2]
[SCHLB4 : TOTAL-Retirements]=[SCHLB4 : Land-Retirements]+[SCHLB4 : Land Improv-Retirements]+[SCHLB4
: Buildings-Retirements]+[SCHLB4 : Building Improv.-Retirements]+[SCHLB4 : Fixed Equipment-
Retirements]+[SCHLB4 : Movable Equip-Retirements]+[SCHLB4 : Vehicles-Retirements]+[SCHLB4 : Other
Equipment-Retirements]+[SCHLB4 : Leasehold Improv-Retirements]
[SCHLB4 : TOTAL-Col 3]=[SCHLB4 : Land-Adjustments]+[SCHLB4 : Land Improv-Col 3]+[SCHLB4 : Buildings-
Col 3]+[SCHLB4 : Building Improv.-Col 3]+[SCHLB4 : Fixed Equipment-Col 3]+[SCHLB4 : Movable Equip-Col
3]+[SCHLB4 : Vehicles-Col 3]+[SCHLB4 : Other Equipment-Col 3]+[SCHLB4 : Leasehold Improv-Col 3]
[SCHLB4 : TOTAL-Col 4]=[SCHLB4 : Land-Current Balance]+[SCHLB4 : Land Improv-Col 4]+[SCHLB4 :
Buildings-Col 4]+[SCHLB4 : Building Improv.-Col 4]+[SCHLB4 : Fixed Equipment-Col 4]+[SCHLB4 : Movable
Equip-Col 4]+[SCHLB4 : Vehicles-Col 4]+[SCHLB4 : Other Equipment-Col 4]+[SCHLB4 : Leasehold Improv-Col
4]
[SCHLB4 : TOTAL-Col 6]=[SCHLB4 : Land Improv-Col 6]+[SCHLB4 : Buildings-Col 6]+[SCHLB4 : Building
Improv.-Col 6]+[SCHLB4 : Fixed Equipment-Col 6]+[SCHLB4 : Movable Equip-Col 6]+[SCHLB4 : Vehicles-Col
6]+[SCHLB4 : Other Equipment-Col 6]+[SCHLB4 : Leasehold Improv-Col 6]
[SCHLB4 : TOTAL-Col 7]=[SCHLB4 : Land Improv-Col 7]+[SCHLB4 : Buildings-Col 7]+[SCHLB4 : Building
Improv.-Col 7]+[SCHLB4 : Fixed Equipment-Col 7]+[SCHLB4 : Movable Equip-Col 7]+[SCHLB4 : Vehicles-Col
7]+[SCHLB4 : Other Equipment-Col 7]+[SCHLB4 : Leasehold Improv-Col 7]
[SCHLB4 : TOTAL-Col 8]=[SCHLB4 : Land Improv-Col 8]+[SCHLB4 : Buildings-Col 8]+[SCHLB4 : Building
Improv.-Col 8]+[SCHLB4 : Fixed Equipment-Col 8]+[SCHLB4 : Movable Equip-Col 8]+[SCHLB4 : Vehicles-Col
8]+[SCHLB4 : Other Equipment-Col 8]+[SCHLB4 : Leasehold Improv-Col 8]
[SCHLB4 : TOTAL-Col 9]=[SCHLB4 : Land Improv-Col 9]+[SCHLB4 : Buildings-Col 9]+[SCHLB4 : Building
Improv.-Col 9]+[SCHLB4 : Fixed Equipment-Col 9]+[SCHLB4 : Movable Equip-Col 9]+[SCHLB4 : Vehicles-Col
9]+[SCHLB4 : Other Equipment-Col 9]+[SCHLB4 : Leasehold Improv-Col 9]
[SCHLB4 : TOTAL-Col 4]=[SCHLB4 : TOTAL-Col 1]+[SCHLB4 : TOTAL-Col 2]+[SCHLB4 : TOTAL-
Retirements]+[SCHLB4 : TOTAL-Col 3]
[SCHLB4 : TOTAL-Col 9]=[SCHLB4 : TOTAL-Col 6]+[SCHLB4 : TOTAL-Col 7]+[SCHLB4 : TOTAL-Col 8]
[SCHLB4 : Land-Current Balance]=[SCHLB : Land-Col 6]
[SCHLB4 : Land Improv-Col 4]=[SCHLB : Land Improvements-Col 6]
[SCHLB4 : Buildings-Col 4]=[SCHLB : Building-Col 6]
[SCHLB4 : Building Improv.-Col 4]=[SCHLB : Building Improvements-Col 6]
[SCHLB4 : Fixed Equipment-Col 4]=[SCHLB : Fixed Equipment-Col 6]
[SCHLB4 : Movable Equip-Col 4]=[SCHLB : Movable Equipment-Col 6]
[SCHLB4 : Vehicles-Col 4]=[SCHLB : Vehicles-Col 6]
[SCHLB4 : Other Equipment-Col 4]=[SCHLB : Other Equipment-Col 6]
[SCHLB4 : Leasehold Improv-Col 4]=[SCHLB : Leasehold Improvements-Col 6]
[SCHLB4 : TOTAL-Col 4]=[SCHLB : TOTAL FACILITY PROPERTY, PLANT & EQUIPMENT-Col 6]
[SCHLB4 : Land Improv-Col 9]=ABS([SCHLB : Accum. Deprec.-Land Improvements-Col 6])
[SCHLB4 : Buildings-Col 9]=ABS([SCHLB : Accum. Deprec. - Building-Col 4])
[SCHLB4 : Building Improv.-Col 9]=ABS([SCHLB : Accum. Deprec. - Building Improv.-Col 4])
[SCHLB4 : Fixed Equipment-Col 9]=ABS([SCHLB : Accum. Deprec. - Fixed Equipment-Col 4])
[SCHLB4 : Movable Equip-Col 9]=ABS([SCHLB : Accum. Deprec. - Movable Equipment-Col 4])
[SCHLB4 : Vehicles-Col 9]=ABS([SCHLB : Accum. Deprec. - Vehicles-Col 4])
[SCHLB4 : Other Equipment-Col 9]=ABS([SCHLB : Accum. Deprec. - Other Equipment-Col 4])
[SCHLB4 : Leasehold Improv-Col 9]=ABS([SCHLB : Accum. Deprec. - Leasehold Improv.-Col 4])
[SCHLB4 : TOTAL-Col 9]=ABS([SCHLB : TOTAL ACCUMULATED DEPRECIATION-Col 6])
[SCHLM : January Medicaid Days less Swing Bed Days]=[SCHLN : January Medicaid Days less Swing Bed Days]
ROUND([SCHLM : January Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : January Medicaid
Patient Days]-[SCHLM : January Swing Bed Days],0)
ROUND([SCHLM : January Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : January
Medicaid Payments]-[SCHLM : January Swing Bed Payments],0)
[SCHLM : February Medicaid Days less Swing Bed Days]=[SCHLN : February Medicaid Days less Swing Bed
Days]
ROUND([SCHLM : February Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : February Medicaid
Patient Days]-[SCHLM : February Swing Bed Days],0)
ROUND([SCHLM : February Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : February
Medicaid Payments]-[SCHLM : February Swing Bed Payments],0)
[SCHLM : March Medicaid Days less Swing Bed Days]=[SCHLN : March Medicaid Days less Swing Bed Days]
ROUND([SCHLM : March Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : March Medicaid Patient
Days]-[SCHLM : March Swing Bed Days],0)
ROUND([SCHLM : March Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : March Medicaid
Payments]-[SCHLM : March Swing Bed Payments],0)
[SCHLM : April Medicaid Days less Swing Bed Days]=[SCHLN : April Medicaid Days less Swing Bed Days]
ROUND([SCHLM : April Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : April Medicaid Patient Days]-
[SCHLM : April Swing Bed Days],0)
ROUND([SCHLM : April Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : April Medicaid
Payments]-[SCHLM : April Swing Bed Payments],0)
[SCHLM : May Medicaid Days less Swing Bed Days]=[SCHLN : May Medicaid Days less Swing Bed Days]
ROUND([SCHLM : May Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : May Medicaid Patient Days]-
[SCHLM : May Swing Bed Days],0)
ROUND([SCHLM : May Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : May Medicaid
Payments]-[SCHLM : May Swing Bed Payments],0)
[SCHLM : June Medicaid Days less Swing Bed Days]=[SCHLN : June Medicaid Days less Swing Bed Days]
ROUND([SCHLM : June Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : June Medicaid Patient
Days]-[SCHLM : June Swing Bed Days],0)
ROUND([SCHLM : June Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : June Medicaid
Payments]-[SCHLM : June Swing Bed Payments],0)
[SCHLM : July Medicaid Days less Swing Bed Days]=[SCHLN : July Medicaid Days less Swing Bed Days]
ROUND([SCHLM : July Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : July Medicaid Patient Days]-
[SCHLM : July Swing Bed Days],0)
ROUND([SCHLM : July Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : July Medicaid
Payments]-[SCHLM : July Swing Bed Payments],0)
[SCHLM : August Medicaid Days less Swing Bed Days]=[SCHLN : August Medicaid Days less Swing Bed Days]
ROUND([SCHLM : August Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : August Medicaid Patient
Days]-[SCHLM : August Swing Bed Days],0)
ROUND([SCHLM : August Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : August
Medicaid Payments]-[SCHLM : August Swing Bed Payments],0)
[SCHLM : September Medicaid Days less Swing Bed Days]=[SCHLN : September Medicaid Days less Swing Bed
Days]
ROUND([SCHLM : September Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : September Medicaid
Patient Days]-[SCHLM : September Swing Bed Days],0)
ROUND([SCHLM : September Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : September
Medicaid Payments]-[SCHLM : September Swing Bed Payments],0)
[SCHLM : October Medicaid Days less Swing Bed Days]=[SCHLN : October Medicaid Days less Swing Bed Days]
ROUND([SCHLM : October Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : October Medicaid
Patient Days]-[SCHLM : October Swing Bed Days],0)
ROUND([SCHLM : October Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : October
Medicaid Payments]-[SCHLM : October Swing Bed Payments],0)
[SCHLM : November Medicaid Days less Swing Bed Days]=[SCHLN : November Medicaid Days less Swing Bed
Days]
ROUND([SCHLM : November Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : November Medicaid
Patient Days]-[SCHLM : November Swing Bed Days],0)
ROUND([SCHLM : November Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : November
Medicaid Payments]-[SCHLM : November Swing Bed Payments],0)
[SCHLM : December Medicaid Days less Swing Bed Days]=[SCHLN : December Medicaid Days less Swing Bed
Days]
ROUND([SCHLM : December Medicaid Days less Swing Bed Days],0)=ROUND([SCHLM : December Medicaid
Patient Days]-[SCHLM : December Swing Bed Days],0)
ROUND([SCHLM : December Medicaid Payments less Swing Bed Payments],0)=ROUND([SCHLM : December
Medicaid Payments]-[SCHLM : December Swing Bed Payments],0)
[SCHLM : Retroactive Rate Increases-Column 4]=[SCHLM : Retroactive Rate Increases-Column 6]
ABS([SCHLM : TOTAL Medicaid Patient Days]-([SCHLM : January Medicaid Patient Days]+[SCHLM : February
Medicaid Patient Days]+[SCHLM : March Medicaid Patient Days]+[SCHLM : April Medicaid Patient
Days]+[SCHLM : May Medicaid Patient Days]+[SCHLM : June Medicaid Patient Days]+[SCHLM : July Medicaid
Patient Days]+[SCHLM : August Medicaid Patient Days]+[SCHLM : September Medicaid Patient Days]+[SCHLM :
ABS([SCHLM : TOTAL Swing Bed Days]-([SCHLM : January Swing Bed Days]+[SCHLM February Medicaid
October Medicaid Patient Days]+[SCHLM : November Medicaid Patient Days]+[SCHLM : :DecemberSwing Bed
Days]+[SCHLM : March Swing Bed Days]+[SCHLM : April Swing Bed Days]+[SCHLM : May Swing Bed
Days]+[SCHLM : June Swing Bed Days]+[SCHLM : July Swing Bed Days]+[SCHLM : August Swing Bed
Days]+[SCHLM : September Swing Bed Days]+[SCHLM : October Swing Bed Days]+[SCHLM : November Swing
Bed Days]+[SCHLM : December Swing Bed Days]))<13
[SCHLM : TOTAL Medicaid Days less Swing Bed Days]=[SCHLN : Total Medicaid Days less Swing Bed Days]
[SCHLM : TOTAL Medicaid Days less Swing Bed Days]=[SCHLM : TOTAL Medicaid Patient Days]-[SCHLM :
TOTAL Swing Bed Days]
ABS([SCHLM : TOTAL Medicaid Days less Swing Bed Days]-([SCHLM : January Medicaid Days less Swing Bed
Days]+[SCHLM : February Medicaid Days less Swing Bed Days]+[SCHLM : March Medicaid Days less Swing Bed
Days]+[SCHLM : April Medicaid Days less Swing Bed Days]+[SCHLM : May Medicaid Days less Swing Bed
Days]+[SCHLM : June Medicaid Days less Swing Bed Days]+[SCHLM : July Medicaid Days less Swing Bed
Days]+[SCHLM : August Medicaid Days less Swing Bed Days]+[SCHLM : September Medicaid Days less Swing
Bed Days]+[SCHLM : October Medicaid Days less Swing Bed Days]+[SCHLM : November Medicaid Days less
[SCHLM : TOTAL Medicaid Payments]=[SCHLO : TOTAL INTERIM PAYMENT AMOUNT]
ABS([SCHLM : TOTAL Medicaid Payments]-([SCHLM : January Medicaid Payments]+[SCHLM : February
Medicaid Payments]+[SCHLM : March Medicaid Payments]+[SCHLM : April Medicaid Payments]+[SCHLM : May
Medicaid Payments]+[SCHLM : June Medicaid Payments]+[SCHLM : July Medicaid Payments]+[SCHLM : August
Medicaid Payments]+[SCHLM : September Medicaid Payments]+[SCHLM : October Medicaid
Payments]+[SCHLM : November Medicaid Payments]+[SCHLM : December Medicaid Payments]+[SCHLM :
Retroactive Rate Increases-Column 4]))<13
ABS([SCHLM : TOTAL Swing Bed Payments]-([SCHLM : January Swing Bed Payments]+[SCHLM : February
Swing Bed Payments]+[SCHLM : March Swing Bed Payments]+[SCHLM : April Swing Bed Payments]+[SCHLM :
May Swing Bed Payments]+[SCHLM : June Swing Bed Payments]+[SCHLM : July Swing Bed
Payments]+[SCHLM : August Swing Bed Payments]+[SCHLM : September Swing Bed Payments]+[SCHLM :
October Swing Bed Payments]+[SCHLM : November Swing Bed Payments]+[SCHLM : December Swing Bed
Payments]))<13
ABS([SCHLM : TOTAL Medicaid Payments less Swing Bed Payments]-([SCHLM : TOTAL Medicaid Payments]-
[SCHLM : TOTAL Swing Bed Payments]))<13
ABS([SCHLM : TOTAL Medicaid Payments less Swing Bed Payments]-([SCHLM : January Medicaid Payments
less Swing Bed Payments]+[SCHLM : February Medicaid Payments less Swing Bed Payments]+[SCHLM : March
Medicaid Payments less Swing Bed Payments]+[SCHLM : April Medicaid Payments less Swing Bed
Payments]+[SCHLM : May Medicaid Payments less Swing Bed Payments]+[SCHLM : June Medicaid Payments
less Swing Bed Payments]+[SCHLM : July Medicaid Payments less Swing Bed Payments]+[SCHLM : August
Medicaid Payments less Swing Bed Payments]+[SCHLM : September Medicaid Payments less Swing Bed
ABS([SCHLM : TOTAL Zero Payments]-([SCHLM : January Zero Payments]+[SCHLM : February Zero
Payments]+[SCHLM : March Zero Payments]+[SCHLM : April Zero Payments]+[SCHLM : May Zero
Payments]+[SCHLM : June Zero Payments]+[SCHLM : July Zero Payments]+[SCHLM : August Zero
Payments]+[SCHLM : September Zero Payments]+[SCHLM : October Zero Payments]+[SCHLM : November
Zero Payments]+[SCHLM : December Zero Payments]))<13
[SCHLN : January Total Patient Days]=[SCHLN : January Medicaid Days less Swing Bed Days]+[SCHLN :
January Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : January Medicare
Patient Days]+[SCHLN : January Private Patient Days]+[SCHLN : January Other Patient Days]
[SCHLN : February Total Patient Days]=[SCHLN : February Medicaid Days less Swing Bed Days]+[SCHLN :
February Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : February
Medicare Patient Days]+[SCHLN : February Private Patient Days]+[SCHLN : February Other Patient Days]
[SCHLN : March Total Patient Days]=[SCHLN : March Medicaid Days less Swing Bed Days]+[SCHLN : March
Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : March Medicare Patient
Days]+[SCHLN : March Private Patient Days]+[SCHLN : March Other Patient Days]
[SCHLN : April Total Patient Days]=[SCHLN : April Medicaid Days less Swing Bed Days]+[SCHLN : April Unpaid
Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : April Medicare Patient
Days]+[SCHLN : April Private Patient Days]+[SCHLN : April Other Patient Days]
[SCHLN : May Total Patient Days]=[SCHLN : May Medicaid Days less Swing Bed Days]+[SCHLN : May Unpaid
Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : May Medicare Patient
Days]+[SCHLN : May Private Patient Days]+[SCHLN : May Other Patient Days]
[SCHLN : June Total Patient Days]=[SCHLN : June Medicaid Days less Swing Bed Days]+[SCHLN : June Unpaid
Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : June Medicare Patient
Days]+[SCHLN : June Private Patient Days]+[SCHLN : June Other Patient Days]
[SCHLN : July Total Patient Days]=[SCHLN : July Medicaid Days less Swing Bed Days]+[SCHLN : July Unpaid
Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : July Medicare Patient
Days]+[SCHLN : July Private Patient Days]+[SCHLN : July Other Patient Days]
[SCHLN : August Total Patient Days]=[SCHLN : August Medicaid Days less Swing Bed Days]+[SCHLN : August
Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : August Medicare Patient
Days]+[SCHLN : August Private Patient Days]+[SCHLN : August Other Patient Days]
[SCHLN : September Total Days]=[SCHLN : September Medicaid Days less Swing Bed Days]+[SCHLN :
September Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : September
Medicare Patient Days]+[SCHLN : September Private Patient Days]+[SCHLN : September Other Patient Days]
[SCHLN : October Total Days]=[SCHLN : October Medicaid Days less Swing Bed Days]+[SCHLN : October
Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : October Medicare Patient
Days]+[SCHLN : October Private Patient Days]+[SCHLN : October Other Patient Days]
[SCHLN : November Total Days]=[SCHLN : November Medicaid Days less Swing Bed Days]+[SCHLN :
November Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : November
Medicare Patient Days]+[SCHLN : November Private Patient Days]+[SCHLN : November Other Patient Days]
[SCHLN : December Total Days]=[SCHLN : December Medicaid Days less Swing Bed Days]+[SCHLN :
December Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : December
Medicare Patient Days]+[SCHLN : December Private Patient Days]+[SCHLN : December Other Patient Days]
[SCHLN : Total Medicaid Days less Swing Bed Days]=[SCHLN : January Medicaid Days less Swing Bed
Days]+[SCHLN : February Medicaid Days less Swing Bed Days]+[SCHLN : March Medicaid Days less Swing Bed
Days]+[SCHLN : April Medicaid Days less Swing Bed Days]+[SCHLN : May Medicaid Days less Swing Bed
Days]+[SCHLN : June Medicaid Days less Swing Bed Days]+[SCHLN : July Medicaid Days less Swing Bed
Days]+[SCHLN : August Medicaid Days less Swing Bed Days]+[SCHLN : September Medicaid Days less Swing
Bed Days]+[SCHLN : October Medicaid Days less Swing Bed Days]+[SCHLN : November Medicaid Days less
Swing Bed Days]+[SCHLN : December Medicaid Days less Swing Bed Days]
[C391]=[SCHLN : January Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN :
February Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : March Unpaid
Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : April Unpaid Medicaid Claimed
Patient Days as of 60 Days After End of Period]+[SCHLN : May Unpaid Medicaid Claimed Patient Days as of 60
Days After End of Period]+[SCHLN : June Unpaid Medicaid Claimed Patient Days as of 60 Days After End of
Period]+[SCHLN : July Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN :
August Unpaid Medicaid Claimed Patient Days as of 60 Days After End of Period]+[SCHLN : September Unpaid
[SCHLN : Total Medicare Patient Days]=[SCHLN : January Medicare Patient Days]+[SCHLN : February Medicare
Patient Days]+[SCHLN : March Medicare Patient Days]+[SCHLN : April Medicare Patient Days]+[SCHLN : May
Medicare Patient Days]+[SCHLN : June Medicare Patient Days]+[SCHLN : July Medicare Patient Days]+[SCHLN
: August Medicare Patient Days]+[SCHLN : September Medicare Patient Days]+[SCHLN : October Medicare
Patient Days]+[SCHLN : November Medicare Patient Days]+[SCHLN : December Medicare Patient Days]
[SCHLN : Total Private Patient Days]=[SCHLN : January Private Patient Days]+[SCHLN : February Private Patient
Days]+[SCHLN : March Private Patient Days]+[SCHLN : April Private Patient Days]+[SCHLN : May Private Patient
Days]+[SCHLN : June Private Patient Days]+[SCHLN : July Private Patient Days]+[SCHLN : August Private
Patient Days]+[SCHLN : September Private Patient Days]+[SCHLN : October Private Patient Days]+[SCHLN :
November Private Patient Days]+[SCHLN : December Private Patient Days]
[SCHLN : Total Other Patient Days]=[SCHLN : January Other Patient Days]+[SCHLN : February Other Patient
Days]+[SCHLN : March Other Patient Days]+[SCHLN : April Other Patient Days]+[SCHLN : May Other Patient
Days]+[SCHLN : June Other Patient Days]+[SCHLN : July Other Patient Days]+[SCHLN : August Other Patient
Days]+[SCHLN : September Other Patient Days]+[SCHLN : October Other Patient Days]+[SCHLN : November
Other Patient Days]+[SCHLN : December Other Patient Days]
[SCHLN : TOTAL PATIENT DAYS]=[SCHLN : January Total Patient Days]+[SCHLN : February Total Patient
Days]+[SCHLN : March Total Patient Days]+[SCHLN : April Total Patient Days]+[SCHLN : May Total Patient
Days]+[SCHLN : June Total Patient Days]+[SCHLN : July Total Patient Days]+[SCHLN : August Total Patient
Days]+[SCHLN : September Total Days]+[SCHLN : October Total Days]+[SCHLN : November Total
Days]+[SCHLN : December Total Days]
[SCHLN : TOTAL PATIENT DAYS]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[C391]+[SCHLN :
Total Medicare Patient Days]+[SCHLN : Total Private Patient Days]+[SCHLN : Total Other Patient Days]
[SCHLN : Total Zero Pay Days]=[SCHLN : January Zero Pay Days]+[SCHLN : February Zero Pay Days]+[SCHLN
: March Zero Pay Days]+[SCHLN : April Zero Pay Days]+[SCHLN : May Zero Pay Days]+[SCHLN : June Zero Pay
Days]+[SCHLN : July Zero Pay Days]+[SCHLN : August Zero Pay Days]+[SCHLN : September Zero Pay
Days]+[SCHLN : October Zero Pay Days]+[SCHLN : November Zero Pay Days]+[SCHLN : December Zero Pay
Days]
IF(CELL("type",[SCHLA : Report Period Ending Date])="l",[SCHLN : Percent Occupancy]=ROUND(([SCHLN :
TOTAL PATIENT DAYS]/([SCHLN : Licensed Beds]*(datevalue([SCHLA : Report Period Ending Date])-
datevalue([SCHLA : Report Period Beginning Date])+1))),2),[SCHLN : Percent Occupancy]=ROUND(([SCHLN :
TOTAL PATIENT DAYS]/([SCHLN : Licensed Beds]*([SCHLA : Report Period Ending Date]-[SCHLA : Report
Period Beginning Date]+1))),2)) Period Ending Date])="l",[SCHLN : Maximum Patient Days]=[SCHLN : Licensed
IF(CELL("type",[SCHLA : Report
Beds]*(datevalue([SCHLA : Report Period Ending Date])-datevalue([SCHLA : Report Period Beginning
Date]+1)),[SCHLN : Maximum Patient Days]=[SCHLN : Licensed Beds]*([SCHLA : Report Period Ending Date]-
[SCHLA : Report Period Beginning Date]+1))
IF([SCHLO : DC Patient Days],ROUND([SCHLO : DC Cost PPD],4)=ROUND([SCHLO : Direct Care Allowable
Costs]/[SCHLO : DC Patient Days],4),"---FALSE---")
[SCHLO : DC Cost PPD]=[SCHLO : DC Cost PPD]
IF([SCHLO : Therapy Patient Days],ROUND([SCHLO : Therapy Cost PPD],4)=ROUND([SCHLO : Therapy
Allowable Costs]/[SCHLO : Therapy Patient Days],4),"---FALSE---")
[SCHLO : Therapy Cost PPD]=[SCHLO : THERAPY Cost PPD]
IF([SCHLO : Support Services Patient Days],ROUND([SCHLO : Support Services Cost
PPD],4)=ROUND([SCHLO : Support Services Allowable Costs]/[SCHLO : Support Services Patient Days],4),"---
FALSE---")
[SCHLO : Support Services Cost PPD]=[SCHLO : SS Cost PPD]
IF([SCHLO : OP Patient Days],ROUND([SCHLO : OP Cost PPD],4)=ROUND([SCHLO : OP Allowable
Costs]/[SCHLO : OP Patient Days],4),"---FALSE---")
IF([SCHLO : PR Patient Days],ROUND([SCHLO : PR Cost PPD],4)=ROUND([SCHLO : Property Allowable
Costs]/[SCHLO : PR Patient Days],4),"---FALSE---")
ABS([SCHLO : TOTAL COST PPD]-([SCHLO : DC Cost PPD]+[SCHLO : Therapy Cost PPD]+[SCHLO : Support
