Page 188 - Financial Workbook December

Page # 2 Rate Type Semi Semi Semi Semi Semi Semi Semi Semi Semi Semi Semi Semi Page 2 of 10

Room 101-2 117-2 117-2 170-1 A A 106-1 A A 114-2 114-2 - 102-1 102-1 102-1 106-2 A A 101-1 27 1 28

171819202122232425262728293031
A A A A A A A A A A A A A A A A A A A A A 27 27 28 30 30 30 1 1 1 0 0 0 28 28 29 30 30 30

A A A A A A A A A A A A A A A A A A A A A A A A A 30 30 30 0 0 0 30 30 30
A A 30 0 30
A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 30 0 30
A A 30 0 30
A A 30 0 30
A A A A D 30 30 0 0 30 30
1213141516 A A A A A A A A A 31 31 30 0 0 0 31 31 30

1011 A A A A A A A A A A A A A A 30 30 30 0 0 0 30 30 30

A A A A A A 30 0 30
9
8 A A A A A A 30 0 30
7 A A A A A A 30 0 30
A A A A A A
6 30 0 30
A A A A A A
5 30 0 30
A A A A A A 0
4 30 30
3 A A A A A A 30 0 30
2 A A A A A A 30 0 30
1 A A A A A A 30 0 30
Alt Care Level STD STD STD STD STD STD STD
Care Level STD PC140 STD STD00 STD RVB0D RVB40 RVA10 RVA20 RVA30 RVA30 STD

# of Payer Code Days MP 9 MCA 4 PP 27 MBC 31 MP 31 MCA 4 MCA 11 0 MCA 11 MCA 16 MCA 1 MCA 3 MBC 31 921 4 925

ResidentID Number SCOTT, CHARLES (SCOTC) Smith, Martha (SMITHM) Ware, Ruth (WARER) WILLIAMS, ARLON (WILLIA) Willis, Dorothy (WILLD) Wright, Mary (WRIGM) UNPAID DAYS TOTAL DAYS 7:08:14 PM

Resident PAID DAYS 1/18/2018