Services Cost PPD]+[SCHLO : OP Cost PPD]+[SCHLO : PR Cost PPD]))<4
[SCHLO : TOTAL ALLOWABLE COSTS]=[SCHLO : Direct Care Allowable Costs]+[SCHLO : Therapy Allowable
Costs]+[SCHLO : Support Services Allowable Costs]+[SCHLO : OP Allowable Costs]+[SCHLO : Property
Allowable Costs]
ABS(ROUND([SCHLO : RATE A - DC Rate times Days]-([SCHLO : RATE A - DC]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - DC Rate times Days]-([SCHLO : RATE B - DC]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - DC Rate times Days]-([SCHLO : RATE C - DC]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - DC Rate times Days]-([SCHLO : RATE D - DC]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - DC Rate times Days]-([SCHLO : RATE E - DC]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - THERAPY Rate times Days]-([SCHLO : RATE A - THERAPY]*[SCHLO :
RATE A - Paid Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - THERAPY Rate times Days]-([SCHLO : RATE B - THERAPY]*[SCHLO :
RATE B - Paid Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - THERAPY Rate times Days]-([SCHLO : RATE C - THERAPY]*[SCHLO :
RATE C - Paid Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - THERAPY Rate times Days]-([SCHLO : RATE D - THERAPY]*[SCHLO :
RATE D - Paid Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - THERAPY Rate times Days]-([SCHLO : RATE E - THERAPY]*[SCHLO :
RATE E - Paid Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - SS Rate times Days]-([SCHLO : RATE A - SS]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - SS Rate times Days]-([SCHLO : RATE B - SS]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - SS Rate times Days]-([SCHLO : RATE C - SS]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - SS Rate times Days]-([SCHLO : RATE D - SS]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - SS Rate times Days]-([SCHLO : RATE E - SS]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - OP Rate times Days]-([SCHLO : RATE A - OP]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - OP Rate times Days]-([SCHLO : RATE B - OP]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - OP Rate times Days]-([SCHLO : RATE C - OP]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - OP Rate times Days]-([SCHLO : RATE D - OP]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - OP Rate times Days]-([SCHLO : RATE E - OP]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - PR Rate times Days]-([SCHLO : RATE A - PR]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - PR Rate times Days]-([SCHLO : RATE B - PR]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - PR Rate times Days]-([SCHLO : RATE C - PR]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - PR Rate times Days]-([SCHLO : RATE D - PR]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - PR Rate times Days]-([SCHLO : RATE E - PR]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - FA Rate times Days]-([SCHLO : RATE A - FA]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - FA Rate times Days]-([SCHLO : RATE B - FA]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - FA Rate times Days]-([SCHLO : RATE C - FA]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - FA Rate times Days]-([SCHLO : RATE D - FA]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - FA Rate times Days]-([SCHLO : RATE E - FA]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE A - VR Rate Times Days]-([SCHLO : RATE A - VR]*[SCHLO : RATE A - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE B - VR Rate Times Days]-([SCHLO : RATE B - VR]*[SCHLO : RATE B - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE C - VR Rate Times Days]-([SCHLO : RATE C - VR]*[SCHLO : RATE C - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE D - VR Rate Times Days]-([SCHLO : RATE D - VR]*[SCHLO : RATE D - Paid
Medicaid Days]),2))<=1
ABS(ROUND([SCHLO : RATE E - VR Rate Times Days]-([SCHLO : RATE E - VR]*[SCHLO : RATE E - Paid
Medicaid Days]),2))<=1
[SCHLO : RATE A - TOTAL Rate times Days]=([SCHLO : RATE A - DC Rate times Days]+[SCHLO : RATE A -
THERAPY Rate times Days]+[SCHLO : RATE A - SS Rate times Days]+[SCHLO : RATE A - OP Rate times
Days]+[SCHLO : RATE A - PR Rate times Days]+[SCHLO : RATE A - FA Rate times Days]+[SCHLO : RATE A -
VR Rate Times Days]+[SCHLO : RATE A - Total Rate Hold Harmless AJE Rate Times Days])
[SCHLO : RATE B - TOTAL Rate times Days]=([SCHLO : RATE B - DC Rate times Days]+[SCHLO : RATE B -
THERAPY Rate times Days]+[SCHLO : RATE B - SS Rate times Days]+[SCHLO : RATE B - OP Rate times
Days]+[SCHLO : RATE B - PR Rate times Days]+[SCHLO : RATE B - FA Rate times Days]+[SCHLO : RATE B -
VR Rate Times Days]+[SCHLO : RATE B - Total Rate Hold Harmless AJE Rate Times Days])
[SCHLO : RATE C - TOTAL Rate times Days]=([SCHLO : RATE C - DC Rate times Days]+[SCHLO : RATE C -
THERAPY Rate times Days]+[SCHLO : RATE C - SS Rate times Days]+[SCHLO : RATE C - OP Rate times
Days]+[SCHLO : RATE C - PR Rate times Days]+[SCHLO : RATE C - FA Rate times Days]+[SCHLO : RATE C -
VR Rate Times Days]+[SCHLO : RATE C - Total Rate Hold Harmless AJE Rate Times Days])
ABS([SCHLO : RATE D - TOTAL Rate times Days]-([SCHLO : RATE D - DC Rate times Days]+[SCHLO : RATE
D - THERAPY Rate times Days]+[SCHLO : RATE D - SS Rate times Days]+[SCHLO : RATE D - OP Rate times
Days]+[SCHLO : RATE D - PR Rate times Days]+[SCHLO : RATE D - FA Rate times Days]+[SCHLO : RATE D -
VR Rate Times Days]+[SCHLO : RATE D - Total Rate Hold Harmless AJE Rate Times Days]))<7
ABS([SCHLO : RATE E - TOTAL Rate times Days]-([SCHLO : RATE E - DC Rate times Days]+[SCHLO : RATE
E - THERAPY Rate times Days]+[SCHLO : RATE E - SS Rate times Days]+[SCHLO : RATE E - OP Rate times
Days]+[SCHLO : RATE E - PR Rate times Days]+[SCHLO : RATE E - FA Rate times Days]+[SCHLO : RATE E -
VR Rate Times Days]+[SCHLO : RATE E - Total Rate Hold Harmless AJE Rate Times Days]))<7
if([SCHLO : RATE A - TOTAL]>0,[SCHLO : RATE A - Variable Return Percentage]>0,if([SCHLO : RATE A -
TOTAL]=0,[SCHLO : RATE A - Variable Return Percentage]=0,"---FALSE---"))
if([SCHLO : RATE B - TOTAL]>0,[SCHLO : RATE B - Variable Return Percentage]>0,if([SCHLO : RATE B -
TOTAL]=0,[SCHLO : RATE B - Variable Return Percentage]=0,"---FALSE---"))
if([SCHLO : RATE C - TOTAL]>0,[SCHLO : RATE C - Variable Return Percentage]>0,if([SCHLO : RATE C -
TOTAL]=0,[SCHLO : RATE C - Variable Return Percentage]=0,"---FALSE---"))
if([SCHLO : RATE D - TOTAL]>0,[SCHLO : RATE D - Variable Return Percentage]>0,if([SCHLO : RATE D -
TOTAL]=0,[SCHLO : RATE D - Variable Return Percentage]=0,"---FALSE---"))
if([SCHLO : RATE E - TOTAL]>0,[SCHLO : RATE E - Variable Return Percentage]>0,if([SCHLO : RATE E -
TOTAL]=0,[SCHLO : RATE E - Variable Return Percentage]=0,"---FALSE---"))
ABS([SCHLO : TOTAL - DC Rate times Days]-([SCHLO : RATE A - DC Rate times Days]+[SCHLO : RATE B -
DC Rate times Days]+[SCHLO : RATE C - DC Rate times Days]+[SCHLO : RATE D - DC Rate times
Days]+[SCHLO : RATE E - DC Rate times Days]+[SCHLO : RATE F - DC Rate times Days]+[SCHLO : RATE G -
DC Rate times Days]+[SCHLO : RATE G - DC Rate times Days]))<5
IF([SCHLO : DC-Medicaid Patient Days],ROUND([SCHLO : DC-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
DC Rate times Days]/[SCHLO : DC-Medicaid Patient Days],4),"---FALSE---")
[SCHLO : DC-Weighted Rate]=[SCHLO : DC Weighted Rate]
ABS([SCHLO : TOTAL - THERAPY Rate times Days]-([SCHLO : RATE A - THERAPY Rate times Days]+[SCHLO
: RATE B - THERAPY Rate times Days]+[SCHLO : RATE C - THERAPY Rate times Days]+[SCHLO : RATE D -
THERAPY Rate times Days]+[SCHLO : RATE E - THERAPY Rate times Days]+[SCHLO : RATE F - THERAPY
Rate times Days]+[SCHLO : RATE G - THERAPY Rate times Days]+[SCHLO : RATE H - THERAPY Rate times
Days]))<5
[SCHLO : THERAPY-Weighted Rate]=[SCHLO : THERAPY Weighted Rate]
ABS([SCHLO : TOTAL - SS Rate times Days]-([SCHLO : RATE A - SS Rate times Days]+[SCHLO : RATE B - SS
Rate times Days]+[SCHLO : RATE C - SS Rate times Days]+[SCHLO : RATE D - SS Rate times Days]+[SCHLO
: RATE E - SS Rate times Days]+[SCHLO : RATE F - SS Rate times Days]+[SCHLO : RATE G - SS Rate times
Days]+[SCHLO : RATE H - SS Rate times Days]))<5
IF([SCHLO : SS-Medicaid Patient Days],ROUND([SCHLO : SS-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
SS Rate times Days]/[SCHLO : SS-Medicaid Patient Days],4),"---FALSE---")
[SCHLO : SS-Weighted Rate]=[SCHLO : SS Weighted Rate]
ABS([SCHLO : TOTAL - OP Rate times Days]-([SCHLO : RATE A - OP Rate times Days]+[SCHLO : RATE B -
OP Rate times Days]+[SCHLO : RATE C - OP Rate times Days]+[SCHLO : RATE D - OP Rate times
Days]+[SCHLO : RATE E - OP Rate times Days]+[SCHLO : RATE G - OP Rate times Days]+[SCHLO : RATE H -
OP Rate times Days]+[SCHLO : RATE F - OP Rate times Days]))<5
IF([SCHLO : OP-Medicaid Patient Days],ROUND([SCHLO : OP-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
OP Rate times Days]/[SCHLO : OP-Medicaid Patient Days],4),"---FALSE---")
[SCHLO : OP-Weighted Rate]=[SCHLO : OP Weighted Rate]
ABS([SCHLO : TOTAL - PR Rate times Days]-([SCHLO : RATE A - PR Rate times Days]+[SCHLO : RATE B -
PR Rate times Days]+[SCHLO : RATE C - PR Rate times Days]+[SCHLO : RATE D - PR Rate times
Days]+[SCHLO : RATE E - PR Rate times Days]+[SCHLO : RATE F - PR Rate times Days]+[SCHLO : RATE G -
PR Rate times Days]+[SCHLO : RATE H - PR Rate times Days]))<5
IF([SCHLO : PR-Medicaid Patient Days],ROUND([SCHLO : PR-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
PR Rate times Days]/[SCHLO : PR-Medicaid Patient Days],4),"---FALSE---")
[SCHLO : PR-Weighted Rate]=[SCHLO : PR Weighted Rate]
ABS([SCHLO : TOTAL - FA Rate times Days]-([SCHLO : RATE A - FA Rate times Days]+[SCHLO : RATE B - FA
Rate times Days]+[SCHLO : RATE C - FA Rate times Days]+[SCHLO : RATE D - FA Rate times Days]+[SCHLO :
RATE E - FA Rate times Days]+[SCHLO : RATE F - FA Rate times Days]+[SCHLO : RATE G - FA Rate times
Days]+[SCHLO : RATE H - FA Rate times Days]))<5
IF([SCHLO : FA-Medicaid Patient Days],ROUND([SCHLO : FA-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
FA Rate times Days]/[SCHLO : FA-Medicaid Patient Days],4),"---FALSE---")
ABS([SCHLO : TOTAL - VR Rate Times Days]-([SCHLO : RATE A - VR Rate Times Days]+[SCHLO : RATE B -
VR Rate Times Days]+[SCHLO : RATE C - VR Rate Times Days]+[SCHLO : RATE D - VR Rate Times
Days]+[SCHLO : RATE E - VR Rate Times Days]+[SCHLO : RATE F - VR Rate times Days]+[SCHLO : RATE G -
VR Rate times Days]+[SCHLO : RATE H - VR Rate times Days]))<5
IF([SCHLO : VR-Medicaid Patient Days],ROUND([SCHLO : VR-Weighted Rate],4)=ROUND([SCHLO : TOTAL -
VR Rate Times Days]/[SCHLO : VR-Medicaid Patient Days],4),"---FALSE---")
ABS([SCHLO : ROI Weighted Rate]-([SCHLO : FA-Weighted Rate]+[SCHLO : VR-Weighted Rate]))<2
ABS([SCHLO : TOTAL - TOTAL Rate times Days]-([SCHLO : RATE A - TOTAL Rate times Days]+[SCHLO :
RATE B - TOTAL Rate times Days]+[SCHLO : RATE C - TOTAL Rate times Days]+[SCHLO : RATE D - TOTAL
Rate times Days]+[SCHLO : RATE E - TOTAL Rate times Days]+[SCHLO : RATE F - Total - Rate times
Days]+[SCHLO : RATE G - Total - Rate times Days]+[SCHLO : RATE H - Total - Rate times Days]))<5
([SCHLO : TOTAL - TOTAL Rate times Days]=[SCHLO : TOTAL - DC Rate times Days]+[SCHLO : TOTAL -
THERAPY Rate times Days]+[SCHLO : TOTAL - SS Rate times Days]+[SCHLO : TOTAL - OP Rate times
Days]+[SCHLO : TOTAL - PR Rate times Days]+[SCHLO : TOTAL - FA Rate times Days]+[SCHLO : TOTAL - VR
Rate Times Days]+[SCHLO : TOTAL - Total Rate Hold Harmless AJE Rate Times Days])
ABS([SCHLO : TOTAL-Weighted Rate]-[SCHLO : DC-Weighted Rate]-[SCHLO : THERAPY-Weighted Rate]-
[SCHLO : SS-Weighted Rate]-[SCHLO : OP-Weighted Rate]-[SCHLO : PR-Weighted Rate]-[SCHLO : FA-
Weighted Rate]-[SCHLO : VR-Weighted Rate]-[SCHLO : Total Rate Hold Harmless AJE-Weighted Rate])<8
[SCHLO : TOTAL-Weighted Rate]=[SCHLO : TOTAL WEIGHTED RATE]
IF([SCHLO : THERAPY Weighted Rate]>[SCHLO : THERAPY Cost PPD],ROUND(ABS([SCHLO : THERAPY-
Shift Out]),4)<=ROUND([SCHLO : THERAPY Weighted Rate]-[SCHLO : THERAPY Cost PPD],4),[SCHLO :
THERAPY-Shift Out]=0)
[SCHLO : THERAPY - PS RATE]=[SCHLO : THERAPY Lower Cost or Rate]+[SCHLO : THERAPY-Shift In]
IF([SCHLO : SS Weighted Rate]>[SCHLO : SS Cost PPD],ABS([SCHLO : SS-Shift Out])<=ROUND([SCHLO : SS
Weighted Rate]-[SCHLO : SS Cost PPD],4),[SCHLO : SS-Shift Out]=0)
IF([SCHLO : SS Weighted Rate]<[SCHLO : SS Cost PPD],IF(([SCHLO : SS Cost PPD]-[SCHLO : SS Weighted
Rate])<([SCHLO : SS Weighted Rate]*.2),[SCHLO : SS-Shift In]<=ROUND([SCHLO : SS Cost PPD]-[SCHLO :
SS Weighted Rate],4),[SCHLO : SS-Shift In]<=([SCHLO : SS Weighted Rate]*.2)),[SCHLO : SS-Shift In]=0)
[SCHLO : SS-PS RATE]=[SCHLO : SS Lower Cost or Rate]+[SCHLO : SS-Shift In]
IF([SCHLO : OP Weighted Rate]>[SCHLO : OP Cost PPD],ABS([SCHLO : OP-Shift Out])<=ROUND([SCHLO :
OP Weighted Rate]-[SCHLO : OP Cost PPD],4),[SCHLO : OP-Shift Out]=0)
IF([SCHLO : OP Weighted Rate]<[SCHLO : OP Cost PPD],IF(([SCHLO : OP Cost PPD]-[SCHLO : OP Weighted
Rate])<([SCHLO : OP Weighted Rate]*.2),[SCHLO : OP-Shift In]<=ROUND([SCHLO : OP Cost PPD]-[SCHLO :
OP Weighted Rate],4),[SCHLO : OP-Shift In]<=([SCHLO : OP Weighted Rate]*.2)),[SCHLO : OP-Shift In]=0)
[SCHLO : OP-PS RATE]=[SCHLO : OP Lower Cost or Rate]+[SCHLO : OP-Shift In]
[SCHLO : PR Lower Cost or Rate]=[SCHLO : PR-PS RATE]
IF([SCHLO : PR Weighted Rate]>[SCHLO : PR Cost PPD],ABS([SCHLO : PR-Shift Out])<=ROUND([SCHLO :
PR Weighted Rate]-[SCHLO : PR Cost PPD],4),[SCHLO : PR-Shift Out]=0)
[SCHLO : ROI Weighted Rate]=[SCHLO : ROI Lower Cost or Rate]
[SCHLO : ROI Lower Cost or Rate]=[SCHLO : ROI-PS RATE]
[SCHLO : TOTAL WEIGHTED RATE]=[SCHLO : DC Weighted Rate]+[SCHLO : THERAPY Weighted
Rate]+[SCHLO : SS Weighted Rate]+[SCHLO : OP Weighted Rate]+[SCHLO : PR Weighted Rate]+[SCHLO :
ROI Weighted Rate]+[SCHLO : Total Rate Hold Harmless AJE Weighted Rate]
[SCHLO : TOTAL COST PPD]=[SCHLO : DC Cost PPD]+[SCHLO : THERAPY Cost PPD]+[SCHLO : SS Cost
PPD]+[SCHLO : OP Cost PPD]+[SCHLO : PR Cost PPD]
[SCHLO : TOTAL LOWER COST OR RATE]=[SCHLO : DC Lower Cost or Rate]+[SCHLO : THERAPY Lower
Cost or Rate]+[SCHLO : SS Lower Cost or Rate]+[SCHLO : OP Lower Cost or Rate]+[SCHLO : PR Lower Cost
or Rate]+[SCHLO : ROI Lower Cost or Rate]+[SCHLO : Total Rate Hold Harmless AJE Lower Cost or Rate]
[SCHLO : TOTAL SHIFT IN]=[SCHLO : DC-Shift In]+[SCHLO : THERAPY-Shift In]+[SCHLO : SS-Shift
In]+[SCHLO : OP-Shift In]
[SCHLO : TOTAL SHIFT OUT]+[SCHLO : TOTAL SHIFT IN]=0
[SCHLO : TOTAL PS RATE]=[SCHLO : DC - PS RATE]+[SCHLO : THERAPY - PS RATE]+[SCHLO : SS-PS
RATE]+[SCHLO : OP-PS RATE]+[SCHLO : PR-PS RATE]+[SCHLO : ROI-PS RATE]+[SCHLO : Total Rate Hold
Harmless AJE-PS RATE]
[SCHLO : TOTAL PS RATE]=[SCHLO : TOTAL LOWER COST OR RATE]+[SCHLO : TOTAL SHIFT IN]
[SCHLO : TOTAL PS RATE]<=[SCHLO : TOTAL WEIGHTED RATE]
ROUND([SCHLO : UNADJ. PRELIMINARY SETTLEMENT AMOUNT],0)=ROUND([SCHLO : TOTAL PS
RATE]*[SCHLO : PAID MEDICAID PATIENT DAYS],0)
[SCHLO : TOTAL PRELIMINARY SETTLEMENT AMOUNT]=[SCHLO : UNADJ. PRELIMINARY SETTLEMENT
AMOUNT]+[SCHLO : EXCEPTIONAL CARE AMOUNT]+[SCHLO : SWING BED REVENUE]
[SCHLO : SUB-TOTAL]=[SCHLO : TOTAL PRELIMINARY SETTLEMENT AMOUNT]-[SCHLO : TOTAL INTERIM
PAYMENT AMOUNT]
[SCHLO : TOTAL COST SAVINGS]=0
IF([SCHLO : BALANCE DUE PROVIDER]>0,(ABS(([SCHLO : BALANCE DUE PROVIDER]-([SCHLO : TOTAL
PRELIMINARY SETTLEMENT AMOUNT]+[SCHLO : TOTAL COST SAVINGS]-[SCHLO : TOTAL INTERIM
PAYMENT AMOUNT]))))<1,[SCHLO : BALANCE DUE PROVIDER]=0)
IF([SCHLO : BALANCE DUE DSHS]>0,(ABS(([SCHLO : BALANCE DUE DSHS]-([SCHLO : TOTAL INTERIM
PAYMENT AMOUNT]-[SCHLO : TOTAL PRELIMINARY SETTLEMENT AMOUNT]-[SCHLO : TOTAL COST
SAVINGS]))))<1,[SCHLO : BALANCE DUE DSHS]=0)
[SUPPI3 : Total (Line 18)]=[SUPPI3 : Land (Line 18)]+[SUPPI3 : Land Improvements (Line 18)]+[SUPPI3 :
Building (Line 18)]+[SUPPI3 : Building Improvements (Line 18)]+[SUPPI3 : Equipment (Line 18)]
[SUPPI4 : TOTAL DEPRECIATION-Col 5]=[SUPPI4 : Depreciation Land Improv-Col 5]+[SUPPI4 : Depreciation
Buildings-Col 5]+[SUPPI4 : Depreciation Bldg. Improv-Col 5]+[SUPPI4 : Depreciation Equipment-Col 5]+[SUPPI4
: Depreciation Leasehold Improv-Col 5]
[SUPPI4 : TOTAL LEASE PAYMENTS-Col 5]=[SUPPI4 : Lease Payments Land Improv-Col 5]+[SUPPI4 : Lease
Payments Buildings-Col 5]+[SUPPI4 : Lease Payments Equipment-Col 5]
[SUPPI4 : TOTAL PROPERTY-Col 5]=[SUPPI4 : TOTAL DEPRECIATION-Col 5]+[SUPPI4 : Interest-Col
5]+[SUPPI4 : Allocated Expenses-Col 5]+[SUPPI4 : TOTAL LEASE PAYMENTS-Col 5]+[SUPPI4 : Revenue
Offset-Col 5]
[SUPPI5 : Total Assets]=[SUPPI5 : Land Improvement Assets]+[SUPPI5 : Buildings Assets]+[SUPPI5 : Building
Improv. Assets]+[SUPPI5 : Fixed Equipment Assets]+[SUPPI5 : Movable Equipment Assets]+[SUPPI5 : Vehicles
Assets]+[SUPPI5 : Other Equipment Assets]+[SUPPI5 : Leasehold Improv. Assets]
[SUPPI5 : Total Depreciation]=[SUPPI5 : Land Improvement Depreciation]+[SUPPI5 : Buildings
Depreciation]+[SUPPI5 : Building Improv. Depreciation]+[SUPPI5 : Fixed Equipment Depreciation]+[SUPPI5 :
Movable Equipment Depreciation]+[SUPPI5 : Other Equipment Depreciation]+[SUPPI5 : Leasehold Improv.
Depreciation]+[SUPPI5 : Vehicles Depreciation]
[SUPPI5 : Total Cur. Year Depr.]=[SUPPI5 : Land Improvement Acc. Depreciation]+[SUPPI5 : Buildings Cur. Year
Depr.]+[SUPPI5 : Building Improv. Cur. Year Depr.]+[SUPPI5 : Fixed Equipment Cur. Year Depr.]+[SUPPI5 :
Movable Equipment Cur. Year Depr.]+[SUPPI5 : Vehicles Cur. Year Depr.]+[SUPPI5 : Other Equipment Cur. Year
Depr.]+[SUPPI5 : Leasehold Improv. Cur. Year Depr.]
IF(and([SCHLN : January Total Patient Days]>0,[SCHLN : Licensed Beds - January]>0),true,IF(and([SCHLN :
January Total Patient Days]=0,[SCHLN : Licensed Beds - January]=0),true,"---FALSE---"))
IF(and([SCHLN : February Total Patient Days]>0,[SCHLN : Licensed Beds - February]>0),true,IF(and([SCHLN :
February Total Patient Days]=0,[SCHLN : Licensed Beds - February]=0),true,"---FALSE---"))
IF(and([SCHLN : March Total Patient Days]>0,[SCHLN : Licensed Beds - March]>0),true,IF(and([SCHLN : March
Total Patient Days]=0,[SCHLN : Licensed Beds - March]=0),true,"---FALSE---"))
IF(and([SCHLN : April Total Patient Days]>0,[SCHLN : Licensed Beds - April]>0),true,IF(and([SCHLN : April Total
Patient Days]=0,[SCHLN : Licensed Beds - April]=0),true,"---FALSE---"))
IF(and([SCHLN : May Total Patient Days]>0,[SCHLN : Licensed Beds - May]>0),true,IF(and([SCHLN : May Total
Patient Days]=0,[SCHLN : Licensed Beds - May]=0),true,"---FALSE---"))
IF(and([SCHLN : June Total Patient Days]>0,[SCHLN : Licensed Beds - June]>0),true,IF(and([SCHLN : June
Total Patient Days]=0,[SCHLN : Licensed Beds - June]=0),true,"---FALSE---"))
IF(and([SCHLN : July Total Patient Days]>0,[SCHLN : Licensed Beds - July]>0),true,IF(and([SCHLN : July Total
Patient Days]=0,[SCHLN : Licensed Beds - July]=0),true,"---FALSE---"))
IF(and([SCHLN : August Total Patient Days]>0,[SCHLN : Licensed Beds - August]>0),true,IF(and([SCHLN :
August Total Patient Days]=0,[SCHLN : Licensed Beds - August]=0),true,"---FALSE---"))
IF(and([SCHLN : September Total Days]>0,[SCHLN : Licensed Beds - September]>0),true,IF(and([SCHLN :
September Total Days]=0,[SCHLN : Licensed Beds - September]=0),true,"---FALSE---"))
IF(and([SCHLN : October Total Days]>0,[SCHLN : Licensed Beds - October]>0),true,IF(and([SCHLN : October
Total Days]=0,[SCHLN : Licensed Beds - October]=0),true,"---FALSE---"))
IF(and([SCHLN : November Total Days]>0,[SCHLN : Licensed Beds - November]>0),true,IF(and([SCHLN :
November Total Days]=0,[SCHLN : Licensed Beds - November]=0),true,"---FALSE---"))
IF(and([SCHLN : December Total Days]>0,[SCHLN : Licensed Beds - December]>0),true,IF(and([SCHLN :
December Total Days]=0,[SCHLN : Licensed Beds - December]=0),true,"---FALSE---"))
[SCHLC : Direct Care]=[SCHLG : TOTAL DIRECT CARE]
[SCHLC : Total Routine Expenses]=[SCHLG : TOTAL ROUTINE EXPENSES-Column 5]
[SCHLC : Therapy]=[SCHLG : Therapy-Column 5]
[SCHLC : Total Routine Expenses]=[SCHLC : Total Routine Expenses]
[SCHLC : Support Services]=[SCHLG : TOTAL SUPPORT SERVICES]
[SCHLC : Operations]=[SCHLG : TOTAL OPERATIONS]
[SCHLG : TOTAL DIRECT CARE-Column 2]=[SCHLG : TOTAL IN-HOUSE SALARIES-Column 2]+[SCHLG :
Nursing Supplies-Column 2]+[SCHLG : TOTAL PURCHASED SALARIES-Column 2]+[SCHLG : TOTAL
ALLOCATED SALARIES-Column 2]+[SCHLG : Other Allocated Expenses-Column 2]+[SCHLG : NS REVENUE
OFFSET-Column 2]+[SCHLG : NS Fringe Benefits-Column 2]+[SCHLG : NS Payroll Taxes-Column 2]+[SCHLG :
RN FringeTOTAL DIRECT CARE-ColumnLPN Fringe Benefits-Column 2]+[SCHLG : CNA Fringe3]+[SCHLG :
[SCHLG : Benefits-Column 2]+[SCHLG : 3]=[SCHLG : TOTAL IN-HOUSE SALARIES-Column Benefits-
Nursing Supplies-Column 3]+[SCHLG : TOTAL PURCHASED SALARIES-Column 3]+[SCHLG : TOTAL
ALLOCATED SALARIES-Column 3]+[SCHLG : Other Allocated Expenses-Column 3]+[SCHLG : NS REVENUE
OFFSET-Column 3]+[SCHLG : NS Fringe Benefits-Column 3]+[SCHLG : NS Payroll Taxes-Column 3]+[SCHLG :
RN FringeTOTAL DIRECT CARE-ColumnLPN Fringe Benefits-Column 3]+[SCHLG : CNA Fringe4]+[SCHLG :
[SCHLG : Benefits-Column 3]+[SCHLG : 4]=[SCHLG : TOTAL IN-HOUSE SALARIES-Column Benefits-
Nursing Supplies-Column 4]+[SCHLG : TOTAL PURCHASED SALARIES-Column 4]+[SCHLG : TOTAL
ALLOCATED SALARIES-Column 4]+[SCHLG : Other Allocated Expenses-Column 4]+[SCHLG : NS REVENUE
OFFSET-Column 4]+[SCHLG : NS Fringe Benefits-Column 4]+[SCHLG : NS Payroll Taxes-Column 4]+[SCHLG :
RN FringeTOTAL DIRECT CARE]=[SCHLG : TOTAL Benefits-Column 4]+[SCHLG : CNA Fringe Benefits-
[SCHLG : Benefits-Column 4]+[SCHLG : LPN Fringe IN-HOUSE SALARIES-Column 5]+[SCHLG : NS Fringe
Benefits-Column 5]+[SCHLG : NS Payroll Taxes-Column 5]+[SCHLG : Nursing Supplies-Column 5]+[SCHLG :
TOTAL PURCHASED SALARIES-Column 5]+[SCHLG : TOTAL ALLOCATED SALARIES-Column 5]+[SCHLG :
Other Allocated Expenses-Column 5]+[SCHLG : DC REVENUE OFFSET-Column 5]+[SCHLG : RN Fringe
Benefits-Column 5]+[SCHLG : LPN Fringe Benefits-Column 5]+[SCHLG : CNA Fringe Benefits-Column 5]
[SCHLG : TOTAL SUPPORT SERVICES-Column 2]=[SCHLG : TOTAL FOOD-Column 2]+[SCHLG : TOTAL
LAUNDRY-Column 2]+[SCHLG : TOTAL HOUSEKEEPING-Column 2]+[SCHLG : TOTAL DIETARY-Column
2]+[SCHLG : REVENUE OFFSET-Column 2]
[SCHLG : TOTAL SUPPORT SERVICES]=[SCHLG : TOTAL FOOD-Column 5]+[SCHLG : TOTAL LAUNDRY-
Column 4]+[SCHLG : TOTAL HOUSEKEEPING-Column 4]+[SCHLG : TOTAL DIETARY-Column 4]+[SCHLG :
REVENUE OFFSET]
[SCHLG : TOTAL SUPPORT SERVICES HOURS-Column 6]=[SCHLG : TOTAL LAUNDRY HOURS-Column
6]+[SCHLG : TOTAL HOUSEKEEPING HOURS-Column 6]+[SCHLG : TOTAL DIETARY HOURS-Column 6]
[SCHLG : BAD DEBTS]=[SCHLG8 : Medicaid Bad Debts]
[SCHLG : TOTAL OPERATIONS-Column 2]=[SCHLG : TOTAL ADMINISTRATIVE-Column 2]+[SCHLG : TOTAL
MAINTENANCE-Column 2]+[SCHLG : TOTAL OTHER PROPERTY-Column 2]+[SCHLG : REVENUE OFFSET-
Column 2]
[SCHLG : TOTAL OPERATIONS-Column 3]=[SCHLG : TOTAL ADMINISTRATIVE-Column 3]+[SCHLG : TOTAL
MAINTENANCE-Column 3]+[SCHLG : TOTAL OTHER PROPERTY-Column 3]+[SCHLG : REVENUE OFFSET-
Column 3]
[SCHLG : TOTAL OPERATIONS-Column 4]=[SCHLG : TOTAL ADMINISTRATIVE-Column 4]+[SCHLG : TOTAL
MAINTENANCE-Column 4]+[SCHLG : TOTAL OTHER PROPERTY-Column 4]+[SCHLG : REVENUE OFFSET-
Column 4]
[SCHLG : TOTAL OPERATIONS]=[SCHLG : TOTAL ADMINISTRATIVE-Column 5]+[SCHLG : TOTAL
MAINTENANCE-Column 4]+[SCHLG : TOTAL OTHER PROPERTY-Column 4]+[SCHLG : REVENUE OFFSET]
[SCHLG : TOTAL OPERATIONS HOURS-Column 6]=[SCHLG : TOTAL ADMINISTRATIVE HOURS-Column
6]+[SCHLG : TOTAL MAINTENANCE HOURS-Column 6]
[SCHLG8 : PROJECTED MEDICAID BAD DEBTS]=[SCHLG8 : MEDICAID BAD DEBTS]-[SCHLG8 : MEDICAID
BAD DEBTS CLAIMED AS UNCOLLECTABLE IN PRIOR COST REPORTS]-[SCHLG8 : COLLECTIONS MADE
ON PREVIOUSLY ALLOWED BAD DEBT CLAIMS]-[SCHLG8 : PROJECTED COLLECTIBLES FROM LINE (1)]
[SCHLG8 : MEDICAID PATIENT DAYS]=[SCHLN : Total Medicaid Days less Swing Bed Days]+[C391]
(ROUND([SCHLG8 : PROJECTED MEDICAID BAD DEBTS]/[SCHLG8 : MEDICAID PATIENT
DAYS],0)=ROUND([SCHLG8 : MEDICAID BAD DEBTS PER MEDICAID PATIENT DAY],0))
[SCHLG8 : TOTAL PATIENT DAYS]=[SCHLN : TOTAL PATIENT DAYS]
[SCHLG8 : Medicaid Bad Debts]=ROUND([SCHLG8 : MEDICAID BAD DEBTS PER MEDICAID PATIENT
DAY]*[SCHLG8 : TOTAL PATIENT DAYS],0)
[SCHLO : RATE A - TOTAL]=[SCHLO : RATE A - DC]+[SCHLO : RATE A - THERAPY]+[SCHLO : RATE A -
SS]+[SCHLO : RATE A - OP]+[SCHLO : RATE A - PR]+[SCHLO : RATE A - FA]+[SCHLO : RATE A -
VR]+[SCHLO : RATE A - Total Rate Hold Harmless AJE]
[SCHLO : RATE B - TOTAL]=[SCHLO : RATE B - DC]+[SCHLO : RATE B - THERAPY]+[SCHLO : RATE B -
SS]+[SCHLO : RATE B - OP]+[SCHLO : RATE B - PR]+[SCHLO : RATE B - FA]+[SCHLO : RATE B -
VR]+[SCHLO : RATE B - Total Rate Hold Harmless AJE]
[SCHLO : RATE C - TOTAL]=[SCHLO : RATE C - DC]+[SCHLO : RATE C - THERAPY]+[SCHLO : RATE C -
SS]+[SCHLO : RATE C - OP]+[SCHLO : RATE C - PR]+[SCHLO : RATE C - FA]+[SCHLO : RATE C -
VR]+[SCHLO : RATE C - Total Rate Hold Harmless AJE]
[SCHLO : RATE D - TOTAL]=[SCHLO : RATE D - DC]+[SCHLO : RATE D - THERAPY]+[SCHLO : RATE D -
SS]+[SCHLO : RATE D - OP]+[SCHLO : RATE D - PR]+[SCHLO : RATE D - FA]+[SCHLO : RATE D -
VR]+[SCHLO : RATE D - Total Rate Hold Harmless AJE]
[SCHLO : RATE E - TOTAL]=[SCHLO : RATE E - DC]+[SCHLO : RATE E - THERAPY]+[SCHLO : RATE E -
SS]+[SCHLO : RATE E - OP]+[SCHLO : RATE E - PR]+[SCHLO : RATE E - FA]+[SCHLO : RATE E -
VR]+[SCHLO : RATE E - Total Rate Hold Harmless AJE]
[SCHLO : RATE A - TOTAL Rate times Days]=[SCHLO : RATE A - DC Rate times Days]+[SCHLO : RATE A -
THERAPY Rate times Days]+[SCHLO : RATE A - SS Rate times Days]+[SCHLO : RATE A - OP Rate times
Days]+[SCHLO : RATE A - PR Rate times Days]+[SCHLO : RATE A - FA Rate times Days]+[SCHLO : RATE A -
VR Rate Times Days]+[SCHLO : RATE A - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : RATE B - TOTAL Rate times Days]=[SCHLO : RATE B - DC Rate times Days]+[SCHLO : RATE B -
THERAPY Rate times Days]+[SCHLO : RATE B - SS Rate times Days]+[SCHLO : RATE B - OP Rate times
Days]+[SCHLO : RATE B - PR Rate times Days]+[SCHLO : RATE B - FA Rate times Days]+[SCHLO : RATE B -
VR Rate Times Days]+[SCHLO : RATE B - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : RATE C - TOTAL Rate times Days]=[SCHLO : RATE C - DC Rate times Days]+[SCHLO : RATE C -
THERAPY Rate times Days]+[SCHLO : RATE C - SS Rate times Days]+[SCHLO : RATE C - OP Rate times
Days]+[SCHLO : RATE C - PR Rate times Days]+[SCHLO : RATE C - FA Rate times Days]+[SCHLO : RATE C -
VR Rate Times Days]+[SCHLO : RATE C - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : RATE D - TOTAL Rate times Days]=[SCHLO : RATE D - DC Rate times Days]+[SCHLO : RATE D -
THERAPY Rate times Days]+[SCHLO : RATE D - SS Rate times Days]+[SCHLO : RATE D - OP Rate times
Days]+[SCHLO : RATE D - PR Rate times Days]+[SCHLO : RATE D - FA Rate times Days]+[SCHLO : RATE D -
VR Rate Times Days]+[SCHLO : RATE D - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : RATE E - TOTAL Rate times Days]=[SCHLO : RATE E - DC Rate times Days]+[SCHLO : RATE E -
THERAPY Rate times Days]+[SCHLO : RATE E - SS Rate times Days]+[SCHLO : RATE E - OP Rate times
Days]+[SCHLO : RATE E - PR Rate times Days]+[SCHLO : RATE E - FA Rate times Days]+[SCHLO : RATE E -
VR Rate Times Days]+[SCHLO : RATE E - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : TOTAL - TOTAL Rate times Days]=[SCHLO : TOTAL - DC Rate times Days]+[SCHLO : TOTAL -
THERAPY Rate times Days]+[SCHLO : TOTAL - SS Rate times Days]+[SCHLO : TOTAL - OP Rate times
Days]+[SCHLO : TOTAL - PR Rate times Days]+[SCHLO : TOTAL - FA Rate times Days]+[SCHLO : TOTAL - VR
Rate Times Days]+[SCHLO : TOTAL - Total Rate Hold Harmless AJE Rate Times Days]
[SCHLO : Total Rate Hold Harmless AJE-Medicaid Patient Days]=[SCHLN : Total Medicaid Days less Swing Bed
Days]
ROUND([SCHLO : Total Rate Hold Harmless AJE-Weighted Rate],4)=round([SCHLO : TOTAL - Total Rate Hold
Harmless AJE Rate Times Days]/[SCHLO : Total Rate Hold Harmless AJE-Medicaid Patient Days],4)
[SCHLO : Total Rate Hold Harmless AJE Weighted Rate]=[SCHLO : Total Rate Hold Harmless AJE-Weighted
Rate]
[SCHLO : Total Rate Hold Harmless AJE Lower Cost or Rate]=[SCHLO : Total Rate Hold Harmless AJE
Weighted Rate]
[SCHLO : Total Rate Hold Harmless AJE-PS RATE]=[SCHLO : Total Rate Hold Harmless AJE Lower Cost or
Rate]
IF([SCHLG7 : Physical Therapy One-On-One Cost Per Unit]>0,(ABS(([SCHLG7 : Physical Therapy One-On-One
Cost Per Unit]-([SCHLG7 : Physical-One-On-One Expenses]/[SCHLG7 : Total Direct One-On-One Therapy Units -
Physical Therapy]))))<1,[SCHLG7 : Physical Therapy One-On-One Cost Per Unit]=0)
IF([SCHLG7 : Speech Therapy One-On-One Cost Per Unit]>0,(ABS(([SCHLG7 : Speech Therapy One-On-One
Cost Per Unit]-([SCHLG7 : Speech-One-On-One Expenses]/[SCHLG7 : Total Direct One-On-One Therapy Units -
Speech Therapy]))))<1,[SCHLG7 : Speech Therapy One-On-One Cost Per Unit]=0)
IF([SCHLG7 : Occupational Therapy One-On-One Cost Per Unit]>0,(ABS(([SCHLG7 : Occupational Therapy One-
On-One Cost Per Unit]-([SCHLG7 : Occupational-One-On-One Expenses]/[SCHLG7 : Total Direct One-On-One
Therapy Units - Occupational Therapy]))))<1,[SCHLG7 : Occupational Therapy One-On-One Cost Per Unit]=0)
IF([SCHLG7 : Other Therapy One-On-One Cost Per Unit]>0,(ABS(([SCHLG7 : Other Therapy One-On-One Cost
Per Unit]-([SCHLG7 : Other-One-On-One Expenses]/[SCHLG7 : Total Direct One-On-One Therapy Units - Other
Therapy]))))<1,[SCHLG7 : Other Therapy One-On-One Cost Per Unit]=0)
IF(AND([SCHLG : Physical Therapy Salaries-Column 5]<>0,[SCHLG : Physical Therapy Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Physical Therapy Salaries-Column 5]=0,[SCHLG : Physical Therapy Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Speech Therapy Salaries-Column 5]<>0,[SCHLG : Speech Therapy Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Speech Therapy Salaries-Column 5]=0,[SCHLG : Speech Therapy Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Occupational Therapy Salaries-Column 5]<>0,[SCHLG : Occupational Therapy Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Occupational Therapy Salaries-Column 5]=0,[SCHLG : Occupational Therapy
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Other Therapy Salaries-Column 5]<>0,[SCHLG : Other Therapy Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Other Therapy Salaries-Column 5]=0,[SCHLG : Other Therapy Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : In-House Mental Health-Column 5]<>0,[SCHLG : Mental Health hours-Column
6]<>0),TRUE,IF(AND([SCHLG : In-House Mental Health-Column 5]=0,[SCHLG : Mental Health hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Exceptional Care Salaries-Column 5]<>0,[SCHLG : Exceptional Care Therapy Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Exceptional Care Salaries-Column 5]=0,[SCHLG : Exceptional Care Therapy
Hours-Column 6]=0),TRUE,"---FALSE---"))
IF([SCHLN : MEDICAID EXCEPTIONAL CARE DAYS]>=0,TRUE,"---FALSE---")
IF([SCHLN : Licensed Beds]>=0,TRUE,"---FALSE---")
IF([SCHLN : Set-Up Beds]>=0,TRUE,"---FALSE---")
IF([SCHLN : Maximum Patient Days]>=0,TRUE,"---FALSE---")
IF([SCHLN : Percent Occupancy]>=0,TRUE,"---FALSE---")
IF([SCHLN : HOLD ROOM DAYS]>=0,TRUE,"---FALSE---")
IF([SCHLN : SWING BED DAYS]>=0,TRUE,"---FALSE---")
IF([SCHLN : SOCIAL LEAVE DAYS]>=0,TRUE,"---FALSE---")
IF([SCHLN : RESPITE DAYS]>=0,TRUE,"---FALSE---")
IF([SCHLN : NUMBER OF SWING BEDS]>=0,TRUE,"---FALSE---")
IF([SCHLN : Hospice Days]>=0,TRUE,"---FALSE---")
IF([SCHLG : Land Purchase Price-Column 2]>0, TRUE, FALSE)
IF([SCHLG : Building Purchase Price-Column 2]>=0, TRUE, FALSE)
IF([SCHLG : Equipment Purchase Price-Column 2]>=0, TRUE, FALSE)
IF([SCHLG : Other Purchase Price-Column 2]>=0, TRUE, FALSE)
IF([SCHLG : Total Purchase Price-Column 2]>=0, TRUE, FALSE)
IF([SCHLG : Land - Date of Purchase]>0,TRUE, FALSE)
IF(AND([SCHLG : Laundry Salaries-Column 4]<>0,[SCHLG : In-House Laundry Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Laundry Salaries-Column 4]=0,[SCHLG : In-House Laundry Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Housekeeping Salaries-Column 4]<>0,[SCHLG : In-House Housekeeping Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Housekeeping Salaries-Column 4]=0,[SCHLG : In-House Housekeeping Hours-
Column 6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLG : Dietary Salaries-Column 4]<>0,[SCHLG : In-House Dietary Hours-Column
6]<>0),TRUE,IF(AND([SCHLG : Dietary Salaries-Column 4]=0,[SCHLG : In-House Dietary Hours-Column
6]=0),TRUE,"---FALSE---"))
IF(AND([SCHLO : RATE F - DC]<>0,[SCHLO : RATE F - Paid Medicaid Days]<>0),TRUE,IF(AND([SCHLO :
RATE F - DC]=0,[SCHLO : RATE F - Paid Medicaid Days]=0),TRUE,"---FALSE---"))
IF(AND([SCHLO : RATE G - DC]<>0,[SCHLO : RATE G - Paid Medicaid Days]<>0),TRUE,IF(AND([SCHLO :
RATE G - DC]=0,[SCHLO : RATE G - Paid Medicaid Days]=0),TRUE,"---FALSE---"))
IF(AND([SCHLO : RATE H - DC]<>0,[SCHLO : RATE H - Paid Medicaid Days]<>0),TRUE,IF(AND([SCHLO :
RATE H - DC]=0,[SCHLO : RATE H - Paid Medicaid Days]=0),TRUE,"---FALSE---"))
IF(AND([SCH_L : TOTAL NUMBER OF FT DIRECT CARE EMPLOYEES WHO WERE EMPLOYED AT
BEGINNING OF YEAR]<>0,[SCH_L : TOTAL NUMBER OF FT DIRECT CARE EMPLOYEES WHO WORKED
THE ENTIRE YEAR]<>0,[SCH_L : FT DIRECT CARE EMPLOYEE RETENTION RATIO]>0),TRUE,"---FALSE---
")
IF(AND([SCH_L : TOTAL NUMBER OF FT DIRECT CARE EMPLOYEES WHO WERE EMPLOYED AT
BEGINNING OF YEAR]<>0,[SCH_L : TOTAL NUMBER OF DIRECT CARE EMPLOYEES TERMINATED
ANYTIME DURING THE YEAR]<>0,[SCH_L : FT DIRECT CARE EMPLOYEE TURNOVER RATIO]>0),TRUE,"---
FALSE---")
IF(AND([SCHLA : Home Office or Corporate Name]<>"",[SCHG2HO1 : TOTAL OF ALL TOTAL ALLOCATED
COSTS]<>0),TRUE,"---FALSE---")
IF([National Provider Number]<> "", TRUE,"--- FALSE---")
Ken This is the End of the Math Edits--Do Not Go Below This Line
Math Edit Formula using Range Names
[C7055]=[C1110]+[C1120]+[C1130]+[C1140]+[C1150]+[C1160
]+[C1170]+[C1180]+[C1190]+[C1220]+[C1230]
if([C26]>=40544,true,"---FALSE---")
if([C27]<=40908,true,"---FALSE---")
IF(AND([C27]<>0,[C901568]<>0),TRUE,IF(AND([C27]=0,[C90
1568]=0),TRUE,"---FALSE---"))
IF(AND([C901568]<>0,[C901569]<>0),TRUE,IF(AND([C90156
8]=0,[C901569]=0),TRUE,"---FALSE---"))
IF(AND([C901569]<>0,[C901670]<>0),TRUE,IF(AND([C90156
9]=0,[C901670]=0),TRUE,"---FALSE---"))
IF(AND([C901568]<>0,[C901684]<>0),TRUE,IF(AND([C90156
8]=0,[C901684]=0),TRUE,"---FALSE---"))
IF(AND([C901568]<>0,[C901684]<>0),TRUE,IF(AND([C90156
8]=0,[C901684]=0),TRUE,"---FALSE---"))
[C1400]=[C957]+[C968]-[C990]
[C1401]=[C958]+[C969]-[C991]
[C1402]=[C959]+[C970]-[C992]
[C1403]=[C960]+[C971]-[C993]
[C1404]=[C961]+[C972]-[C994]
[C1405]=[C962]+[C973]-[C995]
[C1406]=[C963]+[C974]-[C996]
[C1407]=[C964]+[C975]-[C997]
[C1408]=[C966]+[C977]-[C998]
[C1409]=[C967]+[C978]-[C7000]
[C967]=[C957]+[C958]+[C959]+[C960]+[C961]+[C962]+[C963]
+[C964]+[C966]
[C978]=[C968]+[C969]+[C970]+[C971]+[C972]+[C973]+[C974]
+[C975]+[C977]
[C7000]=[C990]+[C991]+[C992]+[C993]+[C994]+[C995]+[C99
6]+[C997]+[C998]
[C1409]=[C1400]+[C1401]+[C1402]+[C1403]+[C1404]+[C1405
]+[C1406]+[C1407]+[C1408]
[C1601]=[C927]+[C937]-[C947]
[C1602]=[C928]+[C938]-[C948]
[C1603]=[C929]+[C939]-[C949]
[C1604]=[C930]+[C940]-[C950]
[C1605]=[C931]+[C941]-[C951]
[C1606]=[C932]+[C942]-[C952]
[C1607]=[C933]+[C943]-[C953]
[C1608]=[C935]+[C945]-[C955]
[C1609]=[C936]+[C946]-[C956]
[C1609]=[C1601]+[C1602]+[C1603]+[C1604]+[C1605]+[C1606
]+[C1607]+[C1608]
[C41400]=[C934]+[C944]-[C954]
[C936]=[C927]+[C928]+[C929]+[C930]+[C931]+[C932]+[C933]
+[C935]
[C946]=[C937]+[C938]+[C939]+[C940]+[C941]+[C942]+[C943]
+[C945]
[C956]=[C947]+[C948]+[C949]+[C950]+[C951]+[C952]+[C953]
+[C955]
[C934]=[C967]+[C936]
[C944]=[C978]+[C946]
[C954]=[C7000]+[C956]
[C41400]=[C1409]+[C1609]
[C7079]=[C934]+[C7076]+[C7077]+[C7078]
[C7057]=[C41400]+[C1470]+[C1480]+[C1680]
[C7058]=[C1810]+[C1820]+[C1830]+[C1840]+[C1850]+[C1860
]
[C7059]=[C7055]+[C7057]+[C7058]
[C7059]=[C7066]
[C7060]=[C2110]+[C2120]+[C2130]+[C2140]+[C2150]+[C2160
]+[C2180]+[C2190]
[C7061]=[C2510]+[C2520]+[C2530]+[C2540]+[C2550]+[C2560
]+[C2570]
[C7065]=[C3110]+[C3120]+[C3130]+[C3200]+[C7062]+[C7063
]+[C3100]+[C3300]+[C3400]
[C7066]=[C7060]+[C7061]+[C7065]
if([C7067]>0,true,"---FALSE---")
[C4100]=[C7045]
[C4200]=[C7046]
[C4400]=[C7047]
[C7692]=[C4500]
[C7051]=[C4100]+[C4200]+[C4400]+[C7692]
[C5300]=[C7044]
[C7052]=[C7022]
[C6200]=[C7010]
[C6400]=[C6500]
[C7053]=[C7052]+[C6200]+[C6400]
[C7693]=[C4600]
[C6600]=[C7005]
[C7054]=[C7051]-[C7053]+[C7693]-[C6600]
[C7054]=[C7007]
[C3511]=[C3502]+[C3534]+[C3504]+[C3505]+[C3506]+[C3507
]+[C3508]+[C3509]+[C3510]
[C3512]=[C3501]+[C3511]
[C3520]=[C3513]+[C3514]+[C3515]+[C3516]+[C3517]+[C3518
]+[C3519]
[C3530]=[C3521]+[C3522]+[C3523]+[C3524]+[C3525]+[C3526
]+[C3527]+[C3528]+[C3529]
[C3531]=[C3512]+[C3520]+[C3530]
[C3533]=[C3531]+[C3532]
if([C3533]=[C900013],true, false)
[C3709]=[C3702]+[C3703]+[C3704]+[C3705]+[C3706]+[C3707
]+[C3708]
[C3716]=[C3710]+[C3711]+[C3712]+[C3713]+[C3714]+[C3715
]
[C7050]=[C3701]+[C3709]-[C3716]
[C7045]=[C4110]+[C4120]+[C4130]+[C4140]
[C7046]=[C4220]+[C4240]+[C4250]+[C4280]+[C4210]+[C4230
]+[C4260]+[C4270]+[C4290]+[C4310]+[C4320]+[C4330]+[C43
40]+[C4355]+[C4360]+[C4375]+[C4380]
[C7047]=[C4410]+[C4420]+[C4430]+[C4440]+[C4450]+[C4460
]+[C4470]+[C4490]
[C4600]=[C4610]+[C4620]+[C4630]+[C4690]
[C7048]=[C7045]+[C7046]+[C7047]+[C4600]+[C4500]
[C7026]=[C511101]+[C511102]+[C511103]+[C511104]+[C511
109]+[C511111]+[C511112]+[C511113]+[C511114]+[C511116
]+[C511117]+[C511118]+[C511120]+[C511121]+[C511122]+[C
511123]+[C511124]+[C511119]
[C5114]=[C511401]+[C511402]+[C511403]+[C511404]+[C511
409]+[C511411]+[C511412]+[C511413]+[C511414]+[C511416
]+[C511417]+[C511418]+[C511419]+[C511420]+[C511421]+[C
511422]+[C511423]+[C511424]
[C5115]=[C511501]+[C511502]+[C511503]+[C511504]+[C511
509]+[C511511]+[C511512]+[C511513]+[C511514]+[C511516
]+[C511517]+[C511518]+[C511519]+[C511520]+[C511521]+[C
511522]+[C511523]+[C511524]
[C812]=[C676]+[C684]+[C692]+[C700]+[C740]+[C756]+[C764]
+[C772]+[C780]+[C1501]+[C1509]+[C1517]+[C1525]+[C1533]
+[C1541]+[C1549]+[C1557]+[C1565]
IF(AND([C676]<>0,[C684]<>0,[C692]<>0,[C700]<>0),[C51110
1]/[C676]>[C511102]/[C684]>[C511103]/[C692]>[C511104]/[C
700],"---FALSE---")
IF(AND([C511101]<>0,[C676]<>0),TRUE,IF(AND([C511101]=
0,[C676]=0),TRUE,"---FALSE---"))
IF(AND([C511102]<>0,[C684]<>0),TRUE,IF(AND([C511102]=
0,[C684]=0),TRUE,"---FALSE---"))
IF(AND([C511103]<>0,[C692]<>0),TRUE,IF(AND([C511103]=
0,[C692]=0),TRUE,"---FALSE---"))
IF(AND([C511104]<>0,[C700]<>0),TRUE,IF(AND([C511104]=
0,[C700]=0),TRUE,"---FALSE---"))
IF(AND([C511404]<>0,[C702]<>0),TRUE,IF(AND([C511404]=
0,[C702]=0),TRUE,"---FALSE---"))
IF(AND([C511109]<>0,[C740]<>0),TRUE,IF(AND([C511109]=
0,[C740]=0),TRUE,"---FALSE---"))
IF(AND([C511111]<>0,[C756]<>0),TRUE,IF(AND([C511111]=
0,[C756]=0),TRUE,"---FALSE---"))
IF(AND([C511112]<>0,[C764]<>0),TRUE,IF(AND([C511112]=
0,[C764]=0),TRUE,"---FALSE---"))
IF(AND([C511113]<>0,[C772]<>0),TRUE,IF(AND([C511113]=
0,[C772]=0),TRUE,"---FALSE---"))
IF(AND([C511114]<>0,[C780]<>0),TRUE,IF(AND([C511114]=
0,[C780]=0),TRUE,"---FALSE---"))
IF(AND([C511116]<>0,[C1501]<>0),TRUE,IF(AND([C511116]
=0,[C1501]=0),TRUE,"---FALSE---"))
IF(AND([C511117]<>0,[C1509]<>0),TRUE,IF(AND([C511117]
=0,[C1509]=0),TRUE,"---FALSE---"))
IF(AND([C511118]<>0,[C1517]<>0),TRUE,IF(AND([C511118]
=0,[C1517]=0),TRUE,"---FALSE---"))
IF(AND([C511120]<>0,[C1525]<>0),TRUE,IF(AND([C511120]
=0,[C1525]=0),TRUE,"---FALSE---"))
IF(AND([C511121]<>0,[C1533]<>0),TRUE,IF(AND([C511121]
=0,[C1533]=0),TRUE,"---FALSE---"))
IF(AND([C511122]<>0,[C1541]<>0),TRUE,IF(AND([C511122]
=0,[C1541]=0),TRUE,"---FALSE---"))
IF(AND([C511123]<>0,[C1549]<>0),TRUE,IF(AND([C511123]
=0,[C1549]=0),TRUE,"---FALSE---"))
IF(AND([C511124]<>0,[C1557]<>0),TRUE,IF(AND([C511124]
=0,[C1557]=0),TRUE,"---FALSE---"))
IF(AND([C511119]<>0,[C1565]<>0),TRUE,IF(AND([C511119]
=0,[C1565]=0),TRUE,"---FALSE---"))
IF(AND([C511401]<>0,[C678]<>0),TRUE,IF(AND([C511401]=
0,[C678]=0),TRUE,"---FALSE---"))
IF(AND([C511402]<>0,[C686]<>0),TRUE,IF(AND([C511402]=
0,[C686]=0),TRUE,"---FALSE---"))
IF(AND([C511403]<>0,[C694]<>0),TRUE,IF(AND([C511403]=
0,[C694]=0),TRUE,"---FALSE---"))
IF(AND([C511404]<>0,[C702]<>0),TRUE,IF(AND([C511404]=
0,[C702]=0),TRUE,"---FALSE---"))
IF(AND([C511409]<>0,[C742]<>0),TRUE,IF(AND([C511409]=
0,[C742]=0),TRUE,"---FALSE---"))
IF(AND([C511413]<>0,[C774]<>0),TRUE,IF(AND([C511413]=
0,[C774]=0),TRUE,"---FALSE---"))
IF(AND([C511414]<>0,[C782]<>0),TRUE,IF(AND([C511414]=
0,[C782]=0),TRUE,"---FALSE---"))
IF(AND([C511416]<>0,[C1503]<>0),TRUE,IF(AND([C511416]
=0,[C1503]=0),TRUE,"---FALSE---"))
IF(AND([C511417]<>0,[C1511]<>0),TRUE,IF(AND([C511417]
=0,[C1511]=0),TRUE,"---FALSE---"))
IF(AND([C511418]<>0,[C1519]<>0),TRUE,IF(AND([C511418]
=0,[C1519]=0),TRUE,"---FALSE---"))
IF(AND([C511419]<>0,[C1527]<>0),TRUE,IF(AND([C511419]
=0,[C1527]=0),TRUE,"---FALSE---"))
IF(AND([C511420]<>0,[C1535]<>0),TRUE,IF(AND([C511420]
=0,[C1535]=0),TRUE,"---FALSE---"))
IF(AND([C511421]<>0,[C1543]<>0),TRUE,IF(AND([C511421]
=0,[C1543]=0),TRUE,"---FALSE---"))
IF(AND([C511422]<>0,[C1551]<>0),TRUE,IF(AND([C511422]
=0,[C1551]=0),TRUE,"---FALSE---"))
IF(AND([C511423]<>0,[C1559]<>0),TRUE,IF(AND([C511423]
=0,[C1559]=0),TRUE,"---FALSE---"))
IF(AND([C511424]<>0,[C1567]<>0),TRUE,IF(AND([C511424]
=0,[C1567]=0),TRUE,"---FALSE---"))
IF(AND([C511501]<>0,[C680]<>0),TRUE,IF(AND([C511501]=
0,[C680]=0),TRUE,"---FALSE---"))
IF(AND([C511502]<>0,[C688]<>0),TRUE,IF(AND([C511502]=
0,[C688]=0),TRUE,"---FALSE---"))
IF(AND([C511503]<>0,[C696]<>0),TRUE,IF(AND([C511503]=
0,[C696]=0),TRUE,"---FALSE---"))
IF(AND([C511504]<>0,[C704]<>0),TRUE,IF(AND([C511504]=
0,[C704]=0),TRUE,"---FALSE---"))
IF(AND([C511509]<>0,[C744]<>0),TRUE,IF(AND([C511509]=
0,[C744]=0),TRUE,"---FALSE---"))
IF(AND([C511511]<>0,[C760]<>0),TRUE,IF(AND([C511511]=
0,[C760]=0),TRUE,"---FALSE---"))
IF(AND([C511512]<>0,[C768]<>0),TRUE,IF(AND([C511512]=
0,[C768]=0),TRUE,"---FALSE---"))
IF(AND([C511513]<>0,[C776]<>0),TRUE,IF(AND([C511513]=
0,[C776]=0),TRUE,"---FALSE---"))
IF(AND([C511514]<>0,[C784]<>0),TRUE,IF(AND([C511514]=
0,[C784]=0),TRUE,"---FALSE---"))
IF(AND([C511516]<>0,[C1505]<>0),TRUE,IF(AND([C511516]
=0,[C1505]=0),TRUE,"---FALSE---"))
IF(AND([C511517]<>0,[C1513]<>0),TRUE,IF(AND([C511517]
=0,[C1513]=0),TRUE,"---FALSE---"))
IF(AND([C511518]<>0,[C1521]<>0),TRUE,IF(AND([C511518]
=0,[C1521]=0),TRUE,"---FALSE---"))
IF(AND([C511519]<>0,[C1529]<>0),TRUE,IF(AND([C511519]
=0,[C1529]=0),TRUE,"---FALSE---"))
IF(AND([C511520]<>0,[C1537]<>0),TRUE,IF(AND([C511520]
=0,[C1537]=0),TRUE,"---FALSE---"))
IF(AND([C511521]<>0,[C1545]<>0),TRUE,IF(AND([C511521]
=0,[C1545]=0),TRUE,"---FALSE---"))
IF(AND([C511522]<>0,[C1553]<>0),TRUE,IF(AND([C511522]
=0,[C1553]=0),TRUE,"---FALSE---"))
IF(AND([C511523]<>0,[C1561]<>0),TRUE,IF(AND([C511523]
=0,[C1561]=0),TRUE,"---FALSE---"))
IF(AND([C511524]<>0,[C1569]<>0),TRUE,IF(AND([C511524]
=0,[C1569]=0),TRUE,"---FALSE---"))
IF(AND([C5115]<>0,[C816]<>0),TRUE,IF(AND([C5115]=0,[C8
16]=0),TRUE,"---FALSE---"))
IF(AND([C625]<50000,[C626]<50000),TRUE,"---FALSE---")
[C7028]=[C5210]+[C5220]
[C7024]=[C541140]+[C541141]+[C541142]+[C541143]+[C541
145]+[C541146]+[C541151]
[C7025]=[C541440]+[C541441]+[C541442]+[C541443]+[C541
445]+[C541446]+[C541450]
[C5415]=[C541540]+[C541541]+[C541542]+[C541543]+[C541
545]+[C541546]+[C541547]+[C5495]+[C5417]+[C5419]
[C7023]=[C541220]+[C541230]+[C5418]+[C5416]+[C5413]+[C
7025]+[C5415]+[C5422]+[C5423]+[C5424]+[C5425]+[C5426]+[
C5428]+[C5429]+[C5431]+[C5434]+[C5436]+[C5437]+[C5438]
+[C5439]+[C9905]+[C7024]+[C5496]+[C5430]
[C868]=[C820]+[C826]+[C832]+[C838]+[C850]+[C856]+[C862]
[C7241]=[C7233]+[C7234]+[C7235]+[C7236]+[C7238]+[C7239
]+[C7240]
[C7254]=[C7246]+[C7247]+[C7248]+[C7249]+[C7251]+[C7252
]+[C7253]
IF(AND([C541140]>0,[C820]>0),TRUE,IF(AND([C541140]=0,[
C820]=0),TRUE,"---FALSE---"))
IF(AND([C541141]>0,[C826]>0),TRUE,IF(AND([C541141]=0,[
C826]=0),TRUE,"---FALSE---"))
IF(AND([C541142]>0,[C832]>0),TRUE,IF(AND([C541142]=0,[
C832]=0),TRUE,"---FALSE---"))
IF(AND([C541143]>0,[C838]>0),TRUE,IF(AND([C541143]=0,[
C838]=0),TRUE,"---FALSE---"))
IF(AND([C541145]>0,[C850]>0),TRUE,IF(AND([C541145]=0,[
C850]=0),TRUE,"---FALSE---"))
IF(AND([C541146]>0,[C856]>0),TRUE,IF(AND([C541146]=0,[
C856]=0),TRUE,"---FALSE---"))
IF(AND([C541151]>0,[C862]>0),TRUE,IF(AND([C541151]=0,[
C862]=0),TRUE,"---FALSE---"))
[C7016]=[C5441]+[C5447]+[C5446]+[C5444]+[C5448]+[C5445
]+[C5443]
[C7017]=[C5451]+[C5457]+[C5456]+[C5454]+[C5458]+[C5455
]+[C5453]
[C7018]=[C5461]+[C5467]+[C5466]+[C5464]+[C5468]+[C5465
]+[C5463]
[C7019]=[C5471]+[C5477]+[C5476]+[C5474]+[C5478]+[C5475
]+[C5473]
[C7020]=[C5481]+[C5482]+[C5483]+[C5484]+[C5485]+[C5486
]+[C5487]+[C5488]
[C7043]=[C5320]+[C5330]+[C5340]+[C5351]+[C5352]+[C5353
]+[C5354]+[C5360]
[C7044]=[C7043]+[C5375]+[C5390]
[C6227]=[C6221]+[C6222]+[C6223]+[C6225]+[C6226]+[C6224
]
[C6247]=[C6241]+[C6242]+[C6243]+[C6245]+[C6246]+[C6244
]
[C6287]=[C6281]+[C6282]+[C6283]+[C6285]+[C6286]+[C6284
]
[C6297]=[C6291]+[C6292]+[C6293]+[C6295]+[C6296]+[C6294
]
[C7014]=[C6321]+[C6327]+[C6326]+[C6324]+[C6325]+[C6323
]
IF([C7014]=0,[C338]=0,[C338]>0)
[C7010]=[C6227]+[C6247]+[C6287]+[C6297]+[C7014]+[C5111
15]+[C6300]+[C6301]+[C511415]+[C511515]+[C6302]
[C6500]=[C6513]+[C6514]+[C6515]+[C6516]+[C6517]+[C6518
]+[C6519]+[C7231]+[C901021]+[C902032]
[C7005]=[C6610]+[C6620]+[C6630]+[C901071]+[C901072]
[C7006]=[C7022]+[C7010]+[C6500]+[C7005]
[C7007]=[C7048]-[C7006]
[C1004]=[C1000]+[C1001]+[C1002]+[C1003]
[C1009]=[C1005]+[C1006]+[C1007]+[C1008]
[C620006]=[C620001]+[C620002]+[C620003]+[C620004]+[C6
20005]
[C620012]=[C620007]+[C620008]+[C620009]+[C620010]+[C6
20011]
[C620018]=[C620013]+[C620014]+[C620015]+[C620016]+[C6
20017]
[C620024]=[C620019]+[C620020]+[C620021]+[C620022]+[C6
20023]
[C620030]=[C620025]+[C620026]+[C620027]+[C620028]+[C6
20029]
[C620036]=[C620031]+[C620032]+[C620033]+[C620034]+[C6
20035]
[C620042]=[C620037]+[C620038]+[C620039]+[C620040]+[C6
20041]
[C620048]=[C620043]+[C620044]+[C620045]+[C620046]+[C6
20047]
[C620043]=[C620001]+[C620007]+[C620013]+[C620019]+[C6
20025]+[C620031]+[C620037]
[C620044]=[C620002]+[C620008]+[C620014]+[C620020]+[C6
20026]+[C620032]+[C620038]
[C620045]=[C620003]+[C620009]+[C620015]+[C620021]+[C6
20027]+[C620033]+[C620039]
[C620046]=[C620004]+[C620010]+[C620016]+[C620022]+[C6
20028]+[C620034]+[C620040]
[C620047]=[C620005]+[C620011]+[C620017]+[C620023]+[C6
20029]+[C620035]+[C620041]
[C620048]=[C620006]+[C620012]+[C620018]+[C620024]+[C6
20030]+[C620036]+[C620042]
ABS(([C620002]*0.20)-[C620049])<1
ABS(([C620008]*0.20)-[C620050])<1
ABS(([C620014]*0.20)-[C620051])<1
ABS((([C620020]+[C620026]+[C620032]+[C620038])*0.20)-
[C620052])<3
[C620053]=[C620001]
[C620054]=[C620007]
[C620055]=[C620013]
[C620056]=[C620019]+[C620025]+[C620031]+[C620037]
[C620057]=[C620049]+[C620053]
[C620058]=[C620050]+[C620054]
[C620059]=[C620051]+[C620055]
[C620070]=[C620052]+[C620056]
IF([C620006],ROUND([C620071],4)=ROUND([C620057]/[C62
0006],4),TRUE)
IF([C620012],ROUND([C620072],4)=ROUND([C620058]/[C62
0012],4),TRUE)
IF([C620018],ROUND([C620073],4)=ROUND([C620059]/[C62
0018],4),TRUE)
IF(([C620024]+[C620030]+[C620036]+[C620042])<>0,ROUND
([C620074],4)=ROUND(([C620070]/([C620024]+[C620030]+[C
620036]+[C620042])),4),TRUE)
ROUND([C620079],0)=ROUND([C620075]*[C620071],0)
ROUND([C620070],0)=ROUND([C620076]*[C620072],0)
ROUND([C620071],0)=ROUND([C620077]*[C620073],0)
ROUND([C620072],0)=ROUND([C620078]*[C620074],0)
[C620073]=[C337]+[C391]
[C620074]=[C337]+[C391]
[C620075]=[C337]+[C391]
[C620076]=[C337]+[C391]
IF([C620073],ROUND([C620077],4)=ROUND([C620079]/[C62
0073],4),"---FALSE---")
IF([C620074],ROUND([C620078],4)=ROUND([C620070]/[C62
0074],4),"---FALSE---")
IF([C620075],ROUND([C620079],4)=ROUND([C620071]/[C62
0075],4),"---FALSE---")
IF([C620076],ROUND([C620080],4)=ROUND([C620072]/[C62
0076],4),"---FALSE---")
[C620081]=[C773078]
[C620082]=[C773078]
[C620083]=[C773078]
[C620084]=[C773078]
ROUND([C620085],0)=ROUND([C620077]*[C620081],0)
ROUND([C620086],0)=ROUND([C620078]*[C620082],0)
ROUND([C620087],0)=ROUND([C620079]*[C620083],0)
ROUND([C620088],0)=ROUND([C620080]*[C620084],0)
[C620093]=[C620085]+[C620089]
[C620094]=[C620086]+[C620090]
[C620095]=[C620087]+[C620091]
[C620096]=[C620088]+[C620092]
[C620097]=[C620093]+[C620094]+[C620095]+[C620096]
[C511110]=[C620097]
[C630166]=[C630093]+[C630103]+[C630113]+[C630123]+[C6
30133]+[C630143]+[C630153]+[C630162]
[C630167]=[C630094]+[C630104]+[C630114]+[C630124]+[C6
30134]+[C630144]+[C630154]+[C630163]
[C630168]=[C630089]+[C630099]+[C630109]+[C630119]+[C6
30129]+[C630139]+[C630149]+[C630164]
[C630169]=[C630095]+[C630105]+[C630115]+[C630125]+[C6
30135]+[C630145]+[C630155]+[C630165]
[C650073]=[C650003]+[C650011]+[C650019]+[C650027]+[C6
50035]+[C650043]+[C650051]+[C650067]
[C650074]=[C650004]+[C650012]+[C650020]+[C650028]+[C6
50036]+[C650044]+[C650052]+[C650068]
[C650075]=[C650005]+[C650013]+[C650021]+[C650029]+[C6
50037]+[C650045]+[C650053]+[C650069]
[C650076]=[C650006]+[C650014]+[C650022]+[C650030]+[C6
50038]+[C650046]+[C650054]+[C650070]
[C1928]=[C901517]+[C1920]+[C1921]+[C1922]+[C1923]+[C19
24]+[C1925]+[C1926]+[C1927]
[C1937]=[C901518]+[C1929]+[C1930]+[C1931]+[C1932]+[C19
33]+[C1934]+[C1935]+[C1936]
[C901528]=[C901519]+[C901520]+[C901521]+[C901522]+[C9
01523]+[C901524]+[C901525]+[C901526]+[C901527]
[C1946]=[C901529]+[C1938]+[C1939]+[C1940]+[C1941]+[C19
42]+[C1943]+[C1944]+[C1945]
[C21400]=[C901530]+[C21420]+[C21430]+[C21440]+[C21451]
+[C21452]+[C21453]+[C21454]+[C21460]
[C1955]=[C1947]+[C1948]+[C1949]+[C1950]+[C1951]+[C1952
]+[C1953]+[C1954]
[C1964]=[C1956]+[C1957]+[C1958]+[C1959]+[C1960]+[C1961
]+[C1962]+[C1963]
[C1973]=[C1965]+[C1966]+[C1967]+[C1968]+[C1969]+[C1970
]+[C1971]+[C1972]
[C21600]=[C21620]+[C21630]+[C21640]+[C21651]+[C21652]+
[C21653]+[C21654]+[C21660]
[C21400]=[C1928]+[C1937]+[C901528]+[C1946]
[C21600]=[C1955]+[C1964]+[C1973]
[C901530]=[C1400]
[C21420]=[C1401]
[C21430]=[C1402]
[C21440]=[C1403]
[C21451]=[C1404]
[C21452]=[C1405]
[C21453]=[C1406]
[C21454]=[C1407]
[C21460]=[C1408]
[C21400]=[C1409]
[C21620]=ABS([C1601])
[C21630]=ABS([C1602])
[C21640]=ABS([C1603])
[C21651]=ABS([C1604])
[C21652]=ABS([C1605])
[C21653]=ABS([C1606])
[C21654]=ABS([C1607])
[C21660]=ABS([C1608])
[C21600]=ABS([C1609])
[C1023]=[C325]
ROUND([C1023],0)=ROUND([C628]-[C1010],0)
ROUND([C1049],0)=ROUND([C629]-[C1036],0)
[C1024]=[C326]
ROUND([C1024],0)=ROUND([C631]-[C1011],0)
ROUND([C1050],0)=ROUND([C632]-[C1037],0)
[C1025]=[C327]
ROUND([C1025],0)=ROUND([C634]-[C1012],0)
ROUND([C1051],0)=ROUND([C635]-[C1038],0)
[C1026]=[C328]
ROUND([C1026],0)=ROUND([C637]-[C1013],0)
ROUND([C1052],0)=ROUND([C638]-[C1039],0)
[C1027]=[C329]
ROUND([C1027],0)=ROUND([C640]-[C1014],0)
ROUND([C1053],0)=ROUND([C641]-[C1040],0)
[C1028]=[C330]
ROUND([C1028],0)=ROUND([C643]-[C1015],0)
ROUND([C1054],0)=ROUND([C644]-[C1041],0)
[C1029]=[C331]
ROUND([C1029],0)=ROUND([C646]-[C1016],0)
ROUND([C1055],0)=ROUND([C647]-[C1042],0)
[C1030]=[C332]
ROUND([C1030],0)=ROUND([C649]-[C1017],0)
ROUND([C1056],0)=ROUND([C650]-[C1043],0)
[C1031]=[C333]
ROUND([C1031],0)=ROUND([C652]-[C1018],0)
ROUND([C1057],0)=ROUND([C653]-[C1044],0)
[C1032]=[C334]
ROUND([C1032],0)=ROUND([C655]-[C1019],0)
ROUND([C1058],0)=ROUND([C656]-[C1045],0)
[C1033]=[C335]
ROUND([C1033],0)=ROUND([C658]-[C1020],0)
ROUND([C1059],0)=ROUND([C659]-[C1046],0)
[C1034]=[C336]
ROUND([C1034],0)=ROUND([C661]-[C1021],0)
ROUND([C1060],0)=ROUND([C662]-[C1047],0)
[C665]=[C8039]
ABS([C673]-
([C628]+[C631]+[C634]+[C637]+[C640]+[C643]+[C646]+[C649
]+[C652]+[C655]+[C658]+[C661]))<13
ABS([C1022]-
([C1010]+[C1011]+[C1012]+[C1013]+[C1014]+[C1015]+[C101
6]+[C1017]+[C1018]+[C1019]+[C1020]+[C1021]))<13
[C1035]=[C337]
[C1035]=[C673]-[C1022]
ABS([C1035]-
([C1023]+[C1024]+[C1025]+[C1026]+[C1027]+[C1028]+[C102
9]+[C1030]+[C1031]+[C1032]+[C1033]+[C1034]))<13
[C674]=[C616]
ABS([C674]-
([C629]+[C632]+[C635]+[C638]+[C641]+[C644]+[C647]+[C650
]+[C653]+[C656]+[C659]+[C662]+[C665]))<13
ABS([C1048]-
([C1036]+[C1037]+[C1038]+[C1039]+[C1040]+[C1041]+[C104
2]+[C1043]+[C1044]+[C1045]+[C1046]+[C1047]))<13
ABS([C1061]-([C674]-[C1048]))<13
ABS([C1061]-
([C1049]+[C1050]+[C1051]+[C1052]+[C1053]+[C1054]+[C105
5]+[C1056]+[C1057]+[C1058]+[C1059]+[C1060]+[C8039]))<13
ABS([C1074]-
([C630]+[C633]+[C636]+[C639]+[C642]+[C645]+[C648]+[C651
]+[C654]+[C657]+[C660]+[C663]))<13
[C431]=[C325]+[C379]+[C392]+[C405]+[C418]
[C432]=[C326]+[C380]+[C393]+[C406]+[C419]
[C433]=[C327]+[C381]+[C394]+[C407]+[C420]
[C434]=[C328]+[C382]+[C395]+[C408]+[C421]
[C435]=[C329]+[C383]+[C396]+[C409]+[C422]
[C436]=[C330]+[C384]+[C397]+[C410]+[C423]
[C437]=[C331]+[C385]+[C398]+[C411]+[C424]
[C438]=[C332]+[C386]+[C399]+[C412]+[C425]
[C439]=[C333]+[C387]+[C400]+[C413]+[C426]
[C440]=[C334]+[C388]+[C401]+[C414]+[C427]
[C441]=[C335]+[C389]+[C402]+[C415]+[C428]
[C442]=[C336]+[C390]+[C403]+[C416]+[C429]
[C337]=[C325]+[C326]+[C327]+[C328]+[C329]+[C330]+[C331]
+[C332]+[C333]+[C334]+[C335]+[C336]
[C391]=[C379]+[C380]+[C381]+[C382]+[C383]+[C384]+[C385]
+[C386]+[C387]+[C388]+[C389]+[C390]
[C404]=[C392]+[C393]+[C394]+[C395]+[C396]+[C397]+[C398]
+[C399]+[C400]+[C401]+[C402]+[C403]
[C417]=[C405]+[C406]+[C407]+[C408]+[C409]+[C410]+[C411]
+[C412]+[C413]+[C414]+[C415]+[C416]
[C430]=[C418]+[C419]+[C420]+[C421]+[C422]+[C423]+[C424]
+[C425]+[C426]+[C427]+[C428]+[C429]
[C773078]=[C431]+[C432]+[C433]+[C434]+[C435]+[C436]+[C
437]+[C438]+[C439]+[C440]+[C441]+[C442]
[C773078]=[C337]+[C391]+[C404]+[C417]+[C430]
[C1092]=[C1080]+[C1081]+[C1082]+[C1083]+[C1084]+[C1085
]+[C1086]+[C1087]+[C1088]+[C1089]+[C1090]+[C1091]
IF(CELL("type",[c27])="l",[C446]=ROUND(([C773078]/([C443]*
(datevalue([C27])-
datevalue([C26])+1))),2),[C446]=ROUND(([C773078]/([C443]*(
[C27]-[C26]+1))),2))
IF(CELL("type",[c27])="l",[C445]=[C443]*(datevalue([C27])-
datevalue([C26]+1)),[C445]=[C443]*([C27]-[C26]+1))
IF([C448],ROUND([C449],4)=ROUND([C447]/[C448],4),"---
FALSE---")
[C449]=[C575]
IF([C453],ROUND([C454],4)=ROUND([C452]/[C453],4),"---
FALSE---")
[C454]=[C581]
IF([C463],ROUND([C464],4)=ROUND([C462]/[C463],4),"---
FALSE---")
[C464]=[C1909]
IF([C502],ROUND([C503],4)=ROUND([C501]/[C502],4),"---
FALSE---")
IF([C458],ROUND([C459],4)=ROUND([C457]/[C458],4),"---
FALSE---")
ABS([C469]-([C449]+[C454]+[C464]+[C503]+[C459]))<4
[C467]=[C447]+[C452]+[C462]+[C501]+[C457]
ABS(ROUND([C520]-([C478]*[C514]),2))<=1
ABS(ROUND([C521]-([C479]*[C515]),2))<=1
ABS(ROUND([C522]-([C480]*[C516]),2))<=1
ABS(ROUND([C523]-([C481]*[C517]),2))<=1
ABS(ROUND([C524]-([C482]*[C518]),2))<=1
ABS(ROUND([C529]-([C484]*[C514]),2))<=1
ABS(ROUND([C530]-([C485]*[C515]),2))<=1
ABS(ROUND([C531]-([C486]*[C516]),2))<=1
ABS(ROUND([C532]-([C487]*[C517]),2))<=1
ABS(ROUND([C533]-([C488]*[C518]),2))<=1
ABS(ROUND([C1289]-([C496]*[C514]),2))<=1
ABS(ROUND([C1290]-([C497]*[C515]),2))<=1
ABS(ROUND([C1291]-([C498]*[C516]),2))<=1
ABS(ROUND([C1292]-([C499]*[C517]),2))<=1
ABS(ROUND([C1293]-([C500]*[C518]),2))<=1
ABS(ROUND([C1900]-([C504]*[C514]),2))<=1
ABS(ROUND([C1901]-([C505]*[C515]),2))<=1
ABS(ROUND([C1902]-([C506]*[C516]),2))<=1
ABS(ROUND([C1903]-([C507]*[C517]),2))<=1
ABS(ROUND([C1904]-([C513]*[C518]),2))<=1
ABS(ROUND([C538]-([C490]*[C514]),2))<=1
ABS(ROUND([C539]-([C491]*[C515]),2))<=1
ABS(ROUND([C540]-([C492]*[C516]),2))<=1
ABS(ROUND([C541]-([C493]*[C517]),2))<=1
ABS(ROUND([C542]-([C494]*[C518]),2))<=1
ABS(ROUND([C1263]-([C1251]*[C514]),2))<=1
ABS(ROUND([C1264]-([C1252]*[C515]),2))<=1
ABS(ROUND([C1265]-([C1253]*[C516]),2))<=1
ABS(ROUND([C1266]-([C1254]*[C517]),2))<=1
ABS(ROUND([C1267]-([C1255]*[C518]),2))<=1
ABS(ROUND([C1269]-([C1257]*[C514]),2))<=1
ABS(ROUND([C1270]-([C1258]*[C515]),2))<=1
ABS(ROUND([C1271]-([C1259]*[C516]),2))<=1
ABS(ROUND([C1272]-([C1260]*[C517]),2))<=1
ABS(ROUND([C1273]-([C1261]*[C518]),2))<=1
[C565]=([C520]+[C529]+[C1289]+[C1900]+[C538]+[C1263]+[C
1269]+[C800527])
[C566]=([C521]+[C530]+[C1290]+[C1901]+[C539]+[C1264]+[C
1270]+[C800528])
[C567]=([C522]+[C531]+[C1291]+[C1902]+[C540]+[C1265]+[C
1271]+[C800529])
ABS([C568]-
([C523]+[C532]+[C1292]+[C1903]+[C541]+[C1266]+[C1272]+[
C800530]))<7
ABS([C569]-
([C524]+[C533]+[C1293]+[C1904]+[C542]+[C1267]+[C1273]+[
C800531]))<7
if([C508]>0,[C1275]>0,if([C508]=0,[C1275]=0,"---FALSE---"))
if([C509]>0,[C1276]>0,if([C509]=0,[C1276]=0,"---FALSE---"))
if([C510]>0,[C1277]>0,if([C510]=0,[C1277]=0,"---FALSE---"))
if([C511]>0,[C1278]>0,if([C511]=0,[C1278]=0,"---FALSE---"))
if([C512]>0,[C1279]>0,if([C512]=0,[C1279]=0,"---FALSE---"))
ABS([C526]-
([C520]+[C521]+[C522]+[C523]+[C524]+[C902069]+[C902078]
+[C902088]))<5
IF([C527],ROUND([C528],4)=ROUND([C526]/[C527],4),"---
FALSE---")
[C528]=[C574]
ABS([C535]-
([C529]+[C530]+[C531]+[C532]+[C533]+[C902070]+[C902079]
+[C902089]))<5
[C537]=[C580]
ABS([C1294]-
([C1289]+[C1290]+[C1291]+[C1292]+[C1293]+[C902071]+[C9
02080]+[C902090]))<5
IF([C1295],ROUND([C1296],4)=ROUND([C1294]/[C1295],4),"--
-FALSE---")
[C1296]=[C1908]
ABS([C1905]-
([C1900]+[C1901]+[C1902]+[C1903]+[C1904]+[C902081]+[C9
02091]+[C902072]))<5
IF([C1906],ROUND([C1907],4)=ROUND([C1905]/[C1906],4),"--
-FALSE---")
[C1907]=[C1914]
ABS([C544]-
([C538]+[C539]+[C540]+[C541]+[C542]+[C902073]+[C902082]
+[C902092]))<5
IF([C545],ROUND([C546],4)=ROUND([C544]/[C545],4),"---
FALSE---")
[C546]=[C586]
ABS([C1281]-
([C1263]+[C1264]+[C1265]+[C1266]+[C1267]+[C902074]+[C9
02083]+[C902093]))<5
IF([C1282],ROUND([C1283],4)=ROUND([C1281]/[C1282],4),"--
-FALSE---")
ABS([C1284]-
([C1269]+[C1270]+[C1271]+[C1272]+[C1273]+[C902075]+[C9
02084]+[C902094]))<5
IF([C1285],ROUND([C1286],4)=ROUND([C1284]/[C1285],4),"--
-FALSE---")
ABS([C598]-([C1283]+[C1286]))<2
ABS([C571]-
([C565]+[C566]+[C567]+[C568]+[C569]+[C902077]+[C902087]
+[C902096]))<5
([C571]=[C526]+[C535]+[C1294]+[C1905]+[C544]+[C1281]+[C
1284]+[C800532])
ABS([C573]-[C528]-[C537]-[C1296]-[C1907]-[C546]-[C1283]-
[C1286]-[C800534])<8
[C573]=[C604]
IF([C580]>[C581],ROUND(ABS([C583]),4)<=ROUND([C580]-
[C581],4),[C583]=0)
[C585]=[C582]+[C584]
IF([C1908]>[C1909],ABS([C1911])<=ROUND([C1908]-
[C1909],4),[C1911]=0)
IF([C1908]<[C1909],IF(([C1909]-
[C1908])<([C1908]*.2),[C1912]<=ROUND([C1909]-
[C1908],4),[C1912]<=([C1908]*.2)),[C1912]=0)
[C1913]=[C1910]+[C1912]
IF([C1914]>[C1915],ABS([C1917])<=ROUND([C1914]-
[C1915],4),[C1917]=0)
IF([C1914]<[C1915],IF(([C1915]-
[C1914])<([C1914]*.2),[C1918]<=ROUND([C1915]-
[C1914],4),[C1918]<=([C1914]*.2)),[C1918]=0)
[C1919]=[C1916]+[C1918]
[C588]=[C591]
IF([C586]>[C587],ABS([C589])<=ROUND([C586]-
[C587],4),[C589]=0)
[C598]=[C600]
[C600]=[C603]
[C604]=[C574]+[C580]+[C1908]+[C1914]+[C586]+[C598]+[C8
00535]
[C605]=[C575]+[C581]+[C1909]+[C1915]+[C587]
[C606]=[C576]+[C582]+[C1910]+[C1916]+[C588]+[C600]+[C8
00536]
[C608]=[C578]+[C584]+[C1912]+[C1918]
[C607]+[C608]=0
[C609]=[C579]+[C585]+[C1913]+[C1919]+[C591]+[C603]+[C8
00537]
[C609]=[C606]+[C608]
[C610]<=[C604]
ROUND([C612],0)=ROUND([C610]*[C611],0)
[C615]=[C612]+[C613]+[C614]
[C617]=[C615]-[C616]
[C622]=0
IF([C625]>0,(ABS(([C625]-([C615]+[C622]-
[C616]))))<1,[C625]=0)
IF([C626]>0,(ABS(([C626]-([C616]-[C615]-
[C622]))))<1,[C626]=0)
[C324]=[C319]+[C320]+[C321]+[C322]+[C323]
[C7089]=[C35320]+[C35330]+[C35340]+[C35350]+[C35360]
[C7690]=[C35381]+[C35382]+[C35383]
[C35300]=[C7089]+[C35370]+[C35375]+[C7690]+[C35390]
[C7099]=[C7090]+[C7091]+[C7092]+[C7093]+[C7094]+[C7095
]+[C7096]+[C7098]
[C31400]=[C31420]+[C31430]+[C31440]+[C31451]+[C31452]+
[C31454]+[C31460]+[C31453]
[C31600]=[C31620]+[C31630]+[C31640]+[C31651]+[C31652]+
[C31653]+[C31654]+[C31660]
IF(and([C431]>0,[C901550]>0),true,IF(and([C431]=0,[C90155
0]=0),true,"---FALSE---"))
IF(and([C432]>0,[C901551]>0),true,IF(and([C432]=0,[C90155
1]=0),true,"---FALSE---"))
IF(and([C433]>0,[C901552]>0),true,IF(and([C433]=0,[C90155
2]=0),true,"---FALSE---"))
IF(and([C434]>0,[C901553]>0),true,IF(and([C434]=0,[C90155
3]=0),true,"---FALSE---"))
IF(and([C435]>0,[C901554]>0),true,IF(and([C435]=0,[C90155
4]=0),true,"---FALSE---"))
IF(and([C436]>0,[C901555]>0),true,IF(and([C436]=0,[C90155
5]=0),true,"---FALSE---"))
IF(and([C437]>0,[C901556]>0),true,IF(and([C437]=0,[C90155
6]=0),true,"---FALSE---"))
IF(and([C438]>0,[C901557]>0),true,IF(and([C438]=0,[C90155
7]=0),true,"---FALSE---"))
IF(and([C439]>0,[C901558]>0),true,IF(and([C439]=0,[C90155
8]=0),true,"---FALSE---"))
IF(and([C440]>0,[C901559]>0),true,IF(and([C440]=0,[C90155
9]=0),true,"---FALSE---"))
IF(and([C441]>0,[C901560]>0),true,IF(and([C441]=0,[C90156
0]=0),true,"---FALSE---"))
IF(and([C442]>0,[C901561]>0),true,IF(and([C442]=0,[C90156
1]=0),true,"---FALSE---"))
[C800517]=[C9900]
[C7052]=[C7022]
[C800518]=[C511110]
[C7052]=[C7052]
[C800519]=[C9901]
[C800520]=[C9902]
[C800500]=[C900350]+[C900394]+[C900422]+[C900482]+[C9
00523]+[C900524]+[C900391]+[C900392]+[C901706]+[C9017
09]+[C901712]
[C800501]=[C900370]+[C900398]+[C900442]+[C900502]+[C9
00526]+[C900527]+[C900395]+[C900396]+[C901707]+[C9017
10]+[C901713]
[C800502]=[C900390]+[C900402]+[C900462]+[C900522]+[C9
00529]+[C900530]+[C900399]+[C900400]+[C901708]+[C9017
11]+[C901714]
[C9900]=[C7026]+[C5117]+[C5116]+[C5118]+[C5114]+[C5115
]+[C5119]+[C5120]+[C5111]+[C5112]+[C5113]
[C800503]=[C900534]+[C900710]+[C900734]+[C900758]+[C8
00511]
[C9901]=[C7028]+[C7017]+[C7018]+[C7019]+[C9903]
[C800506]=[C884]+[C890]+[C896]
[C9905]=[C623]
[C800507]=[C900644]+[C900686]+[C900783]+[C800514]
[C800508]=[C900661]+[C900694]+[C900794]+[C800515]
[C800509]=[C900678]+[C900702]+[C900805]+[C800516]
[C9902]=[C7023]+[C7016]+[C7020]+[C9904]
[C800510]=[C872]+[C878]
[C800541]=[C800545]-[C800540]-[C800546]-[C800547]
[C800542]=[C337]+[C391]
(ROUND([C800541]/[C800542],0)=ROUND([C800543],0))
[C800544]=[C773078]
[C623]=ROUND([C800543]*[C800544],0)
[C508]=[C478]+[C484]+[C496]+[C504]+[C490]+[C1251]+[C12
57]+[C800522]
[C509]=[C479]+[C485]+[C497]+[C505]+[C491]+[C1252]+[C12
58]+[C800523]
[C510]=[C480]+[C486]+[C498]+[C506]+[C492]+[C1253]+[C12
59]+[C800524]
[C511]=[C481]+[C487]+[C499]+[C507]+[C493]+[C1254]+[C12
60]+[C800525]
[C512]=[C482]+[C488]+[C500]+[C513]+[C494]+[C1255]+[C12
61]+[C800526]
[C565]=[C520]+[C529]+[C1289]+[C1900]+[C538]+[C1263]+[C
1269]+[C800527]
[C566]=[C521]+[C530]+[C1290]+[C1901]+[C539]+[C1264]+[C
1270]+[C800528]
[C567]=[C522]+[C531]+[C1291]+[C1902]+[C540]+[C1265]+[C
1271]+[C800529]
[C568]=[C523]+[C532]+[C1292]+[C1903]+[C541]+[C1266]+[C
1272]+[C800530]
[C569]=[C524]+[C533]+[C1293]+[C1904]+[C542]+[C1267]+[C
1273]+[C800531]
[C571]=[C526]+[C535]+[C1294]+[C1905]+[C544]+[C1281]+[C
1284]+[C800532]
[C800533]=[C337]
ROUND([C800534],4)=round([C800532]/[C800533],4)
[C800535]=[C800534]
[C800536]=[C800535]
[C800537]=[C800536]
IF([C800171]>0,(ABS(([C800171]-
([C620075]/[C620101]))))<1,[C800171]=0)
IF([C800172]>0,(ABS(([C800172]-
([C620076]/[C620102]))))<1,[C800172]=0)
IF([C800173]>0,(ABS(([C800173]-
([C620077]/[C620103]))))<1,[C800173]=0)
IF([C800174]>0,(ABS(([C800174]-
([C620078]/[C620104]))))<1,[C800174]=0)
IF(AND([C6221]<>0,[C716]<>0),TRUE,IF(AND([C6221]=0,[C7
16]=0),TRUE,"---FALSE---"))
IF(AND([C6241]<>0,[C724]<>0),TRUE,IF(AND([C6241]=0,[C7
24]=0),TRUE,"---FALSE---"))
IF(AND([C6281]<>0,[C708]<>0),TRUE,IF(AND([C6281]=0,[C7
08]=0),TRUE,"---FALSE---"))
IF(AND([C6291]<>0,[C732]<>0),TRUE,IF(AND([C6291]=0,[C7
32]=0),TRUE,"---FALSE---"))
IF(AND([C511115]<>0,[C733]<>0),TRUE,IF(AND([C511115]=
0,[C733]=0),TRUE,"---FALSE---"))
IF(AND([C6321]<>0,[C1580]<>0),TRUE,IF(AND([C6321]=0,[C
1580]=0),TRUE,"---FALSE---"))
IF([C338]>=0,TRUE,"---FALSE---")
IF([C443]>=0,TRUE,"---FALSE---")
IF([C444]>=0,TRUE,"---FALSE---")
IF([C445]>=0,TRUE,"---FALSE---")
IF([C446]>=0,TRUE,"---FALSE---")
IF([C339]>=0,TRUE,"---FALSE---")
IF([C340]>=0,TRUE,"---FALSE---")
IF([C341]>=0,TRUE,"---FALSE---")
IF([C342]>=0,TRUE,"---FALSE---")
IF([C343]>=0,TRUE,"---FALSE---")
IF([C34301]>=0,TRUE,"---FALSE---")
IF([C1000]>0, TRUE, FALSE)
IF([C1001]>=0, TRUE, FALSE)
IF([C1002]>=0, TRUE, FALSE)
IF([C1003]>=0, TRUE, FALSE)
IF([C1004]>=0, TRUE, FALSE)
IF([C902033]>0,TRUE, FALSE)
IF(AND([C5451]<>0,[C880]<>0),TRUE,IF(AND([C5451]=0,[C8
80]=0),TRUE,"---FALSE---"))
IF(AND([C5461]<>0,[C886]<>0),TRUE,IF(AND([C5461]=0,[C8
86]=0),TRUE,"---FALSE---"))
IF(AND([C5471]<>0,[C892]<>0),TRUE,IF(AND([C5471]=0,[C8
92]=0),TRUE,"---FALSE---"))
IF(AND([C902036]<>0,[C519]<>0),TRUE,IF(AND([C902036]=
0,[C519]=0),TRUE,"---FALSE---"))
IF(AND([C902047]<>0,[C525]<>0),TRUE,IF(AND([C902047]=
0,[C525]=0),TRUE,"---FALSE---"))
IF(AND([C902057]<>0,[C534]<>0),TRUE,IF(AND([C902057]=
0,[C534]=0),TRUE,"---FALSE---"))
IF(AND([C903270]<>0,[C903272]<>0,[C903276]>0),TRUE,"---
FALSE---")
IF(AND([C903270]<>0,[C903271]<>0,[C903277]>0),TRUE,"---
FALSE---")
IF(AND([M11]<>"",[C903143]<>0),TRUE,"---FALSE---")
IF([M903297]<> "", TRUE, FALSE)
Ken This is the End of the Math Edits--Do Not Go Below This
Line
Date
Values -
following year
update
annually
1/1/2011 40,544 40,909 365
12/31/2011 40,908 41,274 366
initMathEd
1/1/2012 TRUE
its
12/31/2012
Accounts Values
C26 C000026
C27 C000027
C223 C000223
C224 C000224
C225 C000225
C226 C000226
C227 C000227
C228 C000228
C229 C000229
C230 C000230
C231 C000231
C232 C000232
C233 C000233
C234 C000234
C235 C000235
C236 C000236
C237 C000237
C239 C000239
C239 C000239
C240 C000240
C241 C000241
C242 C000242
C243 C000243
C244 C000244
C245 C000245
C246 C000246
C247 C000247
C248 C000248
C249 C000249
C250 C000250
C251 C000251
C252 C000252
C253 C000253
C254 C000254
C255 C000255
C256 C000256
C257 C000257
C258 C000258
C259 C000259
C260 C000260
C261 C000261
C262 C000262
C263 C000263
C264 C000264
C265 C000265
C266 C000266
C267 C000267
C268 C000268
C269 C000269
C270 C000270
C271 C000271
C272 C000272
C273 C000273
C274 C000274
C275 C000275
C276 C000276
C277 C000277
C278 C000278
C279 C000279
C280 C000280
C281 C000281
C282 C000282
C283 C000283
C284 C000284
C285 C000285
C286 C000286
C287 C000287
C288 C000288
C289 C000289
C290 C000290
C291 C000291
C292 C000292
C293 C000293
C294 C000294
C295 C000295
C296 C000296
C297 C000297
C298 C000298
C299 C000299
C300 C000300
C301 C000301
C302 C000302
C303 C000303
C304 C000304
C305 C000305
C306 C000306
C307 C000307
C308 C000308
C309 C000309
C310 C000310
C311 C000311
C312 C000312
C313 C000313
C314 C000314
C315 C000315
C316 C000316
C317 C000317
C318 C000318
C319 C000319
C320 C000320
C321 C000321
C322 C000322
C323 C000323
C324 C000324
C325 C000325
C326 C000326
C327 C000327
C328 C000328
C329 C000329
C330 C000330
C331 C000331
C332 C000332
C333 C000333
C334 C000334
C335 C000335
C336 C000336
C337 C000337
C338 C000338
C339 C000339
C340 C000340
C341 C000341
C342 C000342
C343 C000343
C379 C000379
C380 C000380
C381 C000381
C382 C000382
C383 C000383
C384 C000384
C385 C000385
C386 C000386
C387 C000387
C388 C000388
C389 C000389
C390 C000390
C391 C000391
C392 C000392
C393 C000393
C394 C000394
C395 C000395
C396 C000396
C397 C000397
C398 C000398
C399 C000399
C400 C000400
C401 C000401
C402 C000402
C403 C000403
C404 C000404
C405 C000405
C406 C000406
C407 C000407
C408 C000408
C409 C000409
C410 C000410
C411 C000411
C412 C000412
C413 C000413
C414 C000414
C415 C000415
C416 C000416
C417 C000417
C418 C000418
C419 C000419
C420 C000420
C421 C000421
C422 C000422
C423 C000423
C424 C000424
C425 C000425
C426 C000426
C427 C000427
C428 C000428
C429 C000429
C430 C000430
C431 C000431
C432 C000432
C433 C000433
C434 C000434
C435 C000435
C436 C000436
C437 C000437
C438 C000438
C439 C000439
C440 C000440
C441 C000441
C442 C000442
C443 C000443
C444 C000444
C445 C000445
C446 C000446
C447 C000447
C448 C000448
C449 C000449
C452 C000452
C453 C000453
C454 C000454
C457 C000457
C458 C000458
C459 C000459
C462 C000462
C463 C000463
C464 C000464
C467 C000467
C468 C000468
C469 C000469
C472 C000472
C473 C000473
C474 C000474
C475 C000475
C476 C000476
C478 C000478
C479 C000479
C480 C000480
C481 C000481
C482 C000482
C484 C000484
C485 C000485
C486 C000486
C487 C000487
C488 C000488
C490 C000490
C491 C000491
C492 C000492
C493 C000493
C494 C000494
C496 C000496
C497 C000497
C498 C000498
C499 C000499
C500 C000500
C501 C000501
C502 C000502
C503 C000503
C504 C000504
C505 C000505
C506 C000506
C507 C000507
C508 C000508
C509 C000509
C510 C000510
C511 C000511
C512 C000512
C513 C000513
C514 C000514
C515 C000515
C516 C000516
C517 C000517
C518 C000518
C519 C000519
C525 C000525
C534 C000534
C520 C000520
C521 C000521
C522 C000522
C523 C000523
C524 C000524
C526 C000526
C527 C000527
C528 C000528
C529 C000529
C530 C000530
C531 C000531
C532 C000532
C533 C000533
C535 C000535
C536 C000536
C537 C000537
C538 C000538
C539 C000539
C540 C000540
C541 C000541
C542 C000542
C544 C000544
C545 C000545
C546 C000546
C565 C000565
C566 C000566
C567 C000567
C568 C000568
C569 C000569
C571 C000571
C572 C000572
C573 C000573
C574 C000574
C575 C000575
C576 C000576
C578 C000578
C579 C000579
C580 C000580
C581 C000581
C582 C000582
C583 C000583
C584 C000584
C585 C000585
C586 C000586
C587 C000587
C588 C000588
C589 C000589
C591 C000591
C598 C000598
C600 C000600
C603 C000603
C604 C000604
C605 C000605
C606 C000606
C607 C000607
C608 C000608
C609 C000609
C610 C000610
C611 C000611
C612 C000612
C613 C000613
C614 C000614
C615 C000615
C616 C000616
C617 C000617
C619 C000619
C620 C000620
C622 C000622
C623 C000623
C625 C000625
C626 C000626
C628 C000628
C629 C000629
C630 C000630
C631 C000631
C632 C000632
C633 C000633
C634 C000634
C635 C000635
C636 C000636
C637 C000637
C638 C000638
C639 C000639
C640 C000640
C641 C000641
C642 C000642
C643 C000643
C644 C000644
C645 C000645
C646 C000646
C647 C000647
C648 C000648
C649 C000649
C650 C000650
C651 C000651
C652 C000652
C653 C000653
C654 C000654
C655 C000655
C656 C000656
C657 C000657
C658 C000658
C659 C000659
C660 C000660
C661 C000661
C662 C000662
C663 C000663
C665 C000665
C666 C000666
C673 C000673
C674 C000674
C676 C000676
C678 C000678
C680 C000680
C684 C000684
C686 C000686
C688 C000688
C692 C000692
C694 C000694
C696 C000696
C700 C000700
C702 C000702
C704 C000704
C708 C000708
C710 C000710
C712 C000712
C714 C000714
C716 C000716
C718 C000718
C720 C000720
C722 C000722
C724 C000724
C726 C000726
C728 C000728
C730 C000730
C732 C000732
C733 C000733
C734 C000734
C736 C000736
C738 C000738
C740 C000740
C742 C000742
C744 C000744
C756 C000756
C758 C000758
C760 C000760
C764 C000764
C766 C000766
C768 C000768
C772 C000772
C774 C000774
C776 C000776
C780 C000780
C782 C000782
C784 C000784
C812 C000812
C814 C000814
C816 C000816
C820 C000820
C826 C000826
C832 C000832
C838 C000838
C850 C000850
C856 C000856
C862 C000862
C868 C000868
C872 C000872
C874 C000874
C878 C000878
C880 C000880
C884 C000884
C886 C000886
C890 C000890
C892 C000892
C896 C000896
C904 C000904
C927 C000927
C928 C000928
C929 C000929
C930 C000930
C931 C000931
C932 C000932
C933 C000933
C934 C000934
C935 C000935
C936 C000936
C937 C000937
C938 C000938
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C902021 C902021
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C902027 C902027
C902028 C902028
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M902935 M902935
M902936 M902936
M902937 M902937
M902938 M902938
M902939 M902939
M902940 M902940
M902941 M902941
M902942 M902942
M902943 M902943
M902944 M902944
M902945 M902945
M902946 M902946
M902947 M902947
M902948 M902948
M902949 M902949
M902950 M902950
M902951 M902951
M902952 M902952
M902953 M902953
M902954 M902954
M902955 M902955
M902956 M902956
M902957 M902957
M902958 M902958
M902959 M902959
M902960 M902960
M902961 M902961
M902962 M902962
M902963 M902963
M902964 M902964
M902965 M902965
M902966 M902966
M902967 M902967
M902968 M902968
M902969 M902969
M902970 M902970
M902971 M902971
M902972 M902972
M902973 M902973
M902974 M902974
M902975 M902975
M902976 M902976
M902977 M902977
M902978 M902978
M902979 M902979
M902980 M902980
M902981 M902981
M902982 M902982
M902983 M902983
M902984 M902984
M902985 M902985
M902986 M902986
M902987 M902987
M902988 M902988
M902989 M902989
M902990 M902990
M902991 M902991
M902992 M902992
M902993 M902993
M902994 M902994
M902995 M902995
M902996 M902996
M902997 M902997
M902998 M902998
M902999 M902999
M903000 M903000
M903001 M903001
M903002 M903002
M903003 M903003
M903004 M903004
M903005 M903005
M903006 M903006
M903007 M903007
M903008 M903008
M903009 M903009
M903010 M903010
M903011 M903011
M903012 M903012
M903013 M903013
M903014 M903014
M903015 M903015
M903016 M903016
M903017 M903017
M903018 M903018
M903019 M903019
M903020 M903020
M903021 M903021
M903022 M903022
M903023 M903023
M903024 M903024
M903025 M903025
M903026 M903026
M903027 M903027
C903028 C903028
C903029 C903029
C903030 C903030
C903031 C903031
C903032 C903032
C903033 C903033
C903034 C903034
C903035 C903035
C903036 C903036
C903037 C903037
C903038 C903038
C903039 C903039
C903040 C903040
C903041 C903041
C903042 C903042
C903043 C903043
C903044 C903044
C903045 C903045
C903046 C903046
C903047 C903047
C903048 C903048
C903049 C903049
C903050 C903050
C903051 C903051
C903052 C903052
C903053 C903053
C903054 C903054
C903055 C903055
C903056 C903056
C903057 C903057
C903058 C903058
C903059 C903059
C903060 C903060
C903061 C903061
C903062 C903062
C903063 C903063
C903064 C903064
C903065 C903065
C903066 C903066
C903067 C903067
C903068 C903068
C903069 C903069
C903070 C903070
C903071 C903071
C903072 C903072
C903073 C903073
C903074 C903074
C903075 C903075
C903076 C903076
C903077 C903077
C903078 C903078
C903079 C903079
C903080 C903080
C903081 C903081
C903082 C903082
C903083 C903083
C903084 C903084
C903085 C903085
C903086 C903086
C903087 C903087
C903088 C903088
C903089 C903089
C903090 C903090
C903091 C903091
C903092 C903092
C903093 C903093
C903094 C903094
C903095 C903095
C903096 C903096
C903097 C903097
C903098 C903098
C903099 C903099
C903100 C903100
C903101 C903101
C903102 C903102
C903103 C903103
C903104 C903104
C903105 C903105
C903106 C903106
C903107 C903107
C903108 C903108
C903109 C903109
C903110 C903110
C903111 C903111
C903112 C903112
C903113 C903113
C903114 C903114
C903115 C903115
C903116 C903116
C903117 C903117
C903118 C903118
C903119 C903119
C903120 C903120
C903121 C903121
C903122 C903122
C903123 C903123
C903124 C903124
C903125 C903125
C903126 C903126
C903127 C903127
C903128 C903128
C903129 C903129
C903130 C903130
C903131 C903131
C903132 C903132
C903133 C903133
C903134 C903134
C903135 C903135
C903136 C903136
C903137 C903137
C903138 C903138
C903139 C903139
C903140 C903140
C903141 C903141
C903142 C903142
C903143 C903143
C903144 C903144
C903145 C903145
C903146 C903146
C903147 C903147
C903148 C903148
C903149 C903149
C903150 C903150
C903151 C903151
C903152 C903152
C903153 C903153
C903154 C903154
C903155 C903155
C903156 C903156
C903157 C903157
C903158 C903158
C903159 C903159
C903160 C903160
C903161 C903161
C903162 C903162
C903163 C903163
C903164 C903164
C903165 C903165
C903166 C903166
C903167 C903167
C903168 C903168
C903169 C903169
C903170 C903170
C903171 C903171
C903172 C903172
C903173 C903173
C903174 C903174
C903175 C903175
C903176 C903176
C903177 C903177
C903178 C903178
C903179 C903179
C903180 C903180
C903181 C903181
C903182 C903182
C903183 C903183
C903184 C903184
C903185 C903185
C903186 C903186
C903187 C903187
C903188 C903188
C903189 C903189
C903190 C903190
C903191 C903191
C903192 C903192
C903193 C903193
C903194 C903194
C903195 C903195
C903196 C903196
C903197 C903197
C903198 C903198
C903199 C903199
C903200 C903200
C903201 C903201
C903202 C903202
C903203 C903203
C903204 C903204
C903205 C903205
C903206 C903206
C903207 C903207
C903208 C903208
C903209 C903209
C903210 C903210
C903211 C903211
C903212 C903212
C903213 C903213
C903214 C903214
C903215 C903215
C903216 C903216
C903217 C903217
C903218 C903218
C903219 C903219
C903220 C903220
C903221 C903221
C903222 C903222
C903223 C903223
C903224 C903224
C903225 C903225
C903226 C903226
C903227 C903227
C903228 C903228
C903229 C903229
C903230 C903230
C903231 C903231
C903232 C903232
C903233 C903233
C903234 C903234
C903235 C903235
C903236 C903236
C903237 C903237
C903238 C903238
C903239 C903239
C903240 C903240
C903241 C903241
C903242 C903242
C903243 C903243
C903244 C903244
C903245 C903245
C903246 C903246
C903247 C903247
C903248 C903248
C903249 C903249
C903250 C903250
C903251 C903251
C903252 C903252
C903253 C903253
C903254 C903254
C903255 C903255
C903256 C903256
C903257 C903257
C903258 C903258
C903259 C903259
C903260 C903260
C903261 C903261
C903262 C903262
C903263 C903263
C903264 C903264
C903265 C903265
C903266 C903266
C903267 C903267
C903268 C903268
C903269 C903269
C903270 C903270
C903271 C903271
C903272 C903272
C903273 C903273
C903274 C903274
C903275 C903275
C903276 C903276
C903277 C903277
M1 M000001
M2 M000002
M3 M000003
M4 M000004
M5 M000005
M6 M000006
M7 M000007
M8 M000008
M10 M000010
M11 M000011
M13 M000013
M14 M000014
M15 M000015
M16 M000016
M17 M000017
M18 M000018
M19 M000019
M20 M000020
M21 M000021
M22 M000022
M23 M000023
M24 M000024
M26 M000026
M28 M000028
M29 M000029
M30 M000030
M31 M000031
M32 M000032
M34 M000034
M51 M000051
M52 M000052
M53 M000053
M54 M000054
M55 M000055
M56 M000056
M57 M000057
M58 M000058
M59 M000059
M60 M000060
M61 M000061
M62 M000062
M63 M000063
M64 M000064
M65 M000065
M66 M000066
M67 M000067
M68 M000068
M69 M000069
M70 M000070
M71 M000071
M72 M000072
M73 M000073
M74 M000074
M75 M000075
M76 M000076
M77 M000077
M78 M000078
M79 M000079
M80 M000080
M81 M000081
M82 M000082
M83 M000083
M84 M000084
M85 M000085
M86 M000086
M87 M000087
M88 M000088
M89 M000089
M90 M000090
M91 M000091
M92 M000092
M93 M000093
M94 M000094
M95 M000095
M97 M000097
M98 M000098
M99 M000099
M100 M000100
M101 M000101
M102 M000102
M103 M000103
M104 M000104
M105 M000105
M106 M000106
M107 M000107
M108 M000108
M109 M000109
M110 M000110
M111 M000111
M112 M000112
M113 M000113
M114 M000114
M115 M000115
M116 M000116
M117 M000117
M118 M000118
M119 M000119
M120 M000120
M121 M000121
M122 M000122
M123 M000123
M124 M000124
M126 M000126
M127 M000127
M128 M000128
M129 M000129
M130 M000130
M131 M000131
M132 M000132
M133 M000133
M134 M000134
M135 M000135
M136 M000136
M137 M000137
M138 M000138
M139 M000139
M140 M000140
M141 M000141
M142 M000142
M143 M000143
M144 M000144
M145 M000145
M146 M000146
M147 M000147
M148 M000148
M149 M000149
M150 M000150
M151 M000151
M152 M000152
M153 M000153
M154 M000154
M155 M000155
M156 M000156
M157 M000157
M158 M000158
M159 M000159
M160 M000160
M161 M000161
M162 M000162
M163 M000163
M164 M000164
M165 M000165
M166 M000166
M167 M000167
M168 M000168
M169 M000169
M170 M000170
M171 M000171
M172 M000172
M173 M000173
M174 M000174
M175 M000175
M176 M000176
M177 M000177
M178 M000178
M179 M000179
M180 M000180
M181 M000181
M182 M000182
M184 M000184
M185 M000185
M186 M000186
M187 M000187
M188 M000188
M189 M000189
M190 M000190
M191 M000191
M192 M000192
M193 M000193
M194 M000194
M195 M000195
M196 M000196
M197 M000197
M198 M000198
M199 M000199
M200 M000200
M201 M000201
M202 M000202
M203 M000203
M204 M000204
M205 M000205
M206 M000206
M207 M000207
M208 M000208
M209 M000209
M210 M000210
M211 M000211
M212 M000212
M213 M000213
M214 M000214
M215 M000215
M216 M000216
M217 M000217
M218 M000218
M219 M000219
M220 M000220
M221 M000221
M222 M000222
M223 M000223
M224 M000224
M225 M000225
M226 M000226
M227 M000227
M228 M000228
M229 M000229
M230 M000230
M231 M000231
M232 M000232
M233 M000233
M234 M000234
M235 M000235
M236 M000236
M237 M000237
M238 M000238
M239 M000239
M240 M000240
M241 M000241
M242 M000242
M243 M000243
M244 M000244
M245 M000245
M246 M000246
M247 M000247
M248 M000248
M249 M000249
M250 M000250
M251 M000251
M252 M000252
M253 M000253
M254 M000254
M255 M000255
M256 M000256
M257 M000257
M258 M000258
M259 M000259
M260 M000260
M261 M000261
M262 M000262
M263 M000263
M264 M000264
M265 M000265
M266 M000266
M267 M000267
M268 M000268
M269 M000269
M270 M000270
M271 M000271
M272 M000272
M273 M000273
M274 M000274
M275 M000275
M276 M000276
M277 M000277
M278 M000278
M279 M000279
M280 M000280
M281 M000281
M282 M000282
M283 M000283
M284 M000284
M285 M000285
M286 M000286
M287 M000287
M288 M000288
M289 M000289
M290 M000290
M291 M000291
M292 M000292
M293 M000293
M294 M000294
M295 M000295
M296 M000296
M297 M000297
M298 M000298
M299 M000299
M300 M000300
M301 M000301
M302 M000302
M303 M000303
M304 M000304
M305 M000305
M306 M000306
M307 M000307
M308 M000308
M309 M000309
M310 M000310
M311 M000311
M312 M000312
M313 M000313
M314 M000314
M315 M000315
M316 M000316
M317 M000317
M318 M000318
M319 M000319
M320 M000320
M330 M000330
M331 M000331
M332 M000332
M333 M000333
M334 M000334
M335 M000335
M336 M000336
M337 M000337
M338 M000338
M339 M000339
M340 M000340
M341 M000341
M342 M000342
M343 M000343
M344 M000344
M345 M000345
M346 M000346
M347 M000347
M348 M000348
M349 M000349
M350 M000350
M351 M000351
M352 M000352
M353 M000353
M354 M000354
M355 M000355
M356 M000356
M357 M000357
M358 M000358
M359 M000359
M360 M000360
M361 M000361
M362 M000362
M363 M000363
M364 M000364
M365 M000365
M366 M000366
M367 M000367
M368 M000368
M369 M000369
M370 M000370
M371 M000371
M372 M000372
M373 M000373
M374 M000374
M375 M000375
M376 M000376
M377 M000377
M378 M000378
M379 M000379
M380 M000380
M381 M000381
M382 M000382
M383 M000383
M384 M000384
M385 M000385
M386 M000386
M387 M000387
M388 M000388
M389 M000389
M390 M000390
M391 M000391
M392 M000392
M393 M000393
M394 M000394
M395 M000395
M396 M000396
M397 M000397
M398 M000398
M399 M000399
M400 M000400
M401 M000401
M402 M000402
M403 M000403
M404 M000404
M405 M000405
M406 M000406
M407 M000407
M408 M000408
M409 M000409
M410 M000410
M411 M000411
M412 M000412
M413 M000413
M414 M000414
M415 M000415
M416 M000416
M417 M000417
M418 M000418
M419 M000419
M420 M000420
M421 M000421
M422 M000422
M423 M000423
M424 M000424
M425 M000425
M426 M000426
M427 M000427
M428 M000428
M429 M000429
M430 M000430
M431 M000431
M432 M000432
M433 M000433
M434 M000434
M435 M000435
M436 M000436
M437 M000437
M438 M000438
M439 M000439
M440 M000440
M441 M000441
M442 M000442
M443 M000443
M444 M000444
M445 M000445
M446 M000446
M447 M000447
M448 M000448
M449 M000449
M450 M000450
M451 M000451
M452 M000452
M453 M000453
M454 M000454
M455 M000455
M456 M000456
M457 M000457
M458 M000458
M459 M000459
M460 M000460
M461 M000461
M462 M000462
M463 M000463
M464 M000464
M465 M000465
M466 M000466
M467 M000467
M468 M000468
M469 M000469
M470 M000470
M471 M000471
M472 M000472
M473 M000473
M474 M000474
M475 M000475
M476 M000476
M477 M000477
M478 M000478
M479 M000479
M480 M000480
M481 M000481
M482 M000482
M483 M000483
M484 M000484
M485 M000485
M486 M000486
M487 M000487
M488 M000488
M489 M000489
M490 M000490
M500 M000500
M501 M000501
M502 M000502
M600 M000600
M601 M000601
M602 M000602
M603 M000603
M604 M000604
M605 M000605
M606 M000606
M607 M000607
M608 M000608
M609 M000609
M610 M000610
M611 M000611
M612 M000612
M613 M000613
M614 M000614
M615 M000615
M616 M000616
M617 M000617
M618 M000618
M619 M000619
M620 M000620
M621 M000621
M622 M000622
M623 M000623
M624 M000624
M625 M000625
M626 M000626
M627 M000627
M628 M000628
M629 M000629
M630 M000630
M631 M000631
M632 M000632
M633 M000633
M634 M000634
M635 M000635
M636 M000636
M637 M000637
M638 M000638
M639 M000639
M640 M000640
M641 M000641
M642 M000642
M643 M000643
M644 M000644
M645 M000645
M646 M000646
M647 M000647
M648 M000648
M649 M000649
M650 M000650
M651 M000651
M652 M000652
M653 M000653
M654 M000654
M655 M000655
M656 M000656
M657 M000657
M658 M000658
M659 M000659
M660 M000660
M661 M000661
M662 M000662
M663 M000663
M664 M000664
M665 M000665
M666 M000666
M667 M000667
M668 M000668
M669 M000669
M670 M000670
M671 M000671
M903297 M903297
SCHLO C903600
SCHLO C903601
SCHLO C903602
SCHLO C903603
SCHLO C903604
SCHLO C903605
SCHLO C903606
SCHLO C903607
SCHLO C903608
SCHLO C903609
SCHLO C903610
SCHLO C903611
SCHLO C903612
SCHLO C903613
SCHLO C903614
SCHLO C903615
SCHLO C903616
SCHLO C903617
SCHLO C903618
SCHLO C903619
SCHLO C903620
SCHLO C903621
SCHLO C903622
SCHLO C903623
SCHLO C903624
SCHLO C903625
SCHLO C903626
SCHLO C903627
SCHLO C903628
SCHLO C903629
SCHLO C903630
SCHLO C903631
SCHLO C903632
SCHLO C903633
SCHLO C903634
SCHLO C903635
SCHLO C903636
SCHLO C903637
SCHLO C903638
SCHLO C903639
SCHLO C903640
SCHLO C903641
SCHLO C903642
SCHLO C903643
initalize to ---FALSE---
4 0000 =+_C000026
4 0000 =+_C000027
3 000 =+_C000223
3 000 =+_C000224
3 000 =+_C000225
3 000 =+_C000226
3 000 =+_C000227
3 000 =+_C000228
3 000 =+_C000229
3 000 =+_C000230
3 000 =+_C000231
3 000 =+_C000232
3 000 =+_C000233
3 000 =+_C000234
3 000 =+_C000235
3 000 =+_C000236
3 000 =+_C000237
3 000 =+_C000239
3 000 =+_C000239
3 000 =+_C000240
3 000 =+_C000241
3 000 =+_C000242
3 000 =+_C000243
3 000 =+_C000244
3 000 =+_C000245
3 000 =+_C000246
3 000 =+_C000247
3 000 =+_C000248
3 000 =+_C000249
3 000 =+_C000250
3 000 =+_C000251
3 000 =+_C000252
3 000 =+_C000253
3 000 =+_C000254
3 000 =+_C000255
3 000 =+_C000256
3 000 =+_C000257
3 000 =+_C000258
3 000 =+_C000259
3 000 =+_C000260
3 000 =+_C000261
3 000 =+_C000262
3 000 =+_C000263
3 000 =+_C000264
3 000 =+_C000265
3 000 =+_C000266
3 000 =+_C000267
3 000 =+_C000268
3 000 =+_C000269
3 000 =+_C000270
3 000 =+_C000271
3 000 =+_C000272
3 000 =+_C000273
3 000 =+_C000274
3 000 =+_C000275
3 000 =+_C000276
3 000 =+_C000277
3 000 =+_C000278
3 000 =+_C000279
3 000 =+_C000280
3 000 =+_C000281
3 000 =+_C000282
3 000 =+_C000283
3 000 =+_C000284
3 000 =+_C000285
3 000 =+_C000286
3 000 =+_C000287
3 000 =+_C000288
3 000 =+_C000289
3 000 =+_C000290
3 000 =+_C000291
3 000 =+_C000292
3 000 =+_C000293
3 000 =+_C000294
3 000 =+_C000295
3 000 =+_C000296
3 000 =+_C000297
3 000 =+_C000298
3 000 =+_C000299
3 000 =+_C000300
3 000 =+_C000301
3 000 =+_C000302
3 000 =+_C000303
3 000 =+_C000304
3 000 =+_C000305
3 000 =+_C000306
3 000 =+_C000307
3 000 =+_C000308
3 000 =+_C000309
3 000 =+_C000310
3 000 =+_C000311
3 000 =+_C000312
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5 00000=+_M000001
5 00000=+_M000002
5 00000=+_M000003
5 00000=+_M000004
5 00000=+_M000005
5 00000=+_M000006
5 00000=+_M000007
5 00000=+_M000008
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4 0000 =+_M000015
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4 0000 =+_M000017
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4 0000 =+_M000020
4 0000 =+_M000021
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4 0000 =+_M000026
4 0000 =+_M000028
4 0000 =+_M000029
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4 0000 =+_M000031
4 0000 =+_M000032
4 0000 =+_M000034
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4 0000 =+_M000056
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4 0000 =+_M000059
4 0000 =+_M000060
4 0000 =+_M000061
4 0000 =+_M000062
4 0000 =+_M000063
4 0000 =+_M000064
4 0000 =+_M000065
4 0000 =+_M000066
4 0000 =+_M000067
4 0000 =+_M000068
4 0000 =+_M000069
4 0000 =+_M000070
4 0000 =+_M000071
4 0000 =+_M000072
4 0000 =+_M000073
4 0000 =+_M000074
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4 0000 =+_M000076
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4 0000 =+_M000078
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4 0000 =+_M000099
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3 000 =+_M000126
3 000 =+_M000127
3 000 =+_M000128
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3 000 =+_M000156
3 000 =+_M000157
3 000 =+_M000158
3 000 =+_M000159
3 000 =+_M000160
3 000 =+_M000161
3 000 =+_M000162
3 000 =+_M000163
3 000 =+_M000164
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3 000 =+_M000170
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3 000 =+_M000176
3 000 =+_M000177
3 000 =+_M000178
3 000 =+_M000179
3 000 =+_M000180
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3 000 =+_M000185
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3 000 =+_M000187
3 000 =+_M000188
3 000 =+_M000189
3 000 =+_M000190
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3 000 =+_M000226
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3 000 =+_M000230
3 000 =+_M000231
3 000 =+_M000232
3 000 =+_M000233
3 000 =+_M000234
3 000 =+_M000235
3 000 =+_M000236
3 000 =+_M000237
3 000 =+_M000238
3 000 =+_M000239
3 000 =+_M000240
3 000 =+_M000241
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3 000 =+_M000243
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3 000 =+_M000247
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3 000 =+_M000251
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3 000 =+_M000260
3 000 =+_M000261
3 000 =+_M000262
3 000 =+_M000263
3 000 =+_M000264
3 000 =+_M000265
3 000 =+_M000266
3 000 =+_M000267
3 000 =+_M000268
3 000 =+_M000269
3 000 =+_M000270
3 000 =+_M000271
3 000 =+_M000272
3 000 =+_M000273
3 000 =+_M000274
3 000 =+_M000275
3 000 =+_M000276
3 000 =+_M000277
3 000 =+_M000278
3 000 =+_M000279
3 000 =+_M000280
3 000 =+_M000281
3 000 =+_M000282
3 000 =+_M000283
3 000 =+_M000284
3 000 =+_M000285
3 000 =+_M000286
3 000 =+_M000287
3 000 =+_M000288
3 000 =+_M000289
3 000 =+_M000290
3 000 =+_M000291
3 000 =+_M000292
3 000 =+_M000293
3 000 =+_M000294
3 000 =+_M000295
3 000 =+_M000296
3 000 =+_M000297
3 000 =+_M000298
3 000 =+_M000299
3 000 =+_M000300
3 000 =+_M000301
3 000 =+_M000302
3 000 =+_M000303
3 000 =+_M000304
3 000 =+_M000305
3 000 =+_M000306
3 000 =+_M000307
3 000 =+_M000308
3 000 =+_M000309
3 000 =+_M000310
3 000 =+_M000311
3 000 =+_M000312
3 000 =+_M000313
3 000 =+_M000314
3 000 =+_M000315
3 000 =+_M000316
3 000 =+_M000317
3 000 =+_M000318
3 000 =+_M000319
3 000 =+_M000320
3 000 =+_M000330
3 000 =+_M000331
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3 000 =+_M000333
3 000 =+_M000334
3 000 =+_M000335
3 000 =+_M000336
3 000 =+_M000337
3 000 =+_M000338
3 000 =+_M000339
3 000 =+_M000340
3 000 =+_M000341
3 000 =+_M000342
3 000 =+_M000343
3 000 =+_M000344
3 000 =+_M000345
3 000 =+_M000346
3 000 =+_M000347
3 000 =+_M000348
3 000 =+_M000349
3 000 =+_M000350
3 000 =+_M000351
3 000 =+_M000352
3 000 =+_M000353
3 000 =+_M000354
3 000 =+_M000355
3 000 =+_M000356
3 000 =+_M000357
3 000 =+_M000358
3 000 =+_M000359
3 000 =+_M000360
3 000 =+_M000361
3 000 =+_M000362
3 000 =+_M000363
3 000 =+_M000364
3 000 =+_M000365
3 000 =+_M000366
3 000 =+_M000367
3 000 =+_M000368
3 000 =+_M000369
3 000 =+_M000370
3 000 =+_M000371
3 000 =+_M000372
3 000 =+_M000373
3 000 =+_M000374
3 000 =+_M000375
3 000 =+_M000376
3 000 =+_M000377
3 000 =+_M000378
3 000 =+_M000379
3 000 =+_M000380
3 000 =+_M000381
3 000 =+_M000382
3 000 =+_M000383
3 000 =+_M000384
3 000 =+_M000385
3 000 =+_M000386
3 000 =+_M000387
3 000 =+_M000388
3 000 =+_M000389
3 000 =+_M000390
3 000 =+_M000391
3 000 =+_M000392
3 000 =+_M000393
3 000 =+_M000394
3 000 =+_M000395
3 000 =+_M000396
3 000 =+_M000397
3 000 =+_M000398
3 000 =+_M000399
3 000 =+_M000400
3 000 =+_M000401
3 000 =+_M000402
3 000 =+_M000403
3 000 =+_M000404
3 000 =+_M000405
3 000 =+_M000406
3 000 =+_M000407
3 000 =+_M000408
3 000 =+_M000409
3 000 =+_M000410
3 000 =+_M000411
3 000 =+_M000412
3 000 =+_M000413
3 000 =+_M000414
3 000 =+_M000415
3 000 =+_M000416
3 000 =+_M000417
3 000 =+_M000418
3 000 =+_M000419
3 000 =+_M000420
3 000 =+_M000421
3 000 =+_M000422
3 000 =+_M000423
3 000 =+_M000424
3 000 =+_M000425
3 000 =+_M000426
3 000 =+_M000427
3 000 =+_M000428
3 000 =+_M000429
3 000 =+_M000430
3 000 =+_M000431
3 000 =+_M000432
3 000 =+_M000433
3 000 =+_M000434
3 000 =+_M000435
3 000 =+_M000436
3 000 =+_M000437
3 000 =+_M000438
3 000 =+_M000439
3 000 =+_M000440
3 000 =+_M000441
3 000 =+_M000442
3 000 =+_M000443
3 000 =+_M000444
3 000 =+_M000445
3 000 =+_M000446
3 000 =+_M000447
3 000 =+_M000448
3 000 =+_M000449
3 000 =+_M000450
3 000 =+_M000451
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3 000 =+_M000453
3 000 =+_M000454
3 000 =+_M000455
3 000 =+_M000456
3 000 =+_M000457
3 000 =+_M000458
3 000 =+_M000459
3 000 =+_M000460
3 000 =+_M000461
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3 000 =+_M000463
3 000 =+_M000464
3 000 =+_M000465
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3 000 =+_M000467
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3 000 =+_M000470
3 000 =+_M000471
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3 000 =+_M000473
3 000 =+_M000474
3 000 =+_M000475
3 000 =+_M000476
3 000 =+_M000477
3 000 =+_M000478
3 000 =+_M000479
3 000 =+_M000480
3 000 =+_M000481
3 000 =+_M000482
3 000 =+_M000483
3 000 =+_M000484
3 000 =+_M000485
3 000 =+_M000486
3 000 =+_M000487
3 000 =+_M000488
3 000 =+_M000489
3 000 =+_M000490
3 000 =+_M000500
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3 000 =+_M000600
3 000 =+_M000601
3 000 =+_M000602
3 000 =+_M000603
3 000 =+_M000604
3 000 =+_M000605
3 000 =+_M000606
3 000 =+_M000607
3 000 =+_M000608
3 000 =+_M000609
3 000 =+_M000610
3 000 =+_M000611
3 000 =+_M000612
3 000 =+_M000613
3 000 =+_M000614
3 000 =+_M000615
3 000 =+_M000616
3 000 =+_M000617
3 000 =+_M000618
3 000 =+_M000619
3 000 =+_M000620
3 000 =+_M000621
3 000 =+_M000622
3 000 =+_M000623
3 000 =+_M000624
3 000 =+_M000625
3 000 =+_M000626
3 000 =+_M000627
3 000 =+_M000628
3 000 =+_M000629
3 000 =+_M000630
3 000 =+_M000631
3 000 =+_M000632
3 000 =+_M000633
3 000 =+_M000634
3 000 =+_M000635
3 000 =+_M000636
3 000 =+_M000637
3 000 =+_M000638
3 000 =+_M000639
3 000 =+_M000640
3 000 =+_M000641
3 000 =+_M000642
3 000 =+_M000643
3 000 =+_M000644
3 000 =+_M000645
3 000 =+_M000646
3 000 =+_M000647
3 000 =+_M000648
3 000 =+_M000649
3 000 =+_M000650
3 000 =+_M000651
3 000 =+_M000652
3 000 =+_M000653
3 000 =+_M000654
3 000 =+_M000655
3 000 =+_M000656
3 000 =+_M000657
3 000 =+_M000658
3 000 =+_M000659
3 000 =+_M000660
3 000 =+_M000661
3 000 =+_M000662
3 000 =+_M000663
3 000 =+_M000664
3 000 =+_M000665
3 000 =+_M000666
3 000 =+_M000667
3 000 =+_M000668
3 000 =+_M000669
3 000 =+_M000670
3 000 =+_M000671
0 =+_M903297
RATE A - PP
RATE B - PP
RATE C - PP
RATE D - PP
RATE E - PP
RATE F - PP
RATE G - PP
RATE H - PP
RATE A - HT
RATE B - HT
RATE C - HT
RATE D - HT
RATE E - HT
RATE F - HT
RATE G - HT
RATE H - HT
RATE A - PP Rate times Days
RATE B - PP Rate times Days
RATE C - PP Rate times Days
RATE D - PP Rate times Days
RATE E - PP Rate times Days
RATE F - PP Rate times Days
RATE G - PP Rate times Days
RATE H - PP Rate times Days
TOTAL - Pay for Perfomance Add-On Rate times Days
TOTAL - Pay for Performance Add-On Rate -Medicaid Patient Days
TOTAL - Pay for Performance Add-On Rate -Weighted Rate
RATE A - HT Rate times Days
RATE B - HT Rate times Days
RATE C - HT Rate times Days
RATE D - HT Rate times Days
RATE E - HT Rate times Days
RATE F - HT Rate times Days
RATE G - HT Rate times Days
RATE H - HT Rate times Days
TOTAL - High Turnover Add-On Rate times Days
TOTAL - High Turnover Add-On Rate -Medicaid Patient Days
TOTAL - High Turnover Add-On Rate -Weighted Rate
Total Pay for Performance Add-On Rate Weighted Rate
Total Pay for Performance Add-On Rate Lower Cost or Rate
Total Pay for Performance Add-On Rate -PS RATE
Total High Turnover Add-On Rate Weighted Rate
Total High Turnover Add-On Rate Lower Cost or Rate
Total High Turnover Add-On Rate -PS RATE
Filter Criteria
Range
EditFail
0 TRUE
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
#REF!
#REF!
#REF!
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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#REF!
#REF!
#REF!
#REF!
#REF!
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#REF!
#REF!
#REF!
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Unallowable Oxygen
Unallowable Rev Exp. of Lab/X-ray
Unallowable Non Office Equipment Rentals
Unallowable Sole Source Entral Feeding
Unallowable Rev exp. of Barber/Vending/Meals
Unallowable Nursing Pool Non Licensed
Unallowable Bed Hold
Unallowable Professional License Fees
Unallowable Lobbying Expense
Unallowable Public Relations
Unallowable Rev Exp.of Prescription Drugs
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5495
5495
5417
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STATE OF WASHINGTON
NURSING FACILITY 2011 COST REPORT
GENERAL INFORMATION AND CERTIFICATION
PART A - IDENTIFYING INFORMATION
1. FACILITY NAME 2. NATIONAL PROVIDER NUMBER 3. VENDOR NUMBER
4. FACILITY MAILING ADDRESS CITY ZIP CODE + 4 5. PROVIDERONE ID NUMBER
6. FACILITY PHYSICAL ADDRESS CITY ZIP CODE + 4 7. COUNTY NAME
8. FEDERAL TAX IDENTIFICATION NUMBER 9. DEPT. OF REVENUE TAX REPORTING ACCT. # 10. FACILITY PHONE NUMBER
11. HOME OFFICE NAME 12. HOME OFFICE PHONE NUMBER 13. FACILITY FAX NUMBER
14. HOME OFFICE MAILING ADDRESS CITY STATE ZIP CODE + 4
15. COST REPORT PREPARER 16. FIRM NAME (If Applicable)
17. COST REPORT CONTACT PERSON MAILING ADDRESS CITY STATE ZIP CODE + 4
18. COST REPORT CONTACT PERSON 19. FAX NUMBER 20. PHONE NUMBER
21. ADMINISTRATOR 22. ADMIN. LICENSE NUMBER
23. FACILITY E-MAIL ADDRESS 24. HOME OFFICE E-MAIL ADDRESS 25. CONTACT PERSON E-MAIL ADDRESS
PART B - CERTIFICATION
MISREPRESENTATION OR FALSIFICATION OF ANY INFORMATION CONTAINED IN THIS COST REPORT
MAY BE PUNISHABLE BY FINE AND/OR IMPRISONMENT UNDER STATE OR FEDERAL LAW.
STATE OF
COUNTY OF
CERTIFICATION
I have read the above statement and I have examined the accompanying cost report
and supporting schedules prepared for for the report period
beginning and ending . In accordance
with WAC 388-96-117, I hereby certify that I am the contractor as defined in RCW 74.46.020(13) and certify under penalty
of perjury that this cost report is a true, correct, and complete representation of actual costs related to patient care
prepared in accordance with applicable instructions provided by department, Ch. 74.46 RCW, and Ch. 388-96 WAC.
Further, where other costs not related to patient care are shown, they are classified as unallowable.
I understand that I can be criminally prosecuted if I have willfully made a false statement or willfully failed to
report something I have a duty to report. (Signed)
Contractor, or where the contractor is a legal entity, a partner,
Subscribed and sworn before me on this ______ day of
_______________________, 20______. officer, or official
Notary: _______________________________________
Residing in: ___________________________________
My appointment expires:__________________________ Printed Name and Title
Date
Return to: DEPARTMENT OF SOCIAL AND HEALTH SERVICES
Aging and Disability Services Administration
Nursing Home Rates Section
Post Office Box 45600
Olympia, WA 98504-5600
DSHS 23-003 (REV. 12/11) 2923 Schedule A (Page 2923 of 2)
Period Ending: 1/0/1900
Vendor #: 0
GENERAL INFORMATION AND CERTIFICATION
PART C - OPERATOR (Named on DSHS License)
26. THE OPERATOR (Contractor) OF THE BUSINESS IS (Point and click in front of the correct description):
Proprietary Corporation Non-Profit Corporation Other (specify below)
Governmental Individual Partnership
List the name, address, and acquisition date of individual or organization of the operating entity named on the DSHS contract.
27. Name (Last Name, First Name) Address Acquisition Date License Number
PART D - PROPERTY OWNERSHIP
List the name(s) and address(es) of the owner(s) of the LAND, BUILDING, AND EQUIPMENT, the owner's relationship with the contractor (i.e., same,
lessor, management agreement, subsidiary), asset type and the acquisition date.
28. Name (Last Name, First Name) Address * Relationship Asset Type Acquisition Date
29. Name (Last Name, First Name) Address * Relationship Asset Type Acquisition Date
30. Name (Last Name, First Name) Address * Relationship Asset Type Acquisition Date
IF ANY OF THE ENTITIES LISTED ON LINES 22 THROUGH 25 ABOVE ARE NOT INDIVIDUALS BUT ARE ORGANIZATIONS
OWNING INTEREST IN THE OPERATING ENTITY, COMPLETE SUPPLEMENTAL SCHEDULE A.
* IF LESSOR, THEN IS THIS A RELATED PARTY LEASE? Yes No N/A
PART E - OTHER ORGANIZATIONS CONTROLLED BY OPERATOR(S)
List the names, addresses, nature of control, and acquisition date of all organizations that the operating entity DIRECTLY OR INDIRECTLY controls
or in which the operating entity is beneficial owner. For each, state the nature of the control.
31. Name Address Nature of Control Acquisition Date
32. Name Address Nature of Control Acquisition Date
33. Name Address Nature of Control Acquisition Date
34. Name Address Nature of Control Acquisition Date
35. Name Address Nature of Control Acquisition Date
36. Name Address Nature of Control Acquisition Date
37. Name Address Nature of Control Acquisition Date
DSHS 23-003 (REV. 12/11) 2924 Schedule A (Page 2924 of 2)
Period Ending: 1/0/00
Vendor #: 0
BALANCE SHEET
ASSETS
ENTITY IF OTHER THAN NURSING FACILITY
NOTE: Show all Adjustments and Reclassifications on Schedule G-5. Use column 7 to report adjustment numbers from Schedule G-5.
SCHEDULE G-5
CURRENT
Line ACCOUNT PRIOR YEAR ADJUSTMENTS & ALLOWABLE ADJUSTMENT
ACCOUNT YEAR PER
No. NUMBER PER BOOKS RECLASSIFICATIONS BALANCE NUMBERS FOR
BOOKS
COLUMNS 4 AND 5
DEBIT CREDIT
(1) (2) (3) (4) (5) (6) (7)
1 CURRENT ASSETS
2 Cash 1110 0
3 Marketable Securities 1120 0
4 Patient Accounts Receivable 1130 0
5 Other Receivables (Attach Schedule) 1140 0
6 Less: Allowance for 1150 0
Doubtful Accounts
7 Inventories 1160 0
8 Prepaid Expenses 1170 0
9 Due from Other Funds 1180 0
10 Home Office Current Assets 1190 0
11 Patient Trust Fund Assets 1210
12 Current Intercompany Receivables1220 0
13 1230
Other Current Assets (Attach Schedule) 0
14 TOTAL CURRENT ASSETS (Lines 2 through 13) 0 0 0 0 0
15 PROPERTY, PLANT, AND EQUIPMENT
16 Land 1400 0
17 Land Improvements 1401 0
18 Building 1402 0
19 Building Improvements 1403 0
20 Equipment - Fixed 1404 0
21 Equipment - Moveable 1405 0
22 Equipment - Vehicles 1406 0
23 Equipment - Other 1407 0
24 Leasehold Improvements 1408 0
25 TOTAL FACILITY PROPERTY, PLANT 0 0 0 0 0
AND EQUIPMENT (Lines 16 through 24)
26 Accum. Deprec. - Land Improv. 1601 0
27 Accum. Deprec. - Building 1602 0
28 Accum. Deprec. - Building Improv. 1603 0
29 Accum. Deprec. - Fixed Equipment 1604 0
30 Accum. Deprec. - Move. Equipment 1605 0
31 Accum. Deprec. - Vehicles 1606 0
32 Accum. Deprec. - Other Equipment 1607 0
33 Accum. Deprec. - Leasehold Improv. 1608 0
34 TOTAL ACCUMULATED DEPRECIATION 0 0 0 0 0
(Lines 26 through 33)
35 NET BOOK VALUE - FACILITY ASSETS 0 0 0 0 0
(Line 25 plus Line 34)
DSHS 23-003 (REV. 12/11) 3 Schedule B (Page 1 of 4)
Period Ending: 1/0/00
Vendor #: 0
BALANCE SHEET
ASSETS
NOTE: Show all Adjustments and Reclassifications on Schedule G-5. Use column 7 to report adjustment numbers from Schedule G-5.
CURRENT SCHEDULE G-5
Line ACCOUNT PRIOR YEAR ADJUSTMENTS & ALLOWABLE
ACCOUNT YEAR PER ADJUSTMENT
No. NUMBER PER BOOKS RECLASSIFICATIONS BALANCE
BOOKS NUMBERS FOR
COLUMNS 4 AND 5
DEBIT CREDIT
(1) (2) (3) (4) (5) (6) (7)
36 Construction in Progress 1470 0
37 Home Office Depreciable Assets 1480 0
38 Accumulated Depreciation - 1680 0
Home Office Assets
39 NET PROPERTY, PLANT AND EQUIPMENT 0 0 0 0 0
(Lines 35 through 38)
40 NON-CURRENT ASSETS
41 Long-Term Investments 1810 0
42 Intercompany Receivables 1820 0
43 Unamortized Start-Up Costs 1830 0
44 Goodwill 1840 0
45 Home Office Non-Current Assets 1850 0
46 Other Non-Current Assets 1860 0
(Attach Schedule)
47 TOTAL NON-CURRENT ASSETS 0 0 0 0 0
(Lines 41 through 46)
48 TOTAL ASSETS (Lines 14 + 39 + 47) 0 0 0 0 0
(NOTE: Line 48 must equal Line 81)
DSHS 23-003 (REV. 12/11) 4 Schedule B (Page 2 of 4)
Period Ending: 1/0/00
Vendor #: 0
BALANCE SHEET
LIABILITIES AND EQUITY
NOTE: Show all Adjustments and Reclassifications on Schedule G-5. Use column 7 to report adjustment numbers from Schedule G-5.
CURRENT SCHEDULE G-5
Line ACCOUNT PRIOR YEAR ADJUSTMENTS & ALLOWABLE
ACCOUNT YEAR PER ADJUSTMENT
No. NUMBER PER BOOKS RECLASSIFICATIONS BALANCE
BOOKS NUMBERS FOR
COLUMNS 4 AND 5
DEBIT CREDIT
(1) (2) (3) (4) (5) (6) (7)
49 CURRENT LIABILITIES
50 Accounts Payable 2110 0
51 Notes Payable 2120 0
52 Accrued Payroll and 2130 0
Related Liabilities
53 Current Portion of Long-Term Debt 2140 0
54 Due to Other Funds 2150 0
55 Home Office Current Liabilities 2160 0
56 Patient Trust Fund Liabilities 2170
57 Current Intercompany Payables 2180 0
58 Other Current Liabilities 2190 0
(Attach Schedule)
59 TOTAL CURRENT LIABILITIES 0 0 0 0 0
(Lines 50 through 58)
60 LONG-TERM LIABILITIES
61 Mortgage Payable 2510 0
62 Notes Payable 2520 0
63 Capitalized Lease Obligations 2530 0
64 Intercompany Payables 2540 0
65 Deferred Income Tax 2550 0
66 Home Office Long-Term Liabilities 2560 0
67 Other Long-Term Liabilities 2570 0
(Attach Schedule)
68 TOTAL LONG-TERM LIABILITIES 0 0 0 0 0
(Lines 61 through 67)
69 EQUITY / FUND BALANCES
70 Stockholders' Equity
71 Common Stock 3110 0
72 Preferred Stock 3120 0
73 Treasury Stock 3130 0
74 Additional Paid in Capital 3200 0
75 Proprietorship Equity 7062 0
76 Partnership Equity 7063 0
77 Fund Balance 3100 0
78 Retained Earnings 3300 0
79 Divisional Equity 3400 0
80 TOTAL EQUITY / FUND BALANCES 0 0 0 0 0
(Lines 71 through 79)
81 TOTAL LIABILITIES AND EQUITY 0 0 0 0 0
(Lines 59 + 68 + 80) (NOTE: Line 81 must equal Line 48)
DSHS 23-003 (REV. 12/11) 5 Schedule B (Page 3 of 4)
Period Ending: 1/0/00
Vendor #: 0
Schedule B (Page 4 of 4)
ASSETS AND ACCUMULATED DEPRECIATION
1
ASSETS ACCUMULATED DEPRECIATION
ALLOWABLE
PRIOR YEAR ALLOWABLE CURRENT SCHEDULE G-5
Line ACCOUNT BALANCE PER CURRENT YEAR ACCOUNT
ACCOUNT BALANCE PER ADDITIONS RETIREMENTS ADJUSTMENTS CURRENT YEAR BOOKS
ALLOWABLE ADJUSTMENTS
ACCUM. ADJUSTMENT
No. (Explain Below) BALANCE NUMBER DEPRECIATION (Explain Below) NUMBER
BOOKS (Schedule B, Column 2) DEPRECIATION NUMBERS FOR
(Schedule B, Column 6) (Schedule G, Column 5)
(Schedule B, Column 6) COLUMNS 4 AND 9
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
1 Land 0 0 21410
2 Land Improvements 0 0 21420 0 0 0 21620
3 Buildings 0 0 21430 0 0 0 21630
4 Building Improv. 0 0 21440 0 0 0 21640
5 Equipment
6 Fixed 0 0 21451 0 0 0 21651
7 Moveable 0 0 21452 0 0 0 21652
8 Vehicles 0 0 21453 0 0 0 21653
9 Other 0 0 21454 0 0 0 21654
10 Leasehold Improv. 0 0 21460 0 0 0 21660
11 TOTAL 0 0 0 0 0 0 0 0 0
NET BOOK VALUE OF ASSETS PURCHASED ON OR AFTER MAY 17, 1999 (RCW 74.46.437)
ASSETS ACCUMULATED DEPRECIATION NET BOOK VALUE
ALLOWABLE CURRENT ALLOWABLE NET BOOK VALUE
PRIOR YEAR PRIOR YEAR OF ASSETS SCHEDULE G-5
Line CURRENT YEAR ALLOWABLE CURRENT ACCOUNT
ACCOUNT BALANCE PER ADDITIONS RETIREMENTS ADJUSTMENTS BALANCE ADJUSTMENTS
No. (Explain Below) ASSET DEPRECIATION (Explain Below) YEAR ACCUM. PURCHASED ON NUMBER ADJUSTMENT
BOOKS PER BOOKS
BALANCE DEPRECIATION OR AFTER 5/17/99 NUMBERS FOR
6
Column (5) minus Column (9)
COLUMNS 4 AND 8
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)
12 TOTAL 0 0 0 41401
EXPLANATION OF ADJUSTMENTS
DSHS 23-003 (REV. 12/11)
1
Include as part of your cost report an itemized depreciation schedule.
Period Ending: 1/0/00
Vendor #: 0
STATEMENT OF OPERATIONS
PRIVATE BED-HOLD CHARGE PER PATIENT DAY -
AVERAGE CHARGE TO PRIVATE PATIENTS (WAC 388-96-760) -
(Show on Schedule F how Average Charge to Private Patients was calculated)
Line CURRENT
ACCOUNT
No. YEAR
1 ROUTINE CARE REVENUE (Schedule G, Column 5, Line 5) 0
2 OTHER PATIENT REVENUE (Schedule G, Column 5, Line 24) 0
3 OTHER OPERATING REVENUE (Schedule G, Column 5, Line 34) 0
4 REVENUE DEDUCTIONS (Schedule G, Column 5, Line 41) 0
5 NET OPERATING REVENUE (Lines 1 through 4) 0
6 ROUTINE EXPENSES
7 Direct Care (Schedule G, Column 5, Line 115) 0
8 Therapy (Schedule G, Column 5, Line 116)
0
9 Support Services (Schedule G, Column 5, Line 148)
0
10 Operations (Schedule G, Column 5, Line 222)
0
11 Property (Schedule G, Column 5, Line 241)
0
12 TOTAL ROUTINE EXPENSES (Schedule G, Column 5, Line 242) 0
13 OTHER PATIENT EXPENSES (Schedule G, Column 5, Line 299) 0
14 OTHER OPERATING EXPENSES (UNALLOWABLE) (Schedule G, Column 5, Line 337) 0
15 TOTAL OPERATING EXPENSES (Lines 12+13+14) 0
16 NON-OPERATING REVENUE (Schedule G, Column 5, Line 40) 0
17 NON-OPERATING EXPENSES (Schedule G, Column 5, Line 343) 0
18 NET INCOME (LOSS) (This total must equal the amount from Schedule G, Column 5, Line 345) 0
(Lines 5 - 15 + 16 - 17)
DSHS 23-003 (REV. 12/11) 7 Schedule C
Period Ending: 1/0/00
Vendor #: 0
NOTES TO FINANCIAL STATEMENTS
1. Schedules which support account balances should be attached to Schedule G.
2. Notes to financial statements must include a Schedule of Charges to Private Patients.
3. Indicate how Average Charge to Private Patients from Schedule C was calculated.
REFERENCE
DSHS 23-003 (REV. 12/11) 8 Schedule F
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
REVENUE
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT
(1) (2) (3) (4) (5) (6)
0 ROUTINE CARE REVENUE
1 Medicare 4110 0
2 Medicaid 4120 0
3 Private 4130 0
4 Other Routine Care (Attach Schedule) 4140 0
5 TOTAL ROUTINE REVENUE 4100 0 0 0 0
6 OTHER PATIENT REVENUE
7 Physical Therapy 4220 0
8 Speech Therapy 4240 0
9 Occupational Therapy 4250 0
10 Other Therapy (Attach Schedule) 4280 0
11 Physician Care 4210 0
12 Pharmacy 4230 0
13 Nursing Supplies 4260 0
14 Equipment Rental 4270 0
15 Patient Activities 4290 0
16 Laboratory and Radiology 4310 0
Expanded Community Services and
17 Community Home Project 4320 0
18 Oxygen 4330 0
19 Other Patient Revenue (Attach Schedule) 4340 0
20 Respite Care 4355 0
21 Mental Health 4360 0
22 Supplementation (Attach Schedule) 4375 0
23 Hold Room 4380 0
24 TOTAL OTHER PATIENT REVENUE 4200 0 0 0 0
25 OTHER OPERATING REVENUE
26 Laundry 4410 0
27 Meals 4420 0
28 Vending Machines 4430 0
29 Barber & Beauty Shop 4440 0
30 Gift Shop 4450 0
31 Patient Telephone 4460 0
32 Property Rental 4470 0
33 Other Operating Revenue (Attach Schedule) 4490 0
34 TOTAL OTHER OPERATING REVENUE 4400 0 0 0 0
35 NON-OPERATING REVENUE
36 Gain on Sale of Fixed Assets 4610 0
37 Interest Income 4620 0
38 Dividend Income 4630 0
Other Non-Operating Revenue 4690 0
39 (Attach Schedule)
40 TOTAL NON-OPERATING REVENUE 4600 0 0 0 0
41 REVENUE DEDUCTIONS (Attach Schedule) 4500 0
42 TOTAL REVENUE 0 0 0 0
(Lines 5 + 24 + 34 + 40 + 41)
DSHS 23-003 (REV. 12/11) 9 Schedule G (Page 1 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
DIRECT CARE EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
43 IN-HOUSE SERVICE
44 DNS 5111.01 0 0
45 RN 5111.02 0
46 LPN 5111.03 0
47 Nursing Assistants & Rehab Aides 5111.04 0
48 Activities Director & Assistants 5111.09 0
49 Medical Director 5111.11 0
50 Pharmaceutical 5111.12 0
51 Social Worker 5111.13 0
52 Medical Records 5111.14 0
53 Geriatric Nurse Practitioner 5111.16 0
54 Inservice Director 5111.17 0
55 Patient Care Coordinator 5111.18 0
56 Patient Choices Coordinator 5111.20 0
57 Staff Development Director 5111.21 0
58 Quality Assurance 5111.22 0
59 QMRP 5111.23 0
60 Infection Control 5111.24 0
61 Physician 5111.25 0
62 Other (Attach Schedule) 5111.19 0
63 TOTAL IN-HOUSE SALARIES & HOURS 0 0 0 0 0
64 Fringe Benefits - RN 5111 0
65 Fringe Benefits - LPN 5112 0
66 Fringe Benefits - Nursing Assts & Rehab Aides 5113 0
67 Other Fringe Benefits 5117 0
68 Payroll Taxes 5116 0
69 Direct Care Supplies (Attach Schedule) 5118 0
70 PURCHASED SERVICES
71 DNS 5114.01 0
72 RN 5114.02 0
73 LPN 5114.03 0
74 Nursing Assistants & Rehab Aides 5114.04 0
75 Activities Director & Assistants 5114.09 0
76 Medical Director 5114.11 0
77 Pharmaceutical 5114.12 0
78 Social Worker 5114.13 0
79 Medical Records 5114.14 0
DSHS 23-003 (REV. 12/11) 10 Schedule G (Page 2 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
DIRECT CARE EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
80 PURCHASED SERVICES (Cont.)
81 Geriatric Nurse Practitioner 5114.16 0
82 Inservice Director 5114.17 0
83 Patient Care Coordinator 5114.18 0
84 Patient Choices Coordinator 5114.19 0
85 Staff Development Director 5114.20 0
86 Quality Assurance 5114.21 0
87 QMRP 5114.22 0
88 Infection Control 5114.23 0
89 Physician 5114.25 0
90 Other (Attach Schedule) 5114.24 0
91 TOTAL PURCHASED SERVICES 5114 0 0 0 0 0
92 ALLOCATED SERVICES (Schedule G-2)
93 DNS 5115.01 0
94 RN 5115.02 0
95 LPN 5115.03 0
96 Nursing Assistants & Rehab Aides 5115.04 0
97 Activities Director & Assistants 5115.09 0
98 Medical Director 5115.11 0
99 Pharmaceutical 5115.12 0
100 Social Worker 5115.13 0
101 Medical Records 5115.14 0
102 Geriatric Nurse Practitioner 5115.16 0
103 Inservice Director 5115.17 0
104 Patient Care Coordinator 5115.18 0
105 Patient Choices Coordinator 5115.19 0
106 Staff Development Director 5115.20 0
107 Quality Assurance 5115.21 0
108 QMRP 5115.22 0
109 Infection Control 5115.23 0
110 Physician 5115.25 0
111 Other (Attach Schedule) 5115.24 0
112 TOTAL ALLOCATED SERVICES 5115 0 0 0 0 0
113 Other Allocated Expenses (Schedule G-2) 5119 0
114 REVENUE OFFSET (Attach Schedule) 5120 0
115 TOTAL DIRECT CARE 9900 0 0 0 0 0
(Lines 63 through 69 + 91 + 112 through 114)
DSHS 23-003 (REV. 12/11) 11 Schedule G (Page 3 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
THERAPY EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
116 THERAPY (Schedule G-7, Line 23) 5111.10 0
ITEMIZED LIST OF REVENUE AND EXPENSES
SUPPORT SERVICES EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
117 FOOD 5210 0
118 REVENUE OFFSET (Attach Schedule) 5220 0
119 TOTAL FOOD (Lines 117 + 118) 5200 0 0 0 0
120 LAUNDRY
121 Salaries and Wages 5451 0
122 Fringe Benefits 5457 0
123 Payroll Taxes 5456 0
124 Purchased Services 5454 0
125 Allocated Services (Schedule G-2) 5458 0
126 Allocated Expenses (Schedule G-2) 5455 0
127 Supplies/Other (Attach Schedule) 5453 0
128 TOTAL LAUNDRY 0 0 0 0
129 HOUSEKEEPING
130 Salaries and Wages 5461 0
131 Fringe Benefits 5467 0
132 Payroll Taxes 5466 0
133 Purchased Services 5464 0
134 Allocated Services (Schedule G-2) 5468 0
135 Allocated Expenses (Schedule G-2) 5465 0
136 Supplies/Other (Attach Schedule) 5463 0
137 TOTAL HOUSEKEEPING 0 0 0 0
138 DIETARY
139 Salaries and Wages 5471 0
140 Fringe Benefits 5477 0
141 Payroll Taxes 5476 0
142 Purchased Services 5474 0
143 Allocated Services (Schedule G-2) 5478 0
144 Allocated Expenses (Schedule G-2) 5475 0
145 Supplies/Other (Attach Schedule) 5473 0
146 TOTAL DIETARY 0 0 0 0
147 REVENUE OFFSET (Attach Schedule) 9903 0
148 TOTAL SUPPORT SERVICES 9901 0 0 0 0 0
(Lines 119 + 128 + 137 + 146 + 147)
DSHS 23-003 (REV. 12/11) 12 Schedule G (Page 4 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
OPERATIONS EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
149 GENERAL AND ADMINISTRATIVE
150 IN-HOUSE SALARIES
151 Administrator 5411.40 0
152 Assistant Administrator 5411.41 0
153 Administrator in Training 5411.42 0
154 Supply/Ward Clerks 5411.43 0
155 Accounting/Bookkeeping * 5411.45 0
156 Legal (Attach Schedule) 5411.46 0
157 Other (Attach Schedule) 5411.51 0
158 TOTAL IN-HOUSE SALARIES 0 0 0 0 0
159 Administrator, Assistant Administrator, 5412.20 0
Administrator-in-Training Fringe Benefits
160 Administrator, Assistant Administrator, 5412.30 0
Administrator-in-Training Payroll Taxes
161 Other Fringe Benefits 5418 0
162 Other Payroll Taxes 5416 0
163 Administrative Supplies 5413 0
164 PURCHASED SERVICES
165 Administrator 5414.40 0
166 Assistant Administrator 5414.41 0
167 Administrator-In-Training 5414.42 0
168 Supply/Ward Clerks 5414.43 0
169 Accounting/Bookkeeping * 5414.45 0
170 Legal (Attach Schedule) 5414.46 0
171 Other (Attach Schedule) 5414.50 0
172 TOTAL PURCHASED SERVICES 0 0 0 0
* Attach a schedule showing how much of these Accounting/Bookkeeping costs are associated with
fair hearings and legal pursuits against the department.
DSHS 23-003 (REV. 12/11) 13 Schedule G (Page 5 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
OPERATIONS EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
173 ALLOCATED SERVICES (Schedule G-2)
174 Administrator 5415.40 0
175 Assistant Administrator 5415.41 0
176 Administrator-In-Training 5415.42 0
177 Supply/Ward Clerks 5415.43 0
178 Accounting/Bookkeeping * 5415.45 0
179 Legal (Attach Schedule) 5415.46 0
180 Other (Attach Schedule) 5415.47 0
181 Allocated General Management Services 5495 0
182 Allocated Management Fees 5417 0
183 Other Allocated Expenses (Attach Schedule) 5419 0
184 TOTAL ALLOCATED SERVICES 5415 0 0 0 0
185 Mgmt Fees Paid to Outside Mgmt Company 5496 0
186 Travel (Attach Schedule) 5422 0
187 Telephone 5423 0
188 Dues and Subscriptions (Attach Schedule) 5424 0
189 Education & In-Service Training 5425 0
190 Insurance 5426 0
191 Miscellaneous Taxes (Attach Schedule) 5428 0
192 Start-up/Organizational Costs (Attach Schedule) 5429 0
193 Safety Net Assessment Fee (SNA) 5430 0
194 Advertising (Attach Schedule) 5431 0
195 Other Vehicle (Attach Schedule) 5434 0
196 Group Retro Expenses 5436 0
197 Office Equipment Lease Payment 5437 0
(Attach Schedule)
198 Licenses (Attach Schedule) 5438 0
199 Other (Attach Schedule) 5439 0
200 BAD DEBTS (Schedule G-8, Line 9) 9905 0
201 TOTAL ADMINISTRATIVE 5400 0 0 0 0 0
(Lines 158 through 163 + 172 + 184 through 200)
* Attach a schedule showing how much of these Accounting/Bookkeeping costs are associated with
fair hearings and legal pursuits against the department.
DSHS 23-003 (REV. 12/11) 14 Schedule G (Page 6 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
OPERATIONS EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
202 MAINTENANCE
203 Salaries and Wages 5441 0
204 Fringe Benefits 5447 0
205 Payroll Taxes 5446 0
206 Purchased Services 5444 0
207 Allocated Services (Schedule G-2) 5448 0
208 Allocated Expenses (Schedule G-2) 5445 0
209 Supplies/Other (Attach Schedule) 5443 0
210 TOTAL MAINTENANCE 7016 0 0 0 0
211 OTHER PROPERTY
212 Utilities 5481 0
213 Property Insurance 5482 0
214 Real Estate Taxes 5483 0
215 Personal Property Taxes 5484 0
216 Allocated Expenses (Schedule G-2) 5485 0
217 Minor Equipment 5486 0
218 Other (Attach Schedule) 5487 0
219 Incidental Rentals (Attach Schedule) 5488 0
220 TOTAL OTHER PROPERTY 7020 0 0 0 0
221 REVENUE OFFSET (Attach Schedule) 9904 0
222 TOTAL OPERATIONS 9902 0 0 0 0 0
(Lines 201 + 210 + 220 + 221)
DSHS 23-003 (REV. 12/11) 15 Schedule G (Page 7 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
PROPERTY EXPENSES
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
223 DEPRECIATION
224 Land Improvements 5320 0
225 Buildings 5330 0
226 Building Improvements 5340 0
227 Equipment - Fixed 5351 0
228 Equipment - Moveable 5352 0
229 Equipment - Vehicles 5353 0
230 Equipment - Other 5354 0
231 Leasehold Improvements 5360 0
232 TOTAL DEPRECIATION 0 0 0 0
233 INTEREST 7035
234 ALLOCATED EXPENSES (Attach Schedule) 5375
235
236
237
238
239
240 REVENUE OFFSET (Attach Schedule) 5390 0
241 TOTAL PROPERTY (Lines 232+233+234+240) 5300 0 0 0 0
242 TOTAL ROUTINE EXPENSES 0 0 0 0 0
(Lines 115 + 116 + 148 + 222 + 241)
Line SUPPLEMENTAL BUILDING INFORMATION
No. PRIMARY BUILDING SQ. FT DATE BUILT (mm/dd/yyyy) AGE IN YEARS
243 Original Structure
244 Addition or Remodel or Replacement #1
245 Addition or Remodel or Replacement #2
246 Addition or Remodel or Replacement #3
247 Addition or Remodel or Replacement #4
248 Total Sq. Footage 0
249 Facility Average Age 0
NOTE: List the largest construction projects based on SQ. FT. since the building's inception on lines 240 through 243 and any remaining projects on Detail for Schedule G.
Line No. TYPE OF CONSTRUCTION OF NURSING FACILITY
1. Building has fireproofed structural steel frames with reinforced concrete or masonry floors and roofs.
2. Building has reinforced concrete frames and concrete or masonry floors and roofs.
3. Building has masonry or concrete exterior walls, and wood or steel roof and floor structures, except for concrete slab
on grade.
4. Building generally has wood frame, floor, and roof structure. It may have a concrete floor on grade and other substitute
materials but, are considered combustible construction. This class includes the pre-engineered pole- or post-frame
buildings.
250 BUILDING TYPE THAT IS BEST DESCRIBED FROM THE LIST ABOVE (Enter 1 or 2 or 3 or 4 in box)
DSHS 23-003 (REV. 12/11) 16 Schedule G (Page 8 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
OTHER PATIENT EXPENSES (NON-ROUTINE)*
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
251 PHYSICAL THERAPY
252 Salaries and Wages 6221 0
253 Fringe Benefits 6222 0
254 Payroll Taxes 6223 0
255 Purchased Services 6225 0
256 Allocated Expenses (Schedule G-2) 6226 0
257 Supplies/Other (Attach Schedule) 6224 0
258 TOTAL PHYSICAL THERAPY 0 0 0 0
259 SPEECH THERAPY
260 Salaries and Wages 6241 0
261 Fringe Benefits 6242 0
262 Payroll Taxes 6243 0
263 Purchased Services 6245 0
264 Allocated Expenses (Schedule G-2) 6246 0
265 Supplies/Other (Attach Schedule) 6244 0
266 TOTAL SPEECH THERAPY 0 0 0 0
267 OCCUPATIONAL THERAPY
268 Salaries and Wages 6281 0
269 Fringe Benefits 6282 0
270 Payroll Taxes 6283 0
271 Purchased Services 6285 0
272 Allocated Expenses (Schedule G-2) 6286 0
273 Supplies/Other (Attach Schedule) 6284 0
274 TOTAL OCCUPATIONAL THERAPY 0 0 0 0
275 OTHER THERAPY
276 Salaries and Wages 6291 0
277 Fringe Benefits 6292 0
278 Payroll Taxes 6293 0
279 Purchased Services 6295 0
280 Allocated Expenses (Schedule G-2) 6296 0
281 Supplies/Other (Attach Schedule) 6294 0
282 TOTAL OTHER THERAPY 0 0 0 0
283 MENTAL HEALTH
284 Salaries and Wages 5111.15 0
285 Fringe Benefits 6300 0
286 Payroll Taxes 6301 0
287 Purchased Services 5114.15 0
288 Allocated Expenses (Schedule G-2) 5115.15 0
289 Supplies/Other (Attach Schedule) 6302 0
290 TOTAL MENTAL HEALTH CARE 0 0 0 0
291 EXPANDED COMMUNITY SERVICES AND COMMUNITY HOME PROJECT
292 Salaries and Wages 6321 0
293 Fringe Benefits 6327 0
294 Payroll Taxes 6326 0
295 Purchased Services 6324 0
296 Allocated Expenses (Schedule G-2) 6325 0
297 Supplies/Other (Attach Schedule) 6323 0
298 TOTAL EXPANDED COMMUNITY SERVICES AND COMMUNITY HOME PROJECT 0 0 0 0
299 TOTAL OTHER PATIENT 6200 0 0 0 0 0
EXPENSES
(Lines 258 + 266 + 274 + 282 + 290 + 298)
* For financial statement purposes only. For reimbursement of therapy costs and exceptional care and Extended Community Services costs, complete Schedules G-7 and O-1 respectively.
DSHS 23-003 (REV. 12/11) 17 Schedule G (Page 9 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
OTHER OPERATING EXPENSES (UNALLOWABLE)
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
300 Other Unallowable Expenses
301 Unallowable Depreciation 6513 0
302 Unallowable Bad Debts 6514 0
303 Unallowable Advertising not related to recruitment 6515 0
304 Travel outside of WA, ID, OR, POBC, Home Office State 6516 0
305 Unallowable Interest 6517 0
306 Unallowable Allocated Property 6518 0
307 Unallowable Lease Payments 6519 0
308 Unallowable CNA Training (Direct Care) 901021 0
309 Unallowable CNA Training (Operations) 902032 0
310 Other (Specify Below)
311 Unallowable Oxygen 0
312 Unallowable Rev Exp. of Lab/X-ray 0
313 Unallowable Non Office Equipment Rentals 0
314 Unallowable Sole Source Entral Feeding 0
315 Unallowable Rev exp. of Barber/Vending/Meals 0
316 Unallowable Nursing Pool Non Licensed 0
317 Unallowable Bed Hold 0
318 Unallowable Professional License Fees 0
319 Unallowable Lobbying Expense 0
320 Unallowable Public Relations 0
321 Unallowable Rev Exp.of Prescription Drugs 0
322 0
323 0
324 0
325 0
326 0
327 0
328 0
329 0
330 0
331 0
332 0
333 0
334 0
335 0
336 Total Other (Lines 311 through 335) 7231 0 0 0 0
337 TOTAL OTHER OPERATING 6500 0 0 0 0
EXPENSES (Lines 301 through 309 + Line 336)
DSHS 23-003 (REV. 12/11) 18 Schedule G (Page 10 of 12)
Period Ending: 1/0/00
Vendor #: 0
ITEMIZED LIST OF REVENUE AND EXPENSES
NON-OPERATING EXPENSES (UNALLOWABLE)
SCHEDULE G-5
ADJUSTMENTS & ADJUSTMENT
RECLASSIFICATIONS NUMBERS FOR
Line ACCOUNT AMOUNT ADJUSTED COLUMNS 3 AND 4
No. ACCOUNT NUMBER PER BOOKS DEBIT CREDIT AMOUNT HOURS
(1) (2) (3) (4) (5) (6) (7)
338 Loss on Sale of Fixed Assets 6610 0
339 Income Taxes 6620 0
340 Other (Specify Below) 6630 0
341 0
342 0
343 TOTAL NON-OPERATING EXPENSES 6600 0 0 0 0
(Unallowable)
344 TOTAL EXPENSES 0 0 0 0 0
(Line 242 + 299 + 337 + 343)
345 NET INCOME (LOSS) 0 0 0 0
(Line 42 minus Line 344)
DETAIL FOR SCHEDULE G
346 THE REPORTED LAND COST REFLECTS ACRES.
347 IF NECESSARY PER WAC 388-96-762, HAS A LAND EXEMPTION BEEN GRANTED? Yes No N/A
PURCHASE AND SALE PRICE
Line PURCHASE Line SALE
No. ACCOUNT PRICE No. ACCOUNT PRICE
348 LAND 350 LAND
349 BUILDING 351 BUILDING
350 EQUIPMENT 352 EQUIPMENT
351 OTHER 353 OTHER
352 TOTAL $0 354 TOTAL $0
353 Date of Purchase: 355 Date of Sale:
ATTACH COPY OF YOUR PURCHASE AGREEMENT OR OTHER ORIGINAL INSTRUMENT OF SALE WHICH DOCUMENTS YOUR PURCHASE OR SALE PRICE,
IF NOT PREVIOUSLY SUBMITTED TO DEPARTMENT.
LIST BELOW ALL "POOL" (i.e. REGISTRY) COMPANIES, LICENSE NUMBERS, AND CORRESPONDING COSTS:
DSHS 23-003 (REV. 12/11) 19 Schedule G (Page 11 of 12)
Period Ending: 1/0/00
Vendor #: 0
DETAIL FOR SCHEDULE G
DSHS 23-003 (REV. 12/11) 20 Schedule G (Page 12 of 12)
Part A - TRANSACTIONS WITH RELATED ORGANIZATIONS OR INDIVIDUALS [1]
(OTHER THAN ALLOCATED ARMS-LENGTH TRANSACTION COSTS)
Schedule G-1
Period Ending: 1/0/00
Vendor #: 0 Point and Click here if SCHEDULE G-1 is not applicable to this facility - N/A
NAME AND ADDRESS OF COST TO COST OF EXCESS
Line LINE NO. DESCRIPTION OF ACCOUNT REPORTED
RELATED ORGANIZATION RELATED COMPARABLE REPORTED
No. SCHED. A PRODUCTS/SERVICES NUMBER COSTS
OR INDIVIDUAL ORGANIZATION SERVICES COST
(1) (2) (3) (4) (5) (6) (7) (8)
1 0
2 0
3 0
4 0
21
5 0
6 0
Explain why the above are reported as transactions with related organizations rather than allocated costs on Schedule G-2. (Attach additional sheets as needed):
Part B - OWNER AND RELATIVE COMPENSATION [1]
SERVICES PERFORMED COST REPORT OTHER
Line NAME RELATION- HOURS ACCOUNT SALARY FRINGE PAYMENTS TOTAL AMOUNT
No. (Last, first) SHIP DESCRIPTION [2] NUMBER BENEFITS & BENEFITS COMPENSATION UNALLOWABLE
(1) (2) (3) (4) (5) (6) (7) (8) (9)
7 $0
DSHS 23-003 (REV. 12/11)
8 $0
9 $0
10 $0
11 $0
[1] If management services, complete Schedule G-4.
[2] Total hours during report period
HOME OFFICE ALLOCATED SERVICES AND EXPENSES
Schedule G-2_HO (Page 1 of 2)
(This schedule should only contain Home/Central Office allocations. All other allocations must be reported on Schedule G-2.)
Period Ending: 1/0/00
Vendor #: 0 Point and click here if SCHEDULE G-2, HO, Page 1 is not applicable to this facility - N/A
PART A - JOINT FACILITY (Chain)
ALLOCATED TO OTHER ENTITIES
COST ALLOCATED (Specify Entity)
Line SERVICE OR EXPENSES ALLOCATION REPORT TOTAL COST TO COST
NAME OF HOME OFFICE
No. BASIS ACCOUNT TO BE REPORTING
PROVIDING SERVICES
NO. ALLOCATED ENTITY
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
General Management Services
1 (Salaries and Benefits) * Sch. G, line 5495
181
General Management
2 Services (Overhead Costs) 5495
Sch. G, line 181
3 Management Fees (Sch. G, line 182) 5417
4 OTHER SPECIFIC SERVICES OR EXPENSES AND THE RELATED OVERHEAD COSTS. (Specify Each Specific Service or Expense Below)
(SPECIFY)
5
(Overhead/Indirect Costs)
(SPECIFY)
6
(Overhead/Indirect Costs)
22
(SPECIFY)
7
(Overhead/Indirect Costs)
(SPECIFY)
8
(Overhead/Indirect Costs)
(SPECIFY)
9
(Overhead/Indirect Costs)
(SPECIFY)
10
(Overhead/Indirect Costs)
(SPECIFY)
11
(Overhead/Indirect Costs)
(SPECIFY)
12
DSHS 23-003 (REV. 12\11)
(Overhead/Indirect Costs)
13 Yes No TOTAL: 0 0 0 0 0 0
Are costs allocated according to an approved * ALSO COMPLETE SCHEDULE G-4.
Joint Cost Allocation Disclosure?
If "No", explain on Schedule F.
Period Ending: 1/0/00
Vendor #: 0
HOME/CENTRAL OFFICE ALLOCATION OF INDIRECT COST TO UNALLOWABLE COST CENTERS
PART B Point and click here if SCHEDULE G-2, HO, Page 2 is not applicable to this facility -
Schedule G-2_HO (Page 2 of 2)
N/A
ALLOCATED ALLOCATED TO UNALLOWABLE COST CENTERS (Specify)
Line ALLOCATION TOTAL COST TO BE TO ALLOWABLE OTHER
TOTAL
No. STATISTIC COST ADJUSTMENT ALLOCATED COST CENTERS (ATTACH
UNALLOWABLE
SCHEDULE)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
1 FOOD AMOUNT 0 0
2 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
3
4 PROPERTY AMOUNT 0 0
5 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
6
7 GENERAL AMOUNT 0 0
8 AND ADMIN. PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
9
10 MAINTENANCE AMOUNT 0 0
11 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
12
13 LAUNDRY AMOUNT 0 0
14 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
15
16 HOUSE- AMOUNT 0 0
17 KEEPING PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
23
18
19 DIETARY AMOUNT 0 0
20 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
21
22 OTHER AMOUNT 0 0
23 PROPERTY PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
24
25 FIXED AMOUNT 0 0
26 ASSETS PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
27
28 OTHER (Specify) AMOUNT 0 0
29 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
30
31 OTHER (Specify) AMOUNT 0 0
32 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
33
34 OTHER (Specify) AMOUNT 0 0
DSHS 23-003 (REV. 12/11)
35 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
36
37 TOTAL AMOUNT 0 0 0 0 0 0 0 0 0
38 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
39
ALL OTHER ALLOCATED SERVICES AND EXPENSES
Schedule G-2 (Page 1 of 2)
(Home/Central Office Costs are now excluded from this schedule and reported separately on Schedule G-2, HO.)
Period Ending: 1/0/00
Vendor #: 0 Point and click here if SCHEDULE G-2, Page 1 is not applicable to this facility - N/A
PART A - JOINT FACILITY (Combination / Other Shared Costs)
COST ALLOCATED ALLOCATED TO OTHER ENTITIES (Specify Entity)
Line SERVICE OR EXPENSES ALLOCATION REPORT TOTAL COST TO COST
No. BASIS ACCOUNT TO BE REPORTING
NO. ALLOCATED ENTITY
(1) (2) (3) (4) (5) (6) (7) (8) (9)
General Management Services
1 (Salaries and Benefits) * Sch. G, line 5495
181
General Management
2 Services (Overhead Costs) 5495
Sch. G, line 181
3 Management Fees (Sch. G, line 182) 5417
4 OTHER SPECIFIC SERVICES OR EXPENSES AND THE RELATED OVERHEAD COSTS. (Specify Each Specific Service or Expense Below)
(SPECIFY)
5
(Overhead/Indirect Costs)
(SPECIFY)
6
(Overhead/Indirect Costs)
24
(SPECIFY)
7
(Overhead/Indirect Costs)
(SPECIFY)
8
(Overhead/Indirect Costs)
(SPECIFY)
9
(Overhead/Indirect Costs)
(SPECIFY)
10
(Overhead/Indirect Costs)
(SPECIFY)
11
(Overhead/Indirect Costs)
(SPECIFY)
12
DSHS 23-003 (REV. 12/11)
(Overhead/Indirect Costs)
Yes No
13 TOTAL: 0 0 0 0 0 0
Are costs allocated according to an approved * ALSO COMPLETE SCHEDULE G-4.
Joint Cost Allocation Disclosure?
If "No", explain on Schedule F.
Period Ending: 1/0/00
Vendor #: 0
ALLOCATION OF ALL OTHER INDIRECT COST TO UNALLOWABLE COST CENTERS
Schedule G-2 (Page 2 of 2)
PART B Point and click here if SCHEDULE G-2, Page 2 is not applicable to this facility - N/A
ALLOCATED ALLOCATED TO UNALLOWABLE COST CENTERS (Specify)
Line ALLOCATION TOTAL COST TO BE TO ALLOWABLE OTHER
TOTAL
No. STATISTIC COST ADJUSTMENT ALLOCATED COST CENTERS (ATTACH
UNALLOWABLE
SCHEDULE)
(1) (2) (3) (4) (5) (6) (7) (8) (9) (10)
1 FOOD AMOUNT 0 0
2 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
3
4 PROPERTY AMOUNT 0 0
5 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
6
7 GENERAL AMOUNT 0 0
8 AND ADMIN. PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
9
10 MAINTENANCE AMOUNT 0 0
11 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
12
13 LAUNDRY AMOUNT 0 0
14 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
15
16 HOUSE- AMOUNT 0 0
17 KEEPING PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
25
18
19 DIETARY AMOUNT 0 0
20 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
21
22 OTHER AMOUNT 0 0
23 PROPERTY PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
24
25 FIXED AMOUNT 0 0
26 ASSETS PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
27
28 OTHER (Specify) AMOUNT 0 0
29 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
30
31 OTHER (Specify) AMOUNT 0 0
32 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
33
34 OTHER (Specify) AMOUNT 0 0
DSHS 23-003 (REV. 12/11)
35 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
36
37 TOTAL AMOUNT 0 0 0 0 0 0 0 0 0
38 PERCENT 100.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
39
Period Ending: 1/0/00
Vendor #: 0
Point and click here if SCHEDULE G-4 is not applicable to this facility - N/A
PART A - ORGANIZATIONS AND INDIVIDUALS PROVIDING ALLOCATED EXPENSES
Name, Address, and Phone # of "allocating entity". Name and Address of Other Organizations Receiving Services from "allocating entity".
Name: Name: Address:
Address: Name: Address:
City/State: Name: Address:
Phone: Name: Address:
List Each Officer or Principal of the "allocating entity" (Last Name, First Name)
1. Name: 2. Name: 3. Name:
Address: Address: Address:
City/State: City/State: City/State:
Title: Title: Title:
Percent Owned: Percent Owned: Percent Owned:
4. Name: 5. Name: 6. Name:
Address: Address: Address:
City/State: City/State: City/State:
Title: Title: Title:
Percent Owned: Percent Owned: Percent Owned:
PART B - ORGANIZATIONS AND INDIVIDUALS PROVIDING MANAGEMENT
SERVICES OR RECEIVING MANAGEMENT FEES
Name, Address, and Phone # Name and Address of Other Organizations Receiving Services
Name: Name: Address:
Address: Name: Address:
City/State: Name: Address:
Phone: Name: Address:
List Each Officer or Principal of the Management Company (Last Name, First Name)
1. Name: 2. Name: 3. Name:
Address: Address: Address:
City/State: City/State: City/State:
Title: Title: Title:
Percent Owned: Percent Owned: Percent Owned:
4. Name: 5. Name: 6. Name:
Address: Address: Address:
City/State: City/State: City/State:
Title: Title: Title:
Percent Owned: Percent Owned: Percent Owned:
Are there related party relationships between the nursing facility and the management company? Yes No
If yes, give names and relationships between all management company and nursing facility personnel or organizations, and complete Schedule G-1.
DSHS 23-003 (REV. 12/11) 26 Schedule G-4
Period Ending: 1/0/00
Vendor #: 0
Schedule G-5
OTHER RECLASSIFICATIONS, ADJUSTMENTS AND FOOTNOTES
TO SCHEDULES B AND G
Note: Adustments on this schedule must be numbered. Use the adjustment numbers in column 7 from Schedules B and G.
ACCOUNT AMOUNT
ACCOUNT NAME NUMBER DEBIT CREDIT EXPLANATION
(1) (2) (3) (4) (5)
27
DSHS 23-003 (REV. 12/11)
24
Schedule G-7
Period Ending: 1/0/00
Vendor #: 0
MEDICAID ALLOWABLE THERAPY WORKSHEET
Point and Click here if SCHEDULE G-7 is not applicable to this facility - N/A
DIRECT ONE-ON-ONE THERAPY CHARGES BY PAYER
LINE MEDICARE - PART B MEDICARE- ALL OTHER TOTAL
NO. KIND OF THERAPY MEDICAID Medicaid Other PART A PAYERS THERAPY
ONLY Co-Insurer Co-Insurer CHARGES
(1) (2) (3) (4) (5) (6) (7)
1 PHYSICAL 0
2 SPEECH 0
3 OCCUPATIONAL 0
4 RESPIRATORY 0
5 MENTAL RETARDATION SPECIALIST 0
6 MENTAL HEALTH PROFESSIONALS 0
7 OTHER 0
8 TOTAL ONE-ON-ONE CHARGES 0 0 0 0 0 0
TOTAL
28
LINE COMPUTATION OF ALLOWABLE PORTION PHYSICAL SPEECH OCCUPATIONAL
OTHER
NO. (8) (9) (10) (11)
9 MEDICARE PART B (Col. 3 x 20%) 0 0 0 0
10 TOTAL THERAPY CHARGES FOR MEDICAID ONLY (Col. 2) 0 0 0 0
11 TOTAL MEDICAID AND MEDICARE PART B THERAPY CHARGES (Line 9 + Line 10) 0 0 0 0
12 PERCENTAGE OF MEDICAID & MEDICARE PART B TO TOTAL THERAPY CHARGES (Line 11 / Col.7) (4 decimal places) 0.0000 0.0000 0.0000 0.0000
13 TOTAL DIRECT ONE-ON-ONE THERAPY EXPENSE Source Document:
14 TOTAL DIRECT ONE-ON-ONE THERAPY UNITS PROVIDED (A unit of therapy is equal to 15 minutes of billable therapy service)
15 TOTAL DIRECT ONE-ON-ONE THERAPY COSTS PER UNIT (Line 13 / Line 14) 0.00 0.00 0.00 0.00
16 MEDICAID ALLOWABLE THERAPY EXPENSE (Line 13 x Line 12) 0 0 0 0
17 MEDICAID PATIENT DAYS (Schedule N, Line 13, Col. 1 plus Col. 2) 0 0 0 0
18 RATE PER PATIENT DAY (Line 16 / Line 17) (Round to 4 decimal places) 0.0000 0.0000 0.0000 0.0000
19 TOTAL PATIENT DAYS (Schedule N, Line 13, Col. 7) 0 0 0 0
20 TOTAL ALLOWABLE ONE-ON-ONE THERAPY EXPENSE (Line 18 x Line 19) 0 0 0 0
DSHS 23-003 (REV. 12/11)
21 THERAPY CONSULTANT EXPENSE
22 ALLOWABLE THERAPY EXPENSE (Line 20 + Line 21) 0 0 0 0
23 TOTAL ALLOWABLE THERAPY EXPENSE (Line 22, Col. 8 + Col. 9 + Col. 10 + Col. 11) (Must equal Schedule G, Line 116, Col. 5) 0
Period Ending: 1/0/00
Vendor #: 0
CURRENT
Line No.
YEAR
1. MEDICAID BAD DEBTS
0
2. MEDICAID BAD DEBTS (included in line 1) CLAIMED AS UNCOLLECTABLE
IN PRIOR COST REPORTS
3. Current Year COLLECTIONS MADE ON PREVIOUSLY ALLOWED BAD DEBT
CLAIMS
4. PROJECTED COLLECTIBLES FROM LINE (1)
5. Current Year PROJECTED MEDICAID BAD DEBTS [line (1) - line (2) - line (3) - line (4)] 0
6. MEDICAID PATIENT DAYS (Schedule N, line 13, columns 1 & 2) 0
7. MEDICAID BAD DEBTS PER MEDICAID PATIENT DAY
(Line 5 divided by line 6) 0.0000
8. TOTAL PATIENT DAYS (Schedule N, line 13, column 7) 0
9. TOTAL ALLOWABLE BAD DEBT FOR MEDICAID COST REPORT
(Line 7 times line 8 and must equal Schedule G, line 200, column 5) 0
DSHS 23-003 (REV. 12/11) 29 Schedule G-8
Period Ending: 1/0/00
Vendor #: 0
PERSONNEL INFORMATION RELATED TO DIRECT CARE FULL TIME EMPLOYEE RETENTION AND
Schedule L
TURNOVER RATIOS
1. Total number of direct care W-2's
2. Total number of direct care W-2's for temporary or part-time employees
3. Total number of full time direct care employees who worked anytime during the year
4. Total number of full time direct care employees hired during the year
5. Total number of full time direct care employees who were employed at the beginning of year
6. Total number of full time direct care employees terminated anytime during the year
30
7. Total number of full time direct care employees who worked the entire year
8. PRIMARY REASON FOR UTILIZING TEMPORARY OR PART-TIME DIRECT CARE
EMPLOYEES (1-Efficiency, 2 - Inability to Hire In-House, 3 - Temporary Replacement)
9. DIRECT CARE STAFF MOST DIFFICULT TO RETAIN (1-RN, 2 - LPN, 3 - AIDE, 4 -
OTHER (please specify))
10. PRIMARY REASON FOR DIFFICULTIES IN DIRECT CARE EMPLOYEE RETENTION (1-
Compensation Packages, 2 - Job Market, 3 - Work Environment, 4 -Other (please specify))
DSHS 23-003 (REV. 12/11)
11. Full time direct care employee retention ratio
(Line 7 divided by Line 5)
12. Full time direct care employee turnover ratio
(Line 6 divide by Line 5)
Period Ending: 1/0/00
Vendor #: 0
Schedule L-1
Section 206, c. 329, Laws of 2008
COMPENSATION FOR LOW-WAGE WORKERS IN NURSING HOMES
Step 1 – Calculate How Dollars are Spent (Note: Compensation Effective July 1, 2008 or Later)
Line # Column A Column B Column C Column D Column E Column E(a)
Wage Category Medicaid Nursing Code Effective Date Dollars Spent Estimated Number of Staff
Home Cost Report Receiving Add-On (only account for
Account Number the same staff member once)
Line 1
Line 2
Line 3
Line 4
Line 5
Line 6
Line 7
Line 8
Line 9
Line 10
Line 10a Total Dollars Spent pg 1 0.00 0
Line 10b Total Dollars Spent pg 2 0.00 0
31
Line 11 Total Dollars Spent pg 1 & 2 0.00 0
Wage Category limited to: CNA (Nursing Assistants), Rehab Aides, Activities Director & Assistants, Social Worker, Supply/Ward Clerks, Laundry, Housekeeping, Dietary, Patient Choices Coordinator,
Expanded Community Services Workers. Any other wage categories not listed above but impacted due to resulting compression (Code C) must be separately identified on the schedule.
Codes: (Note – a separate line will be completed for each code affected within each Wage Category. For example, if CNAs received both increased wages and increased hours, a line would be completed
to reflect dollars spent for Code A and dollars spent for Code B)
A. Increase Wages D. Paid out as Bonus
B. Increase Hours for CNAs E. Paid as additional Fringe Benefit
C. Increase Wages due to resulting compression F. Paid as additional Payroll Taxes
Compensation Reporting Dates- July 1, 2008 or effective date, whichever is later though December 31, 2008 for reporting the expenditures related to wage increase, bonus and/or benefit changes.
Step 2 – Calculate the Total Amount Paid to Provider through the Wage Add-on
Column F Column G Column H
Paid PPD Add-On Amount (Note: subject Total Medicaid Days for Rate Add-on Period Dollars Paid (Column F, Line 12
to change based on Caseload Forecast times Column G, Line 12)
Council forecast)
Line 12 $1.57 0 0.00
Step 3 Amount Spent, Amount Paid Comparison
DSHS 23-003 (REV. 12/11)
Column I
Difference in Dollars Paid (Column H, Line 12) and Dollars
Spent (Column E, Line 11) - if dollars spent are greater than
dollars paid, then zero
Line 13 0.00
Any amount on Line 13 greater than zero will be paid back to the department.
Period Ending: 1/0/00
Vendor #: 0
Schedule L-1_pg2
Section 206, c. 329, Laws of 2008
COMPENSATION FOR LOW-WAGE WORKERS IN NURSING HOMES
Step 1 – Calculate How Dollars are Spent (Note: Compensation Effective July 1, 2008 or Later)
Line # Column A Column B Column C Column D Column E Column E(a)
Wage Category Medicaid Nursing Code Effective Date Dollars Spent Estimated Number of Staff
Home Cost Report Receiving Add-On (only account for
Account Number the same staff member once)
Line 14
Line 15
Line 16
Line 17
Line 18
Line 19
Line 20
Line 21
Line 22
Line 23
Line 24
Line 25
Line 26
32
Line 27
Line 28
Line 29
Line 30
Line 31
Line 32
Line 33
Line 34
Line 35
Line 36
Line 37
Line 38
Line 39
Line 40
Line 41
Line 42
Line 43
Line 44
DSHS 23-003 (REV. 12/11)
Line 45
Line 46
Line 47
Line 48
Line 49
Line 50
Period Ending: 1/0/00
Vendor #: 0
Schedule L-1_pg2
Section 206, c. 329, Laws of 2008
COMPENSATION FOR LOW-WAGE WORKERS IN NURSING HOMES
Step 1 – Calculate How Dollars are Spent (Note: Compensation Effective July 1, 2008 or Later)
Line # Column A Column B Column C Column D Column E Column E(a)
Wage Category Medicaid Nursing Code Effective Date Dollars Spent Estimated Number of Staff
Home Cost Report Receiving Add-On (only account for
Account Number the same staff member once)
Line 51
Line 52
Line 53
Line 54
Line 55
Line 56
Line 57
Line 58
Line 59
Line 60
Line 61
Line 62
Line 63
33
Line 64
Line 65
Line 66
Line 67
Line 68
Line 69
Line 70
Line 71
Line 72
Line 73
Line 74
Line 75
Line 76
Line 77 Total Dollars Spent pg 2 0.00 0
DSHS 23-003 (REV. 12/10)
Period Ending: 1/0/00
Schedule M
Vendor #: 0
SUMMARY OF MEDICAID PATIENT DAYS AND INTERIM PAYMENTS
MEDICAID PATIENT [1] MEDICAID [2] PAYMENTS FOR MEDICAID "ZERO PAY"
Line DAYS PAID AS OF SWING BED DAYS LESS MEDICAID PATIENTS PAYMENTS FOR PAYMENTS LESS PAYMENTS NOT
MONTH
No. 60 DAYS AFTER DAYS SWING BED PAID AS OF 60 DAYS SWING BEDS SWING BED PAYMENTS SHOWN ON RA
END OF PERIOD DAYS AFTER END OF PERIOD (Column 4 - Column 5) (Include in Col. 4)
(1) (2) (3) (4) (5) (6) (7)
1 JANUARY 0 $0
2 FEBRUARY 0 $0
3 MARCH 0 $0
4 APRIL 0 $0
5 MAY 0 $0
6 JUNE 0 $0
34
7 JULY 0 $0
8 AUGUST 0 $0
9 SEPTEMBER 0 $0
10 OCTOBER 0 $0
11 NOVEMBER 0 $0
12 DECEMBER 0 $0
DSHS 23-003 (REV. 12/11)
RETROACTIVE RATE
13 INCREASE/RECOUPMENTS $0
14 TOTAL 0 0 0 $0 $0 $0 $0
[1] These days equal what is reported on Schedule N, Column 1 and do include zero paid days.
[2] The total from this Column equals the amount reported on Schedule O, Line 86.
Period Ending: 1/0/00
Schedule N
Vendor #: 0
PATIENT DAY STATISTICS BY MONTH OF SERVICE
MEDICAID DAYS UNPAID MEDICAID "ZERO PAY"
MEDICARE LICENSED BEDS
Line LESS SWING CLAIMED PATIENT MEDICARE PRIVATE OTHER TOTAL DAYS NOT
ADVANTAGE (Licensed Bed Count
No. MONTH BED DAYS DAYS AS OF 60 DAYS PATIENT DAYS PATIENT DAYS PATIENT DAYS PATIENT DAYS SHOWN ON RA
PART C by Month)
(Schedule M, Column 3) AFTER END OF PERIOD (Include in Col. 1)
(1) (2) (3) (4) (5) (6) (7) (8) (9) 1/0/1900 Change Dates
1 JANUARY 0 0 1/0/1900 0 1/1/2011 1/31/2011
2 FEBRUARY 0 0 0 2/1/2011 2/28/2011
3 MARCH 0 0 0 3/1/2011 3/31/2011
4 APRIL 0 0 0 4/1/2011 4/30/2011
35
5 MAY 0 0 0 5/1/2011 5/31/2011
6 JUNE 0 0 0 6/1/2011 6/30/2011
7 JULY 0 0 0 7/1/2011 7/31/2011
8 AUGUST 0 0 0 8/1/2011 8/31/2011
9 SEPTEMBER 0 0 0 9/1/2011 9/30/2011
10 OCTOBER 0 0 0 10/1/2011 10/31/2011
11 NOVEMBER 0 0 0 11/1/2011 11/30/2011
12 DECEMBER 0 0 0 12/1/2011 12/31/2011
13 TOTAL 0 0 0 0 0 0 0 0 0
(Do not include days from
14. MEDICAID EXPANDED COMMUNITY SERVICE 0 19. HOLD ROOM DAYS Lines 19 or 20 on 0
AND COMMUNITY HOME PROJECT DAYS Lines 1 through 13 above.) 12/31/2011
15. TOTAL LICENSED BEDS As of ending report period. 20. SWING BED DAYS 0
DO NOT INCLUDE SWING BEDS ON LINE 15 OR 16.
16. TOTAL SET-UP BEDS 21. SOCIAL LEAVE DAYS
17. MAXIMUM PATIENT DAYS 0 22. RESPITE DAYS
23. NUMBER OF SWING BEDS
18. PERCENT OCCUPANCY 0 24. HOSPICE DAYS
Amount from line 13, column 6 divided by amount from line 17.
DSHS 23-003 (REV. 12/11)
1/0/00 1/0/00
0 0 1
SHIFTING WORKSHEET - 2011 PRELIMINARY SETTLEMENT
Facility : 0 Date Run: 9/14/2012
Vendor # : 0
Period Ending : 1/0/00
DIRECT CARE
Cost Rate Maximum 0.0000 IN
$0.0000 - $0.0000 = $0.0000
$0.0000 = $0.0000 DC 0.0000
TH 0.0000
FROM: Therapy 0.0000
Total $0.0000
THERAPY
Cost Rate Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
IN
FROM: Direct Care 0.0000
Total $0.0000 DC 0.0000
TH 0.0000
DIRECT CARE plus Support Service Shift
Rate Cost Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
THERAPY plus Support Service Shift
Rate Cost Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
$0.0000 = $0.0000
DIRECT CARE
Cost Rate Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
FROM: Support Services 0.0000
Total $0.0000
THERAPY
Cost Rate Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
FROM: Support Services 0.0000
Total $0.0000
SUPPORT SERVICES
Rate Cost Maximum 0.0000
$0.0000 - $0.0000 = $0.0000
20% x $0.0000 = $0.0000
36 Shifting Worksheet
Period Ending 1/0/00 Date Prepared 9/14/2012 0
Vendor # 0 Vendor Name 0 0
PRELIMINARY SETTLEMENT REPORT 1/1/11 Through 12/31/11
PART A - 2011 RATES
LINE RATES RATE A RATE B RATE C RATE D RATE E RATE F RATE G RATE H
NO. (1) (2) (3) (4) (5) (6) (7) (8)
1 Effective Date
2 Direct Care
3 Therapy
4 Support Services
5 Operations
6 Property
7 Financing Allowance
8 Variable Return
9 Low Wage Earner Add-on
10 Pay for Performance
11 High Turnover
12 Comparison Add-on
13 Acuity Add-on
14 Safety Net Assessment
15 TOTAL $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
NEW PART B FOR ESSB 5581 ALLOCATION OF ACUITY ADD-ON AND COMPARISON ADD-ON
LINE JUNE 30, 2010 RATES JUNE 30, 2010 RATES
NO.
16 JUNE 30, 2010 DC COMPONENT
17 JUNE 30, 2010 TC COMPONENT
18 JUNE 30, 2010 SS COMPONENT
19 JUNE 30, 2010 OP COMPONENT
20 JUNE 30, 2010 PR COMPONENT
21 JUNE 30, 2010 FA COMPONENT
22 JUNE 30, 2010 VR COMPONENT
23 JUNE 30, 2010 WE COMPONENT
24 JUNE 30, 2010 PP COMPONENT
25 JUNE 30, 2010 HT COMPONENT
26 TOTAL $0.00
IF LINE 12 IS >0 THEN JUNE
LINE 30, 2010 RATES MINUS LINES 7 RATE A RATE B RATE C RATE D RATE E RATE F RATE G RATE H
THROUGH 17 RATES ELSE 0
NO. (1) (2) (3) (4) (5) (6) (7) (8)
27 Effective Date 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900
28 Direct Care $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
29 Therapy $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
30 Support Services $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
31 Operations $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
32 Property $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
33 Financing Allowance $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
34 Variable Return $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
35 Low Wage Earner Add-On $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
36 Pay for Performance $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
37 High Turnover $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
38 TOTAL $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
DSHS 23-003 (REV. 1/12) 37 Schedule O (Page 1 of 3)
Period Ending 1/0/00
Vendor # 0 Vendor Name 0
PART C - COST PER PATIENT DAY MONTH DAYS
LINE ALLOWABLE PATIENT COST PER
COST CENTER 1 0 0 0 0 0 0 0 0 0
NO. COSTS DAYS PATIENT DAY
(1) (2) (3) 2 0 1 1 1 0 0 0 0 0
39 Direct Care 0 0 0.0000 3 0 0 0 0 0 0 0 0 0
40 Therapy 0 0 0.0000 4 0 MONTH MONTH MONTH MONTH MONTH MONTH MONTH MONTH
41 Support Services 0 0 0.0000 5 0 0 0 0 0 0 0 0 0
42 Operational 0 0 0.0000 6 0 0 0 0 0 0 0 0 0
43 Property 0 0 0.0000 7 0 0 0 0 0 0 0 0 0
44 TOTAL 0 0 0.0000 8 0 0 0 0 0 0 0 0 0
PART D - WEIGHTED RATE (COMPARISON ADD-ON AND ACUITY ADD-ON ALLOCATED PER SCHEDULE O NEW PART B (DOES NOT INCLUDE SNA)) 9 0 0 0 0 0 0 0 0 0
LINE RATES RATE A RATE B RATE C RATE D RATE E RATE F RATE G RATE H 10 0 0 0 0 0 0 0 0 0
NO. (1) (2) (3) (4) (5) (6) (7) (8) 11 0 0 0 0 0 0 0 0 0
45 Effective Date 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 1/0/1900 12 0 0 0 0 0 0 0 0 0
46 Direct Care $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL 0 0 0 0 0 0 0 0 0
47 Therapy $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 0
48 Support Services $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 0
49 Operations $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0 0 0 0 0 0 0 0
50 Property $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
51 Financing Allowance $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
52 Variable Return $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
53 Low Wage Earner Add-on $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
54 Pay for Performance $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL WITH COMPARISON MEDICAID WEIGHTED
AND ACUITY ADD-ONS
55 High Turnover $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ALLOCATED PATIENT RATE
56 TOTAL $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 DAYS (Col 6 /
57 Paid Medicaid Patient Days 0 0 0 0 0 0 0 0 (Lines 46-55 Columns 1-8 (Sched. N, Col. 7)
to nearest whole dollar) Col. 1, Ln 13) .----
RATES TIMES PATIENT DAYS (COMPARISON ADD-ON AND ACUITY ADD-ON ALLOCATED PER SCHEDULE O NEW PART B (DOES NOT INCLUDE SNA)) (6) (7) (8)
58 Direct Care $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
59 Therapy $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
60 Support Services $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
61 Operations $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
62 Property $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
63 Financing Allowance $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
64 Variable Return $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
65 Low Wage Earner Add-On $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
66 Pay for Performance $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
67 High Turnover $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
68 TOTAL $0 $0 $0 $0 $0 $0 $0 $0 $0 0 0.0000
DSHS 23-003 (REV. 1/12) 38 Schedule O (Page 2 of 3)
Period Ending 1/0/00
Vendor # 0 Vendor Name 0
PART E - PRELIMINARY SETTLEMENT RATE
74.46.165(3) COST SHIFTING PRELIMINARY
WEIGHTED RATE INCLUDES
LINE WEIGHTED COST PER OR RATE SETTLEMENT
NO. COMPARISON ADD-ON AND RATE PATIENT DAY OR OUT IN RATE (.----)
ACUITY ADD-ON (Part B, Col. 8) (Part A, Col. 3) OVERPAYMENT (Col. 3 + Col. 5)
ALLOCATED (1) (2) (3) (4) (5) (6)
69 Direct Care 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
70 Therapy 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
71 Support Services 0.0000 0.0000 0.0000 0.0000 0.0000
72 Operations 0.0000 0.0000 0.0000
73 Property 0.0000 0.0000 0.0000
74 Return on Investment 0.0000 0.0000 0.0000
75 Low Wage Earner Add-on 0.0000 0.0000 0.0000
76 Pay For Performance 0.0000 0.0000 0.0000
77 High Turnover 0.0000 0.0000 0.0000
78 TOTAL 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
PART F - PRELIMINARY SETTLEMENT AMOUNT
LINE AMOUNT
NO.
79 PRELIMINARY SETTLEMENT RATE (Lesser of Part E, Column 1, Line 78 or Column 6, Line 78) 0.0000
80 PAID MEDICAID PATIENT DAYS (Schedule N, Column 1, Line 13) 0
81 UNADJUSTED PRELIMINARY SETTLEMENT AMOUNT (Line 79 x Line 80) $0
82 ADDITIONAL SETTLEMENT AMOUNT FOR EXPANDED COMMUNITY SERVICES AND COMMUNITY HOME PROJECT (Supp. Sch. O-1, Col. 6, Line 13) $0
SWING BED REVENUE ((Jan to Jun Swing Beds Days times Swing Bed Rate) plus (July to Dec Swing Bed
Days times Swing Bed Rate))
83 ((Sch. M column 2, Lines 1 to 6 times * 166.24) + (Schedule M colunm 2, Lines 7 to 12 times * 170.37 )) $166.24 $170.37 $0
84 TOTAL PRELIMINARY SETTLEMENT AMOUNT (Line 81 + 82 + 83) $0
85 SAFETY NET ASSESSMENT PAYMENT (For Medicaid Patient Days Only) $0
86 Less TOTAL REPORT PERIOD INTERIM PAYMENTS (Schedule M, Column 4, Line 14) Less SAFETY NET ASSESSMENT (Line 85) $0
87 SUB TOTAL (Line 84 less Line 86) $0
88 BALANCE DUE PROVIDER (Excess of Line 84 over Line 86) $0
89 BALANCE DUE DSHS (Excess of Line 86 over Line 84) $0
DSHS 23-003 (REV. 1/12) 39 Schedule O (Page 3 of 3)
Period Ending: 1/0/00
Vendor #: 0
Point and click here if Schedule P is not applicable to this facility - N/A
PROSHARE REVENUE AND EXPENSES - Ch. 518. Laws of 2005
This Schedule is Only for Public Hospital District Nursing Homes Participating in ProShare
CALENDAR
Line
ACCOUNT DESCRIPTION YEAR
No.
AMOUNT
1 PART A - IDENTIFYING THE ALLOCATION AND USE OF PROSHARE FUNDS
2 Total Proshare Funds Received (from state)
3 Total Proshare Funds Returned (to state)
4 Total Proshare Funds Retained by Public Hospital District (line 2 - 3) 0
5
6 PART B - TOTAL PUBLIC HOSPITAL DISTRICT EXPENDITURES OF PROSHARE FUNDS
7 Hospital
8 Nursing Home
9 Other - please detail below
10 Total Proshare Expenditures (line 7 + 8 +9) 0
11
12 PART C - UNSPENT PROSHARE REVENUE
13 Unspent Funds Sitting in Public Hospital Account - please detail below
14
15 PART D - NURSING HOME PROSHARE EXPENDITURES BY RATE COMPONENT
(Note: Any costs in an allowable cost component must be removed on Schedule G- 5)
16 Direct Care - please detail below
17 Therapy Care - please detail below
18 Support Services - please detail below
19 Operations - please detail below
20 Property - please detail below
21 Unallowable - please detail below
22 Total Proshare Expenditures by Rate Component (line 16 + 17 +18 + 19 + 20 + 21) 0
(line 22 must equal line 8, else "errrrrrrrrr")
Notes (or Details)
DSHS 23-003 (REV. 12/11) 40 Schedule P
Period Ending: 1/0/00
Vendor #: 0
GENERAL INFORMATION FOR ORGANIZATIONS
PART C - OPERATOR(S)
Name of organization (as listed on line 22 of Schedule A, Page 2) 0
1. THE ORGANIZATION IS: Proprietary Non-Profit Other (specify below)
Governmental Individual Partnership
List the names, addresses, percent ownership, and acquisition date of individuals or organizations that DIRECTLY
OWN A 5% or greater interest in the operating entity. (Attach schedule if necessary).
2. Name (Last Name, First Name) Address % Owned Acquisition Date
3. Name (Last Name, First Name) Address % Owned Acquisition Date
4. Name (Last Name, First Name) Address % Owned Acquisition Date
5. Name (Last Name, First Name) Address % Owned Acquisition Date
6. Name (Last Name, First Name) Address % Owned Acquisition Date
PART D - PROPERTY OWNERSHIP (ORGANIZATION ONE)
Name of organization (as listed in lines 23-25 of Schedule A, Page 2)
7. THE ORGANIZATION IS: Proprietary Non-Profit Other (specify below)
Governmental Individual Partnership
List the names, addresses, percent ownership, and acquisition date of individuals or organizations that DIRECTLY
OWN A 5% or greater interest in the organization owning property. (Attach schedule if necessary).
8. Name (Last Name, First Name) Address % Owned Acquisition Date
9. Name (Last Name, First Name) Address % Owned Acquisition Date
10. Name (Last Name, First Name) Address % Owned Acquisition Date
11. Name (Last Name, First Name) Address % Owned Acquisition Date
PART D - PROPERTY OWNERSHIP (ORGANIZATION TWO)
Name of organization (as listed in lines 23-25 of Schedule A, Page 2)
12. THE ORGANIZATION IS: Proprietary Non-Profit Other (specify below)
Governmental Individual Partnership
List the names, addresses, percent ownership, and acquisition date of individuals or organizations that DIRECTLY
OWN A 5% or greater interest in the organization owning property. (Attach schedule if necessary).
13. Name (Last Name, First Name) Address % Owned Acquisition Date
14. Name (Last Name, First Name) Address % Owned Acquisition Date
15. Name (Last Name, First Name) Address % Owned Acquisition Date
16. Name (Last Name, First Name) Address % Owned Acquisition Date
Supplemental
DSHS 23-003 (REV. 12/11) 41 Schedule A
Period Ending: 1/0/00 Point and click here if SUPPLEMENTAL SCHEDULE O-1 is not applicable to this facility - N/A
Vendor #: 0
Supplemental
Schedule O-1
EXPANDED COMMUNITY SERVICES (ECS) AND COMMUNITY HOME PROJECT (CHP) SETTLEMENT AMOUNTS
NURSING HOME ECS AND CHP REVENUE
LINE MEDICAID PER DIEM ROUTINE CARE REVENUE TOTAL ECS AND CHP OVER ROUTINE
PAYMENT RATE TOTAL ECS AND CHP DAYS PORTION OF ECS AND CHP REVENUE REVENUE
(From Revenue/Census Report Class (From Revenue/Census Report
NO. MONTH Code 50 and 60) (Col. 2 X Col. 3) Class Code 50 and 60) (Col. 5 - Col. 4)
(1) (2) (3) (4) (5) (6)
1 JANUARY 0 $0
2 FEBRUARY 0 $0
3 MARCH 0 $0
4 APRIL 0 $0
5 MAY 0 $0
6 JUNE 0 $0
7 JULY 0 $0
8 AUGUST 0 $0
9 SEPTEMBER 0 $0
10 OCTOBER 0 $0
11 NOVEMBER 0 $0
12 DECEMBER 0 $0
42
13 TOTAL 0 0 0 $0
1. Amounts for Column 3 and Column 5 should be taken from the MEDICAID REVENUE AND CENSUS REPORT, CLASS CODE 50 AND 60.
Use Billed Days and Billed Dollars.
2. Amount from Line 13, Column 6 must agree with Schedule O, Line 82.
DSHS 23-003 (REV. 12/11)
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